Barbell Shrugged - [Dementia and Alzheimer’s] Evidence Based Strategies to Reduce Risk of Dementia and Alzheimers w/ Dr. Tommy Wood, Anders Varner, Doug Larson, and Dr. Andy Galpin Barbell Shrugged #668

Episode Date: November 9, 2022

Tommy Wood is a Senior Fellow in the Pediatrics Department at the University of Washington, and Chief Scientific Officer of Nourish Balance Thrive, an online-based company using advanced biochemical testing to optimize performance in athletes. Tommy was born in the US to Icelandic and British parents (which means he has three passports in two different names). He was predominantly raised in the UK, but also spent periods of time at school in Iceland, Germany, and France. Tommy received a bachelor’s degree in Natural Sciences and Biochemistry from the University of Cambridge before studying medicine at the University of Oxford. He worked as a junior doctor in central London for two years after medical school, and then moved to Norway to complete a PhD in physiology and neuroscience at the University of Oslo. Tommy is currently President-elect of Physicians for Ancestral Health, he is a director of the British Society of Lifestyle Medicine and the Icelandic Health Symposium, and is on the scientific advisory board of Hintsa Performance. Tommy has also coached and competed in multiple sports including rowing, CrossFit, powerlifting, and ultra-endurance racing. Alongside his career in medicine and research, Tommy has published and spoken on multiple topics surrounding functional and ancestral approaches to health, including examining the root causes of multiple sclerosis and insulin resistance. In today’s episode of Barbell Shrugged you will learn: Why brain health is not a fixed state and can be upgraded throughout life Why we are so good at the physical and struggle to understand brain health Early onset vs. late onset cognitive decline Why early onset Alzheimers is not modifiable Why late onset Alzheimers is 90% of cases and can see improvements  Differences between Alzheimers and Dementia Why physical fitness is so important to brain health   To learn more, please go to https://rapidhealthreport.com Connect with our guests: Dr. Tommy Wood on Instagram Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram Dan Garner on Instagram

Shrug family, this week on Barbell Shrug, Dr. Tommy Wood is hanging out. Dr. Andy Galpin is on the show as well. We're talking about brain health. Dr. Tommy Wood just posted a new paper recently about dementia and Alzheimer's and how we are able, the six things that you can do really to reduce the risk of getting Alzheimer's and dementia, and you could even throw Parkinson's into that as we age. It's very obvious that we have gotten really, really good as a species at keeping the hardware of our body moving. We can go replace all your organs and fix your heart and do all the things to keep the body

moving, the physical body moving and maintain physicality throughout many, many years, like people live in over 100 now, which is crazy. But something happens with our brains, and we haven't quite figured out exactly how to keep the brain health thing going. And in today's episode, we're going to walk through many things that you can do and start thinking about as well as if you have been affected by Alzheimer's or dementia or family members or friends. Maybe some ways that you can start to challenge them. There can be language, there can be music, but training, fitness, lots of things that we go over in the show that may be very beneficial to people that have already been affected by it.

And as always, friends, head over to rapidhealthreport.com. That's where you're going to see Dan Garner reading my labs. You get to go watch me show the world about my low testosterone and how we fixed it. That's over at rapidhealthreport.com. Friends, let's get into the show. Welcome to Barbell Shrug. I'm Anders V, Doug Larson, Dr. Andy Galpin, and Dr. Tommy Wood. Today on Barbell Shrug, we're going to be talking about some new research, a paper that you just put out in which Andy Galpin stole all the credit on Rogan for. Literally, all of your hard work and what does Galpin do but get his instagram up on rogan for an

afternoon anders have you not paid attention to my career this is literally my career it's never my work i know all the smart people and i will repost their work yes and i don't tag either and i give no credit so but i well i did get a tag. I'll take it. I always tag. And I usually tag in the first couple of words. So it's not just buried 24,000 words there. But today we're going to be talking about Alzheimer's, dementia, Parkinson's, which is something that's very near and dear to my family,

most likely your family at the rate that this is becoming a big topic in the world. And also, as Doug mentioned before the show, got to be the most terrifying thing that could ever happen to you. Before we get into that, though, can you give us a little bit of background and where this interest came that you wanted to dig into this? Yeah, sure. So I am a neuroscientist. I'm a faculty at the University of Washington in Seattle. And I have a whole bunch of random stuff that I've done in my career. I was an undergrad at biochemistry, went to med school. I worked as a doctor in London for a couple of years. Then I did a PhD in neuroscience and physiology. And throughout that whole time period, I was also working with various elite performers, athletes,

