121. How to Protect Your Brain at Every Age

How much control do you actually have over how your brain ages? Most people assume memory loss and cognitive decline are inevitable, but the science tells a very different story. In this solo episode, I break down why brain health is something you can actively protect decades before symptoms ever appear. I walk you through the core systems that shape how your brain functions over time, from blood sugar regulation and inflammation to sleep, stress, circulation, and daily movement. We explore how lifestyle signals either strengthen or slowly erode cognitive resilience, and why modern research now allows us to detect risk far earlier than ever before. I also explain the biomarkers I watch, the habits that make the biggest impact, and how small daily choices compound over years. This episode is a practical roadmap for anyone who wants sharper thinking, stronger memory, and long-term cognitive health. Whether you are focused on prevention or performance, these principles apply at any stage of life and give you tools to protect what matters most. What's Discussed: (00:00) Why Brain Aging Is More In Your Control Than You Think (05:45) The Brain's Energy Problem Most People Overlook (12:14) Why Alzheimer's Is Now Called "Type 3 Diabetes" (18:55) How Chronic Inflammation Quietly Damages Cognition (25:38) Blood Pressure, Blood Flow, And Memory Loss (32:40) What Sleep Actually Clears From Your Brain At Night (41:03) Stress, Cortisol, And Shrinking Your Memory Center (53:46) The Hidden Brain Injuries No One Warns You About Thank You for Our Sponsors: Timeline: Go to timeline.com/drshah http://timeline.com/drshah to get 20% off your order. Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd https://www.instagram.com/darshanshahmd/

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

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Hello, everybody. Today is going to be a solo zone. I haven't done one of these in a while, but a lot of people have requested me coming back to the solo zones. So here we go. I'm going to talk today about one of my favorite topics, and probably the next three or four solo zones will be about the same topic. And this topic is your brain. We're going to be talking about brain health. Now, your brain, as you know, sits on top of your neck, and it's only about three pounds, but it runs the entire show of our existence. It's responsible for our memories, our emotions, your personality, your creativity, and just the entire way that you experience life. And what's really exciting right now is there's been a ton of research. Even in the last few years, things have really changed.

• 1:33Dr. Darshan Shah?

  And we really do know that we have a lot more control over how our brain is aging than we ever thought before. And we have new ways to look into our brain, to see what's actually going on, and prevent problems way before they occur. So in this episode, I'm going to walk you through my 10 core pillars of maintaining lifelong brain health. And like I always say, maintaining health and avoiding disease, the side effect of this is feeling incredible and having incredible amounts of ability for cognition, for memory, for sharpness, all of it. So you're going to get both by doing these 10 things. And each of these are grounded in science. So I'm going to talk to you about the research that I'm referencing.

• 2:18Dr. Darshan Shah?

  And that way you can refer back to these research articles if you really want to do a deeper dive. And we're going to link these articles in the show notes as well. So with that, let's get started. And whether you're 25 years old or 75 years old, all of these principles are going to apply. It's never too late almost to start working on your brain. And I think it's never too early either. I see people doing a lot of damaging things early on in life. And this damage piles up over time, just like the rest of our body. Our brain is incredibly resilient before it shows signs of brain damage. And we need to protect it a lot sooner than we are right now. So let's dive right in. So the first thing I want to talk about is your brain's energy.

• 3:01Dr. Darshan Shah?

  Your brain needs a lot of energy. It's an energy hungry organ. And the problem with this is that even though it's only 2% of your body weight, it uses about 20% of your daily energy intake. And the energy it runs on is almost entirely glucose. So it really requires a stable blood sugar level throughout the day. And this allows your brain cells, your neurons to take up the glucose and deliver that glucose to the mitochondria so that the mitochondria can function effectively in making energy. And then this energy is what's used to transmit nerve signals, but also to create neuroplasticity.

• 3:43Dr. Darshan Shah?

  Neuroplasticity is the process your brain uses to connect neurons to each other. So obviously, having a stable blood glucose level is extremely important. But what happens to many of us is that we have too much glucose running around in our bodies. And so just like every other organ in our body, and your fat cells, your liver cells, et cetera, you can become insulin resistant in your brain. In fact, your brain can get diabetes. And a lot of researchers, when they talk about brain health issues, especially Alzheimer's, they call it type 3 diabetes. Now, the key study here, it's called Brain insulin resistance and Alzheimer's disease. It was published in two thousand and eight in the Journal of Diabetes Science and Technology.

