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The Real Reason Dementia Is Rising And How to Prevent It | Dr. Tommy Wood | DSH #1875
01:07:24
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- [00:00]
A
But one of the reasons why Alzheimer's disease is expected to double or triple in the next few decades is because we're living longer. We think stress is bad, we need to avoid all of it, but in reality, like, stress is actually good. It's important. People who drink something like two to four cups of coffee a day on average have a lower risk of dementia. There's definitely evidence that, like, coffee and tea seem to benefit the brain long term.
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B
Okay, guys, Dr. Tommy Wood here today with the new book the Stimulated Mind. Congrats on the launch, man.
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A
Thanks so much. I'm excited to get out there and I'm excited to be here with you.
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B
Yeah, I think when this airs, it'll be fully out. So, yeah, talk to everyone about the book, why you made it and what, what's going on here.
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A
Yeah, sure. So the book is essentially about how to improve brain function and cognitive performance today and then through those same strategies, decrease the risk of dementia long term. So the book I basically wrote because I got to the point where working across multiple different fields, I've got a research lab where we study ways to treat brain injury. I work with Formula One drivers, try and improve their cognitive performance. We've done research looking at the different lifestyle factors that affect dementia risk. And so across all of those different spheres, we see the same things coming up again and again and again in relation to how to improve brain. Brain health, brain function, decrease risk of long term cognitive decline, improve recovery after injury. And so all of that are kind of put together in the book. And my hope is that people can sort of use it as a manual for brain health and then apply it in their own way to improve their performance today and then also decrease their risk of dementia long term.
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B
Yeah, brain health is one of the most important things to focus on.
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A
Right, Absolutely.
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B
Affects your livelihood.
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A
Yeah, it's. It's having a bit of a moment right now, which I think is. Is great. Kind of. Historically, we've spent a lot of time focusing on weight loss or like, you know, how, how we function below the neck. Right, right. Heart. You spend a lot of time as a society focused on heart disease and things like that, which are obviously super important and affects brain health too. But right now, I think recently people have felt like their brains are struggling and they're worried about how their brains are going to function 5, 10, 50 years in the future. So I think it's, I think it's good that people are starting to think about that and yeah, yeah, hopefully I can help.
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B
I also think there's a big movement with gut health, which. There's a link there, right, with the brain.
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A
Yeah, absolutely. They're, they're in like constant bi directional communication. So everything that you do that affects your. Yeah. Like your body's health affects gut health. That can affect brain health. The brain obviously directly runs a lot of what happens in the gut. So. Yeah, two are directly connected. Yeah.
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B
Are you seeing the aging of the brain kind of correlated with person's health span their lifespan?
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A
Yeah. So there are, there are two parts to that. Right. So there's lifespan just being how long, how long people live. But what, what people like you speak to most people, they just care about living a healthy life as long as they live for. Right. So it's probably a minority of people who really care about whether they could live to be 100 or 110 years old. But most people might want to get to 80 or maybe 90 and just they're still physically intact, they're still, they're still sharp. Yeah. But one of the reasons why Alzheimer's disease in particular, which is the most common form of dementia, is expected to double or triple in the next few decades is because we're living longer. Right. So we've, we've gotten really good at treating heart disease and other things that cause people to die sooner. So now sort of like the next frontier of trying to prevent long term decline in physical and cognitive function is to focus on dementia prevention and what we can do for our brains because, you know, the, the primary reason that we get significant cognitive declines because we get older and the longer we live, the higher the risk. So that's like now is really the time to focus on that.
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B
Interesting. So you're seeing as the lifespan increases, the rates of dementia go up, basically.
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A
Yeah. So exact. Exactly right. And there's two interesting things going on. So one, actually, over the last hundred years, the risk at any given age of being diagnosed with dementia has actually decreased as we've improved population health, we've improved cardiovascular health. Like the nutrient status of the population has actually improved compared to say the 1930s, 1940s, but because of that, we have a lower risk. So if you, if you're like 70 years old now, you have a lower risk of dementia than at 70 than you did 10 or 20 years ago. But because we're living longer and because the metabolic health of the population is continuing to decline. Right. Increased risks of diabetes, obesity, metabolic syndrome, there's kind of this risk that we're going to see start going back in the other direction because of Aging and then because of, you know, overall physical health.
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B
Yeah. And what role does environment play in all this? All the toxins, the air pollution?
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A
Yeah, it can, it can play a really big role. So we know that an air pollution is, is the perfect example because it's been quite closely tied to a risk of Alzheimer's disease. It causes inflammation in the brain and that sort of compounds, you know, all these other things that we might have going on. It's possible that other things that we might get, you know, in the water. So in some places in the country. Right. There's still lead in the, in the water, in the water supply or in the pipes. And we know that lead is a risk factor for dementia, as are some of, you know, potentially some of the other forever chemicals that are sort of in the water supply. And most places are fine. But, but it certainly seems like doing what we can to attend to our, the quality of, quality of our water, quality of the air that we breathe. So there are some really nice studies where just having an air purifier in the house significantly improves blood pressure. We know that blood pressure is a risk factor for dementia. So not everybody can move where they, where they live and not everybody can like, install water filters like go into their house, but you could get a water filter that goes, that goes in like just a jug in your fridge. You can get an air purifier that like sits in the rooms that you spend a lot of time in, particularly if you live near roads or other like, industrial, industrial activity. So even just like small things like that, you know, could, could add up to have a big effect.
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B
Yeah. When I was house shopping out here in Vegas, I found a beautiful house, but it was right off a highway.
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A
Yeah.
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B
And I literally didn't buy it just because of that, but it was an amazing property.
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A
Yeah. And you know, you can overcome some of that, right. You, you put in some filters and things and a lot of people, they, you know, they don't get the option to, to move. But like I said, there are studies that show that you can significantly improve health if you're particularly for a high risk and you, you have a high air pollution burden. Like air quality in the house tends to be, can often be worse than outside because it, right, you, it's, you don't get fresh air kind of coming through and clearing stuff out. So. Yeah, filters. And then, you know, I live in Seattle in the summer, we often have, you know, wildfire season. So if it's really smoky outside, you know, spending less time outside or you know, maybe getting like N95 masks or something. Just like when it's really smoky, like, you know, in one year, maybe it doesn't have a big effect, but over time that kind of stuff can add up.
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B
Well, there's that many fires out there.
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A
Yeah, yeah. So the. I think the last several years I've lived there usually by sort of August, you know, end of August, there's this and wildfires and that either stuff blows up from California or down from Canada or obviously we have local fires in, in Washington and Montana. So. Yeah, that's crazy.
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B
I didn't know that my new Cali had a bunch. So it's getting all the way up there.
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A
Oh yeah, yeah. So like there have definitely been times when the, you know, there's like this post apocalyptic look of the sun. You sort of like wake up and it's all kind of like dusky orange because there's so much smoke in the air. So. So yeah, you have to be, you have to be careful with that if you can. Jesus.
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B
I do want to talk about social media because it's ironic. Like I make a living off it. I know there's some downsides to it.
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A
Yeah.
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B
And I'm on my phone eight hours a day. I just saw this thing today that like I'm affecting parts of my brain because of the short form attention.
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A
Yeah. So like there's. There's multiple things that. To unpack there. The. You're right. That there's. There's been some interesting studies looking at how short form media, like affects our attention. Because we only train ourselves to pay attention to like these short little clips.
