Hello everyone i am the codirector of Aspen Ideas Health and executive idea aspen global and sick baiters group and. Want to thank you for joining a sable but will be a fascinating conversation. While the pandemic has prevented us together in person on campus we are so excited to continue to host informative and inspiring conversations between a leading health practitioners, artists, scientists and innovators. Today we are honored to be hosting this great fascinating a breakthrough conversation with doctor lisa mosconi and Natalie Morales about doctor mosconi book the xx brain in Womens Brain Health bridge makes it her lifes work decided the female brain and this new book she provides women with a roadmap for reducing their risk of dementia. If you do not have the book yet and youre interested in buying a copy will put a link in the chat now for you to be able to get it and find more information. I would certainly recommend it is fantastic. So as we begin to dive into this conversation let me briefly improperly introduce our really wonderful speakers. Lisa mosconi is professor of neuroscience, neurology and radiology at cornell medical college. She is the founder and director of the womens brain initiative. An associate director of the alzheimers prevention clinic. She is an adjunct member of the department of psychiatry at nyu school of medicine. And she holds a phd in neuroscience and nuclear medicine. Her research is from the Early Detection of alzheimers disease and atrisk individuals, especially women and how memory loss at alzheimers disease can be prevented through the combination of medical care and lifestyle modification. Their diet, physical intellectual fitness. Shes also the author of rain food another excellent book and the xx brain. Welcome lisa perrys event thank you so much for having its great to be here today. Sue and thank you lisa. Were also delighted to be joined by Natalie Morales. Natalie as many know shes the west coast anchor of nbc today show. She is the host of dateline and anchor behind closed doors with Natalie Morales. She previously served as host of the nbc and cohost of accent life as well as news anchor of today when she cohosted the show third hour. She was joined today and 2006 as a National Correspondent reports for all nbc news platforms including nbc nightly news, dateline, and msnbc. We are really grateful natalie for your excellent reporting during these tumultuous times. We are delighted you made time for this talk today. I also want to point out that natalie has a special connection to this. She has a book called simple recipes for healthy living. For my family to yours where she shares same her Favorite Recipes and tips for healthy lifestyle. Welcome natalie we are delighted to have you with this. Thanks much for being with us today. It is my pleasure, peggy. Thanks so much with a warm introduction. Its a wonderful topic and opportunity for us to focus on her health especially right now. Doctor mosconi this book you wrote, the xx brain is fascinating. I think is so important for women to really understand the significance of the research. But also the preventative tips that you put out in this book. I am thrilled to be able to share this time with you and hopefully get the message out there. Will turn the mic over to you and have a wonderful conversation. Thank you so much. Sue and doctor mosconi lets talk first. The book is called the xx brain. So we are talking about women and the fact of the matter is we are two thirds more likely to end up developing alzheimers in our lifetime. Our womens brain that different than mens . I dont are from mars and women are from venus. [laughter] we are all wired so differently. We are wired differently. I am a neural scientist i am a brain scientist. Nuclear medicine, the weight i approach i look at a brain in many different ways and what stands out most clearly is that womens brains age differently than mens games. Most recently as part of my research the way women change is key to brain aging in women. Which is a connection that is being largely unexplored. Its venting your topics and i think it is worth talking about. All women go through menopause. And that really especially for a brain parts mechanism thing i am getting there. [laughter] at some point we all do. Host yes. Guest we need to understand what happens to our brain during this transition to menopause. And why that is associated with women and the way society, depression, memory loss increase the number of medical conditions to talk about. Are going to dive deep into all these topics grateful were also fascinated about. And how can i better perhaps decreased my chances of developing alzheimers. We will get into that. Let me get in its a Scientific Community really only now is starting to understand that women and our homelands may be somewhat linked. But yet, why has gender been removed from the problem and from the equation in the medical community . Guest that is such a good question something i have personally struggled for really long time. Ive been trying to study womens brains for 20 years. In part because they have a history of disease they affect women in my