• 4:27Dr. Darshan Shah?

  And it showed that Alzheimer's disease behaves just like a metabolic disorder inside the brain. The neurons actually become resistant to insulin, just like regular diabetes, like I said, in any other organ in your body, and they lose the ability to make energy. So this type three diabetes model that they talk about in this study explains why impaired insulin signaling leads to more inflammation, which then causes beta amyloid, you've probably heard of this, is the protein that builds up in your brain when people get Alzheimer's, and causes cognitive decline. So what do you do about this? Well, you get your blood sugar level under control. And how do you do that? Obviously, you want to stop adding sugar to your diet,

• 5:10Dr. Darshan Shah?

  but it really goes a lot more beyond that. Most of the sugar that we take in our diet comes from ultra-processed food, so avoiding ultra-processed food. And if you've been listening to my podcast for any length of time, you know that the continuous glucose monitor is one of my favorite devices to use to give you constant feedback for how stable your blood sugar energy is. And recently, we've done some episodes on GLP-1s. GLP-1s are excellent for your metabolic health. So if you're suffering from diabetes and you need additional support in reducing your hemoglobin A1C, which is the biomarker of diabetes, GLP-1s can definitely help. Okay, let's move on to number two. Inflammation, and specifically neuroinflammation, neuro meaning brain inflammation.

• 5:53Dr. Darshan Shah?

  Inflammation doesn't just occur in your body, it actually does occur in your brain as well. Your brain's immune cells, these are called microglia, try to protect you from inflammation. But when there's constant inflammation around, this is also known as chronic inflammation, then microglia get overwhelmed, and what happens is that they actually start damaging your neurons. There's a major study done here as well, it was done by Cagnan, and it was published in two thousand and one in the Journal of Neurology, and it was called "Microglial Activation in Early Alzheimer's Disease." And what Cagnan did was he did PET scans, which is a special brain scan on people that have Alzheimer's disease.

• 6:36Dr. Darshan Shah?

  And it showed that the microglia are highly activated in people with early Alzheimer's disease. And you see this way before you actually get symptoms of Alzheimer's disease. So this was one of the first real world demonstrations that inflammation comes before cognitive decline. So what causes inflammation in your brain? It's all the same things that cause it in your body. Poor sleep, lots of stress, ultra-processed foods, excess sugar, being sedentary, not moving your body, not exercising, even poor gut health can cause inflammation. So really, the same inflammation that you might be suffering from in your body, you can really protect your brain by doing the same things that you would do for body inflammation.

• 7:21Dr. Darshan Shah?

  So what are some of the things that you can do? Well, the number one thing in my view, again, is avoiding ultra-processed food and taking toxins in your food. Number two is getting to the gym and doing some strength training. Number three is not being sedentary, getting those 8,000 steps in a day. And then number four is looking at your gut, lots of inflammation. In fact, most inflammation, the origin is in our gut. Our gut, remember, also starts in our mouth, so taking care of your oral health is extremely important. The key biomarker here for inflammation is HSCRP, high sensitivity C-reactive protein. This is another blood test that you can do, and you want to get this level as close to zero as possible.

• 8:02Dr. Darshan Shah?

  Anything over one, in my view, is too much, and we need to start looking for where is inflammation coming from and changing our lifestyle. Okay, let's move on to number three. And number three is the health of your blood vessels. The health of your blood vessels are directly related to your brain health. Remember, your brain, just like every other organ in your body, has millions and millions of miles of blood vessels running through them. And there are large blood vessels, which are called your carotid arteries, and they branch down into smaller and smaller blood vessels, all the way into blood vessels that are tinier than a strand of hair. And these distribute nutrients and blood throughout your entire Your brain, there's over 400 miles of blood vessels that deliver oxygen and nutrients to your brain.

• 8:45Dr. Darshan Shah?

  When those vessels get stiff or they get clogged, obviously, there's not blood being delivered to your neurons. And what happens is the neurons can't work properly. They actually lose their ability to create energy. And then they can actually die. You can actually get neuronal degeneration. There's a big study done here. It's called the Sprint Mind Trial. So you might have heard about me talk about the Sprint Trials, which talk about blood pressure. They did a special trial on the brain called the Sprint Mind Trial. This was published in JAMA, one of our biggest journals, in 2019. And the name of the study was Effective Intensive Versus Standard Blood Pressure Control in Dementia.