looking at blood tests, urine tests, stool tests. Like if you can give me any fluid that comes out of your body, I was willing to measure stuff in it and look at it. And sort of over time, what I became most interested in is how do we keep the brain healthy, essentially for the entire lifespan. So I've done research in neonatal brain injury, traumatic brain injury, doing more stuff in sort of Alzheimer's, dementia, cognitive decline, neurodegenerative conditions, I've done some work in multiple sclerosis. And so then what's interesting to me is that you can kind of

see these same threads of what's important across the entire lifespan. So in neuroscience, we generally focus on one disease and we like dig really, really, really deep into it, right? So like you're just the stroke guy, or you're just the multiple sclerosis guy, or you're just the Alzheimer's disease guy. But actually, some of the same things are important essentially regardless of where you are in the life and which sort of aspects of the brain you're talking about and so that's what's really interesting to me and then that's kind of drawing those threads across your entire life then allows us to figure out like what where can i intervene um and you can intervene almost at any time point and probably change your trajectory of brain health.

And I like that because it's not just this fixed thing. We used to be told that your brain, you just have this amount of brain and brain cells, and then you just kill them over time. Every time you don't sleep properly, every time you have a couple of drinks, there's just this continuous decline. There's nothing you can do about it. And that's not true. And so I find that really interesting.

And so then this is where sort of all those different bits and pieces come come together can i add a little context to tommy before we go on just on his background tell the cool part and not the um right laid down part right so brag um tommy when you when you say you've worked with uh athletes you don't you don't mean a small number this is a very very large number how many hundreds of athletes have come through you your supervision oh yeah i mean i've looked at i've looked at blood tests and test results from i know two or three thousand athletes uh right at least yeah and you're still currently working with formula one racers uh drivers and a whole host of things. So this is no small sample size here. And last thing I wanted to add is Tommy himself is no stranger to strength training here.

So you still compete in strongman, right? Like occasionally. So very, very versed in strength training background. So you're not just some dorky neuroscientist out there like working in brain health. You're one of us. You're a're a you're a total and utter bro in fact one of your companies is called like bro research is that the name yeah that's the thing yeah i appreciate that that's true and actually like i was saying uh barbell shrug was the first podcast i ever listened to because i mean i've been a bro for a long period of time. Correct order.

Athlete, bro, medical doctor, PhD, scientist at the University of Washington Medical Center. Being a bro, that's right. That's where all the credibility comes from. I was going in order of what's happening. Not a PhD neuroscientist. In order of chronological order is what happened. You turn into a scientist way later yeah yeah exactly

graphic designer putting together that pyramid of importance yeah i've been a huge fan of tommy stuff for for so many years um some of the other stuff he's built in the past so uh i'm stunned i'm stunned you haven't been on here it's going to be incredible so i appreciate it um it it seems broad broad strokes that we've gotten very good at figuring out the physical body and how to So I appreciate it. It seems broad, broad strokes that we've gotten very good at figuring out the physical body and how to keep it finely tuned for a very long time. But the next phase of this thing is now we're living for a very long time, but it's hard for us to keep our brain fit.

And it leads to very terrifying things. I mentioned at the beginning, it's hit close to home. And I'm sure many people have gone through this, but my grandma was like 20 years deep into dementia. And it is one of the most taxing things I've ever seen on just family, the next generation, their kids living in the home. And I'm sure I'm just echoing what everyone else would be saying if they've had somebody go through this. Why is, what is so much more challenging about the brain than understanding the physical body and how long we're able to keep the health of the body going, but we haven't understood why the brain starts to break down. And we now are faced with this, I don't know how it's not like

a pandemic, but like this, this new era where we have to figure out how to keep our brains healthy, because the body can live for so long. Yeah, you're absolutely right. Depending on who you ask, some people say that Alzheimer's disease is the disease that's going to bankrupt Medicare, Medicaid, other healthcare systems around the world. And that's not even taking into account the carer burden, like you mentioned. there's billions of of dollars of people you know have lost productivity as people stay home from work to look after to look after parents or don't work to look after parents with the get alzheimer's disease or other types of dementia and if you look at trends in mortality over the last 30 years or so in the u.s pretty much everything like by cause