family. Started asking soon as i was 19 i started doing brain scans as a volunteer of course. Might chance a nuclear, kind of runs in my family. Its very interesting. But the point is nobody had answers for me. My questions were different for a woman than men in terms of disease. Is it connected is that lifestyle is it Something Else . And they think the problem is we have a huge gender gap in research. Especially related to brain health. Still today it Womens Brain Health is the most overlooked, underdiagnosed and underresearched. And there are three things that happened. The first one is that women were actively excluded from research until 1993. Especially from Clinical Trials for a number of reasons, but the point is there is no research with women and it. And the second thing is all of this medical research was substantiated as buyin its biased against womens brains. Really like saying what makes a woman a woman from a medical perspective is a reproductive organ. Those parts of the body. If you think about Womens Health its about their breasts, their ovaries, their hormones. We dont talk about the brain. Especially talk about womens and brain. I mean about Womens Health. We never talk about womens and brain. This is women be excluded from research there underdiagnosed. See what its fascinating for you talk about your connection to alzheimers. My motherinlaw was diagnosed in her mid 60s with earlyonset alzheimers parade this is been a passion of mine to try to crack the code and figure out what we can be doing better in our lives, our lifestyle. Lets go back to the question of hormones. Specifically asked surgeon with women. What does asked surgeon have to do with alzheimers . Its really good question and something theyre actively exploring right now. I think whats missing from the conversation is a brain cannot work in isolation. The brain is connected with the rest of the body. Especially for women with the brain and the reproductive system is really key to brain aging. And that is communication between the brain and the reproductive system. And we all know that hormones are different between the genders. Women have more asked surgeon. But people dont realize the same hormones we have in her body at the same hormones we have in our brain. They just have a different function in the brain. We think of these hormones being involved in reproduction. But in the brain serve a completely different function is having energy. For women literally pushes neurons to have energy. If your estrogens higher brain energy is high. It is superpowers in the brain. It keeps your Brain Healthy and young. Its different for men. That very gradually over time not a typical day where women have the superpowers of estrogen and midlife, but then we live another 30 years without that protection that the estrogen provides. So how does that affect the brain then as we start to go through menopause . And we experiencing the loss of estrogen . Guest we can see on brain scans is that the neurons makes less energy. And that is associated with the agent process. I think a lot of women record that after menopause not all women obviously many women notice her skin as the dryer, their hair is more fragile. It is not a huge, severe proble problem. The brain is also responding to age. We can see that on brain scans. For some reason the changes are very, very mild. For others they are extreme. We have published studies by hundreds of women we do find quite a big jump in Energy Levels in the brain. Which i want to clarify does not correlate with produce cognitive performance. Womens perform just as well as the men of the same age. Host thank you. [laughter] womens brains are concentrating. We are trying to find out how we are compensating. Because the brain lose energy lose estrogen. But it performs well pretty one to understand what has happened so that we can promote and support that mechanism. Sue and theres a couple chapters in the book but a whole section particularly that focuses on hormone replacement therapy and who should think about it, who shouldnt. I will recommend people read that. Because there is a lot of different areas where you go through and say you should or shouldnt, obviously you had cancer Breast Cancer survivor you have to approach it differently. But for those who are approaching menopause are already there already, what do need to be asking ourselves what comes hrt . Do really needed and why do you want to . I think theyre very Different Things that can be achieved safely. Its important to know your risk, your strength and you need to discuss with your doctors. Some women are not eligible. Others really depends on what youre trying to achieve, what kind of symptoms you want to alleviates. Number one id really like to test prevention. Has been done in some ways, but not in the best possible way of who want to start younger before menopause. That has not been done yet. I think that is very important and unexplored area of research. There are many questions that need to be answered. Also interested in things we can do instead of hormonal therapy. You can consider many natural behavior strategies that can be used pretty much