#247: Drs. Dean and Ayesha Sherzai - Protect Your Brain from Cognitive Decline
Learn More About The Brain Docs
Our brain plays a role in everything that we do. It not only informs our cognitive function, but also our moods, behaviors, personality, how we view the world, how we react and respond to that world around us, how we receive and send messages…everything! Naturally, we should want to know as much about the brain as possible.
Thank goodness for the Team Sherzai - Drs. Dean and Ayesha - Neurologists, researchers, and public health advocates. Together, they are a forcefield in the study of the brain with the unique ability to share their knowledge at a level that is both educational and approachable.
Today, they dive into the latest Alzheimer's research and prevention, they discuss their role in the Netflix documentary "You Are What You Eat," they discuss menopause and hormone replacement therapy for women, highlight key vascular factors for brain health, and stress the importance of evidence-based recommendations.
It’s entertaining. It’s informative. It’s Team Sherzai - The Brain Docs.
Episode Highlights
3:16 Catching Up with Team Sherzai
5:51 Catching Up and Reflecting on Past Podcast Episodes
7:37 Empowering Communities through Lifestyle Changes
19:07 The Brain Health Revolution Podcast and the “Your Brain On…” Series
24:07 Quick Facts on Alzheimer's Disease - How many cases are there in the US?
24:36 Quick Facts on Alzheimer's Disease - Why are women disproportionately affected?
26:03 Quick Facts on Alzheimer's Disease - Why are blacks and hispanics also affected more?
26:30 Quick Facts on Alzheimer's Disease - How Many Years for the Disease Process to Start?
28:18 Quick Facts on Alzheimer's Disease - What percent of Alzheimer's is purely driven by genes?
30:00 Quick Facts on Alzheimer's Disease - What percent of Alzheimers is Preventable?
33:26 The Remarkable Human Brain
38:52 Protecting Cognitive Decline Through Social Connection and Relationships
44:02 Exercise as a Brain Stimulant
49:25 Avoiding Mental Retirement
56:30 What Happens to the Brain in Perimenopause and Menopause?
1:02:12 What is the Latest Research on Hormone Replacement Therapy? (HRT)
1:04:52 Essential Micronutrients for Brain Health
1:09:28 Omega 3s and Its Impact on Cognitive Health
1:14:16 Nutraceuticals and Evidence-Based Choices
1:18:58 Sleep Apnea and its Consequences
1:21:20 Myths and Truths About Breathing Techniques
1:38:40 Three Key Factors for Vascular Health
1:45:03 The Impact of Alcohol on Brain Health
1:47:46 Following the Science on Olive Oil Research and Emphasizing Evidence-Based Research
About The Sherzais
We’re practicing neurologists, scientists, authors, parents, and a husband and wife duo that know the value of healthy lifestyle choices and we’ve seen the impact that our NEURO Plan framework has in making the sick healthy and in taking healthy to the next level.
We met as young physicians and in our first conversation we learned that both of our grandparents had spent their remaining days on this Earth suffering from dementia.
It was then that we vowed to do whatever we could to help others avoid this fate and build healthy minds and bodies.
Our academic journey led us to conduct research, treat patients, and serve as professors at Georgetown University, Columbia University, the National Institutes of Health, Mount Sinai, and Loma Linda University, where we serve as the co-directors of The Alzheimer’s Prevention Program.
We’ve worked with devastatingly disease-ridden populations and some of the healthiest people in the world – the Loma Linda 7th Day Adventist population (a Blue Zone community, defined by living measurably longer and healthier lives due to optimal nutrition, exercise, stress management, and social support.).
Episode Resources
Plant-Stock is BACK in person from August 16th-18th in Black Mountain, NC! Register Here
To stock up on the best-tasting, most convenient, 100% PLANTSTRONG foods, including our cornbread, teas, stews, pancakes cereals, granolas, pizza kits, broths and soups, check out all of our PLANTSTRONG products HERE. Use code: STRONG15 for 15% off your first order.
Learn more about our 2024 PLANTSTRONG Retreats in Sedona, AZ
Give us a like on the PLANTSTRONG Facebook Page and check out what being PLANSTRONG is all about. We always keep it stocked full of new content and updates, tips for healthy living, delicious recipes, and you can even catch me LIVE on there!
We’ve also got an Instagram! Check us out and share your favorite PLANTSTRONG products and why you love it! Don’t forget to tag us using #goplantstrong 🌱💪
Full Transcript via AI Transcription Service
[0:00] I'm Rip Esselstyn, and you're listening to the PLANTSTRONG Podcast. No one, and I mean no one, does more to help others improve their brain health than today's guests, Drs. Dean and Ayesha Sherzai. Team Sherzai, they're back, and they're better than ever for their third appearance on the PLANTSTRONG Podcast for a spectacular and in-depth catch-up. It's a courageous conversation with two of the best in the business right after this message from PLANTSTRONG. Stay tuned.
[1:44] Our brain plays an instrumental role in everything that we do. It not only informs our cognitive function, but also our moods, behaviors, personality, how we view the world, how we react and respond to that world around us, how we receive and send messages. Everything is influenced by our brain. So naturally, we should want to know as much as we can about the brain as possible. Thank goodness for the Sherzais, doctors Dean and Ayesha, neurologists, researchers, and public health advocates. advocates together. They are a force field in the study of the brain, but also have a unique capacity to share their knowledge at a level that is not just educational, but also approachable. I'd say even entertaining. Today, we talk about the latest research on brain health and Alzheimer's, their involvement in the Netflix documentary, You Are What You Eat, menopause and hormone replacement considerations for women, three key vascular factors for brain health, and why. Why you must always follow the science when making claims and recommendations. It's entertaining. It's informative.
[3:11] Music. All right, Dean and Ayesha Sherzai, welcome back to the PLANTSTRONG Podcast. Podcast it is so fantastic to see you too because it's been way too long it has it's been way too long we were counting and I heard a number and I can't believe it's been that long since we haven't spoken with you well yeah it's been five years almost to the day five years when you guys first appeared on the PLANTSTRONG podcast I actually visited you in Redondo Beach. Are you still there same same location? Yes,yes we're in the same location. Yes, yes I remember that was a lot of fun it was it was and if people tuned into that episode they'll recall that i've never been in a home that was that organized uncluttered and just open for massive creativity creativity.
[3:12] It's TeamSherzai, the Brain Docs.
[4:13] I appreciate it. Thank you so much. Not always like that, that clean, but since then the kids have grown up and, and, uh, uh, no, it's, it's been five years. Life changes significantly. It really does. It really does. Speaking of your kids, any kids in home or at home or are they out and about now? Okay, kind of like in and out. Our son is Alex. He's about to leave. We're very proud of him. He got into a graduate school and he's going to study computational medicine, which is a completely new field. AI. Artificial intelligence, machine learning. What's that? The hope is that they're going to cure diseases way faster than we did so through computational and AIdriven mechanisms hopefully find cures at a rate never seen before yeah for diseases that have no treatment and kind of you know early detection and fascinating field yeah and our daughter is 16 and she's um into she's in college she's a senior in college biomedical engineering and she's doing very well. We're very proud of her. She's still at home. Wow. And so she's 16 and you say she's a senior at college. Yes.
[5:34] That's a bit of a, you know, wow. That's, that's incredible. But Hey, it doesn't surprise me. She's a Sherzai. No, no, no. We attribute it to the plant-based eating. Yes. Yes. All their life.
[5:47] He, they both graduated high school at 10 and he finished college at 17. And it's not the to share that it's it's the plant-based eating there that's a good start that's a good right yeah when people ask us they've been they've been on a plant-based diet all their lives and they're thriving they're doing very well um and no we're very happy for them oh my gosh well i'm i'm happy for them as well incredible so the first time you guys were on the podcast was back in 2019 and you guys were episode number three just number three and we talked a lot about um about sleep. The next time you were on, it was episode 75. I think it was about two and a half years ago. And we talked all about the 30 day Alzheimer's solution, your second book that came out. And that was, that was fantastic. But I want to kind of, I want to revisit with you guys, so much has happened since then. And just, just kind of a nice touch base. Yes. So I'd love to point out like, so what's new with you guys? Are you still with Loma Linda? Is that no more or what's going on there?
[7:00] Yeah, we are not seeing patients in the hospitals anymore. We are still affiliated with these universities, CDU, Loma Linda, and UCLA, and the affiliations are growing, but hopefully the responsibilities.
[7:17] Except for teaching, is reducing. We're doing research, continuing to do research, meaningful research at the population level, seeing what sticks. Sticks it's not just a matter of fact that you know broccoli works but how do you implement lifestyle and populations and different populations in a way that's not contrived and.
[7:38] That that's not forced that is part of their flow of their existence uh without that it's it's one program after another program that comes and goes so we're working on multiple communities we are proud that we won the national academy of medicine award for our work in the african-american churches and in other communities, and we're expanding our work in communities around nutrition, but also other things, our neuro concept, which is nutrition, exercise, stress management, sleep, optimizing sleep, and then mental activity, which is a very unique approach we have taken, which is almost the subject of our third book coming out, which is really super powering the brain. We kind of implemented it in our own household and our kids and with other individuals that we've actually moved forward with this process. But optimizing the brain in a way that really opens up the doorways of consciousness and cognitive prowess. So those are the five elements. In the last few years, Ayeshastill has thousands of people following the cooking and all of that. But the cognitive optimization is a unique aspect that we, and it's our own unique brand of how we approach cognitive improvement that we've been working on.
[9:00] So earlier you mentioned kind of a program that's stickable, right? That you can, it's very repeatable and it's just kind of part of your flow. It sounds very familiar to kind of what Dan Buettner is trying to do with the Blue Zones. Is that, are you guys working in conjunction with Dan at all? Or is this something separate?
[9:20] Yeah yeah go ahead so so yeah I think the behavioral um manifestations or the behavioral neurology of lifestyle is a specific field um where um understanding people's resources and their needs um both at an individual level but mostly at a community level is is something that we've worked on for a while.
[9:48] Dan is a great friend. We're not collaborating per se with him, but I think the science of implementation of lifestyle in individuals and in communities, something that we're looking into, and we're trying to find out variations between people and between communities. What works for one individual may not work for another individual. What works for one community may not work for another community. And what are those differences And how can we breach those without ever making people feel like something is being imposed on them? So it comes from our work in community-based participatory research where we have focus groups and conversations and even, you know, we have these gatherings, whether it's in a faith-based community or other community centers, to speak about how a lifestyle can be implemented. Because as you know, there are a lot of times there are a lot of barriers. For example, a lot of communities have specific traditions, specific cultural norms that don't allow them to accept a change from the outside.
[10:55] But when you find out in NIDIS a particular point that will actually move them towards a better mission, a better vision towards their health, that's where we actually work with community members. And whenever we go into a community, we want them to be the owners of this conversation. A lot of times people go into a community with pamphlets and brochures, right? And then they give those resources to them and then they just kind of back off without ever making sure that they're implemented. But if we train trainers, so for example, in one of our research projects, we have training of brain ambassadors, which are individuals from that community, whether they're social workers, nurse practitioners, nurses, midwives, doctors.