everything is coming down except for alzheimer's disease which is essentially just rocketing upwards um and you're right that part of the reason for that i think is we've become very good at preventing or treating um other diseases that might kill you first so um we've become pretty good with with heart disease with various different things we're increasingly good with various types of cancers um but the brain is somewhere where essentially we haven't been able to pharmaceuticalize it there's no drug um that we've been able to figure out yet um and therefore that seems to be to taking off. So that's the bad news. However, if you look at the risk factors for Alzheimer's disease and multiple neurodegenerative conditions,

they're actually pretty similar to a lot of the other things that we talked about, certain cancers, heart disease. And it's just the fact that we don't have a really easy way to intervene there from a drug standpoint and that's hard because what it takes is manipulating behavior and the environment. So it's all about physical activity, nutrient status, sleep is obviously critically important and the thing that we talked about in the paper particularly was focusing on cognitive demand which is basically this idea that um and we tie a lot of uh similarities to exercise because like muscles are something you can see

right and it's and performance is something that's very easy to measure and is done very routinely like you know if you're getting bigger or fitter in general, right. You can just look in the mirror half the time. And we're just like, you know, how, how my number's been in the gym, but it's more difficult with the brain. But essentially the idea is very similar, which is that the function of a tissue is proportional to the demands that you put on it with some period of

rest and recovery so for the brain in particular that sleep um but you have to challenge the brain in the first place and that's something that in modern society we're doing less and less of right all your scripted learning happens in school early in life um the biggest cognitive demands you have in your life when you're when you're a baby right learning motor skills um language skills social skills it's incredibly taxing for the brain right but then if you think about most adults they go they wake up every day go to work they do the same thing every day they may feel busy but that's not the same as challenging your brain um and then they retire and you see in multiple studies that as soon as you retire your risk of

cognitive decline dramatically increases because you've taken away the one thing that was actually challenging your brain um so the big driver and you can see it again we can talk about multiple different strands of evidence that support this but the sort of a major driver of cognitive decline seems to be the fact that we just don't use our brains that much anymore one of the things i loved about your paper was that it was so it was written so colloquially like it was not challenging to follow as obviously i'm a scientist in physiology but the neuroscience is it's almost difficult for me to read as anybody else i don't know what those terms are yeah this paper was not that challenging to follow um the throughput was was pretty easy i think maybe before we get too far down we don't need to go through a detailed physiology of

alzheimer's or anything like that but just to really clarify sort of what you're talking about is the difference between early onset alzheimer's and late onset slash sort of dementia so just like really quickly what's the difference there which one can we modify and we'll kind of move on to the strategies yeah yeah it's a really important point it's actually something we address very early on because when you talk about alzheimer's disease you're talking about two very distinct and different diseases that have been lumped together um so one is early onset alzheimer's disease which uh occurs usually people in their 30s to 50s is caused by usually just one genetic mutation um and it drives a sort of like consistent predictable declining in cognitive function over time that's what

alzheimer the doctor who first described it, that's what he was seeing in a cluster of patients. In general, that's not something you can do with. That's not something that we think we can modify. Although I have, I do know some doctors who say that if you're really get all your ducks in a row from like a nutritional and lifestyle standpoint, they've seen people who have normal cognitive function later into life. But traditionally, we say that's not really modifiable. Shark Family, I want to take a quick break. If you are enjoying today's conversation, I want to invite you to come over to rapidhealthreport.com. When you get to rapidhealthreport.com, you will see an area for you to opt in, in which you can see Dan Garner

read through my lab work. Now, you know that we've been working at Rapid Health Optimization on programs for optimizing health. Now, what does that actually mean? It means in three parts, we're going to be doing a ton of deep dive into your labs. That means the inside out approach. So we're not going to be guessing your macros. We're not going to be guessing the total calories that you need. We're actually going to be doing all the work to uncover everything that you have going on inside you. Nutrition, supplementation, sleep. And then we're going to go through and analyze your lifestyle. Dr. Andy Galpin is going to build out a lifestyle protocol based on the severity of your concerns. And then we're going to

