Cognitive Decline Expert: The Disease That Starts in Your 30s but Kills You in Your 70s

Alzheimer’s expert LOUISA NICOLA explains early Alzheimer’s risk, why creatine fuels brain energy and memory, deep sleep hacks, and why sitting is a silent killer! Louisa Nicola is a leading neurophysiologist and human performance coach who studies the brain and nervous system. She is the founder of Neuro Athletics, a consulting firm that provides scientific strategies for cognitive performance, and is also currently finishing her PhD at the University of Washington. She explains: ▪️Why 70% of Alzheimer's patients are women ▪️The "leaky brain" warning signs you are ignoring ▪️Why menopause triggers a 30% drop in brain energy ▪️How 20 minutes of Zone 5 training reverses heart aging ▪️Why your "willpower muscle" shrinks without hard challenges (0:00) Intro (2:31) Why I’m on a Mission to Prevent Alzheimer’s for Millions (2:58) Alzheimer’s Might Be More Preventable Than You Think (4:34) How Lifestyle Habits Quietly Lead to Dementia (8:43) Why Some Older Adults Stay Mentally Sharper Than the Young (12:35) What Short-Form Content Is Doing to Your Brain (13:47) The Hidden Cognitive Power of Exercise (16:31) Why Strong Legs Might Be a Key to Brain Health (17:23) How Resistance Training Rewires Your Brain (21:08) Can Exercise Actually Help Suppress Cancer? (22:58) The One Exercise That Shields Your Brain Over Time (25:42) Can Aerobic Training Help Prevent Alzheimer’s? (28:47) What Cardiovascular Health Really Means for Your Brain (32:15) Why VO2 Max Could Predict How Long You’ll Live (34:45) The Best Exercises for Long-Term Brain and Mental Health (41:45) What to Do Right After an Alzheimer’s Diagnosis (45:05) Why the Ketogenic Diet Could Benefit Perimenopausal Women (50:12) What You Should Know About Hormone Replacement Therapy (52:31) How to Find the Best HRT for Your Body and Brain (1:00:24) Ads (1:01:56) The Overlooked Link Between Sleep Loss and Alzheimer’s (1:03:42) Why You Need to Rethink Your Sleep Habits Now (1:07:01) Can Ashwagandha and Rhodiola Really Reduce Stress? (1:10:02) The Most Potent Brain Supplement You’ve Never Tried (1:14:04) How Vitamin D Supports Longevity and Brain Health (1:15:03) The Most Affordable Way to Boost Brain and Body Function (1:34:34) Ads (1:36:27) Why Doing Hard Things Literally Grows Your Brain (1:43:28) Are Chatbots Causing Brain Rot? Here’s What We Know (1:49:03) The Truth Women Deserve to Hear About Their Health (1:57:39) What Happens When You’re Obsessed With Your Mission Enjoyed the episode? Share this link and earn points for every referral - redeem them for exclusive prizes: https://doac-perks.com Independent Research: https://stevenbartlett.com/wp-content/uploads/2026/02/DOAC-Louisa-Nicola-Independent-Research-further-reading.pdf Follow Louisa: Instagram - https://linkly.link/2ZgsR YouTube - https://linkly.link/2ZgsW X - https://linkly.link/2Zgsa Neuroathletics - https://linkly.link/2Zgsf Podcast - https://linkly.link/2ZmIF You can learn more about ‘BRAIN CODE’, here: https://linkly.link/2ZmIC The Diary Of A CEO: ◼️Join DOAC circle here - https://doaccircle.com/ ◼️Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼️The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb ◼️Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼️Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsors: Apple Card - https://Apple.co/get-daily-cash Apple Card issued by Goldman Sachs Bank USA, Salt Lake City Branch. Offer may not be available everywhere. Terms and limitations apply. Ketone - https://ketone.com/STEVEN for 30% off your subscription order Wispr - Get 14 days of Wispr Flow for free at https://wisprflow.ai/DOAC

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Steven Bartlett?

  We have this white powder in front of me. You've got a big smile on your face.

• 0:04Speaker 01

  I do because I don't care who you are. You should definitely be having this. So let's talk about creatine. Phenomenal research shows you can creatine your way out of sleep deprivation. It can protect your brain against a concussion, stroke, from stress. And there was a study done on Alzheimer's disease patients. And they found that patients not only preserved their cognitive functions, but they had more energy and they were able to exercise more. And I know this because I'm a clinician. And over the last decade, I've been surrounded by the greatest neurosurgeons in the world studying the brain. And so I'm here to tackle one disease, and that is Alzheimer's, because it generally starts in our 30s. And 60 million people worldwide have Alzheimer's, 70% being women.

• 0:48Speaker 01

  And I get angry and I get passionate because women have been lied to. They've been underrepresented. They downplay their symptoms or they're too scared to ask their doctor for advice. And what people don't really know is that it is a preventable disease. But it's like end-stage cancer. Once you get the diagnosis, there is no cure. And the fact that so many people are at the mercy of a disease that is preventable is not okay with me. And I don't think people understand these things. Like people don't really know that we're becoming more sedentary, which is a disease. And there was a study that was done on this that showed that if you do 10 air squats every hour, this can compensate for your sedentary lifestyle. And then we have several lifestyle factors that can lower your risk of getting Alzheimer's

• 1:31Speaker 01

  disease, as well as showing you what five minutes a day can do for your brain performance just using a tennis ball and an eye patch.

• 1:42Steven Bartlett?

  Guys, I've got a favor to ask before this episode begins. 69% of you that listen to the show frequently haven't yet hit the follow button. And that follow button is very smart because it means you won't miss the best episodes. The algorithm, if you follow a show, will deliver you the best episodes from that show very prominently in your feed. So when we have our best episodes on the show, the most shared episodes, the most rated episodes, I would love you to know. And the simple way for you to know that is to hit that follow button. But also the fact that I think what 41% of you have chosen to follow the show, that listen to it regularly, is the reason why we've been able to improve everything. It's the simple, easy, free thing that you can do to help us make the show better. I would be hugely grateful if you could take a minute on the app you're listening to this on right now and hit that follow button. Thank you so, so, so much.

• 2:31Steven Bartlett?

  Louisa, what is it you do in simple terms? And I guess most importantly, why is it that you do it? And why now?

• 2:41Speaker 01

  Over the last decade, I've been studying the brain. I'm both a clinician and an academic, so I get to see the brain and I also get to research it. And I'm really here to tackle one disease, and that is Alzheimer's disease.

• 2:57Steven Bartlett?

  Why is this so important now?

• 3:00Speaker 01

  Right now, because 60 million people worldwide have Alzheimer's disease. That number is going to triple by the year 2050. 110 million women will have Alzheimer's disease by the year 2050. This is a disease that robs you of who you are, your complete identity. So we're going to get really into this straight away because I brought Henry with me.

• 3:26Steven Bartlett?

  And for anyone that can't see, Henry is a model brain that she's holding in her hands.

• 3:30Speaker 01

  This is around two pounds. And if you actually feel it, and you know, if you actually feel a real human brain, it feels like tofu. But this is everything you are. And the fact that so many people are at the mercy of a disease that is preventable is not okay with me. It doesn't sit well with me. We used to think that women were disproportionately affected by Alzheimer's disease because we lived longer, because age played a role in it. But we now have substantial evidence to show that it's not the fact that women live longer or people in general, because dementia and Alzheimer's disease are not part of the natural brain aging process. For women, and they differ from men, and we can separate the sexes and talk about it.

• 4:14Speaker 01

  For women, it is purely because being a woman is a risk factor for getting this disease. Now, if we go through and we have a look at all of the people that currently have Alzheimer's disease, 95% of them could have been prevented because this is not a disease of genetics, it's a disease of lifestyle.

• 4:34Steven Bartlett?

  95% of it could have been prevented?

• 4:36Speaker 01

  Correct. We're, we're born with our, with our genetic makeup, meaning that, for example, if you have a genetic mutation on chromosome four, you will get Huntington's disease. There is nothing we can do about that. That's how you were born. But when it comes to Alzheimer's disease, there's around 20 to 30 genes involved in the disease. Only around three percent of the disease cases right now were driven through those genetic mutations. The genetic mutations that you are born with, you get them from mum and dad, are pre-sinellen one, pre-sinellen two, and the amyloid precursor protein.

• 5:17Speaker 01

  So if you have a genetic mutation in one of these genes, you will get some form of dementia.

• 5:23Steven Bartlett?

  What is the age range where people will start to experience Alzheimer's?

• 5:28Speaker 01

  Let's just actually take a broad overview of what Alzheimer's disease is, okay? So you've probably heard of dementia.

• 5:34Steven Bartlett?

  Yeah.

• 5:35Speaker 01

  So dementia is the umbrella term. So Alzheimer's disease sits under the umbrella. It's a form of dementia. There's frontotemporal dementia, which is what Bruce Willis has. There's dementia with Lewy bodies. There's Parkinson's dementia. There's vascular dementia. This disease, dementia, or Alzheimer's disease, is a disease of midlife. And so it generally starts in our thirties. It starts in our thirties, but the first symptoms show up in our late sixties, seventies, and beyond.

• 6:07Steven Bartlett?

  When you say it starts?

• 6:08Speaker 01

  Yes. Our brain fully develops at around 25 years old, 25 to 30. And after that, that's when we, if we don't take care of our brain, we start getting a decline in these functions. Now, let's go back to the brain. The brain is 87 billion neurons, around 5,000 to 10,000 connections per neuron. My favorite area of the brain is the cerebellum, and the Pkinje cells inside the cerebellum have upwards of 50,000 connections per cell. So, so tightly dense, and there is so much happening, it takes 20% of the total calories that you consume every day to power this thing. And it's the most vascular rich organ in the entire body.

• 6:51Speaker 01

  Over time, through things such as sleep deprivation, poor diet, lack of physical activity, environmental toxins. This slowly erodes at the functioning of the brain. And over time, this starts to compound because that's what biology is. Everything is compounding. One night of sleep deprivation raises your risk of amyloid beta, which is one of the hallmarks of Alzheimer's disease pathology, by four percent. That's just one night of sleep deprivation. Imagine a new mother or a shift worker or a physician in their residency getting countless nights of sleep deprivation, day in and day out. Imagine all of that compounding. And what happens?

• 7:33Speaker 01

  Well, we end up with either neuronal loss, which is like the complete atrophy of certain parts of the brain. And that's what is mild cognitive impairment. Mild cognitive impairment is a pre dementia state.

• 7:46Steven Bartlett?

  So what is this that I have here, this photo?

• 7:49Speaker 01

  So.

• 7:49Steven Bartlett?

  Of a brain.

• 7:50Speaker 01

  You've got the sagittal view right now of the brain and we're looking at a healthy brain on here. As you can see, I'm going to show it up here. On the left hand side, you can see that the brain is thick. We can see that the integrity of the grey matter, which sits out here, is thick, it's voluminous. Okay, we can see that the ventricles are smaller. We go over here and we see thinning of the cortex. You can see these big spaces between the gyrus. These are thick because the grey matter has atrophied. It's shrunk. You can see that the space between the cortex itself and the skull, there's a bigger space. You can see these ventricles here, these butterfly shaped ventricles. This is thicker. This is thinner.

• 8:33Speaker 01

  We can see atrophy down here. So essentially, the brain is getting smaller and smaller.

• 8:41Steven Bartlett?

  At the age of thirty, if I do everything right, and we were to sort of plot this on a graph of where I land at seventy, what is the variance of where I'll end up at seventy? You know, my brain is quite important to me. And I do worry, I think, fuck, like.

• 8:57Steven Bartlett?

  I think I worry in part because I sit and interview a lot of people at a lot of different ages. And one thing you notice as an interviewer is some people at sixty are razor sharp.

• 9:09Speaker 01

  Mm hmm.

• 9:09Steven Bartlett?

  And some people at sixty are not as razor sharp.

• 9:12Speaker 01

  Yeah.

• 9:13Steven Bartlett?

  Their ability to articulate their words, their memory recall, their ability to understand stats and stories, all of this. And I sit here and go, I wonder what the difference is.

• 9:20Speaker 01

  Yeah. And that's actually beautiful because it brings up this important concept in neuroscience called cognitive reserve. And that's your brain's ability to withhold capacity to overcome stresses. Okay. So you've probably heard, for example, let's use the analogy of physical performance.

• 9:38Steven Bartlett?

  Hmm.

• 9:39Speaker 01

  Your VO2 max, which is a measure of your peak respiratory fitness, you know, how well you can utilise oxygen.

• 9:46Steven Bartlett?

  Hmm.

• 9:46Speaker 01

  When you are at a, at a high intensity state. How well does your body utilise oxygen? The, the fitter you are, the more reserve you have to overcome stress. Stress such as an infection, everyday stresses, sleep deprivation, surgery. The more reserve you have in your bank to overcome that. The same is with your brain. The more cognitive reserve that you have, the more cognitive capacity that you have been training year on and year out, will save you at sixty from harmful insults, such as, you can get a woman at the age of eighty with a head full of amyloid beta.

• 10:31Steven Bartlett?

  Amyloid beta being?

• 10:32Speaker 01

  The, one of the hallmarks of Alzheimer's disease. You can get somebody with a head full of amyloid.

• 10:37Steven Bartlett?

  Which is like a plaque on the brain.

• 10:39Speaker 01

  Yeah, it, it's a protein that's actually, it's a, it's a protein that lives inside the neuron itself. And we can explain what that is, which I will in a second. But let me just tell you, you can have a head full of amyloid in this person and they have retained their cognitive functions. Then you can have somebody else with hardly any amyloid, but they've lost their cognitive functions. And this all comes down to cognitive reserve.

• 11:05Steven Bartlett?

  And cognitive reserve lives where in the head?

• 11:07Speaker 01

  You've got around five to 10,000 connections per cell. Over time, those connections fail. Now, those connections are responsible for your thinking, your processing speed. Every time you have a thought, you build a new connection. The more connections that you have, the more things that you see, the more novelty that you give your brain, the richer it gets, the more stable it gets. So the ends of these, of the neurons, we have dendrites. And coming off the dendrites are these little trees. Imagine a branch, that's the dendrite. And all of the leaves that come off of all these little dendritic trees, if you will. And they connect to nearby cells, 10,000 cells. Over time, those are the connections that fall. Those are the connections that fail.