[11:40] Parishes, pastors, whoever it may be in a community, they're going to become the brain health ambassador. And they will be equipped with all the information about whole food plant-based diet, about the importance of exercise, about the importance of identifying their stressors, about the importance of identifying sleep disorders in a community, or how they can keep their minds active to reduce the risk of diseases like Alzheimer's disease or stroke or other dementias. So that's the realm that we work in. It's such a beautiful concept because it really honors the community. I mean, a lot of times we're not aware.
[12:16] But we're actually even in the nicest ways, we impose our own wills. One of the things I was doing when I was doing my PhD thesis, I was kind of fortunate because I was, you know, one of the clinicians in the hospital. So I had better privileges. We went to multiple communities, the African-American, Hispanic, Native Americans and the Native American community that I went to. They said, we don't want to work with you guys. I'm like, why? Why they're like, um, everybody comes, talks to us. They have their brochures. They have their questionnaires. They have their pamphlets. They have their talking points. They have their smiles. And then after they're done collecting data or they're doing some, some documentary or something, and then they're gone and you never see them again and nothing is left behind. And, and the way we do it is we actually, in the very first conversation there and in the lead, and then even creating questionnaires, they're involved. We have people from their own communities involved. And so every step is involvement of communities. And by they, I don't mean all of us, because we all have certain communities. So it's not about when I say this African-American, Hispanic, Native American. It's actually every one of our communities have their unique aspects. We're in an age of personalization. Well, this is actually personalized community approach, which is I say that the new leadership Leadership is hearing others.
[13:40] Leadership is not Henry V, let's march up the hill and you'd go and thousands die. And then you don't even know why you did that. And so it's about listening, hearing, and then implementing where it's possible.
[13:54] And not just you implementing, but together with whatever the community. And the community could be a family. It could be a group of families. communities defined by common shared beliefs and values um that you can actually work around it's such a such an incredibly empowering wonderful feeling for for the researchers for that matter very gratifying you know one thing that you do get out of when in retrospect looking whenever as researchers you go into communities you leave feeling a little devoid a little empty a little like okay I went through a process and it was people and then you left the people and but this feels like as if you've connected and you've left something permanent meaningful so that's sorry that was a short of it yeah yeah yeah so well give me give me an example of a community that you've gone in and you've you've worked with and you've done this.
[14:54] Yeah. Yeah. So one of the communities we're working with now is the faith-based community at Christ Church in L.A., where it's an incredibly lovely community that's welcomed us. And we've had conversations and we've had three events in the community, three really massive events with the festival. And now we're going to have a huge, huge festival coming up in October. Yes. You guys are all invited. And I'd love to. Yeah. And it's going to be about health. It's going to be about lifestyle. It's going to be about the nutrition, but it's going to be in their own terms and their own plan and their own steps in a measurable way. So it's not going to be, I know that one thing that Dr. Esselstyn and you and everybody says is if you leave it too loose, it's going to just dissipate. And absolutely that's, that's the case. You can't say, and my least favorite word is moderation. Like what does that mean? You know, But it's measurable changes, but it's measurable changes that are dictated by the community and empowered and it's just lovely. And so this community has been very active. Right. And we're looking forward to building it, expanding it to all of L.A. And yeah, it's so it's so obvious how much you guys just love and cherish your work. And it's so it's so wonderful to see.
[16:21] Yeah. You guys. Get up out of bed and move forward and at such a young age it's just remarkable young so young.
[16:58] It's true it's true but you got I mean I mean it's funny like when I when Icame out, to have you on the podcast in 2019 as far as I know you guys didn't have a podcast I mean you guys got a podcast going on now right called the brain revolution the brain health revolution, podcast you just you started this new little mini series within it called your brain on right love or sugar or football or dry january it's brilliant I think it's so awesome it really is so excited you know it's been two days two days since brain on so we've actually evolved from brain health revolution to your brain on and in two days it's already number 16 and all of sciences and worldwide. It's just crazy. Yeah. Yeah.
[17:47] No, you should be. I mean, it's such a relevant, timely topic and everybody knows, is concerned about it. And you guys are, you know, you guys are the absolute perfect people to be, to be doing this. I mean, it's so great. Oh yeah, absolutely. We are very passionate as you are about sharing evidence-based information. You know, there's so much misinformation out there. There are people who are just, you know, trying to play with people's hopes, and especially with diseases like, you know, dementia, that's pretty scary, because we don't really have any treatment for it, or diseases like stroke, and mental health issues. You see people just, you know, selling their vitamin concoctions and kind of focusing in on things that have no, they don't even have any scientific validity. So we wanted to kind of, you know, present it, this information in a fun way. So people have access to all these brilliant minds who are actually doing the work behind the scene, but they probably don't have an Instagram account or a Facebook account, you know, all these amazing people who are, you know, doing wonders in the community, in the field of science. So that was the goal to kind of bring them to the front and people to know that
[19:05] there's a lot of great work that is being done, guys. And this is coming from our heart. So we are very honorary people. We don't, if we don't like something, we don't acknowledge it.
[19:17] In the plant-based world, I think there is nobody that's better than your family. I mean, from the time we met Essie to your mom, which is a dynamo. I mean, my goodness. And Jane, and then you guys, really, there's a thing that I quote often, Stephen Covey's. It's a book, Speed of Trust. And every relationship, it's about trusting people's integrity and capacity. So if they have a lot of capacity, but no integrity, run, run away from that person. That's a slick person that's going to get everybody in trouble. And if they have a lot of integrity, no capacity, well, that's a great friend to have a party with. But you're not going to change the world. But to find people that have capacity and integrity like you guys, And anybody who knows me, I don't give compliments away like this. I just wanted to say that I love that. I love the integrity with which you guys have led this revolution, this movement of health.
[20:21] So that's why we're connected. We love you guys, basically. That's what we want to say. Yeah. That's right. We love you guys. On a day of love. On a day of love. Well, the day after. The day after. What's also remarkable to me is like, I was checking out your Instagram channel, right? The brain docs and, and, you got over 700,000 followers. Now, the last I looked, you had like 50, 60, like, when did that all happen? It's like remarkable. And, and Ayesha, I'm assuming you're the one that's kind of driving that. I could be wrong, but you're a hundred percent right. But, but you're so consistent with your posts, the amazing content. Uh, so it's very, very valuable. So anyway, thank you. Thank you for very kind of you. Thank you so much. No, I'm the face. I, Dean is in the background pushing everything forward, honestly. That couldn't be further from the truth. I'm just afraid. The last thing we could say is that you're the face. She's the brain. She's the body. She's the face. And the way we moved up from 50 to 700,000 was reduce Sher-Dean and increase Ayesha. And it goes up so fast. That's hilarious.
[21:35] Well, and also, I mean, I. I, I, but you know, this new documentary has recently come out, right? You know, you are what you eat and you guys are, obviously you're featured in that. And I'm wondering if, you know, a lot of people have discovered you because of that. It's on Netflix. It's very, very been very well received, I think. And if you wouldn't mind explaining it, like what was your role in that documentary?
[22:00] Our role was the cognitive part. So the Stanford team was nutrition and the biomarkers and things of that nature. And ours was the cognitive element. And even from the very beginning, we and we are very rigid with the data and stuff. And, you know, we said that two months is too short, but we'll do it. It was a very robust cognitive exam. There are there are multiple things that that made made it difficult to get a cognitive signal. One is the population was younger. So when they're younger, it's difficult to detect that change, right? Because their baseline is pretty robust. They don't have any cognitive decline. So that's the same thing. And then the second one, the sample was small. It was 40-something people. And so that makes it a little difficult. And the timeline. So the three things usually you look at in a study to make it robust is size, the length, and the tool of investigation. The tool of investigation was good, but the length and the time was very short. But it was a good baseline to get because.
[23:07] We'll follow these people over time in the future and see how they do. And we always do these cognitive tests. And we think that a minimum amount of time that's needed to see a signal, if it's a sample that's, let's say, several hundred people is six months. If you have a larger sample, maybe a little shorter, but at least six months to a year to see a signal. And that means for a larger population, a little bit older population. And we've seen it. We've seen it repeatedly in our own clinics. We've seen it in our own populations and our own studies. We've seen that others have seen the same thing, as you know, the mind study and others. And we'll talk about what all of that is actually plant based centered.
[23:47] So it was our part was to bring the cognitive element. And we were very, very happy about the way it turned out, the whole the whole study and the whole documentary. Yeah. Yeah. Well, congratulations on your your involvement. Thank you so much.
[24:04] Yeah. I want to ask you guys a couple of questions right now. And this is just kind of a level set as far as like what people need to know about Alzheimer's. And so I'm gonna ask you six questions and I'm just looking for a pretty quick response, but like how many cases are there right now in the United States that you're aware of? Nearly 70 million, sorry, nearly 7 million cases of Alzheimer's are at this point. Okay. And what percent are male and what percent are female?
[24:36] About two-thirds of cases of Alzheimer's disease are women, so it's mostly women. And do you know why that is? We think that there are multiple factors. We're still trying to understand it better. One of the reasons that we think women have a higher proclivity for Alzheimer's disease is potentially because of the hormonal changes that they go through. Menopause plays a very important role. But also, one of the hypotheses is that, and I'll keep it brief, is that, you know, the women that are in this generation who are in their 70s and 80s, back when they were younger, they probably did not really meet the need for challenging their brains or being cognitively active as much as men were. So you know men were the ones who were going outside of the house and they were more cognitively active and women were not as cognitively active and that has shifted over the years so we're trying to see if the trends will change the next few years to decades when it comes to the relationship but yes mostly right now menopause and hormonal issues as well as how women respond to vascular disorders so for example having high ldl and high blood pressure in women impacts their brain in a different way than it does a man, and they may be more sensitive to it. It's a very interesting area of research, and we're learning more about it. Yeah.
[26:03] And Blacks and Hispanics are what times more likely to get Alzheimer's than, let's say, Caucasian? Two to three times more. There are two to three times greater risk of developing dementia. And in those cases, it's almost almost all related to lifestyle and environmental factors. Right. Right. And that that makes a lot of sense.
[26:30] How many years before we start seeing symptoms does the process start? Typically, do you guys have any idea? Decades, 20 to 30 years, there have been studies where, you know, both imaging studies where they've done functional MRIs, and they've done neuropathological studies where, you know, they actually look at brain samples. And the bad proteins or the harmful substances that have been associated with Alzheimer's disease can be seen 20 to 30 years earlier before even the first symptom of memory disorder or cognitive complaint. plane. That sounds pretty scary, but I think it's important for people to know that Alzheimer's disease is not a disease that starts right away. It's the accumulation of these harmful substances in the brain over decades that results into it. Yeah.