also build out all the programs that go into that based on the most severe things first. This truly is a world-class program. And we invite you to see step one of this process by going over to rapidhealthreport.com. You can see Dan reading my labs, the nutrition and supplementation that he has recommended that has radically shifted the way that I sleep, the energy that I have during the day, my total testosterone level, and it's my ability to trust and have confidence in my health going forward. I really, really hope that you're able to go over to rapidhealthreport.com, watch the video of my labs and see what is possible. And if it is something that you are interested in, please schedule a call with me on that page. Once again, it's rapidhealthreport.com. And let's get back to the show. The late onset Alzheimer's disease is

what everybody is terrified of. And it's more than 90% of cases of Alzheimer's disease, probably more than 95% now as Alzheimer's disease increases. And this is late onset. Now we're talking 60s, 70s, 80s. It's very heterogeneous right it's very different from person to person um and it's not necessarily very predictable in its course um but this is the type of alzheimer's disease that we think is modifiable because all the almost all the important risk factors and the things that we know are associated with the likelihood of you getting it um are lifestyle and environmentally driven. So that means that we have potential intervention points. And there are studies that have done that, right?

If you change, you do some brain training, you improve diet, you add some physical activity, maybe some stress mitigation, you can start to see either slowing of decline or reversal. So we know that this is a process that you can intervene in. Yeah this is the part we want to talk about um it's a little bit like shin splints right where it's like we're calling this all all homers slash dementia but it's probably a whole bunch of different things yeah um that is that's different than the actual mutation alzheimer's when you're 40 cancer okay so that's the foundation i wanted to lay now we can sort of move into yeah uh the actual science so real quick on the defining term space like you you basically said a second ago like what's what's the difference between alzheimer's and dementia and then in the same vein like uh you mentioned cognitive decline is that just like a one step before you

actually are diagnosed with a condition and or is brain fog even like one step further down the chain like once you start having quote-unquote brain fog is that what like the first sign of cognitive decline which is leading toward dementia and or alzheimer's or is that a separate thing like or is that is or even like a really a clear definition for that other than people are just kind of like i'm having trouble thinking how do you define that yeah that's another really important point. So dementia is basically a clinical doctor's diagnosis of disordered brain function, usually associated with issues in memory, but there's also things like executive function, like decision making and that kind of stuff. And there are lots of different causes of dementia. and the the most common one is what we would call alzheimer's disease or alzheimer's

dementia and again by far the most common version of that is the one that we were just the one that we were just talking about on your way towards uh dementia right there's a there's a sliding scale so there's this continuum of of of cognitive function that decreases over time and that's what we call cognitive decline so you know this like process that right at some point like dementia is this hard cut off because you need to diagnose it to treat it and that kind of stuff but obviously it's a it's a sliding scale um if there's a period before dementia where you still have you know you have some a decrease in function we call it mild cognitive impairment and that's another like

clinical diagnosis you would get a do some tests with your neurologist and they'd see some deficits and and they'd call it that but even then before then you know there's there's a decrease in fun in function over time um and that and that's sort of like cognitive decline is on that entire, on that entire scale. The first bits of cognitive decline are entirely subjective, right? Only you will notice them. Um, and it's relative to your personal experience, right? So, so one of the things, one of the issues with diagnosing cognitive impairment later in life is that it's on standardized tests which don't take into account what your function was previously right and we know that people have a whole range of you know cognitive functions so people who

you know have a very high cognitive function on a particular scale a particular test they might have to lose a lot of function before you pick it up on a standardized test. So the first bit, only you will probably tell. Other people probably can't tell until slightly later in the process. But you might notice, I'm just not as sharp as I used to be. I don't quite remember things the same way that I used to. And so that could be one of the manifestations that somebody might call brain fog. So in some people, that may be like the early steps, but they're just starting to notice that there's some issues going on. That's probably a good thing because we know that the earlier on in the process that you change things, if you identify, you know, here are like the big rocks that may be affecting

my brain function. We know that the earlier on in that process, the more likely you are to be able to reverse or prevent it um i hope i'm not jumping too far ahead but we had dr rady uh the the author of spark on probably like a year and a half ago and he works with the population of very young kids as they develop and understanding like how physical fitness plays into overall testing, standardized testing and grades and just brain development in younger children. Do the same principles kind of in a way apply as we get older and that physical fitness needs to be a part of the day-to-day life? And why is the brain and physical fitness so specifically interconnected that we have to continue to do this and go lift weights and run and be physically fit

in order to maintain mental health? Because maybe the layman would not see those two as being connected so so yes it's almost exactly the same and this is something that is most interesting to me because like in my day job i'm a i'm in the division of neonatology i'm a neonatal neuroscientist i look at ways to treat the injured newborn brain. And what's interesting is that the things that matter. That's a day job, by the way. That's my day job. Something tells me you don't just go like apply for that job.