• 9:26Dr. Darshan Shah?

  And what they found in over 9,000 adults was that if you manage blood pressure really intensely, getting the systolic blood pressure down to 120, systolic is a top number. This very significantly lowered the risk of cognitive impairment. So this is a very powerful finding. This really tells us that the longer that we stay close to 120 over 70 during our lifetime, which means diagnosing high blood pressure as early as possible and aggressively managing your blood pressure can protect your brain for the long term. And we know it can also protect your heart for the long term, your liver, your kidneys, virtually every organ in your body.

• 10:07Dr. Darshan Shah?

  There's another powerful finding in a 2011 study published in PNAS, showing that aerobic exercise increased the size of the hippocampus by about 2% or your memory center. And how does it do that? Well, the way it does that is by improving the health of your blood vessels. So we're getting your blood pressure to normal is key. And also continually improving your blood pressure and your blood vessel health using aerobic exercise is also critical. Let's move on to number four, sleep. Sleep is incredibly important for your brain. And I know we all hear that all the time and we feel it. When we get a poor night of sleep, we don't function as well. What's happening during sleep, well, many things are happening during sleep.

• 10:52Dr. Darshan Shah?

  But the critical element here is understanding that during sleep, your brain is detoxing. There's a detox cycle that happens in your brain. And this was described in a study called the glymphatic system and clearance of amyloid beta that was published in Science Journal 2013. And what they show that during deep sleep, your brain activates the glymphatic system, what I told you about earlier, which is a cleansing system of your brain. They actually took pictures of this that are quite beautiful, showing that these glymphatic vessels fill up at nighttime during deep sleep. And what are they filling with? Well, they're filling up with toxins, toxic proteins like beta amyloid and tau and other toxins that are created by all of the intense activity

• 11:37Dr. Darshan Shah?

  that's occurred during the day in your brain and in your neurons. So this landmark study showed that the brain's waste removal system is 10 times more active during sleep. And this was a real paradigm shift because we finally understood why sleep deprivation leads to increasing beta amyloid levels. So consistently sleeping fewer than six hours a night accelerates your cognitive decline. Sleep is not optional, my friends. It is the brain's maintenance cycle. It is the brain's detox mechanism. And there's so much more happening during sleep. As you know, you're consolidating memories. You are also, dreams need to occur, where creativity develops. There's so much that's critical about sleep and getting a good amount of sleep every night.

• 12:22Dr. Darshan Shah?

  So what's a good amount of sleep? Let me give you another critical biomarker. I really like getting my sleep score. I get my sleep score from different ways because I am a freak about monitoring my sleep. I use an Oura ring. Sometimes I also wear a root band and I have an eight-sleep mattress that also gives me a sleep score. And what I found is, yes, definitely there's differences between the measurements between the sleep scores on these different devices. But I can tell you that trends. Following the number over time, in general, they all correlate and they all do a really good job of telling you how much your sleep is suffering when maybe you've had a late meal, maybe you had a drink late at night, maybe you're stressed and thinking about something

• 13:04Dr. Darshan Shah?

  too much and it's preventing you from falling asleep. All of these indicators, your time in deep sleep, your time in REM sleep, the number of sleep cycles you have, the amount you wake up in the middle of the night, the time it takes you to fall asleep, all of these numbers are combined into a sleep score. So, one of my favorite biomarkers for sleep is sleep score, and I'm very confident that if you get your sleep score from one of these devices and you work on improving it and try to get up to above 80 or 85, and a stretch goal is above 90, and you keep it consistent, meaning that most nights of the month, you have a sleep score in that area, I could almost guarantee you that you will notice a significant effect in your

• 13:49Dr. Darshan Shah?

  cognition, and this will protect your brain from Alzheimer's disease in the future and other neurocognitive diseases.

• 14:00Dr. Darshan Shah?

