Most people in the health space, a lot of the experts out there, including myself, I'm not an expert, have recommended a daily dose of five grams of creatine for brain health. Everybody knows that. But some groundbreaking research that you've covered in your newsletter now shows that we might have gotten it completely wrong. That in fact 10 grams a day can be dramatically beneficial when it comes to boosting cognitive function. and doses as high as 20 grams can even play a role in helping with memory and potentially Alzheimer's disease as well. So, Louisa, as a neuroysiologist, talk to us about this latest cuttingedge research and why it's so important for people who are on a mission just like you to improve their brain health and potentially reduce their risk of Alzheimer's disease. I'm so excited that we're starting with this because I put a statement out there saying that I was wrong because I've also been suggesting that five grams of creatine per day is sufficient enough. But we now have like groundbreaking evidence actually out of Germany, a a really great cohort out of Germany who did the study that showed that 5 g of creatine per day saturates the muscle. But in order to saturate the brain, which is where we want to get the cognitive benefits, comes at at least 15 grams a day to 20 grams a day. So let's break it down for a moment. Creatine is a naturally occurring molecule in the body. So we produce it endogenously, right? We produce it, we don't produce enough of it. And 95% of the creatine that we produce actually goes into the muscle. So 95% of it lives in the muscle. 5% lives in the brain. So, we don't have that much. And when you look at the brain, it's around 2 pounds and it takes up 20% of the total calories that we ingest every day. So, it's a hungry organ. It takes a lot to just have it functioning normally. Now, add to it the cascade of insults that we've got every day. Whether it's being stressed, whether it's air pollution, whether it's lack of proper nutrition, lack of exercise, it's now under attack more often than not. So, it needs as much energy as possible. So, that's why this study really excited me because what it showed is when you have that 5 g and it goes into the muscle, it doesn't reach the brain. Now, the brain has this, I would say, a collection of cells on the outside, and this forms the bloodb brain barrier. And they're really great because they're tight. They're binded together by these tight junctions, which means that some things can get in and some things stay out, which is really good, like the bouncer of a club. And in order for things to pass through it, certain molecules like creatine, it has to bypass these channels. So, it has to work hard to get into the brain. So upping your dose to around 10 grams a day would allow for the passive diffusion, if you will, of the creatine to get into the brain. And once it gets there, it helps the brain cells produce more energy, which we want, right? Because we've got around 100 billion neurons, 100 billion nerve cells, each of them having around 10 to 15,000 connections. So that's a big powerful machine. So, if it's got more energy to run, to produce, you're going to be able to enhance your cognitive functions like information processing speed, memory, uh, attention, focus, which are the things that tend to go down during Alzheimer's disease. Right? So, prior to being diagnosed with Alzheimer's, you've got this 30-year period of all these stages. And one of those stages is subjective cognitive impairment, which is the first stages of Alzheimer's disease, right? You you sometimes your thinking's not not up to scratch or you forgot where you put your keys or you're getting slower reaction times. These are all cognitive functions. They start to decline. Then you've got mild cognitive impairment, which is a pre-dementure state and that lasts around 20 years. So, it's during these states that you need as much brain energy as you can, and we can get that from creatine. So, I've just gotten my parents who are my mother just turned 70, my father is 72. I've gotten them on my father's actually on 20 grams of creatine per day and mom is on 10. And what we find from a lot of people is they may have GI distress when they take this because what you know the push back on this that I have received is but what about if it affects my hair and and my kidneys and what about if I get bloated from it. I have to say that creatine should be now mandatory in everybody's tool kit just like brushing your teeth or exercising, right? I think everybody should be supplementing with creatine. And if you do get mild GI distress, you can simply split it. So, it turns out that in this trial, they showed that even if you're having 10 grams a day, you don't have to have 10 grams all at once. You can split the doses. It doesn't degrade in hot water. So you can have it in your morning coffee and then have maybe another five grams at night. You can have 20 grams all in one go if you feel like you can. It doesn't matter what age you are. But when we move into more of the upper doses, okay, so maybe let's let's talk about well do I need 10 grams? Do I need 15? Do I need 20? It really comes down to pathology, right? So my father for example, why is he why have I got him on 20 and mom on 10? Well, my father in 2019 had a stroke. Okay. And we know that with strokes, every hour counts after you've had a stroke. Every hour your brain actually loses a million neurons. Wow. Which is quite scary. And there was some time from noticing I wasn't in Australia at the time, noticing that he had a stroke to actually taking him into the emergency department. So, you know, he he probably lost and we've seen it cognitively. So his brain now it has to work extra hard to produce normal daily functions. So we've gotten him on a higher dose than what we have for my mom who's also lower weight and shorter. Yeah. Wow. That's incredible. I mean first of all groundbreaking research. Second of all literally has the opportunity to help people especially in the case of somebody like your father who's been through something so traumatic. I'm sorry to hear about that. could literally help you recover faster. Yeah. Preserve the brain power that you have and maybe even is there any research to show potentially, you know, lower the risk of a stroke in the future or is it more about prevent uh protecting what he has remaining after the stroke? Well, it's more so about you've got to have a look at the brain as this this huge story, right? It's it works together to ensure that you know you've got adequate uh blood volume that goes to the brain. You've got adequate cognitive functions. There's nothing that's going to reverse what's ever all the damage that's happened to him. When you kill the neurons off in the brain, that is it. Right? When you get dementia or Alzheimer's, that is it. There is no cure. There's no reversing it. But when you help your brain in any way through the metabol metabolism, if you can help your brain produce more energy, it has a birectional effect on everything else. Giving giving him energy to perform activities of daily living like being able to go out and walk and exercise and weight train and do everything else around that. Being able for him to actually see and process information has been monumental for him. That's incredible. I want to tease out a few things that you mentioned that were included in your newsletter, which by the way is fantastic. We have a link in the show notes. Everybody should subscribe to your newsletter. So, one of the ones you mentioned, working memory participants exhibited remarkably, remarkably enhanced retention and quicker recall, critical for daily functioning and independence. That is nuts. the fact that you might have in the earliest stages of cognitive decline feeling like I can't remember what was that person's name or what was that situation or what did they say earlier and the fact that you're having faster recall from just a higher dose of creatine that's pretty incredible. It is incredible because you also have to look at the cohort, right? Let's let's look at what happens over the course of a female's life, right? If we look at the 45 years and above, they start to enter depending on the individual, something called pmenopause, which I'm sure you know about, that's when you start to see a decline in a critical hormone called estrogen. And estrogen is a really powerful bioenergetic hormone in the female brain because females have estrogen receptors all over their brain. and almost everywhere as well, but in the brain it serves as a critical role and it serves as a neuroprotective hormone. So it protects the neurons as well. So if we've got a loss of that, right, and we've got a loss of estrogen not meeting the, you know, in the bone. So we also are at the risk of getting osteoporosis. So we're already at the mercy of a naturally occurring phenomenon that's going to happen. So supplementing, so women who supplement with high doses of creatine at that age group of permenopausal, especially menopausal and postmenopausal, are going to get the biggest bang for their buck because that's when they need it most because again going back to the bioenergetics, right? Your brain needs energy to recall information, to react to anything. And when I say reaction time, I'm talking about being on the road. back to my father. He thought he was fine, you know, I think it was about six months after the stroke and he went out and he actually had a car accident because he couldn't see that the light was red. Wow. And he was fine, but his car flipped three times and he ended up on his head. And that was because he just couldn't see. He didn't know what he didn't know. He thought he was he could see fine. That was a reaction time. That was his recall and reaction time and cognitive functions that were deteriorating due to the stroke. So that's why we've got him on 20 grams a day. But being able to react faster, think faster, recall information is huge. And it's not just being able to read a book or being able to be on a podcast. It's actually lifechanging and life saving. Sure. We talk so much about people protecting themselves from a fall, which happens to there older individuals, but a big part of that is reaction time and of course muscle mass, which a lot of individuals have talked about like yourself. But how quickly can you put your arm down or how quickly quickly can you grab something to hold you to prevent you from falling? So this reaction time is crucial and could be life-saving for us. But you also think like look at all of the studies now that are coming out around high doses of creatine and depression. So they're now doing a lot of uh experimental studies and clinical trials on people who have been diagnosed with clinical depression. And I'm not talking about the everyday depressed ones who are actually being prescribed Prozac, for example. And when they split these two cohorts up, you've got somebody on the trial group who is actually taking Prozac, and then you've got the other group who was just taking a sugar tablet, for example. And they're also getting them to supplement with 20 grams of creatine per day. And what they found is that the people who are doing 20 grams of creatine per day are act the creatine is mimicking the effects of the Prozac. So people with clinical depression are actually feeling better. They're noticing better signs of happiness, subjective uh happiness. And so then that makes you think why? So you have to bring it down to energy. It takes energy to be happy. Incredible. couple of the highlights