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B
Yeah.
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A
Plus the way the algorithm works, it's designed to not give you all the good stuff immediately. Right. So you keep, so you keep scrolling, right. So it's almost like, you know, you're playing the slots and so like, right. Stuff won't happen then. Right. Then you hit the jackpot. You get like your nice little dopamine bump because you enjoy it. And dopamine is there to, to teach you about things. And so you're like, oh yeah, if I did this stuff and I scrolled enough, right. I get, I get my ex bump. I. I'm going to learn something. That's really what the brain's looking for is sort of information so it can learn. Right. It thinks from social media you're learning about your social context, which is something that humans prioritize. And so because of that, you're sort of driven to just look for these small snippets that you then enjoy and they're relatively short. And so we know that your brain, where the primary driver of how your brain works is how you use it. And that's essentially like the, the whole kind of thesis of my book. And that you know, you can use that for good or you can use that for evil. And when we don't spend time doing things that require really deep focus attention, we lose our ability to, to pay attention to things for extended periods of time. Another thing that we see is that often when we're using social media, we're not just using social media, right? You've got Netflix on and you're looking at social media and you're like chatting on WhatsApp or texting or you're doing your emails, right? And so when we do this in the scientific research, it's called multimedia multitasking. And the, the human brain is, is only really good at doing one thing at a time. If we allow it to do one thing, one thing at a time. But if you spend a bunch of time doing that, the brain does adapt. So you get better at dealing with multiple inputs from multiple places. But you also become more distractible because the brain is constantly on the lookout for like what's the next thing, where's the information going to come from? And again, it's just, it's responding to the inputs that you're giving it. So if you're trying to think about, right, you make your living on social media, you can't get off it entirely. Like what are ways that you can potentially minimize some of the downsides? Yeah, one would be when you're on social media, just, just use social media, right? Just like focus on one thing at a time. Others will be spend. And I think this is probably the most important thing. Spend some time doing deep focused work and learning some kind of skill that requires your undivided focus attention. Because we know that when people do that they sort of train their focus muscle and then, and then you can maintain it and learning skills, sort of challenging ourselves both physically and cognitively. That's how we build capacity and function in the brain. So if you're right, any of us, we have to spend our time sort of like my days are made up of zoom calls and teams meetings and somebody's messaging me on Slack and I have to respond to emails, right? So then it's just making sure that you spend some time during your, during your day doing really deep focused work. Whatever it is. It could be research, it could be learning, it could be preparing presentations. It's just something that really takes all of your focus and attention. And then another part of social media that's problematic is just. Is the way that our brains interpret what we're seeing. So, like I said, humans kind of prioritize social information. Um, and in the scientific literature, sometimes it's called prime information. So prestigious in group moral and emotional. Right. Because as social beings and as our. It was our social groups that really drove human brain evolution. We're kind of. We're primed to look for social cues and to understand where we fit in, like the social world. So we know now, and people have talked a lot about this recently, we know that when you become socially isolated. Right. That causes a stress response that increases inflammation, it increases chronic disease risk. But we experience very similar responses when we feel socially stressed in other ways. And so that includes social stress by comparing yourself to others. And as you can imagine, if your social media feed is filled with people who are, like, more successful, more rich, more jacked than you are, which most are. Which most are, are, then you spend all your time, like, internally demoting yourself, or I'm not as good as these people. I'm not doing enough. I'm not working hard enough.
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B
That's how I was in high school and college.
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A
Right. And then when you do that, that causes a stress response because you don't. You feel like you. You sort of. You've decreased your social rank. Right. And that's. That's inherently stressful. So for those where this isn't necessary for your job or whatever, curating your feed as much as possible so that it's not all just people making you feel bad about yourself. Right, Right. I think that's gonna. That's gonna be a really critical part of it as well.
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B
Yeah. I do want to dive into stress because that's something I need to tackle. This year. I got this aura ring, and it says I'm stressed about six hours a day, which sounds like a lot. As men, I think we just push through it naturally. Like, I. I genuinely didn't even know I was stressed.
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A
So in. In some ways, that's, that's. That's probably a good thing that you didn't know, because there's some interesting research that says that if we think we're stressed and we feel stressed and we think that stress is bad for our health, then that has a greater impact on our health. Wow. Right?
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B
Well, now I know. So ignorance is bliss, right?
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A
Yeah. Yeah, exactly. In some respects it is. So that doesn't mean that you shouldn't like think about your stress. And we know that stress has an effect on long term brain health and dementia risk primarily through like physical things that we can measure. Right. So there's this idea called allostatic load, which is essentially the total burden of things that you're exposed to, other things that you have to deal with. And people who have a high allostatic load tend to have higher blood sugar, high blood pressure. They look a lot more like somebody with metabolic syndrome. They tend to have poor nutrient state or poor own nutrient stasis, like lower vitamin D. Yeah. And we're not really sure if that's like cause or consequence, but that's something that can be addressed. They have higher, higher levels of inflammation. You can measure like CRP on a blood test. So if people are worried about their stress, one good thing to do is just like get a checkup, like see, like make sure your blood sugar is good, make sure your blood pressure is good. And so that's certainly something that you could keep an eye on. And then, then you just have to think about like where are your stresses coming from and what could you potentially do about it. And the most important thing that I think people can do is think about the stresses that you have control over. And often stress and burnout are related to a loss of control. Like that's, and that's really what seems to tie stressors to increase risk of dementia, increased risk of depression, of depression as well. So can you eliminate some things. Right. Just because you don't need to do them, although they're not important? Yeah, if, if you can't do that, then think about ways that you can, but that you can buffer against a bun, against stress. So some things might be. We know that we can improve our resilience to stress if we exercise. So that's been shown in several studies that if you regularly exercise, you tolerate stress better. It has less of a physiological like effect on you. You can also do a whole host of different kind of meditation or mindfulness strategies that seem to again improve blood pressure, improve stress responses, and it doesn't really matter which one you do, like loving kindness, meditation, transcendental meditation, formal mindfulness, just sort of like 5 to 15 minutes a day seems to improve our tolerance for stress and sort of like help us relax. Interesting. And obviously like people can take that really deep. Like they can do hours and hours of meditation a day. In certain people that comes with an increased risk of, of its own mental health issues. But just like taking a break during the day can have a big effect and so it doesn't even need to be mindfulness of meditation. Like, there are studies. There are studies that show that just taking a break outside, you don't have a lot of green space around you outside, right? But if you have, like, a view of nature, that can help. But even just, like, watch the. You can. You could even resort to your. Resort to your phone if you had to, watching stuff that allows you to truly disconnect. So there have been studies using, like, TV shows that you're familiar with. So, like, watch a rerun of something that you enjoy, right? There's no sort of none of the social stress that you have on social media. It's funny, it's relaxing, it's calming. They've had done studies showing that if you watch five. Five minutes of like, a comedy clip on YouTube, that sort of reinvigorates you to go back and do hard cognitive work. So just like anything that kind of breaks up your day allows you to truly kind of relax and step away from whatever it is that's causing the stress like that. But even those small breaks can have a big effect. And then the final thing that's important is just as, you know, with whatever stresses you have left. There's some interesting research on the idea of reframing stress and thinking about what stress is really for. And when you do that, that decreases some of the negative effects of it. So nowadays when we talk about stress, we think, right, stress is bad. We need to avoid all of it. But it. But in reality, like, stress is actually good. It's important, okay? It's there to divert resources. And that could be, you know, blood sugar, energy, focus, and attention to something that's. That's important, right? So anytime you're really, like, focused and locked in, you've actually activated a small part of the stress response. You know, noradrenaline and dopamine and some of these other, like, stress hormones get up regulated, and that's what allows you to kind of like, focus in.
