Episode 583: Dr. David Perlmutter: Brain Health Expert: The Daily Habits That Protect Your Brain as You Age

What if the health of your brain decades from now is being shaped by what you are doing today? We tend to think about Alzheimer's and cognitive decline as problems that show up later in life, once memory starts slipping or confusion becomes noticeable. But many of the factors associated with brain decline can begin much earlier. Blood sugar, insulin resistance, sleep, inflammation, muscle mass, exercise, social connection, oral health, and even the medications you regularly take may all influence the environment your brain is aging in. This matters because brain health gives you more areas to act on than most people realize. You can pay attention to metabolic markers before they become major problems, build and preserve muscle, protect your sleep, stay socially connected, take care of your oral microbiome, and understand which emerging therapies actually have evidence behind them. The earlier you start thinking about your brain this way, the more opportunity you have to influence how well it functions later. Dr. David Perlmutter is a board-certified neurologist, six-time New York Times bestselling author, and internationally recognized expert in brain health, nutrition, and neurodegenerative disease. His latest book, Brain Defenders, explores microglia, the brain's immune cells, and how their function may influence conditions including Alzheimer's and Parkinson's. His work focuses on giving people practical ways to protect brain health through metabolism, lifestyle, and emerging neuroscience. What's Discussed: (05:51) What research suggests about slowing or even improving cognitive decline in people already diagnosed with Alzheimer's through intensive lifestyle intervention. (10:47) Why Alzheimer's should not be viewed as purely genetic and how lifestyle and metabolic health can influence risk even when genetic predispositions are present. (12:19) How loneliness and social isolation may affect brain health through stress, cortisol, oxytocin, inflammation, and changes in the brain's immune cells. (20:50) Why the biological conditions associated with cognitive decline may begin in your 40s and 50s, decades before memory problems become obvious. (30:34) How exercise supports the brain through BDNF, irisin, and other chemicals released during muscle activity, and why both cardio and strength training matter. (38:00) Why restorative sleep is an active period for memory consolidation and brain recovery, and how fragmented sleep can undermine brain health even when you spend eight hours in bed. (1:04:34) What the science currently says about NAD, NR, NMN, and IV NAD for mitochondrial function, biological aging, and cognitive health. (1:12:04) How periodontal disease, the oral microbiome, and frequent use of certain antibacterial mouthwashes may affect nitric oxide, metabolism, and long-term brain health. (1:23:05) What emerging research says about GLP-1 drugs for Parkinson's and Alzheimer's, and why using or microdosing them specifically for brain protection is still ahead of the evidence. (1:33:25) Why homocysteine and fasting insulin are two blood markers worth paying attention to when assessing metabolic and long-term brain health. Thank You to Our Sponsors! Magic Mind: Head over to magicmind.com/jen http://www.magicmind.com/jen and use code JEN at checkout. Momentous: Ready to try supplements that actually do what they claim? Head to livemomentous.com http://livemomentous.com and use code JEN for 35% off your first subscription. Therasage: Visit therasage.com http://therasage.com and use code JEN to get 15% off your order. Your skin Prolon: Prolon is offering listeners 30% off sitewide plus a $40 bonus gift when you subscribe to their 5-Day Program! Just visit prolonlife.com/JENNIFERCOHEN https://prolonlife.com/JENNIFERCOHEN and use code JENNIFERCOHEN to claim your discount and your bonus gift. Tru Niagen®: For supplements that are rigorously tested, third-party verified, and actually deliver what's on the label, head to truniagen.com http://truniagen.com Find more from Jen Cohen: Website: jennifercohen.com https://jennifercohen.com Instagram: @therealjencohen http://instagram.com/therealjencohen Books: jennifercohen.com/books https://jennifercohen.com/books Speaking: jennifercohen.com/speaking-engagements https://jennifercohen.com/speaking-engagements Find more from Dr. David Perlmutter: Website: drperlmutter.com http://drperlmutter.com Instagram: @davidperlmutter https://www.instagram.com/davidperlmutter/ Facebook: David Perlmutter M. D. https://www.facebook.com/DavidPerlmutterMd/ YouTube: @davidperlmutterMD https://www.youtube.com/user/DavidPerlmutterMD LinkedIn: David Perlmutte, MD https://www.linkedin.com/in/david-perlmutter-md/ Book: Brain Defenders https://drperlmutter.com/books/brain-defenders/

• 0:01Speaker 00

  Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it.

• 0:06Speaker 01

  Welcome to Habits and Hustle, where I sit down with the world's biggest thinkers, entrepreneurs, top experts to uncover the habits, strategies, and mindset shifts that actually move the needle on your health, happiness, and success. And today, I'm sitting down with Dr. David Perlmutter, a board-certified neurologist, bestselling author, and leading voice in the brain health and neurodegenerative disease. We discuss why protecting your brain starts decades before symptoms appear, how inflammation and metabolic health impact brain function, and what you can do now to reduce your risk of cognitive decline. We also cover loneliness, sleep, strength training, oral health,

• 0:49Speaker 01

  fasting, and insulin. Oh my God, the list goes on. This conversation is packed with practical ways to take more ownership of your brain health instead of waiting until something goes wrong. David breaks down that everyday habits, health markers, and lifestyle choices that actually influence how your brain ages, plus some of the emerging science that can completely change the way we think about Alzheimer's and other neurodegenerative diseases. So now, let's dive in.

• 1:25Speaker 01

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• 2:10Speaker 01

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• 2:52Speaker 01

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• 3:03Speaker 01

  You guys, we have a special podcast today. You know, I'm on this really big bandwagon of doing everything for our brain health, cognitive health, all the things. And we have a doctor named Dr. David Perlmutter, who I still can't believe I've never met before. This is absurd, considering I've been doing this for many years. You've been doing this for even more years, and we just never, our paths never crossed.

• 3:27Speaker 00

  Well, the circle is complete now, isn't it?

• 3:29Speaker 01

  Yes, it totally is. The loop is now finally closed. Doctor, what do you want me to call you? David?

• 3:35Speaker 00

  David Works.

• 3:36Speaker 01

  David or Dr. Perlmutter?

• 3:37Speaker 00

  I, you know, you see Dr. Perlmutter, I keep looking for my dad.

• 3:41Speaker 01

  So I'll call you David, but yes, but I know, right? You still probably still look for your dad. I know, I don't like when my, when my, when my kids' friends call me Miss blah, blah, blah. I feel like a very old person. I don't like it. I like them to call me Jennifer. So David, or Dr. Perlmutter, has written his 16th book, and this one is called Brain Defenders. You may have read his book Grain Brain. There's so many, there's so many books. But we're going to talk all about the new book. And like I said, it's called Brain Defenders. I can never seem to see the harness the power of your immune cells to protect your brain for life. So, thank you for being here.

• 4:21Speaker 00

  Well, thank you for having me, and the subtitle really tells it all. It tells the story of the power of the brain's unique immune cells, called microglial cells, to really determine your brain's destiny, whether you're going to be along for the ride with your brain or the brain's not going to be there to participate in the rest of your life. So, we fear things like Alzheimer's and Parkinson's and all of these issues that, you know, we run the risk of. But it turns out that we absolutely have a big say in determining whether that's in our future or not. And it all has to do with what's going on with the brain's immune cells, over which you have control. That's what we'll talk about today.

• 5:03Speaker 01

  Yes, I mean, this is, you know, I was really eager to have you on the podcast for personal reasons. My mother was diagnosed with Alzheimer's. I just came back from Montreal to see her. And she's now past the point of mild, I would imagine, in the mid-area of Alzheimer's. And, you know, we talk a lot about preventative things. What I would love to hear from you is, like, where is, where is the science, or is there any evidence that you can reverse signs of Alzheimer's, dementia, if you're already past a certain point?

• 5:40Speaker 00

  The answer is yes. How about that? Now, we've never been told that, have we? Here in America, there have been FDA-approved drugs to treat Alzheimer's disease that, according to a recent Cochrane analysis, have abjectly failed. They do not have any meaningful effect on the time course of the decline in the Alzheimer's patient and are associated with a significant risk of side effects in at least a quarter of patients, either hemorrhage in the brain, swelling, or even death. And these are drugs that are FDA-approved. It's the best that pharmacy can offer us. And yet, when we look at research, for example, there's a study that came out last year by Dr. Rudolph Tanzi at Harvard, along with Dr. Dean Ornish.

• 6:25Speaker 00

  They took a group of patients who were diagnosed with Alzheimer's already, not at risk because they had diabetes or obesity or something. These patients were already diagnosed. 51 patients, 20-week study. What did they do? They changed their diets, they changed their level of activity, and they reduced their stress. And these individuals, it didn't slow down their progression. In 70% of them, it stopped their progression or led to improvement in their cognitive function. There's never been any drug that could do that. And the side effects were in these individuals, that their blood sugars improved, their body weight improved, and they overall felt better. And think about that. And you're looking at me right now with a look on your face like,

• 7:09Speaker 00

  I haven't heard of that. And you should have heard of that, and you haven't.

• 7:12Speaker 01

  What is it called?

• 7:14Speaker 00

  It's Lifestyle Intervention.

• 7:15Speaker 01

  But this is the thing. I'm looking at you like that.

• 7:18Speaker 00

  Published in a peer-reviewed journal, and I wish you had heard of it. And I'm not blaming you for not hearing about it, but I'm blaming the emphasis in our modern Western world to really offload the agency of our brain's destiny to a hope that a drug is developed. It's, I hate to say it's wrong. I sound so aggressive when I do that.

• 7:38Speaker 01

  No, be aggressive.

• 7:39Speaker 00

  But my dad died of Alzheimer's. And had there been a drug, would I have been, written the prescription for him? You bet I would have. I mean, his nursing home was, I could see his window from my examining rooms in my office. That's how close my situation was with his progressive downhill decline every single day. And so, having said that, would I use a drug? I absolutely would have.

• 8:04Speaker 01

  What was the drug called, though, again?

• 8:05Speaker 00

  Well, there was no, there is no drug. There is, was no drug. The drugs I've talked about right now.

• 8:10Speaker 01

  It's lifestyle.

• 8:11Speaker 00

  Well, yeah. The drug is lifestyle.

• 8:13Speaker 01

  Yeah, the drug is lifestyle right now.

• 8:14Speaker 00

  And you cannot patent that. It's not a billion-dollar blockbuster.

• 8:17Speaker 01

  You cannot patent that. This is, but I know, but with your dad, though, you said that there was no, there was no pretend, there was no, no drug or at that point.

• 8:25Speaker 00

  Right, nor is there now.

• 8:26Speaker 01

  Right. There are these random drugs, but they have bad side effects. My mother was on one for a little bit. They took her off of it. It wasn't doing anything.

• 8:34Speaker 00

  Well, here's the news. If they would do something, I would have a different conversation with you, Jen, right this minute. But here's what a recent Cochrane analysis revealed. This is the most highly-regarded gold standard way of answering a medical question. Here is the two-part question. Part one, does it work? Part two, is it threatening? Is there side effects?

• 8:55Speaker 01

  Right.

• 8:55Speaker 00

  Are there? And here's what the Cochrane analysis of 20,342 individuals in 17 studies, 18 months each study, revealed, just published. Number one, the threat of using these drugs is about 25% of people will have brain hemorrhages, brain swelling, or possibly even die.

• 9:18Speaker 00

  What about the benefit? The word they used was trivial. So the drugs don't work and they're really risky. And that's very likely what they put your relative on. And why they stopped it because likely she was beginning to have side effects. And so, you know, it's not that your guest is really, as we talked about earlier, iconic classic. You had a different word for it.

• 9:38Speaker 01

  Irreverent.

• 9:39Speaker 00

  What?

• 9:40Speaker 01

  Irreverent.

• 9:40Speaker 00

  Yeah. And I am, I guess. And I'm irreverent because I see, you know, my, my mission is above all do no harm. And that's doing harm. And I will speak out about, I talk about it in the book.

• 9:52Speaker 01

  Yeah.

• 9:52Speaker 00

  And that was before this Cochrane analysis that just came out to be supportive of what I'm contending in this book. And I'm certainly not anti-drug. We talk about the potential of GLP-1 Ozempic-like drugs to treat Alzheimer's.

• 10:06Speaker 01

  I was gonna ask you about that.

• 10:07Speaker 00

  Yeah.

• 10:08Speaker 01

  For inflammation?

• 10:09Speaker 00

  Open for that? You bet. Inflammation and metabolism. That story hasn't been fully written yet. And we're waiting for it. We can double click on that at some point and really go do a deep dive.

• 10:19Speaker 01

  I want to ask you about that now because they're saying even for people, there's a couple of things. So you did, you do talk about the fact in the book, in this book, and you've said it many times, that Alzheimer's is not genetic, right? There's like-

• 10:31Speaker 00

  By and large, it is not genetic. Are there some genetic predispositions that an individual can have to increase her or his risk? Yes, there are. We know that carrying, for example, a, a variation in a gene called APOE-4 is associated with increased risk. Either if you have one of those alleles, five times risk, or two of the alleles, in other words, APOE-44, that your risk may be 10 to 12 times increased compared to others who don't carry it. There are other genes, there are about 60 different genes that play a role. But by and large, important message here, here's the soundbite. Alzheimer's should not be considered a genetic disease.

• 11:13Speaker 00

  It's a disease related to lifestyle choices that is very empowering because we can make better choices and reduce our risk. Genes load the gun, lifestyle pulls the trigger.

• 11:25Speaker 01

  So just to keep on this for one second, and we won't, we won't need to drone on and on about my mom, okay? But this is why, why I thought this was a very pertinent thing to talk about. Because you don't know my, you never knew my, you don't know her. But so she's also in the medical field. Interestingly enough, she did everything, everything right. Her blood sugar was completely intact. She worked out every day. She likes physically, even to this day, she's not on any medication except vitamin D. Physically, top notch. But her brain still declined. Now, she did, this happened because in my, when COVID started, she was extremely isolated and extremely lonely because she was very, had a lot of anxiety around going to see people.

• 12:08Speaker 01

  Is, to me, what that tells me is loneliness, isolation is probably predominantly more imperative or more of a, of a trigger than let's say even exercise or nutrition. What'd you say to that?