[27:28] Well, I suppose that it's kind of like that with just about everything, isn't it? Whether it's cancer, whether it's heart disease, whether it's probably insulin resistance and diabetes. Yes, correct. Absolutely. Absolutely. The one unique factor with cognition is that one of the elements is cognitive activity. How much you've challenged your brain, which I should have touched on earlier with the high risk in women, the core that's come to us at this point. People who have challenged their brain significantly have tremendous protection. So that's an element that's outside of the regular aspects of lifestyle. And it's incredibly important. Yes, socialization is important, but even outside of socialization, certain types of cognitive challenges are profoundly important.
[28:18] What percent of Alzheimer's is purely driven by genes?
[28:25] So everything we do has some influence. It has been influenced in some way by genes, right? Right. Even even yours and my ability to drive or lack thereof. But yeah, or or everything, our behaviors to some extent. I mean, we're talking about people who have courage and anxiety and manage anxiety so that they can be in a more uncomfortable situations. We know that there's a dopamine receptor that that increases and decreases your your proclivity to take on risks, social or otherwise. And and speaks to all these migrations the people that have migrated had a larger proportion of this kind of protein dopamine receptor it's just remarkable it's lovely um by the way it's going to be in the next book all of this and oh that's really cool I can't wait amazing I mean I want to just stop you for a sec because it's I find this so fascinating like alex and all do you know who alex is i'm wondering if he's in your book he he did the free solo attempt on el capo yes of course He obviously must have some sort of a different thing going on there. Yes, absolutely. But in those cases, so there's meta level, there's a neurochemical level, and then there's a structural level, then there's a psychological level.
[29:41] So there's, in his case, all three levels are involved. And he's a very unique, unique individual, isn't he? When you listen to him, you know that you're talking to somebody very unique and a lovely person, but very unique person. Yes, very much so. And, um.
[30:00] And this is something that I love about what you guys are doing. And I think it flies in the face of what so many people think. What percent of Alzheimer's would you say is preventable? Up to what percent? So we are very careful in making sure that we assign the right language to the right science.
[30:24] I would say that the idea that I am actually talking to you right now is not a hundred percent.
[30:31] Okay so I just want to give people comfort with discomfort comfort with uncertainty but an uncertainty that has a mechanism and a direction and a and a and a system that has worked for us where you're actually sitting in a metallic uh fuselage of a 747 and flying in the air that has work, that level of uncertainty that has a system to it work. So the science so far, not perfect. It's epidemiological data, some prospective data points to about between 40 to 60% preventable. I mean, this is the harder science, both epidemiological, and then you combine that with lifestyle factors and all that, even that number, I'm kind of meshing it together to come up with a number. But we think, and this is extrapolation, so take it for that. Extrapolation based on our experience, based on research, other research, and based on the genetic patterns. The previous question you asked was about what percentage of Alzheimer's is driven by gene. I think it speaks to these genes would make you have Alzheimer's no matter what you do. They call it 100% penetrant genes. Only 3% to 5% of Alzheimer's is driven by 100% 10 penetrant genes.
[31:47] The rest are genes that are influenced by environment and lifestyle. Even the second highest penetrance, which is APOE4, if you have one gene from one parent, your risk goes up three to four times. If you have two, as much as 12 times, but about 50% of people who have two genes never developed the disease.
[32:05] And the reason is because APOE4's function is, here's the clue, lipid transport, fat transport. APOE2 does a great job of transporting and managing fat. So they have very low risk of Alzheimer's. APOE forehead does a poor job. I'm using soft terms, not poor, but let's just say poor job. So it raises the risk. So, you know, I always bring up this joke for the millionth time, which ages me. Red Skelton said, Doc, it hurts when I do this. Don't do that. So if I have a gene that is defective in lipid transport, be more aware of your lipids and fats. But I say be aware of your fats. Everybody should be aware of your saturated fats. That's specifically saturated. So given that, that 3% to 5% is driven by genes that are 100% penetrant, we're saying that if somebody lived an absolute optimal life, and there's nobody that's going to do that, but let's say that they do from childhood on, they would reduce their risk by 90%. Alan Goldhammer might. Alan Goldhammer might. Oh, yeah, yeah, yeah, yes, yes. Wow. Okay. So that's, okay. That's, that's really, that's really incredible.
[33:27] What in your opinion, Ayesha and Dean, and maybe it's the same answer. What do you think is the most remarkable organ in the human body? Oh, you're going to get us in fights with our cardiologist friends. Yeah. We were just talking to Columbus Batiste. Oh yes. And he's like, come on in the, in the podcast, we kind of got like into a back and forth of which organ is better in a fun way. I love him. He's awesome. I think so, you know, with respect to all the other organs, of course, the body works in content, but I think it's the brain. I mean, because you can replace most of the other organs, but you can't replace the brain. I mean, the minute you replace the brain, You've replaced the person. It's us. It's you. It's your emotions. It's your history. It's your story. So it is a remarkable organ. My answer to Columbus was the very thing you used to make that argument about the heart came from your brain.
[34:29] To the best of your ability, has there ever been a brain transplant? I would imagine not. No, no, no. So if you change somebody's heart, it's the same person. But if you change somebody's brain, it's the new person, right? It's the new brain. Yeah. Yeah. Yeah. Okay. Hey, you know, we're moving faster with technology. Just trying to keep up. We are. We sure are. Definitely. It's just amazing. The ability to communicate with whales. I heard this and I have to validate. Did you hear that? I have to validate this because I always, I'm incredulous about things I hear. I just heard it.
[35:05] I'm kind of uncomfortable bringing it up without validating it. But our ability to so our ability to read people's brains is there now with with these intrasurgical eegs and and then for and somebody thinks of something after multiple patterns ai detects the pattern and then they think of something and then the machine says this is what you thought so we're there we've done that we've seen the really that's okay wow it's just remarkable and and our ability to connect the brain to tools which is actually the neural link Ilan's Neuralink is there. We're within the next few years, we're paralyzed people will be walking hopefully, by connecting the motor cortex right to the spinal cord or even further more distally to make the muscles move incredibly fast. So that's that's good. But as we're at a precipice that we've never been at this speed at this and we can't even predict where we're going. And for brain science, it's incredibly exciting.
[36:07] Imagine being able to, and this scares some people, and it should give us some pause and be circumspect. We shouldn't be either binary one way or the other because it's coming. It's the ability to expand memory, ability to expand our ability to think faster, ability to process things faster, ability to see more. You know, what is the shrimp that Alex always brings up this one shrimp that has 70,000 color perception, the range is 70,000 times more than humans per se, I think what he said, color perception, color perception. Yeah, imagine being able to see that now I'm getting a little past 50. And I have to like squint to see the TV. I'm like, Oh, my goodness, forget about the 70,000 colors. Let me see this. The Stuber ball.
[36:54] Yeah. Well, so what did you, but you started that whole thought process by saying something about whales, didn't you? Yeah. I kind of pulled back because I have to validate it, but supposedly they were able to understand whether it was well or another, the pattern of communication and they were all able to communicate back and forth. I will validate it, but it's just a remarkable piece of data that or time in history. We're in where our horizon are expanding exponentially.
[37:21] At a rate that's never been seen before. Yeah. Well, you mentioned Elon Musk and Neuralink. Have you guys read or listened to his book at all? We haven't, no. No, I have not read his book yet. Yeah. It's Walter Isaacson. Yes. Yeah, yeah. I'm three quarters of the way through it. It's pretty phenomenal. And how that guy, the way he thinks and all the things that he is making an impact on. Right. Yeah. It's, it's nuts. It is. Yeah. I agree. Yeah. I mean, can you, I mean.
[38:02] It'll, I don't see to your point, Dean, I think you said this, we can't, I don't think any of us can predict where we will be in 20 years from today, let alone 10 years from today. Correct we can't we can't there there's no there people will be guessing but the futurists of today are uh they're gonna have a hard time figuring out where we're gonna end up yeah yeah uh all right i'm gonna unwind it a little bit here uh you guys you have a a great post on instagram and it's basically like brain health facts for 2023 and i'd love to go through some of these because 2023 wasn't too long ago, right? And I know that 2024, you'll have another bunch of them, but let's step back into 2023.
[38:52] Especially, so this first one I have for you, You talk about how positive relationships and meaningful social interactions are so important for cognitive health. And I'm wondering, based upon what we all saw happen starting in 2020 till 2022 ish with COVID and how a lot of those social kind of relationships and social connections were basically cut off at the legs. eggs.
[39:23] Just love to hear your thoughts on that. Yes. No, thank you for bringing that up. I think over the year, after having conversations with just remarkable scientists who work in the field, we've noticed and we've learned that when you use the word health, it is definitely a multifaceted concept, which essentially means that there are so many ingredients in that recipe. There are some of us that focus on one versus the other, which is important. Everybody's contributing to their field. But I think if you had to look at health as a wheel, the spokes and everything that is involves in everything that is involved in it is important, but at the center of health, at the center of well-being, whether it's an individual or as a community, is our ability to connect with each other and our ability to live together in harmony.
[40:37] And even for introverts who may not be very comfortable in social environments, having a community that one can rely on and having individuals that are close to us, that communicate with us, that support us is critical. Not just for, you know, health, but also for longevity, for the health of that particular community and for the world at large. And whether it was the cohort study that came from Harvard that looked at, you know, individuals and their relationships for how long was that? I just don't want to put it for 80 years. And they found that the number one factor that resulted in longer life, but longer positive life with, you know, positive outcomes was relationships.
[41:34] How people actually related themselves to others and whether they had a partner, not necessarily in marriage, but, you know, having a core group of people that took care of them. So we could call that Moai, we could call it a tribe, we could call it family, we could call it friends, whatever. whatever, chosen family, whatever that is. I think that's critical. And I think it makes sense because when people have strong relationships and a strong community, that brings so many different things. It makes specific habits easy because it becomes a culture.
[42:17] So whether it's eating, whether it's walking, whether it's going to sleep at the same time and waking up at the same time, whether it's challenging your cognition by conversations, by challenging each other. Even I say arguments are also great cognitive activity. If you don't agree with someone, that's fine. But as long as you are able to speak about it and as long as you are pushed to think about it, as long as you're pushed to. Are you trying to tell me something? Are we up for something? No, it came from you. Dean always tells the kids, like, we don't have to agree, but we should never be quiet.
[42:57] We should always come together and, you know, have a very civilized argument and try to learn. So when it comes, you know, from the realm of neuroscience, that essentially means growth. That means connections between neurons. That means improving neuroplasticity. That essentially means opening one's mind for newer thoughts and new behaviors and new challenges. And definitely that results in longevity. Definitely that results in better human health. So yeah, I think it's a very core feature of health. And a lot of times we kind of put that in the background because I think we assume that that's always there. But no, I think the one thing that the pandemic showed us is that isolation can be a huge problem for health.
[43:46] And so we need to cherish our relationships and grow them. We need to have what you refer to as the tribe, you know, coming to the PLANTSTRONG, you know, the festival and all that, that idea of connecting with individuals is so important for health. Yeah.