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B
Interesting.
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A
When you exercise, you also increase the stress response, right? And so cortisol goes up, adrenaline goes up, blood sugar, you know, often blood pressure, depending on the type of exercise, right? They all go up. And this is to divert, again, resources so you adapt to whatever's coming in. So knowing that stress is actually a survival thing and it's important. And if we want to get, you know, better cognitively, if we want to get better physically, we have to activate the stress response to, like, divert resources to that part of the body so it improves its function.
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B
Yeah.
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A
So often when we're stressed, right. We're doing something cool or important and it could be, it could be life threatening or not, but. Right. Your body is then responding to that and saying, okay, I need to make sure that I can do this thing, so I'm gonna like divert my energies towards it. Right. That's what, that's what stress does. So stress only becomes a problem when the stressor doesn't switch off. Right. So like, if it's starting to impact your sleep, you're constantly ruminating, you're worrying about it. Right. That's definitely a problem.
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B
Yeah.
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A
But going into a stressful situation, they've done studies where you sort of randomize people to two groups. In one group, you sort of prime them with some videos and some scientific information. You say, do you know what? Like, stress is really bad for you. Right. It's bad for your health. It causes things to break down, like long term, you know, stress can have a big negative effect.
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B
Yeah.
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A
The other group is, is told, you know, stress is there to allow you to do something important. Think about all the amazing people who've done incredible things under stress. And that could be like military leaders of countries. Like they use, like Sully Sullenberger, the guy who landed the plane in the Hudson. Right. Just like, think about these people were incredibly stressed and they, you know, they performed under significant pressure. And when people then go into a stressful situation in these studies, both groups get stressed. Right. But cortisol, the stress hormone, goes up in both. But in that second group where they talk about this idea that stress is enhancing. Right. Actually it's there to build our capacity. They also release other hormones that are associated with improvements in function, like dhea. And we know that people who release more DHEA when they're stressed, they actually perform better under stress. So changing your mindset, going into a stressful situation can actually improve how you then perform in that situation. So all these things become important. Right. For some people, the chronic stress thing, that's where they need to focus. But for, for the rest of us, often it's just reframing how we think about stress because it has an important role and we want to be able to perform in the moment when we're stressed.
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B
Yeah. That is fascinating. That's a really good segue into the F1 work you do with these drivers who are probably experiencing a lot of stress.
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A
Yeah. So even though these guys, you know, they do this for, they do this for a living, it can be very common for them for them to be stressed and So a lot of what we do, I work with a company called Hints of Performance. We provide coaching and medical services to, you know, a good number of drivers on the grid and several, several teams. And a lot of my work is with the coaches. So if you've ever watched Formula one, there's always like a person who's carrying the helmet, carrying the, the umbrella over the car if it's hot or if it's raining. And they're like doing like helping the driver do drills and stuff beforehand. And this is, these are usually one of our coaches. And the coaches are sort of like fully inserted into the life of the driver. They're doing the training program, they're doing the nutrition, they're organizing travel and all this other kind of stuff. So we work in particular with the coaches to help track data. They might have auras, they might have whoops. Right. We do blood tests, we look at their blood tests, figure out, can we tweak nutrition, all these other things. And so often it's like, how can we make it so that we can allow these guys to, to relax, to switch off? If we think about this idea that how you use your brain is the primary driver of how it functions, and in particular, like skill development and driving the car, these are the best drivers in the world. Right. And so they get plenty of that sort of training stimulus. Right. But we know if you want to adapt to a, to a stimulus, it's the same if we're doing physical training or we're doing cognitive training. You need a period of like rest, recovery in order to, in order to adapt to it. So sleep is when a lot of this happens. And so a lot of what we do is we think, well, they're already, you know, spending time in the simulator, spending time in the car. They were in all these meetings with engineers, like, their brains are getting plenty of input. What we need to focus on is how can we get them to, you know, relax in the, in the short periods that they have. Right. They're basically jet lagged nine months of the year.
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B
Wow.
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A
They're in a different country every week, sometimes often going several time zones. And so like they're traveling all the time. Especially like sometimes they have three races on consecutive, on consecutive weekends. So you have to, where you race on a Sunday, then you have to like travel either the Monday or Tuesday you get a day on the ground and then like Thursday you're back in it with like practice and getting everything going for the next race. So then we're thinking about how can we how can we build in additional rest time? How can we get them to, to downregulate? And so sometimes we're thinking about sleep routines, sometimes we're thinking about sort of breath work and other things. Sometimes, you know, sometimes it's supplements that can help with sleep. Sometimes there are, there are some other things. So, you know, if there's like technologies that can help people sort of relax. So like right now something that's quite popular is a shiftwave chair. I don't know if you've, if you've heard of those.
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B
I heard of that.
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A
It's like this, it kind of looks a little bit like a lawn chair. And sort of embedded in it are these, are these pads that vibrate really strongly. And so you kind of put you, it's, you do like these, this guided breath.
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B
Oh, I just did this.
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A
Yeah, in like time. In like time with the vibrations. And it, A lot of people like it because it's sort of like a very quick, quickly kind of calms them. Yeah, you can, you can achieve the same result if you do some breath work or, or something. But it's just, it's quite sort of, it's quite immersive. Yeah.
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B
For me with adhd because breath work has been difficult with me. Meditation with adhd, but with that I had no choice but to.
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A
You have to. Yeah, you have to kind of get, get into it and just do what it says. Yeah, yeah, yeah, exactly. So like with a lot of these guys, if they're struggling to switch off something like that, the kind of. Really, there's no other option. Right. And this is the thing with things like mindfulness and meditation. They can, they can have a big impact, but they often just become this other thing that we all know that we're supposed to do, but like nobody has time to do. Yeah, yeah. And so stuff like that can, can like, can make that a little easier. So there's that kind of long term stress component. But then similarly, sometimes when we're getting in a car, like these guys can, these guys can get anxious. Even though there's millions of people watching, often there's a lot on the line. There could be contracts on the line, careers on the line. So then it's kind of something very similar like what can we do in the moment to kind of help them calm down? So often we're avoiding things that would be very stimulating. I think every F1 coach and driver I've worked with has a story where like they had a couple of espressos or some like a caffeine shot before they got on the car. And then they feel super jittery and they make a mistake while you're trying to navigate all these other cars at 200 miles an hour. So like avoiding things like that. But then also, you know, what kind of things can we do to sort of like get them locked in? And that's why, you know, you have some of those drills that you might see on, on tv. And similarly, we might, we might use some other breath work or some other tools to kind of make sure that they're not too anxious or stressed or too aroused when they get.
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B
Yeah, yeah. And I feel like the mindset's what separates the top athletes from the rest.