• 11:52Speaker 01

  They fail because you don't utilise them.

• 11:55Steven Bartlett?

  So the way that one would build reserve at the age of 30 is to?

• 12:00Speaker 01

  Is by exercising. We can build reserve in a number of different ways. In fact, there was a really wonderful study that just came out that I just read about. And they found that those who preserved cognitive capacity at 75 years old were handwriting and reading. So handwriting and reading preserves cognitive functions. Exercise is one of the most potent stimulus for brain health and Alzheimer's disease prevention and cognitive reserve. The more you exercise, the bigger your brain.

• 12:35Steven Bartlett?

  What about scrolling on social media? Does it improve my reserve if I'm watching videos?

• 12:40Speaker 01

  It's in the opposite.

• 12:41Steven Bartlett?

  Why would that be? Because I'm still learning stuff.

• 12:43Speaker 01

  Yeah.

• 12:44Steven Bartlett?

  When I'm on the internet.

• 12:44Speaker 01

  Because what you're doing then is you are relying on short dopamine hits. Every time you scroll, you're sending signals to your brain that you're getting a dopamine hit. And your brain gets used to it. Remember, your brain is only there for two things, survival and reproduction. So every time that you stress your brain, in the smallest amount of times you're giving it dopamine hits, it doesn't allow us to do other things for a sustained period of time, like focus, read, have a conversation.

• 13:17Steven Bartlett?

  So writing and reading are good for building up my neurological reserves.

• 13:22Speaker 01

  Yeah, neurological reserves. It doesn't compare to what exercise can do for the brain. And it's so sad because around eighty percent of the US population don't exercise for at least thirty, thirty minutes a week, which is actually quite scary. The physical activity guidelines are a hundred and fifty minutes to three hundred minutes of moderate to rigorous physical activity per week.

• 13:47Steven Bartlett?

  What's the most compelling study you've ever encountered that proves that exercise is central to Alzheimer's prevention and brain health?

• 13:54Speaker 01

  When we look at all of the data, we can see that the biggest amount of return on investment is from resistance training.

• 14:03Steven Bartlett?

  Resistance training being?

• 14:04Speaker 01

  Strength training. One of the most compelling studies was probably the, um, the SMART trial where they, uh, took a group of people with mild cognitive impairment and gave them two to three times per week of resistance training. And they not only preserved their cognitive functions, they enhanced their processing speed, they enhanced their fluid intelligence, and they had slowing of the grey matter.

• 14:28Steven Bartlett?

  The grey matter?

• 14:28Speaker 01

  Yeah, so your brain consists of both grey and white matter. So grey matter are the cell bodies that lives on the outer side, outer portions of your brain. And the white matter is deep within the brain, and that's where all of our myelinated neurons live. And over time, we see that we can have little lesions in the white matter of the brain. So a lot of the times people ask me, Stephen, I'm scared. My mother had Alzheimer's disease, I'm scared I'm going to get it. And we were talking about genetics before. And there's another genetic risk factor that we didn't talk about. The ApoE4 gene, uh, is one of the, the strongest risk factors of getting Alzheimer's disease, but it is not a foregone conclusion that you're going to get it.

• 15:13Speaker 01

  So Chris Hemsworth was tested and he has two copies of this gene. So you get two copies, one from Mum, one from Dad. It's the Apolipoprotein E gene. And it comes in three main variants. So you've got ApoE2, ApoE3, and ApoE4.

• 15:33Speaker 01

  So I'm a three, three carrier. I've been tested. And that's the general population, they're three, three. So it doesn't raise my risk of getting the disease, but it also doesn't protect me. If you've got a copy of the APO E two gene, it protects you against the disease. But when you have a copy of the APO E four gene, it raises your risk by two to three times. If you have two copies of the gene, it raises your risk by 10 times if you are a male. Here's the devastating thing. If you are a female with one copy of the gene, you are at doubled the risk than your male counterpart. So one copy of the gene of APO

• 16:15Speaker 01

  E four gene for a female raises your risk by about sixfold, whereas two copies raises your risk by 15fold.

• 16:24Steven Bartlett?

  And how would one go and get checked?

• 16:26Speaker 01

  You can get the APO E four gene checked out with your doctor. It's a simple blood test.

• 16:31Steven Bartlett?

  On this point of resistance training, I've heard you talk about how the legs are so important, having strong legs.

• 16:40Speaker 01

  Having strong legs is by far the most important tool in your toolbox for the prevention of Alzheimer's disease. And this was made certain to me when I read a study done on identical twins, exact same genetic profile. And they tracked them and they did cognitive tests and MRIs and they tracked them over a 10 year period. And what they found was that the twin who possessed the greatest strength and the most leg power had a bigger brain, larger grey matter volume. They preserved their cognitive functions. They did better on different cognitive tests.

• 17:23Steven Bartlett?

  Why is resistance training increasing the size of my brain?

• 17:27Speaker 01

  Resistance training does so much for your brain. The first thing is, we have to think about the journey that we're going on, right? So when you look at all of the studies, I want to make it really clear, all of the studies show that in order to produce the neural effects of resistance training, you need to be lifting at around 80% of your one repetition max.

• 17:49Speaker 01

  So eighty percent of one RM, so that's quite heavy. There is so much controversy on social media right now. Should I lift heavy? Should I lift light? And when it comes to hypertrophy alone, so increase in muscles, muscle mass, muscle cell size, you can get there. Men can get there, women can get there by lifting light, high reps. Or you can get there by lifting heavy and low reps. It just depends on who you are and how much time you have. But when it comes to the brain specifically, you want to be lifting heavy for several reasons. The first one is when we lift heavy, when we literally, like when we contract our muscle like this, we are releasing a whole set of chemicals, they're called myokines.

• 18:35Speaker 01

  And when they're released from the muscle, they go up to the brain and they do beneficial things for our cognitive performance, our cognition, and they help with the growth and proliferation of new neurons in the hippocampus. And it's the first thing to go during Alzheimer's disease. It actually shrinks. This holds our memory. This is where a lot of our memory consolidation and learning takes place, which is why short term memory is the first thing to go during this disease. Okay, and as we get older. And what we've found is that you can grow new neurons in the hippocampus from structured exercise and consistent exercise.

• 19:15Speaker 01

  The biggest growth is going to occur because of B D N F, brain derived neurotropic factor. So this is a growth factor for the brain and it gets released when we exercise. It gets released abundantly when we are doing aerobic training, when we're running, when we're cycling for long distances. But it also gets released when we do resistance training. Now, here's the beautiful thing about it. When we do resistance training. And we're releasing all of these myokines. These myokines are signalling molecules, they work together. So we've got one called irisin, okay? And that's a messenger molecule. So what it does is it actually helps B D N F express itself.

• 19:57Speaker 01

  So when we release this myokine, it goes into the brain, crosses the blood brain barrier, and it tells B D N F to express itself. So then B D N F goes in and it helps grow new neurons in the hippocampus. But then we've got another myokine, let's just take isle six, interleukin six, it comes from the interleukin family.

• 20:17Steven Bartlett?

  What is that, sorry?

• 20:18Speaker 01

  The interleukin family is a, a class of pro-inflammatory cytokines. So these get released when we are under stress or you've got an infection or a virus, for example. But when we exercise, it depends on where the site is, interleukin six, instead of acting as a pro-inflammatory cytokine, instead of creating inflammation, it acts as an anti-inflammatory cytokine. So it goes into the brain and it lowers inflammation. In fact, this is one of, this was one of the first ever myokines to be studied. And they showed that interleukin six is also responsible for the down regulation of tumor cell growth.

• 21:00Speaker 01

  So exercise is a potent anti-cancer intervention as well, by way of myokines.

• 21:08Steven Bartlett?

  How much exercise does one need to do to avoid the cancer-related side effects, but also the Alzheimer's problem?

• 21:17Speaker 01

  Well, just thirty minutes a day of aerobic physical activity can down-regulate thirteen types of cancers. And the most prominent ones being breast cancer, colon cancer, and prostate cancer. So these three have been studied most and you get your anti-cancer effects from the myokine release. So quite specifically, when we exercise, we're getting a robust release of something called natural killer cells.

• 21:49Speaker 01

  And when we get these natural killer cells into the plasma and into the bloodstream, they go into the tumour site and they do what they were born to do. They kill. So they go into the tumour site and they start to kill the tumour. And this is where you get your anti-cancer effects of it. But you can also get it from the anti-inflammatory effects of resistance training, anti-inflammatory effects of aerobic training. So these myokines are really powerful. In fact, pharmaceuticals are spending billions of dollars trying to replicate these myokines in a bottle and they can't do it. I want both men and women lifting heavy because you've got areas in your brain,

• 22:31Speaker 01

  right across here, lives your motor cortex. Think of your brain as real estate. There's real estate in your brain reserved for lifting heavy. So every time you lift a heavy weight as opposed to a lightweight, it takes more neural real estate to lift that heavy weight. So the heavier you lift, the greater the neural drive. The greater the neural drive, the better it is for your brain.

• 22:58Steven Bartlett?

  If you had to do just one exercise for the rest of your life to protect your brain and you could only pick one, what would it be?

• 23:05Speaker 01

  Deadlift.

• 23:07Steven Bartlett?

  Why?

• 23:08Speaker 01

  If done correctly, the deadlift can use almost every muscle in your body, erector spinae, you've got the glutes, you've got the quads, you've even got serratus anterior, you've got your calf muscles. There is so much compounding in that one lift. Would probably be comparable to a barbell squat as well.

• 23:29Steven Bartlett?

  According to the World Health Organisation, we're getting increasingly more sedentary. I mean, we're moving less and less in part because of technology, but also there was this really interesting study done by the Cleveland Clinic, where they talk about people who are active sedentary. And this.

• 23:46Steven Bartlett?

  This felt a little bit personal, if I'm honest. It says, a major finding in 2025 found a danger of being active sedentary, which is people who exercise for like thirty to sixty minutes, but sit for the remaining ten hours a day. If you sit for more than ten hours a day, your risk of cardiovascular disease increases, even if you meet weekly exercise goals. Because prolonged sitting shuts down lipoprotein lipase, an enzyme essential for burning fat and cleaning glucose from the blood. That was, that's annoying to read because I feel like that's me.

• 24:18Speaker 01

  Yeah, and being sedentary is a disease. You can change the trajectory of your life by doing ten air squats every hour on the hour. And there was a study that was done on this that showed that if you do ten air squats every hour, this can compensate for your sedentary lifestyle. Because unfortunately, this is the life we're living in. We are becoming more sedentary in our day to day lives. We're sitting more, we're not going out as much. There is younger kids on video games, they're scrolling. There's so much happening that is involving our sedentary lifestyle, which is obviously, like you said, increasing our risk of type two diabetes, cardiovascular disease, et cetera. Yep, you can do it.

• 25:02Steven Bartlett?

  Like this?

• 25:04Speaker 01

  There you go, ten of those. If you do ten of those, you can outweigh the benefits of a thirty minute power walk.

• 25:12Steven Bartlett?

  Every hour?

• 25:13Speaker 01

  Yeah.

• 25:13Steven Bartlett?

  For how many hours?

• 25:14Speaker 01

  Eight.

• 25:15Steven Bartlett?

  Okay, so I could set an alarm on my phone?

• 25:17Speaker 01

  Every hour, just get up or every forty five minutes, get up and do an air squat. And this is primarily because, have you heard that when you eat, you get a massive spike of glucose? And the best way to bring that glucose spike back down is by doing any form of exercise. You can albeit go out, go for a fast run, do an air squat, bring that, bring that glucose level back to baseline.

• 25:42Steven Bartlett?

  And do you think much about aerobic training as a preventative measure for Alzheimer's?

• 25:48Speaker 01

  I love aerobic training. Women are facing a dilemma on social media because they're being given so much information. There is this huge uproar of should I do zone two exercise or should I not do zone two exercise?

• 26:05Steven Bartlett?

  What is zone two exercise?

• 26:06Speaker 01

  So we can think of physiology in zones. Zone one is what you and I are in right now.

• 26:12Steven Bartlett?

  Hmm.

• 26:13Speaker 01

  Right? Zone two is that next level up. And that's generally when we're looking at exercising at around sixty percent of our maximum heart rate. It's where you can, where you're jogging, but you can have a conversation, but where you're huffing and puffing. When we're exercising, we need to produce energy. And that energy firstly starts in the mitochondria. So we need, all of our energy gets created, we create ATP, and that's how we are able to perform the given task. As soon as we get out of that zone and we go into zone three, zone four and zone five, we're producing energy outside of the mitochondria, in the cytoplasm.

• 26:54Speaker 01

  And when we're doing that, in order to do that, we're breaking down glucose so fast via a pathway called glycolysis. The byproduct of that is lactate. And then we produce lactate. And that's actually a fuel source for the brain. It's also a myokine, right? So that's when we're in zone three, zone four, zone five. So a lot of women have been doing zone two, they've been going to the gym, they've been doing zone two. And I'm trying to push women to get out of zone two for several reasons. Not because it's not good for you. I think all forms of exercise are good for you.

• 27:37Speaker 01

  The more you move, the better, right? But let's be really honest. A lot of people in midlife are busy. They're time poor. Men actually get a greater return on investment by doing zone two. Women don't get the same return on investment from doing zone two. So I'm trying to push women to first work on zone five, zone three, zone four, zone five, if they can, just do zone five. Then do two to three sessions of resistance training a week. And if you have time left over, that's right there. I've just described around four hours of exercise. If you have time left over, then you can work in zone two. Now, zone two is great. If you're going to go out and go for a long run, you're doing many things.

• 28:22Speaker 01

  You are secreting a lot of B D N F, which we need. It's a growth factor for the brain. You're getting a massive amount of blood that's going into the brain, which is great as well. It's sustained. Blood delivers oxygen and nutrients to the brain. You're doing a lot of things, right? But what you're not doing is having a complete effect on the chambers of your heart.

• 28:47Steven Bartlett?

  Is it better for me to do five kilometres on a treadmill or outside?

