Podcast Summary: The Interview with Leslie Heaney
Episode: [Part 2] Alzheimer’s and Brain Health - feat. Dr. Kellyann Niotis
Release Date: June 13, 2025

Introduction

In the second part of her enlightening conversation with Dr. Kellyann Niotis, Leslie Heaney delves deep into the realm of Alzheimer's and brain health. Coinciding with June being Alzheimer's and Brain Awareness Month, this episode focuses on modifiable risk factors for dementia—factors individuals can influence to potentially prevent or delay the onset of neurodegenerative diseases such as Alzheimer's, Lewy Body dementia, and Parkinson's disease.

Understanding Family History and Genetics

Leslie Heaney emphasizes the importance of understanding one's family medical history as a foundational step in assessing dementia risk. She shares a personal anecdote about her mother-in-law's late diagnosis, underscoring the need for early awareness and intervention.

Dr. Kellyann Niotis concurs, stating, "You cannot fight what you don't know you're up against." (03:46) She urges listeners to gather comprehensive information about their relatives' health histories, including age of onset and specific symptoms, to better understand their own risks.

Modifiable Risk Factors for Dementia

Dr. Niotis outlines 14 fully established modifiable risk factors for dementia, with the discussion focusing on several key areas:

1. Cholesterol Management

High cholesterol is a significant risk factor, especially for individuals carrying the APOE4 gene.

Quote:
"Diet and exercise can only go so far, especially in people who have genetic predispositions to have high cholesterol." (05:20)

Dr. Niotis explains the importance of medicinal intervention when lifestyle changes aren't sufficient, highlighting options like statins, Zetia, and PCSK9 inhibitors.

2. Blood Pressure Regulation

Maintaining optimal blood pressure is crucial. The ideal systolic range is between 90 and 120 mmHg.

Quote:
"Monitoring your blood pressure at home...is when you're going to get the most accurate measurements." (08:35)

She advises regular home monitoring to avoid the inaccuracies of in-office measurements influenced by stress or nervousness.

3. Insulin Resistance and Diabetes

Managing blood sugar levels is vital, as insulin resistance is linked to poor brain health.

Quote:
"Insulin resistance really comes from our diet and our body composition." (10:03)

The discussion touches on medications like GLP1 receptor agonists, which show promise in reducing neurodegenerative disease pathology by affecting tau protein accumulation.

4. Alcohol Consumption

Excessive alcohol intake is directly toxic to brain cells and a known risk factor for dementia.

Quote:
"Excessive alcohol...is directly toxic." (20:10)

Dr. Niotis advises moderation, distinguishing between social enjoyment and using alcohol to cope with stress.

5. Sarcopenia and Obesity

The combination of sarcopenia (age-related muscle loss) and obesity, termed sarcobesity, doubles the risk for neurodegenerative diseases.

Quote:
"A lot of people who are using GLP1 drugs are developing sarcobesity because they're losing muscle." (24:33)

She recommends regular muscle mass assessments and incorporating strength training into one's routine.

6. Nutrition and Supplements

A Mediterranean-based diet rich in fruits, vegetables, lean proteins, and omega-3 fatty acids supports brain health.

Quote:
"Omega 3s are super important for the brain." (36:52)

Dr. Niotis highlights the importance of testing and optimizing levels of omega-3s, B vitamins, and vitamin D through both diet and supplementation.

7. Hearing and Vision Health

Undiagnosed hearing and vision impairments are significant modifiable risk factors.

Quote:
"Hearing loss...is one of the biggest modifiable risk factors for dementia." (30:52)

She advocates for regular screenings and the use of hearing aids to prevent social isolation and maintain cognitive engagement.

8. Preventing Head Injuries

Head injuries, including concussions, increase the risk of developing neurodegenerative diseases.

Quote:
"Even a mild head injury can increase your risk." (33:23)

Dr. Niotis stresses the importance of safety measures like wearing helmets and seatbelts, especially during high-risk activities.

