9/6/2020 The NEURO Plan (Nutrition, Exercise, Unwind, Restore, Optimize) NUTRITION:

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Team Sherzai
April, 2018

The NEURO Plan

(Nutrition, Exercise, Unwind, Restore, Optimize)
A Simple Framework for Optimal Brain Health
by Dr. Dean and Dr. Ayesha Sherzai

NUTRITION:
Top Twenty Brain-Nourishing Foods to Increase:

Avocados: This fruit is packed with monounsaturated fats that support brain structure
and blood flow.
Beans: Beans are high in antioxidants, phytonutrients, plant
protein, iron, and other minerals, and have been shown to increase longevity and
reduce the risk of stroke (one of the four most common neurodegenerative diseases
that shares risk factors with dementia). Beans can lower cholesterol and regulate blood
glucose even many hours after being consumed—hence the phrase, “second meal
effect” (where certain foods affect blood sugar and insulin levels during subsequent
meals).
Blueberries: In a Harvard longitudinal study conducted on 16,000 nurses, the
consumption of berries, especially blueberries and strawberries, was associated with a
lower risk of cognitive decline. Specifically, the study suggested that regular
consumption of berries delayed cognitive decline by two and a half years.
Broccoli: Rich in lutein and zeaxanthin, carotenoid antioxidants that can cross the
blood-brain barrier and reverse damage caused by free radicals and normal aging. A
large study at Harvard Medical School of over 13,000 women found that those
participants who ate more cruciferous vegetables like broccoli had less age-related
memory decline.
Coffee: The caffeine in coffee is an adenosine receptor antagonist, which stimulates
the production of acetylcholine, a known neuroprotective agent in the brain. Coffee also
contains potent antioxidants in the form of polyphenols and chlorogenic acid.
Dark Chocolate: Dark unprocessed cocoa or cacao nibs, the purest forms of chocolate,
are incredible sources of flavanol phytonutrients that have been shown to relax arteries
and help supply oxygen and nutrients to the brain. In fact, people who eat dark
chocolate have a lower risk of stroke.
Flax Seed: Contains the highest amount of plant-based omega-3
fatty acids that have been shown to decrease inflammation and reduce LDL (“bad”)
cholesterol levels. Flax also contains lignans, chemical compounds that protect blood
vessels from inflammatory damage.

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Team Sherzai
April, 2018

Herbal Tea: Mint, lemon balm, and hibiscus teas are the three most anti- inflammatory
beverages available. Iced herbal tea (with added stevia or erythritol for sweetness) can
easily replace sugary drinks in the summer.

Herbs: Fresh or dried herbs like cilantro, dill, rosemary, thyme, oregano, basil, mint,
and parsley contain ten times the antioxidants of nuts and berries. Even a small amount
boosts your daily antioxidant consumption.
Leafy Greens: A rich source of polyphenols (plant-derived antioxidants that fight free
radicals), folic acid, lutein, vitamin E, and beta carotene, all nutrients that are associated
with brain health.
Mushrooms: Whether they’re fresh, dried, or powdered, mushrooms improve overall
immunity and reduce inflammation in the blood vessels of the brain. Cremini
mushrooms are an excellent plant source of vitamin B12, which is linked to a lowered
risk of Alzheimer’s disease.
Nuts: Nuts provide the highest source of healthy unsaturated fats, which have been
shown to reduce the risk of Alzheimer’s in multiple studies.
Omega-3 Fatty Acids (derived from algae): High-powered, plant-based omega-3s
that reduce inflammation and boost the immune system.
Quinoa: One of the most nutrient-rich foods. Quinoa is the only grain that’s a complete
protein source (most grains lack the amino acids leucine and isoleucine). It also
contains ample fiber, vitamin E, and minerals like zinc, phosphorus, and selenium, all
essential building blocks for brain cells and their supporting structures.
Seeds (Chia, Sunflower): High in vitamin E and other brain-boosting minerals.
Spices: Spices contain the highest amounts of antioxidants per ounce compared to any
other food and are excellent at supporting the brain’s innate detox systems. Both spices
and herbs like cinnamon, cloves, marjoram, allspice, saffron, nutmeg, tarragon, and
others should be a regular part of our diet, not just a once-in-a-while addition.
Sweet Potatoes: Packed with phytonutrients, fiber, vitamins A and C, and minerals, this
tuber actually has the ability to regulate blood sugar. Its anti-inflammatory effects have
also been documented in numerous studies.
Tea: Green tea contains green tea catechin, another polyphenol that activates toxin-
clearing enzymes.
Turmeric: Curcumin, an extract of turmeric, is an antioxidant, anti- inflammatory, and
antiamyloid powerhouse. In studies of both animals and humans, curcumin has been
shown to have a direct effect in reducing beta-amyloid.
Whole Grains: Packed with cholesterol-lowering fiber, complex carbohydrates, protein,
and B vitamins. The starch in whole grains like oats, buckwheat, millet, teff, sorghum,
and amaranth is the most beneficial type of complex carbohydrate: it both feeds good
bacteria in the gut and provides an excellent source of sustained energy for the brain.