• 28:52Speaker 01

  I would say it's better for you, for the brain, to do a smaller amount of exercise and a higher threshold.

• 28:59Steven Bartlett?

  Because I was, I think I read somewhere one time that running outside is better for the brain because it stimulates the brain.

• 29:06Speaker 01

  Well, you're outside, so you've got so many things around you. Imagine your brain, I told you, it's got prime real estate. Every part of the brain is responsible for a different function, from what you see to what you hear. You go outside and you can see so many things. You've got forward embulation, so that's going to help you with drive, motivation, dopamine. But then you're also taking in the sounds, the senses. It down-regulates inflammation. So you get so many other things from doing that, yes. But five kilometres outside compared to 20 minutes of high aerobic physical activity? What is better for the brain? I would say that the zone five is better for the brain. The zone five training does a lot for the chambers of your heart as well. Now, I'm going to grab this.

• 29:51Speaker 01

  We've got a little model here. And we can see that. We have a left chamber, we have a right chamber. We have actually four chambers of the heart, but we have something in the heart called a ventricle. We've got a left ventricle and we've got a right ventricle. Now, the left ventricle delivers oxygenated blood to the entire body. It's really interesting because the chamber of the left ventricle is like a, is like a muscle. Right, it's responsible for pumping blood to your entire body. It first gives blood to the brain, which means it's the most important part of your body. After it's done giving blood to the brain, it goes through to the rest of the body.

• 30:31Speaker 01

  As we get older, we get stiffening of these arteries, okay? Stiffening of all of the arteries in the heart. And we get, we get something called left ventricular hypertrophy. So that's when the ventricle, the left ventricle, it starts to get thicker. And when it gets thicker, that means that we can't, it's not as strong. It can't pump a lot of blood, as much as it could when it was younger, to the rest of the body. Ben Levine, Dr Ben Levine, he's a sports cardiologist. And he did this landmark study which changed how I thought about zone five training. He took a group of sedentary males, average age, I think it was around forty seven to fifty five.

• 31:14Speaker 01

  So around fifty years old. And he scanned their hearts. He did, you know, he looked at, he did echocardiograms, he took photos of the heart. He did everything he could to see when I was first starting the protocol, what does their heart look like? He then subjected them to around four hours of exercise per week. And that was stratified against, he did one resistance training session a week. One was high intensity physical activity at around ninety percent of the maximum heart rate, the VO two max heart rate. And then in between, he did some long sessions as well, right? But it was all moderate to rigorous exercise. And that was done over two years.

• 31:55Speaker 01

  At the end of those two years, what he found was that he remodeled the heart. By twenty years. So he reversed the age-related effects and defects of the heart by twenty years, essentially turning the fifty-year-old hearts into thirty-year-old hearts, just from physical activity alone.

• 32:15Steven Bartlett?

  Four hours a week for two years.

• 32:17Speaker 01

  Four hours a week for two years.

• 32:19Steven Bartlett?

  And what kind of exercise was it?

• 32:21Speaker 01

  So he got them to do, like, let's say, for example, one of the, um, one of the protocols was exercising at ninety percent of your maximum heart rate. So when we do this, we're generally looking at increasing our VO2 max. So you've probably heard that VO2 max, along with strength, but VO2 max is the strongest predictor of all-cause mortality. Right? So if you want to improve your VO2 max, and if you want to get the heart-related changes that he did, what you want to do is you want to do twenty minutes of VO2 max per week, just to keep your VO2 max, because it does decline year on and year out, starting at the age of around thirty-five. We start to see a decline in VO2 max. So if we want

• 33:06Speaker 01

  to work on our VO2 max, we want to be doing a, what we call the Norwegian four-by-four. It's the gold standard of increasing your VO2 max. So you want to get your heart rate elevated to ninety to ninety-five percent for four minutes on, four minutes off, repeat four times. So, how do I do this? Well, I actually do this twice a week, because the more you do, the better. I do this on a stepper, I do this at the gym, and I put my stepper on to, I think I'm at like a level fourteen, and I'm working my way up and I'm staying on there for four minutes, and then I'm having a complete stop and a complete rest for

• 33:50Speaker 01

  four minutes. And I'm repeating that four times.

• 33:54Speaker 01

  So what I'm doing in that moment, I'm not just getting a massive shunting of blood to the brain, okay, which is good. I'm not just getting a massive release of myokines and exokines to the brain. I'm also remodeling the heart. I'm down regulating tumor cell growth. I'm improving my cognitive performance. I'm doing so much more than just exercising alone.

• 34:21Steven Bartlett?

  So that's once a week in Levine's study that reversed these guys' hearts by 20 years.

• 34:28Speaker 01

  Yep.

• 34:29Steven Bartlett?

  That you do that once a week.

• 34:31Speaker 01

  You only have to do that once a week, but he also did, he did around 70% of maximum heart rate for around two hours a week, and he also threw in one resistance training session. So consistency is key.

• 34:44Steven Bartlett?

  I'm just looking at some of the findings of that study, and one of the surprising things is it showed that there is a biological exploration day per se for the reversal of the heart.

• 34:56Speaker 01

  Yep.

• 34:57Steven Bartlett?

  And then the heart retains its plasticity, the ability to remodel itself until the age of 65. If this intervention had started after the age of 65, the heart was too stiff to be physically remodeled to get to that 20-year reversal.

• 35:09Speaker 01

  Yep.

• 35:09Steven Bartlett?

  You have to start in late middle age.

• 35:12Speaker 01

  Exactly. So midlife is the window of opportunity for brain health and for longevity.

• 35:19Steven Bartlett?

  I didn't realise you could sort of remodel the heart yourself. That's interesting.

• 35:23Speaker 01

  Yeah, you can remodel the heart, and the heart is amazing, okay, because what you see with the aorta, right? So the aorta goes up, and we've got, we've got two, we've got the main blood supply for the brain exists in the vertebral arteries, okay? So there's branching off of the aorta, comes from the heart, vertebral arteries which supply the posterior part of the brain and the cerebellum with blood. And then you've got the carotid arteries, so one on each side, branching off the aorta, which supply the frontal and middle part of your brain with blood. The brain is the most vascular-rich organ in the entire body. In times of stress such as hypertension, okay, that is elevated blood pressure.

• 36:06Speaker 01

  We see that we can actually kill off the tiniest parts of the blood vessels, which are called the capillaries. You can see the capillaries up here. They supply even the blood brain barrier. So they supply mainly the outer cortex of the brain with blood. When we have elevated blood pressure, we are starting to kill off those tiny little capillaries of the brain. Those capillaries are feeding different neurons in the brain and also feeding the blood brain barrier. So when we get breaking off of these, we lose the blood supply, we lose the oxygenation, we get a breakdown of the blood brain barrier itself, which is scary. And we see that in patients who have got mild cognitive impairment.

• 36:51Speaker 01

  You can call it, you've heard of leaky gut, we can call it leaky brain. If you have a leaky brain, what happens eventually is, so your blood brain barrier sits like this, okay? And there are cells, and we call them parasites, for example, and they're bound together by tight junctions. That's what the blood brain barrier is. It's like a, you think of the blood brain barrier as the bouncer of a nightclub. They are all standing there like this, responsible for who can come in and who can't. And they don't allow some molecules to get in. But over time, when this starts to degrade and become leaky, they start to spread apart. And when they do, you can have the passive diffusion of all these molecules coming in,

• 37:35Speaker 01

  and that's really bad for your brain. So we want to maintain the integrity of the blood brain barrier by maintaining the capillary health. We don't want the capillaries to die. They're one cell thick. Any type of damage can damage them and kill them. Hypertension, there was a really great study, it was called, it was actually the sprint child. And it was, it's now the gold standard for the recommendation of one twenty over eighty. So when you have your blood pressure taken, we get the systolic over diastolic. And you've probably, I don't know if you take your blood pressure, but doing your blood pressure every day is a really great, inexpensive and effective tool for maintaining good

• 38:16Speaker 01

  brain health. So you measure your blood pressure and if you are hypertensive, this is anywhere over a hundred and thirty five, okay, systolic over a hundred and thirty five. That's when things start to break down. That's when we start to get the breakdown of those small, one cell thick capillaries. So in this trial, in the spring trial, what they found was that when they aggressively manage these patients and they bring their blood pressure down, they did it pharmacologically through something called an ACE inhibitor. It's a medication to drive down blood pressure. When they bring it down pharmacologically,

• 38:57Speaker 01

  these patients preserved their brain, grey matter and their cognitive functions. So we now have a gold standard and this is what I would recommend anybody. On Amazon, it costs about twenty five dollars for a blood, an automatic blood pressure monitor. Do it every single morning and watch your blood pressure.

• 39:15Steven Bartlett?

  And then if it's high, what do I do about it?

• 39:18Speaker 01

  Well, outside of pharmacology, if we don't want to take a medication, we want to get stronger and we want to do this via exercise. Stress is one of the biggest things driving high blood pressure. Manage stress, manage cortisol, manage chronic inflammation by way of exercise, sleep, all of the things that mother nature gave us.

• 39:39Steven Bartlett?

  I was just looking at the, um, the study that reversed, uh, the heart by twenty years and trying to figure out what exercises they did. And as you said, the first one was the high intensity workout, the four by four.

• 39:49Speaker 01

  Yep.

• 39:49Steven Bartlett?

  Um, then they did a long aerobic exercise. Again, this is all once a week. So sixty minutes, once a week, doing a longer exercise, like it could be hiking or tennis or cycling. A moderate intensity workout, thirty minutes where they did the talk test. You should be able to break a sweat but still be able to speak. So that was once a week. And then lastly, strength training once a week. So it's really a variety of exercises that caused such a profound impact on the heart.

• 40:16Steven Bartlett?

  And I think cardiovascular diseases are the single biggest killer.

• 40:19Speaker 01

  Yeah, cardiovascular disease. Dementia is the number one killer of women in the UK, the number one.

• 40:28Steven Bartlett?

  Really?

• 40:28Speaker 01

  It's the number one cause of death in Australia for both men and women.

• 40:33Steven Bartlett?

  How does it kill you? Because we all think about memory loss and stuff like that, but.

• 40:37Speaker 01

  And so this is the actual devastating part. We don't die of Alzheimer's disease specifically. Over time, what happens is in these patients, you have to remember Alzheimer's disease is like end stage cancer. Once you get the diagnosis, there is no cure, there is no going back, there is no reversal. You have the disease and that's the scariest part. Mild cognitive impairment, you can slow the progression of that. Like I said to you, it goes for 20 years, mild cognitive impairment. You can slow the progression of mild cognitive impairment, but as soon as you get diagnosed on that awful day that your mother or your friend gets diagnosed with Alzheimer's disease, it's a sad day.

• 41:20Speaker 01

  And what ends up happening with these patients is you can die of asphyxiation. You can die of, you, your brain loses the signal to swallow. It loses the signal to, maybe you fall because you've lost balance. It's really, it's a really scary moment, but it's not like you die of Alzheimer's disease specifically.

• 41:45Steven Bartlett?

  If you were diagnosed with Alzheimer's disease.

• 41:51Steven Bartlett?

  It's an interesting reaction.

• 41:54Speaker 01

  Because I would have no hope. I think a better question is.

• 41:59Steven Bartlett?

  You'd have no hope?

• 42:00Speaker 01

  If I was diagnosed with Alzheimer's disease, there is nothing I could do.

• 42:06Steven Bartlett?

  How would that change?

• 42:09Steven Bartlett?

  Your life and the decisions you make, or would it at all?

• 42:13Speaker 01

  I would aggressively aggressively exercise. I would monitor my diet. I would aggressively monitor my diet and I would potentially have a ketogenic diet. Because what we've found is that during this metabolic crisis that happens in your brain. Okay, where you lose the ability to use glucose as your primary fuel source. So the brain doesn't know how to use glucose as its primary fuel source. So it's under attack.

• 42:42Steven Bartlett?

  During Alzheimer's.

• 42:43Speaker 01

  During Alzheimer's, but also during this window in for women as well in the perimenopause state. So the brain cell, when it's under attack and it can't utilise glucose effectively. And it doesn't have any energy, it starts to think about survival. It starts to think, what can I do? I'm under attack. So it starts to break down the myelin sheath. And in that moment, it's actually the astrocytes, they're the supporters of the brain. So of the brain cells. So they start to think, okay, let's break down the myelin sheath. From that, the astrocytes produce ketone bodies. And then the ketone bodies get shuttled into the brain and that's how we use energy in the brain.

• 43:24Speaker 01

  So in that state of metabolic crisis, I would make sure that I am having a ketone rich diet. Or I may be getting exogenous ketones. I would aggressively exercise. I would aggressively manage my my lipids. I'd have a high intake of omega three fatty acids. And I would preserve, if I could, any form of cognitive function by way of talking to people. By going outside, socialising, having hard conversations. If I was intact and I could do so, I would throw tennis balls to the wall.

• 44:01Steven Bartlett?

  So on that point of the ketogenic diet,

• 44:05Steven Bartlett?

  the reason is because ketones are an alternative fuel source to glucose.

• 44:09Speaker 01

  Yep.

• 44:09Steven Bartlett?

  And the brain likes ketones.

• 44:13Speaker 01

  The brain loves ketones and it actually utilizes them more effectively than glucose. But glucose is the primary fuel source for the brain. And here's what's really interesting and devastating, if you will, for females. During the onset of perimenopause, right? When we see a decline in estrogen, right? We see a decline in estrogen. What happens is a 30% reduction in brain glucose metabolism. So when these receptors start to die, because we don't have, we don't have a lot of estrogen circulating in the bloodstream anymore. What happens? Well, we can't utilize glucose as effectively. So during that state, that's when we start to get the breakdown of the myelin sheath

• 44:59Speaker 01

  to use that as ketone bodies as an alternative brain fuel source.

• 45:05Steven Bartlett?

  So do you think women going through menopause should be considering a ketogenic diet?

• 45:10Speaker 01

  Yes, I do think that. I think that women who are going through perimenopause and who are at the mercy of this brain energetic crisis should be adopting, if they can, a ketogenic diet. It's one of the best diets for the brain.

• 45:26Steven Bartlett?

