The Brain You’re Building in Midlife
You can listen to the full podcast episode using the embedded player above.
“You are building the body and brain you are hoping to live in for decades.” - Rachel Carta, RN
The Woman You’re Building, Twenty Years From Now
My dad had dementia in the last years of his life, and it's still difficult for me to talk about what that experience was like. His dementia was not so much about forgetting who we were. He still knew us, which I know was an incredible blessing because so many families experience something very different. For him, dementia showed up more as a change in his personality, and in some ways that was incredibly painful to witness because I could still see my dad, but parts of the person I had always known were gone.
There were times I would sit beside his bed and wonder how much of him was still there. He stopped smiling, and the way he interacted with us changed so much that it was hard to know what was happening inside of him. Watching someone you love change that profoundly is something I would never wish on another family, and it left me with a fear of dementia that I do not pretend isn't there.
That is probably part of the reason a recent episode of The Dr. Hyman Show about brain health pulled me in so deeply. I was driving home from Massachusetts to Pennsylvania, which is usually when I catch up on the longer podcasts I never seem to have time to listen to, and as I listened, I kept thinking about my clients and about women in midlife in general.
If you're in your forties, fifties, or sixties and you're already noticing brain fog, losing words, forgetting why you walked into a room, or simply feeling like your brain doesn't work quite the way it used to, it's easy to focus only on how to feel sharper right now. What this conversation reminded me, though, is that there is another reason to pay attention to brain health in midlife: the things we do now may influence the brain we have in our seventies and eighties.
Brain Health Is Not Just an Old-Age Conversation
We tend to think of dementia as something that begins much later in life, almost as though the process starts when someone receives the diagnosis, but brain health is being shaped long before that point. One of the statistics discussed in the episode was that among people who live into older age, the lifetime risk of developing dementia may reach somewhere around 40 to 50 percent. That is an enormous number, and for someone like me who has watched dementia affect a parent, it's impossible to hear that without feeling something.
The episode also looked at research around ultra-processed food, metabolic health, inflammation, physical inactivity, sleep, depression, social isolation, and other factors connected with dementia risk. What interested me most, though, was not the idea that we should become afraid of Alzheimer's disease. Fear is not a health plan, and I don't want women leaving conversations like this with another list of things to worry about.
What I found much more useful was realizing that many of the things that may support our brain twenty or thirty years from now are the same things that help us feel better today. Better sleep, more stable blood sugar, regular movement, stronger muscles, better metabolic health, nourishing food, meaningful relationships, and support for our mental health are not separate conversations. They are all part of the same picture.
Your Brain Is Not Separate From the Rest of Your Body
One of the reasons I approach health through a root-cause lens is because our bodies do not operate in the separate categories we tend to create for them. We talk about gut health over here, blood sugar over there, cardiovascular health somewhere else, and then brain health becomes another isolated topic, but your body does not recognize those divisions.
Your brain is affected by what is happening with your blood sugar, blood pressure, cardiovascular system, gut, sleep, stress, nutrition, relationships, and mental health. All of it is communicating all of the time, which is why I think a much more useful question than simply asking what you can do “for your brain” is asking what kind of environment your body is creating for your brain every day.
Are you constantly moving through blood sugar spikes and crashes? Are you sleeping four or five hours a night? Are you sitting for most of the day? Has convenience slowly taken over so that most of what you eat comes from a package? Are you under chronic stress and rarely coming all the way back down from it? Are you surrounded by people and still feeling lonely?
None of those things mean dementia is inevitable, and I would never want anyone to interpret them that way. They simply show us where we may have influence, and influence is very different from control.
Let's Talk About Food Without Making Food Scary
The research around ultra-processed food is an area where health advice can become extreme very quickly. We hear that processed food is bad for us and suddenly we're worried about anything that comes in a container, even though technically frozen vegetables, Greek yogurt, and canned beans are all processed foods.
That's not really what we're talking about when we talk about ultra-processed food. These are generally foods that have been changed significantly from their original form and often contain refined starches, sweeteners, emulsifiers, flavorings, and additives that most of us would not use in our own kitchens. Think sugary cereals, packaged snack foods, candy, soft drinks, many fast foods, and foods designed to be extremely convenient and very easy to keep eating.
That does not mean you can never eat chips again, and it certainly does not mean you have to turn your kitchen upside down tomorrow morning. I don't teach nutrition that way because rigid, all-or-nothing approaches usually make eating feel harder, not easier.
A more useful question is simply how much of your diet is coming from food that still looks like food. There is a big difference between having something packaged every now and then and realizing that almost everything you eat from morning until night comes out of a wrapper or a box.
