All references accessed as of April 2019.
Introduction: Reclaiming Women’s Health
the most common form of dementia: Alzheimer’s disease facts and figures. Alzheimers Dement 2016;12:459–509.
One of the most startling facts: www.alz.org/media/HomeOffice/Facts%20and%20Figures/facts-and-figures.pdf.
to avoid risks to the fetus: Kinney L, et al. Ann Intern Med 1981;95:495–99.
dosages are rarely adjusted by sex: Yang X, et al. Genome Res 2006;16:995–1004.
the first “female Viagra”: https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022526REMS.pdf.
a greater risk of dementia: Cheng HT, et al. J Am Geriatr Soc 2017;65:2488–95.
discharged mid–heart attack: Pope JH, et al. N Engl J Med 2000;342:1163–70.
influenced by emotional distress: http://nationalpainreport.com/women-in-pain-report-significant-gender-bias-8824696.html.
Chapter 1: The Inner Workings of the Female Brain
brain function as well: McEwen B. J Appl Physiol 2001;91:2785–801.
driver of women’s brain health: Brinton RD, et al. Nat Rev Endocrinol 2015; 11:393–405.
sexual differentiation of the brain: Nugent BM, et al. Horm Metab Res 2012;44:577–86.
mood, sleep, and even appetite: Nishizawa S., et al. Proc Natl Acad Sci USA 1997;94:5308–13.
depending on gender: Rahman A, et al. Frontiers Res Topics 2019;in press; Ferretti MT, et al. Nat Rev Neurol 2018;14:457–69.
better interconnected: Ingalhalikar M, et al. Proc Natl Acad Sci USA 2014;111:823–8.
having a family: Rogan MT, LeDoux JE. Cell 1996;85:469–75.
a key protective element: Mosconi L, et al. Neurology 2017;89:1382–90; Mosconi L, et al. PLoS One 2017;12:e0185926.
accelerate the aging process: Lin J, et al. Brain Res 2011;1379: 224–32.
a major hallmark of Alzheimer’s: Mosconi L, et al. PLoS One 2018;13: e0207885.
not in old age: Sperling RA, et al. Nat Rev Neurol 2013;9:54–8.
genetic, medical, and lifestyle events: Kivimaki M, et al. Lancet Neurol 2018;391:1574–5.
affecting predominantly females: Folsom DP, et al. Dialogues Clin Neurosci 2006;8:45–52.
Emerging research is pointing: Rahman A, et al. Frontiers Res Topics 2019;in press.
The two major symptoms: Feldman HA, et al. J Clin Endocrinol Metab 2002;87:589–98.
It has been estimated: Harlow SD, et al. Menopause 2012;19:387–95.
Chapter 2: Dispelling Myths Around Women’s Brain Health
than 1 to 2 percent of the population: Clancy S. Nat Educ 2008;1:187.
switching select genes on and off: Jirtle RL, et al. Nat Rev Genet 2007; 8:253–62.
medical and environmental factors: Wong M, et al. Nat Rev Neurosci 2001;2:343–51.
Medical conditions: Jimenez-Sanchez G, et al. Nat Genet 2001;409:853–5.
an unhealthy lifestyle: Willett WC. Science 2002;296:695–8.
medical and lifestyle shifts: Norton S, et al. Lancet Neurol 2014;13:788–94.
less than five years: www.cia.gov/library/publications/the-world-factbook/geos/us.html.
less than two years: Bennett JE, et al. Lancet 2015;386:163–70.
rapidly narrowing gender gap: Beltrán-Sánchez H, et al. Proc Natl Acad Sci USA 2015;201421942.
Alzheimer’s patients are women: Throughout the book, I intentionally avoid characterizing women as being at higher “risk” of Alzheimer’s than men. This is because, statistically, increased “prevalence” (i.e., the number of people affected) doesn’t equal to increased “risk.” In order to talk about increased risk, there has to be both increased prevalence and “incidence,” which is the rate at which people develop a disease over time. While everybody agrees that Alzheimer’s prevalence is higher in women than in men (two-thirds of Alzheimer’s patients are indeed women), there is conflicting data over whether the incidence of Alzheimer’s is also higher. This is mostly because very few studies have looked into it so far. So, statistically speaking, women aren’t (yet) considered at higher “risk” of Alzheimer’s than men. For an in-depth discussion about this topic, see Ferretti MT, et al. Nat Rev Neurol 2018; 14:457–69. Regardless of semantics, at the end of the day, more women than men end their lives battling dementia. Most importantly, the factors that put women at risk are not necessarily the same factors that put men at risk. Our goal today is to identify what risk factors women need to watch out for and how to neutralize those risks.
the same 2:1 ratio: Vina J, Lloret A. J Alzheimers Dis 2010;20 Suppl 2:527–33.
kills more women than men: Gao S, et al. Arch Gen Psychiatry 1998; 55:809–15.
99.6 percent drug failure rate: Cummings JL, et al. Alzheimers Res Ther 2014;6:37–40.
for men than for women: Haywood WM, et al. Am J Geriatr Pharmacother 2006;4:273–86.
every one of them has failed: Andrieu S, et al. Lancet Neurol 2015; 14:926–44.
brain plaques were gone: Holmes C, et al. Lancet 2008;372:216–23.