  I didn't really understand this idea that during menopause, there was a glucose deficiency or metabolism problem in the brain.

• 45:35Speaker 01

  30% reduction in brain glucose metabolism.

• 45:38Steven Bartlett?

  Is this why women report having brain fog and all these kinds of things?

• 45:42Speaker 01

  Yeah, absolutely. Because when the brain can't utilize its fuel source effectively, what happens? Well, metabolites start to shift. We don't sleep properly. Around 60 to 65% of women in menopause report having a hot flash or night sweats. It wakes them up at night. That's also causing cognitive decline and brain fog.

• 46:07Steven Bartlett?

  So, I mean, this graph's pretty shocking.

• 46:09Speaker 01

  Hmm.

• 46:10Steven Bartlett?

  Can you explain what it shows?

• 46:12Speaker 01

  Oh, this is showing the estrogen levels at birth, going through all of the life cycles that a woman will go through, puberty, perimenopause, and then eventually menopause. There is one thing that is certain. After age, I mentioned earlier, being a woman is the next strongest risk factor for getting this disease.

• 46:34Steven Bartlett?

  Forgetting Alzheimer's.

• 46:35Speaker 01

  Forgetting Alzheimer's. And that largely lies in our per- in our menopausal shift that occurs. The downsizing of estrogen. However, we do have forms of estrogen that we can, you know, supplement with.

• 46:51Steven Bartlett?

  So I just need to keep the estrogen up.

• 46:53Speaker 01

  Yep.

• 46:53Steven Bartlett?

  Because then the brain health is going to be up and normal.

• 46:56Speaker 01

  This is where the controversy lies, yes and no. So I want everyone to understand, I am sitting right now. So my entire doctoral thesis is focused on women and Alzheimer's disease. And I'm Switzerland right now when it comes to hormone replacement therapy. That is replacing your hormones.

• 47:14Steven Bartlett?

  You're Switzerland.

• 47:15Speaker 01

  I'm Switzerland, meaning that there is no evidence to suggest. Right now, we don't have large scale randomized control trials to show that hormone replacement therapy prevents dementia. So what I will tell you is this, it is a signal, it is a supporter. It will help you do the things that can lower your risk of dementia. We've seen multiple times that having hormone replacement therapy can reduce your risk of getting Alzheimer's disease by up to thirty percent. We know that, but it's not because estrogen alone is minimizing your risk. It's because when you have estrogen, it helps get rid of the hot flashes.

• 48:00Speaker 01

  It helps with the night sweats because during menopause, when we actually have a dysregulation of the, of estrogen in our brain, what happens in the hypothalamus, which is an area in the brain that controls our temperature regulation. When we lose the ability to monitor our temperature for a woman, what will happen is when she feels the slightest bit hot, her temperature, you know, is rising a little bit. The hypothalamus doesn't know what to do, so it signals, I'm super hot. So it'll raise your temperature right up and that's a hot flash and then it'll bring it right down. And as a result, this is keeping women up at night. And we know that sleep deprivation is a risk factor for Alzheimer's disease, of course it is.

• 48:44Speaker 01

  Compounding sleep deprivation will accumulate amyloid beta in your brain. So if we can replace, if we can use hormone replacement therapy as a signal and as a support to help us sleep at night, then that's a good thing. Another thing, estrogen is anabolic to muscle.

• 49:06Steven Bartlett?

  What does that mean?

• 49:07Speaker 01

  It means that it helps with muscle protein synthesis.

• 49:10Steven Bartlett?

  Oh, it helps you make muscles?

• 49:11Speaker 01

  Yeah, we've got estrogen receptors on our bone, we've got estrogen receptors on our muscle. So if estrogen is anabolic to muscle, if estrogen helps with muscle protein synthesis, if estrogen helps with bone mineral density, then replacing estrogen during that menopause state is going to help us with all of the risk factors of Alzheimer's disease.

• 49:36Steven Bartlett?

  So when does estrogen, I mean, it really, in this image, drops off a cliff?

• 49:40Speaker 01

  Yeah, and it varies. So it tends to generally happen at around forty five years old as an average, and that, that perimenopause stage lasts around ten years.

• 49:51Steven Bartlett?

  But it starts going down on this graph at about thirty.

• 49:54Speaker 01

  It starts to go down and everyone's different, okay? You can have a woman in her late thirties going to perimenopause, or the general age is around forty two to forty five. Most OBGYNs that I've spoken to say that you need to start checking in with your doctor at around forty years old to check for this.

• 50:13Steven Bartlett?

  So do you think, thinking about my fiance now, do you think that someone like her should go on hormone replacement therapy at like forty?

• 50:21Speaker 01

  Well, so that's the, that's the big question, that's the elephant in the room. Should you go on hormone replacement therapy or should you not? And that's definitely a conversation between you and your physician. However, we've got large scale studies right now to show that we don't have to be afraid of hormone replacement therapy. And without going too deep into the weeds, there was a massive study that was done, the Women's Health Initiative, that scared women out of taking hormone replacement therapy in fear of getting breast cancer. Correct. We went from having forty percent of women on hormone replacement therapy to just four percent of women on hormone replacement therapy.

• 51:00Speaker 01

  We know that even at the onset of menopause, a woman's risk of having a heart-related event triples. A woman's risk of getting Alzheimer's disease increases. So there is something to posit here about the benefits of hormone replacement therapy that we still haven't yet studied.

• 51:25Steven Bartlett?

  Will you do hormone replacement therapy?

• 51:27Speaker 01

  I definitely will.

• 51:28Steven Bartlett?

  And what kind of hormone?

• 51:29Speaker 01

  And look, so this is really interesting. So this was given to me by a friend and this is the capsule. So this is estradiol and progesterone. Okay, so progesterone is that one that's going to help you sleep at night. This one here is vaginal estrogen. So this is a cream that actually gets, you know, depending on how it is, it can get inserted. And the vaginal estrogen, apparently, if you put it on your face, is probably the best form of skincare that you could ever have. Yeah, we have estrogen receptors all over our tissues, including our skin. These are estradiol inserts, so that's not the cream itself. But if you get vaginal estrogen in the form of a cream, you can put it on your face and

• 52:13Speaker 01

  it can help with skin elasticity, collagen, dermal thickness. This is why I'm actually most excited about it.

• 52:21Steven Bartlett?

  So, I mean, are these the only ways that one can do hormone replacement?

• 52:24Speaker 01

  No, there's also a patch and that's what most women are opting in for.

• 52:28Steven Bartlett?

  What will you do?

• 52:29Speaker 01

  The transdermal patch.

• 52:30Steven Bartlett?

  When the time comes?

• 52:31Speaker 01

  I will probably do the patch.

• 52:34Steven Bartlett?

  Why?

• 52:35Speaker 01

  Because it's the easiest, that's the one that I've researched the most. I'm not afraid of hormone replacement therapy in the slightest. You do have to, you know, everyone has to check with their doctor. But I definitely think that this is going to be one thing that is going to help with the Alzheimer's disease crisis that is occurring.

• 52:56Steven Bartlett?

  Go ahead.

• 52:57Speaker 01

  I mentioned earlier plaques, right? So a lot of people ask, well, what distinguishes Alzheimer's disease from the rest of the dementias? And it comes down to two proteins, amyloid beta and tau protein. And here's where it gets really interesting and actually dates back to nineteen oh one, the first ever Alzheimer's disease patient Augusta D T. She was fifty two years old and she went to the hospital, her and her husband went, complaining of difficulties of word finding, word fluency, and she couldn't remember where she put her keys. And her husband said she is delirious.

• 53:39Speaker 01

  And Augusta told the doctor on board, he was a psychiatrist, his name was Alois Alzheimer. She said to him, and I quote, I don't know who I am anymore. As I mentioned, this disease robs you of who you are. In nineteen oh six Augusta D T died. And that was the first ever patient to be recorded of having Alzheimer's disease. And so postmortem, they cut her brain open and they found that she had these plaques in her brain. And they didn't really know, they didn't really understand what it was. But that was the first ever induction of this disease in society.

• 54:23Speaker 01

  And ever since then, ever since then, we are still trying to tackle this disease. In the two thousands, we had this notion that Alzheimer's disease was the amyloid cascade hypothesis, meaning that great, Alzheimer's disease means when you get a head full of amyloid, this toxic protein that builds up. So we were demonizing this protein. We were demonizing this peptide protein that builds up in the head. And so then came the medications, okay, in the form of I V drugs. So you go to the hospital, you get an I V in the promise that it will clear out amyloid. Great, we've got a cure. But what they found was that when they were taking out the amyloid in these brains,

• 55:06Speaker 01

  they were taking with them brain tissue and causing micro hemorrhages. And in some patients, it was resulting in death.

• 55:16Speaker 01

  So we now know that the problem here isn't amyloid. In fact, amyloid is a antimicrobial peptide. So amyloid is actually a good thing. Amyloid beta is a good thing because it protects the brain cells. Now, here's what happens. We have this beautiful process during sleep that occurs. When we get into deep sleep, we activate the glymphatic system. Okay, so the glymphatic system comes from the word glial cells. We have glial cells in the brain. They sit outside of the neurons.

• 55:57Speaker 01

  And this is what is responsible for immunity. They're a chief immune response cell. During deep sleep, they shrink. And when they shrink, all of this amyloid beta that's floating around in the cerebral spinal fluid gets washed out. So it's like a washing machine that occurs in your brain. Right? But what tends to happen in Alzheimer's patients is they don't get a chance to wash out the amyloid. What happens in perimenopause and menopause due to the hot flashes, you don't get to get into deep sleep because you're having a fragmented sleep because you're waking up due to hot flashes and night sweats. So that is what's doing, that is what's causing the buildup of amyloid. Now, stick with me.

• 56:42Speaker 01

  We've got another protein that is a hallmark of Alzheimer's disease. It's tau protein. And tau lives in the axon of the cell. The one that I said is covered in the myelin sheath. And what happens under times of stress? What happens is this tau protein phosphorylates. So it breaks off and basically tau protein stabilizes the microtubules. Okay, imagine these railroad tracks in the axon. Okay, just going up and down the axon.

• 57:17Steven Bartlett?

  The axon's in the, in the cell or in the brain?

• 57:19Speaker 01

  So the, the, the brain cell itself, the neuron, is the neuron cell body. And the axon is like the trunk of the tree.

• 57:27Steven Bartlett?

  Okay.

• 57:28Speaker 01

  Right?

• 57:28Steven Bartlett?

  Yeah.

• 57:29Speaker 01

  So, holding up the tree are microtubules. And those microtubules are bound by tau proteins. The, the tau proteins keep the microtubules intact. So the trunk of the tree is stabilised and it sits there. Why does it need to be stabilised? Because that's how speed of thought travels. Information processing speed travels up there. When the tau protein phosphorylates, it starts to form tangles. They're called neurofibular tangles. So that happens in the axon. And when all these tangles clump together, we get the collapse of this axon. The collapse of these microtubules. So we're not just having a cascade of environmental disaster

• 58:15Speaker 01

  inside the cerebral spinal fluid of the brain and inside the brain outside the cells. We've also got this cascade happening inside the cell body itself. So the brain is under attack inside the cell and outside the cell.

• 58:28Steven Bartlett?

  Why?

• 58:29Speaker 01

  Why exactly? Why? Why does this happen? Because of how we treat our brains.

• 58:35Steven Bartlett?

  Because of how we treat our brains?

• 58:36Speaker 01

  Yes. The reason why your brain is hyperphosphorylated and the reason why these tau proteins are hyperphosphorylated is because of many things. One is, we have seen time and time again that we have estrogen receptors that are on, in the brain cell themselves, in the axon. So when we don't have adequate estrogen, estrogen actually is so smart. What it is doing, it's blocking an enzyme that is responsible for phosphorylating the tau. So if we don't have the estrogen there, then the tau, the enzyme is there to phosphorylate the tau

• 59:20Speaker 01

  and break it down and cause these neurofibular tangles. But let's just say you're a man and you don't have, you don't need the, a testos, you don't need the estrogen there. Although testosterone is neuroprotective. Testosterone actually aromatizes into estrogen, which is why you actually have an extra added protection in your life.

• 59:42Speaker 01

  What else causes this? Well, stress.

• 59:44Steven Bartlett?

  You're talking about sleep, don't you?

• 59:45Speaker 01

  Yeah. So sleep is, I think by far, the most underrated Alzheimer's disease prevention tool that we have. It's underrated because

• 59:56Speaker 01

  We have been doing it all our lives and we think that we can just go to sleep and the magic happens. But I think now in 2026, we actually need to train for sleep. So during deep sleep, we activate the glymphatic system and sadly, a large proportion of us aren't getting into deep sleep. So sleep is one of the reasons.

• 1:00:19Steven Bartlett?

  How do you sleep?

• 1:00:21Speaker 01

  Yeah, I sleep, I make sure I sleep seven and a half hours a night.

• 1:00:25Steven Bartlett?

  This message is brought to you by Apple Card. It's a great time to apply for an Apple Card. You'll love earning unlimited daily cash on every purchase. That includes 3% daily cash when you buy the latest iPhone, AirPods or Apple Watch from Apple. Through this special referral offer, when you get a new Apple Card, you can earn bonus daily cash. To qualify, you must apply at apple.co/getdailycash. Apple Card issued by Goldman Sachs Banks USA Salt Lake City Branch. Offer may not be available elsewhere. Terms and limitations apply. All I had to do was brain dump. Imagine if you had someone with you at all times that could take the ideas you have in your head, synthesize them with AI to make them sound

• 1:01:07Steven Bartlett?

  better and more grammatically correct, and write them down for you. This is exactly what Whisperflow is in my life. It is this thought partner that helps me explain what I want to say. And it now means that on the go, when I'm alone in my office, when I'm out and about, I can respond to emails and Slack messages and WhatsApps and everything across all of my devices just by speaking. I love this tool. And I started talking about this on my behind the scenes channel a couple of months back. And then the founder reached out to me and said, we're seeing a lot of people come to our tool because of you. So we'd love to be a sponsor. We'd love you to be an investor in the company. And so I signed up for both of those offers. And I'm now an investor and a huge partner in a company called Whisperflow. You have to check it out. Whisperflow is four times faster than typing. So if you want to give it a try, head over to wisprflow.ai/DOAC to get started for

• 1:01:52Steven Bartlett?

  free. And you can find that link to Whisperflow in the description below. A lot of people struggle with sleep and they've just kind of gotten used to it. I hear this from friends of mine that'll say, you know, I'm a bad sleeper. I'll sleep for five hours. And they kind of have just gotten used to it. Do you think that's okay?