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Team Sherzai
April, 2018

Top Ten Foods to Reduce or Eliminate:

Processed Foods: Chips, cookies, frozen dinners, and white bread are all high in salt,
sugar, and saturated fats that clog the brain’s arteries and directly damage brain tissue.
Processed oils like canola, and even other “healthy” oils are concentrated sources of
fat, which can damage the inner lining of our arteries and cause inflammation.
Processed Meats: Meats like pastrami, salami, bacon, and hot dogs are filled with
preservatives, salt, saturated fats and carcinogenic compounds that promote
inflammation and damage blood vessels and the supportive structures in the brain.
Red Meat: Farmed or grass-fed beef and wild game meat are high in inflammatory
saturated fats. They may cause less inflammation than processed meats, but they still
result in considerable damage at the vascular and cellular levels.
Chicken: Chicken is the main source of cholesterol in the standard American diet.
Chicken contains three times more fat than protein and is a major contributor to obesity.
Butter and Margarine: High in saturated and trans fats that clog arteries and shrink the
brain.
Fried Food and Fast Food: High in trans fats that reduce brain volume, contributing to
cognitive decline.
Cheese: High in saturated fat. Damages blood vessels in the brain.
Pastries and Sweets: High in sugar. Cause inflammation and brain burn-out.
Sugary Drinks: The main source of sugar in the standard American diet. Causes
inflammation and neuronal damage.
Excessive Alcohol: Alcohol is neurotoxic and directly damages brain cells.

THE MANY NAMES OF SUGAR:

Sugar may be lurking in your favorite foods. Here are some of the many forms to look
out for:
• agave syrup • invert sugar
• brown sugar • lactose
• corn sweetener • maltose
• corn syrup • malt syrup
• dextrose fructose • maple syrup
• fruit juice concentrate • molasses
• glucose • raw sugar
• high-fructose corn syrup • sucrose
• honey • sugar

Source: https://www.nia.nih.gov/health/publication/whats-your-plate/solid-fats-added-sugars

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Team Sherzai
April, 2018

EXERCISE:
Important Properties of A Successful Exercise Program:

• Convenience: Your program must be easy. If it’s too difficult, you’ll get
discouraged.
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• Repeatability: A successful exercise program must be repeatable on a regular

basis. Repeatable activities are easy, efficient, and ideally enjoyable.

• Incremental Success: You have to see success in what you’re doing. This could
be as simple as being able to do nine squats instead of eight, or being able to
pedal one minute longer than your baseline.

• Measurable: You should be able to measure how much exercise you’ve done,
and your progress should be visible at all times. You might use a whiteboard in
your home, a notebook, or an app on your smartphone.