Recent clinical trials: Kivipelto M, et al. Nat Rev Neurol 2018;14:653–66.
Chapter 3: Unique Risks to Women’s Brain Health
than having an affected father: Mosconi L, et al. Proc Natl Acad Sci USA 2010;107:5949–54.
different effects on health: Bertram L, et al. Nat Rev Neurosci 2008;9:768–78.
than men with the gene: Farrer LA, et al. JAMA 1997;278:1349–56.
already in midlife: Mosconi L, et al. Neurology 2017;89:1382–90.
increased risk of Alzheimer’s: Scheltens P, et al. Lancet 2016; 388:505–17.
other forms of dementia: https://www.alz.org/national/documents/report_africanamericanssilentepidemic.pdf.
than those who are white: www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/African-Americans-and-Heart-Disease_UCM_444863_Article.jsp#.WzaWkBJKhBy.
“mini strokes”: Morris MS. Lancet Neurol 2003;2:425–8.
6 to 8 percent of all dementia patients: Sims-Robinson C, et al. Nat Rev Neurol 2010;6:551–9.
in a big way: Biessels GJ, Reagan LP. Nat Rev Neurosci 2015;16:660–71.
pre-diabetes or diabetes: Menke A, et al. JAMA 2015;314:1021–9.
later in life: Nordstrom A, et al. PLoS Med 2018;15:e1002496
longer to recover: Harmon KG, et al. Br J Sports Med 2013;47:15–26.
greater among women: Stockl H, et al. Lancet 2013;382:859–65.
in their lifetime: www.cdc.gov/violenceprevention/pdf/cdc_nisvs_ipv_report_2013_v17_single_a.pdf.
acting as a trigger: Wyss-Coray T. Nat Med 2006;12:1005–15.
worse in women: Hall JR, et al. J Alzheimers Dis 2013;35:363–71.
the jury is still out: Breitner JC, et al. Alzheimers Dement 2011;7:402–11.
triggering its appearance: Perry V, et al. Nat Rev Immunol 2007; 7:161–7.
cycles out of whack: Klein SL, et al. Lancet Infect Dis 2010;10:338–49.
12 million of whom are women: National Institute of Mental Health: http://www.nimh.nih.gov/publicat/numbers.cfm.
worsens during menopause: Goldstein JM, et al. Front Neurosci 2014;8:247.
later in life: Goveas JS, et al. J Am Geriatr Soc 2011;59:57–66.
in her lifetime: www.womenshealth.gov/a-z-topics/thyroid-disease.
her brain seem to remain: Shadyab AH, et al. Menopause 2017; 24:35–44.
higher risk of cognitive decline: Gilsanz P, et al. Neurology 2019;92:in press.
or widowed women: Pankratz VS, et al. Neurology 2015;84:1433–42.
Chapter 4: The Brain’s Journey from Pregnancy to Menopause
2 million per second: ed. Shonkoff JP, Phillips DA. From Neurons to Neighborhoods. Washington, DC: National Academies Press, 2000.
to social signals: Hoekzema E, et al. Nat Neurosci 2017;20:287–96.
working memory: Henry JD, et al. J Clin Exp Neuropsych 2007; 29:793–803.
definitely unaltered: Christensen H, et al. Br J Psychiatry 2010; 196:126–32.
nearly twenty years: Fraser Am, et al. Circulation 2012;125:1367–80.
several weeks or more: Wisner KL, et al. New Engl J Med 2002; 347:194–9.
in recent years: www.cdc.gov/nchs/data/databriefs/db309.pdf.
reported in Europe: van Keep PA, et al. Maturitas 1983;5:69–75.
in China: Han C, et al. BMC Anesthesiology 2103;17:103.
memory decline and dementia: Bove R, et al. Neurology 2014;82: 222–9.
anxiety and depression: Rocca WA, et al. Menopause 2018;25:1275–85.
in part genetically linked: Jiao X, et al. Trends Endocrinol Metab 2018;29:795–807.
go through perimenopause: Jacobs EG, et al. J Neurosci 2016;36:10163–73.
future heart disease: Thurston RC. Climacteric 2018;21:96–100.
reproductive conflict: Cant MA, et al. Proc Natl Acad Sci USA 2008; 105:5332–6.
Chapter 5: The Age of Precision Medicine
may be inaccurate: Dorschner MO, et al. Am J Hum Genet 2013; 93:631–40.
40 percent of cases: Tandy-Connor S, et al. Genet Med 2018;20:1515–21.
presenilin 2 (PSEN2) genes: Tanzi RE, et al. Neuron 2001;32:181–4.
than many people fear: Ritchie K, et al. Lancet 2002;360:1759–66.
for clinical use: www.genomicslawreport.com/index.php/2011/05/12/.
by age eighty-five: Qian J, et al. PLoS Med 2017;14:e1002254.
psychological risks: Green RC, et al. N Engl J Med 2009;361:245–54.