• 1:02:10Speaker 01

  No.

• 1:02:12Speaker 01

  And they will pay for this in their sixties and seventies.

• 1:02:17Steven Bartlett?

  How do you know?

• 1:02:18Speaker 01

  Because I know that just one night of sleep deprivation is raising your risk of amyloid beta by at least four to five percent.

• 1:02:26Steven Bartlett?

  Just one night?

• 1:02:27Speaker 01

  Just one night. So you can imagine the accumulation of this. Not only that, we know that you're interrupting with the hormones that are responsible for hunger and society. We know for hunger and satiety, we know that you're increasing your risk of type two diabetes with sleep deprivation. But not just that. We also see that this compound effect can't be reversed, meaning that a lot of people think, I'll just sleep for six hours a night and then just bank on it on the weekend. But sadly, that's not how our brain works. It's not like debt that we can repay to the bank.

• 1:03:06Steven Bartlett?

  I heard from Matthew Walker the other day, though, that we can save it up. He said, he said, you can't make up for lost sleep.

• 1:03:12Speaker 01

  Exactly.

• 1:03:13Steven Bartlett?

  But if on Monday I've got something where I know I'm going to be deprived, he says, on the weekends, like Saturday and Sunday, if I got a huge amount of sleep, it's kind of like, I can use that.

• 1:03:23Speaker 01

  Yeah, it's kind of like, yeah, it's kind of like the reserve. Yeah. Actually, I do this. I do long haul flights. I'll be at like six hours between L A and New York, but also to Australia. And so if I know I'm going on a long haul flight, I'll bank on my sleep for about a week leading up to that. Because I know I'm going to be sleep deprived on the plane.

• 1:03:43Steven Bartlett?

  So if you were one of those people that struggles with sleep that's listening right now, and they're slightly concerned that, you know, you talked about this glymphatic system, which sort of comes out at night and cleans up the brain, and they're hearing, shit, my glymphatic system isn't going to be optimal if I'm not sleeping. If that was you, and for whatever reason, you start sleeping poorly. What would you do about it?

• 1:04:04Speaker 01

  I would get really serious about examining my lifestyle the day before. So this generally involves two things. You have to ask yourself, are you having trouble falling asleep? Or are you having trouble staying asleep? A lot of women report trouble falling asleep, meaning they've got a racing mind. Men too. They've got this racing mind. They can't, you know, just stop that default mode network and the the racing thoughts that happen. That's one thing.

• 1:04:36Speaker 01

  And then there's the, I can't stay asleep, meaning that I'm waking up due to heat. I'm waking up because I'm stressed and I'm having bad dreams. There's all different reasons as to why you wake up. So for the person who is having trouble falling asleep at night, I would strongly recommend introducing a supplement called GABA, which is gamma amino butyric acid. It's our chief inhibitory neurotransmitter. And when you have this, it really helps stabilize all those thoughts. It helps with erasing mind and it can help calm you down at night. The next thing I'll do is I will think about what I'm eating.

• 1:05:19Speaker 01

  Actually, it turns out that eating starchy vegetables, something that's gonna make you, like, you know, sweet potatoes, for example, it's gonna have a better benefit backloading your carbs at night for helping you sleep. If you start training for sleep, as if sleep is your marathon, and start preparing for that at eight P M. at night, getting off, you know, don't email, don't have any hard conversations, don't watch anything crazy at night, you'll settle your mind down, you'll settle your nervous system down.

• 1:05:54Speaker 01

  But where I think most of the optimization occurs is when you're actually in sleep. I would also work on sleep regulation. So what we know is that in order to fall asleep and stay asleep, our core body temperature needs to drop at least two degrees. And I'm doing this with a temperature controlled mattress because it's working on thermal regulation. A lot of people who don't have that can do several things, like sleeping with their feet outside of the sheets or turning the air conditioning on, the thermostat on to cooling the room, to cooling down your body temperature, core body temperature. One thing that you can supplement with is glycine,

• 1:06:35Speaker 01

  and I think is amazing because it helps with sleep by way of temperature regulation. It can bring down your core body temperature. And in fact, and I don't know too much about the mechanism behind this, glycine itself has one of the greatest longevity benefits for improving lifespan. So taking glycine can also help with that. Now, in terms of the person who is having trouble staying asleep.

• 1:07:02Steven Bartlett?

  What about this one? You didn't talk about the old ashwagandha.

• 1:07:06Speaker 01

  Oh, yeah. Ashwagandha is great. Okay. Ashwagandha is going to help you with stress. And you've got here ashwagandha rhodiola. So what they both are, they are adaptogens. And basically, an adaptogen is great because it goes in and it adapts to what is happening in your body. So let's just say you have elevated cortisol. And this tends to happen during different cycles, mainly during the daytime when we wake up, where cortisol levels are at its peak. But it can also happen at night. Having this can actually stabilize that cortisol because it can go in, it can bind to cortisol and bring it down.

• 1:07:47Speaker 01

  Likely, if something is not elevated and it's low, it can bring it up. So it's really good. It's an adaptogen. And studies show that you can actually take this three times a day and you won't feel fatigued. It doesn't disrupt anything. And it pairs really well with caffeine, for example, so does theanine. So this is actually a really great adjunct to your supplement stack.

• 1:08:12Steven Bartlett?

  And you really talk about how you need to sort of warm up to warm down, a warm up to go to sleep.

• 1:08:18Speaker 01

  Oh, yeah.

• 1:08:18Steven Bartlett?

  Starting at like 7pm.

• 1:08:20Speaker 01

  Yeah, starting at like 8pm. And that's in line with circadian rhythm and circadian biology. You want to try and, when it comes to sleep and your circadian rhythm, you kind of want to mimic the sun and Mother Nature. And when does the sun start to go down? It starts to go down at around 8pm, depending on where you are in the world. And when this happens, we also get the natural release of, I love that you're taking that, by the way. You must be stressed right now. You get the natural release of melatonin. So melatonin is that sleepy hormone that gets released in response to darkness. This may also be another reason why somebody's having trouble falling asleep and staying asleep.

• 1:09:03Speaker 01

  So we want to get the natural release of that. So these bio hacks that occur right now, sleeping with our red light mask on, dimming the lights. Look, dimming the lights is great. I've actually replaced all of my light bulbs at home with, in my bedroom as well, with red light bulbs. So I'm getting, I'm getting rid of the blue light, the junk light. I'm replacing it with red light to help down regulate the nervous system. Yes, I do wear blue light blocking goggles, or glasses, I should say. Do I think that they're providing an immediate and huge benefit? I don't know. But they could have a minor benefit there. So warming down involves doing these things that are going to help you

• 1:09:47Speaker 01

  down regulate your nervous system so you can fall asleep faster.

• 1:09:51Steven Bartlett?

  Sticking on supplements for a second. Omega three.

• 1:09:56Speaker 01

  Yes.

• 1:09:57Steven Bartlett?

  Um, I've got some omega three here. I've got two of them here. But when I brought both of them out, you said that I've got to be quite careful about what brand I buy, but also something about temperature.

• 1:10:07Speaker 01

  So by far, out of all of the supplements, omega three is probably the only one that you have to make sure that you look at the supplement label for. Um, there, there was this study that was done that showed that around ninety five percent of the most popular omega three supplements in the US, and there was about eighty five of them that were tested, exceeded the normal oxidation level, meaning that these pills, because they're omega three fatty acids, they come from fish oil, they are oil. They can become rancid and oxidized, and they usually do this when they're in a heated environment.

• 1:10:51Speaker 01

  Here are the rules of thumbs. One, you want to look for a manufacturer that is highly credible and that is certified.

• 1:11:00Steven Bartlett?

  Certified.

• 1:11:01Speaker 01

  Yeah, so NSF certified. So it's an external governing board that certifies them on, you know, everything, heavy metals. They make sure that the oxidation levels are met and they make sure that, you know, what's in the capsule is actually in the capsule. That's another thing that is scary. The supplement industry is highly unregulated. And I treat my omega threes the same way I treat my olive oil. You want to get oil that is sourced in the area that you are. We're in California right now, so you might want to find an omega three that is sourced in California.

• 1:11:36Steven Bartlett?

  Do I want to put it in the fridge?

• 1:11:38Speaker 01

  You want to put it in the fridge the moment that you get it.

• 1:11:40Steven Bartlett?

  Really?

• 1:11:40Speaker 01

  Yeah.

• 1:11:40Steven Bartlett?

  Why does nobody talk about that?

• 1:11:42Speaker 01

  I'm not sure. But it's just the same as olive oil. You don't want the olive oil to become rancid, so you don't leave it near the stove. You want to put it in a cupboard away from the stove.

• 1:11:54Steven Bartlett?

  And these are good for the brain?

• 1:11:55Speaker 01

  Omega three is by far one of the most potent stimulus that you could have for the brain. They help with cell membrane fluidity. So where your cells meet, neuron to neuron, they create something called a synapse. And in order for that to occur, we have a massive influx of all of these neurotransmitters, dopamine, serotonin, we've also got calcium and potassium, and these help our brain cells communicate, okay? We want to make sure that our membranes, the cell membranes are fluid and they glide in order to help with that synaptic transmission. Another thing that they do is they are comparable to an

• 1:12:38Speaker 01

  NSAID, an anti-inflammatory medication. These have massive anti-inflammatory effects. In fact, I think that these have the safety profile of an FDA-approved drug, and there's only benefits from it. There's no side effects from it. Not just that, sixty percent of our brain is made of fat. Seventy percent of that is made of DHA. And DHA comes from omega three fatty acids. So why do I not want to replace my brain? Or the fat in my brain with what it's made of? And that's what you do when you have omega three fatty acids.

• 1:13:24Speaker 01

  In fact, there's been several trials um to show that omega three fatty acids are most beneficial and most effective for mild cognitive impairment patients. People who have the APOE four gene and people who have got Alzheimer's disease. Because when I told you that our, we get the breakdown of the blood brain barrier, those parasites on the blood brain barrier require DHA. In fact, there's a transporter on the outside of our brain that allows the um, that allows the DHA to come in and get into the brain.

• 1:14:04Steven Bartlett?

  And I know you're a big fan of vitamin D as well, because there's been some very encouraging studies done there.

• 1:14:09Speaker 01

  Vitamin D is phenomenal. We have vitamin D receptors all over our brain, brain stem, and and they're abundantly found in the hippocampus and the memory centers of our brain. And there was this, there was actually a study done on centenarians in China.

• 1:14:27Steven Bartlett?

  Centenarians?

• 1:14:28Speaker 01

  Yeah, those who lived to a hundred, but it was done in women. And they showed that the women who preserved their cognitive functions and who didn't get Alzheimer's disease had high levels of vitamin D, so they weren't vitamin D deficient. In fact, being vitamin D deficient can increase your risk of all cause dementia by forty percent. Likely being, having a high level of vitamin D, which is around sixty nanograms per deciliter, can lower your risk of getting Alzheimer's disease by around eighty percent.

• 1:15:04Steven Bartlett?

  And then we have this white powder in front of me.

• 1:15:09Steven Bartlett?

  You've got a big smile on your face.

• 1:15:11Speaker 01

  I do because there is just so much benefit to this, depending on which brand you've bought, of course, but I can't say enough about creatine. I have my parents on creatine, they're seventy one years old. I've got my dad on high dose creatine, I've got my mother on low dose creatine. It's the most widely studied supplement on the market.

• 1:15:34Steven Bartlett?

  I've never seen you this excited.

• 1:15:36Speaker 01

  I'm so excited because I think that this is a really cheap and effective way to get everything you want from both your physiology, an upgrade on your physiology and your neurophysiology. So let's actually talk about creatine because I know it gets a lot of airtime, but women and men are still scared of it and they're scared of it for two reasons. One, they're scared it's going to cause kidney damage and two, it's they're scared their hair is going to fall out and I'm going to address both of those fears. But first, let's talk about what it is. So creatine is a naturally occurring molecule. We it's we get we produce around two to three grams of creatine per day, gets secreted

• 1:16:20Speaker 01

  from a bit from the brain, but a lot from the liver. And two to three grams a day is great, but it's not enough. So we have to supplement with it. And all through the nineties and all through the two thousands, people were supplementing with five grams a day, that is this scoop here, five grams of creatine per day. Now that we're getting more rigorous with our brain health studies, we have found that creatine has enormous benefits for the brain. But here's the problem, when you have five grams of creatine, you're saturating the muscles. Okay, remember the muscles are so hungry, so they get first dibs and they take up all of that creatine. So then there's none left for the brain.

• 1:17:02Speaker 01

  We also lose a bit of the bioavailability when the creatine goes into the brain. It crosses the blood brain barrier. But when it goes into the brain, we lose some of it. So we have to supplement with more than five grams. And one of the studies that changed my thinking came out last year. It was the first ever pilot study done on Alzheimer's disease patients. You're talking about patients whose brains are under attack. They're in an energetic crisis. They cannot produce energy effectively. ATP is all skewed. Brain glucose metabolism is skewed. They don't remember left from right. Cognitive functions are declined. They put them on twenty grams of creatine per day.

• 1:17:45Steven Bartlett?

  Which is how much? I mean.

• 1:17:46Speaker 01

  That, well, actually, that is four of this. So you wanna go one. And I don't know if they did this all at once, that's two. Or if they did it, like me, over four separate intervals throughout the day. There we go.

• 1:18:02Steven Bartlett?

  That's a lot of.

• 1:18:03Speaker 01

  That's a lot, which is why you probably wanna have this skewed throughout the day. Which is what I did. I had twenty grams today. I had five grams in the morning, five mid morning. And then I think I had ten all at once before I got here. So that is a lot for all at once. And what they found was that these patients not only preserved their cognitive functions, but they had more energy and they were able to exercise more. And it blew my mind that it does not matter how old you are. It doesn't discriminate based on gender. Creatine doesn't discriminate based on age. It doesn't discriminate based on weight.

