What was once a disease diagnosed only after symptoms appeared is increasingly becoming one that researchers hope to detect earlier, intervene against from multiple angles, and perhaps someday prevent altogether.

At NeuroReserve, we spend a great deal of time following new science because it shapes how we think about long-term brain health, nutrition, and prevention — and several developments over the past year have stood out.

Here in NeuroReviews, we discuss three trends influencing Alzheimer’s research: blood-based biomarkers that could transform early detection, the growing interest in GLP-1 medications for brain health, and an expanding treatment pipeline that goes beyond amyloid.

These developments may not represent a cure, but they point to something encouraging: Alzheimer’s research is truly getting closer to prevention as a practical reality.

Blood-Based Biomarkers: What If a Blood Test Could Predict Alzheimer’s?

The idea of predicting your future brain health with a simple blood test may sound unsettling. Researchers, however, see it as something far more empowering.

For people already on the path toward Alzheimer’s disease, earlier detection could mean earlier treatment and a greater opportunity to slow progression. For those who have not yet developed symptoms, it could create a valuable window for prevention — one that may not have existed before.

Recent findings from the U.S. POINTER study reinforced the powerful role lifestyle interventions play in supporting brain health and reducing risk. Blood-based biomarkers could help identify who might benefit most from those interventions and when they should begin.

For decades, clinicians have relied on measures like A1C to assess metabolic health and diabetes risk. Researchers have long hoped for something similar in Alzheimer’s disease: a tool that could reveal biological changes before significant symptoms appear.

Blood-based biomarkers may provide that opportunity.

These tests measure proteins in the blood that reflect changes occurring in the brain. Two of the most important are p-tau217 and amyloid beta 42 (Aβ42). Amyloid beta 42 is associated with the buildup of amyloid plaques in the brain, while p-tau217 reflects these amyloid plaques and also the formation of tau tangles — two hallmark features of Alzheimer’s disease.

What makes p-tau217 particularly exciting is how early it appears. Research suggests levels can begin rising 15 to 20 years before memory symptoms develop.​¹​ It has also emerged as one of the most accurate blood-based markers currently available, closely tracking Alzheimer’s-related brain changes and future cognitive decline.

They also offer practical advantages. Until recently, confirming Alzheimer’s-related changes often required expensive PET brain scans or invasive spinal taps (thousands of dollars). Blood tests are far less costly (hundreds of dollars), more accessible, and easier to incorporate into routine clinical care.

In fact, this technology is already beginning to change clinical care. In 2025, the first FDA-cleared blood-based biomarker test entered clinical use, marking a major milestone in Alzheimer’s diagnosis, and the impact has been immediate.

Read our coverage of this development in our previous article, Highlights from AAIC 2025: Cutting Edge Findings in Brain Health and Alzheimer’s Disease.

Jeffrey Cummings, M.D., Sc.D., a NeuroReserve Medical Advisor, participated in a 2025 implementation study at the Cleveland Clinic Lou Ruvo Center for Brain Health. After introducing plasma p-tau217 testing into the clinic’s workflow, the average time required to reach a biological diagnosis dropped from 11 weeks to just 9 days. The need for spinal fluid testing fell by 67%, and the use of amyloid PET scans dropped by 54%, while maintaining diagnostic accuracy.​²​

For patients, that means faster answers, fewer invasive procedures, and quicker access to appropriate care.

The “Biological Clock” That Could Predict Alzheimer’s Years Before Symptoms

As impressive as these diagnostic advances are, the greatest excitement may lie in what blood-based biomarkers could eventually help us predict.

A groundbreaking 2026 study published in Nature Medicine found that blood levels of p-tau217 may help estimate how close a person is to developing Alzheimer’s symptoms. Researchers described p-tau217 as a potential biological “clock,” capable of estimating symptom onset with a margin of error of roughly three to four years.​³​

Interestingly, the timing appeared to matter. Individuals whose p-tau217 levels became elevated later in life tended to develop symptoms sooner than those whose levels rose at younger ages.​³​

Another major study, published in The Lancet and led by Kristine Yaffe, M.D., pushed the detection window even earlier. Researchers found that Alzheimer’s-related blood biomarkers could already be detected in some cognitively normal adults in their 50s and 60s. Those with positive biomarkers were also significantly more likely to experience accelerated declines in memory and thinking skills over time.​⁴​

In other words, Alzheimer’s-related changes may be affecting brain function years before symptoms become obvious.

As Yaffe noted, “Testing could open a window to embark on interventions that may postpone Alzheimer’s onset.”

That possibility represents a fundamental shift in thinking. Instead of waiting for symptoms to emerge, clinicians may eventually be able to identify biological changes years — or even decades — earlier and help people take action while there is still time to influence their trajectory.

That opportunity is especially important given estimates from the Lancet Commission suggesting that approximately 40% of dementia cases may be preventable through modification of known risk factors.​⁵​

For the first time, researchers can begin to envision a future in which Alzheimer’s prevention is informed not only by population-level risk factors, but also by personalized biological information from a simple blood test. The sooner people know their status, the more they can do ahead of time to stave off or prevent the disease, and that is a real-life transformation in prevention.

GLP-1 Drugs and Alzheimer’s: Why Are Weight-Loss Drugs Being Studied for Brain Health?

Few classes of medications have generated as much attention in recent years as GLP-1 receptor agonists (e.g. drugs named Ozempic, Mounjaro, Zepbound, and Wegovy). Originally developed to help manage type 2 diabetes, these drugs have become household names because of their effectiveness for weight loss.

Their potential applications are branching out from just diabetes and obesity. Researchers are investigating GLP-1 drugs for cardiovascular disease, chronic kidney disease, fatty liver disease, addiction, and even brain disease — including Alzheimer’s.

Be sure to check out our previous article on GLP-1s and brain health.

At first glance, a diabetes medication may seem unrelated to Alzheimer’s disease. However, metabolic health and brain health are deeply connected.

People with diabetes face up to a 50% higher risk of developing Alzheimer’s disease, and growing evidence suggests that disruptions in glucose regulation, insulin signaling, and energy metabolism may contribute to brain aging.​⁶​

This idea has helped fuel what researchers call the “metabolic hypothesis” of Alzheimer’s disease — the theory that problems involving the brain’s ability to produce and use energy may play a role in disease development and progression.

A Year of Big Ups and Downs for GLP-1 Research

Now, researchers are asking how much of a role metabolism plays in this disease. Over the past year, researchers have put that question to the test in some of the largest Alzheimer’s clinical trials ever conducted for GLP-1 medications.

The highest-profile results came from the EVOKE and EVOKE+ trials, which evaluated semaglutide (the same drug used in Ozempic) in people with early Alzheimer’s disease. The studies involved thousands of participants and represented one of the largest tests yet of the metabolic hypothesis. However, the results reported in late 2025 showed that semaglutide failed to meet its primary endpoint of slowing cognitive decline.​⁷​

At nearly the same time, a different GLP-1 medication produced a more encouraging signal. The ELAD trial, which evaluated liraglutide, found evidence of slower brain volume loss and suggested potential benefits for cognitive decline. While the findings were not definitive, they provided enough encouragement to sustain interest in the field.​⁸​

Adding another layer of complexity, several observational studies and meta-analyses have reported lower rates of dementia among people taking GLP-1 medications, with some studies suggesting risk reductions of 20% to 35%.​⁹​

Questions surrounding brain insulin resistance, energy metabolism, and other metabolic processes are now receiving far more attention than they did just a few years ago.

At this stage, GLP-1 drugs have generated more questions than answers. Yet the vast interest surrounding them reflects something important: Alzheimer’s research is expanding beyond traditional theories and exploring a broader range of biological pathways than ever before. And that broader perspective is shaping the future of Alzheimer’s treatments.

Alzheimer’s Drug Development Is Expanding Beyond Amyloid

For decades, Alzheimer’s drug development was dominated by the “amyloid hypothesis” — the idea that preventing or removing amyloid beta plaques from the brain could slow or stop the disease. This theory shaped much of the field’s research agenda and led to the first disease-modifying Alzheimer’s therapies.

Those treatments remain an important milestone. Recent analyses of anti-amyloid drugs such as lecanemab and donanemab suggest that targeting amyloid can slow disease progression, particularly when treatment begins early.​¹⁰​ But they’ve also made one thing clear: amyloid alone is unlikely to explain the full complexity of Alzheimer’s disease.

A major 2026 analysis led by Jeffrey Cummings, M.D., Sc.D., NeuroReserve Medical Advisor, shows how far the field has moved. With 158 drugs in development and 192 active clinical trials, the Alzheimer’s pipeline is now one of the largest and most diverse in its history.

What’s more revealing than the size of the pipeline is how its focus has changed.

Not long ago, roughly one-third of Alzheimer’s therapies targeted amyloid beta.​¹¹​ That share has now dropped substantially, signaling a broader shift as researchers expand into other disease pathways. Today, more therapies focus on tau biology and immune or inflammatory processes, with metabolism also emerging as a growing area of interest.

These shifts point to a major change in thinking.

As Cummings notes, the current pipeline “provides the basis for optimism regarding the emergence of new therapies for patients with Alzheimer’s.”

That optimism is progressively tied to a new treatment model. Rather than relying on a single breakthrough drug, the future of Alzheimer’s care may look more like other complex diseases, such as cancer or cardiovascular disease, where combination approaches target multiple biological drivers at once.

Looking Ahead

These developments reveal an Alzheimer’s research landscape that looks very different from what it did even a few years ago.

Researchers are no longer approaching Alzheimer’s as a single disease driven by a single cause. Instead, they are building a more complete understanding of the many biological factors that contribute to cognitive decline and exploring new ways to detect risk, intervene earlier, and slow progression.

Perhaps the most exciting shift is the growing ability to identify Alzheimer’s-related changes before symptoms appear — opening a window to study prevention strategies that didn’t exist before.

That future is still taking shape. And Alzheimer’s research is entering a new era of possibility.

This article is part of NeuroReviews — our series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References:

​​1. Fu, W. & Ho, P. C.-L. Blood-based biomarkers for Alzheimer’s disease: Advances in early detection and monitoring of age-related neurodegeneration. Ageing Res. Rev. 117, 103058 (2026).

​2. The Healthcare Discovery Team. The Alzheimer’s Blood Test Has Arrived: How Plasma p-Tau217 Is Rewriting Early Diagnosis in 2026. Healthcare Discovery AI https://healthcarediscovery.ai/alzheimers-blood-test-ptau217-early-diagnosis-2026/ (2026).

​3. Petersen, K. K. et al. Predicting onset of symptomatic Alzheimerʼs disease with plasma p-tau217 clocks. Nat. Med. 32, 1085–1094 (2026).

​4. Jiang, X. et al. Alzheimer’s disease neuropathology plasma biomarkers and cognition in midlife: a community-based cohort study. The Lancet 407, 2208–2216 (2026).

​5. Livingston, G. et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet 404, 572–628 (2024).

​6. Li, L. et al. Increased risk of dementia in Type 1 diabetes: A systematic review with meta-analysis. Diabetes Res. Clin. Pract. 222, 112043 (2025).

​7. O’Leary, K. GLP-1 receptor agonist fails to halt Alzheimer’s disease. Nat. Med. https://doi.org/10.1038/d41591-026-00018-2 (2026) doi:10.1038/d41591-026-00018-2.

​8. Edison, P. et al. Liraglutide in mild to moderate Alzheimer’s disease: a phase 2b clinical trial. Nat. Med. 32, 353–361 (2026).

​9. Mullins, R. J. et al. A Pilot Study of Exenatide Actions in Alzheimer’s Disease. Curr. Alzheimer Res. 16, 741–752 (2019).

​10. van Dyck, C. H. et al. Lecanemab in Early Alzheimer’s Disease. New England Journal of Medicine 388, 9–21 (2023).

​11. Cummings, J. L. et al. Alzheimer’s disease drug development pipeline: 2026. Alzheimer’s & Dementia: Translational Research & Clinical Interventions 12, (2026).

A note from NeuroReserve founder, Edward Park, PhD:

When the original U.S. POINTER clinical trial results were released last year, they provided some of the strongest evidence yet that lifestyle changes are powerful enough to chang the cognitive trajectory in people who are midlife and older. Participants who followed a “structured program” that combined the MIND diet, physical activity, cognitive and social engagement, and cardiovascular health monitoring experienced significant improvements (not just maintenance) in cognition over a two-year period.

Researchers are continuing to analyze the data from U.S. POINTER, and what excites me most about these new analyses is that researchers are beginning to uncover not just what, but also why these benefits occur. In this edition of NeuroReviews, we cover a few of the latest U.S. POINTER findings that suggest the same lifestyle habits that support cognitive function may also influence overall healthy aging, including physical resilience, cardiovascular health, and sleep.

This reinforces an important concept: the brain does not operate in isolation. A healthier brain supports a healthier body, and a healthier body supports a healthier brain. As our understanding of these connections grows, so do the opportunities to take meaningful steps toward prevention.

Last year’s results from the U.S. POINTER trial showed cognitive benefits comparable to offsetting age-related cognitive decline by one to two years.¹ Conducted over a two-year period, the trial exemplifies the significant impact of lifestyle change on future brain health and strengthens the idea that it is never too late to take proactive steps to improve cognitive function.

Understanding Why U.S. POINTER Worked

The original U.S. POINTER publication focused on one primary outcome: cognition. Participants in both intervention groups improved their cognitive performance over the two-year study period, with the structured intervention producing the greatest gains.¹

Now, researchers are beginning to understand why.

Several newly released analyses have examined additional outcomes beyond cognition, offering new insights into how lifestyle interventions may influence aging, cardiovascular health, sleep, and other factors closely connected to long-term brain health.

A New Link Between Brain Health and Healthy Aging

One of the most important findings to emerge from recent evaluations of U.S. POINTER data involves something called frailty.

Frailty is not simply feeling “weak” or a measure of chronological age; rather, it reflects biological aging — the gradual accumulation of physical and physiological changes that reduce resilience and increase vulnerability to chronic disease, disability, and other health setbacks.²

While frailty becomes more common with age, it is not an inevitable part of aging. The analysis found that participants in both intervention groups experienced reductions in frailty, with the structured lifestyle program with all four components producing the greatest improvements.²

More importantly, the frailty findings reveal that the intervention may be influencing “system-wide aging biology” — the interconnected processes that shape how the body ages over time. This expands our understanding of U.S. POINTER beyond cognition alone and raises an exciting possibility: lifestyle interventions may impact biological aging processes that, in turn, support brain health.²

The Critical Roles of Vascular Health and Sleep

The newer analyses also suggest that the benefits apply to cardiovascular health.

The brain depends on a healthy cardiovascular system to continuously deliver oxygen and nutrients, and when blood vessels become less healthy, the brain can suffer as well. New observations from U.S. POINTER indeed are showing improvements in both vascular function and blood pressure regulation.³

Beyond cardiovascular health, sleep may be one of the most intriguing areas emerging from the U.S. POINTER data.

Researchers identified a potential reduction in sleep apnea burden. This is notable because sleep apnea has been linked to cognitive decline, impaired memory, and an increased risk of dementia.^4,5

Sleep is one of the brain’s most important maintenance periods. During sleep, the brain consolidates memories, supports learning, regulates inflammation, and helps clear metabolic waste products that accumulate throughout the day.

