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Chapter 1: What is the main topic discussed in this episode?
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People talk a lot about brain fog, Priya. Do you ever experience brain fog? I sometimes experience brain fog, you know, that thickness through life. I don't know.
I don't know if I'm aware enough, honestly, at the minute. I just feel like I'm constantly juggling so many balls and the kids and I do have days where it's more difficult and perhaps that is brain fog, but it's a term that I hear often from patients and it can be after a viral illness.
It can be after many things, but certainly more discussion about this thickness, these cognitive symptoms during menopause and perimenopause.
It seems to be where it comes up most. And of course, that's one of the things we're going to be talking about today on The Health Report.
I'm Priya Alexander on Wurundjeri land.
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Chapter 2: What is brain fog and how does it affect women during menopause?
And what they've done is they've assessed people's cooking frequency at baseline. So they've said, how often do you cook at home? They've then followed these people for six years. They've matched them. So men and women have been matched. So people who didn't cook much, they've been matched with people who did cook a lot at home. They've looked and they've been six years.
And the dementia rates are lower. So basically cooking at least once a week was associated with a 30% reduction in dementia risk. And if you're not a good cook, Norman, and I don't know if that's you or not, I don't know your cooking abilities, but you had an even greater benefit from cooking.
So really interesting study is kind of what you'd want to believe. There is a caveat in this sort of study, which is there's a long preliminary tail, if you like, or lead-in to dementia. So you can have signs of dementia many years before you actually develop dementia.
So it could be, and this study really doesn't unpick that to the full extent, is that was it people who were not really heading for dementia, who tended to cook more because they were cognitively able to?
Mm-hmm.
But there's plenty of other studies showing that it's not a bad thing to actually cook your own food.
I think it's interesting. It might not be the reason that we all think that if you're cooking at home, you're probably eating less ultra-processed foods, less salt, more veggies potentially. But they've also said that it might be that actually the physical activity of going to the supermarket to do the shop, the social interaction, it might all play into it.
So it might not just be the food part of it alone, Norman, and the cognitive skills when you're cooking, when you're dicing the onion.
I was looking this up just sort of to get some moral support for this kind of study. There's an interesting French study showing, I mean, there's all sorts of collateral information. It's really good to be cooking. So this is a French study, again, following up a large group number of people over a period of time. It's called the French Nutrient Santé Cohort. Oh. Cohort. Not bad. And they...
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Chapter 3: How does home cooking relate to cognitive health?
So just to pick up there, really important that it can cause a lot of distress, impact on quality of life, but there isn't actually an objective drop in cognitive function. So there's not mild cognitive impairment that can increase the risk of Alzheimer's dementia, for instance. There's not an objective drop. Is that right? That is right.
So when we do big group studies, we see a subtle decline in areas of learning efficiency. But on an individual level, we do not see a notable objective decline that is, as you say, it distinguishes this from something like a mild cognitive decline where there is an objective cognitive decline.
Why is it so important to have a kind of concrete definition for this? What will it change?
So at the moment, there's not really any great treatments or management strategies that have got an evidence base for the cognitive symptoms. A lot of people might find hormone therapies helpful or different lifestyle strategies helpful, but we don't have a good evidence base.
And I think one of the factors that's hindered our research is because we're using things like a memory task, an objective memory task for a clinical trial, but that isn't what
this is about this is about a subjective experience so I think we really needed to define what the cognitive symptoms are so then we can accept that we need to use a scale that measures that subjective experience and that is what we're trying to improve when we're doing clinical trials or doing research studies trying to improve the cognitive symptoms that people are experiencing.
What's the cause of these symptoms? I would say it's a lot of different things. So the most obvious factor is hormone changes because it happens more frequently across the menopause transition or it's identified as being a part of the perimenopausal transition timeframe. So During perimenopause, our estrogen progesterone levels, in particular, our estrogen fluctuates and gradually declines.
And there's a huge evidence base, predominantly from animal studies, showing that estrogen can have quite significant impacts within the brain in regions that regulate our cognition, particularly our memory, as well as within the frontal lobes are regulating our ability to plan, to organize, to allocate our attention.
So that provides a bit of a rationale as to where the estrogen receptors are located in the brain and why fluctuations and a decline in estrogen might impact aspects of cognition. And we also know estrogen works with neurotransmitters like dopamine and serotonin, the GABAergic and glutamatergic system. These are all neurochemicals that also play a role in our cognition.
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