A lot of women end up there accidentally because life is full. Breakfast becomes a protein bar eaten in the car, lunch is something quick between meetings, dinner is whatever can get onto the table the fastest, and then something sweet shows up later because you're exhausted and finally sitting down. That is not about being lazy or not caring about your health. It is what happens when convenience slowly becomes the default.
Instead of trying to remove everything at once, start adding more real food back in. Add protein to breakfast, vegetables to lunch, fruit, beans, nuts, seeds, and meals made with ingredients you recognize. As you do that more consistently, some of the ultra-processed food naturally begins to get crowded out without requiring you to turn your entire life into a nutrition project.
Blood Sugar Matters for So Much More Than Weight
Blood sugar is another enormous piece of this conversation because it affects so many of the things women notice every day, including energy, mood, cravings, hunger, sleep, and concentration. Metabolic health also matters over the long term, which is why when I talk about eating enough protein, fiber, and healthy fats, I'm not only thinking about whether someone loses weight.
I'm thinking about blood sugar stability, insulin sensitivity, cardiovascular health, and the internal environment your brain may be living in for the next twenty or thirty years. This is also why I wish we would stop using the scale as the only evidence that taking care of ourselves is working.
You can improve your blood sugar, blood pressure, strength, sleep, diet quality, and overall metabolic health even if the number on the scale is not moving in the way you hoped it would. Those changes still matter tremendously, and in the bigger picture they may matter far more than whether you fit into a smaller pair of jeans.
I'm not saying it's wrong to want to lose weight. I'm saying that when we zoom out and look at the health we are building for the next several decades, weight becomes one piece of a much larger story.
Movement Is About the Life You Want to Keep Living
Physical inactivity is one of the modifiable factors associated with dementia risk, but that does not mean you suddenly have to become someone who loves the gym or starts training for a race. Your body simply needs regular movement, and that can look like walking, strength training, yoga, gardening, riding a bike, dancing, carrying groceries, taking the stairs, or finding more ways to move throughout an ordinary day.
For women in perimenopause and menopause, I especially want some form of resistance training in the picture because preserving muscle and bone becomes increasingly important as we age. The conversation I want us to have about movement is much bigger than how many calories we burned or whether a workout was hard enough.
Movement affects glucose regulation, insulin sensitivity, strength, balance, bone health, mood, sleep, circulation, and brain health. When I think about exercise from that perspective, the reason to move becomes much more meaningful. I am not building strength now simply because I want my body to look a certain way. I am building strength because I want to be able to carry my own groceries, get off the floor, travel, and remain independent as I get older.
That is a very different reason to move.
We Have to Talk About Sleep
I don't think we can have a serious conversation about brain health in midlife without talking about sleep because this is such a common struggle during perimenopause. You might fall asleep easily and then wake up at two in the morning, hot and wide awake, with your brain suddenly replaying a conversation from eight years ago. You might sleep lightly all night and still wake up exhausted even though technically you spent enough time in bed.
I understand this one personally because sleep has been difficult for me too, and knowing that sleep matters does not magically make your body cooperate. What I don't want us to do, though, is normalize chronically terrible sleep simply because we are in perimenopause.
Hormonal changes can absolutely be part of the picture, but so can stress, alcohol, blood sugar swings, sleep apnea, pain, anxiety, temperature regulation, and our sleep habits, and often there is more than one thing happening at the same time. One rough night happens, and even a rough week can happen, but if you've been sleeping poorly for months or years, it is worth becoming curious about what is contributing instead of deciding that you're simply a bad sleeper.
Sleep is part of how your brain and body recover, and chronic sleep problems deserve attention.
Relationships Belong in a Conversation About Brain Health
One of the things I loved about this research was the reminder that brain health is not only about food and exercise. Relationships matter too, and social isolation is one of the modifiable risk factors that continues to show up in dementia research.
Midlife can be incredibly isolating even when you are surrounded by people. Your children need you differently, your parents may need you more, your marriage may feel different, friendships shift, work takes more of you, and you can find yourself carrying a tremendous amount for everyone around you while realizing that there are very few places where someone is taking care of you.
Women become very good at saying that they're fine and that they'll handle it, but connection is part of health. Your nervous system responds to safe relationships, and your brain responds to conversation, novelty, challenge, laughter, and connection.
Sometimes the thing that supports your health is not another supplement or another protocol. Sometimes it is having lunch with a friend, joining a class, volunteering, finding a community, or spending time with people who understand the season of life you are in.
Mental Health Counts Too
Mental health belongs in this conversation for the same reason. Depression has been identified as a risk factor associated with dementia, which does not mean that depression causes dementia or that someone who experiences depression is destined to develop it. It simply reinforces something I wish we understood better, which is that mental health is part of whole-body health.