• 12:27Speaker 00

  I think it's incredibly underrated. And when we talk about the dramatic increased risk of Alzheimer's as a consequence of COVID, you know, a lot of the discussion, at least in the medical science field, is what does the virus do? Does the virus increase inflammation? Yes, we know that the virus affect mitochondrial function in brain cells and in brain immune cells, the microglia, the subject of this book. Absolutely it does. But you bring up an incredibly fundamental point, that for a period of time, it may have been more than a year, your mother had a higher level of stress, as many of us did.

• 13:02Speaker 01

  Two years, yeah.

• 13:03Speaker 00

  And isolation. And isolation is a huge event, especially as it continues, as it relates to brain health. Why? The downside of isolation is increased stress and therefore increased cortisol, threatening to the brain's memories under the hippocampus, threatens the microbiome, the gut bacteria, and therefore increases inflammation that can shift the brain's immune cells away from being supportive to being destructive. The other thing, though, is when we are isolated, we're not experiencing love as much. We're not in contact with individuals that we share love with. And why could that be relevant in a, what we're having, I consider a scientific conversation? And I wondered about that for a long time.

• 13:46Speaker 00

  When we looked at, for example, the blue zones, people have a lot of social connectivity, a lot of involvement in their communities, and have a dramatic risk reduction for Alzheimer's, heart disease, various forms of cancers and other degenerative issues. But why? Why Alzheimer's? What's the connection between connection and reduced risk?

• 14:05Speaker 01

  Yeah.

• 14:06Speaker 00

  And many things were at play. Cortisol lower, we know that. But here's something I found really fascinating. The book focuses on the shift of the brain's immune cells from being normally, wonderfully supportive to help the brain remain resistant to decline, shifting to a situation where our brain immune cells basically turn their backs on us. They become what I call in the book, the evil twin. A powerful way of keeping them supportive and loving and nurturing is to stimulate these cells called the M2 supportive immune cells. And one of the powerful stimulants to keep them in their supportive mode is a chemical called oxytocin, a hormone called oxytocin, the love hormone, that increases when we

• 14:51Speaker 00

  have relationships with people. Your mom's isolation, for whatever length of time that was, reduced her oxytocin, oxytocin, and at the same time increased her cortisol. And the, the brain has, you know, significant experience with that. It bodes for a brain to be less able to resist decline. Now, you told me your mother's blood sugar was intact, that she exercised quite frequently, did all of the things. What brain defenders does is through the lens of the brain's immune cells, looks at those things and so many others that influence whether those brain cells are going to be supportive or they will turn their backs on us and pave the way for the brain to decline.

• 15:35Speaker 01

  Because you keep, what you mentioned a lot in the book, what you, what was it called again? The immune cell, micro-

• 15:40Speaker 00

  Microglia.

• 15:41Speaker 01

  Microglia. I've never heard that before.

• 15:44Speaker 00

  And you are going to hear about it left, right and center moving forward.

• 15:47Speaker 01

  See, that's, because you also, in another book, you talked about, uric acid was the other one.

• 15:52Speaker 00

  Uric acid.

• 15:53Speaker 01

  Uric acid. As, I mean, so these are like, these are things that are not very usual, right? You hear about X strength training, you hear about loneliness, you hear about, you know, even now, I know you wrote the book Grain Brain, but like, you know, no process, ultra-processed food. But these are, those are the two things that really kind of stood out to me. Can you talk a little bit about what an immune, what immune cells are?

• 16:17Speaker 00

  You are Canadian. Can I talk about?

• 16:20Speaker 01

  Yeah, about.

• 16:21Speaker 00

  You got me on the about. There you go.

• 16:23Speaker 01

  Yeah.

• 16:23Speaker 00

  Yeah, sure, I can do that.

• 16:24Speaker 01

  Yes, his wife's Canadian, so.

• 16:26Speaker 00

  And I have my, okay.

• 16:27Speaker 01

  And you're Canadian, yes.

• 16:29Speaker 00

  Resident. So it's a new paradigm in neuroscience and it's exciting because-

• 16:34Speaker 01

  How'd you even get to it? Like, how did, like, after all these years of writing about it, like, all of a sudden?

• 16:38Speaker 00

  I didn't write about it for all these years.

• 16:39Speaker 01

  No, no, I'm saying you've been writing about all of this neurology stuff for, for years and years, and now all of a sudden we hear about it?

• 16:45Speaker 00

  And what is so exciting, Jennifer, is that everything I've written about, whether it's the relationship of the gut to the brain and the microbiome, Grain Brain talking about gluten and talking about high refined carbohydrate diets, uric acid and drop acid, how that threatens our metabolism, everything converges on the brain's immune cells. Finally, everything I've studied and written about and lectured about for 40 years has converged on the brain's immune cells. That's the upstream event in everything I've been interested in.

• 17:17Speaker 01

  But what took so long? What took 40 years?

• 17:19Speaker 00

  I think we didn't recognize that the immune cells in the brain, the microglia cells, through such a wide net and were upstream of all of these mechanisms. And it's just come to light, really, mostly in the past five years. I've been talking about the microglia for decades, but we didn't really understand how they could change from being supportive to being destructive.

• 17:39Speaker 01

  Right. So let's talk about that. So what, so explain what, what, what the microglia is and how it can go from being supportive to being destructive.

• 17:48Speaker 00

  And that's the take home message of our time together today because we can control it.

• 17:53Speaker 01

  Yes.

• 17:53Speaker 00

  Understand first that this is the upstream mechanism that underpins Alzheimer's and Parkinson's and MS and issues related to long COVID, PTSD, even major depression. All of these issues are fundamentally related to the change in the microglia cells from nurturing our synapses, nurturing our neurons and blood brain barrier, to suddenly shifting and becoming the evil twin, destroying the synapses, actually gobbling up the connection of one brain cell to the next, setting up an environment in the brain that leads to the neurons falling apart and leading the blood brain barrier, which we depend upon

• 18:34Speaker 00

  to keep the, the brain, you know, excluded from certain things, leads to that breakdown, just like the gut barrier. We have a very important barrier in the brain that needs to be maintained. So many things can threaten to cause these cells to turn their backs on us. Elevated blood sugar, changes in our proteins because they bind to blood sugar, like hemoglobin A1C. Increased inflammation anywhere in the body makes its way to the brain and sends a signal to these cells to shift and become destructive. Think about that. Where can that inflammation come from? A leaky gut. So your diet, whether it's supportive of your microbiome or not, through this mechanism of a leaky gut can increase inflammation,

• 19:19Speaker 00

  tells these microglial cells, we're going to destroy your brain just because the gut changed, because you took antacids or overused antibiotics or other types of drugs, non-steroid anti-inflammatory drugs like ibuprofen.

• 19:34Speaker 01

  Okay, so let's start with, okay, so let's start with the idea of this. So is there a test or a way that people can even know where they, how healthy their microglial, I can never pronounce it, microglia cells are like, is there, is there like some type of blood test for us to know where, where we are in terms of health?

• 19:53Speaker 00

  Absolutely. One thing you can do is look at your calendar, ask yourself how old you are.

• 19:59Speaker 01

  Twenty-nine?

• 20:00Speaker 00

  There you go, because microglia shift more aggressively the older we get.

• 20:05Speaker 01

  Okay.

• 20:06Speaker 00

  So that's a very powerful metric. The next thing you could do is-

• 20:08Speaker 01

  What, what age do we start shifting it?

• 20:10Speaker 00

  It happens earlier than you think. It happens around 50.

• 20:14Speaker 01

  Okay.

• 20:14Speaker 00

  Aggressively, but you know, it happens in our 40s as well.

• 20:17Speaker 01

  Okay.

• 20:18Speaker 00

  It brings me to a very interesting point, and that is the paradigm under which we live right now related to brain degeneration is one that would say, wait until you become cognitively impaired, think about your mother's experience and your experience with your mother. Nobody paid any attention to her brain till suddenly she started complaining about things and went to the doctor and say, hey.

• 20:41Speaker 01

  No, that was just because she got very confused, but yes.

• 20:44Speaker 00

  Confusion.

• 20:45Speaker 01

  Until someone else recognized it. It was so bad.

• 20:47Speaker 00

  Very, very typical.

• 20:48Speaker 01

  Yeah.

• 20:49Speaker 00

  But why do we wait until then? How old, may I ask how old your mother is?

• 20:52Speaker 01

  Well, now she's 83.

• 20:53Speaker 00

  But when did those issues begin?

• 20:55Speaker 01

  It started, honestly, like only a year and a half ago, two years ago.

• 20:58Speaker 00

  Eighty-one or eighty.

• 21:00Speaker 01

  Yeah. Is that normal? Is that a normal age for this?

• 21:02Speaker 00

  My point is, those issues began in her 40s and 50s. That's when the seeds are sown. So your audience needs to hear this, that the metabolic issues that will threaten your brain and presage the cognitive issues begin decades ahead of time.

• 21:20Speaker 01

  See, I did, I did hear you talk about that, that they, they, that's been out there. But then what are the signs? Like, because you know when people, we all kind of joke around like, oh, you know, like I'm in menopause, I'm in perimenopause, or I have got like, you know, like I've got, people think that when they're forgetful or confused, or just kind of just mindless, it's like their situation or circumstance. It's not necessarily that. So how do you, how do you distinguish between if it's like decline of your cognitive functions or just circumstance?

• 21:55Speaker 00

  Yeah, let's get back to, I think, the original question. Where do we get the sense that we're already setting the stage for brain decline? Your blood sugar starts to elevate, your fasting insulin level goes up.

• 22:06Speaker 01

  Okay.

• 22:06Speaker 00

  You're working too much that you can't get exercise. You have fragmented sleep. You're looking at your Apple Watch or your Oura ring and you're seeing that you're not getting enough deep sleep. You are isolated. You're not spending time in nature. Your waist to hip ratio is increasing by a very sophisticated piece of machinery called a measuring tape. I mean, these are powerful indicators that your microglial cells are shifting.

• 22:31Speaker 01

  You know, I'm noticing, you're not wearing an Apple Watch, an Oura ring, a whoop, none of it.

• 22:36Speaker 00

  You're right.

• 22:37Speaker 01

  And is that, is that by design?

• 22:39Speaker 00

  No, because I do.

• 22:41Speaker 01

  Oh, you do?

• 22:42Speaker 00

  And I do wear a continuous glucose monitor.

• 22:43Speaker 01

  You do? But you're wearing a suit, so I can't see that part.

• 22:46Speaker 00

  Oh, I'm not wearing it right now.

• 22:47Speaker 01

  Okay.

• 22:47Speaker 00

  But I do these things not all the time. You know, there's been some commentary that, well, can we get a little neurotic about it? And I find it's a little bit stressful for me, but I do want to know. So I wear my, I use an Oura ring. I do it, you know, for several weeks at a time, every month or two. Same thing with CGMs. I have, you know, boxes of them at home. I work with levels health, so I get as many as I want. But here's the point. I mean, this continuous glucose monitor is powerfully informative for you, Jennifer, as an individual. What is your blood sugar doing in relation to the foods that you choose to eat and your relationship to your level of exercise, quality of sleep, relationships, time in nature, et cetera?

• 23:30Speaker 00

  You wouldn't know that if you don't measure, so you've got to measure. And you can buy a CGM at Costco without a prescription. How wonderful is that? You know, it wasn't that long ago that there was an editorial in Journal of the American Medical Association saying, oh, there's a trend that people who are non-diabetic are wanting to get CGMs to learn about their blood sugar. And the comment was in the editorial, we shouldn't allow that because people are going to become neurotic about their blood sugar. With that logic, we shouldn't allow people to buy bathroom scales because they'll be, they'll wonder what their body weight is. No, we should have the option of knowing these metrics.

• 24:10Speaker 01

  Right. And taking the ownership in our own hands, right? And having an informed, like having informed information.

• 24:15Speaker 00

  That's my mission in life.

• 24:17Speaker 01

  Yeah.

• 24:17Speaker 00

  Is giving people stewardship over their brain's destiny. Right now in America, we offload that stewardship to pharmaceutical companies with the hope that we can live our lives however we want and there'll be a magic drug to fix the problem. That situation is nonexistent right now. I mentioned before, would I be supportive? You, you bet I would be.

• 24:39Speaker 01

  Yeah.

• 24:40Speaker 00

  That's my job and I will put that drug in my toolbox, but we don't have it yet.

• 24:45Speaker 01

  So, okay, so let's just stay on this for the, because you're like, but that's a very, very good point. Like you're, if someone is concerned about a lot of these, you know, diseases that can happen in the 70s, 80s, it starts 40, 30 years before that. And when you're confused between if it's just like circumstance, like menopause, whatever, perimenopause, children, stress, work, whatever it is that you're at, and/or if it's something larger, some of the metrics are to check your blood, blood sugar levels. What was other ones to check your hip, your hip?

• 25:19Speaker 00

  Waist to hip ratio, your fasting insulin level, your A1C. And I think beginning at age 50, a little bit more sophisticated testing. One called PTOW 217, very predictive of Alzheimer's. And I didn't know that when I submitted the manuscript for this book just several months ago, because that study came out three weeks ago in the Journal of the American Medical Association, saying that this PTOW 217 that we used previously as a diagnostic for somebody who's having cognitive decline to determine, is it Alzheimer's? Is now demonstrated to be predictive in terms of who's going to get it. So that would be a great test to have. I just had mine done.

• 26:01Speaker 01

  Where did you, where do people get that test?

• 26:02Speaker 00

  Any lab could do it and you don't need a prescription. Walk into a quest and say, I want a PTOW 217. They'll sit you down in the chair and they'll draw it.

• 26:10Speaker 01

  Really?

• 26:11Speaker 00

  You bet.

• 26:11Speaker 01

  I think this is also, you know, Dr. Dale Bredesen, is that?

• 26:14Speaker 00

  Bredesen.

• 26:15Speaker 01

  Bredesen.

• 26:16Speaker 00

  Very, very well.

• 26:16Speaker 01

  Right, okay. He was on here a while ago. I think he mentioned that test, actually. Or a form, is there another version or a form of that?

• 26:24Speaker 00

  No, PTOW 217.

• 26:25Speaker 01

  That's the one?

• 26:26Speaker 00

  There are others that he talks about, GFAP, neurofilament light. Those are ones that he's very fond of, but he's correct. And the other thing that Dr. Bredesen talks about is he believes that once we reach a certain age, like 60 or 65, that we should have annual evaluations of our cognitive function. He calls it a cognoscopy, like a colonoscopy.

• 26:47Speaker 01

  Yeah, I love that.

• 26:47Speaker 00

  He calls it a cognoscopy.