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A
Yeah, that's definitely the case. But it's interesting that and right. Every athlete is different. And even so often we, we kind of imagine that the top athletes, like, nothing, like nothing ever gets to them, nothing ever bothers them. They can just like sort of keep pushing through. Yeah, but in reality that's, that's not, that's not, that's not the case in, and probably in most sports we're all human, right? Yeah, exactly. And so that's actually, that's actually the key thing when, when you, when you look at traits of successful athletes, this is, this is true in the guys who work with, in Formula one, but you also see it in research in like successful Olympians and other athletes. They do two things really well. So one is they're very good at emotional regulation. And so that's like when you are anxious, when you are stressed, how can you sort of get yourself out of it as a whole? You know, many of the things we've talked about can, can help you do that as well as they have. They might have different sort of processes of getting, of getting ready. They have routines. Right. Some of these things can kind of like help them, help them get locked in if they're feeling anxious or stressed. But the other thing that, that they all do very well is they have, they good athletes tend to have good self compassion. Right. So self compassion is made up of mindfulness and common humanity. These are just things to say. They understand themselves and they understand they're human. They know that humans make mistakes. They kind of treat themselves as they would treat other people. Right. Rather than, you know, that kind of mindset where you're like constantly putting yourself down, like, oh, I'm a piece of, I gotta work harder. I'm not good enough. Right. That works for like some people, but it's actually a surprisingly small group of people. The Rest of the, you know, just have to, you know, build in these tools where they actually really understand themselves. They know that they can think about times and they made a mistake and they come. They came back. The things they. They learned, the things they've overcome, they can sort of treat themselves nicely.
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B
Yeah.
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A
And when they do that, that's. That's the thing that really sets like, these resilient athletes apart. And doing that allows them to focus on. On process. Right. So they're focusing on how can I get a little better, what can I learn, how can I improve over time? And so it's those people who are really focused on process. They end up being successful for long periods of time.
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B
Right.
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A
And it's just like. It's almost like a byproduct of, like, being really focused on the details, but also learning to sort of, like, know and understand.
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B
Yeah. And like you said earlier, certain athletes strive or thrive under stress.
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A
Yeah.
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B
And then other. Other ones fold. Right. I'm a big NBA fan, and you'll see guys with the same talent level, they average the same points per game, but in the final 30 seconds of the game, you could see what kind of separates those athletes.
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A
Yeah. And I think some of. Some of that, like, it might be inherent skills that guys have learned or that. That they've had, but I think a lot of that can also be. A lot of that can also be learned. And it's. It's going to be maybe about a part of the. The team, you know, the. The kind of. The situations they've been put in. Most. Right. So most of the guys that we work with, where we have performed, performance psychologists that they're there to help these guys build the kind of psychological and cognitive tools they need to perform in that kind of setting. And that's not a weakness. Right. That's part of making sure that you've ticked every box. So. So, yeah, like, everybody's gonna have a slightly different mindset in certain scenarios. Some are going to thrive better than others. But I think it's something that we can learn. Right. If we've got the right sort of situation and team around us.
- [30:46]
B
Yeah. I did want to touch on diet. I know you've talked about it a lot, but anything new you're seeing, I guess with diet and all this stuff you're working on.
- [30:54]
A
Yeah. So I think that there were. There are a couple of things that really stand out. So the first. And you kind of see this across that kind of spectrum of people that I've worked with. So, like, athletes on one end and then, you know, people at risk of dementia at the other. And it's just like how much energy your body, body has available, which doesn't sound particularly sexy, but it's actually one of like the biggest levers, if not the biggest lever in nutrition. When you look across big populations of people and multiple populations around the world, if you have low energy availability, we call it, right, so you're not getting enough calories in to kind of run the whole system to maximum effect. That's very common in athletes who are doing a lot of training. They just can't eat enough or they aren't eating enough to like maintain like all their body systems. You see changes in mood, you see changes in brain structure, you see changes in brain function, they don't sleep as well. And so you also see similar things in populations that, where, you know, calories are harder to come by. So certain hunter gatherer populations where, you know, there isn't abundant food, they tend to have lower brain volumes, for example, just because there isn't as much energy to invest in building a brain. But then at the other end, which is kind of what we have is more common in the US and Europe and other countries around the world, you have too much energy availability. All right, so that's where we have metabolic disease, heart disease, high blood sugar, high blood pressure. And you say this, you see the same thing again. You see smaller brain volumes, higher risk of dementia. So there's like this sweet spot where you're still, you're eating enough food, but you're not eating so much that you start to gain weight and you start to have issues with blood sugar and blood pressure. And there are, there are studies where they've tested diets that they thought were particularly neuroprotective. So there's a diet called the mind diet, which is basically like the Mediterranean, a version of the Mediterranean diet for dementia prevention. And they tested that in a group of individuals for three years just compared to like standard calorie restriction. So you're eating the same food. So like the mind diet is, you know, it's going to be nuts and seeds and, you know, and berries and kind of whole foods and like that kind of Mediterranean, like olive oil, Mediterranean style diet. And the calorie restriction group was just, just eating less of the food that you're currently eating. Right? And both groups significantly improve their cognitive function. Because in the sort of an average US Adult, the most important thing is that they're probably a little bit overweight, they've got slightly high blood Sugar, slightly high blood pressure. So just reducing calorie intake is enough to have a significant effect. We do know, though, that nutrient status is, is really critical. So B vitamins, things like. So a measure of the B vitamins that are really important for, for dem, dementia risk or cognitive function is, is homocysteine. It goes up when we're low in things like B12, folate, B6, or riboflavin, which is B2. So, and so that's something that the people you know is worth, is worth measuring. Your doctor can certainly get it. Omega 3s, really, really critical, and those two interact. So there are studies where you give people B vitamins to try and decrease the homocysteine and to decrease their dementia risk. But if they don't have enough omega 3s in their diet, they don't benefit. And you also see the opposite is true. So B vitamins, omega 3s, vitamin D, iron is really important, particularly for, for women, especially as they enter sort of like the menopausal period, sometimes they experience cognitive symptoms because they have low iron. So these are some of the, these are some, like, the basics that we know are really, we have really strong evidence that if we don't hit enough of those, we have a higher risk of, a higher risk of dementia. And so homocysteine and B vitamins also closely tied to some, like, mental health conditions, depression things, a lot.
- [34:54]
B
So let's say someone gets their blood work, because I just got mine and my, my vitamin B levels actually weren't low.
- [34:59]
A
Right.
- [35:00]
B
Would you still recommend these people to consider supplementing?
- [35:03]
A
No. So if you're, if your level's good, so you can measure like B12, folate, and these other things separately. And then you might measure your homocysteine level. If your homocysteine is sort of under 11, under 10, that's kind of like ideal in terms of like, brain health risk. So if you're in that range, no need to supplement, you're getting plenty.
- [35:25]
B
My, the issue with me has been D3.
- [35:27]
A
Yeah.
- [35:27]
B
I'm always super low.
- [35:29]
A
Yeah.
- [35:29]
B
25.
- [35:30]
A
Yeah. Okay. Yeah. So the risk really increases once you're below 20, but you at least want to be above 30. Yeah, I think that's where sort of like the lowest risk starts.
- [35:43]
B
I do get the cold a lot. I think it's related to three levels, which I've had my whole life. Yeah.
- [35:48]
A
And so, so for you, I would definitely supplement with, with, with vitamin D.