Like someone has to come find you. That's my job and I go coach CrossFit. It's a niche field. I'll put it that way. Go figure. But yeah, you're right. There are other jobs that I do. My wife always jokes that unless I have like four jobs that I don't feel like I can't be fulfilled.

What are you doing with your lifetime? It was so ashamed so the interesting thing is that um the things that the things that matter right for the early brain development like you mentioned um matter throughout the entire throughout the entire life and that it's useful to study the developing brain because that's something that people are like really invested in like everybody wants every kid to study the developing brain because that's something that people are really invested in. Everybody wants every kid to have the best possible life and outcome they possibly can. A lot of money is invested there.

And there are lots of databases and looking at what affects kids' development. But you see the same signal essentially wherever you look throughout the life. So I'll give you an example. I do a lot of work in um babies with who are born prematurely and if you're born prematurely you have an increased risk of neurodevelopmental impairment um which is like some kind of issue with brain development and in um in kids who are born prematurely uh the more muscle mass that they gain early in life the better they seem to perform cognitively and the better motor skills they develop the better executive function and

decision making they have um so there's this you know particularly in the at-risk brain so this is a brain that's at risk of having issues physical fitness and developing um motor skills you know other skills seem to be giving benefit in other areas of brain function like executive function decision making and we also see something right at the other end of life so there was a nice study that looked at um people's physical activity levels and physical function so i think they did uh you know vo2 max testing and similar things and then they opened these people's heads up and looked at their brains after they died yeah so there's this really nice data set we were like well we looked at how physically fit they were how active they were and

then we got a chance to to look at their brains and in those who are starting to develop what looked like um these accumulation of of proteins in the brain that we associate with alzheimer's these things like um amyloid beta people have probably heard about or uh hyper phosphorylated tau these are two like these are like clumps of abnormal proteins that just accumulate in the brain um in people who are starting to develop those things in the brain if they had a high degree of physical activity or physical functioning, like cardiovascular fitness, the brain was not responding negatively to those. There are cells in the brain that like release all these immune factors and all this kind of chronic inflammation and physical activity, particularly in those brains was sort of

moderating that effect. So again, this is an at-risk brain um which is in the in the process of maybe having some like pathological processes going on but physical activity was mitigating those effects and then they weren't affecting um like say cognitive function right so it's providing protection even if there are some pathological processes going on so we see that right at the beginning of life we see that right at the end of life and essentially all the way through because we know that physical activity and physical fitness is really important for both resilience to traumatic brain injury but then also recovery after concussions and things like that so again like the same pockets of information appear um and then you can dig into well why why is that

um and there's a whole bunch of potential reasons so we know that your your muscle tissue your skeletal muscle tissue is your best buffer for blood sugar right um if you want to control your blood sugar you need to have a sink for that blood sugar to go and your muscle like the more muscle you have and the more you move it the bigger the sink you have and we know that blood sugar both like how high it is as well as how variable it is is a really important uh predictor and risk factor for cognitive function pretty much any time uh in in the in the lifespan um there was also on that note i've heard alzheimer's called type 3 diabetes is that how accurate is that that uh um that label say yeah yeah that jargon yeah yeah that's that's a it's a. And yes, a type three, the sort of late onset Alzheimer's disease that we that we've been talking about, some people call it type three diabetes, particularly because the brain seems to become insulin resistant and you're not getting glucose uptake into the brain, particularly in regions where you're seeing decreased function.