• 1:18:47Speaker 01

  It doesn't discriminate based on pathology or disease states or ethnicity. It is just there. It is there to support you. It's the most widely studied supplement on the market.

• 1:18:59Steven Bartlett?

  What is it doing?

• 1:18:59Speaker 01

  And it's all risk. It's all reward. There is no risk. It's helping with cell energy metabolism. So basically, it's helping ATP create energy.

• 1:19:12Steven Bartlett?

  So if you're someone that is low energy, you should definitely be having creatine.

• 1:19:16Speaker 01

  I don't care who you are, you should definitely be having creatine.

• 1:19:18Steven Bartlett?

  People with brain fog and.

• 1:19:20Speaker 01

  Yep, people with brain fog. You know, I think one of the greatest benefits are men who are in football, football players. You can actually, it's actually a protective molecule. So what studies has shown is that at high doses of creatine, around thirty grams a day, it can protect you against insults. Insults meaning you take a hit to the head like a concussion.

• 1:19:49Speaker 01

  It can protect your brain against a concussion. It can protect your brain against a stroke. It can protect your brain from stress. The best thing about creatine is that it works in the background of stress. I think that's where most, that's where you'll get most of the benefits from.

• 1:20:05Steven Bartlett?

  After hearing so much about creatine on this podcast, I started recommending it to all the people in my life. There's one particular person actually that's probably out, out, out there in my house at the moment, who had gone through cancer treatments.

• 1:20:18Speaker 01

  Yeah.

• 1:20:18Steven Bartlett?

  And had survived cancer treatments and, in their words, wasn't the same on the other side of the cancer treatments. And I talked to her about creatine and she said to me the other day, she, I think the exact quote was, I feel like I've got my life back because she's been taking creatine every single day for the last, I'd say five months or so.

• 1:20:39Speaker 01

  It's funny you said that because just recently, in the last two weeks, this study was done to show the anti-cancer effects of creatine. And if my memory serves clear, they, they dosed it at, they dosed it at zero point three six grams per kilogram of body weight. So if you are a seventy kilo person, if my mathematics is correct, you're looking at around twenty five grams of creatine per day that can have the effects, the anti-cancer effects.

• 1:21:13Steven Bartlett?

  So the, the study you're referring to, I'll put up on the screen as well for anyone that wants to see it. It's the NANS two thousand twenty five study, which was a major study involving over twenty five thousand adults, found a linear negative association between dietary creatine and cancer prevalence. For every standard deviation increase in dietary creatine intake, the risk of having cancer decreased by roughly five percent to eighteen percent, depending on the demographic.

• 1:21:36Speaker 01

  That is wild.

• 1:21:38Steven Bartlett?

  This protective association was strongest in adults over the age of fifty, suggesting that as we age, maintaining high creatine levels might be more critical for cellular health and immune surveillance.

• 1:21:51Speaker 01

  Well, if you think about life and think about energy, we need energy to survive. We need energy to fight off infections. We need energy to fight off stress, preserve our normal bodily functions. So when we are at the mercy of a low energy crisis, we can't fight off tumor cells. We can't fight off these debilitating diseases. So it actually makes sense that with more energy and with more functional energy, meaning like if our cells can function better, it makes sense that you can see a reduction in cancer incidence. Likely, you can see a reduction in Alzheimer's disease incidence.

• 1:22:31Speaker 01

  When I said that creatine works in the background of stress, also, there's been phenomenal research to show that you can basically creatine your way out of sleep deprivation. So if you've had a long night and you're sleep deprived, maybe you slept four, five, six hours, you're sleep deprived, you can take high dose creatine in the form of around fifteen to twenty grams a day, and you can reverse the negative effects associated with that sleep deprivation.

• 1:23:06Steven Bartlett?

  Does it matter what time you take the creatine?

• 1:23:09Speaker 01

  It doesn't matter what time you take the creatine. It doesn't degrade in hot water. You can take it any time throughout the day, and it doesn't matter whether you're taking it right before exercise, during exercise, after exercise. It works phenomenally. Some people, researchers are now wondering if taking it at night before bed helps with sleep performance, and I think that that's a really exciting area. But the one thing that I want to tell everybody, because a lot of people are scared of this biomarker called creatinine.

• 1:23:43Speaker 01

  Meaning that.

• 1:23:44Steven Bartlett?

  Oh, my doctor said that to me.

• 1:23:45Speaker 01

  Yeah, so meaning that you've got a a high creatinine level. And this is a marker of, it's one marker of kidney function. But this is where I find it uh really invaluable. And this is where a lot of the nonsense comes around on Instagram and social media. A lot of people say, well, I had so much creatine that my doctor told me to get off it because my creatinine levels were high. But creatinine levels are high during times of stress, during times of intense physical activity. Uh and also people who have a lot of muscle mass, higher muscle mass, that's you. Have higher creatinine levels. What you want to test, a greater marker of kidney function and G F R is cystatin C.

• 1:24:30Speaker 01

  So all you have to ask, it's really easy, ask your doctor, could I please get cystatin C in my blood work? And if that is elevated and without, not within normal range, then maybe get off creatine. But right now I cannot see any reason as to not have creatine every single day. I think every single person, no matter what age you are, everybody should be supplementing with creatine. Now, there was this uh recent study that came out on menopausal women. And it was a really small study, it was a randomized control trial.

• 1:25:11Speaker 01

  And they split women into four groups, and these were perimenopausal women. They split them into low dose creatine, where I think they were having seven hundred and fifty milligrams a day. Medium dose, which was around one point five grams a day. Then they had them supplement with a range of both creatine monohydrate and creatine hydrochloride. This was a hydrochloride creatine study. And then there was a placebo group. What they found, it was a very small study, very small group, what they found was that those in the medium. Range, having the one point five, had substantial increases in their mood and their cognitive

• 1:25:56Speaker 01

  functions. So creatine is now being explored in females across the lifespan as it relates to perimenopause, pregnancy, menopause and dementia. So there's just, there, it's, it's, it's phenomenal. The only thing I want to point out, what you want to look for when it comes to creatine are two things. When it comes to manufacturing standards, you want to look, A, has it been NSF certified? And B, you want to look for, is it Creapure? And that's the gold standard of creatine. And it comes from Germany. And a lot, so the one that you've got there, I can tell it's not Creapure.

• 1:26:39Steven Bartlett?

  Excuse me?

• 1:26:40Speaker 01

  I know my creatine.

• 1:26:41Steven Bartlett?

  How can you tell what it is by looking at it?

• 1:26:43Speaker 01

  I can just tell. I can, I, I, I bet you a million dollars that it is the brand that I think it is because it's got this powdered icing sugar substance. If it was pure, gold standard Creapure, it would be gritty. The reason why it's like this is because a lot of manufacturers want to add these different agents in there in order for it to mix well. This probably mixes, mixes really well. A lot of people also complain of feeling GI distress when they take it. And all I have to say is that's not a reason to stop taking it. Maybe take two grams at a time, maybe take three grams at a time, but don't stop taking it.

• 1:27:26Steven Bartlett?

  What do you test for with your own health and how frequently do you test?

• 1:27:31Speaker 01

  I test every three to four months.

• 1:27:33Steven Bartlett?

  What do you test?

• 1:27:34Speaker 01

  Oh, I do everything.

• 1:27:35Steven Bartlett?

  Really?

• 1:27:36Speaker 01

  Oh, I've, I, I just did um lab work uh December fifteenth, the day before my birthday. I do it, you know, around that age. But every year, funnily enough, I test my biological age.

• 1:27:48Steven Bartlett?

  What is your biological age?

• 1:27:49Speaker 01

  It came back as twenty-two.

• 1:27:51Steven Bartlett?

  What's the most important task they don't typically do that you think everybody should be doing?

• 1:27:56Speaker 01

  Lipoprotein little a raises your risk of having a heart-related event or raises your risk of getting cardiovascular disease, but it's hereditary.

• 1:28:06Steven Bartlett?

  And then for dementia?

• 1:28:08Speaker 01

  This is a really exciting part, at least in the US. We now have a predictable way of picking up on mild cognitive impairment and picking up on these Alzheimer's hallmarks. Tau protein, P tau 217 is called on blood work, and amyloid beta. So we can now pick up on this with 90% accuracy of a PET scan.

• 1:28:30Steven Bartlett?

  What are those cards over there?

• 1:28:33Speaker 01

  These are here to test your processing speed.

• 1:28:36Steven Bartlett?

  Pink.

• 1:28:37Speaker 01

  So.

• 1:28:38Steven Bartlett?

  It says pink on it.

• 1:28:39Speaker 01

  Yeah, so this is actually a great measure of brain function. Your brain processes visual information 15 times faster than written words. And so this is going to test your brain function. Okay. So what I want you to do is you're going to see the colour.

• 1:28:52Steven Bartlett?

  Yeah.

• 1:28:53Speaker 01

  I want you to actually say the colour of the card, not the word.

• 1:28:55Steven Bartlett?

  Okay, let me just program my brain. Say the colour, not the word. Okay.

• 1:29:01Speaker 01

  Are you ready?

• 1:29:02Steven Bartlett?

  Green, orange, yellow, green, orange, green, orange, yellow, pink, orange, green.

• 1:29:18Speaker 01

  Now let's do the reverse. I want you to say the words.

• 1:29:21Steven Bartlett?

  Oh, wait, let me just. Okay, yellow, blue, green, black, purple, brown.

• 1:29:31Speaker 01

  Okay, so you're good.

• 1:29:32Steven Bartlett?

  Thank you. Let's do it to Jack. Jack, you come. Sit in the chair.

• 1:29:37Speaker 01

  You called him off guard and he hasn't got creativity. That's unfair.

• 1:29:42Speaker 01

  It's an unfair advantage.

• 1:29:46Speaker 01

  Okay, you ready?

• 1:29:47Speaker 02

  Wait, so what am I doing?

• 1:29:47Speaker 01

  Just say the color of the card.

• 1:29:50Speaker 02

  Okay, just the color of the card.

• 1:29:51Speaker 01

  Yeah, ready?

• 1:29:52Speaker 02

  Green, orange, pink, yellow, yellow, yeah, orange, pink.

• 1:30:03Speaker 01

  Now, let's roles reverse and we need to say what's on the card itself. So just read it.

• 1:30:07Speaker 02

  Okay, brown, purple, pink, green, black, yellow.

• 1:30:15Speaker 01

  Okay, so now we're going to test it even more. That was a starting way.

• 1:30:18Speaker 02

  Good. Not too bad.

• 1:30:20Speaker 01

  That was not too bad. So I want you, this actually involves us standing up and using a tennis ball. So we're going to train your visual cortex, which sits at the back here in the occipital lobe. We're going to train your processing speed, your reaction time, your hand-eye coordinations. One of the best exercises that you can do, physical exercises, is actually hand-eye coordination drills. Tennis, racket sports, but I'm going to show you what five minutes a day can do for your cognitive reserve and your brain performance, just using a tennis ball and an eye patch.

• 1:30:51Speaker 02

  Okay.

• 1:30:53Speaker 01

  So.

• 1:30:56Speaker 01

  First things first, I'm going to give you this tennis ball.

• 1:30:59Speaker 02

  Yeah.

• 1:30:59Speaker 01

  And for the whole time, I want you to throw the ball with an overhand grip.

• 1:31:04Speaker 02

  Oh, like this?

• 1:31:05Speaker 01

  Yep.

• 1:31:06Speaker 02

  Okay.

• 1:31:07Speaker 01

  So I want you to just throw it with the right arm and catch with the right arm.

• 1:31:10Speaker 02

  Over, I mean, what's this?

• 1:31:12Speaker 01

  That's the underarm?

• 1:31:13Speaker 02

  I'm just checking the wall. Okay, okay, so like.

• 1:31:16Speaker 01

  So you might want to move back where the chair is. Okay, no, you would.

• 1:31:20Speaker 02

  Cut that, cut that out.

• 1:31:25Speaker 01

  Good. So now throw with the right and catch with the left and alternate. Yep.

• 1:31:32Speaker 02

  Okay.

• 1:31:37Speaker 01

  You've got it. So what we're doing, we're engaging almost all the executive functions now. You've got hand, you should be able to do this for a minute. Okay.

• 1:31:45Steven Bartlett?

  Okay.

• 1:31:46Speaker 01

  Now, we're gonna make it even harder. It's like placing weights on you. Well, I, I'm not gonna do the one with the eye patch. I'll do the next one. Okay. So basically, what you wanna do, and if you do it with a black ball, it's actually, oh, even better.

• 1:32:02Speaker 01

  So now we're gonna make it a bit hard and a bit neurally demanding. We're gonna put an eye patch on you, which is really gonna block out like 50% of the vision.

• 1:32:10Steven Bartlett?

  Okay. Which eye?

• 1:32:12Speaker 01

  Any eye.

• 1:32:13Steven Bartlett?

  Let's see the left one.

• 1:32:15Speaker 01

  Now, let's see how many you can do. I think we counted around eight before.

• 1:32:18Steven Bartlett?

  A pirate.

• 1:32:21Steven Bartlett?

  What? Wait, this is not flattering.

• 1:32:26Steven Bartlett?

  Okay, cool. Oh, that's so different.

• 1:32:29Speaker 01

  Yeah.

• 1:32:30Steven Bartlett?

  Wow. This feels significantly harder.

• 1:32:32Speaker 01

  I know. Let's go.

• 1:32:33Steven Bartlett?

  This feels, no, this feels like really hard. Let me just double check. Fucking hell.

• 1:32:38Steven Bartlett?

  That's, that's really, that's so hard.

• 1:32:42Steven Bartlett?

  This is...

• 1:32:43Speaker 01

  There you go. You've got it.

• 1:32:45Steven Bartlett?

  Ah, joking.

• 1:32:48Speaker 01

  Okay, let's alternate now. Left hand, right hand.

• 1:32:51Steven Bartlett?

  Left hand, right hand. Like this.

• 1:32:53Speaker 01

  Yeah.

• 1:32:56Speaker 01

  You're training your visual system to work under load and under stress. So when you do this, I'm interrupting you.