Women in midlife are often far too quick to minimize what they are experiencing. We tell ourselves that it is just stress, that we're tired, that it's hormonal, or that we're overwhelmed, but if you're anxious constantly, depressed, numb, angry, unable to enjoy things you used to enjoy, or barely holding everything together, that deserves attention.
We do not need to white-knuckle our way through this stage of life. Hormones may be part of what is happening, but that does not mean we should ignore the emotional and mental health changes that can happen alongside them.
Who Do You Want to Be Twenty Years From Now?
The more I thought about this podcast episode, the more I realized that it wasn't really a conversation about Alzheimer's disease or dementia. It was a conversation about the woman I want to be twenty or thirty years from now, and I don't think we ask ourselves that question often enough.
We spend so much time in midlife asking what we want to weigh, how we can get rid of belly fat, whether our hormones are balanced, or how we can look younger, but we spend far less time asking what kind of life we want to be living at seventy, eighty, or ninety.
When I think about the woman I want to be later in life, I want to be able to think clearly, know the people I love, move my body well, travel if I want to, carry my own groceries, stay connected to people who matter to me, and remain independent for as long as possible. I want a life that still feels like mine.
None of us can guarantee that future, and I think that is important to say because you can do everything “right” and still develop disease. Genetics matter, environment matters, and life happens in ways that none of us can fully control.
But influence is different from control, and we do have influence.
One of the major dementia prevention reports discussed in the episode looked at fourteen modifiable risk factors and estimated that addressing them could potentially prevent or delay around 45 percent of dementia cases. That does not mean every case is preventable, and I would never want to oversimplify something as complex as dementia, but it does mean there are meaningful things we can do to participate in our health rather than simply hoping everything works out.
Health Is Built in Ordinary Days
When you look at the list of things that support long-term brain and metabolic health, most of them are not glamorous. Eat more whole foods, get enough protein and fiber, move your body, build and maintain muscle, pay attention to your blood pressure, blood sugar, and cholesterol, sleep, stay connected to people, get help when your mental health is suffering, don't smoke, be thoughtful about alcohol, protect your hearing, and take care of yourself consistently.
Health gets built in ordinary, boringly consistent days, which is exactly why I don't want you leaving this conversation with fifteen things you suddenly think you need to fix. Choose the one area that feels most obvious right now.
Maybe breakfast is mostly coming out of a package and adding protein would be a useful place to begin, or maybe you have been barely moving during the day and a ten-minute walk after dinner feels realistic. You might have been saying for years that you want to start strength training, or perhaps you have no idea what your blood pressure, blood sugar, or cholesterol actually look like. Maybe you've been sleeping terribly and have finally reached the point where you're ready to figure out why, or maybe you've been feeling lonely and haven't really admitted it.
Choose the thing that makes the most sense for your life and start there. When we look at everything we could change at once, we become overwhelmed and often do nothing, but one change repeated consistently gives us something to build on. Small hinges really do swing big doors.
The things you are doing for your health today are not only about getting through perimenopause, reducing brain fog, sleeping better tonight, or having more energy tomorrow. You are building the body and brain you are hoping to live in for decades, and when I think about my choices that way, they feel less like health rules and more like something purposeful.
So the question I want to leave you with is the same one I asked at the end of this week's podcast: What is one thing you can do for the woman you want to be twenty or thirty years from now that would also help you feel better today?
Start there, and let that be enough for now.
If you know you need help figuring out where to begin because all of these pieces feel tangled together, that is exactly why I created the Living Inspired Life Lab. Inside the Life Lab, we look at the bigger picture, including your symptoms, lab work, blood sugar, sleep, digestion, nutrition, movement, stress, relationships, boundaries, and habits, and then we figure out what actually matters most for your body right now.
The goal is not to give you another giant health checklist or make your life revolve around doing everything perfectly. It is to help you understand what your body is telling you, know where to put your energy, and make small changes that support both the woman you are today and the woman you are becoming.
Because the goal isn't to spend the next twenty years obsessing about your health. It is to take care of yourself well enough that you can keep living your life.
Lots of love,
Rachel
Find Rachel on Instagram: @peaceinperimenopause
Dr. Mark Hyman's episode that was referenced in today's article and podcast: https://podcasts.apple.com/us/podcast/the-dr-hyman-show/id1382804627?i=1000784321249
Rachel's Free Resources:
Mood Swings? Get the 5 minute audio to calm them now. https://rachelcartarn.com/sos
Do you want to understand more of what's changing in your body in midlife and get a few simple tools to feel better now? Get the free guide: The Real Reason You Still Feel Off.
Ready to Talk: Book a Clarity & Relief Session here.