It's definitely associated with insulin resistance elsewhere in the body um and so we know that if you uh pre if you have like normal blood sugar versus pre-diabetes versus type 2 diabetes your cognitive um function like declines more rapidly over time so the worse your blood sugar the the faster you lose your your cognitive function and so that seems to be translating into the brain like the brain is just not getting any energy supply because it becomes the the faster you lose your your cognitive function and so that seems to be translating into the brain like the brain is just not getting any energy supply because it becomes insulin resistant but part of it is also that that other that other bit that we talked about which is cognitive demand so your muscles take up more glucose because you move them right and in the

brain there's this very similar thing um called neurovascular coupling which essentially just says if a brain if an area of the brain is very active it will demand more things like blood and oxygen and glucose so yes there's some bit that like not enough glucose is getting into the brain but at least part of it is probably because you're not using that area of the brain so it's not asking for that glucose to come in in the first place. So one of the, one of the problems that I see when we talk about things like insulin resistance is we don't talk about demand.

Like all we do is talk about supply. Whereas demand is really the issue. It's the same with physical activity in pre and pre-diabetes type diabetes. And I think we're seeing some of the same things in the brain one of the on on that no like we all have like for someone who who is already kind of there there are many steps down this path to having some some degree of cognitive decline and they're maybe they're not um their brain's not processing glucose like like it should be if they're doing keto or taking in exogenous ketones and then they they see a a an improvement in cognition is that because their their brain can't can't get the energy it needs from glucose but it can from ketones and then they they have

improvements in in how well they can think and their memory and whatever else. Yeah. So there are more and more studies coming out on this now. I think we have multiple randomized controlled trials looking at some source of ketones. It could be esters, it could be MCT oil. And that seems to be associated with improvements in cognitive function in people who already have some advanced either mild cognitive impairment or um or dementia and that's probably because the ketones aren't reliant on normal insulin driven signaling in order to get into the brain there are there's a different set of transporters the ketones can get in and then they're readily used uh so yeah if the issue in one individual is the fact that, right, the energy is just not getting there. That's why that area of the brain isn't functioning as well. Then ketones do seem

to be able to overcome that. And, and lactate can, uh, to a certain extent can as well, they use the same transporter system to get into the brain. Um, and going back to kind of the idea of muscle building, um, I'd love to, uh, I've had this train of thought, like, of the like, why do I continue to lift weights when I kind of don't need to? What like, I'm keeping muscle mass is not going to be a problem by just doing some very basic things. And one of the answers that I feel like really makes a lot of sense to me, and I hope it aligns with some of the research is that in this entire process, one of the most important pieces over the life of staying healthy is the ability to go and repair yourself. Is that something that comes from the brain signaling to the body, like time to go fix

your glutes now that you just destroyed on a Tuesday afternoon. And the practice of repairing your body, is that something that actually works with brain health to, to keep that system in, in constant repair and constantly challenging the body to, to have to go repair muscle tissue. So again, what's very interesting and you see it in the brain and you also see it in, in muscle tissue? So again, what's very interesting, and you see it in the brain

and you also see it in muscle tissue, is that activation of repair processes is triggered by stimulating that tissue, right? So if you ask your brain to do something difficult, you upregulate, you know, everybody's really into fasting for autophagy and all this kind of stuff and and repairing repairing tissue the fastest way to upregulate those processes is just do some aerobic

exercise because by stimulating the tissue you upregulate all these sorry about that but it means that you can eat and just go for a walk isn't that that would that's that's my that's my preferred way to upregulate autophagy get out of here with your science tommy sounds better practical rational thinking in relation to your question it basically just says that if you want to repair a tissue the best way to stimulate that process is is to use that use that tissue um and then right we know that you can go too far the other way so you need to provide the opportunity for the repair to happen and that's where sleep and other recovery processes become become critical so if you're worried about the function of a tissue and you think and we we know that as tissues

age um one of the there are nine so-called hallmarks of aging which are things that you can like measure biochemically in a tissue um they're associated with aging and one of them is proteostasis which basically just means that protein like junk proteins just accumulate um and that's inside cells and they can affect cell function and one of the best ways to clear that out is to upregulate this autophagy process. And the best way to do that is just to stimulate the tissue. Just say,