Not only with sleep apnea, but also poor sleep in general has repeatedly been associated with an increased risk of cognitive decline and dementia.⁶

While researchers continue to investigate these findings, the results add to a growing body of evidence showing that sleep health is strongly connected to long-term cognitive function. Collectively, the latest U.S. POINTER results indicate that lifestyle interventions may support cognition in part by improving the body’s fundamental systems for recovery and repair.

Why These Findings Matter

Last year, U.S. POINTER demonstrated that a structured lifestyle program involving four components (MIND diet, physical activity, social/cognitive engagement, and health monitoring) could improve cognition in older adults at risk for decline.

Today, follow-up analyses are providing a more complete picture of why — suggesting those benefits may be tied to changes occurring throughout the body, including improvements in physical resilience, cardiovascular function, and sleep.

As the U.S. POINTER team continues to follow participants over time, the next question is whether these changes can ultimately reduce dementia risk over the long term.

A NeuroReserve Connection to U.S. POINTER

NeuroReserve is particularly delighted that two of our Medical and Scientific Advisors were involved with this trial, both from Rush University Medical Center. Jennifer Ventrelle, M.S., R.D.N., was the Lead Dietitian of the study, and Thomas Holland, M.D., was the Study Clinician at the Chicago site. We are very excited that Jennifer was selected to present aspects of the study at the AAIC conference.

We are also very delighted that U.S. POINTER used the MIND Diet as its nutritional intervention. MIND is an acronym for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” and it is one of the most widely studied and in-depth brain-healthy diets, originally developed at Rush University Medical Center. MIND is like a Mediterranean diet, but it emphasizes certain foods to eat, such as:

• Leafy green vegetables

• Berries

• Cold water fish

• Olive oil

• Nuts and legumes

• Whole grains

• Beans

• Lean poultry, and

• Other colorful vegetables

For more on the MIND diet’s benefits, be sure to check out our previous article:

Not only does NeuroReserve encourage and educate about the MIND Diet and other brain-healthy diets like it, but we also aim to support them with nutritional products, whether through daily supplementation, extra virgin olive oil, or supplemental creatine.

This article is part of NeuroReviews — our series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References:

1. Baker, L. D. et al. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function. JAMA 334, 681 (2025).

2. Espeland, M. A. et al. Relative impact of multidomain lifestyle interventions on deficit accumulation frailty over 24 months in the U.S. POINTER trial. J. Gerontol. A Biol. Sci. Med. Sci. 81, (2026).

3. Brooks, M. US POINTER Trial: Benefits of Structured Lifestyle Program Go Beyond Improved Cognition. Medscape https://www.medscape.com/viewarticle/us-pointer-trial-benefits-structured-lifestyle-program-go-2025a1000xz1 (2025).

4. The U.S. POINTER Structured Healthy Lifestyle Program — Previously Shown to Improve Cognition — May Also Improve Sleep Apnea, Blood Pressure Regulation, and Cognitive Resilience. Alzheimer’s Association https://www.alz.org/news/2025/us-pointer-healthy-lifestyle-program-may-improve-sleep-apnea-blood-pressure-cognitive-resilience (2025).

5. Carvalho, D. Z. et al. Association of Polysomnographic Sleep Parameters With Neuroimaging Biomarkers of Cerebrovascular Disease in Older Adults With Sleep Apnea. Neurology 101, (2023).

6. Sabia, S. et al. Association of sleep duration in middle and old age with incidence of dementia. Nat. Commun. 12, 2289 (2021).

Many conversations around brain health rely on broad recommendations meant to apply to everyone. But research suggests that men and women may experience cognitive aging differently — from hormonal changes and genetics to the way certain lifestyle factors affect the brain over time.

Understanding these differences may help explain why women account for nearly two-thirds of Alzheimer’s cases in the United States and how we can tailor strategies for prevention and healthy aging for each sex.¹

In this edition of NeuroReviews, we spoke with leading experts in brain health and longevity to explore the science behind these differences and what they may reveal about supporting cognitive resilience throughout life.

Men and women’s brains differ in structure, function, and even how they age. These differences may influence everything from memory and emotional processing to susceptibility to cognitive decline later in life.

For example, women face nearly double the lifetime risk of developing Alzheimer’s disease compared to men, with hormonal shifts, genetics, and lifestyle-related risk factors all thought to play a role.¹

Whether you’re looking to enhance your own brain health or simply curious about the ways your mind is influenced by your gender, this exploration will provide valuable takeaways for both men and women alike.

How Male and Female Brains Differ

The brain is an incredibly complex organ, made up of various structures that work together to control everything we think, feel, and do.

The brain is primarily composed of two types of tissue: gray matter and white matter. Gray matter contains active neurons that process and interpret information, while white matter acts like a communication highway, connecting different parts of the brain for smooth and efficient functioning.

Men tend to have more gray matter, which helps with tasks like problem-solving and decision-making. On the other hand, women typically have more white matter, which helps their brain regions communicate with each other efficiently.

These structural differences may explain why men and women approach tasks like memory encoding, emotion processing, and facial recognition in different ways.²

In conversations or social settings, women may be more likely to pick up on subtle emotional cues, such as tone of voice or body language, because their brain’s white matter helps connect areas that process emotions with those that interpret social context. Men, on the other hand, may focus more on the content of what is being said and the logical aspects of the conversation, leveraging their gray matter for detailed processing.

These differences may help explain why men and women sometimes process emotions, communication, and decision-making differently.

The Role of Hormones in Brain Aging

Dr. Annie Fenn, Founder of The Brain Health Kitchen and Medical Advisor to NeuroReserve:

“One of the fundamental differences between men and women’s brains is estrogen. The more estrogen a woman is exposed to in her life, either from her body’s own hormones or other sources (birth control pills, menopausal hormone therapy), the less likely she is to develop dementia. In other words, estrogen in all forms is neuroprotective.

When estrogen levels begin to decline — as early as one’s thirties — a woman’s brain can become vulnerable to developing the sticky plaques and tangles that can put her at risk for Alzheimer’s later.”

Men and women have distinct hormonal patterns that influence cognition and brain aging throughout life. Both genders rely on hormones regulated by the hypothalamic-pituitary-gonadal (HPG) axis, but age-related declines in estrogen and testosterone may increase vulnerability to cognitive decline.³

For women, menopause leads to a drop in hormones like estrogen and progesterone, reducing their neuroprotective effects and potentially increasing women’s susceptibility to Alzheimer’s disease.

Since women spend a significant portion of their lives with reduced levels of these protective hormones, this may explain the higher rates of cognitive decline observed in women as they age.³

You can learn more about how estrogen impacts women with age by visiting our previous article here.

Testosterone, the primary male sex hormone, also declines with age which may in turn cause brain decline. In fact, men with the lowest levels of testosterone have a 43% higher risk of developing any type of dementia, and an 80% higher risk of Alzheimer’s compared to men with higher testosterone levels.⁴

Testosterone helps regulate the accumulation of β-amyloid, a protein linked to Alzheimer’s. Additionally, it has protective effects against cell death induced by β-amyloid and helps reduce oxidative brain damage. Testosterone also supports brain function by influencing synaptic plasticity – the brain’s ability to adapt and change. However, its effects on brain health are complex and may involve both testosterone and estrogen working together.

While testosterone shows promise in protecting against Alzheimer’s pathology, the full impact on human cognition and dementia risk remains an area of ongoing research.⁴

How Risk Factors Affect Men and Women Differently

Dr. Kellyann Niotis, Director of Parkinson’s and Lewy Body Dementia research at the Institute for Neurodegenerative Diseases (IND) Florida and Clinical Assistant Professor of Neurology at Weill Cornell Medicine:

“It is becoming increasingly clear that our biological sex impacts our risk of developing various neurodegenerative conditions later in life. However, the mechanisms behind these sex-related differences are not yet completely understood.

One important consideration is that biological sex may modify the influence of other risk factors on overall risk for diseases like Alzheimer’s. For example, a study published in BMC Medicine this year found that men with sarcopenic obesity had a higher risk of dementia compared to women with the same condition. This aligns with other research showing that sex and age can influence the hormones released by fat tissue (adipokines), which may, in turn, affect dementia risk differently across individuals.

I believe that understanding these differences is a key to preventing diseases like Alzheimer’s. In 2022, we published key results showing an individualized risk reduction plan that accounts for differences in biological sex is equally effective at reducing Alzheimer’s and cardiovascular disease risk in both men and women.”

In our discussions reviewing the Lancet Commission Report, we’ve highlighted various risk factors that can increase the likelihood of brain decline over time. Some of these are modifiable, like managing blood pressure or maintaining a healthy weight, while others are non-modifiable, such as genetic predisposition.

Interestingly, research shows that men and women experience different impacts from these risk factors. For example, men tend to have more modifiable risk factors for dementia, but the way these factors play out for each gender can influence their brain health in distinct ways.⁵

Take diabetes, for instance. While it doubles the cardiovascular risk in men and more than triples it in women — both of which are risk factors for Alzheimer’s disease — women with diabetes face an even higher risk of developing vascular dementia. Women with diabetes showed a 120% greater risk, compared to a 70% greater risk in men, revealing a significant gender difference in how diabetes affects brain health.⁶ Women are also twice as likely to experience depression, which is associated with a 70% higher risk of Alzheimer’s in midlife and may impact women’s dementia risk more overall.

Men, on the other hand, are more likely to have sleep apnea, a condition that disrupts sleep and is linked to cognitive decline. Although sleep apnea also increases in women after menopause, its greater prevalence in men may mean it plays a larger role in their Alzheimer’s risk.⁷

Research from Dr. Kellyann’s recent study further sheds light on this issue, with conditions like sarcopenia and sarcopenic obesity (loss of muscle mass plus obesity) showing similar gender-specific patterns. Sarcopenia, which is the loss of muscle mass, is linked to smaller gray matter in the hippocampus, a region critical for memory. In sarcopenic obesity, women experienced a slight delay in dementia onset, while men showed a more significant advancement in dementia progression.⁸

While many risk factors for dementia are common across genders, the effects can vary, underscoring the importance of gender-specific strategies in managing brain health by managing risk factors.

Why Genetics May Impact Women More Strongly

Dr. Thomas M Holland, Rush University Medical Center researcher and Medical Advisor to NeuroReserve:

“Women with one or two copies of the APOE4 gene generally face a higher risk of developing Alzheimer’s disease compared to men. This risk is compounded by the fact that Alzheimer’s is strongly associated with aging, and women tend to live longer than men.

APOE4 increases the likelihood of developing Alzheimer’s-related neuropathology, and the longer someone lives, the greater the chance of accumulating amyloid plaque burden, impairment, and ultimately dementia. Therefore, it makes sense that women, who live longer, face a higher risk, especially accounting for the potential cognitive vulnerability of hormonal changes they face later in life through the postmenopausal time frame.

Yet, it’s important to note that about 1/3 of individuals with an abundant cognitive reserve — factors like education, mental stimulation, and a healthy lifestyle — may avoid developing the clinical symptoms of Alzheimer’s-related pathology.

Being proactive is key. Adopting brain-healthy habits early can help mitigate these genetic risks, offering a potential to slow the progression and reduce the risk associated with APOE4, regardless of gender.”

The APOE4 gene is the strongest genetic risk factor for Alzheimer’s disease. Having one copy of this gene increases your risk by about three times, and having two copies can raise it up to 12 times.⁹

We’ve talked before about how APOE4 affects brain health, but recent research shows it may be even riskier for women than men.¹⁰ Women who carry even one APOE4 gene face a significantly greater risk than men; in fact, female APOE4 carriers have approximately 1.5 times higher odds of developing Alzheimer’s than male carriers.¹¹

This elevated risk for women is linked to more severe brain changes. APOE4 in women is associated with increased tau pathology (the buildup of tau proteins in the brain), lower glucose metabolism (energy use), and a greater amyloid-β burden, all of which are strongly tied to Alzheimer’s progression.¹¹

For women who carry APOE4, there are noticeable changes in brain function and structure — like lower brain energy use (hypometabolism) and thinner brain cortex, which is involved in thinking and memory. This thinning and decreased energy use are strongly linked to Alzheimer’s progression.

Men with APOE4, by contrast, show fewer and less intense changes; they may only experience slight reductions in brain energy use or even show areas where the brain cortex thickens slightly.¹⁰

Remember, genetics are just one piece of the puzzle when it comes to brain health risk. While genes like APOE4 may increase susceptibility, they don’t determine your destiny. By taking proactive steps, you can help offset genetic risks and support a resilient brain.

Check out our previous article here for practical tips on how lifestyle and nutrition can empower you, regardless of genetic predispositions.

Brain-Healthy Habits for Men and Women

Dan Buettner, Founder of the Blue Zones:

“In blue zones, both men and women engage in habits that contribute to long, healthy lives, but there are some interesting distinctions in how they approach longevity.

Women in blue zone regions often take on roles that emphasize social connection and caregiving, which naturally integrate movement and social bonds into their daily routines. They tend to form tight-knit social circles, such as the moai groups in Okinawa, where women come together to support each other emotionally and financially. These strong social networks have a significant impact on reducing stress and providing a sense of purpose.

Men, on the other hand, often prioritize physical activity and purpose-driven work. In Sardinia, for example, many older men are shepherds, which keeps them active and physically engaged well into their later years. They also maintain meaningful roles within the family and community, whether through leadership or by mentoring younger generations, which reinforces their sense of purpose.

While the principles of diet, movement, social connection, and purpose apply to both genders, the way they are woven into the fabric of everyday life reflects cultural expectations and roles. The key takeaway is that both men and women in blue zones find ways to stay active, eat wisely, build meaningful relationships, and retain a sense of purpose throughout their lives — but they may express these habits in ways that are influenced by their social and cultural contexts.”

A person’s lifestyle and diet play a significant role in brain health, but the way men and women approach these habits is in a different manner.

These differences are shaped by a combination of biological factors, cultural influences, and personal preferences, and they can impact cognitive health in distinct ways. The important thing to remember is that prevention strategies for brain health are helpful regardless of gender. By focusing on specific areas that complement each gender’s natural tendencies and preferences, both genders can find more impactful ways to boost quality of life and overall brain health.

Get Enough Sleep

Both men and women should aim for 7–8 hours of sleep per night for optimal health, but women may need to focus more on improving sleep quality.

Women are more likely to report poor sleep quality, trouble falling asleep, and feeling unrefreshed upon waking. They also face a higher risk of high blood pressure with only 5 hours of sleep or less, whereas men do not.

Especially during the menopause transition, hormonal changes can disrupt sleep, leading to insomnia, frequent waking, and daytime fatigue. Additionally, sleep apnea, though more common in men, is harder to diagnose in women, often leading to undetected sleep-disordered breathing.¹²

Both men and women need to focus on getting enough sleep for their brain health, but women may have to spend more time focusing in this area.

Manage Stress

Men and women experience and cope with stress differently due to unique patterns of brain activity.

Women tend to have increased brain activity in regions related to self-reflection and cognitive processing during stress, which may lead to higher anxiety and a tendency to ruminate. This makes mindfulness techniques, like yoga and meditation, which help quiet overactive thoughts, especially effective for managing stress in women.

On the other hand, men often have reduced brain activity in areas involved in strategy and emotional control, potentially leading to externalizing behaviors under stress. Men may benefit from cognitive behavioral therapy, like goal settings and playing sports with friends, which builds coping strategies and can boost brain activity in regions that aid in stress management.¹³

Stay Active

Exercise is a fantastic way to keep the brain strong — just like it strengthens the body; it also supports brain health.