• 1:33:04Steven Bartlett?

  No, it's okay.

• 1:33:07Speaker 01

  You got it, you got it, you got it. Good, good, good. And then to even make it even harder, okay? Stand on your right foot and put your other foot. There you go.

• 1:33:16Steven Bartlett?

  What, on one leg?

• 1:33:17Speaker 01

  Yeah. Standing on one leg is now engaging the cerebellum.

• 1:33:22Steven Bartlett?

  Okay.

• 1:33:22Speaker 01

  We're getting spatial awareness. Let's go. Posture.

• 1:33:25Steven Bartlett?

  Left, right, left, right?

• 1:33:26Speaker 01

  Yep.

• 1:33:28Steven Bartlett?

  Oh my gosh.

• 1:33:34Speaker 01

  You got it.

• 1:33:35Steven Bartlett?

  I wanna see you do it.

• 1:33:37Speaker 01

  With the eye patch on?

• 1:33:38Steven Bartlett?

  Yeah.

• 1:33:39Speaker 01

  Wow.

• 1:33:42Speaker 01

  I mean, I can be great. My eyelashes have gone now.

• 1:33:47Steven Bartlett?

  It's okay. We can AI that out.

• 1:33:48Speaker 01

  This actually looks great. Okay, we're ready?

• 1:33:54Speaker 01

  Well, I blame my nails. I blame my nails. Let's do it.

• 1:34:00Speaker 01

  Okay.

• 1:34:02Steven Bartlett?

  It's hard.

• 1:34:03Speaker 01

  It's so hard.

• 1:34:04Steven Bartlett?

  And so what is this doing?

• 1:34:05Speaker 01

  This is engaging executive functions, processing speed, hand-eye coordination.

• 1:34:11Steven Bartlett?

  And you did this with NBA players?

• 1:34:13Speaker 01

  I did this with NBA players to improve their executive functions, decrease their reaction time.

• 1:34:20Steven Bartlett?

  And this will, this will change my brain if I do this frequently.

• 1:34:23Speaker 01

  Not just that, but you're also improving cognitive reserve. You're building new connections between the brain cells. You're strengthening neural networks. And you're doing something incredible.

• 1:34:36Steven Bartlett?

  You know, every once in a while, you come across a product that has such a huge impact on your life that you'd probably describe it as a game changer. And I would say for about thirty-five to forty percent of my team, they would currently describe this product that I have in front of me called Ketone IQ, which you can get at ketone.com as a game changer. But the reason I became a co-owner of this company and the reason why they now are a sponsor of this podcast is because one day when I came to work, there was a box of this stuff sat on my desk. I had no idea what it was. Lily in my team says that this company have been in touch. So I went upstairs, tried it, and quite frankly, the rest is history. In terms of my focus, my energy levels, how I feel, how I work, how productive I am, game changer.

• 1:35:20Steven Bartlett?

  So if you wanna give it a try, visit ketone.com/steven for thirty percent off. You'll also get a free gift with your second shipment. And now you can find Ketone IQ at Target stores across the United States, where your first shot is completely free of charge. If there's anything we need, it is connection, especially in the world we're living in today. And that is exactly why we created these conversation cards. Because on this show, when I sit here with my guests and have those deep intimate conversations, this remarkable thing happens time and time again. We feel deeply connected to each other. At the end of every episode, the guest I'm interviewing leaves a question for the next guest, and we've turned them into these conversation cards. And we've added these

• 1:36:02Steven Bartlett?

  twist cards to make your conversations even more interesting. And there are so many more twists along the way with the conversation cards. This is the brand new edition. And for the first time ever, I've added to the pack this gold card, which is an exclusive question from me. But I'm only putting the gold cards in the first run of conversation cards. So get yours now before the limited edition gold cards are all gone. Head to the link in the description below.

• 1:36:28Speaker 01

  So doing hard things is what is going to improve brain function over the lifespan. Doing hard things tells your brain that you can do hard things. Meaning, have you ever heard of this brain area, a little area in the brain called the anterior mid-singulate cortex?

• 1:36:50Steven Bartlett?

  Yes, I have.

• 1:36:51Speaker 01

  What do you know about it?

• 1:36:53Steven Bartlett?

  I'll let you say it.

• 1:36:54Speaker 01

  Well, it's shown that it's larger in what we call super ages and people who age really well and who can withhold a lot of cognitive capacity. And it's really profound in people who can diet well. It gets bigger when we do hard things. So when we do really hard things, this area in the brain gets bigger. And basically, what that is, it's reserved for when life gets hard. It means, it basically tells your brain that no matter what happens, no matter what event comes my way, I have the ability to go in, welcome it, and push through it, no matter how hard it's going to be.

• 1:37:36Speaker 01

  When you give up or when you don't do hard things, this little area doesn't grow, it doesn't get bigger. So doing these neural activating drills that we just did, going to the gym and pushing well above your threshold and pushing really hard is going to help grow this little area of the brain.

• 1:37:59Steven Bartlett?

  And they call this the willpower muscle.

• 1:38:01Speaker 01

  The willpower. This is why I think that when people go out to set their goals during the year and they say, I'm going to lose 20 pounds, I'm going to do this, I'm just going to increase my willpower. I think it's not willpower, it's neurobiology.

• 1:38:16Steven Bartlett?

  I think it's really important to just spend a little bit of a moment talking about this part of the brain because when I discovered it, I found it absolutely fascinating. And I think it was Andrew Huberman who said,

• 1:38:25Speaker 01

  Yeah.

• 1:38:26Steven Bartlett?

  either to me or he said publicly that he thinks it's one of the most fascinating or important discoveries of the last century.

• 1:38:33Speaker 01

  Of course, well, you think about how we're living our lives. We're punishing ourselves for not being able to read a book, for not being able to pay attention. How many people are now diagnosing, self diagnosing themselves with ADHD, low attention spans? And they're blaming it on environment. They're blaming it on circumstances when they should be blaming it on neurobiology and they should be blaming it on their brain state. This area of the brain, if you can push, and this is why these super ages seem to have.

• 1:39:05Steven Bartlett?

  What's a superager?

• 1:39:07Speaker 01

  A superager is somebody who is aging well. So they're going through life, low cardiovascular disease state. They have maintained their cognitive functions. They're at the age of 80, 90 with a VO2 max profile of maybe a 50 or 60 year old. So they're aging quite well biologically. So these, you know, super ages have many, many different facets to them. And one of them is a larger mid secular cortex.

• 1:39:38Steven Bartlett?

  Conversely, the AMCC, anterior mid-singulercortex, shrinks in people who live sedentary lives or avoid challenges. It literally atrophies if you play it safe in life too often. Growth only occurs during resistance. If you love taking ice baths and you take one, your AMCC doesn't change. If you hate the cold, but force yourself to do it anyway,

• 1:40:01Speaker 01

  Yep.

• 1:40:02Steven Bartlett?

  the AMCC grows. Scientists now view the AMCC as the seat of the will to live. Its size and activity level are strong predictors of how long an individual will survive after a major setback in their life, whether it's a health setback or a surgery.

• 1:40:18Speaker 01

  There's something really philosophical about that as well. You know, if you, I don't know if you read Stoicism or anything, but it, it, it really dates back to how the Stoics lived their life, especially Marcus Aurelius, with being able to push through hard times. Little did they know that it was this little area in the brain.

• 1:40:40Steven Bartlett?

  Yeah, I think I was telling the story the other day of Roosevelt and what happened in his life as a young man when he came home one day on Valentine's Day and found that his mother and his wife of, who had just had his newborn baby, had both died, one upstairs, one downstairs. And he went off to the Badlands for two, I think it was two to four years. The Badlands in America were just this horrific natural place where he'd get up at 4:00 AM, ride these like horses in the freezing cold where like the horses would literally die standing still because it was so horrific. He did that to two years to like deal with the grief. But when he came back to New York City after these two years in the Badlands, all of his friends said he was just a completely different man. And what they now know from a neuroscience perspective is that he didn't just build his muscles, he literally rewired his, his brain.

• 1:41:25Steven Bartlett?

  He went on to become the youngest US president of all time. He got shot during a speech and carried on doing the speech. He led the charge in various wars. He's just this unbelievable, I think he won the Nobel Prize. And they point at those two years in the Badlands and say, actually, that forged not just the man, but his, his brain, his AMCC. The studies also show that athletes consistently show much larger AMCC volume. And studies show that individuals struggling with obesity often have smaller AMCCs. But again, but, but it begins to grow the moment they start a successful challenging dietary or exercise intervention.

• 1:42:00Speaker 01

  It's that word challenging because when you place stimulus upon a system.

• 1:42:06Speaker 01

  It adapts and grows. And that is neurobiology at its most infinite source. And this is why we get the breakdown of these synapses. This is why we get into a place of going from 5,000 to 10,000 connections to 2,000 or no connections. These dendritic spines end up breaking down because we don't do the hard thing. And also think being deep rooted in neurobiology, you can see that everything is cause and effect and it's a cycle. If you don't do the hard thing, you don't grow the AMCC. You don't grow the AMCC, you don't do the hard thing again. And it's just this loop and it's this cycle,

• 1:42:50Speaker 01

  which is why so many resolutions, New Year's resolutions, end by February 1st. It's why we have the obesity epidemic. It's largely why I think we've got a crisis of people not being able to meet their goals.

• 1:43:08Steven Bartlett?

  I'm just fascinated from an evolutionary perspective as to why we needed one and like why it wasn't just always big.

• 1:43:13Speaker 01

  In the pursuit, you know, evolutionarily, in the pursuit of hunting and going out and hunting for food sources and being motivated to do that in a near starvation state when times were tough.

• 1:43:29Steven Bartlett?

  And so when times got easier, we didn't need it as much. So we could conserve, I guess, our energy. So we could like scale down our willpower when times were good.

• 1:43:38Speaker 01

  Well, it's interesting that you say that because this brings up the whole brain rot and AI era. Just like with, you know, in 2024 Oxford Dictionary, I think named brain rot the word of the year. And it's interesting because it plays into evolution and what's happening with this AMCC, meaning like we're just there scrolling at mindless information every day, training our brain to get these small dopamine hits, these small rewards from doing absolutely nothing.

• 1:44:11Steven Bartlett?

  What do you think of these chatbots that everybody's using at the moment to write for them and think for them, et cetera?

• 1:44:17Speaker 01

  Oh my god, I think it's on the spectrum of being so incredible but being so detrimentally harmful. I know this with myself. So I was a mathematician, I did my masters of mathematics and I was able, Stephen, to the trigonometry and pure calculus that I could do back then with just my head and a pen was fascinating. Now, I'm going to, I'm going out and I'm calculating on ChatGPT the bill, the twenty percent tip on top of this bill, how much does it cost? And I think, how dumb am I actually getting? So I think it's both good and bad. I think the rate of decline we're seeing in people reading books and exercising their

• 1:45:01Speaker 01

  brain is declining and our ability to think and, and use our cognition is declining.

• 1:45:13Steven Bartlett?

  Louise, I've, I've waited a long time to ask you one particular question, which is, I think is very important, which is, you're clearly very passionate about this stuff. One might say you're pretty obsessed with it. You come across as pretty obsessed.

• 1:45:29Speaker 01

  Do I?

• 1:45:30Steven Bartlett?

  You do, yeah. Why?

• 1:45:33Speaker 01

  We are living in a society that doesn't allow women to ask for what they want. We're living in a society that doesn't allow women to ask for what they need. And when this happens, it results in seventy percent of all Alzheimer's disease cases being women. It results in eighty percent of all autoimmune diseases being female. And These are largely preventable diseases. And when I ask why and I hear that women are wildly misrepresented in academic literature. When I, when I see women who downplay their symptoms or they're too scared to ask their doctor for advice

• 1:46:18Speaker 01

  or they're too scared to ask somebody else for advice because of what they're going through or they're ashamed of some of their symptoms, I get angry and I get passionate. And it reminds me of my grandmother who, uh, she was my best friend. Her name was Louisa and

• 1:46:35Steven Bartlett?

  You're named after her.

• 1:46:36Speaker 01

  I was named after her, yes. And we spent every day together. And, and I'm getting emotional now because I remember her. And she sadly died of pancreatic cancer. It was ovarian cancer that went to pancreatic cancer. And she never asked for what she wanted and she never asked for what she needed, which was help. She didn't understand her symptoms. She didn't go to the doctor when she needed to because she was just more inclined to look after the family and look after the household. And when the time came that she was given her diagnosis, I was sitting there with her. It was, um, it was at home and the doctor came.

• 1:47:21Speaker 01

  She did a house call and my grandmother looked at her. She hardly spoke that much English and she said, please, is there something I can do? I don't want to die. And the doctor said, there is, I'm sorry, there's nothing you can do. And I spent every day with her in the hospital. And I think about that. It's been almost 20 years now, but I think about that moment and I kick myself thinking, why didn't we, why didn't we get her a scan? She told us several times that her stomach was hurting. She told us several times that she felt pain. She never, she hid her symptoms. She hardly ever ate at one point and we never stopped to think about why. And she never stopped to think about why.

• 1:48:06Speaker 01

  So I think about her every day. And then I think about my mother too. And these women, you know, first generation, they came, uh. We migrated to Australia from a country called Cyprus. And they've just been so, they put themselves second. And they, they just look after the family and I can't stand that. And when I see women coming in as patients or caregivers, I think to myself, do you not know that there is something for you to do? And most women don't. And I, I can't believe the amount of money that we are spending that is going towards

• 1:48:49Speaker 01

  putting us on rockets to go to Mars, but we haven't yet found a cure for this disease that is largely preventable. It's just not okay with me. And I would hate to see women go through this.

• 1:49:04Steven Bartlett?

  The emotion is still very present in your face, even though it was so long ago.

• 1:49:09Speaker 01

  It was so long ago. I mean, I was very close to her. I'm very close with my mother. I, I check in with her twice, three times a day. And I just don't think it's fair. I think women deserve the truth. They've been lied to, they've been underrepresented and we need to change that.

• 1:49:28Steven Bartlett?

  With Louisa, your grandmother, wha- what are those range of emotions that have turned into this incredible fire you have?

