Whenever someone asks former U.S. Surgeon General Richard Carmona how his day is going, he typically responds with, “Every day is the same! I’m fighting aging and gravity.”
But unlike many of the rest of us, the 64-year-old doctor has a strategy in place. To combat the natural decline that occurs with aging, he works to protect his brain. Like others, he’s a big believer in exercise, good nutrition and plenty of sleep. He also includes “mindfulness” on his roster of anti-aging strategies — advocating brain-stimulating exercises like puzzles and crosswords.
Carmona’s cognitive health secrets are detailed in his new book, Canyon Ranch 30 Days to a Better Brain, which explains the anatomy of the brain, the effects of stress and toxins, and the often overlooked importance of sleep, and provides advice on how to keep the mind agile and sharp.
The son of Puerto Rican immigrants, Carmona dropped out of school at age 16 and enlisted in the Army at the peak of the Vietnam War. The experience was transformative: He went on to become a paramedic, nurse, police officer, doctor and hospital administrator before being nominated as one of the world’s most influential leaders in healthcare.
Now, he’s president of the Canyon Ranch Institute, a nonprofit public charity affiliated with Canyon Ranch Resort & Spa in Tucson, Ariz., that’s focused on promoting optimal health for all people. In a recent interview, he spoke about why he believes the key to health lies in building a better brain and why exercise is still the best medicine.
This is an edited transcript of the conversation.
What’s the idea behind a “brain gym”?
It’s clear exercising the mind will stimulate it, whether you’re combing your hair with your left hand rather than right, learning to write with your nondominant hand or doing crosswords, you’re sending signals to the brain to make new neural networks.
As we get older, if we don’t exercise our biceps, they atrophy. And if you don’t continue to stimulate the mind, it does tend to undergo atrophy, too. MRI images show the brain shrinks if you don’t use it. It requires that you develop the neural network. It’s not clear whether a crossword puzzle is better than a video game. But generally, challenging and stimulating the brain with new things is good.
Why is sleep so important?
People are staying alert and active throughout the 24-hour cycle and don’t get enough rest. The brain needs time to rest, so it can replenish itself. Otherwise it leads to performance decrement.
What’s performance decrement?
It’s a real measure of the brain’s need to get rest. You’re not as sharp as you should be, and your analytical abilities are off. If you’re driving a car, you need quickness to avoid a collision with someone else who is doing something stupid. Without sleep, our analytical ability and judgment decline. Of all the variables we talk about (with respect to brain health), sleep is probably the one most dismissed or overlooked. People often don’t equate performance with the ability to rest the brain, and the consequence of that is performance decrement.
Do you have a quirky health habit?
I look at my posture at 8 a.m. and compare it to 8 p.m. At night I’m usually all hunched over, which can lead to carpel tunnel syndrome and back or neck problems. Once a day, I put my back against a wall and feel the flatness of the back that you get with perfect posture. I try to remember that during the day when I get lazy.
I tell people to pretend you have a plumb line. Someone has a pulley, and they are pulling you straight up. If you know the feeling when your back is against the wall, you can re-create it. Pull yourself back up, feel the stretch on the core. That’s something I do all the time to make sure I’m not getting sloppy and hunching over.
How much do you exercise?
About five or six hours a week, any time between 5 a.m. and 10 p.m. About five days a week, I cross-train and do some cardio, usually 20 to 30 minutes elliptical, stationary bike or swimming. I also do a weight circuit, which takes 45 minutes to an hour with free weights or machines. I use the concept of muscle confusion.
If you do the same exercise, the body gets used to it. It’s still beneficial but not quite as good.
How do you eat?
At Canyon Ranch, we say, “Everything in moderation, not deprivation.” Many of our colleges in this business provide austere diets. Most mornings, I have oatmeal or a bowl of cereal with a glass of milk. I eat fresh fruits two or three times a day. Lunchtime I'll have a sandwich. I’m cautious of how much protein I need. If I’m exercising, salt is good. I just don’t want excess. I try to stay away from processed food as much as possible, which is hard when you’re on the road.”
You were shot several times as a police officer and wounded in Vietnam. What have you learned about the body’s resilience?
I joke that patients often get better in spite of us physicians. The body has an amazing ability to heal and repair; I’m a testament to that. Surgery is often not any better than good physical therapy. As a youngster I had knee injuries in football. In the military, I had blast injuries, gunshot wounds in combat that hit my legs, back and head. I had a number of falls in the military and the wear and tear of obstacles courses. As a police officer, I was shot on two separate occasions, in the leg and head. I’ve had a knee replacement, and I have a plate in my neck and back. Yes, I live with pain, but I learn to deal with it. The best medicine is to stay physically active.”
Why do you call obesity a “national security issue”?
It’s one of the top reasons men and women don’t stay on active duty. They don’t pass the physical fitness test, or they get sick. It’s hard to recruit and to retain healthy kids. Where will our military come from?