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Daily Essentials Matrix

Updated: Jul 3, 2023

Plaques and tangles. Acrylic on canvas. Bellevue, 2022

Not all evidence is created equal when it comes to evidence based brain-healthy habits. As I’ve noted before, some experts believe that there are at thirty-six “holes” in the roof that need to be fixed, in order to ensure protection against dementia.

The weakest link

I prefer to prioritize brain-healthy practices by the strength of the evidence. And so it helps to know that science is only as strong as the weakest link. In other words, our understanding of human biology is iterative. We think that we know how our things should work based on research study findings, at least until another study comes along to either confirm or refute those findings.

We have all watched this back-and-forth play out in real time with COVID-19, over these past few years. Like when it came to wearing facemasks, we wanted our experts to know what was right and to be able to definitively tell us what to do. And we saw what a struggle it was to reconcile this and that bit of research, until there was enough of a body of evidence to come to consensus.

Dementia is so much harder to study than COVID, partly because neurodegenerative processes take years to manifest. Patients have such a broad range of symptoms, with considerable unpredictability in terms of which aspect of brain function may get worse next. Objective measures of memory, executive function, and so on, are prone to error. And furthermore, compliance with lifestyle practices are hard to study over large populations.

What’s become increasingly clear is that our daily self-care habits matter. How often we move, the quality of our sleep, and what we eat and drink, matter more than supplements or crossword puzzles. So while we want brain health to be as easy as taking a pill, biology just doesn’t work that way.

I’ve learned the hard way that no matter what the experts may say based on research, only I can be the authority when it comes to my body and my preferences, I like to use the scientific literature as a starting point for trying new brain-healthy interventions, but it ultimately comes down to what works for each of us individually.

The Matrix

The Daily Essentials Matrix helps us to figure out where we may be all dialed in as far as brain-healthy habits. And it helps us to identify where we might want to apply some focused time and attention to learn more, or to make a 2% shift.

Brain Health Matrix. © 2023 East West Integrative Medicine

The 3 pillars of the Matrix are Move, Sleep and Nourish, representing the core element of self care, in order of the quality of evidence supporting each. Each pillar is further subdivided:

  • When - refers to timing. i.e. What needs to be considered when it comes to time of day, how long and so on.

  • Where - refers to environment. i.e. What is the ideal setting for you to engage mindfully in that self care practice, and what detracts from your ability to sustain it?

  • What - refers to quality of practice. i.e. What habits are we specifically choosing to tweak, and how will we assess what’s better or worse?


Exercise has repeatedly been shown to have the strongest link to brain health. In fact, by some estimates, routine physical activity could potentially reduce the risk for Alzheimer’s disease by as much as 45%.

Beyond dementia prevention benefits, current brain function is also measurably improved with moderate cardiovascular exercise for 30-60 mins, three times a week. Studies have shown statistically significant benefits in terms of learning skills and reasoning ability, both in asymptomatic adults and those living with mild cognitive impairment.

Power 9 Blue Zones.

We tend to think of exercise in the form of shorter, higher intensity periods of movement like going for a hike or working out in the gym. But studies of Blue Zone residents have shown that healthy aging is correlated with moving naturally all day long.


Sleep is by far and away the most underrated brain-healthy habit in modern society. In the age of the internet and mobile devices, many of us workaholics find ourselves drawn to working all hours of the day and night. The good news is that the explosion of wearable sleep tracking devices means that there is increasing recognition of the importance of sleep hygiene.

I used to believe that being a light sleeper made me a better mom and doctor, and that somehow being an early rise and needing less sleep was a badge of willpower. But the emerging science on sleep benefits for brain health have converted me into a sleep evangelist.


Nutrition science is often confusing and even self-contradictory. And while there continue to be many areas of controversy, we seem to be reaching more of a consensus around the benefits of whole foods versus refined and processed foods.

Photo by Nadine Primeau on Unsplash

Midlife obesity is the number 1 risk modifiable risk factor for dementia, and yet we continue to struggle to manage obesity and diabetes at younger and younger ages.

We have learned that our bodies are so much more complex that we had thought. Turns out that all calories are NOT equal, nor does weight loss come down to simply calories-in being less than calories-out.

Diet books and programs tend to focus a lot on types of foods and exercise, but the timing of our meals may be one of the most under-appreciated aspects of weight management. I have further learned as a diet coach that it’s tremendously helpful to become aware of our bodies’ signals and our social conditioning.

What’s next?

If you are interested in joining our community of midlife women caregivers to learn more about your daily essential habits and the Brain Health Matrix, I would encourage you to start by taking the Brain Health Index Quiz. Learn more about your Brain Health Index Score HERE.

© 2023 East West Integrative Medicine



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