While men and women both benefit from regular physical activity, research shows that women may gain a unique advantage. For instance, weekly moderate exercise has been shown to boost cognitive function by about 5% in men and an impressive 14% in women. So, whether it’s walking, strength training, or aerobics, getting moving is one of the best things to keep your mind sharp.¹⁴

Eat a Brain-Healthy Diet

When it comes to brain-healthy diets like the Mediterranean and MIND diets, both men and women can benefit from the array of nutrition these diets deliver, but women tend to see slightly more advantages.

Research has shown that a closer adherence to the MIND diet is linked to a decreased risk of cognitive impairment and slower rates of cognitive decline in women.¹⁵

However, it’s important to consider eating habits when focusing on these diets. Men often prefer red and processed meats and consume them more frequently than women, making it harder to follow these brain-healthy diets.

Women, on the other hand, are more likely to choose vegetables, whole grains, tofu, and dark chocolate, which align well with the principles of these diets. Men also tend to eat quickly, dine out more, and eat alone, which could affect adherence to healthier eating habits.¹⁶ If men fully embraced the principles of the Mediterranean and MIND diets, they may find themselves enjoying the long-term brain health benefits just as much as women.

Regardless of gender, maintaining a brain-healthy lifestyle can feel overwhelming at times. Between busy schedules, stress, and changing nutritional needs, consistency is often the hardest part. Alongside healthy habits like movement, sleep, and a wholesome diet, daily supplements like RELEVATE provide additional support for cognitive well-being.

Maintaining brain health in men and women requires a tailored approach, as each gender has unique focus areas that can impact cognitive function. It’s definitely not a one-size-fits-all strategy. By understanding the differences in how lifestyle, diet, and other factors affect brain health in each case, everyone can make changes that support their brain’s unique needs and long-term health.

This article is part of NeuroReviews — our series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References

1. Miramontes, S. et al. Alzheimer’s disease as a women’s health challenge: a call for action on integrative precision medicine approaches. npj Women’s Health 2024 2:1 2, 1–5 (2024).

2. Xin, J., Zhang, Y., Tang, Y. & Yang, Y. Brain Differences Between Men and Women: Evidence From Deep Learning. Front Neurosci 13, 442577 (2019).

3. Gurvich, C., Hoy, K., Thomas, N. & Kulkarni, J. Sex Differences and the Influence of Sex Hormones on Cognition through Adulthood and the Aging Process. Brain Sci 8, 163 (2018).

4. Yeap, B. B. & Flicker, L. Testosterone, cognitive decline and dementia in ageing men. Rev Endocr Metab Disord 23, 1243 (2022).

5. Anstey, K. J. et al. Association of sex differences in dementia risk factors with sex differences in memory decline in a population-based cohort spanning 20–76 years. Sci Rep 11, 7710 (2021).

6. Chatterjee, S. et al. Type 2diabetes as a risk factor for dementia in women compared with men: A pooled analysis of 2.3 million people comprising more than 100,000 cases of dementia. Diabetes Care 39, 300–307 (2016).

7. Mielke, M. M. Sex and Gender Differences in Alzheimer’s Disease Dementia. Psychiatr Times 35, 14 (2018).

8. Zhang, J. et al. Sarcopenic obesity is part of obesity paradox in dementia development: evidence from a population-based cohort study. BMC Med 22, 1–17 (2024).

9. Alzheimer’s: Is it in your genes? - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-genes/art-20046552.

10. Sampedro, F. et al. APOE-by-sex interactions on brain structure and metabolism in healthy elderly controls. Oncotarget 6, 26663 (2015).

11. Yan, S. et al. Sex modifies APOE ε4 dose effect on brain tau deposition in cognitively impaired individuals. Brain 144, 3201–3211 (2021).

12. Sleep’s an Important Part of the Health Equation—Now More. https://orwh.od.nih.gov/about/director/messages/sleeps-important-part-of-health-equation-now-more-than-ever.

13. Seo, D., Ahluwalia, A., Potenza, M. N. & Sinha, R. Gender Differences in Neural Correlates of Stress-Induced Anxiety. J Neurosci Res 95, 115 (2017).

14. Lenzen, S., Gannon, B. & Rose, C. A dynamic microeconomic analysis of the impact of physical activity on cognition among older people. Econ Hum Biol 39, 100933 (2020).

15. Sawyer, R. P., Blair, J., Shatz, R., Manly, J. J. & Judd, S. E. Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort. Neurology 103, e209817 (2024).

16. Feraco, A. et al. Assessing gender differences in food preferences and physical activity: a population-based survey. Front Nutr 11, 1348456 (2024).

As part of National Women’s Health Month, we’re taking a closer look at the changes women experience across midlife and how those shifts impact long-term health.

Brain fog, poor sleep, low energy, and mood shifts are often framed as part of the aging process. But research is revealing that many of these changes may be rooted in something more specific: how the body produces and uses energy.

As estrogen declines, there’s an accompanying disruption in the energy systems that support the brain, muscles, and metabolism. At the same time, women naturally have lower creatine stores than men, and these levels decline further with age — creating a gap between energy demand and availability.

This has brought new attention to creatine, beyond its benefits as a sports/athletic supplement, to its role as a foundational nutrient that supports cellular energy and healthy aging — particularly for women experiencing hormonal and metabolic changes.

In this edition of NeuroReviews, we break down the emerging science behind creatine and its role in supporting the brain, body, and long-term resilience for women to thrive in midlife.

Learn more about creatine’s role in brain and whole-body health by exploring our previous articles:

• 7 Things You Need to Know About Creatine and Brain Health

• Beyond the Brain: How Creatine Powers Whole Body Health

Why Creatine May Matter More for Women

Women face disproportionately higher risks of cognitive decline, mood changes, sleep issues, muscle loss, and bone fragility during midlife and aging transitions.​^1,2​

These challenges can stem from disrupted cellular energy function — a vulnerability amplified in women, who have 70-80% less creatine than men and generally consume less creatine-rich, animal-based foods.³

Creatine levels also decline with age, reducing the body’s capacity to buffer energy during cognitively or physically demanding situations.

In addition, estrogen plays a role in creatine metabolism and transport, meaning that midlife hormonal shifts may further compound these energy-related changes in the brain and muscles.​⁴​

New research has proposed the first evidence-based intake recommendations for creatine in adults, reflecting growing recognition of creatine as a conditionally essential nutrient — meaning the body may not always produce enough to fully meet needs under certain conditions.​⁵​

Older adults, vegetarians, vegans, and women with lower dietary creatine intake may be at a greater risk for insufficient creatine availability.​⁵​

These combined factors — lower initial stores, lower intake, age-related losses, and hormonal changes — can undermine metabolic resilience. Creatine supplements can support resilience where energy demands are greatest.

Stronger cellular capacity helps sustain cognition, mood, strength, and structure in women during biological change.

While creatine matters throughout a woman’s life, it becomes especially relevant in midlife due to these significant hormonal changes that affect demands.

Brain Fog, Focus, and Mental Clarity

Many cognitive changes women notice in midlife stem from shifts in how the brain produces and uses energy.

Midlife women report higher rates of brain fog, slower processing speed, reduced focus, and diminished mental stamina during this transition.​⁶​

While many cognitive symptoms like these are often dismissed as inevitable, they are more closely tied to ATP (the brain’s energy currency) availability under stress than to irreversible cognitive decline.

Aging and hormonal changes reduce mitochondrial efficiency, meaning brain cells become less effective at generating ATP when demand increases.​⁷​ This can deplete neurons’ energy during stress, multitasking, or sleep loss.

How Creatine Supports Brain Energy

Creatine directly supports cellular energy by acting as a rapid buffer in neurons, recycling ATP during spikes in demand.

The brain benefits of creatine include sustaining cognitive performance during high-demand tasks and helping maintain mental clarity under conditions of stress, sleep deprivation, and mood disturbance.​⁸​

With age and hormonal shifts, creatine and brain energy decline. Increasing creatine intake may boost brain resilience and protect neurons under cognitive strain.

Mood, Stress, and Emotional Balance

Emotional regulation becomes more vulnerable during midlife as estrogen levels decline.

Estrogen plays an important role in modulating neurotransmitters such as serotonin and dopamine, which are central to mood stability, motivation, and stress response.​⁹​ As this signaling changes, women become more susceptible to mood disturbances, anxiety, and heightened stress sensitivity.​¹⁰​

Chronic stress adds to the problem. High stress increases the brain’s energy requirements while impairing neurotransmission and mitochondrial function. Over time, this can lead to mood swings, lower stress tolerance, and depressive symptoms.

Creatine’s Role in Mood and Stress

Creatine helps regulate mood by supporting energy in brain regions involved in emotional processing, including the hippocampus and prefrontal cortex.

Research suggests creatine influences serotonin and dopamine activity and may enhance emotional stability.​¹¹​

Rather than acting as a mood-altering compound, creatine enhances brain energy for reliable neurotransmitter function. This is particularly important during midlife, when resilience is challenged by hormonal and metabolic changes.

Sleep Loss and Cognitive Fatigue

Sleep disruption is common during perimenopause and menopause, with women experiencing more frequent awakenings, reduced sleep quality, and difficulty achieving restorative sleep.​¹²​

Poor sleep reduces daily energy levels and directly impacts memory, attention, mood, and emotional regulation.

Sleep deprivation creates an energy deficit in the brain. When sleep is reduced or fragmented, ATP availability decreases, while cognitive demand remains high, leading to mental fatigue and impaired decision-making.

How Creatine Helps During Sleep Loss

Creatine may counteract the cognitive effects of sleep loss by maintaining brain energy availability when demand exceeds supply.​¹³​

Creatine is not a sleep aid, however, it may help preserve brain function when sleep is interrupted, reducing cognitive and emotional side effects of poor rest.

Strength, Muscle, and Physical Resilience

Muscle loss accelerates during and after midlife as hormonal changes reduce the body’s ability to maintain lean tissue. Women experience a faster decline in muscle mass and strength during this stage, which affects balance, metabolic health, and overall physical resilience.​¹⁰​

Loss of muscle is not only a strength issue, though, as it increases the risk of falls and injury and contributes to long-term functional decline. Because muscle tissue is metabolically active, reduced muscle mass also impacts energy regulation throughout the body.

How Creatine Supports Muscle and Movement

Creatine supports muscle by increasing the availability of phosphocreatine, which fuels rapid ATP production during movement and resistance-based activity. This improves muscle energy output, encourages strength gains, and helps preserve lean muscle mass with age.​^4,14​

When combined with resistance training, creatine consistently enhances training capacity and recovery, allowing women to generate more force and adapt more effectively to strength-based exercise. This combination has also been linked to improved balance and reduced fall risk in aging populations.​¹⁴​

Creatine may further support muscle health by reducing inflammation associated with aging and muscle loss, helping preserve muscle quality as women age.​¹⁴​

Pairing Creatine with Resistance Training

Resistance training does not need to be intense or time-consuming to be beneficial. Consistency matters far more than intensity.

Try these options for regular resistance exercises:

• Pilates, which emphasizes controlled strength, stability, and core engagement

• Bodyweight exercises, such as squats, lunges, wall push-ups, and step-ups

• Light-to-moderate weight training, using dumbbells or resistance bands

• Strength-focused yoga, which builds muscle through sustained load and balance work

Even brief, consistent resistance training combined with sufficient energy support from creatine helps maintain muscle mass and function during midlife.

Bone Health and Osteoporosis Risk

Bone density drops sharply in women after menopause, greatly raising fracture and osteoporosis risk.​¹⁵​

Fractures later in life can reduce mobility in the long term, highlighting the role of bone health in aging well.

Additionally, bone and muscle health are tightly linked. Muscle contractions place mechanical load on bone, stimulating bone remodeling and strength.

As menopause-related hormonal decline contributes to muscle loss, bones receive less stimulus to maintain density, accelerating bone weakness.​¹⁶​

How Creatine Supports Bone Through Muscle

Creatine does not act directly on bone tissue, but it may support bone health by improving muscle strength and load-bearing capacity.

Stronger muscles generate greater mechanical stress on bones, which helps maintain bone density over time.

Research suggests that creatine supplementation combined with resistance training produces a synergistic effect, improving both muscle function and bone health outcomes more effectively than exercise alone.​¹⁷​

Creatine promotes muscle energy and performance, helping reinforce the muscle-bone connection that becomes increasingly important during midlife.

FAQs About Creatine for Women

If you’re new to creatine, the good news is that supplementation is simple — small, consistent daily doses are enough to support brain, muscle, and energy needs.

Pure creatine monohydrate formulas, such as REVANTA Creatine, provide a well-studied, effective option for supporting consistent daily intake.

1. How much creatine should women take?

A daily intake of 5 grams of creatine is sufficient to promote brain energy, muscle function, and overall cellular resilience for most women. However, those following a plant-based or low-animal-protein diet may benefit from slightly higher intake (up to 10 grams daily), as dietary creatine is primarily found in meat and fish.​^18,19​

2. What is the best creatine for women?

Creatine monohydrate is the safest and most reliable form of creatine, supported by hundreds of studies showing consistent health benefits. It is readily absorbed and efficiently used by the body, with no evidence that alternative forms offer any added advantages.​²⁰​

3. Does creatine need to be taken at a specific time?

Prioritize consistency over timing. Creatine works by gradually increasing creatine stores in muscle and brain tissue over time, not by providing an immediate stimulant effect. Taking creatine once per day at a time that fits easily into your routine is enough to support long-term benefits.

4. Does creatine cause water retention?

Some women notice mild water retention when they first begin taking creatine. This occurs because creatine draws water into muscle cells during normal energy metabolism. This effect is typically subtle and temporary, as well as different from hormonal bloating or fat gain. Most people find that it stabilizes after the first few weeks of consistent use.​²¹​

5. Is creatine safe for women across life stages?

Creatine is considered safe and well-tolerated for most women, and its role in supporting cellular capacity makes it especially relevant during periods of significant hormonal change.

Phases like menstruation, pregnancy, postpartum, and midlife transitions place higher demands on the brain, muscles, and nervous system, all of which rely heavily on efficient energy availability.​³​ Because creatine helps buffer cellular energy and promote metabolic resilience, it may be useful across these phases.

Recent research in female athletes further reinforced creatine’s safety profile, finding no clinically meaningful changes in kidney, liver, or hematological markers during long-term supplementation.​²²​

Important note: Women who are pregnant or nursing should consult with their primary care provider before starting creatine supplementation, as individual needs and medical guidance are especially important during these stages.

What to Expect Over Time

Midlife health changes in women are deeply connected, reflecting shifting energy demands across the brain and body.

As research continues to evolve, creatine is increasingly being recognized as more than a sports supplement.

For women navigating hormonal shifts and aging, creatine offers a practical, well-researched way to promote cognitive resilience, physical strength, and long-term vitality.

This National Women’s Health Month is an opportunity to take a closer look at how nutrients like creatine support the body’s energy systems, impacting overall brain, muscle, and metabolic health.

This article is part of NeuroReviews — our series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References:

​​1. Barth, C., Crestol, A., de Lange, A.-M. G. & Galea, L. A. M. Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer’s disease. Lancet Diabetes Endocrinol. 11, 926–941 (2023).

​2. Sipilä, S. et al. Muscle and bone mass in middle‐aged women: role of menopausal status and physical activity. J. Cachexia Sarcopenia Muscle 11, 698–709 (2020).

​3. Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M. & Candow, D. G. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients 13, 877 (2021).

​4. Smith-Ryan, A. E. et al. Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause. J. Int. Soc. Sports Nutr. 22, (2025).