  So, I'm 52 right now, but I'm still pushing all of my limits. I'm running long distances, I travel across many time zones to support my work, and I just want to live my life to the fullest. Staying active as I age isn't just about willpower, it's about supporting my mitochondria, the powerhouses of my cells, with the energy that they need to recharge my muscles and recharge my brain. Mitopure is a supplement that I take. It's backed by solid research showing that it can boost cellular energy, increase muscle strength, and support overall healthy aging. Personally, I take Mitopure every single day. This helped me continue my active lifestyle, whether it's a high-intensity workout or keeping up with my kids. So, if you are looking to support your body and want to feel younger from the

• 14:45Dr. Darshan Shah?

  inside out, my friends at Timeline are offering you a 10% discount on your first order. Go to timeline.com/drsah to get started. That's timeline.com/drsah. Your future self will thank you.

• 15:05Dr. Darshan Shah?

  Number five is stress and cortisol. So let's talk about chronic stress. So the difference between chronic stress and acute stress, as we all know, is chronic stress is something that's lasting hours, maybe even days or weeks. And chronic stress is more damaging than most people realize. Why? Because when you have mental stress, this turns into the release of cortisol. And when you get high cortisol levels, you actually shrink a structure in your brain called the hippocampus. The hippocampus is a small structure in your brain, but it's one of the key memory and learning centers of your brain. There's a study by Lupien, also in the PNSA journal, published in 1998, called Chronic Stress and Hippocampus Volume.

• 15:50Dr. Darshan Shah?

  And what he found in this study, which is one of the most cited papers on this topic, is that older adults with chronically high cortisol levels had significantly reduced volume of the hippocampus, meaning that the actual amount of hippocampus was shrunken. And when your hippocampus shrinks, it means that your memory also shrinks and your memory performance test goes down significantly. So the good news is, is that even some simple practices can lower your cortisol levels. I'm going to tell you some of my favorite ways to keep your cortisol levels low. Number one is don't allow mental stress to turn into cortisol release. And this usually takes about 30 to 45 minutes before your cortisol

• 16:34Dr. Darshan Shah?

  levels stay really high. And with that information, what you should do is every 30, 45 minutes of doing something stressful, maybe you're writing a bunch of stressful emails, maybe you're on a stressful Zoom meeting, maybe you're just having a stressful conversation with someone, you should remind yourself that how long it's been and you want to take a break. Just get your brain and your physiology away from whatever that stressful situation is before cortisol levels start rising. Some of the ways you can do this is with breathwork, also having a mindful moment, even going outside and having a walk in nature. All of these things can really help your cortisol levels to go down, which improves Your brain health over the long term.

• 17:16Dr. Darshan Shah?

  Stress management is actually really powerful medicine and it's actually very beneficial with neuroscience. And we can actually see this with the volume of your hippocampus, that critical structure in your brain. Now, I have a suspicion that many of you have had the full body MRI done. And some of that full body MRI companies, they can actually give you a hippocampal volume now. And so if this is a test that you're looking at doing, ask them for your hippocampal volume. And they can correlate it with other healthy people of your age. And this can be really beneficial. Pranuvo does full body MRIs, as does Function Health. Another test that you can do is mycognoscopy.com. This is from my friend, Dr. Dale Bredesen.

• 17:59Dr. Darshan Shah?

  And he's created an online 15 minute test that you can do from your own computer. That's actually at no cost, that can tell you how your memory is. And this is one of the metrics that you get from this test. And it can be an indicator to you that maybe you need to do something about maintaining lower stress levels to improve your memory. Finally, let me give you one of my favorite biomarkers of stress. So one of my favorite biomarkers of stress is HRV. This is a time in between heartbeats. And if you have, once again, one of these wearable devices, it's measuring your heartbeats at nighttime. And it was going to give you this interval between your heartbeats.

• 18:39Dr. Darshan Shah?

  And the more variable that time is, actually, the more resistant you are and resilient you are to stress. And so I like to follow HRV as, once again, an indicator of what direction my stress levels are trending. And how interventions such as breath work, meditation, even getting out into nature are improving my HRV numbers over time. Next, we're now at number six. And number six is nutrition, nutrition for cognition. Let's talk about how food directly shapes your brain's chemistry and break down the essentials for you. There are a few elements in our diet that directly affect brain health. And we know this through the research. These are, number one.

• 19:23Dr. Darshan Shah?

  Omega threes. These omega threes make your neuron membranes more fluid, improving communication between brain cells. We know that a lot of your brain is made up of fatty cells and having good omega three levels can help your neurons connect and also help your neurons function better. Number two, polyphenols. Polyphenols are compounds located in plants, and these reduce the oxidative stress and inflammation in your brain. Number three are B vitamins. B vitamins are critical for many cellular functions, even in your brain. It's really important that these B vitamins are activated, meaning that they're methylated.

