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The 4 Pillars of Brain Health According to a Neurosurgeon

By: Dr. Marcella Madera, MD

The  four pillars for having optimal brain function in our practice are optimizing sleep, optimizing stress management, optimizing nutrition, and optimizing physical activity. All of those are day to day practices that anybody can do, and they all can contribute to having a brain that performs at its highest level.


The overarching idea is, we want the body to have the minimal amount of baseline inflammation from our day to day habits so it can optimize to get to our full potential by minimizing inflammation. Exercise, not only does it increase this biochemistry substance. There are many overlaps with your type of exercise, how much exercise, and how many body processes are involved in exercise. It’s not just brain health, it’s cardiovascular health, it’s weight management and metabolism.

There are several diets that we endorse as they connect to an anti-inflammatory state. So you can have an entry-level, anti-inflammatory diet, like whole 30. You can also go on a paleo ketogenic diet. And we really assess the patient where they’re at, how much they know what their baseline is. Are they eating a lot of processed food, which is highly inflammatory and it’s a case-by-case thing? We see where they’re at and then we give recommendations.

I think sleep is probably the biggest one. So what do you do for that? There are sleep hacks that you can do like having a cooler room for yourself, turning off your devices, blue blocker glasses, a chilly pad.

Also, looking at your cortisol stress response, get in with the integrative or functional medicine doctor and ask what is your stress level? A lot of people say, oh yeah, I’m stressed, but I deal with it and I’m fine. And then we look at the numbers and, well, numbers don’t look like you’re dealing with it so fine. So getting that data can be really empowering for people in calming that stress response. Our culture is high stress, high power. That’s good. And that gets you a lot of advancement in your career, and it gets you a lot of money, and these are all good things, but not to the detriment of your body year after year, day after day of intensity of not giving yourself enough time to breathe. For example, not giving yourself enough time to exercise–which helps with stress, helps with mood, helps with BDNF. These things have been known forever. Stress leads to not enough time for sleep, not enough time for exercise, not enough time to care about your diet, and not enough time for your brain to relax.

The message is get with somebody who knows how to work on the thing that you want to work on. So, brain-wise, I think sleep is huge. I also think diet is as important, and they work together. The better your diet, the better your sleep. Exercise, again, like we talked about earlier, and the right type and the right amount– not too much. And then that calming that stress response.

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