​5. Ostojic, S. M. Establishing Dietary Reference Intakes for Creatine in Adults. Nutr. Rev. https://doi.org/10.1093/nutrit/nuag009 (2026) doi:10.1093/nutrit/nuag009.

​6. Caldwell, J. Z. K. & Isenberg, N. The aging brain: risk factors and interventions for long term brain health in women. Curr. Opin. Obstet. Gynecol. 35, 169–175 (2023).

​7. Mosconi, L. et al. Menopause impacts human brain structure, connectivity, energy metabolism, and amyloid-beta deposition. Sci. Rep. 11, 10867 (2021).

​8. Juneja, K. et al. Creatine Supplementation in Depression: A Review of Mechanisms, Efficacy, Clinical Outcomes, and Future Directions. Cureus https://doi.org/10.7759/cureus.71638 (2024) doi:10.7759/cureus.71638.

​9. Russell, J. K., Jones, C. K. & Newhouse, P. A. The Role of Estrogen in Brain and Cognitive Aging. Neurotherapeutics 16, 649–665 (2019).

​10. Guerrero-González, C., Cueto-Ureña, C., Cantón-Habas, V., Ramírez-Expósito, M. J. & Martínez-Martos, J. M. Healthy Aging in Menopause: Prevention of Cognitive Decline, Depression and Dementia through Physical Exercise. Physiologia 4, 115–138 (2024).

​11. Yoon, S. et al. Effects of Creatine Monohydrate Augmentation on Brain Metabolic and Network Outcome Measures in Women With Major Depressive Disorder. Biol. Psychiatry 80, 439–447 (2016).

​12. Monterrosa-Castro, Á., Castilla-Casalins, A., Colmenares-Gúzman, M. & Chedraui, P. Frequency of Sleep Disorders and Their Association with Neurocognitive, Psychological, or Physical Alterations in Postmenopausal Women. J. Midlife Health 16, 166–173 (2025).

​13. Roschel, H., Gualano, B., Ostojic, S. M. & Rawson, E. S. Creatine Supplementation and Brain Health. Nutrients 13, 586 (2021).

​14. Candow, D. G. et al. Effectiveness of Creatine Supplementation on Aging Muscle and Bone: Focus on Falls Prevention and Inflammation. J. Clin. Med. 8, 488 (2019).

​15. Sipilä, S. et al. Muscle and bone mass in middle‐aged women: role of menopausal status and physical activity. J. Cachexia Sarcopenia Muscle 11, 698–709 (2020).

​16. Farhana, F., Sultana, M. A., Hia, R. A. & Hegde, V. Postmenopausal sarcopenia and Alzheimer’s disease: The interplay of mitochondria, insulin resistance, and myokines. Neurosci. Biobehav. Rev. 180, 106501 (2026).

​17. Candow, D. G. & Chilibeck, P. D. Potential of creatine supplementation for improving aging bone health. J. Nutr. Health Aging 14, 149–153 (2010).

​18. Sandkühler, J. F. et al. The effects of creatine supplementation on cognitive performance—a randomised controlled study. BMC Med. 21, 440 (2023).

​19. Gutiérrez-Hellín, J. et al. Creatine Supplementation Beyond Athletics: Benefits of Different Types of Creatine for Women, Vegans, and Clinical Populations—A Narrative Review. Nutrients 17, 95 (2024).

​20. Kreider, R. B., Jäger, R. & Purpura, M. Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review. Nutrients 14, 1035 (2022).

​21. Antonio, J. et al. Part II. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J. Int. Soc. Sports Nutr. 22, (2025).

​22. Garcia, M. P. et al. Safety of long-term creatine supplementation in women’s football players: a real-world in-season study. J. Int. Soc. Sports Nutr. 22, (2025).

​ ​

April is Parkinson’s Awareness Month — a time to reflect on the growing impact of this disease and what we’re learning about it.

Parkinson’s develops as the brain loses dopamine-producing cells, especially in a region called the substantia nigra. Because dopamine drives movement, motivation, and mood, this loss affects nearly every part of daily life.

Since Parkinson’s has become the fastest growing neurodegenerative disease, researchers are expanding their search, asking: what unique factors are driving this disease?

Increasingly, attention is turning to environmental exposures — from pesticides and industrial chemicals to the way our food is produced. In many cases, it’s not just what we eat, but how that food is grown and processed. For example, studies have linked higher consumption of low-fat dairy to increased Parkinson’s risk, pointing to a potential connection between food production, environmental inputs, and long-term brain health.

We can’t control every exposure. But we can become more intentional about the choices we make — especially when it comes to the foods we eat. In this edition of NeuroReviews, we break down the latest research on diet and Parkinson’s and how these choices may support prevention and management.

What Causes Parkinson’s Disease?

Only about 5-10% of Parkinson’s disease (PD) cases can be attributed to genetics as the major factor, while the remaining cases are “sporadic” and attributed to several risk factors (known and unknown).²

Toxic environmental exposure has a profound impact on PD, with exposure to pesticides and herbicides increasing the likelihood of developing the disease. One example of a specific chemical — trichloroethylene (TCE), a solvent commonly used for dry cleaning — has been associated with an increased risk.³

Be sure to check out Dr. Annie Fenn’s talk below with Dr. Ray Dorsey on the environmental impact on Parkinson’s disease, plus more preventative techniques.

Brain Health Kitchen

Preventing Parkinson's with Dr. Ray Dorsey

Hello brain health ambassadors! For today’s podcast episode I am joined by Dr. Ray Dorsey, co-author with Dr. Michael Okun of The Parkinson’s Plan: A New Path to Prevention and Treatment…

Listen now

4 months ago · 39 likes · 3 comments · Annie Fenn, MD

Severe head trauma, such as concussions, is another factor that increases Parkinson’s risk by 50%.⁴

Additionally, there is one very common risk factor that many of us share: diet.

Renowned neurologist and researcher, Dr. Matthew Phillips, has spearheaded the understanding of how our diets stand out as a major modifiable factor that can significantly impact disease risk, whether you’re looking to manage Parkinson’s disease or help prevent it. And the research continues to mount, suggesting our diets are pivotal in disease prevention, let alone overall cognitive health.

This naturally leads us to ask: what dietary choices should I make?

How Diet Influences Risk and Progression

As we cover in a separate article, metabolic health can play a significant role in the risk of developing Parkinson’s disease (and managing its symptoms). Another intriguing perspective lays in our mitochondrial function, where mitochondrial dysfunction has now been named a hallmark of PD.⁵

Mitochondria are the little organelles floating inside our cells that produce energy to power our cells, which is crucial to our health and survival!

Both metabolic and mitochondrial health are heavily influenced by our dietary habits and choices.

The foods we consume provide the nutrients, vitamins, and minerals necessary for cellular metabolism (all essential chemical processes in cells) and energy production.

Therefore, how and what we choose to eat can significantly impact brain cells and other cells (such as in the gut) that contribute to the risk of developing Parkinson’s disease or its progression.

10 Dietary Strategies That May Help Prevent and Manage Parkinson’s

Start With Your Overall Eating Pattern

The Western diet, often called the Standard American Diet (SAD), is a major risk factor for neurodegenerative diseases like Parkinson’s.

For those of us living in the United States, almost all of us are on the SAD to some extent.

The SAD is high in excess calories, saturated fats, and sugars, while low in healthy fats and fiber — think ultra-processed foods.⁶

Given its detrimental effects, it is imperative to explore healthier dietary patterns that aim to prevent and alleviate Parkinson’s disease risk and symptoms.

As neurologist and researcher Zoltan Mari, M.D., explains:

“Looking at Parkinson’s disease from a metabolic perspective is an exciting research area and no longer a fringe idea. The NIH and other researcher groups are actively investigating metabolic approaches and dietary interventions as an extension of how we treat, reduce risk, and potentially even prevent Parkinson’s.

Diet and nutrition are critical to our metabolic health, and it can go one of two ways. Diet can either sabotage our health, or it can serve as a very potent tool for its improvement. Our daily choices and the tools we use will dictate the trajectory it takes.”

Zoltan Mari, M.D. — Lou Ruvo Center for Brain Health, NeuroReserve Medical Advisor

So, how do we know what is considered a “healthy dietary pattern”?

A healthy dietary pattern simply means any eating style that research is showing can help people live longer and have better health and quality of life.⁷

The following are three dietary patterns that have shown to assist in Parkinson’s prevention and management.

1. The Mediterranean Diet (MeDi)

An anti-inflammatory foundation for brain health

The MeDi has long been recommended for many health conditions, so it’s no surprise that it has been ranked as the #1 diet for the 6^th year in a row.⁸

It’s characterized by a diverse blend of fresh vegetables and fruits, fish, whole grains, legumes, seeds, and nuts, as well as a high intake of extra virgin olive oil — particularly, polyphenol-rich extra virgin olive oil, such as BHK EVOO. This dietary pattern also recommends lower consumption of red meat and saturated fats (such as from fast food and packaged snacks).

The MeDi is rich in vitamins, omega-3 fatty acids, polyphenols, and antioxidants, which also have potent anti-inflammatory properties.

Studies have shown that those who eat most closely to the MeDi, have about a 25% risk reduction of Parkinson’s disease with an even stronger 33% lower probability of developing prodromal (pre-symptomatic) PD.⁹

2. Green Mediterranean Diet

A more plant-forward approach with added benefits

The Green MeDi diet, as its name implies, draws inspiration from the traditional MeDi while placing a greater emphasis on plant-based foods. The Green MeDi also incorporates tea as a foundational component.

Research shows that embracing a plant-based dietary approach like the Green MeDi may lower risk of developing Parkinson’s disease by 22%.¹⁰

3. The MIND Diet

A targeted approach for protecting the brain

The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) is a unique fusion of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets.

DASH is an eating plan specifically designed to lower blood pressure through dietary modifications. The MIND diet takes a more targeted approach by focusing on foods that are particularly beneficial for brain health — such as dark green leafy vegetables and berries.

Studies have found that adhering to the MIND diet is associated with up to 42% lower risk of incident Parkinsonism (symptoms related to Parkinson’s) and progression.¹¹

Most recently, a 2026 study highlighted up to 25% lower risk of developing PD specifically in women under the age of 71 through adherence to MIND and Mediterranean patterns of eating, with legumes and a high unsaturated-to-saturated fat ratio offering the strongest protective effects.¹²

This way of eating also naturally provides essential nutrients involved in brain cell protection and repair, such as folate, vitamin B12, and B6. Another recent study highlights how these nutrients may help reduce Parkinson’s risk, with a 17-29% risk reduction in those with higher intake — particularly in individuals at high genetic risk of developing PD.¹³

Nutritional supplements, such as RELEVATE, provide brain-supportive nutrients and help bridge the gap between eating well and staying consistent.

4. Adding a Ketogenic Approach

Supporting energy, mitochondria, and inflammation

Building upon the strategies discussed above, you can further consider integrating ketogenic approaches into any one of these diets.

Ketogenic approaches are characterized by low-carbohydrate, high-fat compositions, which induce a state of “fasting” and “ketosis,” where the body produces ketone bodies from fat as an energy source, instead of using carbohydrates.

Ketone bodies not only serve as fuel, but they also promote resistance to oxidative and inflammatory stress, as well as improve the health of mitochondria.¹⁴

A randomized controlled trial (RCT) indicated that individuals with Parkinson’s adhering to a ketogenic approach experienced a 41% improvement in various non-motor symptoms, including urinary problems, pain, fatigue, daytime sleepiness, and cognitive impairment.¹⁵

Furthermore, a 2025 review suggested that a ketogenic approach may improve non-motor symptoms through anti-inflammatory effects, enhanced mitochondrial function, and changes in the gut microbiome.¹⁶

While ketogenic approaches typically emphasize higher fat intake as a fuel source, it’s important to note that the kind of fat we eat is important. Healthy monounsaturated fats from extra virgin olive oil and avocado oil or polyunsaturated fats such as omega-3s are great options.

Here are a couple of low-carb, high-fat ways to start implementing a keto approach to your diet:

• Choose leafy greens and other vegetables as your grain’s replacement.

• Snack on hard boiled eggs, olives, nuts, seeds, and other low carb options.

• For a sweet treat, eat some berries, or explore alternative sugar substitutes, like monk fruit sweetener or date sugar.

If you want to learn more about how to practice a ketogenic approach to a brain-healthy diet, let us know and we’ll write more about it!

5. Time-Restricted Eating (Fasting Windows)

Helping your body shift into repair mode

Another strategy gaining attention is time-restricted eating, which involves setting a daily window of time where no food is consumed.

Typically, this fasting period lasts 12 hours or more (often overnight), allowing the body to enter a “fasted” state and begin a “switchover” from using carbohydrates to ketone bodies for fuel.¹⁷

As we previously mentioned, mitochondrial dysfunction is a primary factor in Parkinson’s disease. Time-restricted eating may help address this issue by giving mitochondria the opportunity to rest, potentially slowing the pathology, symptoms, and cognitive decline associated with Parkinson’s.

Fasting periods can range from 12 to 18 hours daily, or up to a full 24 hours every other day, with normal eating patterns on alternate days.¹⁸

Entering a “fasted” state boosts ketone bodies, providing brain cells with an alternative energy source and helping to overcome brain insulin resistance, which is common in Parkinson’s patients. This can also trigger BDNF (which supports the creation of new brain cells), reduce inflammation, and promote beneficial genetic changes. Crucially, it may help restore mitochondria.¹⁹

New research reveals that the type of protein consumed while following a time-restricted eating schedule may also matter. Specifically, plant-based protein such as soy (which is often emphasized in plant-forward diets like the Green Mediterranean Diet) may support dopamine levels and help reduce inflammation by increasing beneficial bacteria in the gut — an area of growing interest in Parkinsons’s disease management.²⁰

Additions for Your Parkinson’s Pantry

Now that we’ve explored various dietary approaches, let’s zero in on specific foods and nutrients that can be particularly beneficial for Parkinson’s prevention and symptom management.

6. Polyphenol- and Flavonoid-Rich Foods

Powerful compounds that protect brain cells

Polyphenols and flavonoids have gained attention for their significant role in protecting brain health. Known for their antioxidant and anti-inflammatory properties, these plant compounds can powerfully support Parkinson’s prevention and management.

Your morning drink of choice may be contributing to brain health more than you think. Green tea contains high levels of catechin-rich polyphenols, which have been shown to reduce dopamine loss.²¹

Additionally, studies have shown that drinking coffee daily, even during mid-life, can reduce the risk of developing Parkinson’s disease by 80% compared to non-coffee drinkers; the caffeine in coffee is suspected to be the active compound.²²

Coffee (and the caffeine in it) may be achieving this by reducing brain cell inflammation, keeping the blood-brain barrier strong, and lowering the loss of certain brain cells connected to dopamine.²²

Berries — especially blueberries, blackberries, and strawberries— are another rich source of brain-supportive compounds, particularly flavonoids. Berries contain flavonoids such as anthocyanins, quercetin, and catechins, which have implications on Parkinson’s disease.²³

Research indicates that individuals who consume high levels of flavonoids are 40% less likely to develop Parkinson’s.²⁴

7. Fiber (and Gut Health)

Supporting the gut-brain connection

Fiber is essential for smooth digestion, and it plays a surprising role in Parkinson’s disease and prevention.

Beyond alleviating common gut issues like constipation — which is common in Parkinson’s patients — it offers another powerful effect.