[44:03] This is, this is to me, it's just a given, but it, it made the list and that is the importance of, of exercise, which I don't anticipate ever really going away, but yeah, want to speak about exercise? Yeah, I personally do because I, I, I have you to thank for my injuries. Um, I'm bringing it up. Yes. I'm bringing it. Get ready. So no, no, we didn't. So when, when your thing was coming out, you, you, you broke the backstroke challenge. Yeah. I'm like, okay. So I was a pretty good athlete when I was younger. When it was our first book is coming out. I said, I'm going to do something, right? I work out. I work out. Yeah.
[44:49] If Rip can do it, why can't I do it? Yeah, right. Sure. So I said, I'm going to do something big with pushups, like maybe four to 5,000 pushups in a day. And I started, and I'm a little fanatical about these things. Once I take on something, I overdo it and not with safety and stretching and all that. That so I actually did really well sets of 50 right sets of 50 push-ups and I got to 1700 and at that point I've in one day 1700 one day and then I felt a tear on or pain in both shoulders as it's nothing and then accidentally I fell and I held brace myself and this whole in a pool and this whole super spinate is just ripped off that needed a surgery and then now this needed surgery thanks to you and your antics yeah oh i'm so sorry to hear that yeah you couldn't be sorry but but speaking to sports well first of all doing it safely and most importantly stretch and all do you know when I was in high school I was captain of my soccer team I played tennis all these.
[45:56] Sad to say we rarely stretched well right because you're young and you can but you got to definitely stretch and all that. But exercise is profoundly important. And it's not just meandering walk, which is great. That's meditation. Absolutely. But you got to get the heart beat fast, you know, get it beating fast, you know, at least five to six days a week. And the effect of exercise has been tremendous. Both weight bearing, especially leg strength, and aerobic is just incredibly important for brain health and health in general. Yeah, there are multiple studies that are coming out that shows that when people exercise, then especially not just cardio, but resistance training, and they have more muscle mass, they tend to have better health. And the reasons are, there are multiple reasons for it. But one of the reasons is that the brain is a vascular organ, just like the heart, just like, you know, the kidneys, and when we exercise, there's better blood flow. So they've actually done studies to look at cerebral blood flow during and after an exercise.
[47:02] There's, there's a change, they actually see better blood flow in the brain. And also, when people tend to exercise their muscles, there are a lot of growth hormones that are created in the body. And one of them has been studied extensively, it's called the brain derived neurotrophic factor or BDNF. And this BDNF can be responsible for creating connections between brain cells. And these brain cells are very, very sensitive to that growth hormone. And the number of brain cells don't matter as much as the connection between them do. And so if we can do anything to create more dendritic arborization or connections between these neurons, that translates into better thinking process, better memory, and other domains of cognition, processing information.
[47:48] Retrieving old memories, learning new information, all of that improves significantly. So, yeah, no matter what our ages is, whether we're nine or ninety nine, exercise is super beneficial for. Yeah. Well, you know, and an SCI mean, as he's biking, he's 90 every day. And then and, you know, and dragging tires and. Oh, my God. Lifting. Oh, my God. You name it. I am so inspired by her. I love and. But that those, you know, when she dragged that, that the tire in a conference, just cheering for her. She was amazing. She's amazing. The story that we have is that when we came to your home to his, you know, and we were staying at their home and on the way from the talk to home, I was sitting in front talking to him and he kept asking questions. And that's a sign of incredible human being. I mean, he is well, and he kept asking. And then the exercise, we sat, we sat in the driveway in his car for a good 20 to 30 minutes. Half an hour. Yeah. And we were just talking and the car was on because it was cold and the heater was on and we were just, talking about all the different studies and for the brain. Yeah. He was amazing. And then we went to dinner and the house and he was not there. And everybody, I'm like, where's SES? Oh, he, he heard you talk about exercise. He exercises anyway. He wanted to do some extra biking upstairs to do more. Yeah.
[49:18] An amazing human being. Absolutely.
[49:21] Yeah. Well, thank you guys. Well, Dean, are you, are you able to do pushups again?
[49:25] Yeah, I am. I am. Yes. I'm never going to do the records. And so I'm, I just, but, but, you know, it's, it's about the aerobic and the leg strengths. I, we do quite a bit. Now we have the time. So I should, I go to the gym and work out and it feels so good. I mean, the day that you don't work out, you've literally feel, and we know the effect of exercise on anxiety, you know, as far as this relationship to medication, to, to depression, we're not negating medicine. We're, we're not the type where we, we think has an incredible place, but exercise has a profound effect on anxiety, on depression, on focus on on cognitive building it's it's the it's the ultimate ultimate intervention so you guys I am turning 61 this this month and one of the things that you guys talk about is it's important to avoid mental retirement yes and how and how many people they retire and they're not engaging their brains as much maybe they're you know they've relegated themselves to the the lazy boy recliner watching TV. Hey, I'm retiring and I'm going to, you know, this is my chance to take it easy, but there's certain ramifications that come with that. So you're not a fan, right? Yeah. Yeah.
[50:42] Yeah. I can't see you the type of person who would just sit on a lazy boy with your, you know, like, I cannot, that, that I can't picture you like that at all, but no, you're absolutely right. I think it's this, um, this, this picture that we have in our head that, you know, I'm going to retire from my job and that's it. You know, I'm going to wake up whenever I want to and sleep whenever I want to and watch TV. And that strenuous or that complexity that people were used to in their jobs, even if they didn't like it, that...
[51:16] Is so crucial for keeping the mind sharp. And when people lose that and don't replace it with something as complex and challenging, in studies, they've seen the steepest decline in cognitive scores. So they do neuropsychological testing before and after when somebody has a job that is complex and challenging. And then after retirement, when they don't do it, it's quite obvious how much reserve they lose. And it's very scary. And it's become an epidemic, because now people, you know, they're used to retiring at an early age, they get their pension and everything, right. And then that's it, they don't really do much. And they think that by just and especially for women, because I'm really, really passionate about women's health. They think by just, you know, which there's nothing wrong with it, by gardening, or by taking care of the kitchen, and by just kind of like tinkering around the house, that should be more than enough. I see a lot of my patients and my community members say, well, I'm on my feet all day long, and I'm pretty busy. And then when you basically sit down and break it down for them, it's, you know, feeding the dogs, washing the dishes, doing some laundry, maybe engaging in some gardening, maybe going out for a walk or shopping or for a movie, that's not enough.
[52:38] And in a bank, right? And all they did was math and books and things of that nature. And then not replacing that in real life, that could be a problem. You said it beautifully. I mean, this is the time you take on hobbies that you always wanted to. Musical instrument, dancing, new language, travel, writing, volunteering, running a new business, things that you always wanted to that pushes you we did a meta-analysis in 2018 we were directors of brain health at cedars and the thing that stood out on as not the main subject of the paper but it's purpose.
[53:19] Complexity and challenge that those three uh venn diagrams purpose-driven activities not one person multiple purposes I mean when i'm trying to learn guitar now i'm that's that's a purpose and it's uh and and it's complex because it's not just sudoku you know it's multi-domain activity it's learning to dance is a multi-domain activity learning new language is a multi-domain multiple parts of the brain and challenge means keeps pushing yourself if you get good at one level push yourself to the next level um that's so important thank you for bringing that up because, sometimes people think if they do one thing they're safe they are they do better than the average. But if you do multiple, it is such protection. It just gives that much more exponential level of protection to the brain. I'm laughing and I'm giggling inside.
[54:11] I know how much you're, you're not a fan of Sudoku or Sudoku, whatever. One of these days we're going to get sued by the company.
[54:21] But, but here's the other thing. And I want you to know that I use your names at least once a week, especially with people that I'm with that, that know you and, and love you as much as I do, like Adam Sud and John Mackey and, um, you know, my family. And let me tell you why. so I have become an absolute fanatic fanatic when it comes to pickleball okay oh yes and pickleball to me it it is it has you said you you use the term multiple brain I think activity yeah but it does it all you get your exercise you get the socialization and then keeping score is such an absolute crazy one, one, two, one, one, you know, whatever. And I'm like, this, this is the ultimate Sherzai sport.
[55:17] It's so funny. You bring that up. I, everybody's telling me about pickable. I'm like, no, this is tennis, tennis is, but now I'm changing my mind. It must have something intrinsic that's accessible and fun and complex. And that, that, that's so it's, it's just taking over the whole world. It's just crazy. No, it is. And I, listen, I used to play tennis. Uh, I was very good at tennis. Pickleball is you can go from zero to 60 miles per hour per hour with pickleball in 20 minutes. It tennis does a learning curve, you know, mastering, you know, the, the ground strokes, the movement and all that. It is a whole nother level. and uh but but pickleball it's available to anyone everyone we were playing with my five-year-old daughter you know um years ago um it's I just can't emphasize enough it is such an amazing sport and then the and how good you can get never ends I mean it's just like chess or something like that we're doing this we're doing it so you're yeah that that was an indirect challenge to us we we We take the challenge. We take the confidence. I love it. I love it. I love this.
[56:31] Ayesha, you talked earlier about women more likely to get Alzheimer's, like two-thirds more likely. You mentioned one of the things was perimenopause. And this is one of the brain health facts for 2023. But you mentioned how perimenopause is a significant physiological and neurological transition for women. Yeah. So what is it about it that is so rough? Yeah, thank you for bringing that up. It's fascinating.
[57:05] So, you know, the more we get these amazing tools to understand the human physiology, the more we know that there are these changes during our life, especially for women, that we have to be aware of. When women, you know, perimenopause is a very long period. It can actually range from five to 10 years of experiencing changes in our physiology, in our vascular health and our cognitive health because of the transition and because of the changes in estrogen and progesterone levels.
[57:39] And, you know, we actually have estrogen receptors in our brain and estrogen plays a very important role with how the brain functions, both for men and women, but for women, because of the reproductive, you know, changes and physiology, we go through through these massive changes. So, you know, it can range from different ages for women, but usually 30s and 40s is the time range when most women experience these changes. And it is a critical time for women to understand that they have to be aware of their lifestyle. So eating a healthy diet, mostly plants, if they can't do a plant exclusive diet, we've actually known that people's proclivity for having high cholesterol changes because there's a very close relationship with how cholesterol and specifically LDL damages our the internal linings of the artery with estrogen. So estrogen actually affects our LDL receptors and how cholesterol in general is metabolized in our body. We know that our body needs certain amounts of anti inflammatory anti-oxidants to fight off oxidation and inflammation in the body. So making sure we eat a lot of greens, fruits, vegetables, whole grains, nuts and seeds, and making sure that we reduce saturated fats as much as possible is critical.
[59:06] We have to make sure that we exercise because exercise is so important for brain health and for general muscle health. We even have estrogen receptors in our bones and in our muscles. So these aches and pains that women tend to feel during perimenopause and menopause can actually be improved with exercise and eating better. So it's very important for them to kind of like go into like the next gear or the next level of improving their lifestyle, because there's lots of evidence that even if we're going through this massive change in our physiology, by improving our lifestyle, nutrition, exercise, sleep, managing our stress and improving cognitive activity, we can negate the impacts of perimenopause and menopause. And also...