• 1:49:37Speaker 01

  Anger. Anger is one of the emotions. Anger at society that places women to be everything, to be a, a mother, a caregiver, to go to work, to represent the family. Women represent fifty one percent of the total population.

• 1:50:02Speaker 01

  And then it becomes, I feel, political if that's an emotion. Because you think about healthcare, you think healthcare should be accessible to everybody, but it seems as though, especially in this country, that healthcare is only really accessible by those with a high socioeconomic status, and that I'm not okay with. So it does become political, even though healthcare, I guess healthcare is political because policies have been set, but a woman in need is apolitical. And my grandmother was apolitical, and her needs just were not met.

• 1:50:42Steven Bartlett?

  Anger.

• 1:50:44Speaker 01

  Frustration at the system, frustration at the fact that we still have only 4% of women taking hormone replacement therapy in fear that they're going to get this disease, that they're going to get breast cancer. Utterly frustrated at the cycles of administration who vouch to help you. You look to your, you know, your government and your administration to look up to, to guide you, when you have Secretary Kennedy in 2014 go on national television and say, "Vaccines are totally safe, I had all my kids vaccinated, they've eradicated some of

• 1:51:26Speaker 01

  the most deadliest diseases that have plagued this world, vaccines are so safe." To fast forward to 2025, saying vaccines are so unsafe, do not trust your medical doctor, you need to take your health into your own hands. You start to lose trust, and it's not that we're uninformed, it's the fact that we are confused, because we hear vaccines are bad, "Oh, vaccines are good, vaccines are really good, take them, don't get your kid vaccine." You've got women here who don't even know, they're, they don't even know how to get on the internet or order a blood testing, you're expecting them to take their health

• 1:52:11Speaker 01

  into their own hands. So it upsets me that you see women who are so vulnerable, being sold a vaccine lie, which could potentially save them from a disease, which could potentially save them or their child from getting... The flu, hepatitis P, meningitis, which was just eradicated from the vaccine schedule. I'm not, this is not meant to be political. I am, I'm a scientist. I am not, this is not propaganda. This is not ideology. This is just women who deserve to be treated better.

• 1:52:52Steven Bartlett?

  You're thirty six.

• 1:52:57Steven Bartlett?

  Louisa passed away when you were, how old?

• 1:52:59Speaker 01

  Oh, I was probably eighteen at the time.

• 1:53:02Steven Bartlett?

  You were eighteen?

• 1:53:03Speaker 01

  Around that, eighteen, nineteen.

• 1:53:05Steven Bartlett?

  When she got the diagnosis?

• 1:53:06Speaker 01

  Yeah, it was very fast. It was within a two month timeframe, not even.

• 1:53:12Steven Bartlett?

  And had she not got that diagnosis? And had you not sat there and watched her ask that doctor if there's something that she could do?

• 1:53:20Steven Bartlett?

  Do you think your career would have taken this course?

• 1:53:23Speaker 01

  I became utterly obsessed with disease management. But when I first saw a human brain, I was twenty one. I was in a lab and we had to go into a cadaver lab. And I saw a brain being harvested from a body that was donated. And I stayed back that day, I remember. And I helped in the pathology lab. And when I saw that brain, I knew that I wanted to dedicate my life to it. So ever since then, I've been in ORs and it's where I feel most alive.

• 1:53:55Steven Bartlett?

  Why? Why did you want to dedicate your life to it?

• 1:53:57Speaker 01

  Because when you know what the brain is, that it is responsible for the life that we have, and you can use it for your advantage to overcome any obstacle that comes your way, you become obsessed with understanding it. Metacognition is thinking about your thoughts. And every day, if you can think about why you think, about the things you think about, you can challenge yourself to overcome any adversity.

• 1:54:27Steven Bartlett?

  Is there a cost to your obsession and your passion?

• 1:54:29Speaker 01

  Yes.

• 1:54:30Steven Bartlett?

  What's the cost?

• 1:54:30Speaker 01

  I moved away from my family to be surrounded by the greatest neurosurgeons in the world, which I am, and I'm very thankful for that. I moved away from a population of twenty two million to come to the hardest city in the world.

• 1:54:43Steven Bartlett?

  New York.

• 1:54:44Speaker 01

  New York City.

• 1:54:45Steven Bartlett?

  Are you still paying a cost?

• 1:54:46Speaker 01

  I'm still paying a cost. My health pays a cost. I've missed family, events, travelling for my career.

• 1:54:56Speaker 01

  But I wouldn't have it any other way. Because the people that I've met have forged the way for me to live the life that I want. I'm surrounded by incredible thought leaders in health and medicine and.

• 1:55:11Steven Bartlett?

  So what is success to you then? At the deepest possible level, what is success? We meet again in ten years' time, you say, my life has been a success, or I feel successful. I'm a success. Louisa says, I am a successful woman. What does that mean? What happened?

• 1:55:26Speaker 01

  Being able to control my brain states.

• 1:55:31Steven Bartlett?

  Being able to control your brain states.

• 1:55:33Speaker 01

  I think that the ultimate form of success and high performance, or being able to perform at your peak, is being able to go from brain state to brain state and then be able to recover.

• 1:55:48Steven Bartlett?

  What do you mean by brain state?

• 1:55:50Speaker 01

  Meaning like being able to get switched on when you need to be switched on and inviting neurotransmitters involved in that, norepinephrine, adrenaline, dopamine. But not having that in constant overdrive and being able to know when to switch off. And I think that that is what high performance is. The book that changed my mind on that was Flow by Mihaly Csikszentmihalyi, which actually speaks about the flow state. So being able to know how to separate yourself in these states.

• 1:56:21Steven Bartlett?

  Any goals outside of your professional?

• 1:56:25Speaker 01

  Kids, family, life.

• 1:56:26Steven Bartlett?

  Love kids, family?

• 1:56:27Speaker 01

  Yeah, definitely.

• 1:56:30Steven Bartlett?

  It's tough, isn't it?

• 1:56:32Steven Bartlett?

  It's tough. I was saying earlier to my friend that, you know, I kind of just thought the minute I wanted to have kids, they would just appear. It's not so straightforward.

• 1:56:39Speaker 01

  That's what I thought too, until I realised, oh, but I'm the woman.

• 1:56:44Speaker 01

  I actually have to bear the children as well.

• 1:56:48Steven Bartlett?

  Which is a big sacrifice and an honour and a privilege.

• 1:56:51Speaker 01

  It's an honour and a privilege and a sacrifice that I think everybody, yeah, I, I mean, I think I definitely want.

• 1:56:59Steven Bartlett?

  Are you hopeful for all of your professional endeavours?

• 1:57:03Speaker 01

  Yes.

• 1:57:03Steven Bartlett?

  You are hopeful?

• 1:57:05Speaker 01

  I'm in control.

• 1:57:08Steven Bartlett?

  You think we're gonna move in a good direction as a society as it relates to Alzheimer's?

• 1:57:14Speaker 01

  Yes, I I'm hopeful for that. I'm hopeful for the message that I'm getting across. I think social media is providing the platform for free education and for people to understand that they have agency over their brains. I'm not hopeful for anybody saving us or coming in and giving us a easy way forward.

• 1:57:40Steven Bartlett?

  Do you ever have days where you wished you were less obsessed with your craft? Has there been a day where you're like, you know, I wish I was just a little bit less captivated by this?

• 1:57:49Speaker 01

  Sometimes I do, yeah. I think if I didn't, well, I'd be probably back home in Australia, living an average person's life. I'm not saying that that's it. I'm just saying, you know, maybe I would have done it, done my life differently.

• 1:58:02Steven Bartlett?

  I have days like that where I think if, obviously, because the obsessed brain is the one making this decision. So it's quite difficult to detach. But like if you put a knob in front of me and I could just turn it down just a little bit, would I? Now, my obsessed brain is is the one making this decision. So my obsessed brain's not like, fuck it, turn it up. But I think I do wonder sometimes, I am the way that I am, right? But I do wonder sometimes if I would be happier overall if I could just turn it down a little bit.

• 1:58:33Speaker 01

  But isn't the whole point of life to know thyself and in pursuit of something bigger and better?

• 1:58:41Steven Bartlett?

  Yeah, it is. But I just sometimes worry about what I'm sacrificing and whether at some point, I don't know, when I'm on my deathbed at eighty years old, I'm gonna look back and say, actually, I made a bad trade.

• 1:58:52Speaker 01

  Well, exactly. But we're never gonna know that. I I think about that often. I know, you you think about that often and you think, well, if the world came to a a collapse tomorrow, what would you regret today not having done?

• 1:59:06Steven Bartlett?

  I think it would be like making more memories with people I love. I think that's one of the big ones. I think.

• 1:59:11Speaker 01

  Did you hear what you just said?

• 1:59:12Steven Bartlett?

  Yeah.

• 1:59:12Speaker 01

  Making more memories. And imagine losing those. Imagine

• 1:59:16Steven Bartlett?

  Yeah.

• 1:59:16Speaker 01

  a life full of like

• 1:59:18Steven Bartlett?

  Unthinkable.

• 1:59:19Speaker 01

  you know, creating these experiences and these memories to have them being taken away from you.

• 1:59:25Steven Bartlett?

  Yeah.

• 1:59:26Speaker 01

  To not being able to recognise your wife, your kids, and looking in the mirror and not being able to recognise yourself.

• 1:59:35Steven Bartlett?

  That's why Alzheimer's is just such a disgusting, sinister, like horrific thing, because yeah, it's just

• 1:59:43Speaker 01

  It's

• 1:59:44Steven Bartlett?

  the most heartbreaking thing to to lose someone while they're still alive.

• 1:59:48Speaker 01

  Yeah, and to lose yourself. We've got this one woman who looks in the mirror and she says, who's that?

• 1:59:55Steven Bartlett?

  Really?

• 1:59:56Speaker 01

  Yeah, and you know, it's it's sad because two years ago she knew who I was and now she asks, are you my daughter? And when you're confronted with that every single day, it gets you thinking, you don't live a normal life. You don't live an average life because you do think about every facet of medicine. You think about history. You think about diseases and then you think about life and the people that you spend the most time with.

• 2:00:22Steven Bartlett?

  We have a closing tradition where the last guest leaves the question for the next, not knowing who they're leaving it for. And the question left for you is, what is God to you?

• 2:00:31Speaker 01

  God is that power that you feel and have faith in that you cannot see. The power that um

• 2:00:44Speaker 01

  basically makes you feel like there is somebody there that has you and that is guiding you.

• 2:00:52Speaker 01

  That

• 2:00:55Speaker 01

  always has a a path for you, knowing

• 2:00:58Steven Bartlett?

  You you believe in God?

• 2:00:59Speaker 01

  Yes, I'm I'm I'm I'm Christian, I'm Greek Orthodox.

• 2:01:03Steven Bartlett?

  When you see the brain deteriorating in such a way. And you think about this concept of prayer, like asking God to help me with something. Doesn't it feel pretty, I mean, it's the definition of like hopelessness is watching your brain deteriorate. And I think some part of my struggles with religion since I was an eighteen year old and came from a very religious family was seeing injustice in the world. And this doesn't seem to be much greater injustice than watching someone's brain just deteriorate in front of their family.

• 2:01:32Speaker 01

  Yeah, or somebody going through losing their child and you start to think about God.

• 2:01:38Steven Bartlett?

  People pray for, I can't find my keys, I want my football team to win. I go, there's no point. If people praying for an Alzheimer's cure are having no luck, then maybe I should stop praying for Manchester United to win.

• 2:01:48Speaker 01

  Yeah. If you understood the intricacies of how we were actually brought into this world from the point of conception, from the point of conception to the point of neural development, how a baby is formed and how precise everything has to be for you to come out the way you did. It is so beautiful and so miraculous and so rare, even though there are billions of people in this world, that you cannot just turn to biology anymore. You have to turn to something bigger.

• 2:02:30Speaker 01

  And I used to, trust me, even as a, as a Greek, as a Christian who's read the Bible, I, even in my early twenties, when I was getting into medicine and science, I, I was so gung ho about we, we're born in a body, we die in a body. But then when you get so deep into the literature of science and medicine and biology, it's hard to ignore God. And it's hard to ignore that there is a higher power out there. And why is it that there are chapels in hospitals?

• 2:03:07Steven Bartlett?

  Because people want to go to heaven?

• 2:03:09Speaker 01

  Because people want an alternative method of getting through whatever it is that they can get through, something that science and medicine cannot offer. And believing in something that is not there or something that hasn't occurred yet is having faith.

• 2:03:31Speaker 01

  I work in neurosurgery and some of the cases you think this person's not coming out of here alive. And the fact that they do and they preserve their cognitive functions and they look next to normal after they've had a massive tumor resected, which is a true story from here, the tumor was going all along this one woman's face who was 78 years old, who travelled here from France to have the tumor resected. How is it that she's walking and she's cognitively normal and she's not even on any medication the next day? How is that possible? Is it God? Is it just miraculous neurosurgeons? There's just some things that medicine can't answer.

• 2:04:10Steven Bartlett?

  I agree with that. I am, I don't think I'm arrogant enough to say that I know.

• 2:04:17Steven Bartlett?

  And I'm curious. And I think I'll never know.

• 2:04:20Speaker 01

  Yeah.

• 2:04:21Steven Bartlett?

  So I guess that's where we need to have faith.

• 2:04:23Speaker 01

  Yep.

• 2:04:23Steven Bartlett?

  Louise, thank you so much. It's very important that you do the work that you do because it's people like yourself that are so passionate, so obsessed and so good at communicating that help average people who aren't, who don't have access to the wisdom and the research and the studies and information that you have, understand all of these things. And it's through this understanding that we can make better choices and preserve our life, preserve our brains. And if we preserve our brains, we preserve everything that matters.

• 2:04:46Speaker 01

  Correct.

• 2:04:47Steven Bartlett?

  So thank you for doing what you do. And I appreciate your passion and dedication to it because it's very, very important. And I know it comes at a cost. So I feel obliged to tell you that as a normal person who isn't involved in your field, we're grateful.

• 2:04:57Speaker 01

  Thank you so much, Stephen.

• 2:04:59Steven Bartlett?

  Thank you.