Work Toward Increasing:

• Taking the stairs
• Moving while watching television
• Walking or riding your bike wherever possible
• Using a stepper while working
• Dancing, doing tai chi, or practicing yoga at home
• Squats or step-ups with a stool while at work or in the living room
• Wall push-ups whenever there is an opportunity
• Hamstring workouts with ankle weights in the kitchen/living room/bedroom
• Sit-ups in bed in the morning

Work Toward Eliminating:

• Long hours of sedentary behavior like sitting at an office desk or in your car
• Watching television without exercising
• Avoiding the stairs
• Days without any form of exercise

Types of Exercise Beneficial For the Brain

Aerobic Exercise
• Choose one of these activities to do on a daily basis.
• Brisk walking
• Stationary bike, reclined or non-reclined

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Team Sherzai
April, 2018

• Jumping jacks
• Stepper
• Stairs
• Dance
• Martial arts (tae kwon do, karate, kickboxing)
• Stepping up and down on a stable stool

Strength Training

• Squats
• Lunges (forward, backward, side to side)
• Leg extensions
• Abdominal crunches
• Planks
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• Bicep curls
• Triceps curls
• Shoulder raises
• Push-ups (regular and at the wall)

Balance Training
Below are exercises for balance. Choose one and do it every day. Have a chair next to
you if you are just starting out or don’t feel steady.

• Heel-to-Toe Walk: Place the heel of your foot in front of the toes of your other
foot; both feet should be touching. Walk in a straight line while focusing on a
point ahead of you. Do not stare at your feet.
• Single Leg Balance: Stand on one foot using a chair for support. Raise your leg,
bringing the knee forward, and hold for 10–12 seconds. Lower your leg and
repeat on the other side. For more of a challenge: do the leg raise without
holding on to a chair.
• Back Leg Raises: Stand on one foot using a chair for support. Raise your leg,
pushing the knee backward, and hold for 10–12 seconds. Lower your leg and
repeat on the other side. For more of a challenge: do the leg raise without
holding on to a chair.
• Side Leg Raises: Stand on one foot using a chair for support. Raise your leg,
extending it sideways, and hold for 10–12 seconds. Bring your leg back to the
midline and repeat on the other side. For more of a challenge: do the leg raise
without holding on to a chair.
• Yoga: Tree pose is great for strengthening balance. To start, you can practice it
with your back to the wall or the side of your body (standing leg) to the wall. As
your balance improves, try stepping away from the wall. To further challenge the
pose, you can try it with your arms reaching above your head or with your eyes
closed. Chair and warrior 2 are other excellent poses for strengthening the leg
muscles and core. Be sure to start slow and breathe.
• Tai chi: The Yang short form is best for beginners.

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Team Sherzai
April, 2018

Flexibility Training
Here are the nine main flexibility exercises that you should do regularly throughout the
day:

• Neck Stretch: Tilt your head side-to-side and front to back. Follow with gentle
neck circles.
• Shoulder and Back Stretch: Interlace your fingers and raise your arms above
your head with your palms facing the ceiling. Extend your elbows and press your
arms upward.
• Shoulder Rotator Stretch: Bend your right elbow and place your arm behind your
back with your palm facing away from you. Holding a towel with your left hand,
extend that arm overhead. Slowly bend your left elbow, bringing your left hand
toward your right hand. Hold both ends of the towel firmly. As you breathe you
may be able to bring the hands closer to each other, which increases the stretch.
• Wrist Stretch: Rotate the wrists in circles (both directions). Extend your arm and
use your opposite hand to stretch your fingers both upward and downward.
• Lower Back Stretch: Sit on the ground with your back upright and legs extended
in front of you. Slowly hinge at the waist and reach for your toes. Move slowly.
Over time your abdomen will get closer to your thighs, and your head will get
closer to your knees.
• Hip Stretch: Stand upright. Circle your hips in each direction. Then, with your hips