• 20:05Dr. Darshan Shah?

  The reason I mention this is that many people are unable to activate their B vitamins due to a genetic deficiency called MTHFR. So with these people, we actually have to supplement them with already activated B vitamins. So of course, all of these nutrients are found in food, specifically green leafy vegetables, berries, nuts, olive oil. Getting enough of these in your diet day to day are extraordinarily important to give your neurons and the cells in your brain the precursors they need to function effectively. There's another research study done here that I really like. It's published in Neurology in 2015, and it's called the Mediterranean Diet and Brain Structure. So in this study, Dr. Gu found that people who

• 20:50Dr. Darshan Shah?

  most closely followed a Mediterranean-style diet had a larger brain volume, and this was equivalent to about five years of aging. That's pretty incredible. Food is information, and your brain needs this information every single day. Food is also nutrients. Your brain needs these nutrients every single day to keep the neurons healthy. I talk a lot about the Mediterranean diet because it is really a structure of diet that's been shown to be very helpful, not just for brain health, but also for cardiovascular health. And the structure of this diet is a lot of vegetables every day, many different kinds of vegetables, many different colors of vegetables, and about 500 to 800 grams of vegetables a day. Now, that's kind

• 21:33Dr. Darshan Shah?

  A lot of vegetables, so it's really important to have vegetables almost at every single meal. Secondly, is getting enough protein in your diet from well sourced protein sources such as organic meats, fish, and also from plants that are organic. And thirdly, getting well sourced fats from olive oil, from fatty fish, from nuts, et cetera. Having these three components, you can call the diet whatever you want, Mediterranean diet, Japanese, every culture has some version of this diet. If you stick to this type of dietary pattern is going to be incredibly healthy for your brain and also for your heart and even your gut. So let's talk about some of the biomarkers of nutrition that could be important here.

• 22:14Dr. Darshan Shah?

  One of these is the omega three index. This gives you a level of how much omega three you have. And specifically breaks it down into the inflammatory kind and the anti-inflammatory kind. Another biomarker is vitamin D levels. I like vitamin D levels because most of us are deficient in vitamin D. And it's also a good indicator of your overall sun exposure. Next is vitamin B levels. Vitamin B levels can also be easily measured in your blood. And this can be deficient. And like I told you also, whether it's deficient or not. If you have an MTHFR gene abnormality, you still might need to supplement this. So you get activated vitamin Bs. Number seven is exercise. Exercise is literally miracle bro for your brain.

• 22:57Dr. Darshan Shah?

  Exercise releases a compound in your brain called B D N F, brain derived neurotrophic factor. And this is kind of like a hormone that encourages your neurons to grow and connect and strengthen those connections, which is called neurogenesis and neuroplasticity. There's a study here as well. Exercise Training Increases Hippocampus Volume by Erickson. This was also published in the PNAS Journal in 2011. And a study is worth talking about because it's one of the cleanest demonstrations that we have. That exercise is literally growing your brain tissue. People who perform regular aerobic exercise increase the volume of that hippocampus, the memory center of the brain.

• 23:43Dr. Darshan Shah?

  About 2% in one year where the normal trend is declining as we age. So resistance training is also incredibly helpful. A study from the University of British Columbia showed that improvements in executive function occurred with strength training work. Movement is so necessary for your brain and really aerobic exercise and strength training can both increase BDNF levels and be incredibly healthy for your brain in many other ways that we talked about such as improving the health of your vascular system, which are the blood vessels in your brain. So let me give you two critical biomarkers here. One for aerobic health and aerobic fitness is VO2 max. Many of you have heard me talk about this in the podcast many times in the past.

• 24:27Dr. Darshan Shah?

  And one of the easiest ways to measure your VO2 max is by doing a Cooper's 12 minute run test. Another great biomarker of your strength is your grip strength. And this can be easily measured by about a $15 device called a grip dynamometer that you can order online or get from most exercise stores. And measuring the strength of your grip. If you want to know what the normal values are for VO2 max and grip strength. I have a guide on my website that you can download. You go to drshah.com/fitness and you can download a guide for these critical measurements and how to do them and also what the normal values are. There's a few other measurements in this guide, measurements of mobility, balance, other measurements of lower body strength, et cetera.