Chapter 6: Medical History and Laboratory Tests
than their slimmer peers: Shoberiri F, et al. J Menopausal Med 2016;22:14–9.
the study of dementia prevention: The SPRINT MIND investigators. JAMA 2019;321:553–61.
blood pressure management: Rodrigue KM, et al. JAMA Neurol 2013;70:600–6.
with a regular metabolism: Rettberg JR, et al. Neurobiol Aging 2016; 40:155–63.
or sudden death: Costello BT, et al. Clin Cardiol 2016;39:96–102.
raising LDL cholesterol: Ward H, et al. Arch Intern Med 2009; 169:1424–9.
at or above 13: Seshadri S, et al. N Eng J Med 2002;346:476–83.
the symptoms of dementia: Morris MS. Lancet Neurol 2003;2: 425–8.
vitamin B12 deficiency: Vidal-Alaball J, et al. Cochrane Database Syst Rev 2005;3:CD004655.
dementia in late life: Yurko-Mauro K, et al. PLoS One 2015;10:e0120391; Tan ZS, et al. Neurology 2012;78:658–64.
the high-risk category: Stark KD, et al. Prog Lipid Res 2016;63:132–52.
in a variety of cognitive tasks: Ferretti MT, et al. Nat Rev Neurol 2018;14:457–69.
after menopause: Rentz D, et al. Menopause 2017;24:400–8.
diagnosed sooner: Mielke M, et al. Clin Epidemiol 2014; 6:37–48.
in women than in men: Wiebers DO, et al. Lancet. 2003 Jul 12; 362(9378):103–10.
interactions with our sex hormones: https://seer.cancer.gov/statfacts/html/brain.html.
those undergoing menopause: Diaz JF, et al. Arch Neurol 1991; 48:1022–5.
women in menopause: Mosconi L, et al. PLoS One 2018;13: e0207885.
via their PET scans: Ossenkoppele R, et al. JAMA 2015;313:1939–49.
25 percent of cases: De Wilde A, et al. JAMA Neurol 2018;75:1062–70.
symptoms of the disease: Fantoni ER, et al. J Alzheimers Dis 2018; 63:783–96.
Chapter 8: Hormones, Antidepressants, and Other Meds: Do You Need Them?
as well as overall mortality: Lobo RA. J Clin Endocrinol Metab 2013;98:1771–80.
who had never taken the hormones: Grodstein F, et al. Ann Intern Med 2000;133:933–41.
the opposite of what was intended: Rossouw JE, et al. JAMA 2002; 288:321–33; Anderson GL, et al. JAMA 2004;291:1701–12.
an increased risk of dementia: Shumaker S, et al. JAMA 2003;289:2651–62.
than those who did not take MHT: Manson JE, et al. JAMA 2017; 318:927–38.
39 percent lower risk of death: Salpeter SR, et al. J Gen Intern Med 2004;19:791–804.
initiated soon after menopause: Hodis HN, et al. N Engl J Med 2016; 374:1221–31.
cardiac deaths: Salpeter S, et al. Am J Med 2009;122:1016–22.
cause of early menopause: Doll KM, et al. JAMA Surg 2016;151:876–7.
even premature death: Shuster LT, et al. Maturitas 2009;65:161–6.
they did not take estrogens: Sarrel PM, et al. Am J Pub Health 2013;103:1583–8.
than taking a placebo: Chlebowski RT, et al. N Engl J Med 2009; 360:573–87.
undergone a hysterectomy: LaCroix AZ, et al. JAMA 2011;305:1305–14.
cancer risk with MHT use: North American Menopause Society. Menopause 2012;19:257–71.
carry lower risk: Ross RK, et al. J Natl Cancer Inst 2000;92:328–32.
preexisting high risk of cancer: Collaborative Group on Hormonal Factors in Breast Cancer. Lancet 1997;350:1047–59.
doubling of the risk of dementia: Shumaker S, et al. JAMA 2003;289: 2651–62.
accelerating existing brain issues: Wassertheil-Smoller S, et al. JAMA 2003;289:2673–84; Resnick SM, et al. Neurology 2009;72:135–42.
compared with those who did not: LeBlanc ES, et al. JAMA 2001;285:1489–99.
risk of future dementia: Rocca WA, et al. Neurology 2007;69:1074–83.
who did not take the drug: Bove R, et al. Neurology 2014; 82:222–9.
discontinued treatment: Maki P. Menopause 2013;20:695–709.
six years of menopause onset: Henderson VW, et al. Neurology 2016;87:699–708; Gleason CE, et al. PLoS Med 2015;12:e1001833.
with the APOE-4 gene: Jacobs EG, et al. PLoS One 2013;8:e54713.
40 percent of the patients: Shilling V, et al. Eur J Oncol Nurs 2007; 11:6–15.
increased Alzheimer’s risk: Benson JR. J Natl Cancer Inst 2002;94:1336; Espeland MA, et al. J Womens Health 2010;19:371–9.
raise some concerns: Eberling JL, et al. Neuroimage 2004;21:364–71; Yaffe K, et al. Am J Psychiatry 2005;162:683–90.
for women over sixty-five: Mehta L, et al. Circulation 2018;137:e30–66.
those who used nothing: Crandall C, et al. Menopause 2018;25:11–20.
reduced mood swings: North American Menopause Society. Menopause practice. A clinician’s guide. 5th edition.
with some IUDS: Skovlund CW, et al. JAMA Psych 2016;73:1154–62.