9. Sleep

Adequate sleep is essential for brain health, with less than six hours linked to increased risks.

Quote:
"Sleeping less than six hours seems to be problematic." (34:53)

Prioritizing quality sleep over other activities, such as exercise when sleep-deprived, is recommended.

Case Study: Patient Success Story

Leslie introduces a poignant case of a patient with the APOE4 gene, who proactively engaged with Dr. Niotis to monitor and reduce her risk factors. Through disciplined lifestyle changes and targeted treatments, the patient experienced a decline in symptomatic word-finding difficulties and a reduction in harmful protein markers.

Quote:
"She has now not only is no longer symptomatic... and those proteins have declined." (45:03)

This success story was highlighted in a recent CNN feature, showcasing the tangible benefits of proactive brain health management.

Research and Future Directions

Dr. Niotis discusses ongoing research at the Institute for Neurodegenerative Diseases in Boca, focusing on:

• Blood-based biomarkers for early detection and monitoring treatment efficacy.
• Personalized care through continuous biomarker assessment.
• Impact of hormone replacement therapy and GLP1 agonists on specific at-risk populations.

Quote:
"Testing for these proteins in the blood...can potentially help us monitor the efficacy of the treatments." (47:28)

She expresses optimism about future advancements and the integration of personalized medicine in neurology.

Conclusion

The episode concludes with a call to action for listeners to take charge of their brain health through informed, proactive measures. Dr. Niotis emphasizes that 45% of dementia cases are preventable, highlighting the critical role of lifestyle modifications and medical interventions.

Final Quote:
"This was so important and so empowering for people to hear." (48:57)

Leslie and Dr. Niotis encourage ongoing education, regular health screenings, and maintaining a healthy, engaged lifestyle to safeguard against neurodegenerative diseases.

Key Takeaways

• Know Your History: Understanding family medical history is crucial in assessing personal risk.
• Manage Health Metrics: Control cholesterol, blood pressure, and blood sugar through lifestyle and medications when necessary.
• Healthy Lifestyle: Maintain a balanced diet, regular exercise, and adequate sleep to support brain health.
• Regular Screenings: Monitor hearing and vision to prevent associated cognitive decline.
• Prevent Injuries: Use protective gear to minimize the risk of head injuries.
• Stay Informed: Engage with healthcare professionals to personalize brain health strategies.

Resources Mentioned

• OmegaQuant Testing: For accurate omega-3 level assessments (37:22).
• Thera Cumin Supplements: Specifically Thera Kerman, a form of curcumin that crosses the blood-brain barrier effectively (42:12).
• Shingles Vaccine: Recommended to lower the risk of dementia (43:34).

For more information or to connect with Dr. Kellyann Niotis, visit her website by searching her name online. Stay proactive in managing your brain health and join us next week for another insightful episode of The Interview with Leslie Heaney.

Timestamps

• [03:03] Introduction to Dr. Niotis' Expertise
• [03:46] Importance of Family Medical History
• [05:20] Discussing High Cholesterol and Treatment Options
• [08:35] Blood Pressure Management
• [10:03] Insulin Resistance and Diabetes
• [20:10] Alcohol Consumption and Brain Health
• [24:33] Sarcopenia and Obesity Risks
• [30:52] Hearing Health as a Risk Factor
• [33:23] Impact of Head Injuries
• [34:53] Importance of Adequate Sleep
• [36:52] Nutrition and Omega-3 Importance
• [37:22] OmegaQuant Testing
• [42:12] Thera Kerman Supplements
• [43:34] Shingles Vaccine Benefits
• [45:03] Patient Success Story
• [47:28] Ongoing Research and Future Directions
• [48:57] Closing Remarks

This summary aims to provide a comprehensive overview of the podcast episode for those who seek valuable insights into Alzheimer's prevention and brain health strategies.