[59:54] It wouldn't hurt for people to be connected with, you know, a woman's health specialist to kind of figure out, get themselves tested, get their FSH, which is like follicular stimulating hormone or luteinizing hormone. These are tests that can easily be done for them to find out what stage of perimenopause or menopause they're at. And, you know, we're at an age where we can actually adjust our lifestyle and find out more of what's going on in our body so that we could take care of it. And most importantly um to understand that we can do something about it a lot of times it's you know menopause and perimenopause has been associated with almost like okay this is it you're reaching a point in your life where it's going to be just like you know it's going to be downhill from here on not at all not at all women can thrive in their 30s 40s 50s 60s I mean great Great example is Anne.
[1:00:48] And so, you know, we can actually be better versions of ourselves and we can actually improve our cognition. It doesn't have to be downhill. It is usually downhill because we're, you know, the kind of resilience that we have in our teens and 20s and early 30s, that kind of wears off. So we have to be prepared to take care of our body so that we could live long and happy lives. But here's the thing. And it's also the subject of our third book. Your brain is assumed to decline as we get older. That's absolutely false. Our cognitive capacity can expand significantly. There are two curves, the general population that actually, when they do, they do certain things or don't do certain things that there is a decline. We see that in large numbers. And then there are small proportion that do a specific things that actually increase cognitive capacity. Capacity and we we are certain of this and and we're so uh so so optimistic about the future because we're living longer that's true well that's very exciting uh when will when will that third book be out 2025 beginning of 2025 all right well we're gonna have you back on the podcast and then I can't wait for that thank you tell me this my my my wife is 51 she was having lunch with a.
[1:02:12] The conversation turned to hormone replacement therapy and how about half of her friends are, are doing it. And the other half are like, God, no, I would have no interest in that. And I'm just wondering if you guys have any, any thoughts on HR, HRT. Yes. So we're learning a lot about it.
[1:02:32] So just to kind of give a brief history of.
[1:02:36] So HRT or hormone replacement therapy was the norm, you know, saying if you're going through menopause and you need it. But then this massive study came out in 2013.
[1:02:47] I believe, a little earlier than that, the Women's Health Initiative, which showed that when people take hormone replacement therapy, they could be at a higher risk for having other health problems and that it didn't really make a difference for memory and cognition or other health outcomes. Outcomes uh but since then there's been a lot of other studies and um the big the big answer is it depends right so it depends on multiple different factors there are some people that might benefit from it um and there are some people that may not benefit from it and they may get harmed so understanding what the risk factors are what the different um you know vascular risk factors or other disease burdens that women may have. So it's a very individualized decision. But the one major thing that we learned from, you know, those studies were that starting hormone replacement therapy very late in the game may not be useful at all. For some women starting it early, say, for example, during the perimenopausal state might actually provide some relief to their symptoms to their brain health. And when I say brain health, specifically, reducing the risk of Alzheimer's disease or other types of dementia that are associated with menopausal changes, they have been seen, the numbers are small, so we can't really make a very definitive statement.
[1:04:09] But then coming back to the impact of lifestyle, I think we have more data on the fact that when women take care of themselves, as far as their lifestyle is concerned, they can reduce their the risk of having Having these health problems in any case. But again, this is the conversation that women should have with their health providers, understand what their risk factors are, understand what their disease burdens are, and then make a decision with them. Got it. Next thing I want to talk to you about are vitamin supplementation, nootropics, anything that you think in this realm that is beneficial for brain health?
[1:04:52] That's a great question. So generally speaking, there are some specific micronutrients that are are essential for brain health.
[1:05:06] And we've known this for a while, and multiple studies have actually confirmed our findings. And I'll let you actually describe some of them too. Now, the first one is B vitamins, right? So B vitamins, specifically vitamin B12. And especially for those of us who are on a whole food plant based diet, it's critical, it's crucial for us to make sure that we get vitamin B12. Low vitamin B12 has been associated with cognitive impairment, as well as neuropathies. In that realm also comes vitamin B6, folic acid, vitamin B1, which is thiamine. So taking care and keeping an eye on our B vitamins is important for brain, spinal cord, and nerve health. And it's not just for people who are on a whole food plant-based diet. Unfortunately, when they've done studies, NHANES, this nutrition survey study showed that that 41% of people in the United States, regardless of their dietary patterns, they are deficient in vitamin B12. And that has to do a lot with just, you know, poor quality nutrition, some GI problems that people might have eating too many processed foods, etc. So it's important for us to keep an eye on that and replace it, we have to make sure that we take a vitamin B12 supplementation if we need it. Can I stop you for a sec? Because I want to say that I've recently had a blood panel done.
[1:06:32] Because I wanted to get that done, DE, omega-3s, all that stuff. And Dean, I heard you recently say, so my B12 has always been high, like 900, 950.
[1:06:44] And this test, it was 1,395, and they flagged it as being high. But I saw recently you said something like, in B12, I actually would prefer that you be higher rather than lower. So anyway, I just thought I'd interject. So on the upper end, we don't have much data and it is water soluble. There is not much data that higher levels of B12 is detrimental. We definitely don't want it very, very high because it's going to cause many, many problems. And much beyond that is extrapolation. And even some of the doctors that are saying that might increase risk of cancer and this and that we, there's minimal data when the, when you have excess amount of things that it might increase risk, but the data is not strong. And, and, and, uh, so being in the 900 to a thousand and it's fine. Um, yeah, that's fine. Um, another vitamin that I think that should be addressed is vitamin D more and more and more and more. We're learning the importance of vitamin D and health and brain health in particular and nervous system health in particular. It's a strong correlation with with MS and other cognitive diseases is important. And there seems to be a large proportion of population that have lower levels of vitamin D, even in places like California where we are. Yeah. So what levels are you shooting for?
[1:08:05] Well above you know between above 30 or so is is good yeah so I was like so I was I got tested like I said it was just a week ago yeah my vitamin d was 26 and I was shocked because you know i'm out i'm out playing pickleball all the time right i'm getting sun on my arms and my face and my legs but wow yeah yeah and and we see that I mean to be honest just for transparency my own level, I'm in California on the, we live next to the beach and we walk every day. And yet we had low levels of, I had low levels of vitamin D and that was bewildering. So, so be aware of your vitamin D levels. And for some people that can be genetic too, like for example, I have, you know, my, my family members have a genetic genetically low vitamin D. So we're just very, very aware of it and we get it checked every year. So are you simple? Are you both supplementing with D? I have to supplement. Yes, my mom had it, my aunts have it. So you know, it's important for us to be aware of it. So being aware is first, I hate this wholesale throwing vitamins at people, which is wrong. But the ones that are worrisome to the best of our knowledge today, now in five years, we might find out some other thing. That's okay. That's not a weakness in science. That's a mechanism that keeps expanding. So we know vitamin B12 is important. We know vitamin D is important. The other thing that's very important is omega-3.
[1:09:28] We did a meta-analysis, two, no, sorry. We did two comprehensive reviews, one on omega-3 in the developing brain for children and omega-3 in the aging brain. And in both the trends, again, we were very….
[1:09:44] Cognizant of not overstating things there wasn't profound data but the trends showed that um a vitamin d supplementation seemed to help with children and people in the who are older especially those who have a cognitive decline or having memory issues and and the reason we think that we didn't see it in the middle group is because it's difficult to delineate change right but I And I think it's important. Again, now, this part is us extrapolating. But there's plenty of data that shows omega-3 is very important. Okay, and the other reason is the one fat that your body needs is the omegas, right? Omega-3 is omega-6. You don't have to worry about omega-6, but omega-3, you do. That's the only thing that you need to worry about. Not like some people say, your brain is made of fat, therefore you need fat. No, no. Just omega-3. If you're going to get it from plants, sources, that's fantastic. But make sure that you're getting enough. Um you can even check levels now that we were kind of incredulous about checking levels in the past but we're kind of leaning towards that now um or take supplementation I really don't find it problematic when people take supplementation for these three things especially b12 and omega-3.
[1:10:57] 57 of your brain is made of you know dha and that's the one fat that your body needs and your body can't produce. So if that's not addressed, we know the consequences. When people have low omega-3 levels, we know the consequences as far as brain health. But isn't the DHA, that's a long chain that needs to be broken down from the ALA, right? The short chain. And so my understanding is that some people genetically, their bodies don't have of the enzyme that converts from the ALA to the DHA or the EPA that effectively. And I'm wondering if I'm one of those. And I say that because that's another thing I got checked was my omega-3s, and I was at 4%. And I got flagged as low for that. And I thought I'd be like up around 8%, 9%, 10%.
[1:11:50] And so anyway, I was surprised. I think that that's something that needs to be addressed to the best of our knowledge today. And it's not perfect knowledge. but we have enough little pictures of the fact that omega-3 is so important for the brain. The fact that the brain is made of DHA, a significant proportion of it. The fact that that's the only thing that, that the body can't produce the fact that it can go low. And then when, when it goes low, people have problems. I tell people don't be, don't go fall for the naturalistic fallacy. Yes, we should stay as natural as possible, as clean as possible, plant predominant, all of that stuff. But when your body needs something, you.
[1:12:29] You wouldn't say today that if you needed a surgery for your knee ankle or for your knee, you said, nope, I'm going to do it the natural way. You're going to get surgery. Yeah. And we are there. And I did the public health for an entire country. I created that public health for an entire country in Afghanistan.
[1:12:45] And the first things we did was fortify iodine in that country when we don't have to worry about that. That's in every food. And B12. And that profoundly changed things because 15% of the population in those countries are hypothyroid, which means their brains are affected. So just by a simple change, which is we add something to the food, we changed the entirety.
[1:13:09] Same thing with omega-3. If you think you need supplementation, please don't fall for the naturalistic fallacy and check your levels if you want to. but taking it as, as, uh, seems to be, the trend seems to be showing that that's important. Yeah. Yeah. No, I, for as long as I can remember, I have been only a fan of taking B12. I'm like, you should be able to get everything else you need from your whole plant-based foods. But after being tested and talking to some people from, you know, Michael Greger, Joel Furman, getting my levels tested, I am now actually supplementing with B12, uh, D and the the omega threes and yeah yeah yeah it's it's thank you for saying that that's that's important that um that uh sometimes the plant-based world becomes um uh too naturalistic um you know um I but you know but but uh it has to be science-based and and science-based being science-based and that and plant-based is actually completely aligned yeah we're doing everything perfectly and yeah Yeah, it is. It is perfect.
[1:14:13] Yeah. Yeah. Yeah. All right. Well, thank you for talking about that. Any I know you address this, Aisha, in some of your Instagram posts, but is there anything out there like Lion's Mane or anything else that has been shown to be helpful or not to the extent that you'd like?