• 26:48Speaker 01

  How would we do that?

• 26:50Speaker 00

  You can do them online now. In fact, he has web-based tools that allow you. We talk about him in the book. In fact, I feature him in the book as some of his case reports. And, you know, I so honor his work. And he is, you know, he takes a lot of criticism and wrongly, I believe, because he is a trailblazer. One of his recent books I wrote, The Forward To, and I talked about him in terms of a Nobel Prize because not only the work that he's doing, but the idea that he challenged the idea of modern science looking at one variable to test something, like a drug or a single intervention. As you know, his approach to dealing with Alzheimer's

• 27:32Speaker 00

  brings in multiple inroads, diet, nutrition, exercise, identification of toxins, for example, and even heavy metals, all the things he talks about. And that is absolutely breaking the mold. And I'm grateful that he's done that because now we see new studies coming out where people are doing multiple things at one time and seeing great results and reversing Alzheimer's disease. Yes, it is happening right now without drugs.

• 28:02Speaker 01

  I mean, how old are you?

• 28:03Speaker 00

  Seventy. Seventy one.

• 28:04Speaker 01

  Seventy one. And you're, and you're, you're like sharp as a tack.

• 28:08Speaker 00

  Hopefully.

• 28:09Speaker 01

  Yeah, you don't know, you are, uh, sixteen books later. What is your day to day? Like, what are the habits and rituals that you do daily? To be so like, that you're, that you're doing for ten years from, like, you're probably, you're probably doing things that you'll be healthy for your eighties or nineties. What can people glean from you?

• 28:29Speaker 00

  People ask me this question a lot.

• 28:30Speaker 01

  Of course they would.

• 28:30Speaker 00

  I was thinking about this the other day. And one thing I haven't said that I will say today, that I think is so important is our two words. Have fun. Now, why do I say that? Because I think it's a question people should ask themselves. What do I do that I really enjoy that makes me smile? And I know the things that I do that make me smile, that bring joy to my heart. And that I think it's a good question because that's really important for you to offload stress and to have a good time. The other thing is, you know, I think the real actionable levers that I pull, I exercise every single day. Are there days that I will, I will probably miss tomorrow because I have a six AM flight and I won't get home till probably eight PM at night? But otherwise I exercise every day.

• 29:15Speaker 00

  Exercise is so important. Yeah, for your metabolism, for your waistline, for your body weight, all the things, you'll look good, you feel good, brain loves it. Because your muscles, when they are activated, are secreting chemicals that do wonderful things for your metabolism. Some of those chemicals go into your brain and keep shop. You know, they do good things.

• 29:36Speaker 01

  Talk about the B D and N F. You know, I mean, of course you know what this is. It's like fertilizer for your brain in a way. I feel like the exercise, to me, I mean, I'm not the doctor, but I think exercise is the number one thing that could keep, like, kind of keep these diseases at bay. Because what it does to your, for me, I work out, I mean, I don't work out for my, my physical well being. Yeah, do I want to look good? Yes. But what it does to my brain, more focused, more alert, you have, your brain turns on with exercise. So.

• 30:08Speaker 00

  Yeah, there are a lot of reasons for that. B D and F is one. So B D and F is. Brain derived neurotrophic factor. And it is brain derived. That's the B D. And I think that's an important point, that while muscles do create a very minimal amount of B D and F, they actually create a chemical when you're using your muscles, i.e. exercising, called erasin. And this erasin then able to cross the blood brain barrier. And then within the brain stimulates the production of brain derived neurotrophic factor that does a lot of different things. It nurtures the neurons, keeps them healthy and functional. But it also increases the growth of new brain cells. Who wouldn't want that? Why, that's fantastic. WTF, right? Why, that's fantastic. Right?

• 30:51Speaker 01

  Yeah, I've never heard that one before, but yeah.

• 30:53Speaker 00

  But it stimulates the growth of new brain cells, not throughout the brain, but in some very important areas like the hippocampus, the brain's memory center, the dentate gyrus of the hippocampus.

• 31:02Speaker 01

  Can I ask you a question on that just before you move on? Because I know strength training is extremely important as you age for your bones and for falling and all the things. For your actual brain, though, in terms of its workability, for it to be sharp and on the ball and all the thing, alert, is cardiovascular more important than strength training? Because I feel when I do the cardio part, that's when my brain is triggered and turned on. That's the lever that I pull if I need to be on point. Do you, is that, is there science behind that?

• 31:33Speaker 00

  Yes. And, and what you're saying, I think, is something many people experience. I think when your audience hears you say that, they're gonna say, I feel the same way, then what's all the push about strength training? Now, let's just wind back a little bit to our conversation from about two minutes ago, that the muscles are creating these chemicals that are doing good things for the brain in the long term. Not the, in the acute sense, you're right about the aerobics. So.

• 31:57Speaker 01

  In the acute, yeah.

• 31:58Speaker 00

  If you want more of those chemicals, then you need bigger muscles. So now you're gonna have a bigger resource to create the erasin and the interleukin six and the catepsin D and all of the things that are good for amping up the brain function over the long term.

• 32:14Speaker 01

  Good.

• 32:15Speaker 00

  You want a bigger resource, so you can't forget leg day.

• 32:17Speaker 01

  Right.

• 32:18Speaker 00

  Your leg muscles are the biggest ones and you really, you're not doing leg muscles to look good. I mean, no one's really looking at your legs, or maybe they are. Everyone's doing triceps and biceps and pecs, of course.

• 32:28Speaker 01

  That's men, that's men.

• 32:29Speaker 00

  Men, okay, right.

• 32:30Speaker 01

  Women are doing, are butt and legs, by the way.

• 32:32Speaker 00

  Butt and legs. Well, butt is good because those glutes are pretty big muscles.

• 32:36Speaker 01

  Big, the biggest muscle, the biggest muscle.

• 32:37Speaker 00

  Well, hamstrings and quads as well. So you want to really emphasize, you know, your extensions and your, and your squats. You want to really strengthen those upper leg muscles and calf muscles as well. Pecs are, are, can be big in, in some people, of course, but you don't want to, you don't want to forget leg day. Why? For all the other reasons, yes, and metabolism, of course. Metabolism targets your microglial cells. But just to have more of those great salubrious chemicals produced that make their way to the brain, they move, they're called myo muscle, kine, they move myokines, move from the muscle to the brain. So the muscles are endocrine glands. No, I thought the endocrine glands were the pituitary, the adrenal, the thyroid.

• 33:20Speaker 00

  Because the, and the definition of an endocrine gland is an area in the body, a gland or an organ that produces chemicals that go elsewhere and target other organs and do things. Like the thyroid targets your brain and your muscles and everything else. And the muscles do that. They secrete chemicals that target the heart, that target the blood vessels, that target the pancreas, liver, and even, yes, the brain. So let's take full advantage of that. And yeah, your muscles are making chemicals. I want more of those, therefore I do strength training. So where does the rubber meet the road on answering your question? An interesting meta-analysis means it looked at multiple studies, more than thirty studies,

• 34:01Speaker 00

  was published by Chinese researchers and tried to answer that question, what's better? Aerobics or resistance training? The conclusion that they came up with was both. So that's the recommendation. Not that I feel that's the right thing to do. That's what the science tells us. So aerobics, very important, you feel better, go for it. More of a cardiovascular blood supply kind of approach, more metabolic types of benefits are going to come from the strength training and the added benefit of these chemicals that we talk about. This interleukin six that some would call an inflammatory cytokine, and it is, but at

• 34:40Speaker 00

  the same time, multipurpose, this interleukin six increases something called AMP kinase. And what does AMP kinase do? That increases our ability to burn fat, increases the functionality of insulin. It's how the drug metformin works. So that's what, why we want to build muscle and do both. Now, I'm gonna add to that. The discussion's always aerobics versus strength training. What should I do? And I think there's a third leg, even a fourth leg to this tool. And I would add that we need flexibility training because if you're not flexible and you overdo it at the gym one day, you're gonna hurt yourself. Then the exercise program comes to a crash.

• 35:22Speaker 00

  And if you're not working on balance training, then you run the risk of falling. And the older you get, you know, the higher that risk of falling, break a hip, then you're, you know, in women, hip fractures are associated with ultimately about a forty percent risk of dying from that fracture.

• 35:37Speaker 01

  Yeah.

• 35:38Speaker 00

  Over the long run. So you want to work on your balance so that you're not at high risk for falling.

• 35:43Speaker 01

  So balance, flexibility and strength training and cardio. So the way, okay, so cardio is, but like you said, it is more like in the moment because it turned on your brain. But you also talk about the metabolic piece of it, which is, of course, strength training will help with it, with your metabolism. That makes sense. And of course, so all four. So you really can't get away with just like picking one, basically. It has to be all four.

• 36:07Speaker 00

  All in.

• 36:08Speaker 01

  All in. Okay, so then finish what you're, okay, so I, I kind of cut you off. So you say you work out every day. How long do you work out? What time do you work out? I want to know every detail.

• 36:16Speaker 00

  So for me, it's the morning, and I'm not saying that's what everyone should do.

• 36:20Speaker 01

  What time do you wake up in the morning?

• 36:21Speaker 00

  I wake up about six thirty.

• 36:23Speaker 01

  Okay. Does it matter?

• 36:24Speaker 00

  Sometimes six. Well, I think, when you, when did you go to sleep?

• 36:28Speaker 01

  Right, so my question was.

• 36:29Speaker 00

  So I want to get about eight hours of sleep, of good sleep. I want to measure my sleep and make sure I'm getting restorative sleep, uninterrupted sleep. And that's, I think, very important because people say, well, I slept eight hours last night. Oh, great, how many times to wake up? Well, I don't think I woke up at all last night. How would you know? Because you can almost wake up and not fully wake up to the extent you don't remember it, but you really dropped out of sleeping. And your Oura ring is gonna tell you that, or your Apple watch will tell you that. So I think it's, it's valuable to know that and you, you could fix that. It might be that if you have a partner, that that person is snoring or moving around at night, or got up three times to pee and woke you up in the process.

• 37:11Speaker 00

  So it's that valuable that you might need to make some adjustments in the sleeping arrangements. I was just interviewed about this idea called sleeping divorce, getting a sleeping divorce. What it's. A kind of aggressive moniker, but if you can't sleep with an individual and have a wonderful marriage, or whatever the situation is, by all means, if you have the opportunity to go to a different room, or put a bolster between you, or figure it out, play some white noise in the background if that person's storing and keeping you up. You spend a third of your life, or you should, sleeping, eight hours of a 24 hour period. You don't exercise, or you probably shouldn't for eight hours a day, or eat for eight hours a day, right?

• 37:53Speaker 00

  Or do brain training exercises, but sleep, you know, we used to think, oh, that's when we're taking time off. No, it's a valuable recovery period for consolidation of your memories, for activating your glymphatic system to take out the garbage, allowing your brain to have the optimal internal milieu or environment, so that you don't stimulate your brain's immune cells to shift to being the evil twin.

• 38:16Speaker 01

  You know, I feel like, again, like, things have its ebb and flow and trends. Sleep has become like the new kale. You know, everybody, you know.

• 38:25Speaker 00

  I still love my kale.

• 38:26Speaker 01

  You still love your kale. Good. Me too. I like kale. But I, or cauliflower. I feel like right now, it's like everyone's on the sleep bandwagon. No one talked about it 10 years ago. Now everyone's talking about sleep being the number one thing. It's like the panacea for everything, you know, to be more fit, sleep more, to be more, to be smarter, sleep more, to like, to whatever it is, it's about sleep. Now, why now? Like, why has nobody, again, talked about the importance of sleep?

• 38:55Speaker 00

  Well, I think it's getting a lot of press.

• 38:57Speaker 01

  Well, now it's like a trillion dollar business.

• 38:59Speaker 00

  And, and I think it should be. Because it's taking us away from the idea that popping a particular supplement, or deciding to push the limits and take a certain drug is going to be the answer. You know, it turns out, back to lifestyle. I think that Morton Walker's book.

• 39:15Speaker 01

  Matt Walker?

• 39:15Speaker 00

  Matt Walker's book, Why We Sleep, really, I mean, it was a big hit, really raised our awareness. I think that, you know, looking at this whole science of chronobiology, and the great research Satchin Panda is doing, and getting out to the public, really answers a lot of questions for us about why we're failing. And, you know, this notion of sleep being downtime, it's anything but downtime. When you characterize sleep as being downtime, it, it sort of makes you feel like it threatens your productivity.

• 39:44Speaker 01

  I was gonna say that.

• 39:45Speaker 00

  Because I could have been doing something, I could have stayed up till midnight and really gotten a little bit more done. The answer to that is, no, you are more productive when you get a good night's sleep. Especially important for young people to understand this.

• 39:59Speaker 01

  Yeah.

• 40:00Speaker 00

  You know, kids in high school and in college, you know, cramming for the test, staying up really late. No, get to bed, and consolidate those memories. You'll remember them. You've studied once, go to bed, let those memories, you know, get more inculcated into networks. That's the ticket. And, you know, from my perspective, when we look at the relationships between not getting enough restorative sleep and risk for Alzheimer's, risk for diabetes, risk for obesity, which contributes to Alzheimer's risk, boy, it is an incredible tonic. And I don't think this is gonna be a flash in the pan. You know, various types of supplements that we talk about, you know, are come and go.

• 40:39Speaker 01

  A million. I mean, there's a million of them.

• 40:41Speaker 00

  Yeah.

• 40:42Speaker 01

  But this has become such a big business now. So it's only, only be food, like, people are jumping on the bandwagon because they can make a lot of money from it, but also, because it's something we all do anyway, right? Like, it's pretty brilliant, right? We all sleep at least six, seven, five, whatever, hours a day. Can't get away from it. We all eat, right? So it's one of the, it's like the one most basic function that we do. So the thing is, and everyone, I mean, I just find it interesting that everyone now is like, sleep, sleep, sleep, sleep, sleep.

• 41:10Speaker 00

  No, sleep isn't going away. Sleep, exercise, and what we eat.

• 41:12Speaker 01

  Yeah.

• 41:13Speaker 00

  Because, as you just said, it's things that we are already doing.

• 41:16Speaker 01

  Yeah.

• 41:17Speaker 00

  Well, we may not be taking rapamycin. We may not be taking, you know, metformin, and these things that have their moment of, in the sunshine. And then, then the other things come out that indicate, well, you know, there's no real data here that indicates what is what we should be doing.