25 percent more likely: Skovlund CW, et al. JAMA Psych 2016;73:1154–62.
one or two incidences: Orleans RJ, et al. N Engl J Med 2014;370:1777–9.
after age forty: https://www.cdc.gov/nchs/products/databriefs/db283.htm.
elsewhere in the body: Banks WA. Endocrinology 2012;153:4111–9.
its estrogen in-house: Lu Y, et al. J Neurosci 2019;1970–18.
The diagrams incorporate the North American Menopause Society’s Decision-Making Algorithm for Menopause Management, the American Association of Clinical Endocrinologists Guidelines for Management of Menopausal Symptoms as Related to Breast Cancer, the American College of Cardiology/American Heart Association ASCVD Risk Prediction Score, and the National Cancer Institute’s Breast Cancer Risk Assessment Tool, as well as current data on dementia risk.
Chapter 9: Food Matters for Your Gray Matter
from start to finish: Gould E. Nat Rev Neurosci 2007;8:481–8.
epigenetic lever: Colvis CM, et al. J Neurosci 2005;25:10379–89.
they respond to diets: Lundsgaard AM, et al. Front Endocrinol 2014;5:e195.
as her diet: Heine PA, et al. Proc Natl Acad Sci USA 2000;97:12729–34.
all observed after menopause: Davis SR, et al. Climacteric 2012; 15:419–29.
dietary interventions in women: Kroenke CH, et al. Menopause 2012; 19:980–8.
resistance against cancer: Prentice RL, et al. JAMA 2006;295:629–42.
or heart disease: Howard BV, et al. JAMA 2006;295:655–66.
with a fairly small sample: https://blogs.plos.org/neuro/2016/07/16/ketones-to-combat-alzheimers-disease/.
increased risk of heart disease: Oh K, et al. Am J Epidemiol 2005; 161:672–9.
by up to 67 percent: Hu FB, et al. N Eng J Med 1997;337:1491–99.
who ate fewer than 2 grams: Morris MC, et al. Neurobiol Aging 2014; 35:S59–64.
half that amount: Okereke OI, et al. Ann Neurol 2012;72:124–34.
than those who ate less: Morris MC, et al. Arch Neurol 2003;60:194–200.
in the long term: Pottala JV, et al. Neurology 2015;82:435–42; Tan ZS, et al. Neurology 2012;78:658–64.
lowest levels of Alzheimer’s plaques: Mosconi L, et al. BMJ 2014;4:e004850.
replacing animal fats: Rice MS, et al. Am J Public Health 2016;160:1592–8; Carruba G, et al. Nutr Cancer 2006;56:253–9.
ovarian cancer: Jones LW, et al. Lancet Oncol 2006;7:1017–26.
higher amounts of vegetable oils: Farvid MS, et al. BMJ 2014;348:3437.
better cancer-survival rates: Chlebowski RT, et al. JAMA Oncol 2016;e181212.
“bad” estrogens in their bodies: Wynder EL, et al. JNCI 2007;89:766–75.
stroke later in life: Hu FB, et al. N Eng J Med 1997; 337: 1491–9.
type 2 diabetes: Schulze MB, et al. Am J Clin Nutr 2004;80:348–56.
cancer: Monroe KR, et al. Nutr Cancer 2007;8:127–35.
and dementia: Knopman DS. JAMA 2009;302:686–7; Morris MC, et al. Alzheimers Dement 2015;11:1007–14.
showed the best results: Liu S, et al. Am J Clin Nutr 2000;71:1455–61.
people without diabetes: Crane PK, et al. New Eng J Med 2013;369:540–8.
suited to women’s health: Maki KC, et al. J Nutr 2015;145:S159–63.
world’s life-expectancy charts: www.who.int/mediacentre/news/releases/2014/world-health-statistics-2014/en/.
a positive sign for longevity: Crous-Bou M, et al. BMJ 2014;349:g6674.
sugary beverages: Oh K, et al. Am J Epidemiol 2005;161:672–9.
the largest trial to date: Estruch T, et al. Ann Intern Med 2006; 145:1–11.
much less cognitive decline: Vallas-Pedret C, et al. JAMA Intern Med 2015;175:1094–103.
eating a Western diet: Mosconi L, et al. J Prevent Alz Dis 2014;1:23–32; Walters M, et al. BMJ Open 2018;8:e023664.
five additional years’ worth of aging: Berti V, et al. Neurology 2018; 90:e1789–98.
for both genders: Scarmeas N, et al. JAMA 2009;302:627–37.
balancing estrogen in our favor: Monroe KR, et al. Nutr Cancer 2007; 8:127–35.
breast cancer occurrence in half: Toledo E, et al. JAMA Intern Med 2015;175:1752–60.
in as little as one year: Gold EB, et al. Menopause 2006;13:423–33.
hot flashes and night sweats: Herber-Gast GC, et al. Am J Clin Nutr 2013;97:1092–9.
chronic and mental illnesses: Samieri C, et al. Ann Intern Med 2013; 159:584–91.