have the same results for many women spent working to get into that lifestyle prevention exercise, sleep how that all plays a part. Let me ask you first though, what about genetics . What is the genetic connection and link . As i mentioned my motherinlaw with earlyonset alzheimers, my husband and i are very much about health and wellness now. Because we know perhaps there is a risk for him. I would recommend testing. I have a whole chapter in the book about how to approach testing which is very detailed Family History questionnaire. Because yes early on, it did happen to other family members . Is a multiple family members affected because it is the genetics. In an isolated case it doesnt. Theres a number of things that clinically we would like to find out. I would better guide the assessment. Basically it comes in two major forms for this in early onset genetically determined that is caused by genetic mutation. And that is an aggressive form some hoping husband does not carry any genetic mutations. Sue and 1998, 99 of all alzheimer cases do not carry this genetic mutation. For a majority of those cases treated interplay, but also medical and lifestyle environment altogether modulate. Sweat let me ask you about that. Because there are some medical risk factors that could also affect your risk at developing alzheimers. Heart disease, thyroid disease, metabolic disorder, traumatic brain injury as well. Can you talk a little bit about that . There are many different medical commissions that affect the brain of alzheimers. It could trigger, it could promote a disease. And these include the ones you just mentioned. Especially for women is really, really important. You do have the last component there is thats interactive. I think its really, really important is that there are many different responses that we know of. In the book it says over 30. We are just learning how this affects the gender. It really looks like men and women almost have two separate pathways. Men are in nature but women are more hormonal. So there are some things that affect an increase in women more than men. I think whats funny in a way is men expect women more than men. But only women and not meant in terms of this. The number one response or in men is not being married to a woman. Host what . [laughter] [laughter] suet why is that . Guest there are so many possibilities for that mutation mutations. In the number one factor for men is not being married to a woman. I dont think its necessary being married to a woman as being in a supportive healthy nurturing relationship. Because the studies were done on data that was collected many, many years ago where samesex marriage was not allowed in this country were men who were married to women. But the point is women are really good at taking care of people. They were in charge of the health of the entire family. They schedule the medical appointments make sure the husband is taking i thought it was very cute what i read it. Sue and this is the perfect segue to lifestyle, prevention and some tips. We have some viewer questions. Someone asking with the single most important thing a woman can do for her postmenopausal brain . Guest the single most important thing i believe is to really look at your lifestyle and find the one part of your lifestyle that is not work should be. Or you would like it to be. Because everybody has different baseline. Submit stress, stress reduction i am not good at that. [laughter] but for a lot of women it is diet. Theyre intellectually stimulated think their eight key steps to very Healthy Human brain before and after menopaus menopause. They include mental stimulation, especially when learning is involved. Learning is for your brain what exercises to your muscle. It really stimulates synaptic growth. It stimulants connection. That keeps the brain plastic which in biology means young. You need to challenge yourself. If youd like to read a book, dont read a novel read something this challenging. If you want to watch a movie watch a documentary as well where you learn something. Might mom plays mahjongg almost four times a week. That is always keeping her brain young. Most of her games. [laughter] but besides that, i know that diet has to be in that eight step, right . How important is moderating what you eat, but also what kinds of foods should we be eating . He also wrote the book, the brain book. Guest died is important for two reasons. Number one is the nutrients we eat have been affect not just on our bodies but literally inside our brains. Our brains are made of nutrients, we really need to replenish the nutrients, pretty much on a daily basis and make sure. Especially for women i recommend antioxidants. We have found in brain scans there is a direct correlation between the intake of antioxidants and a diet which is vitamin a, b and see in your brain Energy Levels throughout the lifespan. But also with menopause. The more the nutrients consumed on a daytoday basis most people to which immediately have every day to make a choice of brain health. Not just about the way we look its about feeding her Brain Nutrients and they can support so much better for us. And its a Strong