from the study which by the way it was an eight-w weekek pilot study I think it was a pilot study right it was a pilot study so just noting that we have the link in the show notes to the study that was there but that was pretty remarkable that within eight weeks of doing this daily supplementing at those levels all these results were seen so working memory was one you highlighted the next one was reading recognition there were improvements in processing speed and accuracy indicated better neural processing efficiency And then the last one that you also highlighted inside of there was attention and inhib inhibitory control. Significant progress was observed in sustained attention suggesting enhanced brain network efficiency and control over distractions. That's crazy that something like creatine at the appropriate dosages could help you stay more focused in life. I guess that comes back to energy. It comes back to energy. It comes back to how well are your brain cells communicating with one another um through synaptic transmission. So when I mentioned that brain cells communicate with one another, you know, there's around 15,000 connections when they synapse and that's at the dendrite level. When they synapse and that's where they produce all of the neurochemicals, that's what we call neuroplasticity. So if you can strengthen the neural network in your brain, how one neuron fires with the other, you can get better at neuroplasticity. If you get better at neuroplasticity, you then see the changes in these cognitive functions, which is processing speed, memory recall. That's what actually like having a good healthy brain, good functioning brain is all about. It's the ability to produce greater amounts of neuroplasticity throughout our time. And the way that we do that is by having more brain brain energy. Well, I want to talk about some of the dos and don'ts that you already built on. For example, a lot of people take creatine, they get GI upset, right? You talked about one item, which is splitting it up. I have a couple more questions on some of the dos and don'ts, but before we get there, I want to zoom out a little bit more. You know, I think of you as somebody who helps us sift through what matters and what doesn't. Anybody who's listening to podcast, and I'm sure this podcast has been guilty of it at times, there's just so much information. You cannot do it all. And a lot of it is not even accurately reviewed, tested, or proven over time to significantly move the needle forward. Now, I'm all about letting people and encouraging people do whatever you want, but or and rather and never forget about the basics. Yeah. On your last episode that you were here on this podcast almost a year ago, exactly. Oh, really? We have over a half a million views of people excited about your information about all the evidence-based basics about catching Alzheimer's disease early and preventing it hopefully and the things that are evidence-based that actually show you could reduce your risk of getting it one day or cognitive decline. So, people really appreciated that episode. Today, we're going to go a little bit more technical and we're going to be talking about some evidence-based basics when it comes to things like supplementation and protecting your brain and other categories that are actually worth doing. So, that's the background of why we started on creatine because yes, the memo's out on creatine, but it turns out doubling down on it for certain populations could literally help protect your brain in the future. Anything you want to add to that? Well, I think that across the board, okay, it doesn't matter who you are. It doesn't matter what gender you are, you should I believe everybody should be taking creatine to help them. We now have substantial evidence to show how effective it is in so many different populations. Right? We've got people with mild cognitive impairments seeing great benefits from it. We've got people who've got clinical depression who are seeing great benefits from it. people who have undergone a TBI or a concussion, we're seeing great benefits from it. I haven't seen anything that has been mildly disturbing to suggest that you shouldn't be taking creatine. I've seen the study on DHT being debunked, meaning that there is no hair loss. I have not seen any randomized control trials to show that creatine affects the kidneys or the liver or that creatinine even relates to the whole matter. Uh the only I would say only caveat would be make sure you study the brand of creatine that you're taking because we know that supplements by the way are a highly unregulated industry. We know that I've actually I don't know if you've seen have you seen the study that came out showing that almost all of the supplements that are sold on Amazon are fraudulent. Yeah. I I didn't see a study, but I've seen multiple people, and I'm friends with a lot of these different brands, and they're like, "Dude, every month we're taking down hundreds, thousands of fakes that are coming from all over the world, and you can't tell. Even if you go to a company's store, official store on Amazon, I found out that Amazon co-mingles inventory." And this ended up happening. One time I ordered this uh this herbonin product. Mhm. It's actually a Sydney based company. It's a plant-based uh melatonin. Mh. And I I used it when I would have jet lag traveling overseas. And one time it didn't work. And I remember emailing them and they're like, "Oh, dude, you should get it from us in our store or like full script or something because there are a lot of fakes that are on Amazon." I was like, I think I got a fake. Exactly. So, what they're doing is they're like, for example, I went and bought a real Thorn CoQ10 and then I bought one from Amazon and the label looks identical. So, they're copying the label, but the bottle was slightly different. It was shorter and rounder and bigger. So, the fake one, you could tell through the bottle, but the actual capsules itself looked the same. Yeah. So, that's scary. So, the one caveat I would say is make sure you understand who you're buying from because even though it's the safest supplement on the market, creatine, because it's the most widely studied, you still don't know who you're getting it from. There's actually a really great app uh called Subco and I'm obsessed and I just keep putting it out there mainly because they've done all of the quality assurance for you. All you have to do is go on there, put a a name of a supplement and they give you a scoring their trust score system. Yeah. So they do the heavy lifting and I think they even like you could put in all your supplements that you're taking and they'll kind of tell you like okay are these actually working for what your goals are that are there in case you don't understand supplementation. Yeah. Very We'll link to it in the show notes below. Okay. So, following up on the dos and don'ts. The last time you were on this podcast, you shared a big no no around creatine and my audience was like, "Wow, we didn't know that was true." So, I'm going to ask you again just in case the science has changed around this. What you told our audience and me was that if you put creatine into water in the morning and let's say you're trying to get your morning creatine, you got to make sure you consume that liquid ideally within an hour. So, if you have a big bottle of water that you drink throughout the day, if you put like a couple of scoops of creatine to get to your 10 grams or so and if you're drinking that over like three, four, five, six hours, is the creatine impacted in the water and is it better to drink it within 1 hour? It is better to drink it in 1 hour. Let me give you an analogy. Why do you think there has been a popular drinks for, you know, there's preworkouts, there's like popular soda beverages right now that are out. Some of them contain adaptogens and all these. None have ever contained creatine. Why? Because the creatine would degrade out over a long period of time. Got it? So, you do have to drink it within that hour. Something I also want to point out for everybody listening because this was mind-blowing to me and uh frightening and and really upsetting. Um we have now seen the first ever studies that have been done on the most the top three most popular creatine gummies sold on websites and on Amazon and doesn't matter where they're sold. And they tested the gummies and it turns out that the gummies don't have any creatine in them whatsoever. Yeah, I've heard about that. And it upsets me because I mean, who doesn't want a gummy, right? They taste great. But, uh, a lot of the advertising on these websites will point towards the fact that you're getting 2.5 or 5 g of creatine per gummy. And so many people are buying into this marketing, which now it turns out that you're not getting anything other than sugar. So, I would caution people, especially women, uh, because they make up the majority of the people buying the gummies. That's not my opinion. That's what was um outlined in the study. And it turns out that they're not getting it creatine at all. And it really upsets me because it's like, well, it I don't know if the companies and the manufacturers of the gummies actually know this and the bioavailability of it, but it upsets me that that is out there because my mother is a consumer at the mercy of this marketing claim. Yeah, it's such an important topic to pay attention to. I do want to give credit to probably a couple companies that are out there that at least say they do third party testing. There's like a big one in the space. I have no affiliation with them. I think the company is called create. Oh, I know. I know. I know. Create. Yeah. And great, good. I want more products in the market is if they work, right? I have no affiliation. I don't know if they work or whatever. The only challenge is uh I'm not a big fan of uh consuming a lot of like tapioca syrup, other things, you know, that sort of stuff. I do get it that people are trying to figure out how do you make creatine tasty enough that people actually fulfill it, but they talk regularly about and their CEOs on Twitter all the time. I just come across this post saying you got to be careful because we have independently tested and almost all the best sellers that are out there selling better than our brand on Amazon don't have any creatine inside of it. Ask for transparency if you're a fan of these companies and have them show you some third party testing to actually see is it working. Obviously, I know you're a big fan of Momentus. I'm a big fan of Momentus as well, too. They sponsor you, they sponsor us, but I'd be taking it anyway. So, that's always a safe brand, a brand that has a good trust factor to it as well. Sorry to interrupt, but memory loss is on the rise. And that's why I've created a free guide that you can get right now featuring the top brainoosting foods that you can include into your diet starting today to help you combat this. I've worked with a few of my friends to feature five foods in this free guide. And guess what? A couple of them will probably surprise you. Make sure you're one of the people that focuses on keeping your brain sharp by downloading this guide today. Just click on the link below or scan the QR code and I'll send you the guide right away. What I'm seeing now in the creatine research and this is um I had a a conversation with Dr. Darren Kandal, the leader in the space I believe. And what's uh what people are now studying is mixing creatine with aminos and creating this uh amino acid uh creatine mix and to see if that's going