• 25:13Dr. Darshan Shah?

  And if you go through this fitness guide, it will really help you in about 15, 20 minutes, get multiple measures of your overall physical fitness. Let's move on to number eight, toxic exposure. So let's talk about toxins in your brain. This is a newer field, I would say, because we are just now realizing through the work of people like Dale Bredesen, how toxin exposure affects your brain health. So there are toxins everywhere, right? We have toxins in our air, our water, our food. But one of the critical toxins that are always talked about in relationship to brain health is alcohol. A key study here was published in the British Medical Journal in 2017. And they looked at the UK biobank. Which is a collection of data on thousands of individuals.

• 25:56Dr. Darshan Shah?

  And they found that there was an association of even moderate intake of alcohol with brain outcomes. And in 25,000 people, they found that people that drank one drink a day had an associated reduced brain volume and changes in the integrity of the white matter of the brain. And this effect was dose-defending. The more you drank, the worse it got. So when it comes to brain health, it's always important to remember there's no safe amount of alcohol. Drinking zero alcohol is really the safest thing for your brain. However, moderation is definitely key. And remember not to chug your alcohol or drink your alcohol too quickly. Give your liver the time it needs to detoxify every drink of alcohol, which takes about two hours to do.

• 26:42Dr. Darshan Shah?

  Let's talk about some of the other toxins that are in the environment that could affect your brain. Toxins in the air via air pollution, and specifically indoor air pollution, can be avoided by opening windows and also utilizing a high-quality air purifier. Toxins in your water, heavy metals, for example, that can be present in your water. And there's other toxins can also be avoided through filtering your water, either through a carbon-based filter or using a reverse osmosis system. And there's a lot of toxins in our food, specifically found in ultra-processed food and food in wrapping. There's microplastics in the wrapping of the food. So, you know, eating as organic as possible and staying away from ultra-processed food can also be extremely important, not just for the nutrient density, but also for avoidance of toxins.

• 27:28Dr. Darshan Shah?

  Next on the list, number nine is social connection. Your brain is a social organ. Healthy relationships create new neural pathways and strengthen something called cognitive reserve, which is your brain's ability to withstand aging and disease without showing symptoms. The neurology paper published by Bennett in 2006 called "Social Networks and Cognitive Function in Old Age" showed that older adults with strong social connections had significantly lower cognitive decline, even if they had markers of Alzheimer's. In their brain. This connection is not just emotional. It actually helps the biology by strengthening your neurons, strengthening the connection to your brain

• 28:11Dr. Darshan Shah?

  and preventing you from developing neurocognitive disease over time. Loneliness literally changes the brain structure and increases your dementia risk. So here's where I want to give you a couple of newer biomarkers that you should look into. These are available now, but many doctors don't know about them. And these are biomarkers of amyloid and tau in your brain. These are the proteins that accumulate in your brain when you're developing Alzheimer's disease. And I think these are incredibly transformative biomarkers because finally, for the first time, we have blood tests that can point to us that we're headed in the wrong direction when it comes to Alzheimer's disease. The two biomarkers that I'm utilizing right now in my practice are amyloid ratio

• 28:55Dr. Darshan Shah?

  and P tau 217. And I'm going to describe these more in depth in another solo song. But these are blood tests that actually have a numerical value. So we can track how bad they are, how close you are to developing cognitive impairment. But more importantly, we can track how are the interventions working that we're doing? Things like exercise, changing your diet, toxic exposure avoidance. How are they actually decreasing these biomarkers over time? I think this are going to be game changers in the treatment of Alzheimer's disease, but also more importantly, in the avoidance of Alzheimer's disease. Many of you have heard of the APOE gene test. This gene test, many of my patients avoid it because they just don't want to know where the results are.

• 29:37Dr. Darshan Shah?

  Why? Because the results show you if you have an increased risk of Alzheimer's disease. But now, since we have these new blood-based biomarkers of inflammation in the brain and amyloid and tau protein accumulation, we can finally know with clarity how close we are to developing these diseases. And why is that important? Well, even if you have an APOE gene that puts you at increased risk, you can avoid Alzheimer's disease. We know this to be true. And there's nothing more important than avoiding Alzheimer's, in my opinion, for your overall health span. Why? Because once you start developing- Cognitive impairment, everything else starts to fail. And health span, I would argue, is very directly related to the health of your brain.