Healthy diet. Specifically might own diet i. E. For my brain as much as i can. The way we eat as a family. Given my family is italian its a mediterranean diet which is what you write about in the book, being sort of the diet that most people should follow, right . Guest i think its a really good templates, a very fresh diet that reaches the nutrients the planes brain once and needs is not a deprivation diet. [inaudible] [laughter] i cannot be deprived. [laughter] i want to enjoy my food. I think its a very respectable diet. What i like about it at someone thinking and a book about it. It really is a result of thousands of years of consumer guide to do significantly better than women on a western diet. It doesnt have to be inconvenient. Think its plant based where theres a good amount of vegetable oils especially unrefined ones, a lot of fiber fibers really good for you. Thats something we dont talk that much about and we should. Lagoons is diet and england with hundreds of women showing the more fish you eat, the later on in life you go through menopause. Host interesting. Guest i think its interesting have the mega fatty acids. The carbohydrates the more refined sugar you have your diet earlier in life you go through menopause. Even if you have note genetic ingenuity to do it. Is not just something you do for fun or pleasure food is functio function. Something we can actively do, we have control over it. Exercise also is an important factor. You write in the book that slow and steady wins the race. So modern exercise is the route to go rather than a lot of people are now, were going to jims we could take high intensity classes. Nurturing the videos at home. Why is slow and steady a better place for exercise . How much exercise should we be getting . I think slow and steady really translate to moderate energy. Theyre starting to really look into that in women. Typically only women and not men and women together. This shows a very clear between intensity and gain. Give zero intensity very low intensity of no gain. But if the intensity starts going up sows again into the reach it spot for go high intensity your gains are increasing. And that is for women who are ages 40 and older. So it looks like as long as their hormones and kinesiologist support in general you can fill it out relying, any exercise is super helpful. For many women is a huge group of women what works for the average person. Women who are older than 40 and those in menopause looks like moderate intensity exercise is what is sustainable. It gives you enough gain but you also do it often enough that you can see a benefit. As for many people you go very high intensity and then you are tired, just dont instantly think with important if you dont like it its paid. To feel bad about. Karl is good ask about sleep. How does poor sleep quality impact women and their brains as they age . Guest it does, that is my issue. National Science Foundation really shows that women sleep worse than men. Pretty much at any age. We have trouble falling asleep, we have trouble staying asleep. And the quality of the sleep and the structure is much more easily disrupted as well. That seems to really overlap with life in middle age. I dont want to say everything is hormonal. But the hormonal impact as well. Its a very specific part of the brain called the brainstem and if your estrogen activates this region correctly. When estrogen started at age 25 especially adjuster. The same is not activated correctly. Thats all we have a tendency to wake up in the middle of the night and stresses the same. Melatonin is really high at night at two in the morning. And decreases and adrenaline goes up. Happens to a lot of the music up three in the morning. We know a lot of us during that period so when do you sleep well . I dont try been struggling with sleeping well. Obscure the pandemic it has been worse. I think all of us are feeling stress and anxiety more. I am perimenopausal. Im hot the middle the night have to get up and go back to sleep is very hard. Try been taken read a book as well, valerian and some black. [inaudible] pretty one to ask you for supplements for women. What are some of the ones you recommend . Obviously these are things you should talk with your dr. About and make sure you get something that reacts well with your body. Host im a strong believer in testing before deciding which supplements to take. I think a lot of people go for which makes a lot of sense and principle. It doesnt really help in the short deficient. We do a lot of we do a lot of testing so be vitamins and any deficiencies. First we go through a diet examination. The best way to supplement his changing your diet. That said in some cases the healthy diet is not enough. In that case its helpful. But we tend to recommend the most especially to women is omega3 antioxidants. Especially those who do not eat fish. If you eat fish enough you shouldnt eat them. Something i am very fond of his flaxseed oil. For women who do not eat fish very often or maybe you dont eat fish. Flax seed oil has the highest concentration of mega three. In just 1 tablespoon goes about half of all the omega3s you need for the