- [35:52]
B
Well, I was taking 5, 000 IU a day.
- [35:55]
A
Yeah.
- [35:55]
B
But I guess that's not enough.
- [35:56]
A
I mean, you're a reasonably big guy, so you might, you might need to take more. The kind of, the average dose that gets most people in the right range is like 2,000 a day.
- [36:05]
B
Really?
- [36:05]
A
You might need to take 8,000, 10,000. Like as long as you're measuring it and you're still in the right range. So when I work with athletes, there's some evidence that you might get slightly better performance if you're above 40. So kind of for the 40 to 60 range is usually what we target. So if whatever you, whatever you need to take to kind of get yourself definitely above 30, ideally in that sort of 40 to 60 range like that, that's fine. Where everybody's different. So you just figure out what works for you.
- [36:31]
B
Yeah. Wow. It's almost like a science the way you describe it, how you got to get their levels to certain ranges.
- [36:35]
A
Yeah, yeah.
- [36:36]
B
Optimize their performance.
- [36:37]
A
Yeah, it is, it is a bit of a science. Right. That's what, that's, that's what we do. But, but equally it's easy to get a vitamin D test for most people. Like most doctors will do it well,
- [36:49]
B
even though not my dentist made me do it because I'm getting my wisdom teeth out and he wants you to have high vitamin D3 levels to recover.
- [36:55]
A
Yeah. Okay. So, yeah, I'm. Like I said, you're not deficient. My deficiency would be below 20, but certainly it seems like it might make sense to nudge up your dose. Yeah.
- [37:06]
B
You mentioned coffee earlier, how it kind of affects certain athletes overall for like general people. What are your thoughts on coffee?
- [37:12]
A
Yeah, so I like coffee a lot. I drink it every day for like, again, like the average person. Coffee is one of the most common, if not the only source of antioxidant polyphenols, which can be really important for long term brain health and function. Caffeine in coffee also seems to have some effect. The. There was a, recently, just like a big study that just came out that showed that, you know, people who drink something like two to four cups of coffee a day on average have a lower risk of dementia. And this has actually been found in multiple studies over multiple countries. Tea might have some similar effects because there's some other compounds in there that, that, that have benefit in a similar way. Some studies suggest that like even decaf has the same effects just because, you know, you're getting the compounds for the coffee without the caffeine. The, the one sort of potential downside is if it's negatively affecting your sleep. So There was one study that looked at coffee intake and risk of death and they found that those who drink coffee in the morning had a lower risk of death. But if, though, if people were drinking coffee throughout the day, there was no effect. Like it wasn't negative.
- [38:28]
B
Got it.
- [38:28]
A
It just didn't have an effect.
- [38:29]
B
That makes sense because it's affecting their sleep.
- [38:31]
A
Yeah. And it probably because it's affecting their sleep or they're drinking coffee in the afternoon because they didn't sleep well and then. Right. They're trying to catch up. So it becomes like a sleep deprivation.
- [38:39]
B
What's a sleep deficit?
- [38:41]
A
Sleep deficit or sleep deprivation. Yeah. And so it becomes like a, it's like a feed forward thing. Right. So like you don't sleep, so you drink coffee in the afternoon and then you can't sleep again. Right. So then you need more coffee the next day. So I think there's definitely evidence that like coffee and tea seem to benefit the brain long term. But you know, most, most studies would suggest like stop drinking caffeine sort of, not at least sort of 9ish hours before you plan to go to sleep. So for most people, like midday is a reasonable cut off. Okay. If they, if they can, like small, smaller doses of caffeine, like what you might get in a can of coke or in a cup of tea is probably okay, like within a few hours of bed, but like, you know, a strong coffee or something like that, probably better just for the morning.
- [39:28]
B
Yeah. Yeah. I love talking to experts like you because on social media you see conflicting information sometimes and then you'll see people saying there's mold and coffee.
- [39:35]
A
Oh yeah.
- [39:35]
B
You'll see people saying there's microplastics in the tea bags. And you kind of get scared sometimes on what to take, you know?
- [39:40]
A
Yeah. And so this is, this is one of the things that's most interesting to me across like all kind of health advice. And it happens a lot, it does happen a lot in food, but you get, you get focused on one downside. Right. And you ignore like all the potential benefits. So if mold in coffee, which we're told is like, affects most of the global supply chain of coffee. Right. If mold and coffee was so bad for our, for our health, why do we see again and again and again that coffee is and like not high quality, like just like people buying it at Starbucks or whatever. Right. That coffee is consistently tied with better health outcomes and lower risk of dementia. Right, Good point. So, so even if mold, the, like the mold and mycotoxins in coffee have have a potentially negative effect. It's not. We're not picking it up in us in that signal. Right, right. So it's possible that some people don't tolerate those as well. Right. They. They probably. There probably is some, Some. Some. Some mold in some coffees. There's a mold. There's more than a lot of food. Some people don't tolerate that as well. Right. So for some people it may be an issue, but I think in like, the, the grand scheme of things, everything suggests there's a net. There's a net benefit. And we see the same thing in like, yeah, microplastics and mercury and seafood. Even though even. Even people who eat seafood with a high burden of mercury, they still have a lower risk of dementia because they're getting omega 3s and C and all these other things. Right. So it's easy to get tied up in the downsides. And I don't want to downplay the downsides, but despite those downsides, we still see net benefit. And so the. Yeah. Microplastics in tea bags, again, tea consistently associated with some, Some health benefits. There. There was one study where the tannins in tea, and so this is particularly in black tea, but you also get it in like green tea and white tea. Right. The tannins bind to the microplastics so that you don't. You don't absorb them or they get kind of. So, like, it could be that. So, like, yes, there might be microplastics in the tea bags, but the, just the fact that it's tea also, like, overcomes some of the downsides and that's why you see some benefit. So, so it's not that these things aren't an issue, but it's just that despite those things, we still see a signal of benefit.
- [41:58]
B
Yeah, I definitely fell for that narrative, especially with salmon. I stopped eating salmon because I was scared of microplastics, but now I've just realized it's in everything.
- [42:05]
A
Yeah.
- [42:06]
B
All the food packaging. Like, you can't avoid it.
- [42:08]
A
Yeah. So it, so it is in everything. And. Right. Even despite that, we see benefits of, like, salmon and seafood consumption, you know, again, has been showed consistently to be associated with better brain function, lower risk of dementia, and probably even a stronger signal than supplementing with omega 3s. And like, if you're not eating seafood, you should consider supplementing with omega 3. But seafood def. Is definitely beneficial. But the, the microplastics thing is. Is interesting because it is. Right. They are everywhere. Right. They're in everything. Food packaging. Right. You get your coffee from Starbucks, you're going to leach out the lining of the cup. And so I think that people should do whatever they can to decrease their exposure. You know, store stuff in glass, you know, minimize use of plastic bottles if you can. If you're cooking, use wood or metal utensils. Use like stainless steel pots rather than some of, some of the non stick coating. Right. They can release a lot of microplastics, especially if they're damaged. Right. So if you have damaged cookware, if you can like replace it. But the, a few things have come out of the, of the literature recently around microplastics. The first being that, do you have, did you see that like number like you, you eat like a plastic teaspoon or a credit card's worth of plastic like every week.
- [43:32]
B
That's a classic, right?