Chapter 10: Eight Steps to a Well-Nourished Brain
health-packed greens: Morris MC, et al. Neurology 2018; 90:e214–e222.
didn’t eat these berries: Devore E, et al. Ann Neurol 2012;72:135–43.
all those conditions: Muga MA, et al. BMC Geriatr 2017 Nov 21;17:268.
increased risk of colon cancer: http://globocan.iarc.fr.
for both women and men: Knopman DS. JAMA 2009;302:686–7; Morris MC, et al. Alzheimers Dement 2015;11:1007–14.
lowest risk of heart disease: Liu S, et al. Am J Clin Nutr 1999;70: 412–9.
lower risk of type 2 diabetes: Schulze MB, et al. Am J Clin Nutr 2004; 80:348–56.
as little as eight weeks: Mastroiacovo D, et al. Am J Clin Nutr 2015;101:538–48.
many fruits and vegetables: Franke AA, et al. Proc Soc Exp Biol Med 1998;217:263–73.
by up to 45 percent: Franco O, et al. JAMA 2016;315:2554–63.
their Western counterparts: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx.
to develop breast cancer: Hsieh CY, et al. Cancer Res 1998;58:3833–8.
breast cancer risk in women: Messina M, et al. Oncology 2013;27:430–7.
can even reduce mortality: Nechuta SJ, et al. Am J Clin Nutr 212;96:123–32.
circulating in your bloodstream: Chen MN, et al. Climacteric 2015;18:260–9.
isoflavone-rich soy foods: www.aicr.org/cancer-research-update; Rock CL, et al. Cancer J Clin 2012;62:242–4.
genetically modified soybeans: www.ers.usda.gov/data-products/adoption-of-genetically-engineered-crops-in-the-us/recent-trends-in-ge-adoption.aspx.
snacks and pastas: Anderson JW, et al. N Engl J Med 1995;333:276–82.
especially in women: Mosconi L, et al. BMJ 2014;4:e004850.
who consumed little to none: Morris MC, et al. JAMA 2002;287: 3230–7.
with vitamin C: Engelhart MJ, et al. JAMA 2002;287:3223–9.
helps regulate estrogen levels: Ziaei S, et al. Gynecol Obstet Invest 2007;64:204–7.
ORAC . . . units: Carlsen MH, et al. Nutr J 2010;9:3–18.
bacterial inhibition: Tajkarimi MM, et al. Food Control 2010;21:1199–218.
for post-menopausal women: Fiolet T, et al. BMJ 2018;360:k322.
too much sodium: Micha R, et al. JAMA 2017;317:912–24.
balance to shoot for: Simopoulos AP. Am J Clin Nutr 1991;54:438–63.
risk of premature birth: Saldeen P, et al. Obstet Gynecol Surv 2004;59:722–30.
depression in both genders: Gross G, et al. PLoS One 2014;9:e96905.
more severe symptoms than men do: Giles GE, et al. Nutr Rev 2013;71:727–41.
by up to 70 percent: Kalmijn S, et al. Neurology 2004;62:275–80.
the later you enter menopause: Dunneram Y, et al. J Epidemiol Comm Health 2018;72:733–40.
better cognitive performance: Okereke OI, et al. Ann Neurol 2012;72:124–34.
patients with type 2 diabetes: Devore EE, et al. Diabetes Care 2009;32:635–40.
heart disease and stroke: Hu FB, et al. BMJ 1998;317:1341.
close to 30 percent: Sacks FM, et al. Circulation 2017;136:e1–23.
“we advise against the use of coconut oil”: Sacks FM, et al. Circulation 2017;136:e1–23.
did not show this increase: Khaw K, et al. BMJ Open 2018;8:e020167.
substantial degree in butter: Zong G, et al. BMJ 2016;355:i5796.
diagnosed with Alzheimer’s: De la Rubia Orti JE, et al. J Alzheimers Dis 2018;65:577–87.
who tolerate it well: Chacarro JE, et al. Hum Reproduct 2007;22:1340–7.
heart disease and dementia: Kivipelto M, et al. Ann Int Med 2002;137:149–55.
doubling the risk of dementia: Solomon A, et al. Dement Geriatr Cog Dis 2009;28:75–80.
in healthy individuals: Hu FB, et al. JAMA 1999;281:1387–94.
heart failure later in life: Djousse L, et al. Circulation 2008;117:512–6.
an increased risk of stroke: Bennet AM, et al. JAMA 2007;298:1300–11.
who consumed a comparable amount: Kivipelto M, et al. J Cell Mol Med 2008;12:2762–71.
a family history of Alzheimer’s: Mosconi L, et al. BMJ 2014;4:e004850.
fat in the diet: Shin JY, et al. Am J Clin Nutr 2013;98:146–59.
cognitive performance in APOE-4 carriers: Yassine HN, et al. JAMA Neurol 2018;74:339–47.
people with the APOE-4 gene: Van de Rest O, et al. Neurology 2016;86:2063–70.
supporting brain longevity: Chassaing B, et al. Nature 2015;519:92–6.
the healthiest microbiomes: Claesson MJ, et al. Nature 2012; 488:178–84.
a poor-quality gut microbiome: Chassaing B, et al. Nature 2015; 519:92–6.
high complex-carbohydrate diets: Caro H, et al. J Clin Endocrinol Metabolism 2016;101:233–42.
many unpleasant problems: Heitkemper MM, et al. Gend Med 2009;6:S152–67.
risk of hot flashes: Sievert LL, et al. Ann Hum Biol 2006;33:4–16.
breast cancer: Colditz GA, et al. Nat Rev Cancer 2005;5:388–96.
alcohol consumption may pose even greater risks: Livingston G, et al. Lancet 2017;390:2673–734.
a potent antioxidant: Price NL, et al. Cell Metabolism 2012;15:675–90.
may promote a healthy brain: Eskelinen MH, et al. J Alzh Dis 2009;16:85–91.
among all beverages: Streitburger DP, et al. PLoS One 2012;7:e44195.
by up to 30 percent: Edmonds CJ, et al. Front Hum Neurosci 2013;7:363; Benefer MD, et al. Eur J Nutr 2013;52:617–24.