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stable, extend
• Hamstring your
Stretch: torso
Stand to eachFold
upright. sideatasyour
you waist,
lengthen your waist.
lengthening your torso over
the fronts of your thighs. If your hamstrings are tight, bend your knees. Over time,
as your muscles, ligaments, and tendons start to loosen, work toward
straightening your legs.
• Knee Stretch: Circle your knees in each direction. Gently bend and straighten.
• Ankle Stretch: Rotate your ankles in each direction. While seated, use your hand
to stretch your foot upward, downward, and to the left and right.
• Lunges (forward, backward, side to side)

• Leg extension

• Abdominal crunches

• Planks

• Bicep curls

• Triceps curls

• Shoulder raises

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Team Sherzai
April, 2018

UNWIND:
Manage your stress:

• The most effective way is to change from an Urgency driven living to a

Vision/Purpose driven living
• Identify your monthly ‘Vision’
• Break the activities into:

o Urgent matters
o Substantive activities that will help you reach your goal
o Matters that need to be delegated
• Every day, attend to one urgent matter.
• Every week, attend to one substantive activity that will help you reach your goal
• Delegate at least one item per week
(These ratios can be changed according to your situation)

5 Minutes of Mindful Breathing:

• Find a comfortable place where you won’t be disturbed

• Sit up straight. Consider using a wall to support your back
• Close your eyes
• Breathe slowly and deeply through your nose
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• When you’ve reached the natural point of exhale, breathe out slowly through your
mouth

• Once you’ve gotten into a rhythmic breathing pattern, typically after a minute or so,
start to focus on the sounds around you. Don’t analyze or memorize them. Just listen
quietly and experience them

• When other thoughts arise in your mind, don’t engage them. Let them drift out of your
mind and return your attention to what you can hear
• Try this exercise for 5 minutes each day. As you get more proficient, feel free to
increase the time

Variations on Mindful Breathing:

• Sensation: Focus on different bodily sensations, like the floor beneath you, and the
sensation of air entering your nose and exiting your mouth.

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Team Sherzai
April, 2018

• Progressive Muscle Relaxation: Starting at the top of your body

and moving downward, begin to tense all your muscles—your forehead, eyes, jaw,
neck, shoulders, back, arms, hands, abdomen, buttocks, thighs, calves, and feet.
Hold this tension for at least five seconds. en take a big inhalation, and on your
exhalation release everything. Take a few more deep breaths. Feel the difference
between a tensed body and a relaxed body.

• Visualization: Imagine you’re on a riverbank and that your thoughts are slowly riding
a current that flows from left to right. When a thought arises, simply watch it float
down the river and out of sight.

Alternatives to Traditional Meditation:

• Walking Meditation: Walk the same route every day. This will allow your brain to relax
and focus on the pleasant sensations in your body. The goal isn’t aerobic exercise
(though aerobic exercise is very important for brain health). Instead, find a pace that
feels natural and try to maintain it throughout your walk.
• Yoga: There are many different types of yoga to suit your personality and your
desired level of exercise and mental relaxation.
• Simplifying Your Life: Live in a clean, uncluttered space. Approach your work in an
organized, purpose-driven way.

Meaningful Relationships: Surround yourself with friends, supporters and loved ones.
They naturally reduce your stress levels.
Listening to Music: is one of the best ways to unwind. Try to fill your day with music as
much as possible, and use it at night to relax before sleep.

RESTORATIVE SLEEP:

TECHNIQUES FOR A BETTER NIGHT’S SLEEP

1. Normalize Your Sleep Schedule: Go to bed at the same time each night and
get up at the same time each morning. Keeping regular hours helps your brain
know when to rest and when to be alert. We evolved to sleep with the fall and
rise of the sun. An erratic sleeping schedule interferes with the daily hormonal
processes that help facilitate restful sleep.
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2. Avoid Eating Late at Night: When your gastrointestinal system is working to

digest food, you don’t sleep as deeply and are more likely to wake up.

These foods can be especially disruptive to sleep:

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April, 2018

• Sugary foods give your body quick energy that interferes with relaxation and
sleep.
• High-fat foods can cause indigestion and acid reflux.
• Spicy foods can irritate the stomach and also cause acid reflux.
• Chocolate contains sugar and caffeine, both of which negatively affect sleep.