• 41:32Speaker 01

  Right.

• 41:32Speaker 00

  Though it remains interesting. You know, we look at the GLP-1s, for example. Man, that's having its moment in the sun.

• 41:38Speaker 01

  Oh.

• 41:39Speaker 00

  But we don't know what's going to happen in the long term. And, you know, I talk about it in Brain Defenders, because you, I think, insinuated earlier that this is an intervention that has huge and positive metabolic effects, huge and positive metabolic effects that relate to things like mitochondrial function and blood sugar function.

• 41:59Speaker 01

  I want to talk about that, actually. In fact, I still, we still don't even have all your habits, okay? I keep interrupting you. So far, you sleep eight hours, you work out every day, 6:30, you wake up. Tell me what else, and then we're gonna move on.

• 42:12Speaker 00

  I don't have lunch, or even breakfast, oftentimes. Well, which is breakfast? Because you're, you know, the day you're break.

• 42:18Speaker 01

  You don't eat breakfast? Are you?

• 42:19Speaker 00

  Your break fast. So I do have breakfast, but it may be at 1:00 or 2:00 in the afternoon.

• 42:22Speaker 01

  It's more like lunch.

• 42:24Speaker 00

  Yeah, well, but you're breaking your fast.

• 42:25Speaker 01

  So are you, so you intermittent fast?

• 42:28Speaker 00

  That is, by definition, you know, that's time restricted eating, which is a form of fasting. But these terms are tough to define. What is intermittent fasting? How often do you do that? And what is the time period that characterizes that definition? I don't know. But that is something I do with, with regularity.

• 42:45Speaker 01

  So, okay, so, because you also talk about fast mimicking diet, I believe, in there too.

• 42:49Speaker 00

  Yes, Walter Longo.

• 42:51Speaker 01

  Walter Longo, another.

• 42:53Speaker 00

  Putting out some really powerful research. You know, a lot of his work, though he's recently published on Alzheimer's, a lot of his work has looked at the idea of increasing ketones in the body as an adjunctive way of treating cancer, along with standard approaches to treating cancer. And by all means, he's certainly not the first person to, to recognize that cancer cells thrive in a sugar-rich environment. Reducing blood sugar, getting it under control, empowering the body with ketones, has been looked upon by not just Walter Longo, but many others, as an adjunctive therapy to go along in, with treatment of cancer.

• 43:34Speaker 01

  So is it just overall eat less? It doesn't matter what the name, it doesn't matter if it's intermittent fasting, fast mimicking diet, if it's this or that, the other. The thing is, it's about eating less.

• 43:44Speaker 00

  Yes. And what you may consider to be trendy, but I think it's here to stay, is eat more fat. I mean, these lips utter this, those three words. And, you know, there was a time that I wouldn't say that my medical license would have been yanked, but, you know, I wouldn't say that to my colleagues, because, oh, but all the data says a high-fat diet can cause your children to be more naked, or some horrible thing is going to happen. Back in the day, there were low, everything was low-fat Oreos, you name it. And.

• 44:15Speaker 01

  Yeah, I remember Snack Wells and all the things.

• 44:17Speaker 00

  Yeah, low-fat, because of course, fat is the enemy. Let's nuance that a bit, that I am not saying eat all fat, that all fat is good. We want to characterize those fats as being the right kinds of healthful fats, not highly modified fats that are devoid of, you know, healing potential. So these are not the fats that have a shelf life of months to years, or the fats have been modified that they can go into these ultra-processed foods that have an extended shelf life. We want to avoid those, of course. But wonderful fatty foods like avocado, nuts, fish, shellfish, these are providing to us fats that the body, not just the brain, the brain desperately needs fats. Of course, your brain is 70%

• 44:58Speaker 00

  fat, dry weight. I'm not accusing you of having, being a fat head. Your brain is made from fat. The membranes covering every cell in your body, not just the neurons, are made of fat. It doesn't come from the air we breathe. It comes from the food that we eat.

• 45:13Speaker 01

  Okay, I'm not gonna interrupt again. So, so 6:30.

• 45:16Speaker 00

  I've interrupted, so that's all right.

• 45:17Speaker 01

  Exactly. Okay, we both have. Okay, so 6:30 or so, you wake up. What time do you go to bed at night?

• 45:22Speaker 00

  9:30, 10? 9, 9:30, sometimes even earlier, depending on, you know, if I'm tired, I go to sleep. And I don't have any trouble going to sleep, but my wife, if there's computer time or television time, will have a lot of trouble. So it's either the blue light glasses, or we just don't do it at night.

• 45:40Speaker 01

  Hmm.

• 45:40Speaker 00

  So, you know, read, read before you go to sleep. That works for us, or talk.

• 45:46Speaker 01

  Talk?

• 45:46Speaker 00

  Who knew?

• 45:48Speaker 01

  Exactly. Talking, that's so, that's so archaic of you.

• 45:52Speaker 00

  I know.

• 45:52Speaker 01

  Okay, so you wake up.

• 45:53Speaker 00

  It's the best, though. I still look forward to it.

• 45:56Speaker 01

  Yeah.

• 45:57Speaker 00

  Just the goofy things happen that happen during the day, and we're both trying to, you know, figure out life.

• 46:02Speaker 01

  Yeah.

• 46:03Speaker 00

  What does it mean? What should we be doing with parents? With, how do we raise our children? You know?

• 46:08Speaker 01

  How old are your kids, by the way?

• 46:10Speaker 00

  38 and 36.

• 46:13Speaker 01

  Wow, okay, you're not raising them anymore. I guess they've been raised.

• 46:16Speaker 00

  No, it never ends.

• 46:17Speaker 01

  But is your son a doctor as well, right?

• 46:19Speaker 00

  Yes.

• 46:19Speaker 01

  So your dad was a doctor, your son's a doctor?

• 46:21Speaker 00

  Correct.

• 46:22Speaker 01

  Does he have, does he have a child, your?

• 46:25Speaker 00

  In two weeks.

• 46:26Speaker 01

  Oh, really? Oh, wow. So what type of doctor is your son?

• 46:30Speaker 00

  He is internal medicine.

• 46:32Speaker 01

  Okay.

• 46:32Speaker 00

  And, but he is running a startup company, and running the science research part of startup company called Big Bold Health, that is involved in something called Himalayan Tartary Buckwheat. You may have heard of it.

• 46:43Speaker 01

  Yeah, I have.

• 46:45Speaker 00

  Powerful polyphenol. He works along with a fellow by the name of Jeffrey Bland.

• 46:49Speaker 01

  Yes. Oh, my gosh, I know. That's, your son works with him?

• 46:51Speaker 00

  Yeah.

• 46:52Speaker 01

  Oh, that's, did he, did they get introduced through you? Probably.

• 46:57Speaker 00

  The Bland's and the Pearl Mudders have been friends for 35 years, so.

• 47:01Speaker 01

  Yeah.

• 47:01Speaker 00

  So Jeffrey Bland knew Austin when he was five and six years old.

• 47:05Speaker 01

  A baby, yeah, yeah, yeah.

• 47:06Speaker 00

  We would spend time each summer together in British Columbia, so.

• 47:10Speaker 01

  Really nice.

• 47:10Speaker 00

  Yeah.

• 47:16Speaker 01

  I want to take a quick break from this episode to thank our sponsor Therasage. Their Trillight panel has become my favorite biohacking thing for healing my body. It's a portable red light panel that I simply cannot live without. I literally bring it with me everywhere I go. And I personally use their red light therapy to help reduce inflammations in places in my body where honestly I have pain. You can use it on a sore back, stomach cramps, shoulder, ankle. Red light therapy is my go-to. Plus, it also has amazing anti-aging benefits, including reducing signs of fine lines and wrinkles on your face, which I also use it for.

• 47:58Speaker 01

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• 48:37Speaker 01

  Okay, so not to digress again, get back to your healthy habits, please.

• 48:40Speaker 00

  Digression is totally cool.

• 48:41Speaker 01

  Okay, I'm digressing a lot here with you. Okay, good, I feel, I'm like, I'm gonna get like in the comments, "Stop interrupting him." Okay.

• 48:49Speaker 00

  We're interrupting each other, you guys. That's what conversation is all about. It's very respectful, too.

• 48:54Speaker 01

  Thank you, okay, so, but I am very curious, because I want to jot down what you're doing. So you wake up at 6:00 or you don't eat breakfast. So what do you go right into the gym, like what do you do?

• 49:04Speaker 00

  Generally, I get my exercise done in the morning. And so what do I do? No, not that early. No, I don't, well, I mean, my exercise begins off and around, depending on what my schedule's like, but it could be 8 o'clock.

• 49:16Speaker 01

  Okay, do you drink coffee in the morning?

• 49:17Speaker 00

  I do drink coffee in the morning. And some may say that that is a violation of the time-restricted eating, but I am here to say, it's a ritual, I love it, I feel great, I recognize, here's the, here's the self-selling, that it is rich in polyphenols, that caffeine is good for me, and so I, more than an aficionado, I am a devotee, and then...

• 49:44Speaker 01

  What kind of coffee do you drink?

• 49:45Speaker 00

  I drink purity coffee, as a matter of fact.

• 49:48Speaker 01

  Okay, what do you put in the coffee?

• 49:50Speaker 00

  Generally, nothing, or I might use some whole milk, which is another violation of the time-restricted eating, and...

• 49:57Speaker 01

  I won't tell anyone?

• 49:58Speaker 00

  For the past, well, my life is an open book, it's fine with me. And I often use Alulose.

• 50:05Speaker 01

  Oh, okay.

• 50:05Speaker 00

  So I'm very, very big proponent of Alulose. Then, what is the exercise?

• 50:11Speaker 01

  You should try these, these are really good.

• 50:12Speaker 00

  I'm going to try one, I could try it during the show, who knows?

• 50:14Speaker 01

  You know, I forgot to do them, but they're, they're basically, this one actually has no caffeine. This is the, this is Magic Mine, by the way, you guys have all heard me yam around.

• 50:23Speaker 00

  Ashwagandha, right?

• 50:24Speaker 01

  Ashwagandha, lion's mane.

• 50:26Speaker 00

  Lion's mane.

• 50:26Speaker 01

  Yeah, all the things, they're very good. I'm surprised you don't know about this.

• 50:30Speaker 00

  Well, we just met today, so we've got a lot of ground to cover.

• 50:33Speaker 01

  We've got a lot of ground to cover, my gosh, these are delicious, they're really, this is what I do before I work out, actually, it's like, keeps me focused.

• 50:39Speaker 00

  So my program, then, I have gym equipment at home, and I have a new piece of equipment, which is a stationary bike called an Avalon, which gamifies, which is great, because my mind goes elsewhere, but I frequently go to the gym.

• 50:54Speaker 01

  Wait, is it the bike that's like, it's like an AI bike?

• 50:56Speaker 00

  It's just gamified, and I'm online with other people, and, but then I also go to a gym that's nearby, that is run by the hospital, and I'm, believe it or not, one of the younger people there.

• 51:08Speaker 01

  Really?

• 51:09Speaker 00

  Maybe I just think that, but it's, yeah, a lot of people in my generation there.

• 51:13Speaker 01

  Do you do cardio or strength training?

• 51:15Speaker 00

  Well, I do all of it, so my cardio is, and I run outside, too, but in the gym, my cardio... You run? I do run, yeah.

• 51:22Speaker 01

  What do you say, because, you know, there's like a whole blasphemy now, because I like to run, too, be like, "So terrible for your knees and your joints," and like...

• 51:29Speaker 00

  Actually, that's not what the data shows. The data shows pretty good preservation of knee and cartilage with running. Now, you can overdo it, that's for sure.

• 51:37Speaker 01

  Well, I think the endurance runners are the ones that are like...

• 51:39Speaker 00

  Yeah, I mean, I did my share of that, and, but, so I've taken, not to take it too, but for the past probably decade, I've done elliptical machine. At home, I have a Precor, and I use that machine at the gym as well. So that is a zero-impact way of cardio.

• 51:55Speaker 01

  How much cardio?

• 51:56Speaker 00

  I'll do that for 30 to 45 minutes with interval training, and, which is great, because you get, you see the graph, and also when you do your interval, you see the, you know, the curve come up, and I post that so people can see, this is what interval training looks like graphically.

• 52:10Speaker 01

  Right.

• 52:10Speaker 00

  So, kind of hard to post while you're on it, but we figure it out, right?

• 52:14Speaker 01

  Yeah, yeah, yeah.

• 52:15Speaker 00

  And so I really like that. And then I use a lot of weight machines, some free weights, and then when we travel, as I mentioned before we went on, we live on a boat for four months. On the boat, I have bands, tension bands, a stepping machine, and then I use TRX, which I'm sure many of your audience is familiar with.

• 52:33Speaker 01

  I love TRX, great. So, you give me a Stairmaster?

• 52:37Speaker 00

  A stepper machine, it's not a Stairmaster, it's a little stepper machine that was...

• 52:40Speaker 01

  Oh, just like, just like this?

• 52:41Speaker 00

  Yeah.

• 52:42Speaker 01

  Is that enough?

• 52:43Speaker 00

  Oh, yeah.

• 52:44Speaker 01

  It's not a stair mill?

• 52:45Speaker 00

  No, no, it's a stepping machine, but I can, I can actually run the boat while I'm on that machine. So I can get up on what's called the flybridge, and I can run the boat with a remote control. Our boat is really slow, so I'm not gonna hit anything, and I could be on that machine while we're doing that. And then we get off the boat and hike virtually every single day.

• 53:05Speaker 01

  Oh, okay.

• 53:05Speaker 00

  And we, we're in nature, and we forage for mushrooms, so we do that as often as we can.

• 53:12Speaker 01

  That's great, okay, so, basically you exercise every day. Is there any foods that you are, like, you are just, just addicted to that you have to have every single day?

• 53:23Speaker 00

  No.

• 53:24Speaker 01

  Okay.

• 53:25Speaker 00

  But, you know, I have my, we love salmon, because we catch fish all summer, and we're generally able to freeze enough salmon to keep us throughout the year, the rest of the year when we're off the boat.

• 53:34Speaker 01

  Oh, wow, okay.

• 53:35Speaker 00

  Yeah, so I think salmon's a great food, I love it, I love to catch the fish, I love the DHA content, and I love the assured cleanliness of knowing that it's wild salmon, because it, I caught it.

