A life course approach to good Brain Health

The Lancet has recently written a paper called “The life course approach: setting the stage for healthy ageing”. Never has healthy ageing been more important than it is today. On a daily basis, we’re tempted by fast and processed foods, binge-worthy TV programmes and the endless blue light emitted from our phones. Professor James Goodwin, Director of Science and Research Impact at Brain Health Network gives his take on the paper and what we can do to ensure our own healthy ageing.

A Life Course Approach to Good Brain Health

In 2007, a colleague of mine, Professor Diana Kuh, wrote the first scientific paper explaining that how we lead our lives now will greatly influence the state we are in when we get older.  She called it, ‘A life course approach to healthy ageing’.  In her eponymous book published 7 years later, she began with a marvelous quote from none other than US President Theodore Roosevelt: “Old age is like anything else. To make a success of it, you have to start young”.  I love that quote because over the 100 years since he made it, all scientific evidence has shown how prescient it was.  Moreover, Roosefelt was a sickly child with debilitating asthma but overcame his health problems through a strenuous lifestyle.

Just as impressively, another milestone article in 2008 published by Professor Linda Partridge and other ‘ageing’ colleagues of mine, aired the controversial concept that medicine has it wrong in its approach to curing disease. We shouldn’t be seeking thousands of individual treatments for single age-related diseases, like Alzheimer’s Disease, cardio-vascular disease or Type II diabetes. We should be studying ageing itself which is the common underlying risk factor for all chronic long term illnesses.  Once we understand ageing, we can do something about it, including exiling illness until the last years of a long life. 

These two groundbreaking papers laid the foundation for a long series of successful research programmes which have completely changed our view of how to stay well as we age – including how we preserve our brain health.  And how do I know that these programmes, such as The New Dynamics of Aging, the Disconnected Mind and FUTURAGE were successful? Because they have completely changed our understanding of how we age and what individuals and society can do to slow it down. 

It was therefore unsurprising to me that early in 2025, the Lancet journal re-visits this theme.  They write in their January editorial: “… the foundations of healthy ageing are laid over the course of our lives….  Ageing does not inevitably denote declining health, and we must therefore harness the opportunity throughout our lives to set the stage for a path of healthy longevity”.    

What Life Long Approach means

This approach is exactly what drives us at Brain Health Network. We understand that if we can identify the risk factors in our life, particularly from middle age onwards, then we stand a chance of reducing our risk of cognitive decline, staying sharp and feeling good. I always tell people that it is never too late (or early) to start looking after your brain, it is entirely possible to slow down brain ageing and that ‘DNA isn’t destiny’ – our genome only contributes 25% of the rate of brain ageing.  It’s what we chose to do that makes up an astonishing 75%.

What to do to maintain brain health

To clarify how to go about making the right choices in our lifestyle, we have organized the risk factors to our brain health into 6 areas which we call our ‘Six Pillars’. Together they comprise the ‘Brain Health Method: the Power of Six’. And powerful they are. All of them are based meticulously on the latest evidence and are proven to make a difference – to you, your family, loved ones and beyond. Next is a brief summary of what you may do, to improve your brain health.  

Brain Health Network’s six pillars:

1. Healthy Life

I can always gauge the brain health of the people I meet by estimating their general health.  It is as good a guide as any. Do they smoke? Consume too much alcohol? Have a healthy social life? Have hearing difficulties? Overweight? I could go on but I think you get my point.  Almost anything we do to improve our general health will benefit our brain. One amongst the many risks that we can tackle is maintaining a healthy blood pressure.  Simultaneously, high blood pressure is a massive threat to our health and also one of the easiest to manage.  Blood pressure machines for home use are readily available (don’t rely on a single measurement in your doctor’s surgery) and medication is easily obtained, if your pressure is high.

2. Nutrition

We can easily eat our way to a healthy brain. Science tells us that five of the most important nutrients for brain health are omega 3 fatty acids (or more correctly, the ratio of Omega 3 to Omega 6), Vitamins D and K, Zinc and Magnesium. I always recommend a high fibre Mediterranean diet with dairy products such as yoghurt and unprocessed, grass fed, red meat. But it’s not just what we eat. It’s also how and when. Essentially, try to eat slowly and in the order vegetables, fats, proteins and carbohydrates last. Also, try intermittent fasting – eating no later than 7pm and nothing until 8 or 9 am the next day.

3. Sleep

There is almost no one I know who hasn’t had problems with sleep. It is a universal problem.  The secret to a good night’s sleep is understanding how our sleep changes across our life course and being absolutely ruthless about our ‘sleep hygiene’. As we age, we need the same amount of sleep over 24 hours (7-8 hours) but not all in one go. A short night’s sleep can be made up by napping but for no longer than 40 minutes. And on every single day, weekends included, always go to bed and get up at the same time.

4. Exercise

It’s well documented that 150 minutes of simple, aerobic exercise (such as brisk walking, light jogging, bowls, tennis, swimming and so on) plus two sessions of lifting weights each week will deliver huge benefits to the brain. But it’s not only exercise. We all lead sedentary lives where almost everything we do is done sitting down. As a rule, more than 10 hours per day of sitting will completely erase the benefits of the exercise I have described. We have to declare war on the chair! Humans evolved on the basis of long bouts of continuous activity interspersed by rest. Lack of movement, a sluggish lifestyle and spending our time on the couch are the enemies of good brain health.

5. Gut Health

The idea that gut health is fundamental to the health of our brains is one of the most revolutionary findings of the last 50 years. It is vital that we look after the lining and contents of our gut (micro-organisms). They both massively contribute to lifelong brain health. I recommend eating prebiotics (high fibre food), probiotics, (fermented foods such as yoghurt, pickles, sauerkraut, kimchi, etc) and avoiding ‘fast food’, processed food of all kinds, eg ready meals and high fat and sugary foods. I also recommend paying attention assiduously to good oral hygiene. Above all else, high inflammation in the mouth due to poor hygiene will greatly increase the risks of brain ill-health and decline.

6. Active Mind

I am often asked, will doing crosswords, sudoku and other ‘mind games’ prevent Alzheimer’s disease or dementia? My answer is always the same, ‘it depends’.  Routinely carrying out the same activity is unlikely to reduce your risks of cognitive decline unless there is new learning involved. We call such activities, ‘cognitively stimulating activity’. Two of the best examples are learning a foreign language and dancing. These are what psychologists call, ‘complex interventions’ because they simultaneously engage multiple brain areas in highly challenging operations in which new brain pathways must be involved.

I have often been asked, if you could live at any time in history, when would it be? I would say the future or at least, today. The reason is that today we know more about looking after our health and that includes our brain health than ever before. The systematic study of ageing is only 50 years old. What we know about brain health, less, only 10 years. We are truly lucky. All we have to do is to change some simple things in our life and we can put our health on a new trajectory. It isn’t complicated. But it also isn’t that easy. It requires discipline to stick to it. But the rewards are huge. A longer, healthier and more productive life.  Wouldn’t we all want that?