Fiber can increase the production of short-chain fatty acids (SCFAs) in the gut by feeding certain types of bacteria. In fact, one of these SCFAs, called propionate, has recently been shown as a potentially potent protector of intestinal energy that fights Parkinson’s disease-related neurodegeneration.²⁵

A specific type of fiber called resistant starch has also shown particularly promising results in PD management.

A 2025 study of patients with Parkinson’s discovered that long-term resistant starch intake increased beneficial bacteria and SCFAs while reducing inflammation — which led to improvements in PD symptoms and quality of life.²⁶

Foods containing resistant starch include legumes, lentils, oats, green bananas, and cooked and cooled potatoes.

8. Nuts and Vitamin E

The protective potential of antioxidant vitamins

Next time you reach for a handful of trail mix, know that you’re not just snacking on the go, but also lowering your risk of Parkinson’s.

The nuts in trail mix contain a high amount of Vitamin E, which can contribute to protection against Parkinson’s disease.

In fact, a study found that people who consumed the most Vitamin E had a 32% lower risk of Parkinson’s disease.²⁷

Vitamin E activates cellular pathways involved in antioxidant, detoxifying, and anti-inflammatory responses, while also promoting energy production at the mitochondrial level.²⁸

9. Rethinking Dairy Intake

Why moderation matters

Dairy products are often considered a part of a healthy diet due to their benefits for bones, muscles, immunity, and more. However, recent research has explored its connection to Parkinson’s disease, suggesting higher intake may increase risk.

More specifically, a high consumption of low-fat dairy foods was associated with 30% increased PD risk, and the overall association was stronger in men than women.²⁹

This link may not be about dairy alone. It could reflect how these foods are processed or broader environmental exposures within the food system — an area researchers are continuing to explore.

This does not mean you should eliminate dairy from your diet; it just highlights the importance of moderation, especially if you have other risk factors for Parkinson’s disease.

Consider emphasizing plant-based alternatives as well as the other protective foods discussed throughout this article.

10. Timing Meals Around Medications

Supporting the efficacy of treatments

If you’ve already been diagnosed with Parkinson’s disease, following the dietary recommendations mentioned earlier can still be helpful. However, there are additional factors to consider, especially when it comes to timing meals around medication.

Levodopa, a common Parkinson’s medication, is typically taken multiple times a day and is recommended 30 minutes before or 1-2 hours after eating.³⁰ This makes meal timing a crucial part of optimizing treatment and nutrition.

Additionally, it’s important to pay attention to the composition of your meals.

Heavy protein meals can lead to what’s known as the “protein effect,” where dietary protein interferes with the absorption of levodopa.³⁰ This occurs because levodopa and dietary protein both share similar amino acids for transport into the bloodstream and brain, and in some cases, there aren’t enough transporters to go around.³⁰

Being mindful of meal timing and protein intake can therefore help support the effectiveness of your medication.⁷

The journey to lifelong brain health can be approached with leaps or small steps. But if you commit to it wholeheartedly, progress is inevitable.

So, take that first step and keep moving forward with determination — every effort counts on the path toward a healthier brain, brighter future, and better quality of life.

This article is part of NeuroReviews — our series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References

1. Understanding Parkinson’s | Parkinson’s Foundation. (n.d.). Retrieved March 24, 2024, from https://www.parkinson.org/understanding-parkinsons

2. Jia, F., Fellner, A., & Kumar, K. R. (2022). Monogenic Parkinson’s Disease: Genotype, Phenotype, Pathophysiology, and Genetic Testing. Genes, 13(3). https://doi.org/10.3390/GENES13030471

3. Hancock, D. B., Martin, E. R., Mayhew, G. M., Stajich, J. M., Jewett, R., Stacy, M. A., Scott, B. L., Vance, J. M., & Scott, W. K. (2008). Pesticide exposure and risk of Parkinson’s disease: A family-based case-control study. BMC Neurology, 8, 6. https://doi.org/10.1186/1471-2377-8-6

4. Rugbjerg, K., Ritz, B., Korbo, L., Martinussen, N., & Olsen, J. H. (2008). Risk of Parkinson’s disease after hospital contact for head injury: population based case-control study. The BMJ, 337(7685), 34–36. https://doi.org/10.1136/BMJ.A2494

5. Henrich, M. T., Oertel, W. H., Surmeier, D. J., & Geibl, F. F. (2023). Mitochondrial dysfunction in Parkinson’s disease – a key disease hallmark with therapeutic potential. Molecular Neurodegeneration 2023 18:1, 18(1), 1–20. https://doi.org/10.1186/S13024-023-00676-7

6. Jackson, A., Forsyth, C. B., Shaikh, M., Voigt, R. M., Engen, P. A., Ramirez, V., & Keshavarzian, A. (2019). Diet in Parkinson’s Disease: Critical Role for the Microbiome. Frontiers in Neurology, 10, 489352. https://doi.org/10.3389/FNEUR.2019.01245/BIBTEX

7. Knight, E., Geetha, T., Burnett, D., & Babu, J. R. (2022). The Role of Diet and Dietary Patterns in Parkinson’s Disease. Nutrients, 14(21). https://doi.org/10.3390/NU14214472

8. Burdeos, R. L. J. Top Expert-Recommended Diets Overall. U.S. News and World Report https://health.usnews.com/best-diet/best-diets-overall (2026).

9. Zhao, J., Peng, Y., Lin, Z. & Gong, Y. Association between Mediterranean diet adherence and Parkinson’s disease: a systematic review and meta-analysis. J. Nutr. Health Aging 29, 100451 (2025).

10. Tresserra-Rimbau, A., Thompson, A. S., Bondonno, N., Jennings, A., Kühn, T., & Cassidy, A. (2023). Plant-Based Dietary Patterns and Parkinson’s Disease: A Prospective Analysis of the UK Biobank. Movement Disorders, 38(11), 1994–2004. https://doi.org/10.1002/MDS.29580

11. Agarwal, P., Wang, Y., Buchman, A. S., Holland, T. M., Bennett, D. A., & Morris, M. C. (2018). MIND Diet Associated with Reduced Incidence and Delayed Progression of Parkinsonism in Old Age. The Journal of Nutrition, Health & Aging, 22(10), 1211–1215. https://doi.org/10.1007/s12603-018-1094-5

12. Hajji‐Louati, M. et al. Adherence to the Mediterranean and Mediterranean‐Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay ( <scp>MIND</scp> ) Diets and Parkinson’s Disease Incidence in Women: Results from the Prospective <scp>E3N</scp> Cohort. Ann. Neurol. 99, 1014–1029 (2026).

13. Tao, J. et al. Dietary One‑Carbon Nutrients and Genetic Risk in Parkinson’s Disease: A Prospective Cohort Study. J. Gerontol. A Biol. Sci. Med. Sci. https://doi.org/10.1093/gerona/glag048 (2026) doi:10.1093/gerona/glag048.

14. Kolb, H., Kempf, K., Röhling, M., Lenzen-Schulte, M., Schloot, N. C., & Martin, S. (2021). Ketone bodies: from enemy to friend and guardian angel. BMC Medicine 2021 19:1, 19(1), 1–15. https://doi.org/10.1186/S12916-021-02185-0

15. Phillips, Matthew C L et al. “Low-fat versus ketogenic diet in Parkinson’s disease: A pilot randomized controlled trial.” Movement disorders : official journal of the Movement Disorder Society vol. 33,8 (2018): 1306-1314. doi:10.1002/mds.27390

16. Pokora, B., Pokora, K., Binienda, A. & Fichna, J. The ketogenic diet in Parkinson’s disease: a potential therapeutic strategy. Pharmacological Reports 77, 1491–1513 (2025).

17. Moon, S., Kang, J., Kim, S. H., Chung, H. S., Kim, Y. J., Yu, J. M., Cho, S. T., Oh, C. M., & Kim, T. (2020). Beneficial Effects of Time-Restricted Eating on Metabolic Diseases: A Systemic Review and Meta-Analysis. Nutrients 2020, Vol. 12, Page 1267, 12(5), 1267. https://doi.org/10.3390/NU12051267

18. Neth, Bryan J et al. “The Role of Intermittent Fasting in Parkinson’s Disease.” Frontiers in neurology vol. 12 682184. 1 Jun. 2021, doi:10.3389/fneur.2021.682184

19. Parkinson’s Disease- Dr Matthew Phillips: Fasting & Dietary Strategies as Parkinson’s Therapies - YouTube. (n.d.). Retrieved March 24, 2024, from

20. Li, T. et al. Neuroprotective Effects of Time‐Restricted Feeding Combined With Different Protein Sources in MPTP‐Induced Parkinson’s Disease Mice Model and Its Modulatory Impact on Gut Microbiota Metabolism. Advanced Science 13, (2026).

21. Afzal, Obaid et al. “Green Tea Catechins Attenuate Neurodegenerative Diseases and Cognitive Deficits.” Molecules (Basel, Switzerland) vol. 27,21 7604. 6 Nov. 2022, doi:10.3390/molecules27217604

22. Ren, Xiangpeng, and Jiang-Fan Chen. “Caffeine and Parkinson’s Disease: Multiple Benefits and Emerging Mechanisms.” Frontiers in neuroscience vol. 14 602697. 17 Dec. 2020, doi:10.3389/fnins.2020.602697

23. Gao, X et al. “Habitual intake of dietary flavonoids and risk of Parkinson disease.” Neurology vol. 78,15 (2012): 1138-45. doi:10.1212/WNL.0b013e31824f7fc4

24. Eating berries may protect against Parkinson’s disease | News | Harvard T.H. Chan School of Public Health. (n.d.). Retrieved March 25, 2024, from https://www.hsph.harvard.edu/news/hsph-in-the-news/parkinsons-disease-berries-gao/

25. Wang, C., Yang, M., Liu, D., & Zheng, C. (2024). Metabolic rescue of α-synuclein-induced neurodegeneration through propionate supplementation and intestine-neuron signaling in C. elegans. Cell Reports, 43(3), 113865. https://doi.org/10.1016/j.celrep.2024.113865

26. Petrov, V. A. et al. Resistant starch improves Parkinson’s disease symptoms through restructuring of the gut microbiome and modulating inflammation. Brain Behav. Immun. 132, 106217 (2026).

27. Hantikainen, E., Trolle Lagerros, Y., Ye, W., Serafini, M., Adami, H. O., Bellocco, R., & Bonn, S. (2021). Dietary Antioxidants and the Risk of Parkinson Disease: The Swedish National March Cohort. Neurology, 96(6), E895–E903. https://doi.org/10.1212/WNL.0000000000011373

28. Schirinzi, Tommaso et al. “Dietary Vitamin E as a Protective Factor for Parkinson’s Disease: Clinical and Experimental Evidence.” Frontiers in neurology vol. 10 148. 26 Feb. 2019, doi:10.3389/fneur.2019.00148

29. Akhlaghi, M., Foshati, S., Hashemi Moghaddam, F., Sasani, M. R. & Kazemi, A. Foods and Dietary Intakes and the Risk of Parkinson’s Disease: A Systematic Review and Dose–Response Meta-analysis of Prospective Cohort Studies. Nutr. Rev. https://doi.org/10.1093/nutrit/nuaf224 (2025) doi:10.1093/nutrit/nuaf224.

30. Levodopa Food Interactions & What to Avoid | APDA. (n.d.). Retrieved March 25, 2024, from https://www.apdaparkinson.org/article/levodopa-dosing-and-food-intake/

As you may know, the Mediterranean and MIND diets are consistently and powerfully linked to better cognitive function — from everyday mental clarity to long-term neuroprotection. And a central component of both diets is extra virgin olive oil (EVOO).

Traditionally regarded as a “medicinal food,” EVOO has been used for centuries to support a range of health concerns.¹ Today, research points to the brain benefits of EVOO with high-polyphenol content, compounds known for their powerful antioxidant and anti-inflammatory effects.

High-quality EVOO can contain more than 30 identified polyphenols, including oleocanthal, hydroxytyrosol, and oleuropein, that have been studied for their brain-protective benefits.² And they’re delicious — with a wide variety of flavor profiles and countless ways to improve the taste and health of what we eat.

In this week’s article for NeuroReviews, we explore the science behind olive oil polyphenols, how they benefit the brain, and what exactly to look for when choosing a high-quality extra virgin olive oil.

Understanding Polyphenols: What Are They?

Polyphenols are natural plant compounds celebrated for their protective and health-boosting properties.

Polyphenols can be found in foods such as tea, chocolate, fruits, and vegetables, each offering unique nutrients that contribute to overall wellness. These compounds fall into two main groups: flavonoids and non-flavonoids.

Flavonoids include compounds like quercetin, myricetin, and kaempferol, apigenin, as well as anthocyanins and catechins, which are all known for their health-supportive effects.³ These are widely present in colorful fruits and vegetables. Acting as powerful antioxidants, these compounds help to reduce inflammation and protect cells, including those in the brain.

In EVOO alone, there’s a wealth of flavonoid and non-flavonoid polyphenol compounds that not only support brain health but have also been studied for their potential in lowering risks of cardiovascular disease, neurodegenerative conditions, cancer, and obesity.⁴

The Brain Health Benefits of Olive Oil Polyphenols

EVOO contains a variety of polyphenols, which offer numerous health benefits.

Some of these compounds help reduce inflammation, combat oxidative stress, and even restore blood-brain barrier function, potentially improving cognitive function and reducing brain amyloid-β and tau-related pathologies that are linked to neurodegenerative diseases.

Studies have also shown that those who consume EVOO daily have a 28% lower risk of dying from dementia compared to those who rarely or never use olive oil.⁵

Let’s explore the key polyphenols that give EVOO its highly deserved appreciation for brain health.

Oleocanthal

Non-Flavonoid

Have you ever noticed a tingling or burning sensation at the back of your throat when tasting a high-quality EVOO? That is a key indication that oleocanthal is present.

This powerhouse polyphenol offers potent anti-inflammatory and neuroprotective properties — in addition to giving EVOO its bold flavor.² Recent research even shows oleocanthal’s ability to enhance the clearance of amyloid-beta (Aβ) plaques (which are linked to neurodegenerative conditions like Alzheimer’s disease) by supporting blood–brain barrier transport systems and maintaining blood–brain barrier integrity.⁶

These effects make oleocanthal one of the most potent natural defenders against neurodegenerative disease.

Apigenin

Flavonoid

Apigenin in EVOO helps protect brain health by supporting brain cells, reducing inflammation, and boosting BDNF, which is essential for brain cell growth.

Research shows apigenin can enhance memory and may benefit neurodegenerative conditions like Parkinson’s and Alzheimer’s.⁷

Luteolin

Flavonoid

Luteolin in EVOO supports brain health by reducing inflammation, oxidative stress, and cell damage.

It may also help prevent the buildup of harmful Aβ plaques and support brain cell growth, which can be especially beneficial in neurodegenerative conditions.⁸

Oleuropein & Hydroxytyrosol

Non-Flavonoids

EVOO compounds oleuropein and hydroxytyrosol are powerful antioxidants, protecting cells from oxidative stress, inflammation, and damage.

This antioxidant action is key for guarding against neurodegenerative diseases, cardiovascular disease, diabetes, and metabolic syndrome.

These compounds act by scavenging free radicals and stabilizing harmful molecules, which helps prevent the oxidation of LDL cholesterol, leading to improved blood flow to the brain.⁹

Tyrosol

Non-Flavonoid

Tyrosol in EVOO has been shown to specifically help with Parkinson’s disease.