• 53:46Speaker 01

  Wow, yeah.

• 53:47Speaker 00

  Yeah, so I know that. For whatever reason, I could probably find a way of arguing my way into this, I love onions, I love the cruciferous vegetables, I sprout broccoli seeds at home, and I'm doing it on the boat as well.

• 54:00Speaker 01

  That's a big one, too, there's like, that's huge, broccoli, the sprouted broccoli sprouts, are supposed to be amazing for your brain?

• 54:06Speaker 00

  Well, it's amazing throughout the body. The, I think the, really, the go-to person is a fellow by the name of Dr. Jed Fahey. He is the, probably the world's authority on sulforaphane, and sulforaphane is that chemical that is created when we chew the broccoli sprouts. The broccoli sprouts are rich in something called glucoraphanin, and when you chew broccoli sprouts, the glucoraphanin, in the presence of an enzyme called myrosinase that's liberated by chewing, converts the glucoraphanin into sulforaphane. This sulforaphane then activates a pathway in your body called the Nrf2 pathway that is hugely

• 54:46Speaker 00

  antioxidant, that is hugely involved in detoxification, and powerfully anti-inflammatory. So that is the home run that you're looking for. Dr. Fahey, Fahey just published a new report on the effects of sulforaphane on the brain, and the research is profound, and I've only had him on my podcast, and I will meet him in February. I invite him to be a guest at Integrative Healthcare Symposium as one of our speakers. I can't wait to meet him face-to-face.

• 55:17Speaker 01

  Is this your, is this your symposium, is this your thing, this integrative?

• 55:21Speaker 00

  I am the, I am the chairman of that symposium, but this will be my first year as chairman.

• 55:26Speaker 01

  Oh, okay.

• 55:27Speaker 00

  But I've been speaking there for 25 years.

• 55:29Speaker 01

  Wow, how big is this symposium?

• 55:31Speaker 00

  It'll have probably 800 people as, in attendees, yeah.

• 55:35Speaker 01

  What kind of doctors, does everybody goes?

• 55:37Speaker 00

  That's, it's integrative, that's what we want. So plenty of MDs, DOs, chiropractors, other healthcare practitioners, like dieticians, acupuncturists, body workers, you name it.

• 55:49Speaker 01

  Really? Okay, maybe I'll go. Maybe I should go. When is it?

• 55:52Speaker 00

  It's in February and I'll make sure you get invited.

• 55:54Speaker 01

  I would love to. I'd love to go and see what.

• 55:56Speaker 00

  It's in New York City.

• 55:57Speaker 01

  Yeah.

• 55:58Speaker 00

  Every year at the same Midtown Hilton.

• 56:01Speaker 01

  Really?

• 56:02Speaker 00

  Yeah.

• 56:02Speaker 01

  And 25 years. Who's speaking this year?

• 56:05Speaker 00

  Let's see. One of our guest speakers, who hasn't spoken before, is Dr. Lee Wei Sai. And if she's watching this, she'll understand why I invited her. Because Dr. Lee Wei Sai is at MIT. And she has discovered that flashing a light into your eyes at 40 times per second, so we call it 40 Hz light, actually targets your brain's microglial cells and helps revert them back to being supportive. It's, so she's in the book and, you know, what can I say? Being chairman, I get to sort of influence who gets to speak there.

• 56:41Speaker 01

  Yes, you do.

• 56:42Speaker 00

  Yeah, that's true. So, you know, and there are a lot of wonderful.

• 56:46Speaker 01

  That's really interesting, though.

• 56:48Speaker 00

  Oh, it's breathtaking. And, you know, her work extends to humans, to Alzheimer's patients. The findings that she is getting, you know, our main topic today of discussion is how do we preserve the function of the brain's immune cells to be supportive by making lifestyle choices? But what we talk about is that this is where leading edge neuroscience is exploring right now. So here is MIT looking at reverting the microglial cells to being supportive, using a light flashing in your eyes at 40 times per second.

• 57:24Speaker 01

  How does that work even? I guess I can ask her.

• 57:27Speaker 00

  Well, how does it work? Okay, you'll have to ask her, but I'll tell you.

• 57:29Speaker 01

  Yeah, tell me.

• 57:30Speaker 00

  So what Dr. Sai made very clear is that the healthy brain has a beautiful background rhythm called gamma oscillation, a beautiful sinusoidal curve that is the orchestra playing a symphony. As the brain begins to degenerate, that gamma rhythm deteriorates and it's cacophony, or every instrument playing a different thing. No more music. And what she found was that when we have good gamma oscillation in the background of the brain's activity, that the microglia are being preserved in their function and being kept in their supportive role. She discovered that when you expose the visual center

• 58:14Speaker 00

  and the back of the brain where vision is represented, the occipital lobe, to this particular frequency, that gamma is restored. Can you imagine? So they do, at her laboratory, the Peikauer Institute at MIT, they put EEG leads on a person's head. And they discovered that flashing lights at different frequencies does different things. They tuned it in and right at 40 Hz, gamma is restored.

• 58:41Speaker 01

  So people can then, how do people do that at home? Is there a way you can?

• 58:45Speaker 00

  I have a box next to my computer screen and it's always on while I'm working. And I'm constantly getting 40 Hz light flashing in my, you can buy a light bulb.

• 58:53Speaker 01

  So you know what's interesting? This is like the, you're like, this is kind of like the, not pink elephant in the room, but something like that, like you're leaving the, you're burying the lead. This is like something that anyone can, anybody can do to prevent or reverse any type of immune cell deficiency that would lead to all these terrible diseases.

• 59:14Speaker 00

  It's a definite lever that you can pull.

• 59:16Speaker 01

  So.

• 59:17Speaker 00

  So we've talked about, yeah, training our muscles, strength training, aerobics, diet, etc.

• 59:22Speaker 01

  Metabolic, that's, we talked about that, how to do metabolic health.

• 59:25Speaker 00

  Look at this, dare I call it a hack? I don't want to call it hack. I'm not so keen.

• 59:27Speaker 01

  A tool?

• 59:28Speaker 00

  A tool, a lever to pull.

• 59:30Speaker 01

  A lever to pull, okay.

• 59:31Speaker 00

  And there's a lot of other cool things that are being developed right now. I mean.

• 59:34Speaker 01

  I want to talk about other things that people can do. I, we talked about, of course, the, well, we haven't really talked about the mitochondrial health. Like, what does that mean to people? Like, how do people really have a strong, like, explain to people, or just to me, and then people can hear, about the mitochondria? How we can, what we can do to have a stronger or more functioning mitochondria? Because that also is something you talk about in the book.

• 59:59Speaker 00

  So the question is then, why? Why do we even care about our mitochondria? Why does it matter?

• 1:00:05Speaker 01

  Yes, tell us.

• 1:00:06Speaker 00

  Because it is the fundamental that determines the shift of these microglial cells. It's the failure of their mitochondria, their metabolism, mitochondria, that dictates friend or foe.

• 1:00:18Speaker 01

  Is mitochondria metabolism one of the same?

• 1:00:21Speaker 00

  Yeah, metabolism is, by definition, it's the creation of new materials from raw material. But it also, from a cellular perspective, but most importantly for our discussion, it's the formation of energy molecules from substrate. How do the mitochondria create ATP molecules from glucose?

• 1:00:44Speaker 01

  The reason I'm asking is because we, people, I've heard a lot. People are very confused, right? They hear a lot of these buzzwords. They hear metabolic health. They hear mitochondria. They hear, you know, the, all about the gut, the, how the gut's the new brain. Like, there's all these, like, very buzzy social media things that people, cellular health. But nobody really knows and understands what this means. I mean, they pretend because they hear it so often that you think that you understand. So I thought, since you're such a nov, you know, you know so much about all of this, is what you do. Like, I wanted to kind of like really break it down, like what it means to have, you know, to work, to have, like, to, for your metabolic health, what it, for your, to have, for your cellular health. Is it the same? Is it not?

• 1:01:28Speaker 01

  Like, what can people do? Is there like a very, is there like a, like a, kind of like a cheat sheet of how we can strengthen and improve all of these things to improve our ability, or to, to improve our health? But also to like, help us not get these diseases later on, I guess.

• 1:01:50Speaker 00

  The answer is 100%. That's why I'm here today. That's why we're having this discussion. Because again, there's no fix when you get into this problem from a pharmaceutical perspective. And it doesn't have to be. It isn't a genetic issue by and large. It's related to our metabolism. I'm going to break that down. It's what you want. And we can control that. That's, that's what we're doing here today.

• 1:02:18Speaker 01

  Right, but simply, I want it as simple as possible so people can take it, like an actionable cheat sheet and be like, okay.

• 1:02:23Speaker 00

  The way, and then we'll talk about the actionable points.

• 1:02:25Speaker 01

  Okay.

• 1:02:26Speaker 00

  So again, we just kind of opened the door on mitochondria. The energy producers of the neuron, well, the neuron's very busy. They're sending electricity, connecting the networks, allowing us to think and do, right? That's what the neurons do. But the neurons are only 50% of the cells in your brain. We tend to think, oh, the brain is just a box of neurons. That's not correct. When we talk about brain cells, oh, you mean neurons? Well, no, we're having a different discussion today. We're talking about some other brain cells. In this case, 10% of the brain cells, the brain immune cells called microglia. There are other brain cells called oligodendroglia sites and astrocytes. We're focused on the brain's immune cells and their metabolism. Their metabolism, how their mitochondria are working,

• 1:03:11Speaker 00

  creating these energy molecules or not, determines whether they're going to be destructive and destroy your brain as we see in Alzheimer's and Parkinson's and all the nerdy different conditions. Or they're going to support your brain such that when you're 80, and I'm really old, we're going to come back and have another podcast and it'll be lucid. Okay?

• 1:03:32Speaker 01

  Okay, how about, so like people, like, you know, the rage is NAD, right? People think, that's when they think of mitochondrial health, cellular health, metabolic health. Everyone is injecting NAD or they're, or, you know, taking.

• 1:03:46Speaker 00

  Precursor.

• 1:03:46Speaker 01

  A precursor. Does that actually improve your ability for, and they take it because of aging. They, they want to age better. That's the whole idea. They want to pro-age, or whatever you want to call it. Does it actually make a difference?

• 1:04:00Speaker 00

  Well, I, I think as it relates to oral precursors like enamin and.

• 1:04:04Speaker 01

  Enamin to that, no, NR is the way.

• 1:04:07Speaker 00

  Nicotinamide riboside or nicotinamide ammononucleotide. I'd like to see the data to answer your question. I have not seen it yet. Then we move to the intravenous forms, which people rave about.

• 1:04:18Speaker 01

  Yeah.

• 1:04:19Speaker 00

  Because there is an indication that we can raise certainly blood levels and certainly tissue levels with IV NAD.

• 1:04:28Speaker 01

  Yeah.

• 1:04:29Speaker 00

  But the question is, is there a payoff in terms of cognitive function, preservation of cognitive function and even improvement? I haven't seen that data, but do I think that it makes sense? It does make sense. When we recognize what NAD does, both in terms of mitochondrial function, makes sense to try to keep NAD levels higher, decline as we age, we know that. And the role of NAD in terms of influencing the sirtuin genes. I think on both counts, it makes sense that we should do whatever we can to increase NAD. That's why we exercise. So I think that we still need to see the research that relates the oral precursors

• 1:05:11Speaker 00

  to their ability to carry out these goals. That said, a recent study by Sinclair and Johnson looked at epigenetic clocks, age-related clocks, in terms of using a precursor, for example, and did not find any significant ability of the precursor to influence our biological age. Interestingly, one of the best things that they discovered to reduce biological rate of aging, what's called the Dunedin clock, I think was the one, the metric, was physical exercise. It's there for all.

• 1:05:46Speaker 01

  Right.

• 1:05:46Speaker 00

  It's free of charge.

• 1:05:48Speaker 01

  Right.

• 1:05:48Speaker 00

  You got to buy a new pair of running shoes or whatever it may be, maybe from time to time. So, but I think we're going to watch this evolve. NAD is such a fundamental molecule in the functioning adequately of our mitochondria. To me, everything is about the mitochondria. Why? Because the mitochondria are determining the function of our microglial cells. That's upstream for how the good brain continues to function or the bad brain manifests. It's the function of the microglia which are determined by how their mitochondria are functioning.

• 1:06:25Speaker 01

  So if the, if, because you say in the book, like, many times, brain defenders, that the, how your mitochondria is functioning is a correlation of your brain health, yes?

• 1:06:37Speaker 00

  Absolutely.

• 1:06:38Speaker 01

  So.

• 1:06:39Speaker 00

  Absolutely.

• 1:06:39Speaker 01

  So if NAD.

• 1:06:42Speaker 01

  Helps the mitochondria, it would make that, there is a direct correlation.

• 1:06:46Speaker 00

  You're right, it would make sense. Do I think it does? I do. Do I see compelling science to indicate that? At this time, I do not. So, my emotional response is supportive.

• 1:06:57Speaker 01

  Okay, but there's, there hasn't, there hasn't been any type of science to back it up. Although-

• 1:07:06Speaker 00

  I wouldn't say any type.

• 1:07:07Speaker 01

  Cause I mean, I know that, I even know like, you know, seriously, True Niagen has done a million case studies for NR. Doesn't that count?

• 1:07:14Speaker 00

  It counts, but I want, you know, what you're asking though, is there science that take, that shows that taking a particular uh, NAD precursor is going to benefit brain function? There's some indication that it might, but it's not the solid home run that I'm looking for, to be able to respond to your question that way. Now, do I think emotionally that this makes sense to take some of this? Yes, I do.

• 1:07:37Speaker 01

  Okay, or even any type of even the IV or whatever?

• 1:07:41Speaker 00

  I, I, my sense is yes. My sense is yes, but I have to do better, I have to delineate between, you know, my visceral response and what I do for myself based upon that and recommend versus what does the science support. And that's what you want me to do.

• 1:07:59Speaker 01

  You're trying to be, you're, you're just trying to be, you're, you're just, I understand. You don't want to be in a situation where you're saying something out of term without having the evidence to back it up.

• 1:08:07Speaker 00

  Yeah, out of term is, is well characterized. And the term here is, I, my sense is yes. But I want to be able to quote the study that shows that this is a powerful inroad to Alzheimer's prevention, or even, dare I say, treatment. And not quite there yet.