to have any enhancement on muscle protein synthesis, which I think it would. Um, I started to actually take aminos first thing in the morning just to uh cuz I I I find it really hard to eat first thing in the morning and I want to try and protect um my muscle as much as I can. Plus, I work out in the morning, right? So, mixing I've been mixing aminos with my creatine and I don't know. Well, we're going to see what the results will be in in 3 months or so. That's exciting. Well, let's continue on the theme of evidencebased. In this case, we're talking about supplementation. that actually can move the needle forward or potentially has the opportunity to slow down or be protective when it comes to things like cognitive decline and even Alzheimer's disease. So, this is another big one that you wrote about. A lot of people know that vitamin D is important. Most people don't realize how many people even in a place like Los Angeles are so deficient in it. Most of their doctors are not even ordering lab tests to see exactly where their vitamin D stands. But you wrote about a groundbreaking study that tracked over 12,000 adults for 10 years. And it revealed that vitamin D supplementation slashed eviscerated dementia risk by an astounding 40%. And the big caveat being with women seeing an even greater benefit and at high risk genetic groups experiencing substantial protection too. Talk to us about this study. Yes, because it um that specific study showed that those with a vitamin D deficiency, which is classified as 20 or less, showed an increased risk of 68% of dementia. Right? I loved this study so much because most of the US population is deficient in vitamin D and most people think well I go out into the sun I get enough vitamin D. So first and foremost, what does vitamin D actually do in the brain? Right? We have vitamin D, just like I mentioned with estrogen, we have vitamin D receptors all throughout our brain, specifically in the hippocampus, which is the seahorse shaped structure deep in the temporal loes, which houses our memory formation and consolidation. And this is a really interesting area because it's the first one to be attacked as we age. it it it definitely declines. And if it declines, that's where we see our memory start to fail, right? That's why we get that short-term memory loss. So, we've got vitamin D receptors there. We've got vitamin D receptors on the brain. Now, just remember when I say receptors, receptors are like key unlocks. Okay? You've the hormone itself, which vitamin D is, it's a hormone and acts like a hormone. It's the hormone. And then the receptors are a lock. So they go in, they lodge there and it opens up this gateway for magical things to happen within the cell. So we've got vitamin C receptors there. We've got vitamin D receptors in our preffrontal cortex. Prefrontal cortex is what houses our executive functions like thinking, decision making, processing speed etc. So when we have a high amount of vitamin D which I believe in the US should be 60 nanogs per deciliter or more but 60 is or not or more that's a safe way okay we have better functioning cognitively so that's the actual mechanism at play when we looked at this study and saw increases in executive functions the second part of it what they saw at the root of it is vitamin D helps with neural inflammation and it helps downregulate the inflammatory cascade that occurs during mild cognitive impairment and during Alzheimer's disease. Now I have been researching Alzheimer's dementia for the past 10 years and I've just about to release my second uh first authored paper on mild cognitive impairment. And I can tell you after sifting through, by the way, sifting through, I would say I've I've looked at around 3,000 studies for this specific systematic review, I can tell you that at the root cause of these diseases, dementia, Alzheimer's, is inflammation. Right? So, no wonder we're seeing such benefits of vitamin D supplementation on inflammation. And by the way, this supplementation is around 5,000 IUs per day is the recommendation. Is the recommendation. Yeah. Yeah. And if somebody's really low, like they might be in their 20s or even I had a friend that texted me said, "Hey, my vitamin D is 16. That's pretty good, right?" I'm like, "Dude, that's super low. You need to talk to your doctor about getting it up." So maybe in some of those cases, they might need to be at 10,000 or 15,000, but monitor it closely and then make sure you're not getting over that number too high. Correct. But I think what you also have to realize and if you really go through and and really like read the fine lines of the study, you have to realize that the precursors to vitamin D is also magnesium, right? So magnesium which is at the seat of the chlorophyll molecule which comes from green plants, right? You have to be also understanding that we don't want to just pump you up with vitamin D. You want to be able to understand the full picture, right? Because you can up your vitamin D by just having magnesium alone, right? Or you could be having so much vitamin D in the presence of lead in your in your body and your vitamin D might not be rising. So a lot of people actually come to me and say, Louisa, my vitamin D is not getting above 30 and I'm having 10,000 IUs of vitamin D a day. And I would say just stop right there. We have an absorption issue. The absorption issue might be let's pair it with vitamin K2 or let's say you do that and it's still not rising. We know that vitamin D binds to lead in the blood. So if you have a high presence of lead then you're just going to be pumping it. It actually you can't excrete that lead in a in the presence of vitamin D. So it may be a let's do a total tox screen and see if you've got any heavy metals in your system. Yeah, that's super important. And yes, you don't you're worried about just having vitamin D from supplementation alone without something like a K2 or magnesium because there's even concerns about does that also end up in plaque in the arteries or you know further along calcification or other stuff and and and also too there's debates about vitamin D and when you're getting sunlight on your skin that's synthesized on the skin and as oils and reabsorbed back into the skin That's obviously a little bit different than just taking vitamin D. So, you want a healthy dose of sun that's appropriate for you that's not burning or, you know, being excessive. And that also can make a difference, too. You can have a little bit of vitamin D through supplementation, but also get out in the sun, especially in the morning or in the evening where the UV index is a little bit lower, and still have like safe appropriate sun for skin health. Correct. And then let's talk again about birectional effects here because we have vitamin D receptors on the brain stem a specific area that is actually responsible for putting us into deep sleep. Right? So if we are having you know you this is why if you're standing out in the sun I don't know I'm from Australia so our sun there is really hot and after spending a day out in the sun you get really tired. Yeah. Right. Because it can help with the onset of making you sleepy and putting you to sleep. When you go into that deep sleep, we obviously activate the glimpmphatic system which helps us clear out all of the hallmarks of Alzheimer's disease. So I I believe if I when I was looking through this study, I believe that there is never a it's never it's not going to reduce uh dementia risk by 40% just from having vitamin D alone. I think that there's so many different avenues to what vitamin D offers. Not just from a brain cognitive function perspective, but also because it may now also be helping you sleep better because of the females. It may now also be helping you improve your going from osteopenia to normal bone density because that is also implicated in um in in permenopausal and menopausal women as well. That's a great reminder because this was, as you noted in your newsletter, it was even though it was quite large, tracking 12,388 adults with the average age being about 71 and it was over 10 years, it was still an observational study. It was observational. It's important for us to understand that, okay, hey, there's something going on that's there, but there's probably a lot more to the story, which is it is it just vitamin D by itself, or is it all these other things that you're talking about that vitamin D supports, better sleep, better, you know, dealing with pmenopause, menopause, etc., etc., osteopenia, osteoporosis. That's an important part for people to understand. Exactly. and observational studies are and correlation studies are not randomized control trials meaning that they observed they observed a change over a decade and so that was my understanding right and that's what I that's what I put out in the newsletter because there's so many different facets to improving your vitamin D status even for all cause mortality but when we're in the brain as well with vitamin D with adequate vitamin D levels you're also helping with receptors okay So when we actually produce a syninnapse and we release all of these neurochemicals, serotonin, dopamine, GABA, you are enhancing the functioning of the brain as well. So it helps with that as well. There was one other part of the study that I want to highlight and it connects back to your first appearance on this podcast where you talked about understanding your risk of Alzheimer's disease. And we know that it's not an automatic guarantee that you're going to get it, but you do have a slightly higher risk based on your genetics. And we t you talked about that. And in this study, what was interesting is that you highlighted that even people with APOE E4 carriers, if I'm reading that correctly, the highest risk genetic group for Alzheimer's saw a benefit at a 33% risk reduction. For non-arriers, it was 47%. So that's really interesting. And just another reminder that even if somebody has uh genetic propensity for a more likelihood of getting some disease, in this case we're talking about Alzheimer's, your lifestyle component and how you optimize your health can play a huge role in helping you minimize and hopefully avoid getting that disease in the future. Of course, it's basically getting more help because your um your body works in this fashion of um and and this is what I teach a lot of students as well. Some of us are walking around thinking that we are quote unquote healthy because it's the absence of disease, right? But we're not doing that. And it's it's I believe it's called the theory of constraints. So, you have to be thinking I'm walking out now and there's some type of constraint. A constraint may be the apoE4 gene. That's just a constraint. It doesn't mean you are going to get a disease, but you are constrained. So if you are constrained in that area, then you need to up every area of your life to compensate for that constraint. And so this is where vitamin D comes in and helps you along with many other things. a lip, you know, having a a really robust and phenomenal lipid panel, I believe, for ApoE4 carriers because that's what APOE E4 does. It's involved in lipid metabolism in the brain. So, it kind of doesn't work well. It kind of malfunctions. Therefore, you can't transport cholesterol properly and adequately in the brain and we can get to that later. But when you are supplementing with vitamin D and you are helping with all of the different neural pathways with the receptors, then that's what it's helping with. Yeah. Such an important reminder. Okay, I want to zoom out a little bit because, you