Studies found that tyrosol significantly reduced toxic protein aggregates linked to Parkinson’s and delayed the onset of neurodegeneration.¹⁰

Now that you know the powerful benefits of including quality extra virgin olive oil in your diet, it’s important to learn how to spot the best ones for maximum health benefits.

How to Choose a High-Quality Extra Virgin Olive Oil

Among the hundreds of extra virgin olive oils available on the market, it can be overwhelming to choose the right one.

To get a better understanding of what to look for when choosing a high-quality olive oil, it helps to look at what age-old olive oil farms in regions like Tuscany have done right for centuries — and how today’s most advanced producers are blending tradition with innovation to create oils that are both delicious and exceptionally rich in nutrients.

From careful varietal selection to proper storage, every step in the EVOO-making process matters.

Let’s explore the key factors that affect the quality, flavor, and polyphenol content of olive oil.

1. Olive Varietal (Cultivar)

When it comes to extra virgin olive oil, the olive varietal, or cultivar, makes a big difference in both taste and nutrition.

Cultivars are essentially different types of olives, each with their own genetic makeup. They influence the oil’s aroma, flavor profile, and its polyphenol content.

That’s because different cultivars naturally contain different levels and types of polyphenols. Some varieties, like Arbequina, are favored for their mild flavor but tend to be lower in polyphenols.

Meanwhile, cultivars like Leccino, Moraiolo, and Frantoio are known for their high polyphenol content, especially when harvested early.

These traditional Tuscan varieties are rich in key polyphenols, such as oleuropein, hydroxytyrosol, and oleocanthal, and contribute to the robust, peppery flavor that indicates freshness and potency.¹¹

On the other hand, not all olive varieties offer the same benefits, especially if harvested later in the season to achieve a milder flavor. These oils may still be labeled “extra virgin,” but they won’t offer the same nutrition.

When it comes to long-term brain health, the type of olive and how it’s grown matter.

2. Growing and Harvesting Methods

However, cultivar alone doesn’t determine polyphenol content — irrigation and harvesting practices play a crucial role, too.

As indicated just above, early-harvest olives that are still green in color can contain six times more polyphenols than those harvested later in the season when fully ripe.¹²

Growing conditions make an impact as well.

Healthy soil and avoidance of synthetic nitrogen fertilizers help preserve antioxidant levels in the final product.¹¹ That’s why it’s important to focus not only on the type of olive, but also on how they’re grown and when they’re harvested.

High-quality extra virgin olive oils are typically sourced from estates that prioritize both traditional growing and pressing methods as well as the latest innovations in organic farming. They choose olive varieties known for their flavor, nutrient density, and polyphenol content, while maintaining strict quality standards throughout cultivation.

The result is a polyphenol-rich EVOO rooted in tradition and enhanced by modern innovations.

3. Extraction Method

This process begins immediately as olives are harvested — the quicker and more careful the process, the more polyphenols and delicate nutrients are preserved.

A mechanical cold-pressing method, without added heat or chemicals, is one of the most effective methods for maintaining a smooth flavor and health-promoting properties.

This is how it works:

Cleaning and Preparation

The olives are passed through machines to gently remove leaves and other debris before being washed with fresh water.

Crushing

Then, a hammer mill crusher pulverizes the olives and forces them through a screen. The screen size varies depending on the olive varietal, moisture content, and other factors.

Malaxation

The resulting paste is then gently kneaded in a machine called a malaxer, which encourages the oil droplets to coalesce and aids in separating the oil droplets from the paste.

It is common for mills making EVOO to heat the paste to 84°F (27°C) and process it for up to two hours. However, higher-quality producers will not add any heat, and the process is limited to 30–45 minutes.

This helps retain polyphenols and other aromatic compounds critical for flavor and health benefits.

Separation and Filtration

After malaxation, the paste is then processed through two centrifuges: one to extract the oil and another to clarify it by removing water.

While extremely fresh, unfiltered oil may have higher polyphenol levels; its sediment can cause fermentation and spoilage, which ultimately reduces polyphenol levels after a few months. This can be prevented if the EVOO is filtered and immediately blanketed with nitrogen to remove any oxygen.

4. Storage and Packaging

Proper storage is critical to maintaining the freshness and health benefits of olive oil.

After filtration, high-quality extra virgin olive oil is typically stored in sealed, climate-controlled stainless-steel tins to help preserve delicate flavor compounds and slow oxidation. Some producers use nitrogen gas to eliminate oxygen from the oil and its headspace, further protecting against degradation over time.

When it’s time for packaging, careful handling in small batches can help maintain freshness and reduce the chance of spoilage. Oils stored in light-blocking containers, such as stainless steel, best preserve the flavor and nutritional value of the oil.

5. Shelf Life and Age

Olive oil is considered extra virgin for 2 years after harvest, but its quality over that time is heavily influenced by storage factors involving temperature and exposure to oxygen and farming and milling practices:

Harvest and Milling Practices

Rapid milling after harvest reduces enzymatic breakdown and fermentation, extending freshness.

Farming Practices

Excessive irrigation, overuse of nitrogen fertilizer, and poor soil health can reduce the oil’s antioxidant levels and directly impact shelf life.

Storage Conditions

Storing oil in cool, dark conditions with minimal oxygen exposure preserves freshness.

6. What to Look for in a Good Extra Virgin Olive Oil

Not all olive oils are created equal.

Polyphenols and Flavor

Flavor is another way to indicate an olive oil’s freshness and potency. High-polyphenol oils typically have a peppery, slightly bitter taste, especially in the back of the throat. So, if your olive oil tastes flat, it may be low in polyphenols or past its prime.

At the same time, balance is important. While high polyphenol content offers health benefits, excessively high levels can result in oils that are too bitter or astringent for regular use. The best oils will find the proper balance between flavor and function, because all the polyphenols in the world won’t do any good if the oil isn’t being used because it tastes bad.

Avoiding Defects

Many lower-cost oils labeled as “extra virgin” may not actually meet the standard of extra virgin. Common defects include:

• Rancidity: A waxy, crayon-like aroma or taste caused by oxidation.

• Fustiness: A result of anaerobic fermentation when olives are improperly stored before milling, producing off flavors similar to that of Kalamata olives.

7. Other Olive Oil Products That Are Not Extra Virgin

To help clarify product types, here are examples of oils that are not extra virgin:

• Pure Olive Oil: A blend of refined and virgin oils, with minimal flavor or health benefits.

• Light Olive Oil: Highly refined, with a neutral flavor and color, often used for high-heat cooking.

• Pomace Olive Oil: Made from the residue left after virgin oil extraction, refined and of much lower quality.

A Featured Example: Brain Health Kitchen Extra Virgin Olive Oil

For those looking to incorporate a high-quality extra virgin olive oil into their daily routine, Brain Health Kitchen Extra Virgin Olive Oil (BHK EVOO) is one example that reflects the best standards outlined above.

Developed in collaboration with Dr. Annie Fenn, founder of the Brain Health Kitchen, BHK EVOO is sourced from the Tuscan estate of Podere Ricavo. This award-winning estate in Siena, Italy follows organic and regenerative practices that best support soil health and naturally boost the antioxidant content of olives.

Each year brings a new harvest, because no two harvests are ever the same. Subtle shifts in climate and growing conditions create unique and delicious flavor profiles, while also preserving freshness and maximizing polyphenol potency. BHK EVOO’s latest 2025/2026 harvest captures this season’s distinct character and peak nutritional value. After selling out multiple times, BHK EVOO is back in stock and available for preorder.

This premium EVOO is:

• Organic and non-GMO

• Made from a curated blend of Leccino, Moraiolo, Frantoio, and Corregiola cultivars — iconic, high-polyphenol Tuscan cultivars

• Grown and pressed on an award-winning estate in Siena, Italy

• Cold-extracted and nitrogen-protected

• Packaged in 500 mL light-blocking stainless steel tins, filled in small batches for peak freshness

• Lab-tested confirming over 500 mg polyphenols per kilogram, qualifying it as a high-polyphenol EVOO, a category reserved for the most nutrient-rich olive oils on the market.

Including a high-quality extra virgin olive oil like BHK EVOO in your diet offers a simple and effective way to support your long-term brain health.

This article is part of NeuroReviews — a new series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References

1. (PDF) Potential health benefits and components of olive oil: An overview. https://www.researchgate.net/publication/346339068_Potential_health_benefits_and_components_of_olive_oil_An_overview.

2. Bucciantini, M., Leri, M., Nardiello, P., Casamenti, F. & Stefani, M. Olive Polyphenols: Antioxidant and Anti-Inflammatory Properties. Antioxidants 2021, Vol. 10, Page 1044 10, 1044 (2021).

3. Di Lorenzo, C., Colombo, F., Biella, S., Stockley, C. & Restani, P. Polyphenols and Human Health: The Role of Bioavailability. Nutrients 13, 273 (2021).

4. Cory, H., Passarelli, S., Szeto, J., Tamez, M. & Mattei, J. The Role of Polyphenols in Human Health and Food Systems: A Mini-Review. Front Nutr 5, 87 (2018).

5. Tessier, A. J. et al. Consumption of Olive Oil and Diet Quality and Risk of Dementia-Related Death. JAMA Netw Open 7, e2410021–e2410021 (2024).

6. Infante, R. et al. An Appraisal of the Oleocanthal-Rich Extra Virgin Olive Oil (EVOO) and Its Potential Anticancer and Neuroprotective Properties. Int J Mol Sci 24, 17323 (2023).

7. Charrière, K. et al. Exploring the Role of Apigenin in Neuroinflammation: Insights and Implications. International Journal of Molecular Sciences 2024, Vol. 25, Page 5041 25, 5041 (2024).

8. Jayawickreme, D. K. et al. Luteolin for neurodegenerative diseases: a review. Pharmacological Reports 2024 76:4 76, 644–664 (2024).

9. Bulotta, S. et al. Beneficial effects of the olive oil phenolic components oleuropein and hydroxytyrosol: Focus on protection against cardiovascular and metabolic diseases. J Transl Med 12, 1–9 (2014).

10. García-Moreno, J. C., Porta de la Riva, M., Martínez-Lara, E., Siles, E. & Cañuelo, A. Tyrosol, a simple phenol from EVOO, targets multiple pathogenic mechanisms of neurodegeneration in a C. elegans model of Parkinson’s disease. Neurobiol Aging 82, 60–68 (2019).

11. Vendrell Calatayud, M., Li, X., Brizzolara, S., Tonutti, P. & Wang, S. C. Storage effect on olive oil phenols: cultivar-specific responses. Front Nutr 11, 1382551 (2024).

12. Kılıç, T. & Koyuncu, G. Effect of early harvest on the aroma compounds and bioactive properties of natural olive oils. Harran Tarım ve Gıda Bilimleri Dergisi 28, 471–479 (2024).

The brain is one of the most energy-demanding organs in the body. Muscles can relax, but the brain is always “on” — thinking during the day, consolidating memories at night while we sleep. Its ability to function depends heavily on how well it obtains and uses fuel.

We don’t always think about this when we experience brain fog, forgetfulness, or mood changes; these can be signs of energy deprivation in the brain. Over time, energy deprivation can become an “energy crisis” that can significantly impact cognitive health.

The encouraging news is that brain energy is influenced by the choices we make every day — including how we eat, sleep, move, and manage stress. When these areas are supported, the brain ready to handle the fluctuations of daily energy demands and the overarching challenges of aging.

In this week’s article for NeuroReviews, we dive into the meaning of brain energy metabolism, what happens when it’s disrupted, and the most effective ways you can support a full charge.

The brain accounts for only about 2% of the body’s weight, yet it consumes roughly 20% of the body’s total energy.¹

That constant demand exists because the brain can’t store much fuel — meaning it must produce energy continuously and efficiently to support every mental function, such as forming memories, keeping focus, regulating mood, processing emotions, making decisions, and responding to stress.

How the brain produces, uses, and maintains fuel is known as brain energy metabolism.

Not only is it essential for day-to-day function, but it’s also crucial for long-term brain health as it directly influences neuronal plasticity (your brain’s ability to adapt, change, and reorganize itself) and the brain’s overall resilience as we age.²

What is Brain Energy and How Does it Work?

Nearly all of the brain’s usable energy comes from adenosine triphosphate (ATP), a molecule produced inside neurons and glial cells.

Because the brain uses ATP at an exceptionally fast rate, these cells must continuously generate it to keep essential processes running.

When ATP production falls short of demand, these essential processes may become less efficient — and research shows that lower ATP availability is associated with poorer cognitive performance.³

The brain produces ATP through several interconnected metabolic pathways:⁴

• Glycolysis: Breaks down glucose quickly to make small amounts of ATP.

• Oxidative phosphorylation: Occurs inside mitochondria, producing the majority of brain ATP.

• Phosphocreatine system: Acts as a backup system that rapidly regenerates ATP during moments of high demand.

Together, these systems allow the brain to respond to both everyday cognitive tasks and periods of intense mental work, but they rely on efficiency, which naturally changes with age.

Mitochondria become less flexible, oxidative stress increases, and the brain’s ability to generate ATP declines, contributing to slower processing, more mental fatigue, and reduced cognitive resilience.⁵

What Fuels the Brain? Glucose, Ketones, and More

The brain uses several forms of energy, each with unique advantages and roles.

Glucose is the brain’s primary energy source, especially for memory formation, focus, and the rapid firing of neurons.⁶

When glucose availability is low or metabolism becomes less efficient, the brain shifts into metabolic flexibility.

Ketones serve as an alternative energy source, supporting mitochondrial energy production during fasting, low-carbohydrate diets, or periods of impaired glucose uptake.⁶

Lactate, once considered a metabolic by-product, is now understood as an important brain fuel and signaling molecule. It supports neuroplasticity, improves stress responses, and plays a role in mood regulation.⁷ During exercise or higher demand, the brain can rely on lactate as an additional fuel source to maintain performance.

These processes can’t properly function without adequate oxygen and healthy blood flow, which are essential for mitochondrial ATP production.

Anything that improves blood flow, such as regular movement, high quality sleep, and stress management, can support the brain’s energy production.

Nutrition and overall metabolic health also determine how effectively the brain can access and use its fuel sources. A well-supported metabolism ultimately strengthens the brain’s energy capacity and may help protect against age-related cognitive decline.⁸

What Happens When Brain Energy Runs Low

When the brain lacks adequate or efficient energy, cognitive performance slips quickly.

Because neurons can’t store much fuel, any disruption — whether due to stress, insufficient sleep, aging mitochondria, gaps in nutrition, or poor glucose metabolism — can show up as changes in how we think or feel.

Common signs of low brain energy include:⁹

• Brain fog

• Mental fatigue

• Forgetfulness

• Difficulty focusing

• Headaches

• Trouble with problem-solving

• Light and noise sensitivity

• Poor stress tolerance

• Emotional instability

When the brain struggles to produce or use energy efficiently, chronic metabolic dysfunction can develop, which is linked to inflammation, oxidative stress, and accelerated brain aging.¹⁰

In many cases, early brain aging appears more metabolic than structural, meaning it may be responsive to nutrition, lifestyle, and targeted supplementation.¹¹

How to Recharge Your Brain: Lifestyle and Nutrition Strategies

Brain metabolism, like all aspects of cognitive health, is greatly influenced by our daily choices.

Notably, these habits are crucial for maintaining sufficient brain fuel:

Exercise and Brain Health

Regular physical activity is one of the strongest metabolic supports.