3. Avoid Certain Drinks Too Close to Bedtime:

Caffeine can stay in your body for over eight hours. We recommend drinking
coffee and other caffeinated drinks no later than 2 p.m.

Other drinks to look out for:

• One or two glasses of wine can be relaxing, but more than this will disrupt
sleep cycles and often cause you to wake up in the middle of the night to
use the bathroom.
• Citrus juices can cause acid reflux and irritate the bladder.

4. Avoid Exercising Before Sleep, But Be Sure to Exercise Earlier in the Day:
A brisk walk in the morning has wonderful effects on your sleep. Getting out into
the light helps set your circadian cycles and wakes you up for the day, and
exercise has been shown in many studies to increase the depth of sleep.
Walking after dinner (ideally at dusk) is also a great option. Your brain reacts to
the changing light and naturally prepares for sleep. Be sure to complete
exercise— especially intensive aerobic exercise—at least three hours before
bedtime.

5. Low Light at Night, Bright Light During the Day: Your brain needs bright,
natural light during the day, and softer light at night. If you find it hard to get
adequate natural light, light boxes are a great solution. They provide twenty to
forty times more light than regular lamps and mimic natural light. Many studies
have proposed light therapy as a treatment for seasonal affective disorder and
depression, but it can also help with the sleep-wake cycle. Light boxes should
always be used in the morning—otherwise they could interfere with your sleep.
Use only so lights in your bedroom at night, and turn off electronic devices that
emit bright light.

6. Avoid Playing Games, Watching Stimulating Movies, and Working on Your

Tablet in Bed: The idea is to calm the brain, not rev it up. Try reading instead—
something enjoyable but not too engrossing. It allows the mind to relax and
helps you avoid the blue light in electronic devices that has been shown to
interfere with sleep. It’s best to reserve the bedroom for sleep and sex only.

7. Avoid Napping: For most of us, napping during the day will interfere with our
ability to fall asleep at night. We don’t recommend daily naps unless you have a
long-standing habit of napping. Even then you should set an alarm so that you
sleep no longer than ten to thirty minutes. Anything beyond that can result in

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April, 2018

sleep inertia, a groggy feeling after awakening that can impair performance. If
you’re trying to establish a regular sleeping pattern, we recommend that you stay
awake during the day (unless sleepiness could put you or others in danger).
You’ll be tired enough at night that you’ll fall asleep earlier and faster, which will
help you normalize your schedule.

8. Use Meditation: Meditation is a wonderful addition to your pre-bedtime routine.

is powerful practice physiologically relaxes the body by slowing both breathing
and heart rate and has also been proven to reduce stress.

9. Sound- and Light-Proof Your Bedroom: Both sound and light can wake you up
and disrupt your sleep cycles, robbing you of the deep sleep your brain requires.
Try using white noise or natural so sounds. If you have consistent loud noise,
consider egg-crating the room and insulating the windows and doors. Blackout
curtains are great for keeping your room dark.

10. Get Comfortable: Do you prefer a warm blanket or cool sheets? There seems to
be a difference in temperature preference between men and women. Women
prefer a slightly higher temperature, men slightly cooler. It is certainly true with
the two of us. We use dual blankets (one warmer and one cooler) so we can
sleep together and also enjoy our preferred sleeping temperatures. There are
also beds with dual temperature settings, and even pillows designed to maintain
certain temperatures throughout the night. Because of hormonal fluctuations
throughout the sleep cycle, the temperature pattern for the most restful sleep
seems to be: 1) falling asleep at a temperature just slightly above body
temperature; 2) the temperature slowly dropping throughout the night; and 3) a
minor rise in temperature before waking up.

11. Address Dependence on Medications: Use these techniques under a doctor’s

supervision to slowly reduce your need for medication.