know, we've talked about vitamin D. Yeah. And we've talked about creatine and some really exciting research that's around both of those two topics. And continuing on the theme, you cannot talk about supplements that support brain health without helping people understand just how important omega-3s are for it. And even though everybody's heard about omega-3s, just like creatine, just because you heard of it, when I walk on the street or I text my friends and I'm like, they're like, "Hey, what supplements do you take?" And I'll say, you know, this is some of the ones that I focus on. And I'm asking them, "What do you take?" And they're like, "Oh, I already know about fish oil. I don't know about creatine." But when I ask them, well, okay, how much do you take and when do you take it? They're like, "Oh, I'm not that regular about it." So, I think it's worth touching on because even though you might know about some of the benefits, we're not all following the basics that are there. So, talk to us about omega-3s and brain health and why they're so key. Your brain is m and I confidently say these these numbers is made of fat and protein and around it's 60% lipids. So 60% of your brain made of fat. 10 to 15% of that 60% is made of omega3s, right? Omega3s. So omega-3 fatty acids are comprised of EPA, DHA, and ALA. So that 10 to 15% is made up of DHA, right? So we know that that's really important so far. So DHA, let's just stay on that because I'm giving a bit of a lesson here. So we have to be supplementing with EPA DHA on a regular basis. And here's why. It came from Dr. Bill Harris's group and he formulated the omega-3 index. And basically when he went out and did his studies, he found that people with a high amount of omega-3 fats in their red blood cells had a lower risk of sudden cardiac death, had a lower risk of all cause mortality, had a lower risk of Alzheimer's disease and dementia, and had a lower risk of atrial fibrillation. Why is that? At the root cause of it, I will tell you what it is. It's inflammation. But I'm going to go through it even deeper and I'm going to tell you what the mechanism is here and I want everyone to stay with me but what the mechanism is when we actually ingest DHA. So DHA itself as the molecule when it goes into the brain cell and it goes into the cell membrane. Okay. So it it helps with cell membrane fluidity. That's the first and foremost. When you have good cell membrane fluidity, it allows for you to release chemicals at a much better rate, such as serotonin, uh, norepinephrine, dopamine, all these neurotransmitters that are responsible for different things in our life, making us happy, making us vigilant, giving us drive, keeping us motivated. So, we need that. We need it for optimal neuroplasticity. The other thing that it does is when it's released from the cell membrane, it creates this bioenergetic field and it helps to downregulate inflammation. Omega-3s have a sister. It's called omega6. I think you've heard of it. So, omega6 contains arachidonic acid and this is involved in prostaglandins. And we don't have to go too deep into it, but basically when we have a lot of prostaglandins, we'll take a panadol. So when we release prostaglandins and we're feeling pain, we would normally take a Tylenol. Okay? Because that's what omega6 does. That's why people are scared of omega sixes, right? If we have a high amount of circulating omega-3s in the blood, it can stop those prostaglandins and downregulate the pain and downregulate the inflammation. So, at the seat of this, what we're seeing is we're seeing a down regggulation of inflammation. I think that that is at the seat of why omega-3 fatty acids are so good for the brain. Not just that in a child's life when they are firstborn for the first few years, they have high amounts of myelination. Right? So, uh part of the neuron, you've got this part called the axon and it is covered with this fatty layer. It's an insulating layer that's responsible for our conduction velocity. Um, it's called the white matter tracks in the brain. It needs high amounts of omega-3 to actually form itself. So, you're not just you're not just helping your brain in the adult brain, but you're also helping the developing brain as well. So, omega-3 fatty acids, in my opinion, are so incredibly so incredibly important for everyone to have. Yeah. Now, back to Bill Harris and their group. When they found that having a low omega-3 index increases your risk of sudden cardiac death and all cause mortality, they give you a they give you an omega-3 test, right, which is a pin prick test. It's really easy to do and it's presented to you on a baseline from 1% to up to 12%. The scary percentage is they all of the people who had an increased risk of sudden cardiac death etc was at a 4% or less. People who didn't have this risk was at an 8% or more. So when you are doing this test a really good measure of an omega-3 index is having an omega-3 index of 8% or more. I just did mine. I do mine once a year and I got 11.8%. So I feel like I'm safe in that zone. funnily enough uh because they see an increase of life expectancy by five years from having an 8% or more. Funnily enough, people in Japan have a 5-year increase in life expectancy over the US population. And guess what? It's like the it's like the average norm in Japan that they have an omega-3 index of 8% or more. Yeah. And they're obviously taking that primarily from eating fish. Correct. Yeah. And if you're not somebody who's eating enough fish, you'll see in this test. And by the way, this test, I think the basic version is like 60 bucks. It's pretty cheap. You can do it from home. So easy to administer. You don't need a doctor to order it. You can just order it straight from their website. And then there's like an advanced one that you can pay a little bit more and it gives you like also the breakdown of trans fats in your blood and other stuff. But we had Dr. Bill Harris on. I think he's so fascinating. And to add to what you were saying is that it was so protective to be in a 8% or more that even smokers who had a very high omega index, right? This is one of his kind of big quotes that he talks about, but I'll just reshare for the audience. smokers, which obviously we don't want anybody smoking, but if you happen to be smoking in this Framingham data, I think they extracted some of the data and they looked at the individuals that were smoking, those who had a high omega index, 8% or higher, had more protection than even non-smokers who had a lower omega index. And that just drives home whether it's for brain health, cardiovascular health, you do not want to sleep on your omegas. Yeah, they're so so so key. You were also finding that it can when you've got increased membrane fluidity, you have a a greater propensity to be able to flush out the hallmarks of Alzheimer's disease, which is amaloid beta and tow proteins, but more so for amaloid beta because that lives outside in the CSF that lives outside in in the brain, outside of the neurons. It I felt it firsthand. This is kind of what got me into the health world. Just a little sidebar, I was practicing a vegan diet in college and I felt fantastic. You're young, you feel invincible. I'm cutting out a lot of processed food because I was more like a processed food vegetarian at the time. So, I'm not eating as much processed things. I'm eating a lot more fruits and vegetables, other stuff. But after about like seven years of doing that, for the first time, I'd felt like my brain is not working the way that I wanted to. Mhm. And I met a few people that were in the more precision medicine space and that's when one of them had recommended there is this company called Omegaquant. I have no affiliation but that's Dr. Bill Harris's company. Why don't you check yourself because you know if you've been vegan for a while or you don't like fish even if you're not vegan you could have a very low omega index. And I did the test and I don't remember the exact number but it was really low. Yeah. I started eating fish then. That's kind of what got me to stop being vegetarian or vegan. And I felt for the first time in my life like my brain after those that period I not the first time ever, but after like that seven-year period, I felt like man, my brain is like finally like turning back on. Yeah. And um I'm not sure if you know this, but the precursor to DHA is ALA. Yeah. U but the conversion process, you know, takes not. It's not great. No. And ALA we know comes it's the plant form of omega-3s which comes from chia seeds and flax seeds. Right. Right. So that could probably be why. Um funny story. I don't know if you've seen the headlines. Um but uh and this was only a few days ago the headlines in the New York Post came out. Apparently there's this trend happening right now called Sardine Girl Summer. Oh yeah. I've seen this. Uh which I am actually on board with. Okay. Okay. So explain it for our audience. Well, sardine girl summer. I believe a lot of people are now getting into designer labeled sardines. So, they're actually seeing that could this be a new trend to prevent dementia and Alzheimer's disease. And I love this so much. So, about a year ago, I was shopping. I live in New York. I was down in the East Village and I went into this shop and they had a whole wall of like I I don't know how to describe it, but it's like designer labeled tuna and sardines. and I started picking them up, right? And I think Patagonia also makes their own line now and it's just regular sardines, but the packaging is so pretty and so fancy. And I've noticed this huge trend. So, I think that's where the trend derives from. And this is a trend I can get on board with. Finally, a Tik Tok trend I can get on board with. Oh, amazing. I love that. So, for all the ladies out there and the men, too, you can enjoy your starting girl or starting boy summer. send us photos of your favorite sardines. You know, you mentioned something super important and that was this idea, zooming out, that inflammation is behind so many of these things that age the brain and age the body. And I want to talk to you about what you feel are the top sources of inflammation in people's lives. We know for sure, we've done a lot of podcast episodes, we know that having a highly ultrarocessed diet is something that's naturally going to bring with it inflammation both in the absence of a lot of good nutrients that would be there. Do you think that's because of the omega-6 profile that the fact that they're missing out on omega sixs? Yeah, probably. No, because they're increasing because missing out on omega-3 increasing. I think that's part of it. I think the other part of it too is that those who tend to be on uh eating a higher ultrarocessed diet are eating more calories. Just maintaining a lot more weight is inflammatory to the body. You have more visceral fat which in itself is sort of like an organ system in the body. I'm sure it's multi-layered that are there. But do you have any thoughts on that? What I think is really interesting and I put a post out um on social media not long ago about the role that GLP1s are playing in Alzheimer's disease. And we've seen um the first ever trial to show that GP1s are showing a very big effect in reducing the risk of Alzheimer's disease. Now caveat the study was done on people with type 2 diabetes which is originally why GLP1s were invented. Okay. So now we're seeing that you can micro dose with GP1s and we're seeing females have a higher rate of uh fertility outcomes. Yeah. Why is that? And if you keep looking down the root of it, we're seeing that GLP1s are