Exercise increases glucose delivery, improves blood flow, strengthens mitochondrial function, and raises lactate availability — providing the brain with more flexible fuel options.¹²

• Boost brain energy today with a brisk walk, cycle session, some light strength training, or a short home workout. Even modest movement can make a meaningful shift in energy metabolism.

Stress Management for Mental Clarity

Stress has a hand in everything — especially in depleting the brain’s energy!

Chronic stress elevates inflammatory signaling and disrupts mitochondrial function, forcing the brain to work harder to produce the same amount of ATP.¹³

• Maintain metabolic stability and promote clarity by practicing simple breathing techniques (such as the 4-7-8 method), scheduling downtime, and setting boundaries around work and other stressors. Remember, prioritizing your brain health is key to healthy living.

Sleep and Cognition

Unsurprisingly, the body’s natural time to recharge is also crucial for replenishing your brain’s battery.

Sleep restores energy balance by clearing metabolic waste products and assisting in glucose regulation.¹⁴

• Refresh your body and brain with small nightly improvements. Try going to bed 30 minutes earlier, establishing a relaxing sleep routine, or limiting nighttime screen use for a clear mind in the morning.

Nutrients for Cognitive Function

Food is fuel — and quality matters.

The Mediterranean and MIND diets support optimal brain energy by providing antioxidants, omega-3 fatty acids, polyphenols, B vitamins, magnesium, and other micronutrients vital to ATP production.

A 2024 study shows that following the Mediterranean diet for brain health can improve mitochondrial efficiency and restore ATP-linked energy production, reinforcing the idea that nutrition directly supports the body’s underlying energy systems.¹⁵

• Nourish your brain with foods like high quality extra virgin olive oil, fatty fish, leafy greens, legumes, berries, nuts, seeds, and whole grains as they provide the raw materials used to generate essential energy in the brain.

In addition to a brain-healthy diet, supplementation offers a nutritional safety net for common gaps. Look for supplements (such as RELEVATE) that include the key nutrients listed above.

Creatine’s Emerging Role in Brain Energy

Creatine has long been known for its muscle-building benefits, but studies are now exploring its exciting potential for cognitive health.

It plays a central role in the phosphocreatine system, in which ATP rapidly regenerates during periods of high demand.¹⁶

This becomes especially important for memory support, executive function, and any situation where the brain is under high demand — including stress, sleep loss, and intense mental workload.¹⁷

Creatine levels naturally decline with age, which may contribute to slower ATP recovery and reduced mental endurance.¹⁸

Research shows that older adults, who commonly have lower baseline levels, experience notable improvements in memory, cognitive performance, and mental fatigue with supplementation.¹⁹

Further studies suggest it can enhance cognitive performance during high-demand tasks, support mitochondrial efficiency, and encourage neuroprotection by stabilizing cellular energy during metabolic stress.^16,17

By strengthening rapid ATP regeneration and broader metabolic resilience, creatine helps bridge everyday mental performance with longer-term brain support.

Midlife adults, seniors, individuals with lower dietary intake, or anyone noticing more mental fatigue than usual can benefit by adding creatine to their diet.

The Takeaway: Protecting Your Brain’s Energy

Brain energy is the foundation of how we think, feel, and function. When ATP production is sufficient, the brain can support memory, mood, focus, and stress resilience — strong indications of cognitive health.

As we age, preserving that energy becomes increasingly important, and daily choices such as nutrition, movement, stress management, and sleep are key to maintaining healthy brain metabolism. In addition to these foundational habits, targeted support can make a meaningful difference.

Creatine is emerging as a powerful aid in sustaining rapid ATP production and protecting the brain during periods of higher demand. As research continues to expand, creatine’s role in cognitive support and healthy aging promises to become an even more exciting area of discovery.

This article is part of NeuroReviews — a new series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References:

1. Balasubramanian, V. Brain power. Proceedings of the National Academy of Sciences 118, (2021).

2. Watts, M. E., Pocock, R. & Claudianos, C. Brain Energy and Oxygen Metabolism: Emerging Role in Normal Function and Disease. Front Mol Neurosci 11, (2018).

3. Lopez, F. V. et al. Frontal adenosine triphosphate markers from 31P MRS are associated with cognitive performance in healthy older adults: preliminary findings. Front Aging Neurosci 15, (2023).

4. Rumpf, S., Sanal, N. & Marzano, M. Energy metabolic pathways in neuronal development and function. Oxford Open Neuroscience 2, (2023).

5. Bélanger, M., Allaman, I. & Magistretti, P. J. Brain Energy Metabolism: Focus on Astrocyte-Neuron Metabolic Cooperation. Cell Metab 14, 724–738 (2011).

6. Jensen, N. J., Wodschow, H. Z., Nilsson, M. & Rungby, J. Effects of Ketone Bodies on Brain Metabolism and Function in Neurodegenerative Diseases. Int J Mol Sci 21, 8767 (2020).

7. Cai, M. et al. Lactate Is Answerable for Brain Function and Treating Brain Diseases: Energy Substrates and Signal Molecule. Front Nutr 9, (2022).

8. Rae, C. D. et al. Brain energy metabolism: A roadmap for future research. J Neurochem 168, 910–954 (2024).

9. Kunasegaran, K. et al. Understanding mental fatigue and its detection: a comparative analysis of assessments and tools. PeerJ 11, e15744 (2023).

10. Yin, F., Sancheti, H., Patil, I. & Cadenas, E. Energy metabolism and inflammation in brain aging and Alzheimer’s disease. Free Radic Biol Med 100, 108–122 (2016).

11. Cunnane, S. C. et al. Brain energy rescue: an emerging therapeutic concept for neurodegenerative disorders of ageing. Nat Rev Drug Discov 19, 609–633 (2020).

12. Camandola, S. & Mattson, M. P. Brain metabolism in health, aging, and neurodegeneration. EMBO J 36, 1474–1492 (2017).

13. van der Kooij, M. A. The impact of chronic stress on energy metabolism. Molecular and Cellular Neuroscience 107, 103525 (2020).

14. St-Onge, M.-P. The Role of Sleep Duration in the Regulation of Energy Balance: Effects on Energy Intakes and Expenditure. Journal of Clinical Sleep Medicine 09, 73–80 (2013).

15. Segala, A. et al. A Mediterranean Diet-Oriented Intervention Rescues Impaired Blood Cell Bioenergetics in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease. Diagnostics 14, 2041 (2024).

16. Smith, R. N., Agharkar, A. S. & Gonzales, E. B. A review of creatine supplementation in age-related diseases: more than a supplement for athletes. F1000Res 3, 222 (2014).

17. Roschel, H., Gualano, B., Ostojic, S. M. & Rawson, E. S. Creatine Supplementation and Brain Health. Nutrients 13, 586 (2021).

18. Marshall, S., Kitzan, A., Wright, J., Bocicariu, L. & Nagamatsu, L. S. Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults. Nutr Rev https://doi.org/10.1093/nutrit/nuaf135 (2025) doi:10.1093/nutrit/nuaf135.

19. Prokopidis, K. et al. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev 81, 416–427 (2023).

The APOE4 gene variant has long been associated with an increased risk of Alzheimer’s disease, and ongoing research is diving into its nuances, investigating questions like how we can use it as a therapeutic target, how it interacts with menopause, and its oral health connections, just to name a few. There’s still so much to learn about this gene.

One thing to remember, especially if you carry one or two copies of APOE4: it does not guarantee an Alzheimer’s diagnosis, and lifestyle modifications are still the strongest protection against all forms of cognitive decline. APOE4 can be a “pliable” gene, and we must “bend it” to a healthier outcome. So it’s never too late to take meaningful steps to support your brain health, even with genetic predispositions.

In this installment of NeuroReviews, we’ll do a refresher on APOE4 with focus on what you can do to stay ahead of cognitive decline.

Recognized as a “risk gene,” APOE4 increases the likelihood of developing Alzheimer’s. Each person can carry up to two copies of APOE4. While carrying one copy may increase risk up to 3-4 times, carrying two copies may increase risk up to 10-15 times.¹

A 2024 study published in Nature Medicine explored the possibility that carrying two copies of APOE4 is more than just a risk factor and may represent a new genetic form of Alzheimer’s disease — similar to other genetic conditions, such as having Down syndrome or cystic fibrosis.²

But evidence indicates that carrying APOE4 does not guarantee a person will suffer from Alzheimer’s disease.¹

Proactive lifestyle and nutrition modifications can significantly reduce your risk of neurodegenerative disease and general age-related cognitive decline, including strategies that may be particularly important for APOE4 carriers. Read on to learn more.

Thomas Holland MD, from Rush University Medical Center, and NeuroReserve Medical Advisor shares an important note on decreasing neurodegenerative risk:

“Being a carrier of APOE4, regardless of if it’s one or two copies, confers an increased risk of developing Alzheimer’s disease. This does not mean you will develop Alzheimer’s disease. Gene-lifestyle interactions play a role. While we don’t fully understand these factors, we know that some lifestyle factors that have been associated with decreased risk regardless of APOE4 status include a brain healthy diet, regular exercise, and avoiding alcohol. These all play a large role for APOE4 carriers, and we strongly encourage these behaviors in our clinical practice and research.”

The good news is that the latest research into APOE4 brings greater awareness to it and creates more opportunities for dialogue and education about it among physicians, researchers, and the general public.

A Refresher on the APOE Gene

We’ve discussed APOE4 in detail previously here, but let’s have a quick refresher on what the APOE gene is and how it can impact your risk of Alzheimer’s.

APOE is the strongest and most prevalent genetic risk factor for Alzheimer’s disease.

The APOE gene contains the code to make a protein called apolipoprotein E, which moves fat throughout the body. Each person carries two copies of the APOE gene, one from each parent. The gene comes in three forms: APOE2, APOE3, and APOE4, resulting in six possible combinations: e2/e2, e2/e3, e2/e4, e3/e3, e3/e4, and e4/e4.

• The APOE2 form may decrease the risk of Alzheimer’s disease.

• APOE3, the most common form, is associated with an average risk.

• APOE4 is linked to an increased risk, as mentioned, with one copy raising the risk 3-4 times and two copies increasing it up to 15 times.³

Understanding the Biological Impacts of APOE4

APOE4 brings with it some unique biological impacts, including how our bodies process fats and cholesterols, neuroinflammation, blood brain barrier aging, insulin resistance, and amyloid beta “plaque” buildup in the brain.

Again, learn more by visiting our previous article here.

Those biological impacts can leave clues in our blood and other parts of our body, called biological markers. The recent Nature Medicine article focused primarily on the biological markers of APOE4 in the brain and cerebrospinal fluid (CSF, which is the fluid in the spinal cord and brain).

Biological markers are typically obtained through lab tests to measure substances in the body or analyze genetic material. However, diagnosing Alzheimer’s disease involves more than just biological tests; it also requires clinical assessments of symptoms, cognitive tests, and medical history.

It’s important to remember this difference between biological markers and fully diagnosed disease.

Analyzing Major Insights from the Nature Study on APOE4

A few major findings from the Nature Medicine article:

People who carry two copies of APOE4 start showing biological markers of Alzheimer’s disease at an earlier age than non-carriers, starting as early as age 55.

It also showed that by the time APOE4 double carriers turned 65 years old, almost all had abnormal levels of amyloid beta in their cerebrospinal fluid, and the vast majority (75%) had detectable levels of amyloid beta plaques in the brain through brain imaging scans.²

You may recall, amyloid beta plaques are a pathological “hallmark” of Alzheimer’s disease, though it is also not uncommon for people to have such plaques in their brain but not show any cognitive symptoms.

Regarding cognitive symptoms, another finding from the study is that people who carry two copies of APOE4 tend to be diagnosed earlier than non-carriers (i.e. people who carry two copies of APOE3), on average around 65 years old in showing cognitive symptoms.

However, it is important to note that this age of onset has a range with some showing symptoms earlier, while others show symptoms later.

The question is: what can cause these biological markers and cognitive symptoms to be delayed a little, by a lot, or even delayed indefinitely?

NeuroReserve Medical Advisor Dr. Annie Fenn shares her perspectives in her article, 21 Things You Can Do To Reduce the Risk of ApoE4.

Are Double APOE4 Carriers Guaranteed an Alzheimer’s Diagnosis?

The short answer: no.

The Nature Medicine study provides great new evidence that gives us a better idea regarding the sequence of when biological markers and symptoms may occur for APOE4 carriers.

However, as we mentioned earlier, developing Alzheimer’s involves many factors, and APOE4 carriers can take advantage of those other factors to bend the trajectory in their favor.

As an APOE4 carrier, it’s crucial to consider how proactive you are about reducing your risk. Lifestyle and nutrition are significant areas you can manage to influence your risk.

How to Proactively Lower Risk: Areas That Are Particularly Important for APOE4 Carriers

Certain dietary and lifestyle factors have a bigger effect on APOE4 carriers vs non-carriers, presenting a bigger opportunity for positive impact.

Exercise

Physical activity is very helpful for APOE4 carriers.

A 21-year study showed that midlife physical activity reduces the risk of Alzheimer’s in APOE4 carriers. It found that amyloid beta shares a sequence with insulin and binds to insulin receptors, increasing insulin resistance. Higher insulin resistance is linked to reduced Alzheimer’s-related brain function.

Physical activity decreases insulin resistance and lowers chronic inflammation, countering the harmful effects of amyloid beta.⁴

Managing Health Factors

The APOE4 gene doesn’t impact your brain in isolation; it also interacts with other health issues.

It’s particularly important for APOE4 carriers to manage hypertension and diabetes, as these may exacerbate the effects of APOE4.

Additionally, a study found that better cardiovascular health is linked to a lower risk of dementia for both APOE4 carriers and non-carriers. Interestingly, women were significantly impacted by their cardiovascular health status in relation to dementia risk, even in the presence of APOE4.

So, taking good care of the heart is often good for the brain.^{5, 6}

Restricting Alcohol Intake

APOE4 carriers must be especially careful about their alcohol consumption.

Even moderate drinking can raise low-density lipoprotein (LDL) levels, often referred to as “bad” cholesterol. Elevated LDL levels can increase the risk of Alzheimer’s disease by contributing to the buildup of harmful plaques in the brain.

Higher alcohol intake can lead to greater cognitive decline and an earlier onset of Alzheimer’s. To protect brain health, APOE4 carriers should limit alcohol as much as possible.⁷

Sleep

Sleep is the most precious time for your brain, as it’s during sleep that our brain can clear out and fight back against amyloid beta buildup.

Research suggests that older adults who sleep longer at night tend to have lower levels of amyloid beta buildup in their brains.

Making sure you have good sleep habits, checking for underlying sleep disorders, and aiming for 7-8 hours of sleep each night are non-negotiables for APOE4 carriers.

It’s important to note that getting 7-8 hours of continuous sleep is the key. Daytime naps have been associated with increased buildup of amyloid beta in the brain.⁵

Avoid Air Pollution if Possible

Keeping the air fresh around APOE4 carriers may be important.

There’s early and growing evidence of this, and in one study of people who had prolonged exposure to the debris from the September 11, 2001 World Trade Center attack, APOE4 carriers had higher risk of mild cognitive impairment.⁶

Nutrition

APOE4 carriers may benefit from specific nutrients that their brains either struggle to obtain in adequate amounts or that help offset the impact of APOE4. Here are a few that are recommended by researchers at Weill Cornell Medical Center for APOE4 carriers:⁸

B-vitamins

B-vitamin supplementation, especially B12, can improve homocysteine levels. Elevated homocysteine levels are associated with Alzheimer’s disease, particularly when linked with APOE4 status.