• 1:08:24Speaker 01

  I understand. What about oral health? I heard you, not I heard, it's in your book. That, what, brushing your teeth can, can uh, starve away any type of brain decline? Is that the correlation?

• 1:08:39Speaker 00

  Any type of brain decline again.

• 1:08:40Speaker 01

  Well, no, but I'm saying you're giving all these things. You're talking about genetic testing, you talk about metabolic health, you talk about, there's a whole chapter on oral health that I saw. There's also two tests that you, that doctors don't tell you about, right? You talk about that. The homocysteine test and what was the other one? And the fasting, was it the fasting insulin test? These are things that I think are, like, these are all part of the cheat sheet, in my opinion.

• 1:09:06Speaker 00

  Yeah. I, I'll answer both of those questions more, but I want to tell you, this is a great interview, BTW.

• 1:09:11Speaker 01

  Really?

• 1:09:12Speaker 00

  It really is, because we're just going to what really matters.

• 1:09:15Speaker 01

  Yes, thank you.

• 1:09:16Speaker 00

  The mission here is to give your audience the cheat sheet, or whatever are the tools, and you keep teeing it up. So I, I want you to know, I appreciate that.

• 1:09:23Speaker 01

  Thank you so much. I appreciate that. I, I do, I, I, I try. I like to get to the meat of the matter. I like to, like, no BS. I like just to know the facts and at, giving people actionable things that they can do, you know, and then, so that's why I like, I know we kind of like digress and we go on these tangents, but I, cause I'm a very curious person and I, and I, when I have someone like you who's like, who, who's very knowledgeable, I want to like, I want to kind of get as much, I want to extract as much possible information.

• 1:09:51Speaker 00

  And we only have two and a half hours more to go, so we better, we better step up the pace.

• 1:09:56Speaker 01

  Exactly, exactly. Cause I know, chop, chop.

• 1:09:59Speaker 00

  Let me, uh, let me get to the first question first, which was the oral health. And it's a bit of a surprise. I mean, years ago, I, I wrote a book called Brain Maker that said, you know, there's a connection between the gut and the brain. Well, who knew, right? Well, Hippocrates knew, but uh, more recently it was like, are you kidding me?

• 1:10:15Speaker 01

  What year did you write that one?

• 1:10:18Speaker 00

  That came out, I guess, 12 years ago, something like that.

• 1:10:22Speaker 01

  Saying, and now it's become like, everyone's just talking about it, like it's been, so you were, that's what I'm saying, you were like writing about this stuff before it became like cool and trendy.

• 1:10:33Speaker 00

  Well, I didn't want it to become, yeah, trendy, I, I went with, cool was, uh, no, I like iconoclastic, because I always want to be, you know, on the edge, irreverent. I love that word. I'm, I'm going to take that from you.

• 1:10:45Speaker 01

  Just give me the credit.

• 1:10:46Speaker 00

  I, I will credit you, okay. You own the hashtag.

• 1:10:49Speaker 01

  Okay, thank you.

• 1:10:49Speaker 00

  Um, but the idea that oral health is important, we know that, that gut health is important and, and the digestive system is important for brain health, and who knew the mouth is part of the digestive system? This is where the tube begins and we know where the tube ends. So it begins here. And the data that's coming out really relates very powerfully. Risk for Alzheimer's if you have periodontal disease goes up dramatically. I mean, to levels that you'd be, you know, you'd be surprised. We know that there are particular bacterial organisms that characterize periodontal disease that have been found in the brain, or at least parts of them, if not all the organism.

• 1:11:25Speaker 01

  Like a root canal? If you have a root canal, that can lead to?

• 1:11:29Speaker 00

  Well, more the periodontal disease, the area around your teeth being inflamed, bleeding. Well, the, the root canal is more the tooth itself and the, and the root of the teeth.

• 1:11:38Speaker 01

  I know you're not a dentist, but I'm just trying to like, you know.

• 1:11:40Speaker 00

  Yeah, but, but you know, not that there's not some concern about root canals. We could talk about the idea that this gut aperture that's used at the root canal can harbor bacteria, but let's go back to the periodontal disease, the gum disease, basically. And that this correlation with, with uh, heart disease and vascular disease and brain disease, all of which are inflammatory, but we're able to find this one organism, for example, that's getting a lot of attention that Dr. Bredesen brought to light, uh, called Porphromonis gingivalis, that will not be on the quiz. But the idea that we find these organisms that are mouth-related organisms in the brain. So we begin to talk about something called the oral microbiome. Now with the same sort of skepticism and hopefully soon the same sort of appreciation

• 1:12:25Speaker 00

  that we previously applied to the gut microbiome, that the oral microbiome is important. I talked about it in Drop Acid, the book about uric acid. That's where our dietary nitrates from certain foods, uh, like beets, for example, get converted into nitrite that our body uses to make nitric oxide. Helps blood supply to the brain and organs and helps insulin do its job. We don't want to sterilize the mouth. We don't want to be using mouthwashes that say kills 99.9% of germs. We love our germ. There are some germs that are bad in the mouth, I just mentioned one. But the idea of sterilizing the mouth once or twice a day with mouthwash,

• 1:13:08Speaker 00

  you know, when I first heard this from somebody on my podcast, uh, he said, you know, if you go to the gym and work out, and then when you're getting your clothes on, you take a shot of mouthwash and spit it out, you've just offset the entire benefit of your workout. And, uh,

• 1:13:25Speaker 01

  I know what you're talking about.

• 1:13:25Speaker 00

  And I, I heard him say that, and I thought, well, you know, podcasts, you gotta let people talk. And I thought, oh, how silly that is. Then I saw the research that came oddly enough from Puerto Rico. That demonstrated that people who frequently use a particular, particular types of mouthwash that sterilize the mouth, that we're all familiar with the brands, I will not mention it. That frequent use of mouthwash is associated with a significant increased risk of hypertension, as well as a significant increased risk for becoming a type 2 diabetic. Both of which are powerful inroads to becoming an Alzheimer's patient. Consider that.

• 1:14:03Speaker 01

  Is that really true?

• 1:14:04Speaker 00

  It's really what the, the science.

• 1:14:07Speaker 01

  You actually saw the science on that.

• 1:14:08Speaker 00

  I did see the science. When I first heard this, my surprise was what yours was.

• 1:14:13Speaker 01

  Cause I, I, I know what you're talking about, cause I heard the same thing and I was like, it's from the same guy who talks about this nitric, nitric oxide.

• 1:14:21Speaker 00

  It is all about nitric oxide. I didn't hear it from him.

• 1:14:24Speaker 01

  Oh, you didn't? I heard it from him. And I was like, what? I heard it on a podcast. And I was like, that sounds crazy to me.

• 1:14:30Speaker 00

  I'm grateful this individual, uh, made this clear to me and very close friend, it's Max Lugavere, you probably-

• 1:14:36Speaker 01

  I know Max, yeah, of course, I'm friends with Max.

• 1:14:38Speaker 00

  When he told me this, I thought-

• 1:14:40Speaker 01

  Maybe it was him who told me too, actually. It could have been.

• 1:14:42Speaker 00

  I love that guy. I really do. I have so much respect for him.

• 1:14:45Speaker 01

  Yeah, he's very well-

• 1:14:47Speaker 00

  I made him breakfast one day. We did a, some kind of live thing and uh, he's, he's great. I mean,

• 1:14:53Speaker 01

  Yeah, he's great, yeah.

• 1:14:54Speaker 00

  He had a, uh, you know, his situation with his mother and has done his best to help others not go through that. So, God bless Max Lugavere. A genius life, hey Max. And thank you for the T-shirt, by the way.

• 1:15:09Speaker 01

  I'm gonna, I'm gonna clip this for Max, cause we love you, Max.

• 1:15:12Speaker 00

  We love you, Max.

• 1:15:13Speaker 01

  So, that's interesting. I, that, that whole mouthwash thing was very, very curious to me.

• 1:15:19Speaker 00

  So, but it doesn't mean we shouldn't take care of our teeth. It means we absolutely should.

• 1:15:22Speaker 01

  How about a tongue scraper? Is that why?

• 1:15:24Speaker 00

  You bet, tongue scraper, great idea. Uh, I travel with a water flosser. It's rechargeable, USB rechargeable water flosser. It broke two days ago. I immediately was at the, uh, may I say the name, Walgreens yesterday and bought a new one. That's-

• 1:15:40Speaker 01

  Really? So you even go that far? I was gonna ask-

• 1:15:42Speaker 00

  Oh, it fits in your, it's this tall, it fits in your suitcase.

• 1:15:45Speaker 01

  No, I was gonna say, so you're saying like, just, cause I was gonna say like flossing, um, a tongue scraper, you know, when you floss, you know, there's some that, like, this is like so random, but like, if it's not a good kind of uh, floss, you're not getting in there and getting all the good stuff out of there.

• 1:16:00Speaker 00

  I floss, uh, but I don't like it. I don't like flossing. I like sticking my fingers in my-

• 1:16:06Speaker 01

  Yeah, it's weird, yeah.

• 1:16:07Speaker 00

  My teeth are tight.

• 1:16:08Speaker 01

  Doesn't get everything, you always miss the teeth.

• 1:16:10Speaker 00

  The water flosser.

• 1:16:10Speaker 01

  I'm gonna get one of those.

• 1:16:11Speaker 00

  I mean, I use, it's a water pick, but not the kind that you have to plug in in your, in your bathroom at home. You can travel with this thing. USB rechargeable, I mean-

• 1:16:20Speaker 01

  Can you send me a link? I would buy one of those.

• 1:16:22Speaker 00

  I will absolutely do that.

• 1:16:23Speaker 01

  Yeah, no, I love that. I'm gonna, so okay, a water flosser, no mouthwash. I have been using the more healthy one. Is that a good, is that a good box?

• 1:16:31Speaker 00

  Healthy what?

• 1:16:32Speaker 01

  The mouthwash. I'm not using like-

• 1:16:34Speaker 00

  I, I can't tell you, cause I don't know. If it, if it has an antibacterial in it, I would think twice.

• 1:16:40Speaker 01

  Not, yeah.

• 1:16:41Speaker 00

  The, the bacteria that live on the top of your tongue are important because they're first step for your body to make nitric oxide. Nitric oxide, you need, it helps insulin work, it helps your blood vessels expand to improve the blood supply to your brain.

• 1:16:58Speaker 01

  Because, okay, so that's the part like I don't understand about this nitric. How does that fend off brain disease? I don't get the connection.

• 1:17:07Speaker 00

  I'm going to explain the connection for you and you'll get it. You'll never forget.

• 1:17:11Speaker 01

  Okay.

• 1:17:11Speaker 00

  Nitric oxide is important for metabolism, i.e. insulin functionality, blood, blood pressure, blood supply. And metabolism, when it's not appropriate, is what threatens your microglial cells. That's the connection.

• 1:17:27Speaker 01

  So why, is that why people are putting it in toothpaste? Or they're putting it on, in serums?

• 1:17:31Speaker 00

  I don't think you're going to, you, you're not going to be able to put nitric oxide.

• 1:17:36Speaker 01

  They have, I, I was just saying.

• 1:17:37Speaker 00

  But it's not nitric oxide, it's a precursor. So usually things like arginine are put into toothpaste. And it's what more importantly is happening with toothpaste. The bad things are coming out of toothpaste, which is really good. There's all kinds of issues that have been in toothpaste for an awful long time. Sodium, loral sulfate, uh, which is, you know, is somewhat threatening certain of the sweeteners. Uh, so I'm glad to see that there's been a real effort, conscious effort to create, uh, various brands of toothpaste. I use one called FIG, F Y G G, for your good guys. What does that mean? For your good guys means my mouth bacteria.

• 1:18:14Speaker 01

  Mm hmm.

• 1:18:14Speaker 00

  I want to, I want to keep them healthy. They're on my side. They're along for the ride and this is their home.

• 1:18:20Speaker 01

  Yeah, I mean, like people like, it's also these things that sometimes common sense isn't so common. Right? Like it's, it makes sense why that would make a difference. Like your mouth, because that's where every, all these like living organisms are in your, in your mouth. And if you have an infection or it'll go into your brain, it makes perfect sense. Do you know they even said UTIs? Like anything like these, these, why would a UTI?

• 1:18:45Speaker 00

  Because a UTI is characterized by total body inflammation. When there's infection anywhere in your body, a urinary tract infection, lung infection, uh, any infection in your body.

• 1:18:57Speaker 01

  And inflammation.

• 1:18:58Speaker 00

  Those inflammatory chemicals called cytokines are increased in your body. And they make their way to the brain and they polarize our microglial cells away from being brain defenders to being brain destroyers. That's why it's important to, you know, we, we think about the quality of the water that we drink. Right? You're drinking the water. You want to avoid water that might have chlorine in it, certainly microplastics and all of that.

• 1:19:20Speaker 01

  Right.

• 1:19:21Speaker 00

  But what about the air you breathe? No one talks about that.

• 1:19:25Speaker 01

  Right. It's in the book too. You talk about that.

• 1:19:27Speaker 00

  You breathe 20,000 times a day. And we want to breathe clean, pure air without these PM 2.5 particles that, you know, in the time of our discussion today, this is a time where wildfires are rampant in North America. I just came down from British Columbia. The air quality index is terrible. The sky is yellow and you can smell the smoke. That's why I stay indoors with an air purifier. And when I'm outdoors, at times I'll wear a mask because it's threatening to the brain. It's associated with an increased risk of Alzheimer's because it increases inflammation. That is bad. Now, do people look at me, uh, in a funny way when I'm walking on the street with a mask?

• 1:20:11Speaker 00

  They might, but other people are doing it.

• 1:20:14Speaker 01

  Yeah, makes sense.

• 1:20:15Speaker 00

  And I don't care.

• 1:20:16Speaker 01

  Yeah.

• 1:20:17Speaker 00

  But I, I use, um, at home, even, we live in Florida. I have an air purifier. It's in our bedroom. We're breathing pure air. It's called Lichen Air, L I C H N. The Lichens are these things in the forest that keep the air pure. So that's what we breathe. It measures the air quality. You can get an app to look at the air quality index, the AQI, wherever you are. We were recently in Cairo and the air quality index was mind numbing. Literally it was, you know, greater than 300. And I didn't want to go to these, on these tours to the sites, the Sphinx, everything, but I did. And I wore a mask.

• 1:20:54Speaker 01

  Yeah.