7 percent drink none at all: Goodman AB, et al. Prevent Chron Dis 2013;10:E51.
“purified” water and beer: LaComb RP, et al. Food Surveys Research Group Dietary Data Brief No. 6, August 2011.
risk of ovulatory infertility: Caan B, et al. Am J Public Health 1998;88:270–4.
thyroid function: Diamanti-Kandarakis E, et al. Endocr Rev 2009; 30:293–342.
raises serious concerns: Korach KS., Reproductive and Developmental Toxicology, Marcel Dekker Ltd, 1998.
increased risk of Alzheimer’s: Yan D, et al. Sci Rep 2016;6:32222.
with the APOE-4 gene: Livingston G, et al. Lancet 2017;390:2673–4.
women in general: www.niehs.nih.gov/health/topics/agents/pesticides/index.cfm.
and promote longevity: Mattson MP, et al. J Nutr Biochem 2005;16:129–37.
in as little as one year: Kroenke CH, et al. Menopause 2012;19:980–8.
to reduce this risk: Michels KB, et al. Cancer 2007;109:2712–49.
in as little as three months: Witte AV, et al. Proc Natl Acad Sci USA 2009;106:1255–60.
six months on the diet: Harvie MN, et al. Int J Obesity 2011;35:714–27.
burn fat more efficiently: Mattson MP, Wan R. J Nutr Biochem 2005;16:129–37.
against obesity and diabetes: Chaix A, et al. Cell Metab 2014;20:991–1005.
Chapter 11: Supplements for Women’s Brains
one supplement for brain-health reasons: https://www.aarp.org/health/brain-health/global-council-on-brain-health/supplements/.
from artificial supplements: Hercberg S, et al. Arch Intern Med 2004;164:2335–42.
the discomforts of menopause: Franco O, et al. J Am Med Assoc 2016;315:2554–63
validated clinical efficacy: Franco O, et al. J Am Med Assoc 2016; 315:2554–63.
patients with mild depression: Larkin M. Lancet 2000;355:1619.
mental clarity: Scarmeas N, et al. Lancet Neurol 2018;17:1006-15.
protective against Alzheimer’s: Mosconi L. Brain Food: The Surprising Science of Eating for Cognitive Power. Avery/Penguin Random House, 2018.
balancing effects on homocysteine: Tangney CC, et al. Neurology 2009;72:361–7.
when measured via MRI scans: Douaud G, et al. Proc Natl Acad Sci USA 2013;110:9523–8.
together with omega-3s: Jernerén F, et al. Am J Clin Nutr 2015;102:215–21.
particularly in APOE-4 carriers: Yassine HN, et al. JAMA Neurology 2018;74:339–47.
reduced risk of dementia: Yurko-Mauro K, et al. PLoS One 2015;10:e0120391.
overall cognitive function: Tan MS, et al. J Alzh Dis 2015;43:589–603.
following a TBI or stroke: Raghavan A, et al. Neural Regen Res 2014;9:1104–7.
hot flashes and night sweats: Franco O, et al. J Am Med Assoc 2016;315:2554–63.
a 46 percent reduction: Cisafulli A, et al. Menopause 2004;11:400–4.
good at easing night sweats: Lipovac M, et al. Gynecol Endocrinol 2012;28:203–7.
without any serious side effects: www.aicr.org/cancer-research-update.
at a dose of 400 IUs per day: Ziaei S, et al. Gynecol Obstet Invest 2007;64:204–7.
reduced hot flashes: Franco O, et al. JAMA 2016;315:2554–63.
it is superior to a placebo: Franco O, et al. JAMA 2016;315:2554–63.
ameliorate hot flashes: Taku K, et al. Menopause 2012;19:776–90.
at least in some women: Ernst E. Ann Int Med 2002;136:42–53.
short-term treatment of mild depression: Larkin M. Lancet 2000; 355:1619.
depressed mood: Bae JH, et al. Nutr Res 2018;50:1–9.
especially in women: Yang JR, et al. Neuropsychiatr Dis Treat 2015;11:2055–61.