not only helping with fat loss or overall weight loss, it's also helping down reggulate inflammation, neural inflammation. We're seeing women reporting headaches have gone away. And do you think that that's just because you're not eating correct? Because the vast majority of the people that are on GLPs, there have been some initial surveys that are done that people want healthier things, right? Um but people are probably still eating a lot of processed food in America. That's there. They're just eating less of it. Eating less of it. Eating less of it. And that matters and it makes a difference. That's what I think it is. That matters. It makes a difference. We're seeing people report that they no longer want to smoke or drink alcohol, which is phenomenal. Whether you're on the just the GLP1 or whether you're on GLP and GIP, I think that there is something to be said there around the down reggulation of inflammation. So I think that that's a really good pathway. But then I rather talk about instead of what are you doing? You know, are you ingesting this? What are you not doing? So if you can get your baseline working, which is if you are sleeping adequately, and I'm talking regular sleep cycles because we know that regularity matters. Um if you're getting into your deep sleeping, your REM sleep, if you are eating well and you are exercising, that's the first things that you should think about instead of going full ball elimination of everything. Yeah. Think about well, how can I preserve myself first and foremost and create a shield? Yeah. No, that's super important. And within that, I think there's categories of things that we're all exposed to that we can just be a little bit more mindful of, right? For example, you had a really great social media clip recently where you were talking about the role that air pollution plays when it comes to inflammation and ex especially when it comes to the brain. If I could read here from what you posted, right? So you talked about a recent meta analysis that studied over 340,000 people across Asia tracking to the tracking their exposure to pollutants like PM2.5 and other um other particulate matter that's there PM10 I think as well um and uh using satellite data and this study found that these pollutants were linked to higher death rates from heart disease, cancer and potentially even increased the levels of cognitive decline that were there and affecting your unborn child through the placenta. Yes. Of the mother because it was shown in women. Totally. And last part of what you had written, higher air pollution significantly increased the risk of cardiovascular and cardiovascular disease and cancer deaths, especially this particular component called nitrogen dioxide. And since vascular health is directly impacts the brain, pollution could be aging your brain too. And here's why I want to bring this up. There's this is multifaceted. There's the bigger issue which is that a lot of big cities around the world and they looked at primarily Asia. I think some cities in China. China at one point in time had like out of the top 50 most polluted uh cities in the world. I think like 20 of them were in China, right? Another 10 were in India. And then you know there population size. Yeah. Population size. but also the fact that industry and factory were in the city centers whereas in the United States you don't have that anymore. It used to be an issue for example um the London fog. Yeah. Which was primarily commercially driven which actually related to brain health. It was the first time that this researcher whose name was Parkinson noticed that there were people during the London fog that were exhibiting this behavior which later was coined as Parkinson's disease and that the thought process was that Parkinson's disease was largely an environmentally driven component of the toxicity a man-made disease. Um and we've had experts on this podcast like Dr. Ray Dorsy who have talked about that. Uh so cities are polluted and obviously as more awareness comes, China has done a great job of cleaning up a lot of its cities because their population doesn't want this and people are becoming more aware and so a lot of cities that were super polluted, they've done a huge job of getting the industry out and doing a better job of of of pollution. But the second layer that's there that I think is important to talk about with us, especially in the Western world spending so much time indoor, people don't realize that there was a groundbreaking study by the EPA that was done in 1989 and I think still holds true that often indoor air can be up to 300 times more polluted. You know, we're sitting in my studio here in Los Angeles. The air feels really clean in here. The air is really clean. We have an air filter here. We have an air monitor on that side. But when I first built it out, you know, this soundproofing that's on the wall here, this is all standardized and it's made out of polyester. Mhm. It's microlastics. It's this, it's that. You paint the walls, you have VOCC's, you get new tables, new carpets. That happens to all of us anytime we get a new car, a new home, or we get new furniture in. But if we're a little bit more mindful, since we spend so much time indoors, if you can slightly improve that air quality, yeah, you're most likely going to have a better outcome in health, especially when it comes to the long term. So that's why I thought that this was not only fascinating research but worthwhile touching on to the connection of air quality and inflammation inside of the body and it comes down to endothelial function. Yeah. Right. Can you talk about that? So your brain is the most vascular rich organ in the entire body. Okay. Vascule when I talk about that I'm talking about three things. I'm talking about when I talk when it's comprised of blood vessels such as capillaries which are just one cell thick. Then we go into arteries and then we've got veins. The arteries are like these tubes and around the arteries coats the the lining of it, okay? And it's made of smooth muscle just like the muscle in your in your biceps, okay? And on your quads and the endothelium part of that can become disrupted. It can become thinner due to inflammation and a whole array of other things, okay? And this is actually something else that interferes with the whole cardiovascular disease debate. But what ends up happening is we want a sturdy amount of blood flow that goes through the body. And that's what the arteries are doing. They're just shunting blood. If we have an unflexible or a really stiff artery wall, arterial wall or it starts to break down, that's where we're at the seat of uh clogging up the arteries with plaque or um we have increased risk of not delivering blood to the brain which is increases in which we which we know that blood delivers oxygen and nutrients to the brain. So if we have dysfunctions in these areas due to inflammation, what's it going to do? It's going to erode that pathway that pathway to delivering blood to the brain. And we're seeing this in even your you the first thing to go in the brain during hypertension are the capillaries. So even if you are mildly hypertensive that is an increasing your blood pressure the gold standard is 120 over 80. Even if you are 130 right over 85 or 130 over 90, you start to kill off these tiny little blood vessels. These blood vessels along with the arteries are supplying nutrients to every cell in your brain, 100 billion of them. So when they start to die off or they're not getting the adequate supply of blood, what happens? Brain cell death, losses in cognitive functions, and that's what then is resulting in vascular dementia. which not many people talk about. Alzheimer's dementia, Parkinson's dementia, it's all about blood flow. It's super important. And parallel to that, that plays right into endothelial health, which goes back to a lot of your core writing is important of importance of exercise. Yeah. In particular, because of its ability to increase maintain nitric oxide levels, especially as we age. As just one caveat. I mean, there's many reasons that exercise is very important to help with the pump pumping to helping with pumping. Yeah. And to that nitric oxide, as I understood from my cardiologists who I've had on this podcast, is that it's that gas that evaporates so quickly inside of the body first starts in our nasal cavity. We had uh I don't know if you ever met him before, but Dr. Lou Ignaro, have you heard of this guy? So Dr. Dr. Luaro, PhD researcher and was part of the original team whose work was given Nobel Prize for the discovery of nitric oxide. He's actually based here in Los Angeles. Really, really sweet guy. And that work was letter later used towards people um in the uh pharmaceutical space turning that into the drug Viagra. Mh. which not only is, you know, been a gamecher for men who have like ED and other things like that, but that some people were starting to get recommended by their doctor for Alzheimer's disease and health. Yeah. Because blood flow is everything. And when you actually look at why highintensity exercise such as uh your zone your zone 5, okay, or your V2 max training, why why is it so beneficial? It's because of the amount of blood that is shunted throughout the body. And we also see, and I don't know, did I bring up Ben Lavine's um study on my last podcast? I can't remember. So Ben Lavine, do you know his study? He's a he's a phenomenal sports cardiologist. And I'm absolutely obsessed with his work. And what he did was he took a group of 50-year-olds and Oh, this was about reversing. He re Yeah. So he subjected them over the course of two years. into a group of I think around 50 50 year olds and subjected them to that highintensity zone five training that is at the zone where you feel like you're going to die. Okay, you can only sustain it for a couple of minutes, right? Okay. And we should be doing this every week. But what he found was that he reversed the heart related decline that occurs as we age by 20 years ultimately turning these 50-year-old hearts into 20 into 30-year-old hearts. Why is that? Because as we age and we see this natural decline in our heart, two things happen. One is we are all at the mercy of having stiffer arteries like I mentioned earlier with the endothelial um lining. So when the arteries become stiffer, it means that blood can't pass through the arteries at a fast rate. Right? along with that is we get something in our heart. We've got um the left ventricle and the right ventricle. The left ventricle of the heart pumps blood to the entire body including the muscles, the brain, the organs etc. And then you get the deoxxygenated blood that comes into the right ventricle. Over time we get something called left ventricular hypertrophy. Meaning the wall of the left ventricle becomes thicker. And we can see this on a diagram. And when it becomes thicker, what does that mean? That means that we don't have a lot of blood that is able to pump through the left ventricle because there's not enough space. And when it can't pump through a lot of blood, that means we don't get a lot of blood pumping through the body. Now, both your brain and your body needs a certain amount of lers of blood per minute in order for us to just function. So, if it can't, it senses that, right? An ejection fraction. It senses, okay, this pump, this this heartbeat didn't squeeze out enough blood to the brain and the body. So, we're going to have to increase her heart rate and make it pump more. This is why the fitter you are, the lower your resting heart rate, right? Right. Because you