• 30:22Dr. Darshan Shah?

  So finally, with these new biomarkers, we can measure and we can tell, maybe even decades ahead of time, whether or not you're developing Alzheimer's disease and other neurocognitive diseases. Finally, we're finally at number 10, protecting your brain, and specifically protecting your brain from injury. This is an area that almost everyone overlooks when talking about longevity. Traumatic injury of the brain is a real thing. Concussions are what get all the attention, right? So you have people that are playing football that have massive amount of concussions. And these people, we've noticed over time, have significant amounts of Alzheimer's disease, but also psychiatric symptoms. And sadly, many of these young football players,

• 31:07Dr. Darshan Shah?

  they pass away from self-inflicted injuries after suffering from these psychological symptoms at a very young age. And we know this is a huge problem. Trauma in football, in soccer, in rugby, and other sports, where kids and adults are exposed to repeated concussive injuries of the brain. However, it's much more than just concussions that can cause this repetitive brain trauma. Subconcussive hits, these are small repetitive blows to the brain that don't actually cause symptoms, are far more damaging over time than even concussions are. There's a study done by Dr. Mez in the Annals of Neurology, published in 2019

• 31:50Dr. Darshan Shah?

  from the Boston University CTE Center. And what they did was analyze hundreds of athletes and found that the lifetime exposure to repetitive head injuries was the strongest predictor of CTE pathology, not the number of actual concussions that were diagnosed. This means that the number of hits that you actually don't notice, that don't cause symptoms, may matter more over times than the ones you do. So how do you protect your brain? Number one, avoid repetitive impact from sports, especially during childhood, but even after childhood. Number two, treat any concussion that you get with complete rest and recovery. That means you stop playing the game immediately and get off the field.

• 32:33Dr. Darshan Shah?

  You go and get evaluated and you protect your brain for days and weeks to come. Number three, prioritize the strength of your neck. Your neck is actually what protects you against the acceleration forces that happen with head injuries. Next is wear proper protective equipment in any type of risky situation or activity. Next, consider baseline and follow-up cognitive testing, especially if you're in a sport that does cause injuries to your head. Next, reduce alcohol intake and do anti-inflammatory support during the recovery from any type of head injury. And finally, avoid drills where you are using your head. So if you're practicing soccer, for example, don't use head blows during the practice sessions.

• 33:19Dr. Darshan Shah?

  Sparring in boxing or karate, same thing. And also even considering reduction of head injury by micro traumas during higher risk copies like car racing. Or even for you roller coaster enthusiasts out there. As we age, our brain cannot tolerate repeat trauma from mechanical injuries. Even the really small ones that we don't notice. Our brain is not like muscle. It doesn't repair the same way muscle does. You probably know your brain neurons, once they've been torn or injured, they can't actually repair themselves and you've lost them for good. Protecting your brain from these injuries not only protect you from neurocognitive disease, but it can also protect you from psychological symptoms. And there you have it. We went through the top 10 ways that you can protect your brain.

• 34:04Dr. Darshan Shah?

  Your brain is an absolutely astonishing organ. It has about 86 billion neurons. Each of these are capable of forming thousands of connections. Currently, there is no supercomputer on earth that can match the complexity of our brain. This incredible organ is incredibly fragile and it's shaped every single day by the choices that you make. In your nutrition, your sleep, your level of stress exposure, even your relationships. All of these are signals that your Brain is responding to, and the response of these signals either build a resilient, long-lasting brain, or they can cause degeneration of your brain. So these 10 pillars that we cover today, they're not just health tips.

• 34:45Dr. Darshan Shah?

  These are incredibly important foundations of how you protect your identity, your memories, and your ability to live a long and fulfilling life. If you take care of your brain, it's going to take care of you for decades and decades to come. If you loved this episode and you want a brain health blueprint guide, please go to my social media site for the Extend podcast. And once you're there, comment on the social media post for this episode on Instagram, and I will send you the brain health blueprint in your email. Thanks again for joining me today on Extend. I really hope you liked this solo show. I'll be doing a few more on your brain health. Look forward to seeing you again soon.

• 35:26Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best, and it's always important to seek their guidance.