218 during perimenopause and post-menopause: Franco O, et al. JAMA 2016;315:2554–63.
help you fall asleep: Brezinski A, et al. Sleep Med Rev 2005;9:41–50.
insomnia, anxiety, and stress: Cropley M, et al. Phytother Res 2002; 16:23–7.
in as little as three months: Henmi H, et al. Fertil Steril 2003;80:459–61.
hot flashes and disturbed sleep: Leonetti HB, et al. Obstet Gynecol 1999;94:225–8.
the effects of supplementation are not very consistent: Abbasi B, et al. J Res Med Sci 2012;17:1161–9.
combat the effects of stress: Stough C, et al. Nutr J 2014;13:122.
blood sugar regulation: Spasov AA, et al. Phytomedicine 2000;7:85–9; Darbinyan V, et al. Phytomedicine 2000;7:365–71.
after taking ashwagandha: Choudhary D, et al. J Evid Based Compl Altern Med 2017;22:96–106.
after just sixty days: Chandrasekhar K, et al. Indian J Psychol Med 2012;34:255–62.
during times of stress: Abdou AM, et al. Biofactors 2006;26:201–8.
fat-burning properties: Verpeut J, et al. Nutr Res 2013;33: doi:10.1016/j.nutres.2013.04.001.
metformin or rosiglitazone: Jun Y, et al. Metabolism 2008;57:712–7.
markers of cardiovascular health: Desideri G, et al. Hypertension 2012;11:1930–60.
Chapter 12: Women and Exercise: Could Less Be More?
evident on multiple fronts: Hillman CH, et al. Nat Rev Neurosci 2008;9:58–65.
aging at the cellular level: Tucker LA. Prevent Med 2017;100:145–51.
enlargement of those areas: Van Praag H. Trends Neurosci 2009;32: 283–90.
higher number of Alzheimer’s plaques: Okonkwo OC, et al. Neurology 2014;83:1753–60.
brain changes far ahead of time: Walters M, et al. BMJ 2018;8:e023664.
most convincing trials to date: Erickson KI, et al. Proc Natl Acad Sci USA 2011;108:3017–22.
exercised less or not at all: Brown BM, et al. Alzheimers Dement 2017; 13:1197–1206.
better off than those who don’t: Head D, et al. Arch Neurology 2012;69:636–43.
obesity, or hypertension: Norton S, et al. Lancet Neurol 2014;13:788–94.
physical activity per week: www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201605.pdf; accessed August 2018.
once high school ends: Armstrong S, et al. JAMA Pediatr 2018; 172:732–40.
hampered from exercising: Hull EE, et al. J Phys Act Health 2010; 7:577–83.
more time to exercise: Nomaguchi KM, et al. J Marriage Fam 2004;66:413–30.
for women of all ages: Middleton LE, et al. J Am Geriatr Soc 2010; 58:1322–6.
later in life: Hörder H, et al. Neurology 2018;90:e1298–35.
women with a diagnosis of dementia: Hogervorst E, et al. J Alzheimers Dis Parkinsonism 2012;2:e117.
within just a few months: Eggermont L, et al. Neurosci Biobehav Rev 2006;30:562–75.
more in women than in men: Middleton LE, et al. J Am Geriatr Soc 2010;58:1322–6.
our sex hormones affect it: Braun B, et al. Exerc Sports Sci Rev 2001;29:149–54.
glucose more efficiently: Ashley CD, et al. Sports Med 2000;29:221–7.
the greater the benefits: Cotman CW, et al. Trends Neurosci 2007;30:464–72.
strength and balance: Lance C, et al. J Sports Sci Med 2006; 5: 662–71.
for optimal ovulatory fertility: Rich-Edwards JW, et al. Epidemiology 2002;13:184–90.
heart disease, diabetes: Earnest C, et al. Am J Cardiol 2013; 111:1805–11; Lucke J, et al. Biol Res Nursing 2010;12:162–70.
diminished the returns: Kyu H, et al. BMJ 2016;354:i3857.
than those who exercised less: Blumel JE, et al. Menopause 2016;23:488–93.
maintain bone density and mass: Bonaiuti D, et al. Cochrane Database Syst Rev 2002;2:CD000333.
by a good 35 percent: Scarmeas N, et al. JAMA 2009;302:627-37.
Chapter 13: Be Mindful: De-Stress, Sleep, and Balance
higher levels of stress than men: www.apa.org/news/press/releases/stress/2010/national-report.pdf.
before you even turn fifty: Echouffo-Tcheugui JB, et al. Neurology 2018;91:e1961–70.
“tend-and-befriend”: Taylor SE, et al. Psych Rev 2000;107:411–29.
the area in charge of reason: Wang J, et al. Soc Cogn Affect Neurosci 2007;2:227–39.
different areas of the brain: Mather M, et al. Neuroreport 2010; 21:933–7.
60 percent of these caregivers: www.caregiving.org/data/Caregiving_in_the_US_2009_full_report.pdf.