[1:14:31] Thank you for asking that. I was actually going to extend this conversation a little bit more because I think it's very important. In the same vein of making sure that we're aware of these numbers, sometimes it's difficult for the general population to delineate between what is evidence-based and what is not. And unfortunately, there are a lot of individuals who are just selling these nutraceuticals and, you know, vitamin concoctions. And, you know, sometimes they slap a paper on it. But that paper, that scientific paper is just junk, you know. So just to kind of briefly go over other nutraceuticals, things like lion's mane, things like ginkgo biloba or ashwagandha or goodness gracious, I'm forgetting some of the other ones. You're making a lot of people angry right now. I'm not. I just love everyone. I love you guys, but there's really no good evidence for these things. I mean, mushrooms are amazing. Amazing. Our favorite thing is mushrooms. Eat mushrooms as much as you can. They're a great source of vitamin D. They have amazing amount of fiber and other anti-inflammatory.
[1:15:44] Oh, the texture. Mushrooms are incredible. They're low calorie. They're high in fiber. But don't spend your money on lion's mane and the promise that it can improve your cognition. Because the only study that was done was dismal. It was done on 30 people and they had to eat like insane amounts of lion's mane extract. And the kind of cognitive testing that they did was not validated. So it's not really based on good evidence at all. And I see the prices. Have you seen the prices on these things? They're so expensive. It's like one small little bottle of lion's mane extract is like 60 something dollars. And it doesn't even last a month. So no, don't waste your money on that. just eat mushrooms or grow mushrooms if you want to. But there's no evidence for that. Same thing for ashwagandha or ginkgo biloba, or all these, you know, strange names, the only thing that you have to worry about is your vitamin B 12, your check your vitamin D, and if you need to take it and then omega three fatty acids, the rest, we don't have any evidence. Even with curcumin, we did the study, the main study turmeric and cedars, where we looked at the accumulation of curcumin and retina, because retina is a continuation of the brain. And you can find that in PubMed. And we saw that it actually bound to amyloid. Wow. If somebody else would have found that kind of data, that would have been a whole business, a billion dollar business. Curcumin binds to amyloid, therefore it removes it.
[1:17:14] Just because it binds, it doesn't mean that it booms it. And then the other thing is what dose, what kind. Just put it in your food. Yeah, just have some turmeric in a curry or in your food. Add some in some soy milk for like a golden latte with a tiny bit of maple syrup and just enjoy that. But I don't think there's any need for us to take tons of it in pill form or in supplement form. Yeah, yeah. I had Dr. Michael Greger on the podcast talking about his new book, How Not to Age. And I asked him, I said, are there any foods that you're eating now that you weren't eating before or more of because of your research and how not to age and to kind of slow down or stop the 11 pathways of the mTOR pathway? And he said, yes. He said wheat germ. He said, I can't believe what I discovered about wheat germ, mushrooms, and then a lot more strawberries. So those were three things. Amazing. Fantastic foods. Yeah. Yeah. Yeah. But, uh, there you go. Um, I know how important sleep is for you guys and the brain. And that was what our whole first episode was about. But, um, for people that have sleep apnea or restless legs, you say that this can significantly, um, heighten their risk of dementia. Um, um.
[1:18:40] Can you explain? Yeah, not just dementia, but there's been study, large data that increases risk of heart attacks and other diseases as well, such as strokes.
[1:18:53] So sleep apnea, there are two types, obstructive sleep apnea and essential sleep apnea.
[1:18:59] Essential sleep apnea is when the brainstem is not working as well to get this automatic process of breathing going, especially at night. And obstructive although it's been associated with obesity but you can find thin people that have obstructive sleep apnea quite often and what happens is overnight they're holding their breath or that's being obstructed so over time the oxygen level goes down the oxygen saturation of the blood goes down and that has consequences on the blood it has consequences on all the tissues that's why the heart attack risk and stroke risk and if it's not addressed of course the quality of sleep goes down which means that the this restorative properties of sleep are not brought into its full effect and therefore it has consequences that causes damage to the brain both directly and indirectly through diseases um and it's treatable um we we have multiple tools sleep app the c-pap machine which is a terrible device but people get used to it the alternative is worse I tell people I know that it's I never uh understated it is difficult to get used to but people get used to it and and then there are other devices that could you be used as well now inspire this this stimulator and all of these things that can be used as well and if you do it you reduce your risk significantly that's that's remarkable for restless leg it's treatable often because if it's either iron deficiency or folate deficiency or or a neuropathy or a spinal thing all.
[1:20:25] Of those can be addressed and treated and and people just live with it for a.
[1:20:29] Long time yet with the if you suspect Expect it, address it. And how do you expect sleep apnea?
[1:20:36] If you're sleeping eight hours and you're still tired during the day, or you need coffee to stimulate you every time to rev you up, if you are snoring excessively, if somebody's seeing you hold your breath.
[1:20:50] Or if you're moving around a lot at night during sleep, these are hallmarks of sleep apnea that they should then get tested. What do you guys have any thoughts on... Taping your mouth closed so that you're breathing through your nose. I know that that seems to be a popular thing right now. Well, Ayesha suggested that for me, but it wasn't during sleep. So I don't know what you're talking about.
[1:21:20] Take your mouth. No, no, unfortunately I know it's so common, but there's really no good evidence for that. I hear such weird things for sleep. I do know that But there are people who actually have like an anatomical variation. So, for example, they have a thicker tongue or they have their jaw that kind of pushes back and blocks their their airway when they fall, when they fall asleep or when they're sleeping in a supine position. And when they put, you know, some, what do you call it, like a specific kind of mouth guard, or some mold, and they go to an ENT, and they kind of, you know, get something made for them that might work. And without, you know, any CPAP machine, there are people who actually benefit from those kind of things. But there are few people, but no mouth taping, there's actually no evidence for that at all. And that could actually be dangerous, too, because a lot of of times people can't really, you know, breathe properly through their nose because of their anatomy, deviated nasal septum, or just kind of having a smaller holes, and they need to breathe through their mouth, and they might actually become hypoxemic if they tape their mouth. So it's not a good idea. Right, right. I also heard recently that.
[1:22:38] Depending upon how you sleep, if you sleep on your back, your right side or your left side also affects kind of how you can clear out the brain. Like the right side, something about being on the right side with the carotid artery there, it enhances the flow. Have you heard anything about that? I have. Yeah.
[1:22:58] There's no science behind that at all. No. We have such an elegant system in our brain whether you're upside down right side up one side or other side it will continue to function and adjust it kind of reminds me of uh of uh you know like the ph waters like that that alkaline water that you know come on your stomach is so acidic when you drink alkaline water it neutralizes it like right away and and you know your body is so sensitive to your ph that you have a dedicated system to it to change you know to keep it within normal limits and if there is like a 0.01 percent change in your ph you actually go into shock and people actually have to go to an icu to get that fixed whether it's because of a kidney issue or a lung issue or a heart issue a same thing for with the brain we have such an amazing system to kind of make sure that the glymphatic system functions well that the cerebral blood flow is within normal limits that no matter what position you are, whether you're in space or on Earth, whether you sleep on your right side or left side, it doesn't matter. Good to know. I'm going to keep sleeping on my back then. Yes, absolutely.
[1:24:12] Absolutely. All right. There is so much noise swirling around out there that I don't even know.
[1:24:20] I want to know if this is as frustrating for you as it is for me. And that is regarding lectins and phytates and oxalates. And I want to avoid foods that contain anything that smells of any of these three things. And of course we're talking about you know fruits vegetables whole grains and beans and now i'm just wondering like if you guys could address uh I would imagine that all these things are good for brain health and not not not wreaking havoc on it a hundred percent they're good for brain health I want to take a deep breath before I talk about this emotional didn't you go first.
[1:24:57] No, I agree. This is junk science. It's sensationalism. It's bringing the new word. It's an old charlatan technique. It's separating science from the population and then throwing your magical wand into the mix. Whether it's hydrogen water or or alkaline water or lectin being bad or or phytates or these are all the concepts that are shiny enough that attracts people and and it's also a one act right if I do this one thing i'm going to be healthier it's always attractive as and and we say that, well, whole food plant-based is great, but that's going to help you quite a bit, but you've got to walk quite an exercise quite a bit as well.
[1:25:50] That's great, but you've got to sleep quite eight hours of deep. That's great, but you've got to challenge your brain as well. And so- It's a combination, complex, without sexy terms. Hopeful plant based, walk, brisk walk, meditate, relax, sleep, and then challenge your brain. It's not like phytates and ginkgo and lion's mane and lectins being bad for you. And these are term-driven attractions that have been used repeatedly throughout history. And now they have this one off paper that supports them.
[1:26:31] Somebody somewhere did one off paper that was badly done. But they say, there it is, or an animal model, or even worse than that cell model that somebody did in their lab so that they could support their and then they just use that one variable. The idea that right now we have a movement of a carnivore diet, which is killing people. We just got data that we're getting people who have been on carnivore diet with LDLs in the high, near thousand level, high hundreds. And they're having cardiac conditions and things of that nature. And yet it's popular. Why? Because it's telling people to do what they want to hear. And it's a very simple thing, not much change from baseline and in the direction they want to do. It's a very difficult time, but I think one of the most important tasks that we all have, even independent of our own areas of work, is fight for a scientific method of coming to truth. Yeah, I think it's a very serious problem that we have because, you know, the public, they look up to individuals with, you know, with some titles, and it's quite unfortunate that people don't. Have an MD or a doctor or a PhD or a master's next to their name and spreading like junk science like this.
[1:27:59] So it's very difficult for people to, you know, who to trust. And a lot of these individuals who are spreading this misinformation have amazing marketing and PR teams. And so kind of making it look as if it's, it's, it's science, and they throw all these, you know, like citations and and things of that nature. So it's difficult. But for the general population, and your lovely audience was listening to this, I think it's, it's important for them to kind of remember this. It's not a trick, but it's a tip, I guess it's a tip. If someone is saying something that is completely outlandish, you know, like saying, Oh, did you know that greens are killing you, right? Or greens have poison in them. It's very important for you to kind of stop on your track with a good amount of skepticism, say, ah, you know, this doesn't really make any sense, because so far, we've known that greens are really good for you, or lentils are really good for you.
[1:28:57] So instead of just kind of going with that flow, it's important for us to stop and questions like, hey, where did you get this information from? Who's saying it? What kind of a trend is this before kind of falling into that bandwagon? Because a lot of people keep on changing their bandwagon, like Dean said. And in science, science is not like a person or an organization, it's a mechanism, right? So for example, the way we accept something is, if there is 100 piece of data, and 99 of them point towards one direction, we kind of say, Oh, you know what, there's a trend, all of this research is showing us that this is the trend. For example, there's 100, I'm just Just creating an example, there's a hundred piece of research on eating lentils, okay? 95 of them say lentils improve your LDL, they improve your cardiovascular health, they improve your cognition.