12. Use Cognitive Behavioral Therapy (CBT) if Necessary: Seek help from a
qualified therapist if you are experiencing excessive anxiety or distorted sleep
patterns. CBT is most effective for those who still experience anxiety after trying
both the relaxation techniques and the sleep hygiene techniques. Anxiety that
doesn’t respond to any of these techniques may require an initial round of
therapy.

13. Look for Signs of Sleep Apnea: If you suspect you might have this common
sleep disorder, ask your doctor to order a sleep study (this is the only way to
know for sure). Review the results and then discuss the best solution for
improving your sleep.

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April, 2018

PROGRESSIVE MUSCLE RELAXATION: AN EXERCISE YOU CAN DO IN BED

Try this exercise when you have trouble falling asleep:

• Take a deep breath. Hold it for five seconds, and then breathe out.
• Take another deep breath. This time contract all the muscles in your feet and
hold for five seconds. Then breathe out and completely relax your body. Feel the
contrast between tension and relaxation, the way your body releases deeply after
holding tension.
• Move slowly upward, contracting and releasing your ankles, calves, thighs, hips,
abdomen, lower back, upper back, fingers, forearms, upper arms, shoulders,
neck, jaw, mouth, cheeks, nostrils, eyelids, temples, and forehead. Be sure to
inhale deeply and exhale completely each time.

Work Toward Increasing:

• Relaxation before bedtime
• Time spent without electronics
• Enjoying a regular schedule
• Meditation
• Light during the day
• Exercise earlier in the day

Work Toward Eliminating:

• Bright light late at night
• Eating before bed
• Drinking coffee in late afternoon, evening and at night
• Noise that wakes you up at night
• Physical activity and exercise later in the evening

OPTIMIZE COGNITIVE AND SOCIAL ACTIVITY:

Building cognitive activity is not difficult. Building a resilient, connected brain
takes more than simple puzzles and memory exercises. The brain thrives on
challenges, especially those that are personally relevant and involve multiple
cognitive domains. Identify what optimizing brain function means in your life;
you’ll then learn about memory-enhancing techniques and many activities that
will boost your cognitive function and protect against decline.
Memory:
Short term: Recall a list of names of colleagues and one other related item, such
as the names of their family members and their birthdays.
Long Term: In your contact list of colleagues that you have created over the last
few years, recall their names, faces (visuospatial recall) or any other features.

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Problem Solving:
Ability to solve more complex problems (team-building exercises).
Visuospatial Skills:
Ability to recognize, understand and execute processes in a visual world. An
exercise to build visuospatial skills is to visuals a familiar path to a destination,
such as walking out of your office building to a nearby coffee shop, a subway
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station towards, or a restaurant etc. It helps you create a detail-oriented mindset.
____________________________________________________________________

ACTIVITY:
PROVIDE PICTURE OF AN OFFICE WITH MULTIPLE OFFICE ITEMS AND
FURNITURE
Glance at this picture for the next 30 seconds and then stop and turn the page.
On a white page, write down the names of all the objects you saw in the room in
the approximate place correlated with the picture.
How many objects did you see? Where was each one placed?
____________________________________________________________________

Attention and Focus: This is the foundation of all the other cognitive capacities.
You can build focus by doing mathematical calculations in your head. In this
case, it’s not about the complexity of the math but your ability to stay focused
during the process. Try subtracting 3s from 1,000 all the way down to single
digits. Then try subtracting 7s. If you have trouble, start with 100 instead.

WORK ON YOUR WEAKNESS

Our research shows that the cognitive domains benefit most from activities that
focus on each individual’s weaknesses. So, focusing on what is difficult will
create more brain cell connections and resilience.

Memorization Strategy:
ACES: These exercises combine four different thought processes to enhance
memorization:
A = Attention. Pay attention to the piece of information you’re trying to remember.
C = Connect. Associate that information with other related information using a
mnemonic device—something that will make the information distinctive.
E = Emotion. Create an emotional link to the information to consolidate it further.
S = Senses. Try to associate other senses with the information (images, smells, tastes,
etc.).

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