- [43:33]
A
Yeah. So there was another study that suggested that that was probably off by about two orders of magnitude, basically meaning that it's. The amount you actually consume is probably about 1% of a credit card rather than a whole credit card.
- [43:46]
B
That's a big difference.
- [43:47]
A
Yeah. Or at least like the way they estimated it, they felt like it was, was probably an exaggeration. And then there's the other thing. You might have seen studies where they're looking at microplastics in the brain.
- [44:00]
B
The testicles.
- [44:01]
A
Yeah, in the testicles, in the heart. And so micro. And they. So there was one study that said that people who had Alzheimer's disease had more microplastics in their brain than people, than people who didn't. But the, the way that they measure microplastics in tissues, what they do is they, they take the tissue, they dry it out and they, they essentially do this thing called pyrolysis, which is just a fancy word of saying. They, they sort of set fire to it, they heat it up a lot and then like what comes out, they kind of measure the different compounds in it when. And what they're looking for is a compound called polyethylene. So, Right. You look at a plastic container or something, you see that little recycling thing, it says PE in it? Yeah, that's polyethylene. When you take fat tissue, particularly saturated fat, which is in all of our tissues to some extent, and you run it through the same method, it looks like polyethylene. So a lot of people who are sort of, you have looked at the methods of these studies and there was like one sort of like important paper that came out and said that the method that they're using to measure microplastics in tissues isn't a valid method because it could just be saturated fat in those tissues that ends up looking like polyethylene. That's crazy.
- [45:16]
B
So it might not actually be in.
- [45:18]
A
So. So there is probably some. Right. And yes, there may well be issues because we know that, like bpa. Right. The plasticizers, we. We know they have health effects and we know that thing like pfas. Right. Also in plastics. Why? We know they have health effects. Right. So it's not like we can ignore it entirely, but it's very possible that when they're measuring microplastics in tissues, they've dramatically overestimated how much we have in our bodies. Yeah.
- [45:44]
B
When you think of rankings on what affects brain health the most, does plastics even show up pretty high on that for you?
- [45:50]
A
If. If I'm honest, it doesn't show up that high because I. You know, if I. If we think about the. The risk factor, the modifiable risk factors for dementia, let's say, which are sort of like, important contributors to. To. To our brain health today. Right. So the things that affect dementia long term, they would affect your cognitive function today, even if you're 20, 30, 40 years out. And so right now, depending on which study you read and which sort of like, statistical analysis you prefer, it's thought that somewhere between 45% and maybe 70% of dementias are preventable. And what they mean by that is that if you removed the risk factors entirely from the population, which is. On. Which is impossible.
- [46:33]
B
Yeah.
- [46:34]
A
But if you did do that, that's the proportion of dementias they would expect to no longer happen.
- [46:39]
B
Wow.
- [46:40]
A
And so the biggest risk factors are things like low education. So education is the way that we build our brains in the first place. And people who get less education have a higher risk of dementia.
- [46:50]
B
Wow. I didn't know that.
- [46:51]
A
Yeah. And that's one of the strongest risk factors for dementia is. Is. First of all, it's low education early in life and then not having cognitively stimulating work later in life.
- [47:01]
B
That one I could see. Yeah.
- [47:03]
A
And so that is the. It's the same reason. One is one builds function, the other one maintains. Right. Or actually can build function too. But. And so people who just, for whatever reason, didn't get access to much education early in life, if they do cognitively stimulating work later in life, or they do a lot of know hobbies and learn new skills, they offset a lot of that. A lot of that risk. So you don't have to worry about what happened earlier. You can Always change that trajectory, right. By doing things, more interesting, complex things with your brain later in life.
- [47:33]
B
And how early are we talking, like
- [47:36]
A
elementary school or before that in terms of education?
- [47:39]
B
Yeah. Like not getting education at early age. Are we talking like as a baby, as, like a child, as teen?
- [47:44]
A
Yeah. So, so most people, like, not everybody, but like most people might finish high school, right. But then it's, you're not everybody gets to go to either a two year or a four year college. Right. Not everybody gets to get a graduate degree. And what you essentially see is that the, the higher your level of educational attainment, right? So the further you get through that process, the higher and later the peak of like average cognitive function. So those who complete high school do a little better than those who never completed high school. And those who go to junior college do a little bit better than those, those who just completed high school, like on average.
- [48:19]
B
Wow.
- [48:20]
A
So it's not the same for, it's not going to be the same for everybody, but this is kind of like average. So essentially like more is better. But like I said, some of that is driven by the opportunities that we get that we don't always have. We don't have control over that. Right. So regardless of what happened earlier, you can then focus late and then, so any time later in life, right, you could be in your 20s, 30s, 40s, 50s. Regardless of what education you may have had decades previously, if you start like new skill learning, you, you're, you're reading, you have hobbies, you're engaged, right. You have a lot of friends, like big social, like a lot of social connection, that's going to buffer and help build cognitive function even later in life.
- [49:02]
B
Got it.
- [49:03]
A
But that's one of the biggest risk factors. Things like hearing loss are a major risk factor as our vision loss. So when you lose senses, you tend to lose cognitive function. And I have both of those. But it's, it's, it's reversible. So if you get cataracts, you have a higher risk of dementia. If you get cataract surgery, that risk decreases. That hasn't been done in randomized controlled trials, but there have been trials of hearing aids. So people with hearing loss, like older in life, if you're, if you, if you have a high risk of dementia because you have cardiovascular disease or a family history of dementia or something like that, and you have hearing loss and you get hearing aids, hearing aids significantly decrease your risk of dementia. So. Wow. The main thing is just to maintain it, right. So, you know, make sure you always up to date on like getting the right prescription for your classes. Right. And if you're losing more hearing, make sure you get hearing aids if you need them. So those are big risk factors. And then on top of that, risk factors include like brain trauma, smoking, alcohol, obesity, high blood pressure. And so based on everything that we have in terms of the long term data of what we know about risk probability decline and maintaining brain function, like I would think about sleep, physical activity, skill learning, nutrient status, physical health, lowering your heart disease risk. I think all of those things right now are where I would focus rather than getting like super worried about microphone
- [50:31]
B
planets, which social media is. I've talked about a lot about that and parasites.
- [50:35]
A
Yeah, yeah. And again, I find the parasite thing kind of interesting because most of, the, most of the foods that the people are worried about when it comes to parasites. Like those parasites can't like parasites in salmon or parasites in oysters yet. Right. So there can be bacteria that can cause significant. Right. You can get salmonella. Right. From an oyster. Right. But most of the parasites in those, like they can't survive in humans or we have a completely different physiology. So.
- [51:03]
B
Wow.
- [51:03]
A
And then. But that's not true for. So like parasites in pork. But. Right. You cook pork properly, it's, it's not, it's not an issue or it's like high quality pork if you get access to it. So I think some of these things, I'm not saying they're not important, it's just like in the grand scheme of things, they're not the things that I would really worry about.
- [51:20]
B
Yeah. Which is very interesting because on social media, I guess people just kind of prey on your emotions a little.
- [51:25]
A
Yeah.
- [51:26]
B
And they'll show you a Parasite video gets 5 million views.
- [51:28]
A
Yeah.
- [51:29]
B
Buy my parasite clones.
- [51:30]
A
Yeah, yeah. I've seen, I've seen all these like we get like some sushi and then. And I'm certain it's just like stitched together stuff.