• 1:20:55Speaker 00

  Guarantee you, I wore a mask. And I wasn't alone.

• 1:20:58Speaker 01

  Um, yeah, that, well, it makes, again, it makes sense. So anything that brings a body inflammation. So at the end of the day, it sounds like inflammation is the core cause of any, really, any disease at the end of the day.

• 1:21:10Speaker 00

  Uh, it's, you know, it's certainly not the cause of trauma, but it is a fundamental player. It is a fundamental issue here. And upstream, uh, that we have to pay attention to is what is inflammation doing? What are toxins doing? What is elevated blood sugar and insulin resistance doing to our brain's immune cells? And what did, all these things are doing and many more infections are shifting our brain cells away from being supportive. And we want them to be on our side.

• 1:21:39Speaker 01

  So what if you take a GLP-1 just for, not for your, not for weight loss, just for bringing the body's inflammation down? Does that work then, just for that? Is it, is it strong enough? Is it true? Is there any real backed research?

• 1:21:54Speaker 00

  To be fair to you, let me talk about the science first of all, and then I can shift to being speculative. And I want to clearly delineate between the two.

• 1:22:02Speaker 01

  Yeah.

• 1:22:03Speaker 00

  So if you accept that what makes a good brain go bad are changes in metabolism, mitochondrial function, and how that plays out of the brain's immune cells. What if we were to target metabolism using a GLP-1 drug? It's a powerful way of targeting metabolism. So in 2024, in the New England Journal of Medicine, April of 2024 was a study that involved 151 patients who had diagnosed Parkinson's disease. It wasn't a question. They had Parkinson's, their medications not doing well. And it was a one-year study that either treated them with placebo or an injection of a GLP-1 drug every day for the entire period.

• 1:22:45Speaker 00

  Now, the placebo patients basically didn't get treatment. What happened to them in the one-year period of time? They declined in their functionality as we see with Parkinson's. The group getting the GLP-1 agonist drug stabilized and actually demonstrated a tiny improvement. To me, that is.

• 1:23:04Speaker 01

  Where you see tiny, how tiny?

• 1:23:07Speaker 00

  Well, the idea that they even stabilized, to me, is the home run.

• 1:23:10Speaker 01

  Mm hmm.

• 1:23:10Speaker 00

  But even beyond that, they actually had slight improvement, which we've never, ever seen. Except for one study that we actually are, we carried out years ago using intravenous glutathione. But functionality improved by giving them a, a drug targeting their mitochondria.

• 1:23:28Speaker 01

  So that's interesting because I heard that, uh, uh, someone was telling me, it was like a biohacker was telling me, oh yeah, I'm taking not the semaglutide one. They're taking either retinocortinoid that works on the three receptors or the trisapetide too, whatever.

• 1:23:43Speaker 00

  Trisapetide, uh huh.

• 1:23:44Speaker 01

  Yeah, that they're taking, they're microdosing it for, to, to fend off Alzheimer's or dementia or any type of cognitive decline. Is there any accuracy at all to that then? Or is it just speculative?

• 1:23:59Speaker 00

  First of all, I don't know what a microdose is in the context of this person.

• 1:24:03Speaker 01

  I mean, that's exactly a good, I know you're going to say that.

• 1:24:05Speaker 00

  Yeah, I mean, I know what that means. I mean, what is microdosing of psilocybin? What is microdosing of GLP-1? I don't know. Define the terms. But is there any science to support what I'm about to say? Or is there any science to support the idea that that's a good practice? No, there isn't. Uh, and we'll review what the science is in terms of Alzheimer's in just a moment. Cause recently there was a completed trial called the Evoke and the Evoke Plus, uh, studies that were just, uh, completed. Uh, that involved more than 3,000, uh, individuals in over, I think, 500 institutions globally. Well, let me, well, talk about that real quick. What did they find? This study did not reach therapeutic endpoint, meaning that the oral semaglutide

• 1:24:46Speaker 00

  did not demonstrate benefit in existing Alzheimer's patients. But interestingly, one of the findings that is not talked about is the fact that the C-reactive protein, a marker of inflammation, went down dramatically in the group receiving the drug by, so 30%. That's important. We don't know how that will play out. Could this study be refined? IV or, uh, rather subcutaneous injections, GLP-1 and a different GLP-1 that might make its way to the brain a little bit better? Yes, I think so. We'll see where the science, uh, takes us. The idea of a GLP-1 being good for the brain, I think, has merit. And I actually mentioned it in the book.

• 1:25:26Speaker 00

  I, I'm keeping an open mind, uh, to the idea that some formulation of a GLP-1 may be good for the treatment of Alzheimer's in the future. Jennifer, Alzheimer's is an almost uniformly fatal condition. It is the third leading cause of death of, of adults in, in America. Uh, and so the idea of using a drug that may have a side effect profile that may be helpful is something we have to keep our eyes open to. And I remain open to including it in the toolbox. Once we know which GLP-1, which formulation can we use, how safe it will be.

• 1:26:05Speaker 00

  And how efficacious it is. So I think it's very powerful. I think just the hit and miss trials of GLP-1, because I think it's a good idea. I'm in a microdose, not going to tell you what the dosage is because I'm not really sure. I vary from day to day. That's maybe interesting for an individual, but it's not science.

• 1:26:23Speaker 01

  So you wouldn't take it?

• 1:26:24Speaker 00

  No.

• 1:26:25Speaker 01

  Are you on any GLP-1s?

• 1:26:26Speaker 00

  No.

• 1:26:27Speaker 01

  Because what do you think of the overall use of them? Do you think people are just like this at this point, they're just, they're being abused by everybody? Do you think it's going to go away? Do you think it's a trend?

• 1:26:39Speaker 00

  No, I think it's not a trend. Barring some demonstration of a significant side effect that's widespread, I think they're here to stay. And, you know, because on one hand, there's this huge effort to get people to eat crappy foods, these ultra-processed foods. That's not going away despite what we see the effort being to make people aware of the GLP-1, I mean, of the ultra-processed foods. I'm one of those people trying to raise awareness that consuming these foods is associated with Alzheimer's risk, specifically, and diabetes, and obesity, and all the things. That's not going away, and therefore the GLP-1s will not go away. Are they completely safe? They are not. We don't know how many people are going to suddenly lose vision.

• 1:27:24Speaker 00

  By one report, as many as 30,000 people have lost vision acutely as a consequence of using these drugs. That's, that's a worrisome, you know, it's not a big number in comparison to the number of people who are using the drugs. So the incidence of that side effect seems to be low, but that's 30,000 people, no matter how you slice it. They don't care about the others. So the idea, though, of targeting metabolism, I think, is very important. And there may be supplements and drugs that are able to do that, that I will keep an open mind for. In the meanwhile, most of what we talk about are the lifestyle. I don't want to call them hacks, but the tools, that was your term, that we've talked about today,

• 1:28:05Speaker 00

  that do a hell of a job in targeting our metabolism, like getting enough sleep, restorative sleep, and exercising in both forms that we talked about, with the addition of balance and flexibility,

• 1:28:16Speaker 01

  Yes.

• 1:28:16Speaker 00

  and the type of foods we eat and connecting with other people.

• 1:28:21Speaker 01

  Do you think it matters if you're a carnivore or a planet, like a vegetarian? Do you think how much, what about protein? Do you think protein's been over, over, again, over, now it's so trendy?

• 1:28:31Speaker 00

  Protein is de jour, no question about it, and it's trendy. Did I have supplemental protein today because I hope I get enough? Yes, I sure, I sure did. We'll get back to the question in a second.

• 1:28:40Speaker 01

  We need some electrolytes after this interview.

• 1:28:42Speaker 00

  Some lights. But I, you know, at, at my age, it's harder to maintain muscle mass. And that's a huge risk for all types of degenerative conditions, for injury and for Alzheimer's as well. I mean, one of the most powerful risk markers for Alzheimer's is sarcopenia, loss of muscle mass.

• 1:29:02Speaker 01

  Yeah.

• 1:29:02Speaker 00

  And loss of grip strength, because your muscles are weaker. So I'm doing everything I can to maintain muscle mass, and that means for me, making sure I get adequate amount of, adequate amounts of protein, exercising a lot, like I've told you. And I happen to use a testosterone gel just to make sure that I'm, I'm as anabolic as I should be, not as I can be. You know, there are other things out there that I am not doing. I mean, there are gene therapies now that help you build muscle. I have not gone that. Am I thinking about it? I'm considering it, but I'm not really willing to accept that risk just yet. Let's wait for more data.

• 1:29:37Speaker 01

  Or peptides in general.

• 1:29:39Speaker 00

  Or peptides in general. I'm not using any peptides.

• 1:29:42Speaker 01

  Yeah.

• 1:29:42Speaker 00

  Would I in the future? Yes, but I want more data. You know, to me, it's really above all, do no harm. And talking about me now, and so.

• 1:29:51Speaker 01

  Yeah.

• 1:29:52Speaker 00

  Yeah.

• 1:29:52Speaker 01

  And. Well, it's interesting because when you talk to real, like, when I say real doctors, I mean real doctors. They don't want to be on a GLP-1. They don't put their, their wives or their husbands on GLP-1s, but for patients, it's okay, right?

• 1:30:05Speaker 00

  Oh, that's very common. Do as I say, not as I do.

• 1:30:08Speaker 01

  Exactly, because there are risks. People don't, it's not trendy to talk about it. It's not something that is popular because people like, people are visual and it's like easy and, and it's like a quick fix. It is a quick, a lot of it could be a quick fix. You're getting these things from China. You don't know what's in your body. No one wanted to take a COVID shot. Remember like the conspiracy theories around taking, you know, the vaccine? But people are like shooting themselves up with 27 peptides. They don't know what those are. The hypocrisy is crazy.

• 1:30:38Speaker 00

  I, I would say to a patient who is asking me to go on a GLP-1 drug, let's just say for weight loss.

• 1:30:44Speaker 01

  Yeah.

• 1:30:45Speaker 00

  I would say, are you willing to commit to being on this drug for the rest of your life? Why did you ask me that, doctor? The reason I'm asking you that question is because when you stop, if you decide not to do that, and you're not going to be on it the rest of your life, and now it's time to quit, chances are significant and most likely that you're going to gain back all your weight and then some. And that's where you're going to be when you decide you're not going to take this drug anymore. Now, that's a different conversation from the one I would have with the family and loved ones of an Alzheimer's patient if it were proven that this were an effective intervention.

• 1:31:23Speaker 01

  Right.

• 1:31:23Speaker 00

  Because we lack that right now. I would say that, you know, we're going to commit mom or dad to being on this drug because it does show significant efficacy, knowing that if we don't do it, that this is a fatal condition.

• 1:31:36Speaker 01

  Yeah.

• 1:31:36Speaker 00

  So we have, you know, what do we have to lose?

• 1:31:39Speaker 01

  Right, at that point, that's a whole different, that's a whole different ballgame. Okay, talk about the two tests that people, that your doctors don't tell you about that could be very beneficial.

• 1:31:48Speaker 00

  Right.

• 1:31:49Speaker 01

  To knowing where you are.

• 1:31:49Speaker 00

  Neither of which requires a prescription. So you can go to your lab, ask them to do a homocysteine, H-O-M-O-C-Y-S-T-E-I-N-E. There's probably a graphic right now on the screen that says homocysteine. There it is, magic. And so homocysteine is an amino acid that when it accumulates and reaches a higher level than normal, we'll talk about that in a moment. It increases the risk of Alzheimer's. Cardiovascular disease is threatening to the lining of blood vessels. It's a bad player in your body. And it's simple as can be to fix. How do you lower homocysteine? If it's elevated, you take a methylated B complex.

• 1:32:29Speaker 00

  Not just a B complex at the health food store, but one that says methylated B complex at the health food store, online, buy it. So you can get the blood test without a doctor and you can do the response without your doctor. And I put the parameters of where you want your homocysteine to be in the book. Now, there are genetic predispositions to having elevated homocysteine. I have that. It's called MTHFR. If you have it and you've got your genome sequence, you've heard of MTHFR. There's been mood disorders characterized by having MTHFR. The main thing for me is it causes me not to use regular B vitamins appropriately. So my homocysteine went up to 11. I took methylated B vitamins.

• 1:33:13Speaker 00

  I take them religiously. My homocysteine ranges between six and eight, so I'm okay. The other test, and we mentioned earlier, is a fasting insulin test that is predictive in terms of where your blood sugar is going to go, where your A1C is going to go in the future. Because the first thing that goes up is your insulin level. Then the blood sugar elevates, then your A1C elevates. So that's the great test to know where you are in terms of risk of that critically important metabolic marker, your blood sugar, right now.

• 1:33:45Speaker 01

  So how about the, you said something in the book, I don't remember exactly, mood disorders, like anxiety, depression. Does that cause inflammation in the brain, which then can also be a precursor for someone getting dementia or Alzheimer's?

• 1:34:01Speaker 00

  So there's a profound relationship between mood disorders, primarily depression, but anxiety as well, and the presence of inflammation in the body. It is not to say that the mood disorder caused the inflammation. It is the opposite, that the inflammation leads to the feelings of depression, et cetera. When you are sick, you have inflammation in your body, you have the flu, you have COVID. How do you feel about interacting with other people? You don't. You don't want to be with other people. You, you feel crappy, you're weak. And it's because inflammation is actually changing your neurochemistry and leading to these changes in your mood. And that's probably good for the herd, right?

• 1:34:44Speaker 00

  That's probably good for all the rest of us, that you decide you're going to isolate right now because you just don't feel like being around other people. You feel crappy. And so that might be why that happens. But to be sure, this is the inflammation that polarizes our brain's microglial cells away from being brain defenders to being brain destroyers. Again, we can image the human brain in living people to determine the state of function of our microglial cells. We can image the Alzheimer's brain and see that it's lit up on this special type of PET scan called a TSPO PET scan. I talk about it in the book. It lights up with those microglial cells being shifted to their M1 configuration. But guess what?

• 1:35:28Speaker 00

  This TSPO imaging is positive in Alzheimer's. I mentioned that. Parkinson's, MS, multi-system atrophy, progressive supranuclear palsy, PTSD, a major depressive disorder, long COVID, autism spectrum disorder, all of which are characterized by this activation of these microglial cells. Well, that's interesting from a research perspective, but it tells you and me something very important, that this is a huge net that is thrown, that if we can figure out how to rein in these microglial cells and bring them back to be supportive, that is a home run across so many areas.