day. What oh wow. I switch now musing that. Fascinating. What about vitamin d, vitamin c . The antioxidants would encourage postmenopausal women to consider taking them. But it doesnt really help asleep. Especially the combination of the cream with vitamin c really alleviates the night sweats and Clinical Trials. The seven that shown to work for many women. The worst case it doesnt work. Sue insert overthecounter progesterone cream. You need to check with your doctor, but that might help. Im very strong antioxidant as well also stimulates blood flow and oxygen levels in the brain. They keep their energy high and the precursor to vitamin a. And honestly antioxidants are obtained from the nutrients in the food we eat. It appeared to have more orange, yellow vegetables and fruits, healthy nuts and dark green leafy vegetables that is probably the best way. See when theyre so much information is book i encourage everyone to read it again it is the the xx brain. One more question because you talked about testing. Fewer ask you talk about what tests or scans used to study alzheimers . And to track the progress of the disease. As a testing accurate . Before you went live you said you yourself are going to have a brain scan which you have not done before. Can you talk about that . Guest it is the best tool we have right now the help that an individual basis. Its a really good predictive tool. Your work to really make sure that we address the concerns that we make them comfortable. But you do not have to do brain scan if you dont want to breed most of my Patients Want to. We do mri scans, and then we do a pet scan with nuclear medicin medicine. We been doing that for 20 years. I we look at everything we can pray we look at the structure of the brain. We look at the anatomy of the brain. We try to see if theres any shrinkage of the brain. Those are red flags. We look for inflammation in the brain. Look for integrity which is how well different parts of your brain communicate with each other. We look at Energy Levels in the brain. Look at sinus plaques we look at pathology which is another we look at whats important especially for women in the brain. Its worse for women after menopause. We look at a lot of things. Why always tell our patients the youngest is 40 so just decrease the range of 35. With really helpful to have a good baseline, its helpful to you for life. Right now you have no problem. This is your brain now when you have no problems. Dont forget in ten years you do have some issues or some concerns with menopause it happens a lot. And we do another brain scan and we compare. Because if you come to me when youre having trouble theres only so much there is a very clear problem that i can see immediately. So once you have a baseline to compare it to. Yes its always better to be able to check or change for no change. Because if there is no change you just having a hard time and we need to address the symptoms. There is a change that we need to readdress your brain. It really helps a lot to have as many time points as possible. Host again theres so much information in this book. It is called the xx brain, doctor lisa mosconi. Its brilliant i read it cover to cover within a couple of hours because i wanted to digest every bit of information. And so thank you so much. And thanks to all who participated here today. And be sure to check out doctor mosconis book if youd like more information. You will be seeing, hopefully he missed the beginning of this podcast you will be able to or this webcast, you can see it at a future time as well. Will take and put it up on the Aspen Institute health streaming services as well. Thank you very much and have a good day. You are watching book tv on cspan2. Television for serious readers. Here are some programs to watch out for ten nights. New yorker staff writer evan ausmus discusses the life and political career of president elect joe biden and howie biden presidency might look. And on her Author Interview program after words law Professor John fabian witt examines the relationship between law, epidemics and Public Health guidelines. Those are some the programs youll see tonight here in book tv. For a complete schedule visit booktv. Org check your program guide. Soon i cares of the current bestselling nonfiction books according to the washington post. Topping the list is the best of me a collection of stories and essays by author and humorist david sedaris. Then its Pulitzer Prize winning author exploration of what she calls a hidden system in the united states. Thats fell by actor Matthew Mcconaugheys memoir green lights. And i and a gartens modern comfort food in repping up the look at some of the bestselling books according to the washington posts activist glenna doyles memoir untamed. Some of these authors appeared on book tv and you can watch their vents online on booktv. Or booktv. Org. Its great to be back as we kick off the fall season. In our inaugural speaker as you mentioned is ed freeman. He is the professor of business at the Darden School at uva. Now today he is come to discuss his latest book which is so relevant given the current discourse thats going on and our nation