- [51:38]
B
Right, right.
- [51:38]
A
But you get the sushi and they scrape the sushi and then all of a sudden you're looking under the microscope
- [51:42]
B
and it's full of parasites and it works. I stopped eating sushi. You know what I mean? I stopped going. I used to go to sushi buffets.
- [51:47]
A
Yeah.
- [51:48]
B
I kind of miss sushi.
- [51:49]
A
I still eat sushi.
- [51:50]
B
You still eat it?
- [51:51]
A
Yeah, yeah.
- [51:51]
B
I mean, I'm sure if it's quality.
- [51:53]
A
Yeah, yeah, yeah.
- [51:54]
B
Parasites wasn't the only reason I was worried about the mercury.
- [51:57]
A
Yeah. And so again, like we know mercury is a neurotoxin. We know that particularly higher species of fish like swordfish. Right. We. We know they're going to have a higher mercury content. But one of my, one of my favorite studies, just because it's like, it goes back to the stuff you were talking about earlier and it's so like, counterintuitive. And this won't necessarily be the, you know, it's not like it's been done dozens of times, but like this one, in this one study, they looked at the brains of people who had Alzheimer's and didn't. Right. They've experienced dementia or they didn't. And they, they looked at mercury content in their brains. The people who didn't get dementia had more mercury in their brains. What didn't get dementia, didn't get dementia, had higher mercury in their brains. And it's because they were eating more seafood. Right.
- [52:41]
B
Really.
- [52:41]
A
So despite the higher mercury burden, they still had a lower risk of dementia. And that's probably because of all the good stuff that's in seafood. So again, I'm not like, we know mercury is, we is bad, right. And we should, and we should minimize our exposure to it, but like stop eating fish entirely or sushi entirely because of mercury kind of puts us at greater risk because then we're not getting enough of something like Omega 3s, which we know is really important for, for brain health. And selenium in seafood helps to offset some of the negative effects of, of mercury. So it's like it's all a balance of these things. Right. But it's, it's like focusing on the negative really puts us at risk of not eating foods that could actually be. Be a net benefit.
- [53:30]
B
That's good to know. I will dabble with some sushi, though. Let's go.
- [53:33]
A
I miss sushi.
- [53:34]
B
Yeah.
- [53:35]
A
Like, you know, an occasional, like toro nagiri.
- [53:38]
B
Right.
- [53:39]
A
And I just enjoy it.
- [53:40]
B
Yeah, for sure. I know you've talked about creatine before. I started taking it again for mental performance when I was growing up. I took it for just purely lifting.
- [53:50]
A
Yeah, it's, it's. Creatine is having a. It's is having its moment as well. And actually this is a moment that I'm, I'm quite happy with. I take, I take creatine every day, I have for a long, long period of time. But like previously, mainly for the, for the physical side as well. When you're thinking about cognitive performance in like an average, young, healthy person, there isn't that much evidence it's going to have that much of an effect. The best evidence is in older adults, those who are already experiencing some level of cognitive decline. So in randomized trials, creatine seems to improve memory in particular.
- [54:29]
B
Wow.
- [54:31]
A
There are. There are now also several studies where individuals with depression were randomized. And a few of them, they previously been treated with some kind of antidepressant. They had an incomplete response, then they like, added creatine on top, or there was a group that just like, added a placebo, and creatine seemed to improve some symptoms of depression. When we're. When people are sleep deprived. Multiple studies show that taking creatine helps to maintain cognitive function under sleep deprivation. The first study was in rugby players more than a decade ago now. And then there was another, more recent study where they, like, put them in, put people in. They did brain Scans, they did MRIs, and they looked at, like, energy metabolism in the brain when people were sleep deprived, and that was improved with creatine. And they improved their cognitive function. And then sort of like, finally there's. There's. There's like one study in individuals with Alzheimer's disease where they gave them creatine and they saw some improvements in cognitive function. But the one sort of downside is that there wasn't a control group, there wasn't a placebo group. And we know that when you give people the same cognitive test multiple times, even if they have dementia already, they will get better at it.
- [55:38]
B
Really?
- [55:39]
A
Yeah. So one of the big problems with cognitive function tests is what we call learning effects. You just get better at the test. This is also one reason why people who have higher levels of education do better on cognitive function tests is just. They've taken more tests, they're just like, better at tests. But even across all of those things, I think that we see this signal that creatine, particularly in settings where we have some kind of. Some kind of like, it's like a cognitively degraded state sleep deprivation or there's some evidence after traumatic brain injury, concussions, individuals already experiencing some cognitive decline, this, like creatine, seems to have. Have some benefit. Um, we often use it in athletes, like some of the. Some of the Formula one drivers take it before they get in the car. Because for some people, it can be like a very mild stimulant. Right. So it can. It seems to improve focus and attention a little bit, or at least that's how people. How people feel without being sort of like jittery and anxious, which you can get with things like caffeine.
- [56:38]
B
Yeah.
- [56:39]
A
So, yeah, there's. There's a number of reasons why why creatine is sort of like having a moment for the brain. Right.
- [56:44]
B
Now, have you figured out why some people get anxiety from caffeine? Because certain coffee brands cause it. For me, it's weird.
- [56:51]
A
Maybe it's all those mycotoxins. Yeah.
- [56:54]
B
Who knows?
- [56:56]
A
It's. So some of it will probably be related to, right. The amount of caffeine. Because that actually can vary very widely.
- [57:03]
B
That's true.
- [57:04]
A
Right. It could be like two or three times more or depending on the company, like depending on the company. And then it's like everybody has a very different caffeine, caffeine tolerance. And some people just like a small amount will make them feel very jittery, very anxious. When you look at the studies on caffeine and cognitive function, right. So you have people do formal cognitive function tests. When you have them do like a really complex task. So one task that's commonly done in these studies is a working memory task called NBAC where you get like a list, like a continuous list of like letters or numbers. And then you have to remember whether the number or letter that you're being shown right now is the same as like the number backs.
- [57:50]
B
Right.
- [57:50]
A
If it's one back, it's like, is it the same as the one you just saw? If it's two back, it's like, is it the one you saw like two before? If it's three back, which is really hard, it's like, is it the one that you saw three before? Right. So you have to have, you have to maintain the list of numbers and continuously update it to kind of like remove.
- [58:06]
B
Yeah, that's hard, right?
- [58:06]
A
It's really hard. And even in people who regularly drink caffeine, if you give them a, like a, you know, like a normal dose of caffeine, like a couple hundred milligrams, and you have them do an N back task, they'll actually perform worse. They'll think they're performing better, but they're actually performing worse.
- [58:24]
B
Wow.