• 1:36:09Speaker 01

  Okay, I have a couple of other questions, random, not random.

• 1:36:12Speaker 00

  Don't stop, you're doing great.

• 1:36:14Speaker 01

  Thank you, thank you. There's a, what's that erectile dysfunction medication?

• 1:36:18Speaker 00

  Viagra.

• 1:36:19Speaker 01

  But not Viagra, it's another one. Cialis. Cialis. I heard that Cialis is actually, people are taking Cialis to lower their.

• 1:36:31Speaker 00

  Risk for Alzheimer's.

• 1:36:32Speaker 01

  Risk for Alzheimer's. Is that, is that, does that actually work?

• 1:36:36Speaker 00

  In an evaluation of more than several million medical records, a study was performed to determine is there any indication that people taking any particular drug that might therefore with crunching this data would be associated with a lower risk of Alzheimer's, it turned out to be these types of drugs. It turned out to be sildenafil in particular, which is Viagra. Why would that be? It gets back to an earlier conversation we had that relates to the mouth organisms, nitric oxide. How do these erectile dysfunction drugs work? What is an erection? An erection is opening of blood vessels to allow the erection to happen.

• 1:37:18Speaker 00

  Blood fills the penis and it becomes developed what's called Tugger pressure. Tugger pressure is what makes it hard. That's what an erection is. It's caused by blood supply increasing suddenly to the corpora cavernosa of the penis allows that to happen. It is a dependency upon nitric oxide, allowing that dilatation to happen. That's why these drugs work. Now, nitric oxide improves blood supply, improves blood supply, as I mentioned earlier, throughout the brain and nitric oxide improves insulin functionality for better utilization of glucose, keeping the blood glucose under control. So is there evidence that these people are doing the right thing? Hard to say.

• 1:38:03Speaker 00

  There hasn't been an interventional trial that I'm aware of as yet. Do I think it has merit? I absolutely do.

• 1:38:09Speaker 01

  So should we all go on Cialis or Viagra?

• 1:38:11Speaker 00

  Well, I don't, I can't have the answer. You know, you want me to quote the science? That study hasn't been done yet. But is it mechanistically plausible that that is the right thing to do? The answer is yes.

• 1:38:21Speaker 01

  So which one has more nitric oxide, Cialis or Viagra?

• 1:38:25Speaker 00

  I don't have the answer for that.

• 1:38:26Speaker 01

  Okay.

• 1:38:27Speaker 00

  I think that Cialis is designed to have a longer half-life. So it might be a more appropriate choice than Viagra in terms of keeping that nitric oxide elevated for a longer period of time. But there's no data that I can quote to you right now that that's an appropriate choice.

• 1:38:42Speaker 01

  Okay, so that's interesting. Okay.

• 1:38:44Speaker 00

  Mechanistically, it makes sense.

• 1:38:45Speaker 01

  Mechanic, okay. The other one I have to ask you about is Benadryl. I heard not to take Benadryl because it does cause Alzheimer's.

• 1:38:53Speaker 00

  Well, I'm not going to say that Benadryl causes Alzheimer's.

• 1:38:58Speaker 01

  Taking it too often, though, can.

• 1:38:59Speaker 00

  Oh, yeah. I mean, but is there a ratio, relationship between taking diphenhydramine, which is what Benadryl chemical name is, frequently and risk? There is that relationship of risk. There's a bit of a nuance, more than a nuance. I think it's important to delineate between saying that taking Benadryl is going to give you Alzheimer's to the idea that frequent use of diphenhydramine or Benadryl or Valium or anticholinergic drugs that help you because you get up frequently at night to pee and risk for Alzheimer's. We know that's true, that risk is increased in men.

• 1:39:36Speaker 01

  But why?

• 1:39:36Speaker 00

  Who take those types of drugs? Well, anticholinergics block acetylcholine. Acetylcholine is a critically important neurotransmitter. That might be the reason. So that may be the reason, there may be other reasons.

• 1:39:49Speaker 01

  How much is considered too much? Like, can I take Benadryl once in a while?

• 1:39:52Speaker 00

  If you take it once in a while. I cannot imagine that's a huge issue. We know that, for example, people who take antacids, these proton pump inhibiting antacids that are advertised on television where you see somebody tries to eat a sausage and they get heartburn, they gotta take this PPI.

• 1:40:08Speaker 01

  So anything, anything, when you overdo anything.

• 1:40:12Speaker 00

  Yeah, but I mean, people don't think they're overdoing it because the messaging is take it every day and you won't have acid reflux or heartburn. And, you know, the people who take those drugs every day do have a dramatic increased risk for Alzheimer's disease. That's published research.

• 1:40:31Speaker 01

  I also heard Xanax, all these drugs, like all these anti.

• 1:40:36Speaker 00

  Benzodiazepines.

• 1:40:37Speaker 01

  Yeah.

• 1:40:37Speaker 00

  Now, that's true as well.

• 1:40:39Speaker 01

  That's true, for sure.

• 1:40:39Speaker 00

  But, but for me, so I see this data that relates taking these proton pump inhibitors. I talk about it in the book.

• 1:40:45Speaker 01

  I know.

• 1:40:45Speaker 00

  Why might that be? Well, these are drugs that block acid. They change the pH of your gastrointestinal system. What will that do? pH is tightly regulated and the organisms that live there, that's the environment they like. All of a sudden, you change the acidity and they don't like to live there anymore. They're gonna move, you know, it's too cold to live in Indianapolis, I'm gonna move to Fort Lauderdale. They don't want to live here anymore and they're not there doing their job anymore.

• 1:41:12Speaker 01

  Right, right, right.

• 1:41:13Speaker 00

  So the microbiome has been one powerful explanation as to the association of non-steroidal anti-inflammatory drugs with Alzheimer's risk and with these anti-acid drugs as well. Certainly, and I talk about in the book, antibiotic over-usage is associated with dramatic changes in the microbiome and Alzheimer's risk. Please be clear. I'm not saying we should never take an antibiotic. They're life-saving, they are wonderful, but you know.

• 1:41:41Speaker 01

  You can overdo anything, though.

• 1:41:43Speaker 00

  Well, the research indicates that about 50% of the antibiotics used in America are used inappropriately and 80% of the antibiotics manufactured in America are used in animals that we eat to make them fatter.

• 1:41:58Speaker 01

  Right, of course.

• 1:41:59Speaker 00

  80%, more than are used in humans.

• 1:42:02Speaker 01

  That's why organic, I think, is obviously, that's why people don't want to eat regular, I guess, non-organic meat.

• 1:42:09Speaker 00

  It's just breathtaking that we have to have a special effort.

• 1:42:14Speaker 01

  I know.

• 1:42:15Speaker 00

  To find foods that aren't covered in chemicals. And I talk about that in the book as well. I cover a lot.

• 1:42:22Speaker 01

  Well, look at those chickens at Costco. Have you seen the size of those chickens?

• 1:42:25Speaker 00

  I have. That's not normal.

• 1:42:26Speaker 01

  I know.

• 1:42:27Speaker 00

  And what stimulates their growth? Antibiotics.

• 1:42:30Speaker 01

  Well, that's what I'm saying. Like, they're like, oh yeah, it's $5 a chicken. Yeah, but you're literally just eating a bunch of like antibiotics.

• 1:42:36Speaker 00

  Bargain now on the chicken and you will be spending more money in the future dealing with your illnesses.

• 1:42:40Speaker 01

  100%. You pay now or you pay later?

• 1:42:43Speaker 00

  That's right.

• 1:42:43Speaker 01

  You know? I have one random other question for you. Were you ever, like, because you've been writing books for 100 years. Did you ever practice? Did you have like an, do you actually see patients?

• 1:42:54Speaker 00

  Now, I don't. Now, I.

• 1:42:56Speaker 01

  Well, not now, but when did you stop?

• 1:42:57Speaker 00

  I practiced for 30 years.

• 1:42:58Speaker 01

  So you were actually, like, you were.

• 1:43:00Speaker 00

  I had the largest integrative neurology clinic probably in the world.

• 1:43:05Speaker 01

  Oh, excuse me.

• 1:43:06Speaker 00

  Yeah.

• 1:43:06Speaker 01

  Until when?

• 1:43:07Speaker 00

  Until I retired, which was about 12 years, 13 years ago.

• 1:43:10Speaker 01

  So you were writing these books and also practicing?

• 1:43:14Speaker 00

  And raising kids and all the things.

• 1:43:15Speaker 01

  Oh, you were doing both.

• 1:43:16Speaker 00

  Coaching baseball, writing a book. Give me, yeah, it was.

• 1:43:19Speaker 01

  Oh, I love that.

• 1:43:20Speaker 00

  Oh, it was great.

• 1:43:21Speaker 01

  Because I, because the reason why I'm asking is so many times, and I say this a lot on the show, like, you know, people are all on the show as doctors, but they're not really doctors. They just play one on TV, literally. Like, they're media doctors or social media doctors.

• 1:43:34Speaker 00

  Yeah.

• 1:43:35Speaker 01

  But they have, they don't see a patient, they're not really out there because now they just want to, you know, be out there.

• 1:43:40Speaker 00

  That, that's the reason I do what I do now. Because I, I was in, you know.

• 1:43:46Speaker 01

  You were doing it all.

• 1:43:47Speaker 00

  The one in the ER at night, talking to the family, saying, you know, what the outcome's going to be and wondering why did that patient have to end up here? Couldn't we have prevented this? That's what I'm saying to myself. That's not the discussion you have in the ER at night.

• 1:43:59Speaker 01

  Right, right, right, right.

• 1:44:01Speaker 00

  But, you know, why did this stroke happen? You know, why are there 800,000 strokes occurring in America?

• 1:44:08Speaker 01

  Yeah.

• 1:44:08Speaker 00

  Right now? And, you know, and then in my office practice, dealing with people who, mom, dad, spouse is now cognitively impaired.

• 1:44:19Speaker 01

  Yeah.

• 1:44:20Speaker 00

  I wasn't taught that in neurology training about what are the causes of the problem, only what prescription to write, end of story, out they go, done. That's not good enough. So.

• 1:44:30Speaker 01

  Good for you.

• 1:44:31Speaker 00

  Yeah, I was not wanting to focus on the smoke. I wanted to focus on the fire. And I will say that having a father who died of Alzheimer's really solidified my dedication to this because patients would say to me, you know, doc, you just don't know how rough this is for our family. And I would say, as a matter of fact, I do. Been through it, you know? And I remember that the moment I realized my father had Alzheimer's, I couldn't imagine how I missed it for so long. Because I'm, I was, you know, a very good diagnostician. I could diagnose Parkinson's across the parking lot, for crying out loud. But, and still do at the airport, and I go, oh, anyway.

• 1:45:13Speaker 00

  But I missed it with my own father until one day he asked me a question from the bottom of the stairwell. He yelled up the stairwell and asked me this question and I finally went, oh my goodness. He, because we just talked about something the day before.

• 1:45:26Speaker 01

  Yeah, he didn't remember.

• 1:45:27Speaker 00

  And then I realized, and then everything else that he'd been doing made sense, but I did miss it, the diagnosis in him. But.

• 1:45:35Speaker 01

  How old was he, by the way?

• 1:45:37Speaker 00

  He was in his, he was about 84.

• 1:45:42Speaker 01

  So he was also around my mom's age, he was older.

• 1:45:44Speaker 00

  That's right.

• 1:45:45Speaker 01

  And how long did it take? Like, when you noticed it, was he already, he was in a mild form, I guess, or?

• 1:45:51Speaker 00

  It was very mild and it took years to progress.

• 1:45:54Speaker 01

  How long?

• 1:45:54Speaker 00

  And then at the end, it took about six, seven years to really progress. But then at the end, it progressed very quickly as we generally see, you know? And that's why doing the things now with your mother are so important. Did I mention to you the study done by Rudolph Tanzi and Dean Ornish at Harvard? Again, let's revisit that. That was an interventional trial in patients who are diagnosed with Alzheimer's disease that in 70%, they either arrested their decline or even improved.

• 1:46:29Speaker 01

  What did they do exactly? Can you tell me?

• 1:46:30Speaker 00

  I'm going to send you the entire protocol.

• 1:46:32Speaker 01

  Because right now, my mom's in that middle to advance. She's not like at the end, like, she's now in a 24-hour care facility. She's very confused. Is it too late?

• 1:46:42Speaker 00

  Nope. Not at all.

• 1:46:44Speaker 01

  You'll send me that stuff?

• 1:46:45Speaker 00

  I will send you that stuff. As a matter of fact, we have it right outside.

• 1:46:48Speaker 01

  You do?

• 1:46:48Speaker 00

  Yeah.

• 1:46:49Speaker 01

  Okay. And if, I mean, that'd be great. I would love to see it.

• 1:46:53Speaker 00

  Yeah.

• 1:46:53Speaker 01

  What else can we go over? It's been 100 years, but.

• 1:46:57Speaker 00

  Let's let what we just talked about sit for a second.

• 1:47:00Speaker 01

  100%.

• 1:47:00Speaker 00

  Because this is why we do what we do.

• 1:47:03Speaker 01

  You can come back.

• 1:47:04Speaker 00

  Well, that's all right, but.

• 1:47:05Speaker 01

  You'll have another book pretty soon.

• 1:47:06Speaker 00

  Call it like it is, you're suffering. I know you are. And I've been there too. And it's so challenging because you're told there's nothing that can be done except for, and your mom tried the medicine, right?

• 1:47:17Speaker 01

  She was on something that made her like very, like, agitated.

• 1:47:22Speaker 00

  Yeah. So again, thank you for, for having this time together today because this is, you know, I believe such a critical message and I'm so glad that you've given me this opportunity to get it out there a little bit more.

• 1:47:36Speaker 01

  Absolutely. I really enjoyed your book. I think your book is very, it's, there's so much in it. And even if people just like read a little bit, put it away, come back to it, like you really cover the gamut in it. And so I'm so glad that I finally got to, to meet you.

• 1:47:51Speaker 00

  Me too.

• 1:47:52Speaker 01

  Thank you for coming on the show, really. The book, really, I'm really, I'm honored to have you here, so.

• 1:47:58Speaker 00

  I'm honored and grateful to be here. Thanks for this opportunity.

• 1:48:01Speaker 01

  Thank you. And guys, pick up the book. It's called Brain Defenders. It's out now by David Perlmutter and that's it. Have a good one. Bye.