don't need that much heart pumps to produce that adequate amount of blood to the rest of the body. So if you're if you have left ventricular hypertrophy as you age, that means your heart has to work like twice as hard to get adequate blood to the rest of the body. So he was able to decrease that left ventricular hypertrophy, meaning that he turned these hearts into 30-year-old hearts. That's incredible. What a beautiful and powerful study. We'll link to it in the show notes. If you've written about it, we'll link to that newsletter. It's also a reminder too that as you age and let's say for various reasons, you know, I hear from people who listen to this podcast all the time and as you age, you're hearing everybody talk about the benefits of working out, but I've seen so many folks that are in the 50 plus, 60 plus, 70 plus, 80 plus who have not been working out regularly and they get scared when their heart rate gets high and they're worried that something is is wrong, you know, and naturally When you work out, your heart rate is designed to get high. Is is designed to be higher and it's designed to do the work. It's designed to be stressed put on. It's designed to be stressed and we're intentionally stressing it. We're intentionally kicking our own butts because when you do that, you are making it fitter and it can actually rest a little bit more when we're not in that stage. And it's just a good reminder that, you know, working out is tough and it's tough to make it a regular and consistent thing, but you're doing it for the right reasons. And know that in a short amount of time, I think this group that he was working with, like how short of a period was it that he years, two years, that's not that long. That's not that long at all. That's not that long at all. I mean these sessions you should be doing them anyway just to increase your V2 max because we know that V2 max is the strongest uh metric for longevity in my opinion. Uh but even doing this can have massive amounts of benefits especially in cancer. We're seeing that uh cancer reductions from exercise and the mechanisms of exercise through myioine release. We see them u the myioines that get released from the cells of the muscles when they go into the bloodstream. they can have an effect on prostate cancer. Uh I put up a one of the first trials that's been done to show the effects of combining both exercise with chemotherapy and you have better outcomes in that stage. So it's exercise in my opinion is medicine. It's so medicine. Let's close the loop on one item just to get any other practical tips you have. I was talking about how there's all around us things that sort of can accelerate inflammation. We talked about air pollution. Talked about indoor air being one thing that at least we can control for in certain aspects. You can get a high quality filter. You can also, you know, you don't have a filter, that's fine. Open your windows every so often. Let the air circulate a little bit. Make sure to like clean up dust that accumulates. Dust is where a lot of these sort of particulates can kind of live and continue recirculating in the air. If you have dusty fans, you know, that dust has microlastics. and this and other things inside of it. So, clean all that up. Any other tips that you have for uh improving air quality in the home that you've done yourself? My home is actually equipped with like three or four different like air doctors like you. Okay. You know what actually was really interesting? If you're cooking, make sure you open all the windows. And the reason I know that is because my air purifier, I have a Jasper and it goes wild when I cook. It goes it shoots up and it goes on to full speed and I never knew why. So, I didn't know that this was actually increasing the air quality as well when you cook. Yeah. Such when you've got the haird dryer on. Hair dryer on. Yep. That's another big one. When my wife is in the bathroom um blowd drying her hair, especially after she's like shampooed or used a bunch of conditioner, the air filter on our bedroom starts freaking out a little bit because all these particulates are floating around. I'll throw in one more thing that's definitely a first world problem, but when you get a new car, there is I there these portable air monitors that I've picked up a couple. Yeah, I've got one, too. If you ever get a new car and you bring that in and just knowing how much America especially is a car country, you're sitting in that car, maybe you have a new child, other stuff, the air quality is abysmal. So just even having um cleaning a car, you know, thoroughly inside to wipe down and and to make sure that you know, these are all like new materials, plastics, other stuff. Cleaning it down, everything like that, getting rid of a little bit of that new car smell. And then if you can, if you have a garage and you feel safe and everything like that, lower your windows if it's not going to rain or you're going to be in a place where you're not worried about some animal jumping inside or being robbed or whatever, which may not be Los Angeles. Uh, open your windows in your garage. Let the air circulate a little bit. let the car breathe so that you can get rid of that new car smell because I have not seen a worse air quality uh for anything that I've experienced than when I bought my wife a new car a few years ago and you know we want to start a family one day and everything else and we'd be driving for long periods of time in this new car down to San Diego to visit family we would get headaches we get other stuff so I started bringing this air monitor uh no affiliation it's this company called u Atome I'll link to in the show notes and it links to your iPhone and it not only gives you PM 2.5, it gives you uh PM 10 and a bunch of others. The particulate count was crazy. And so I just ended up having somebody that I just paid to like clean the car multiple times inside over the course of a few weeks, let it air out a little bit, and that made a difference and started to improve the air quality inside. And then again, wow, just opening the windows when you're driving is another big thing as well, too. Well, I live in New York, so I don't have a car. There you go. But I can imagine what the air quality on the subway is like. Oh, yeah. Who knows? It might surprise you. Yeah, maybe it's better than uh than being in a new car. Uh, you know, I love, as I've mentioned before, I love your content. Your social media, your newsletter are such great places to get what's new, interesting, and exciting, or what is recently come out that people are feeling excited about. And then how do you contextualize that for your life to actually make it practical? So you do a fantastic job of doing that. You're on Substack. Can we mention where you're where people go to get your newsletter? Yes. Uh the Substack is actually called Neuroathletics. Yeah. Neuroathletics. But it's easier to click on the show link below um the show notes and you can go there and the newsletter is free. Anybody can sign up. Anybody can sign up and it's fantastic. We've got over 70,000 subscribers. That's huge. Congratulations. So, why I brought this up besides giving you a shout out that you deserve is I find you're always on the new and cutting edge thing and but you're showing us things that actually have some data around them. So, I'm going to move on from brain health a little bit and have fun a little bit with this next topic that we're going to get into. But I will also include that probably one of the most fascinating things that we found and I think I we did do a newsletter on this cuz I did put it on Instagram. It was a twin study. They took a group of 300 sets of twins, female twins, aged 55, right? And they tracked them over a decade, and they did the they were measuring leg power. Oh, yes. Leg power. Yeah, leg power. I don't know if you're going to bring this up, but I had to for all the ladies in here. It was on my list. And what they found was that and they were track they were measuring them through a leg extension. This is from King's College London. Yes, King's College. And what they found, you've done your homework, but what they found was that the twin who had greater leg power had better global cognition and better cognitive scores. Crazy. Crazy. The more powerful your leg, Yeah. the better your brain. Yes. And then they did a further study 12 years later and they took a subset of twins, so a smaller group, and they worked on them and they worked on leg power over those 12 years. And what they found was that they had greater gray matter volume as seen on MRI with volutrics. So what does that mean? Okay, if we just want to cut it all the way down, it means the bigger the legs, leg muscles, the bigger the brain. So there is something to be said of lower body exercises and compound movements like obviously leg extensions but squats and deadlifts and having better brain health outcomes. What do you think it is? Just like we were talking about vitamin D and what could be playing a role. What do you think it is about having stronger and more powerful legs, which typically also means bigger legs, right? I don't want anybody to get worried about having big legs, but it means like having stronger legs, which usually means more muscle mass that are there than where you're at right now. What is it about that that is so connected to the brain? Well, I think one thing is you've got more mitochondria because mitochondria lives in the the cells of the muscles. So, you'll have greater amounts of mitochondria. We know that having more mitochondria means more energy. That could be one thing. I think that because we know that type two diabetes is a huge risk factor for Alzheimer's disease and dementia. We know that more muscle it muscle is a storage sink for glucose. So that could be one one pathway. The other pathway may be greater. I don't want to look at it as just leg power. Okay. And the end result which is strength and muscle mass. I love to look at it. This is where my research is. I love to look at the journey that it takes to get there. Just like the journey that it takes to get a high V2 max, right? What is the journey that it takes to get there? Well, it means that you have to work out and go to the gym at least three times a week. What you're doing while you're lifting weights is you are extruding all of those myioines, those muscle-based proteins that are having the effect on global cognition. So, it's not just having big, you know, we can't just go and insert muscles into our legs, right? and have better brain power. I've actually thought about that. I'm like, well, would this correlate? And that was one of the hypothesis. And it turns out it's not because we can go and get kadaavas and then put, you know, attach them somehow and that's not going to increase it. What's going to increase it is what's happening during that time frame. So, it's the actual journey that it takes to getting the leg strength, leg power, and leg muscle mass. So, let's say there's somebody listening today and is like, "You know what? I'd love some of those benefits that this twin study study at King's College found looking at these 324 healthy female twins." I'm excited for whoever thought of even doing that. I know that's great because yeah, same genetic profile, right? Same genetic profile. If they were going to get started, you know, they're walking regularly, maybe occasionally going to the gym, but they're not seriously training their lower body. What would be a great way to get started on that? I always recommend if you can financially getting a personal