- [58:24]
A
And we see this with a lot of stimulants. So in, in people who don't have adhd, but then you give them something like modafinil methylphenidate, like provigal, like any of those sort of like stimulant based ADHD medications, you see the same thing. They feel great, right? They feel alert, they feel focused, they have high energy, but actually their complex cognitive function has decreased because they've become too, they've become too aroused. So this is something that's kind of just, you have to be mindful of with some of these things, like even with something like caffeine, it can cause an uncoupling of how you feel versus how you're like, truly objectively performing. If you could like, kind of, kind of measure it. And that's not necessarily a bad thing. Right. I drink coffee every morning. But just sometimes you feel good, but you're not performing better. Right. And so in some people, especially if they notice, they get anxious or jittery if they drink caffeine, there are other compounds that you could potentially think about. So sometimes you might have something that's tea based. Right. So green tea does have some like caffeine compounds, but also has L theanine or you can take L theanine, which kind of balances some of the, some of the jitters. Some, some people do better with the compounds that you find in chocolate. So theobromine is kind of related to caffeine, but some, some people can, can have dark chocolate. Right. But can't have coffee. And there's increasing interest in like, related compounds now as supplements. So paraxanthine is a metabolite of caffeine that seems to have a lot of the, like, the cognitive effects of caffeine, but doesn't have like the heart rate and blood pressure effects or at least not the same way. So now there's coffee where they've like taken out the caffeine and added in paraxanthine instead. And then there's other things like a theocrine or T cream, which is like a, it's a related compound. You can get it as a supplement now. And they've done some studies showing that it can. If you combine it with caffeine, you need less of a dose of caffeine, but you can still get the same benefits without some of the, some of the downsides. So there's now like this whole kind of like cabinet full of stimulants that you can, that you can, you can try. If coffee doesn't work well for you, of course, like, you don't need stimulants to perform. But if people want some kind of hot beverage or something like that, then there are, there are now like more options.
- [60:37]
B
Yeah, I gotta look into that. I haven't heard of those. Do you drink any alcohol?
- [60:42]
A
Yeah, occasionally. Oh, wow. This, this is another thing that is sort of like come up a lot on social media where now we're at a point where we're told that like, any alcohol is bad and we should avoid it entirely. Right. And I think some of the studies that have been used to justify that. They'll say stuff like, oh, yeah, alcohol is a neurotoxin. And, yeah, like, we know that in high doses, alcohol is a neurotoxin, but there are some, like, animal studies that suggest that small doses of alcohol can have a hormetic effect. So, like hormesis being this, like, what doesn't kill you makes you stronger. Yeah. And. And then. So there may be some of that in humans. I don't think that's the reason why I would drink alcohol. But, like, some studies suggest that a small amount may have a potential benefit. In reality, what I think we see from human data is that a small amount essentially has no net effect. So the studies that suggest that any alcohol is bad, they do this weird statistical technique where they try and predict alcohol intake from genetics. And then based on that, they say if you have a higher genetic risk of alcohol intake, you have a higher risk of dementia or something like that. Okay. Right. But it's not actually measuring how much people are drinking.
- [61:58]
B
Huh.
- [61:58]
A
So it's. And. And the way they build those genetic scores is based on studies where people, they ask people how much they're drinking and then they look at their genes. Yeah. So it's not that it's anecdotal, it's just that you're now like, two steps away from the actual thing that you care about, which is how much alcohol people are drink. People are drinking, and they worry about asking people how much they drink and then looking at their disease outcomes. Because when you start to develop chronic disease, maybe tied to your drinking, you drink less. So then people who drink, who drink less may have higher disease risk because of their previous history of drinking. It's kind of like difficult to unpick all of that. But basically what I think all the data now show is that if you're drinking the equivalent of like one or two drinks a week, and that's. This is a. This is a US standard drink. And a US standard drink is 14 grams of ethanol. And some of these data were collected in the UK, where one UK unit is 8 grams of ethanol. So, like, one UK unit is about half a US standard drink. But basically, if you're drinking something like the equivalent of one or two drinks a week, which isn't very much, There's. There's basically a known no net effect. There's maybe a slightly lower risk of heart disease, a slightly higher risk of stroke and cancer, and it's just like, it's a wash in terms of, like, overall health outcomes once you get above that. So now, you know, you're averaging like more than half a US drink a day or like one UK unit a day, which is like a small glass of wine. Right. Once you're drinking more than that, then you start to see an increase of dementia, smaller brain volumes, which we know is also tied to dementia risk. So yeah, it was my wife's birthday a couple of weeks ago. We went out for dinner, I had a cocktail. Yeah, right. I'm having a nice evening, like we're having a nice dinner, like enjoying it in that kind of setting. I have no problem with that whatsoever. But if you're getting to the point where you're like drinking every day or drinking several drinks a week or drinking, you know, several drinks multiple times and you know, multiple times a week, then we know that's type with a higher disease risk. But like the, the occasional drink I don't think is anything to worry about.
- [64:12]
B
Yeah. And that was my father. He drank every day.
- [64:14]
A
Yeah.
- [64:14]
B
Typical Irish drunk. But that scares me because I do have the APO E4 gene from his side.
- [64:20]
A
Yeah.
- [64:21]
B
And I did see in his later years that there were signs of Alzheimer's in my opinion.
- [64:24]
A
Yeah. And so my, my grandfather was, was also an alcoholic and he, he essentially died because of dementia. Right. One of the complications of, of dementia. So like, I know this is a real thing. This is, this is a real risk. And like some people have a higher risk of excessive drinking or alcohol abuse. Right. That has genetic components as well. So if you're not somebody who can drink in, you know, small amounts and just drink occasionally, then it's probably better to not drink at all.
- [64:52]
B
Right.
- [64:52]
A
Because we know that going too far the other way is going to, is, is going to carry a lot of health issues. And so that like to kind of segue onto the Apoe 4 thing. The, the main thing that happens with Apoe 4 is it's a risk multiplier. Right. So if you have other lifestyle related risk factors, then having a copy of Apoe 4, they have a bigger effect on your dementia risk than somebody who doesn't have APO4. Right. But there are also studies that, that suggest that in the absence of those risk factors there probably isn't that much of an increased risk of, of dementia and, or heart disease, which is another Sapoe for is also heart disease. So there are studies looking at like different hunter gatherer tribes like the Bolivian Tymani. There was a study looking at the Nigerian, Nigerian Yoruba in Nigeria. There was a study looking at indigenous Americans Here in the US There was a study looking at Sicilian Americans either in. In. In Italy or over here in the us and in all of those populations, like when they're in their sort of native environment or their ancestral environment, APOE4 wasn't associated with an increased risk of dementia. So it seems like most of the risk comes from an interaction between Apoe 4 and the modern environment. So there are studies that show that if you have one or two copies of Apoe 4 and you then drink excessive alcohol, you get a bigger bump in your risk than if you. You didn't have apple before and you drink and you drink a lot of alcohol. Same for low diet quality, same for low physical activity. So I think the main thing to do is just focus on the risk factors that you have control over, because the, the Apple E4 is like a risk multiplier rather than just like a baseline increase risk that there's nothing you can do about it.
- [66:43]
B
Got it. Great advice. Well, Dr. Tommy, this was amazing. Where could people keep up with you? Get the book and follow your work.
- [66:51]
A
Yeah, thanks. So the book, you can go to either my website, Dr. Tommy wood.com or the stimulated mind.com. follow me on Instagram @doctor Tommy wood. Dr. Tommy wood. Um, and then I've also got a. A st, a substack and a podcast with a friend of mine, Josh Turkner, who's a neurologist. Go to BetterBrain Fitness. You can sign up for the free substack and everything's there.
- [67:12]
B
Beautiful. Check them out, guys. We'll include the links below. See you next time. Thanks for watching all the way to the end, guys. It means a lot. Please click here if you you want to watch the next episode and please subscribe to the show. It helps us get more guests and helps grow the brand.