Hispanic and African American women: Nebel RA, et al. Alzheimers Dement 2018;14:1171–83.
chronic health conditions: Navaie-Waliser M, et al. Am J Pub Health 2002;92:409–13.
resting when necessary: Schulz R, et al. Ann Behav Med 1997;19:110–6.
heart disease, stroke: www.apa.org/news/press/releases/stress/2010/national-report.pdf; Schulz R, et al. JAMA 1999;15:2215–9.
developing Alzheimer’s themselves: Bottiggi Dassel K, et al. Gerontologist 2017; 57:319–28.
than male caregivers: https://www.caregiver.org/women-and-caregiving-facts-and-figures.
an additional emotional toll: Alzheimer’s disease facts and figures. Alzheimers Dement 2016;12:459–509.
a reduced risk of dementia: Holt-Lunstad J, et al. PLoS Medicine 2010;7:e1000316.
as often as possible: Fratiglioni L et al. Lancet 2000;355:1315–9.
employee recovery and health: Park Y, et al. J Occup Health Psychol 2011;16:457–67.
circadian rhythm: Chang AM, et al. Proc Natl Acad Sci USA 2015;112:1232–7.
for the mind and the body: Bratman GN, et al. Proc Natl Acad Sci USA 2015;112:8567–72.
liver disease, or endometriosis: Rada G, et al. Cochrane Database Syst Rev 2010;9:CD004923.
has a positive influence on neuroplasticity: Tang YY, et al. Nat Rev Neurosci 2015;16:213–25.
regularly practicing TM: Schneider RH, et al. Circulation 2012;5: 750–8.
Alzheimer’s patients and their caregivers: Paller KA, et al. Am J Alzheimers Dis Other Demen 2015;30:257–67.
compared with a group that did not: Carmody JF, et al. Menopause 2011;18:611–20.
within eight weeks: Khalsa DS. J Alzheimers Dis 2015;48:1–12.
improvement in their overall cognitive function: Khalsa DS, et al. Alzheimer’s Association International Conference 2018.
after just twelve weeks of treatment: Eyre HA, et al. Int Psychogeriatr 2017;29:557–67.
reduced symptoms of stress and insomnia: Newton KM, et al. Menopause 2014;21:339–46.
those on chemotherapies: Cramer H, et al. Cancer 2015; 121:2175–84.
achieved by MHT: Avis NE, et al. Menopause 2016;23:626–37.
experience more daytime sleepiness: https://sleepfoundation.org/sleep-polls-data/sleep-in-america-poll/2007-women-and-sleep.
dementia has made an appearance: Yaffe K, et al. Lancet Neurol 2014;13:1017–28.
relieving itself from harmful toxins: Xie L, et al. Science 2013; 342:373–7.
seemingly healthy people: Spira AP, et al. JAMA Neurology 2013;70:1537–43.
with poorer cognitive function: Mander BA, et al. Nat Neurosci 2013;16:357–64.
with a minimum of six for those sixty-five or older: Isaacson RS, et al. Alzheimers Dement 2018;14:1663–73.
a bit longer in women than in men: Mourtazaev MS, et al. Sleep 1995;18:557–64.
affecting over half of all post-menopausal women: Jehan S, et al. J Sleep Med Disord 2016;3:1064–9.
visit the National Sleep Foundation website: www.sleepfoundation.org/sleep-disorders-problems/sleep-apnea-treatment.
Chapter 14: More Ways to Protect Your Brain
lowering the risk of dementia later in life: Fabrigoule C, et al. Lancet Neurol 2002;1:11.
maintaining cognitive fitness over time: Schneider AL, et al. J Am Geriatr Soc 2012;60:1847–53.
as compared with those who did not: Verghese J, et al. Neurology 2006;66:821–7.
even prevent Alzheimer’s plaques: Landau SM, et al. Arch Neurol 2012;69:623–9.
delayed onset of any cognitive decline: Aguirre-Acevedo D, et al. JAMA Neurol 2016;73:431–8.
formal education: Vemuri P, et al. Ann Neurol 2012;72:730–8.
higher, for women than for men: www.census.gov/prod/2012pubs/p20-566.pdf.
or cognitive performance: Kable JW, et al. J Neurosci 2017; 37:7390–402.
not in memory skills: Rebok GW, et al. J Am Geriatr Soc 2014; 62:16–24; Wolinksy FD, et al. PLoS One 2013;8:e61624.
limited or modest effects: Lampit A, et al. PLoS Medicine 2014;11:e10001756.
6 percent lead over female smokers: www.lung.org/finding-cures/our-research/trend-reports/Tobacco-Trend-Report.pdf.
smoke to relieve stress: Smith PH, et al. Prev Med 2016;92:135–40.
associated with habit formation: Cosgrove K, et al. J Neurosci 2014; 34:16851–5.
before they turned fifty: http://dx.doi.org/10.1136/tobaccocontrol-2015-052510.
persisted for over six years: Gold EB, et al. Am J Public Health 2006;96:1226–35.
Alzheimer’s for both women and men: Ott A, et al. Lancet 1998;351: 1840–3.
diminishes this risk: Hu FB, et al. N Engl J Med 2000;343:530–7.
even steeper risks: Livingston G, et al. Lancet 2017;390:2673–734.
of all deaths worldwide: Landrigan PJ, et al. Lancet Comm 2018;391:462-512.
contributing to cancer development: www.breastcancer.org/risk/factors/cosmetics.
who never took the medicines: Gray SL, et al. JAMA Intern Med 2015;175:401–7.
an increased Alzheimer’s risk: Billioti de Gage S, et al. BMJ 2014;349:g5205.
often completely overlooked: Teixeira FB, et al. Front Aging Neurosci 2017;9:327.
brain inflammation and Alzheimer’s plaques: Kamer AR, et al. Neurobiol Aging 2015;36:627–33.