trainer. That is because if you learn how to do movements correctly, and by the way, it's to do a a completely fantastic squat. It's not easy, especially a barbell squat, you really need to know how to hip hinge, how to like how to get your knees in the right placement, and you don't want to be you don't want to succumb to an injury. You want to just start really lightly. Don't scare yourself. sometimes even with body weight just to master the technique. Master the technique. Yeah. You know, you can you can see benefits and you can actually get hypertrophy which is increases in muscle cell size uh as little as two days a week of strength training. So you don't have to go hard every time you go to the gym. You just have to put in the work. So once you get the movements, you have to set yourself up to understand that it is going to be hard right at some point because that's what's going to produce the effect. Once you place the stress on a stimulus, that's what produces the that's what produces the output, right? So, you want to be lifting heavy once you get the technique downpacked. So, just starting light, getting the getting the technique downpacked, getting familiar with the gym, getting familiar with weights, and then go going from there. Yeah. And the nice added bonus is that if you're also working out with a trainer, at least initially in the beginning, and a trainer who's sort of documenting your progress, you know, there's a lot of different apps that trainers can use to, you know, maintain a record of like how much did you lift last week, how much are you lifting this week to see the progress and to make sure they're bringing some level of progressive overload, you're actually going to see those improvements that are there. Sometimes when I see people who are just starting out just go to the gym, maybe they might have, you know, trained a little bit when they were younger, but if they're not recording or properly sort of stressing their body in a progressive way, they sometimes don't feel like I'm really making that progress that's there. But when you look at it and if you're regular, you will make that progress. I think investing in a trainer is such a good recommendation. Whilst we're on the subject, what I think is also important to point out, okay, in terms of like all of the other things that are happening, there is something that not a lot of people are really talking about right now, there is a bone brain cross talk, right? So your bones talk to your brain in a specific pathway. We know that women uh during permenopause and menopause are at the mercy of osteoporosis. Yeah. Because we have estrogen receptors on our bone. And we're seeing many many women going and getting their bone density scans and having a T-core of less than 2.5 which is really scary, right? Yeah. So there is a really phenomenal group outside of New Zealand. Okay. I forget the researchers name uh but she's done a really great study on menopausal women taking women in the menopause period who are osteopenic to normal bone density in 10 weeks. Wow. And the protocol for that is jumping for 10 minutes three times a week. That's all it is. No heavy lifting. Just jumping on the spot or with a skipping rope for 10 minutes three times a week. Because what you're doing is that pressure that you're placing on your bone every time you jump is creating new bone tissue. Okay. It's the stimulus that forces the body. Yeah. And so the reason I bring this up now is because when you have greater leg muscles, you're going to have greater bone density in your feur and in your in your calf muscle in your calf bones. That's incredible. Uh like a year and a half ago, we had this woman on our podcast. Inspiring story of exactly this. Her friends call her Jenny Jenny McConnell. Have you heard about her? She's the oldest regularly competing Oh, yes. female American Ninja Warrior, right? And just I've talked about this before and we've had her on the podcast, so some of my audience knows, but at the age of her early 60s, I think she went in for her normal sort of uh checkup and her doctor basically, I don't think she had a DEXA scan at the time or maybe he got her one, but it he basically came back and told her, "Hey, look, you have osteopenia. You're on your way to getting osteoporosis." And she was like, "Well, what should I do about it?" And, you know, the doctor was well intentioned. He said, "You know, just didn't really have much to say." Then she told her daughter, who was a really uh top um athlete into CrossFit and everything, and her daughter said, "Mom, working out can actually help with this. Let's get you serious." And she was like, "I can't work out. Like, I'm in my 60s. I've been a ballerina my whole life and a model and other stuff. and I've always stayed thin, but like working out is my thing. She's like, "No, no, we're going to start with the basics." Her daughter got on the rep program. She started lifting weights, eating protein, you know, making sure she was appropriately fueled slowly. Like when she started, she couldn't even do one pull-up, she says. And then after like a year, she was doing like five, six, seven pull-ups, right? Slow and steady, heading in the right direction, doing leg presses and all sorts of other lower body movements. And she went back a year and a half later on and there was no sign of osteopena that was there. See what I mean? And not only that, she then went on to go and enter into her first American Ninja Warrior competition. And now she's like inspiring women of all ages and men too, just out there talking about her story and just saying like it's never not that 60s old, right? 60s so young, but it's never too late to turn things around. You just got to get started. Yeah. Yeah. That's a powerful story. And now we can have fun. Yeah. Well, on that topic, you know, we've talked about so many things that are in the evidence base that are there that are things that you want to make sure that you don't miss out on and in fact you double down on, right? That's been a lot of the themes of the things that we've covered so far. What are things for you in your life right now that might be I think of you as also in the evidence base, but you're also a little bit of an explorer, right? you try new things and not everything we always try has like a lot of evidence base around it. Could be something new, something experimental. So, I got a couple to ask you about, but I want to hear from you. Is there anything fun or new or interesting that even if it doesn't have evidence base around it, it's exciting and you've liked incorporating it into your life or your routine recently? Yes. But also, no. I stick to the basics, which is exercise, sunlight, nutrition. But, um, quite recently, I traveled to Australia. I just got back a few days ago and the day that I got back I felt horrific. I felt like I've been hit by about three or four buses and I went into Next Health and I actually went into a red light bed and I am obsessed with this. Okay. If I could out of any any tool that I could have at home, if I could have an infrared light bed, I would because for some reason I know that red and I know there's evidence around this, but I know that, you know, red light can go in and um penetrate through the superficial layers and get to the the superficial organs. Okay. So, I know that it's having an effect on me, but I felt incredible, right? So, I did that and I've actually started to do this twice a week. M then I went into and this is where the evidence is actually skewed. I did hyperbaric oxygen therapy. The evidence is is still skewed on that. Yes, you get you get a delivery of 100% oxygen to the brain tissues and and and the body, but we don't know if that is actually having any type of an effect yet. Like it has an effect on people who have just undergone trauma. Okay, like a stroke uh within the first 72 hours. If you do hyperbaric, then you're going to have, you know, phenomenal results in terms of recovery. But a healthy young individual like myself, it's probably not doing that much. I just did it because I felt horrible after the plane. Um, and then I did something else as well, which I don't know whether it was sleep deprivation. I don't really fully believe in NAD. Mhm. But I did it that day. Right. Why? I don't know. But I'm like, let's just see what people are going through. It's my first time ever doing it. And I don't know what made me feel good after. Maybe I also had a liter of um fluids as well. So maybe that's what made me feel good. But I did I'm doing things that my audience keeps asking me about. And everyone's asking me about NAD. And I have asked everyone I've asked Matt Cable who's a longevity expert and researcher. I've asked Dr. Inigo Salon about NAD. And the consensus is it increases plasma levels of NAD, but it doesn't really penetrate the cell, which is where NAD is actually degrading as we age. So, I don't know why so many people are doing it. So, I tried that out. And you felt the difference, but you're not sure cuz it was a bunch of different stuff that you were trying. I did glutathione as well. So, yeah. It's more in the experimental category. And you know what? Sometimes those things, if your budget allows, they might be fun. They might be fun to explore. They might be fun to try. But again, we want to make sure that that's not at the expense of any of the things that are super proven that have a long track record that we know that we can bank on on and are our insurance policy to protect not only the body but the brain. Uh, another thing I went through a small phase was having methylene blue and uh, I've tried that a couple times. Yeah. So, I was experimenting with that. What I don't like about it is it was making my mouth blue and I didn't think that and my whole lips and so I'm like where am I going to go looking like this? Uh I didn't see that much benefit personally. I don't know if you did. I didn't see a benefit and I also felt like I just kept on getting a headache when I took it. Yeah. And mine didn't taste the best. So, it wasn't helpful. And then couple that with the fact that so I'm surrounded by neurosurgeons um as a neurohysiologist. So, uh, up at Lennox Hill and I they saw me, they're like, "What's with your blue mouth?" And then they were the first ones to tell me that it stains your organs. Oh, wow. Not that it's a bad thing, but it's like, you know, why would you want to have a blue brain, for example, or a a blue kidney? I was like, "Oh my gosh, or a blue liver." Well, I guess the people who are selling it or the proponents of it, they're like, "Well, that's that's just something that comes along with the territory, but here's all these benefits." But again, those are largely anecdotal as I understand. Yeah. And whatever research is there is kind of limited. Very limited. And I always get worried too. No, no there. I don't want to yuck somebody's yum as the saying goes. If you're into that, great. But I always get a little bit worried, and this is where I've changed my mind over the years, is that sometimes people get into the hype of these things. And there's only so many things that you can do and you feel like you're making progress on your health and then you forget about omega-3 fish oil or you forget about just eating enough fish or you forget about working out enough because you think, "Oh, I'm taking these 25 different supplements." Well, there's no better supplement than working out on a consistent basis and getting good quality sleep and some of the other basics we talked about. You'd be actually surprised if you lived in a week with me and