Lowering these levels is usually recommended as it can decrease APOE4 gene expression, which is important for cholesterol transport in the brain.

B-vitamin complex supplementation slowed brain atrophy, especially in individuals with high homocysteine and omega-3 levels. B-vitamins also work well with DHA, as they help support brain health by aiding DHA transport and utilization.

Omega-3’s (DHA)

Research indicates that people with Alzheimer’s disease typically have reduced levels of DHA in their brains, while diets high in DHA-rich fish (like salmon, mackeral, and sardines) are associated with lower rates of Alzheimer’s.

DHA possesses anti-inflammatory properties and enhances the function of microglia, especially significant for APOE4 carriers who might need elevated DHA intake to counter increased metabolism and possible challenges in delivering DHA to the brain.

Quercetin

This nutrient is an antioxidant found in onions and capers, has been shown to reduce the activity of MMP-9, an enzyme found in elevated amounts in the brains of Alzheimer’s sufferers.

The Mediterranean and MIND Diets

The Mediterranean dietary pattern includes the nutrients mentioned, plus others known to protect the brain and more.

Specifically, participants who ate the Mediterranean way most consistently had a 23% lower risk of developing dementia compared to those who ate it the least consistently.⁹

There are some wonderful resources to learn more about eating a Mediterranean-style, brain-healthy diet. We highly recommend Brain Health Kitchen with Dr. Annie Fenn and The Official MIND Diet by Laura Morris and Jennifer Ventrelle.

For additional support, consider a brain health supplement like RELEVATE — formulated based on the Mediterranean and MIND diets — to cover gaps in your diet and keep your brain sharp and strong.

The Takeaway

It’s encouraging to see ongoing research delving into various factors related to Alzheimer’s disease, reflecting a growing focus on this critical area.

However, it’s vital to view each study not in isolation but as part of a larger body of evidence. For people who carry two copies of APOE4, you should not interpret such findings as grounds for fear but rather as motivation to take proactive steps.

There’s still ample room to support brain health and change our individual risk.

So, rather than being alarmed and anxious, let this information inspire steady action and a commitment to lifelong brain health.

This article is part of NeuroReviews — a new series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

References

1. M. Di Battista, A., M. Heinsinger, N., & William Rebeck, G. (2016). Alzheimer’s Disease Genetic Risk Factor APOE-ε4 Also Affects Normal Brain Function. Current Alzheimer Research, 13(11), 1200. https://doi.org/10.2174/1567205013666160401115127

2. Fortea, J., et al. (2024). APOE4 homozygozity represents a distinct genetic form of Alzheimer’s disease. Nature Medicine 2024 30:5, 30(5), 1284–1291. https://doi.org/10.1038/s41591-024-02931-w

3. Alzheimer’s: Is it in your genes? - Mayo Clinic. (n.d.). Retrieved September 11, 2023, from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-genes/art-20046552

4. Jeon, S. Y., et al. (2020). Midlife Lifestyle Activities Moderate APOE ε4 Effect on in vivo Alzheimer’s Disease Pathologies. Frontiers in Aging Neuroscience, 12, 507310. https://doi.org/10.3389/FNAGI.2020.00042/BIBTEX\

5. Lee, M., et al. (2022). Education and Cardiovascular Health as Effect Modifiers of APOE ε4 on Dementia: The Atherosclerosis Risk in Communities Study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 77(6), 1199. https://doi.org/10.1093/GERONA/GLAB299.

6. Berkowitz, C. L., Mosconi, L., Rahman, A., Scheyer, O., Hristov, H., & Isaacson, R. S. (2018). Clinical Application of APOE in Alzheimer’s Prevention: A Precision Medicine Approach. The Journal of Prevention of Alzheimer’s Disease, 5(4), 245–252. https://doi.org/10.14283/JPAD.2018.35/METRICS

7. Angelopoulou, Efthalia et al. “APOE Genotype and Alzheimer’s Disease: The Influence of Lifestyle and Environmental Factors.” ACS chemical neuroscience vol. 12,15 (2021): 2749-2764. doi:10.1021/acschemneuro.1c00295

8. Norwitz, N. G., Saif, N., Ariza, I. E., & Isaacson, R. S. (2021). Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers. Nutrients, 13(4). https://doi.org/10.3390/NU13041362

9. Shannon, et al. (2023). Mediterranean diet adherence is associated with lower dementia risk, independent of genetic predisposition: findings from the UK Biobank prospective cohort study. BMC Medicine, 21(1), 1–13. https://doi.org/10.1186/S12916-023-02772-3/FIGURES/3

Welcome to MindFully Living, the Substack of NeuroReserve. NeuroReserve is a nutrition company focused on brain health and aging. Over the years, we’ve regularly written about the science, lifestyles, and nutrition that optimize cognitive and neurological health. We’d been looking for a place to share these long-form pieces and realized Substack offers an ideal platform for the greatest educational and community-building impact.

Our Substack is organized into three sections: Brain Waves, for quick reads and actionable ways to implement healthy habits; Brain Table, for delicious and easy brain-healthy cooking; and NeuroReviews, for deeper-dive articles. In this first edition of NeuroReviews, we explore the science of stress and the brain, along with practical ways nutrition and lifestyle choices can help strengthen long-lasting resilience.

We often accept stress as a normal part of daily life. In fact, stress can be beneficial in the right amounts, helping us grow and adapt. But when stress becomes chronic, it’s more than just a feeling — it’s a biological process that influences nearly every system in the body, especially the brain. Over time, persistent stress can impact memory, mood regulation, sleep quality, and long-term cognitive function.

We hope you enjoy learning more about how this works — and a few things you can do about it.

What Stress Actually Is (and Why It’s Necessary)

Stress is the body’s natural response to life’s challenges, big or small, triggering the release of hormones like cortisol and adrenaline as part of the “fight-or-flight” mechanism.

While this system is critical in short bursts to handle immediate threats — such as avoiding danger — it becomes detrimental when activated repeatedly due to ongoing pressures like work demands, family issues, or health challenges. Even seemingly minor stressors, such as juggling multiple tasks, skipping meals, or lacking sleep, can accumulate and contribute to overall stress on both the body and brain.

How Chronic Stress Changes the Brain

Chronic stress affects brain function, altering its chemistry and structure. Prolonged exposure to stress hormones can particularly affect regions tied to memory, emotion, and decision-making, leading to changes in how we think and behave.

Stress, Depression, and Alzheimer’s Risk

Individuals experiencing chronic stress are significantly more likely to develop mood disorders such as anxiety and depression.

This is because long-term stress overactivates the body’s stress-response systems, leading to excessive cortisol and altered neurotransmitter signaling in key areas of emotion regulation, such as the hippocampus and amygdala.² These changes make it harder for the brain to turn off the stress response, creating a pattern where anxiety and low mood become more easily triggered, even in situations that wouldn’t normally feel overwhelming.

Unfortunately, long-term stress exposure contributes to cognitive decline. Notably, a recent study found that individuals experiencing depression may face a twofold increased risk of developing Alzheimer’s disease.³

The Stress Spiral: Sleep, Diet, and Isolation

Chronic stress interferes with several of the brain’s most important support systems, including sleep, diet, and social connection — creating a cycle that becomes increasingly difficult to break.

High cortisol levels disrupt your natural circadian rhythm, making it difficult to fall asleep and achieve restful sleep. Yet sleep is essential for the brain to perform some of its most important maintenance processes, including memory retention, energy restoration, emotion regulation, and toxin removal. When sleep suffers, the brain becomes even more reactive to stress, thus continuing the cycle.⁴

High stress also impacts food cravings and appetite. It’s common to begin craving large amounts of sugary and highly processed foods as they provide a brief dopamine boost and a quick burst of energy. Unfortunately, these foods can worsen inflammation and blood sugar instability, both of which are linked to reduced cognitive performance and impaired mood regulation.⁵

Chronic stress can also lead to social withdrawal. Over time, isolation deprives the brain of necessary emotional support and cognitive stimulation, contributing to cognitive decline later in life.⁶

Stress, Inflammation, and Accelerated Brain Aging

Chronic stress doesn’t only affect mood and behavior — it also drives long-term inflammation in the brain.

When cortisol remains elevated, it disrupts immune balance and activates the brain’s immune cells, known as microglia. These overactive microglia then release inflammatory molecules that damage neurons and interfere with communication between brain regions involved in emotion and memory.⁷

Chronic stress continually stimulates both the body’s stress response and immune systems, leaving the brain in a prolonged state of vulnerability.

Research shows that individuals experiencing high stress in midlife may face greater declines in memory and cognitive performance later in life.⁹ Long-term stress has also been associated with structural changes in the brain and a higher risk of neurodegenerative diseases like Alzheimer’s.¹⁰

However, a recent review suggests that many of the brain changes linked to chronic stress can be slowed and even partly reversed through consistent lifestyle and stress-management strategies.¹¹

How to Protect Your Brain from Chronic Stress

Our brains are truly remarkable — they have the ability to adapt, heal, and even strengthen when we provide them with proper support. Simple habits like moving your body, prioritizing good sleep, connecting with others, and practicing mindfulness aren’t just meant to make you feel better, but they’re also the foundation for a healthy stress response and, in turn, a resilient brain.

Exercise for Brain Aging and Stress Relief

Moving your body and being outside are two of the most brain-protective habits you can adopt. Regular exercise supports circulation, regulates stress hormones, and builds new neural connections, and spending that time outdoors lightens the mental load and protects against anxiety and depression.¹²

• Start here: Aim for moderate movement most days of the week with a brisk walk, light hike, cycling session, or even some household or yardwork. Bonus points if you can spend time in the fresh air.

Sleep Better to Break the Cycle

Because sleep has a bidirectional relationship with stress, it’s easy to get pulled into a harmful loop of worsening sleep that leads to long-term stress effects. Good sleep hygiene enables proper brain maintenance, which helps reduce cortisol levels and promotes overall resilience, making it a non-negotiable aspect of stress management.¹³

• Try this tonight: Get to bed at a consistent time, avoid screens, keep your bedroom dark when it’s time to sleep, and aim for 7-9 solid hours of rest.

Preventing Cognitive Decline through Social Connection

Social interaction provides essential cognitive stimulation. When stress drives us into isolation, our brains face the consequences. Fortunately, connection offers an emotional support system, encourages healthier lifestyle habits, protects against mood disorders, and combats brain aging.¹⁴

• Simple habit: Grab coffee with a friend, schedule weekly calls with loved ones, or join a group activity that piques your interest.

Mindfulness for Brain Health

Engaging in calming, enjoyable activities such as meditation, prayer, reading, or taking a quiet moment helps reset your stress response and gives the brain a chance to slow down. Research shows that something as simple as taking time for mindfulness has a significant effect on cortisol levels and brain resilience.¹⁵

• Take a reset moment: Take a couple of deep breaths, read a chapter of a good book, or go for a calming and refreshing walk outside.

How Nutrition Shapes Your Stress Response

What you eat has a direct impact on how your brain manages stress.

A balanced diet helps regulate cortisol, supports steady energy levels, and strengthens the body’s systems that help maintain a stable mood. In fact, high-quality diets rich in whole foods, healthy fats, fiber, and antioxidants are strongly associated with lower rates of anxiety, improved mood, and a more effective overall stress response.¹⁶

Below are the key nutrients that play a significant role in stress regulation — along with foods that provide them.

• Omega‑3 fatty acids help reduce inflammation, support neurotransmitter function, protect neurons, and lower cortisol responses to stress.¹⁶

  • Food sources: Salmon, sardines, trout, chia seeds, flaxseed, and walnuts.

• Magnesium supports relaxation, calms the nervous system, and can improve sleep, one of the most essential factors in chronic stress recovery.¹⁶

  • Food sources: Leafy greens, pumpkin seeds, almonds, black beans, and dark chocolate.

• B vitamins (especially B6, B9, and B12) help regulate neurotransmitters, support energy levels, and play a role in mood stability.¹⁶

  • Food sources: Eggs, poultry, lentils, chickpeas, whole grains, bananas, and leafy greens.

• Polyphenols and antioxidants combat oxidative stress, a major contributor to inflammation, aging, and elevated cortisol levels.¹⁶

  • Food sources: Berries, green tea, olive oil, dark leafy greens, and colorful fruits and vegetables.

• Probiotic foods help cultivate a healthy gut microbiome, which promotes mood regulation, cortisol balance, and emotional wellness through the gut-brain connection.¹⁷

  • Food sources: Yogurt with live cultures, kefir, sauerkraut, kimchi, miso, tempeh, and naturally fermented olives and pickles.

Closing Nutritional Gaps During Stress

When stress is high, it’s easy to skip meals or reach for quick, less nutritious foods. While these choices may provide a short-term fix, they can widen nutrient gaps and intensify the impact of stress on the brain.

Supplementation is an option for targeted nutritional support for stress resilience. Magnesium, B vitamins, omega-3 fatty acids, vitamin D, polyphenols, and other antioxidants can be individually supplemented, and future articles will explore these nutrients in more detail.

You can also take brain-specific multi-nutrient blends, such as our flagship product RELEVATE, which includes 17 brain-relevant nutrients that are commonly underconsumed in high-stress lifestyles.

How the MIND and Mediterranean Diets Calm Stress and Boost Brain Function

The Mediterranean and MIND diets are rich in the whole foods, healthy fats, and antioxidants that support neurotransmitter function, reduce inflammation in the brain, and protect against damage caused by chronic stress.

Think of it this way: good food, good mood.

The more consistently you eat nutrient-dense foods, the more often you’ll feel calmer, focused, and more capable of handling everyday stress.¹⁸

Why Extra Virgin Olive Oil is a Brain-Protective Staple

Extra virgin olive oil (EVOO), central to both diets, is especially beneficial for brain health. It contains potent polyphenols, including oleocanthal, oleacein, tyrosol, and hydroxytyrosol, which combat oxidative stress and inflammation.¹⁹ Regular EVOO consumption has been linked to reduced anxiety, lower rates of depression, and improved emotional well-being.²⁰

Including EVOO in your daily meals — drizzled over salads, roasted vegetables, or grains — is a simple and delicious way to support your brain’s stress resilience while enhancing cognitive health.

The brain-protective benefits of EVOO depend largely on polyphenol content, which varies by olive variety (or cultivar), harvest timing, and production methods. Choosing a high-quality oil helps ensure a richer polyphenol profile and greater anti-inflammatory and cognitive-supportive benefits.

When selecting an olive oil, look for details such as harvest date, whether it is cold (or mechanically) pressed, and listed polyphenol content — ideally 250 mg/kg or greater. Premium EVOOs are often organic (or have a protected designation of origin certification) and single-origin (from a single farm).

One EVOO option to consider is our Brain Health Kitchen EVOO, which meets these criteria and contains over 500 mg/kg polyphenols, including high levels of the brain-healthy polyphenol oleocanthal.

Building a More Resilient Brain

Stress is an unavoidable part of life, but its long-term effects don’t have to be.

The encouraging news is that the brain is highly adaptable. Daily habits such as regular movement, restorative sleep, meaningful social connection, and a nutrient-dense diet can help regulate the body’s stress response and promote healthy brain aging.

Effectively managing stress today helps build a strong foundation for long-term cognitive health.

This article is part of NeuroReviews — a new series diving into the emerging science in brain health, with commentary from NeuroReserve founder Edward Park, PhD.

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