[1:29:54] We're like, oh, wow, 95 of them say this is good. Okay, this is what we accept. We're going to eat lentils. But then if five of them say like lentil causes inflammation or lentil actually is bad for your gut health or lentils is actually associated with long-term dementia, we're not really going to go with that. That's the problem. These individuals just pick and choose mechanistic studies that haven't really been replicated properly. And they've been done in very interesting circumstances, either animal studies or in a petri dish, they pick that and then they blow it out of proportion and say, but this research showed that lentils cause harm to your body. So, you know, we have to go with what most studies, most interventions, most randomized control trials show, not just the 5% that shows the contrary. And don't even go with the person in front of you.
[1:30:45] One of the things we tell people is, don't worry about who's in front of you, Dean and Ayesha, degrees, universities, nothing the thing that comes out of my mouth the next moment is it based on an argument that i'm making that is it based on a method that makes sense and the data that's robust that's it and and or am I cherry picking data and and that's critical I think one of the best things we could do in our school systems one is it's great that we're learning algebra and calculus well algebra is necessary but calculus not but I think even before that statistics I think schools should should teach statistics and how to analyze statistics. The other is critical thinking and critical analysis and scientific thinking.
[1:31:27] And when people are armed with that, when they become cynical and only assess according to data, weight of data, not the person in front of them, how shiny, how confident he is standing there saying that hydrogen water is going to cure you. And then they have like some big name behind them. Then we have freed the country from the same fight we keep doing.
[1:31:52] It's just bewildering. And even in the plant-based world, all of a sudden somebody says something weird, like aluminum is causing Alzheimer's and a big name. And I'm like, oh, no, no, no, no. We don't play that. It's name, no name. You're making a claim like that. You better come up with it with data. And it's critical that we all actually, and I love the fact that you guys really stick to that kind of concept and not just by appeal to authority. Yeah. Thanks. Thanks for the lengthy explanation about that. You said keep it short. I forgot. No, no, no, no. It's good. It's good. So next thing I want to talk about is, because I think this is really important for people, the three key vascular markers that are essential for optimal brain health. You guys cite them as blood pressure, LDL, and hemoglobin A1C. I want to know, what are ideal numbers that, what should people be hitting for, striving for with all those three?
[1:33:05] Those are amazing. Yes. If people could actually keep an eye on these three numbers, I think most of our cardiovascular disease and brain health issues are going to go away the number specifically for blood pressure, to the best of our knowledge today, and based on the Joint Commission, the American Heart Association, and the American College of Cardiology, normal blood pressure is systolic, you know, the high number being 120, and less, and diastolic, which is the lower number being 80 and less. Anything beyond that comes into to the realm of mild, moderate, and very high or extreme hypertension, which they need to take care of. That's blood pressure. As far as LDL, or low density lipoprotein cholesterol is concerned, making sure that it is 70 milligrams per deciliter or lower is critical. Now, if somebody has high blood pressure along with high LDL, that number could definitely be lower, could be lower than 55 milligrams per deciliter and lower. That's the latest accepted number by the European cardiology group and the American Heart Association as well. So keeping it less than 55. As a matter of fact, you know, is that with or without medication?
[1:34:22] Could be both. I mean, it would be great if it's without medication. But you know, if people have a number of risk factors, say, for example, it's not just LDL, but it's also blood pressure, or it's also pre diabetes that are diabetes, they need to work with their healthcare provider to continue to lower it down. And we have to be cognizant, some people have genetic factors that no matter what they do, they can't lower it. So they need medication. Absolutely, absolutely.
[1:34:48] And so that's an important thing. And you know, there's some people are concerned about lowering their LDL too much. They say, you know, there's some individuals who have their LDLs in the 30s. Like, is that dangerous? Should I start eating more fat to actually increase it? And the answer is no, the lower LDL hasn't been associated with any disease product. We actually have systems in our brain that continues to create cholesterol so we don't need any cholesterol or fat from the outside other than dha to improve our brain health that was ldl i'm keeping a brief riff listening to you and as far as sugar metabolism is concerned hemoglobin a1c you know if it actually goes beyond 5.6 percent you're actually in the realm of pre-diabetes so So making sure that it is lower than that is critically important. And that's a number that kind of looks at your sugar levels over a span of three months. So it's a good indicator of how your glucose has been. I don't think healthy people need to wear a continuous glucose monitor to look at the rise and fall of their glucose levels because physiologically, it's very normal for us when we eat a banana or a mango for our sugar levels to go down. That's supposed to happen. Those are very popular right now. Yeah, they're getting freaked out.
[1:36:08] They are. And that's why I kind of inserted that in there, because you get to see these influencers who are saying, well, if you eat, you know, like a little bit of fat, and then you eat a banana, it's not going to rise. Don't listen to that. There's no evidence for that. Physiological rise in your glucose levels is absolutely normal after eating a high carbohydrate diet. And you don't need to wear it. The CGMs are usually for people who have, say, for example, type one diabetes, or they They have type 2 diabetes, and they want to make sure that they keep an eye on their glucose metabolism. But for individuals who don't, hemoglobin A1C is all they need to worry about. Yeah. You know, I mean, but I look at those three markers that you mentioned.
[1:36:50] Are looking at for optimal brain health. And I think, well, what percent of American adults have a healthy blood pressure? That's, you know, 120 over 80 or less. And what is it? Is it like 60% of Americans are on some sort of a hypertension, hypertension? I look at LDL, what percent without meds are under 70? I don't, I don't know many. I really don't, you know, I'm at 65. Yeah. And then hemoglobin A1C, the fact that we've got now close to 50% of the population that's either type two diabetic or pre-diabetic, they're probably not hitting those numbers either.
[1:37:32] So those, I mean, but I, what I like is it's, it's so simple the way you've identified those three markers, but unfortunately I don't think most Americans are, are sitting in in a very pretty position when they look at those three numbers but but the empowering thing is that it is those are three numbers that we have we know what they are we can follow them and we can affect them and just at that level we can have profound effect on our brain health and health in general but especially brain health just blood pressure management has been shown to or high blood pressure has been associated with 20 or higher levels of dementia and alzheimer's just blood pressure yeah the same thing with insulin resistance we did a study in in haines the two of us and I looked at younger people with pre-diabetes not even diabetes we excluded diabetes and they had cognitive decline so if you address that with food would I mean even if some people who need medication but let's say with proper food and exercise you reduce your risk profoundly so I think that's not a negative thing that's an incredible opportunity as a
[1:38:36] nation that we We can change brain health and health in general. I couldn't agree more. And I was painting that kind of bleak picture because the solution is so absolutely right there at the end of your fingertips. Yes. Right? Yes. Yeah.
[1:38:54] What about, what's your opinion of alcohol? Any thoughts on alcohol? Yeah. Are you sure you want your podcast to end like this? You're gonna lose a lot of followers but but this isn't quite the end I know i've kept you a lot longer than I said I would have a quick 45 to an hour and we are approaching an hour 40 but you know what this is what I love when I talking to you guys I just can't thank you so much no so the amount of alcohol to the best of our knowledge today and and if you get sick of that statement there's a reason we're repeating that it's a it's a statement of humility of science and the fact that if we change direction with data, that's not a weakness of science, that's a strength of science because that's the only thing we have. Otherwise, we have to go from, a sage's opinion to another sage's opinion or another influencer's opinion so the to the best of our knowledge as far as data is shown the amount of alcohol that's good for your brain is, drum roll zero zero yeah zero zero alcohol well so let me ask you this yeah do you guys drink at all um first of all I don't like alcohol but if I go to a party I hold a glass of wine maybe yeah I just fake it on rare rare occasion even we don't even fake it but on rare occasions wherever it's It's like a wine. I did a couple of times just to make sure that, you know, friends and family don't get remember the Beverly Hills party where it was a wine and cheese party.
[1:40:18] We don't drink wine and we don't eat cheese. Yeah. And the party wasn't that funny either because it was, yeah, in any case.
[1:40:27] So yeah, let's say no, because to be honest, I can't even remember the last sip I've had. No, I've never. Listen, I'm right on board with you. I haven't had alcohol in seven years. It's such a, I find, I find people that avoid alcohol, their lives are enhanced. They really are. What about, what about there? There seems to be a lot of noise these days regarding saunas and ice baths. Any, any data or science to support that we should be doing those for? Yes, there is. Yes. If you're a high socioeconomic person from Finland, you should definitely have a sauna.
[1:41:07] There you go. Literally, honestly. Honestly, I know that there's a lot of data to that, to support that. If I'm not mistaken, I haven't looked at the data in the past month, but there were so many studies coming out that sauna is associated with 65% or 70% reduced risk of dementia. And you know some really... Some really prominent people on social media even put it in their books. And when you look at the data, like Dean said, they're from a higher socioeconomic status, rich people from Finland, which is very, very, very common, right? In Finland, almost everybody has access to saunas. And a homogeneous population, which means that you can't even extrapolate and say you can generalize. Right. Sorry about that. And it hasn't really been replicated in any other parts of the world. That's it. And they had reduced risk of Alzheimer's disease. But to be honest with you, Finnish people actually live longer. They live longer. They have a really great healthcare system. They have access to doctors and hospitals. I mean, the numbers are just crazy. Yeah.
[1:42:20] To extrapolate from that population, even if it was a well-done study, even if it was a well-done study, it's next to impossible until you reproduce it in other populations. Right. And as far as the ice bath is concerned, again, I mean, you know, it might feel good, it might actually wake people up, but there's really no legitimate data on long term impacts on brain health and mental health. And there's actually some data that may be dangerous for certain populations. Yeah, it actually might even increase the chances of someone going into arrhythmia, especially people who have cardiovascular disease, it might actually be harmful for them. I've actually spoken with cardiologists who say that people can be harmed by this. So people have to be very skeptical of these. But the question is about heuristics, the idea that putting your body under stress so that the body develops a response that is protective. There is something to that. You know what's a good way that you can do that?
[1:43:25] Uh push-ups push-ups yeah but the right way brisk walk run bike 20 miles if you can I mean don't just jump to 20 but push yourself and that level heuristics also helps with emotional aspects because it it resets the dopamine pathway which is actually the same people that talk about the sauna and stuff they're killing the dopamine whole concept as well everything is dopamine everything is dopamine yeah but nonetheless hormesis yes the concept of hormesis essentially means and this is brought up like over and over again in so many uh podcast days which essentially means in simple words that a little bit of stress is good for you right hormesis means that the body actually develops resilience if it is exposed to stress to a certain extent and the ice baths are are considered as one of them, but there are no population studies. There are no observational studies on them. And most of them are very, very, you know, very small studies on small populations and no long-term outcomes. They just look at immediate feeling. I mean, obviously if someone like dips in ice and comes out, they're like a little bit more awake. But like you said, you can get that from anything.