just saw that I did everything that is very much in line with mother nature. uh experimenting. I mean, I don't know what else you can experiment with, but every day I see something really stupid and ridiculous on Instagram that is just pushed in our faces that I know that there's no evidence for. Um, but here's the thing. If it makes you happy, I wear every night uh blue light blocking glasses. Do I think that they are really blocking out the light and the blue light? I'm not sure. I I've seen I've seen studies that show that it's not doing anything, and then I've seen other studies that show uh that it is. It depends on the type of frame you have and the actual glass that you're utilizing. And if it's orange versus clear. So, a lot of variables. So many variables, but it's I've it's a habit of mine. And I've I've just got them on as soon as it hits 9:00 at night, I'm wearing them. My wife forces me not to put them on too early cuz she knows whether it's placebo or real and I feel like I've bought from a really good source that I think that I trust and I'm excited about and everything. I feel it immediately and I start to get I start yawning and I start to really train my nervous system to wind down. But yes, I have se seen some of these mixed papers that are out there and studies because there's so many different types of lenses that are out there. And I think even when one study that was featured on NPR where they were really criticizing blue light blockers, they were using um glasses that were yellow. Yeah. Right. They weren't even blocking all the different rays that are there. So you obviously make sure you get high quality uh glasses. Just going back to red light, you wrote about this a little bit. Yeah. That you had been experimenting with it and I think a lot of people are wondering, you know, is the red light thing a myth? Is there something there? And if I could just read from one of the newsletters that I excerpt for today's podcast. So you talked about a 2014 randomized control trial that demonstrated that just 30 sessions of red light therapy and you put in the wavelength which was somewhere between 611 and 650 um nm and wavelength significantly improved skin roughness, enhanced collagen density, and reduced wrinkle depth by a striking 69 to 75% compared to control groups. Was that study enough to convince you to make red light a regular part of your routine? Yes. So, I'll tell you what. I've never been more obsessed than I am right now in how my skin is aging. I don't know whether that's an age thing, but uh I know that five years ago I wasn't really worried about it. And now I'm really looking I'm like, "Oh, I'm noticing changes." So, now I'm looking deep into the data of what can help me stimulate my natural production of collagen, right? Because we know that that obviously uh degrades as we get older. And it turns out that there's so much high quality evidence to show that red light therapy at the appropriate wavelengths can help stimulate collagen and can help with fine lines and wrinkles. I think in that one I put a before and after photo of wrinkles of a before and after one. We'll put on the screen over here so people can see it. So we put a before and after of the woman who underwent this uh this protocol and she saw a reduction in wrinkles. And so that is something that I'm really like really bullish on. I have red light masks. I've got a red light panel. I've got a red light little face uh handheld device. So, I'm really huge on that. But not just because of the be so-called beauty benefits of it, but also because of the immunity benefits of this. Have you interviewed Robert uh Robert Schultz? No, I haven't. Yeah. He's um he's he's entire so he's a medical doctor, but he's uh studying heavily wavelengths and red light therapy and light and and sunlight as a whole. He's seeing that uh even hospital reductions uh people have less time in the hospital when they're placed next to a window because they're getting more natural light and they're being more exposed to light. So there is something to be said of natural sunlight but also red light. Yeah. So like I said to you and there's different types of beds that I've actually been been in like full body beds and when I go in there I spend about 30 minutes it knocks me out. I get extremely tired. So, you know that it's definitely having an effect at the mitochondrial level. Um, if I could I tell you I think these mach I think these beds are like probably like they're expensive 250,000 right and they're like medical grade. Yeah. But I'm telling you if I would I would get that. Yeah. Do you want to know something I've changed my mind on? Yeah. Let's talk about it. Completely changed my mind on ice baths and I used to be big. I have one in my Is that ice baths in all versions of cold therapy exposure or just ice baths? Ice bars because of the the the the levels that I was getting to. So, it turns out now we're seeing all of the data come out to show that ice baths actually aren't good for women. Mhm. And I used to get into an ice bath first thing in the morning. And I would get in just like the men and I would get in at around 40° which is numbingly cold. 40 degrees Fahrenheit by the way. I'd get in first thing in the morning when my cortisol is already elevated as more so than men. So we, you know, we're different. Women are different. And it turns out that women actually don't need to be getting that cold to even begin with. It turns out that if we do want to engage in cold water immersion that we should be doing it at around 55° F, which is also still very cold. It's still, but not as cold as what I was in. Men can get down there and do that, but for women, it just shoots our cortisol through the roof. So, it's actually not good. So, I've now changed my mind on that. Wow. Yeah, that's amazing. Uh, you know, I hope that we all continue to see new information, be open to changing our mind. I'm not a subject matter expertise. I like listening to people like you and I'm always weighing out because there's only so many things that I can do in a week because we also have jobs, we have lives, we have relationships, you know, many people have kids who are listening. So, I love taking on new information, evaluating what's there and putting it through my sort of first principal thinking, which is, okay, how do I double down on the basics? cuz if I can be better at the things that I already know that work, I'm going to probably extract the most amount of joy, results, and everything that comes along with that for the long term. So, I hope that everybody who got a chance to listen today with all the information we shared, my hope is at least that there's one area in their lives that they felt like, you know what, I'm giving that attention, but I could give it a little bit more attention based on the data that you write about in your newsletter. And maybe there's some people that weren't giving those things attention and are at least slightly dep prioritizing something that may not have as strong of an evidence base around it so they can put a little bit more attention around something that has. Louisa, it's always a pleasure to have you on. As you saw from your last episode, our audience couldn't get enough of you. They are huge, huge fans. I think a few of the clips that we that we put on your social media as well did really fantastic. That's more of a testament to you than it is to me. Any final words you want to leave our audience with? Yes. Um, one of the best things you can do for your brain over the long term is surrounding yourself with quality people and investing in quality relationships. And this comes out of the Harvard 80-year follow-up study which showed that the people who live the longest really are the ones who have got good quality relationships. and not just romantic relationships, but investing in um in in having long-term good quality friendships. And I know that you do this with your men's Yeah. group every Thursday, our men's group. I really want to come for a walk on that group. But come and join. Come and join. But I think that that's a really really beautiful way to nurture your relationships over the long term. I'll leave you with the question that for the audience, you don't have to answer right now unless you feel inspired to. where we usually have a question of the day for our men's group. Every month there's a different captain. I'm the captain for the July and uh one of our default question which men are not great at this. I don't want to typ cast but they're not great at sort of opening up about their lives and what's going on. So a really beautiful simple question that I stole from a group that I was part of uh called Summit Junto that we ask the guys uh every so often is we say no matter how big or small just tell us one thing in your life that you're celebrating you know especially high achievers men and women they tend to not celebrate and acknowledge themselves for what's going on and what's going well in their lives. And then tell us one thing in your life right now that you're navigating. What's something sticky, even if it's small, that you haven't had a chance to talk about? And what every guy says, and over this last month, we've had a mutual friend of ours in town who's been able to join, Rupy. Yes. Doctor's Kitchen who's in town. What every guy says, they say two things. Number one, when they talk, especially about the navigating side, which is tough sometimes for guys to talk about, it might have been the first time that they ever said that out loud to to to anybody really. Yeah. They haven't talked about that. I think women, again, generalizing here, they're so much better about, oh, this thing is going on in my life and and women are just better based on all the data of maintaining relationships, social connections, opening up, etc. I think men have to work on that a little bit. And then the second thing they say is that when you hear somebody else opening up about both what they're celebrating, what they're navigating, there's a sense of camaraderie that I'm not alone. I'm not the only person who's going through something. Maybe I'm not going through the same thing that this person's going through, but you know, it means something to me that somebody who's there and this is a group of entrepreneurs that somebody who's also like who's successful or maybe a further ahead in life or has kids is also going through something tough right now. Like I don't feel like I'm alone in the things that I'm dealing with my life that are challenging. So those are two things that guys regularly say being part of a group. I love that. Yeah. Yeah. So, if you uh are catching up with somebody and you want to connect at a deeper level, it's a question that anybody can use. Just what's one thing in your life you're celebrating right now? You know, and if they feel open to sharing, what's one thing they're navigating? Louisa, on the topic of friendship, I super appreciate your friendship and I'm glad that we've gotten a chance to get connected over the years. Again, everybody, please check out the uh newsletter. We have the link below as well as uh Louisa's podcast and social media. We've linked to all those below. Thank you again for being back on the show. Thank you, Drew. Hey YouTube, if you enjoyed what you just saw, keep watching for more great content on how to improve your brain and your life. The image that I like to give for people is that every single time you move your body, it's like giving your brain a wonderful bubble bath full of beneficial neurochemicals. And so this is what I like to tell