[1:44:40] What about, you know, it seems like marijuana Marijuana has become very, very, like, you know, it's been legalized now in I don't know how many states. Is there anything that you guys have come across showing that marijuana or the
[1:44:58] substances in marijuana are beneficial or not beneficial to brain health? Yeah. So let's approach this a little more complexly because I think the idea of banning a product like that was wrong. And to ban it even to research was wrong. Here's a chemical that actually binds to specific receptors in the brain. What an opportunity to learn about the brain and all that. So that should have been studied. The idea of things being open and legal and not, that's a very complicated political science question and philosophical question that we've had many conversations with the kids. And it's complex. But the benefits of it, no. There's no evidence at this point that marijuana. In fact, if anything, chronic marijuana use has been shown to affect short-term memory and memory in general. So there's definitely data to that end.
[1:45:50] But it should be, yeah, there needs to be further studies. But at this point, that's what we have. One of the things that people need to know is that the brain is such a malleable and an ever-changing organ. The brain continues to grow well into your 20s. Like the brain actually doesn't mature up until the age of 25. And even by our mid 40s it continues to kind of morph into its mature state so that age you know where we used to think that after age five the brain kind of stops growing but now we actually know that it continues to evolve well into your 40s and you know we actually have evidence for that we were speaking with some neuroscientists about that so imagine in our podcast the brain on podcast, imagine exposing yourself to, you know, substances like this that could potentially.
[1:46:46] Either impede or, you know, shift that growth period that could shift that, that construction period. So people have to be very careful about it. Yeah. You know, the term that I hear quite frequently is brain shrinkage. And what exactly is brain shrinkage because it sounds so absolutely scary yeah that's what they there are many ways that brain shrink you know that night when you sleep the brain shrinks it creates spaces for the lymphatic fluid to flow but but that's not what they mean what they mean is actually cell loss, loss of neurons especially in the temporal lobe and the medial temporal lobe where the memory centers are an emotional center the limbic system is so there's actually cell loss that and when you you look on the MRI, you see that that part of the brain is actually smaller. Got it. Got it. And I've heard that there's something that's been proven to cause brain shrinkage, and that's olive oil. No, no, no.
[1:47:46] So, you know, Ayesha, that, you know, obviously my father, this audience is not a fan of olive oil. But like you said, I mean, I love that you guys like to follow the science, right? Right. And what is the science? What is the data showing us? And I saw you on Simon Hill's podcast recently, and you basically are showing that, you know, maybe olive oil is is OK. And I'd love for you to talk about that for a second. Yeah. Yeah, absolutely. No, I think as far as olive oil, I think this audience is going to hate us more about this than the alcohol. No, no, no, no, no, no, no, no, no, no. We were part of this community. I'm not trying to convince anybody to start drinking. Let me start from there, actually. This hyper vigilance or this massive campaign for drinking olive oil is nonsense. I mean, there is really we don't have any evidence that addition of extra virgin olive oil to our diet is absolutely.
[1:48:56] And Starbucks just added a drink that has olive oil in it, right? Right. I mean, there are physicians and there are people in the realm of brain health that think that extra virgin olive oil is absolutely necessary for brain health. And I'm going to say it. There's actually no evidence for that at all.
[1:49:17] The issue is people cook, right? They cook. And they use some sort of a fat to cook their food. Studies have shown that if they switch from butter or from animal sources of fat, which contain mostly saturated fats, and they move to sources of polyunsaturated fatty acids, they do better.
[1:49:40] That essentially shows us how important it is for us to lower our saturated fat intake. There's almost a causal relationship. In science, we're very, you know, we use a lot of humility. We don't say this causes that we say this is associated with that, because there might be a chance that that association might change with more data to come right. Right. But the amount of data we have that shows that consumption of saturated fat increases LDL, which increases cardiovascular disease, which also increases the chances of Alzheimer's disease is so strong that we actually use the word cause.
[1:50:19] Saturated fat causes cardiovascular disease. Saturated fat is very, very closely linked with increased risk of strokes and Alzheimer's disease. And so reducing it is absolutely important. Now, as far as switching from butter, for example, or lard or other sources of, you know, fat, animal fat to polyunsaturated fatty acids actually improve those outcomes because polyunsaturated fatty acids don't have the same kind of harm. They don't increase your LDL. Now, here's another thing that has been exaggerated, the anti-inflammatory effects of extra virgin olive oil. I think if you consume greens and if you consume olives and, you know, intact, you might actually get more anti-inflammatory products there instead of drinking extra virgin olive oil. The rest is, from our perspective, associated with energy consumption. If you are someone who does not need more calories, if you're someone who has been on the verge of developing metabolic syndrome, which is most Americans, unfortunately, we actually are suffering from this metabolic syndrome, which is obesity, high sugar levels, high LDL, high blood pressure. Most like about 50% of the population are either on the verge of or in the midst of metabolic syndrome.
[1:51:44] Addition of more calories is unnecessary, right? But if somebody who's not in that, in that category, and if they want to eat more plant-based, and if they want to enjoy their food, addition of a little bit of extra virgin olive oil may not harm them. So I hope that makes sense, kind of creating this nuanced, complex picture.
[1:52:04] Absolutely. But, you know, I obviously, you know, most I'd say like obviously my father's patients, right? Yes. That have heart disease. A lot of them end stage heart disease, right? My father doesn't want them touching olive oil.
[1:52:23] You know, I look at olive oil. Well, you look at the nutritional facts panel and it's 15% saturated fat. It's obviously a hundred percent fat. And it's like, listen, if you really want, if you feel like you need those, those, some of those monounsaturated fatty acids, you need some of those, you know, polyphenols, whatever, get them from olives instead of getting them from olive oil. But to your point, I absolutely, I see that as well. But I thought I'd have fun and ask you that question. So thanks. No, I thank you for asking. No, thank you so much. This is one of my favorite books, Courageous Conversations. This has to be, we have to have those courageous conversations. Otherwise we get into our silos and then we will find data. So this is wonderful. Thank you so much. One of the things that we see is when we go to communities, we tell them the optimal diet is this and the optimal diet is whole food. And And these are communities where the only food that's most prevalent is because there are fast foods everywhere. Kentucky fried chicken, pizza, you know, you name it, all of these. And to go from that kind of environment to no salt, no sugar, no fat, no meat, no cheese, no butter, no fish. And then, yeah, it's going to be no share side.
[1:53:44] So it's not that we don't compromise the science. At the beginning, we say that this is the science. The science says whole food plant-based, da-da-da, all of these things. But if you're going to compromise, I'll tell you. Very transparently, we are whole food plant-based because of ethics first, environment, and then health. As it happens, it's perfectly aligned. But even the people that we first started because of animal rights, we say that for a certain population, if you're going to eat fish, absolutely. The data against fish is not there, to be honest. We think there's poisons, we think there's microplastics, but data, data is not there. But it shouldn't be the last stage. The next stage should be plant-based. And it makes us difficult because we know that we're destroying the oceans and by 2045 and all of that stuff, we're very versed in what we're doing to the oceans and destroying them. But we really have to take the communities into perspective with staying true to science. Always. This is the reality. Here you are. And your steps are very small steps that are doable for you. And if we don't do that, we're always going to be talking to ourselves in our own silos. Yeah, it's an ever-growing silo, but it's growing so slowly that the planetary change will catch up faster. Yeah. Yeah. That's great.
[1:55:10] Have you guys eaten anything yet today? You're not doing intermittent fasting or anything like that, right? No, no. I had a big bowl of oatmeal with blueberries in the morning. Both of us. Yes. Yes. Oh, and so do you like, do you use Rob, Bob's Red Mill Extra Thick Oats? What brand do you use? Yes, that is my favorite, I have to say. The extra thick one. And I like the texture and I don't like it mushy. I like chewing it. And I add a little bit of soy milk and some blueberries. I like the tiny little, you know, the wild blueberries from Trader Joe's. They're delicious. They're delicious.
[1:55:48] So do you prefer, well, do you like steel cut oatmeal then? Because that's got a little bit more of a, you know. Yeah. I do. Dean loves that. Yeah. Dean loves steel cuts. I like rolled oats. So it depends if, you know, I make some for him and then I have his and then I make some for me some of the days. And then we just kind of like go back and forth between steel cut oats and rolled oats. Yeah. Yeah. And the kids love those. Yeah. The kids love them. That's our breakfast every morning. Yeah. Did you, did you hear that Bob Moore, the, uh, from Bob's Red Mill passed away over the weekend? Oh, I didn't know that. Oh my God. He was in his, he was, I think he was 90 or 92, something like that. Oh my goodness. Quite a man. And he, he really did, uh, created quite a, uh, quite a company. Sure did. We're grateful to him. Yes, exactly. Exactly. Um, what do you got on the menu for lunch? Anything?
[1:56:40] Goodness. I think it's a burrito. Yeah, it's a burrito. It's like some tofu with like tons of veggies, some brown rice wrapped in a whole wheat tortilla. It's amazing. Yes. And who who does most of the cooking in the in the household? So I try to be the sous chef. If I'm not injuring myself, I try. I definitely do all the dish washing the dishes. He does. I do all the dish washing. I do all the cleaning, the kitchen mopping, everything. Yeah. And then I do some of the sous chef cutting and stuff. I'm getting better at it, but she does a lot of the cooking and she loves it. And she's, she's amazing at it. She's amazing. Well, I know when I was there, you, you had, uh, all kinds of dishes for us and it was so, um, it was so pleasant. It was so healthy.
[1:57:28] You guys, thank you for your time today. I really appreciate the ketchup. I hope to see you guys soon and please let's have you back on as soon as the next book comes out and do you have a name for it yet or is it still under wraps under wrap it's under wrap but we'll definitely let you know and we would love to see you maybe we can actually come to austin and we can do a live podcast together well that or we can get you back to PLANTSTOCK and really things up something like that. That'd be fun. Thank you for everything you do, Rev. We really appreciate you and we love you and the family very much. Thank you. Right back at you. And I want you to know, you know, the almost two hours that we've been together, I can actually feel my brain, my hippocampus starting to get larger.
[1:58:19] I love it. I love hanging out with you guys. We feel the same too. Thank you very much. Thank you for having us. Hey, give me a virtual PLANTSTRONG fist bump on the way out. Out there it is love you bye-bye.
[1:58:35] The Sherzai's recently launched a new podcast called Your Brain On, where they give neuroscience tips and advice about your brain on, well, everything. Alcohol, exercise, sleep, ADHD, sugar, love, and a lot, lot more. It's a fantastic view of how our brain operates and responds to everything that life throws at us. For more information visit thebraindocs.com and I'll be sure to link up to that in the show notes, until next time give yourself a loving pat on the head and thank your brain for everything that it does make sure that you give it plenty of rest and feed it only the best foods how always always.
[1:59:25] Music. The PLANTSTRONG Podcast team includes Carrie Barrett, Laurie Kortowich, and Amy Mackey. If you like what you hear, do us a favor and share the show with your friends and loved ones. You can always leave a five-star rating and review on Apple Podcasts or Spotify. And while you're there, make sure to hit that follow button so that you never miss an episode. As always, this and every episode is dedicated to my parents, Dr. Caldwell B. Esselstyn, Jr. and Ann Crile Esselstyn.
[1:59:28] Keep it PLANTSTRONG,