Hey, I still need you around. You're still useful. So now we should probably like clear house because you know, it's going to be important for, for, for function. So regardless of which tissue,

and it could be your glutes or it could be a hippocampus, which is, you know, really critical for memory, if you want to stimulate repair, which is a critical part of function, the best thing you have to do is stimulate the tissue, use it, and then provide an opportunity for recovery, which in most cases is either the sleep, plus or minus some other kind of,

even just rest and recovery. Earlier you mentioned amyloid plaque buildup. To what degree is that similar to like the plaque buildup you would get that would cause a stroke or heart attack or any like peripheral vascular disease, etc. So in terms of its structure, it's not really similar at all. It's just the it's just the same. It's just the same name. In terms of, you know, broad strokes, yes, this is the accumulation of, you know, some kind of, we think it's some kind of injury process that's then sort of forms this focus in an area that we call a plaque. But in terms of like their actual structure and what causes them well

there may be some similarity similarities because again the risk factors for heart disease and the risk factors for alzheimer's disease are very similar um and in both cases the plaque is forming in response to this injury process um in the brain in particular, the accumulation of amyloid plaque is probably, well, I've argued, like I and some colleagues have argued in a couple of papers, that it's probably just what we would call an epiphenomenon. It just means that people think that amyloid is the driving factor, but it's probably just accumulating in response to neuronal stress like neurons get stressed there's some disease process could be inflammation infections um other kind of toxic exposures um hyperglycemia like issues with blood sugar it's more than in response than anything yeah so in response yeah the brain just makes this because actually it's protective in some cases this amyloid protein is protective in some cases so the brain produces it to try and respond to the insult and then it's kind of you know we've talked about you know multiple talk people talk about say in heart disease, right?

You don't blame, like if you find something in a plaque, it's like the fireman, you don't blame the fireman for the fire. Right. And so like in some cases, amyloid, amyloid in the brain seems to be similar. Yeah. So if kind of following up on this, but with the whole Alzheimer's potentially type three diabetes, it's clearly, as you're mentioning glucose dysregulation in the brain, right? That's some association there. You can think about classic type two diabetes, like you have a threefold problem, maybe twofold problem, right? Some dysregulation of the pancreas and you have some maybe liver, but like really pancreas is a problem. And then you've got receptors and muscle tissue, right?

So you've got GLUT4 receptors that are the things that you need to actually get glucose from blood in the muscle, right? And so you can have an upregulation of those or desensitization or downregulation or some change in their function with type 2 diabetes, especially long-term. So I'm curious with the brain, is there a similar thought of, is there, are there specific GLUT'm curious with the brain is a similar thought of is there is there are the specific glute receptors needed uh in the brain and then so like is that a place of dysfunction is that what the resistance is coming from or is it just like a blood supply it's like what is actually causing theoretically insulin resistance in the brain yeah it's a good

question because typically blood glucose uptake into the brain is not insulin dependent right it's just it's it's substrate driven like how much how much glucose have you got um and so then multiple factors will come into play but like vascular supply is is very important so what affects the your blood vessels in your heart as are also affecting the blood vessels in your brain and they don't become good adapting to demand right so normally like we talked about earlier if if a certain area of the brain is very active it will ask for more blood supply but that requires the blood vessels to be responsive and functional which they will not be over time if

you know particularly in the setting of pre-diabetes type 2 diabetes so that's part of it um and then uh the other the other part of it may just be that um due to persistently elevate like high blood sugar levels the the the glucose receptors are just down regulated like we know that in in physiology right there's there's a lot of negative negative or negative feedback which basically means if you you've put in a bunch of stuff um you'll you'll decrease the signal it's the same right if you take exogenous um hormones then your body will make less of their own right it's the same thing so if you're persistently exposing the brain to high levels of glucose it may just decrease the number of

receptors or transporters in response to decrease that signal because the the the brain is really good at least early on at regulating what comes in because it because it's it's so critical for for overall function so i think there's a vascular supply problem. There's like this peripheral body, like essentially bathing the brain in glucose that it tries to turn down the signal. And then there's the lack of demand, right? You're not asking for increased uptake. So then in response, again, you decrease the ability to take up glucose. So I think it's probably some combination of those things. Yeah. So that gives you two avenues of action right for prevention or treatment doesn't matter which is either one regulate blood glucose input nutritionally or whatever right or regulate blood glucose utilization

activity right and in the case of muscle muscle doesn't really respond to challenging tasks in terms of confusion because there is no decision making there. Right. So it's basically if you want to keep yourself out of type two diabetes from a skeletal muscle perspective, it is regulate food intake or energy intake in a right ways or it is make the muscle contract and move. The brain is different because it has other ways you can get it to burn energy that are not necessarily just contraction based. Right. Its form is cognitive challenge its form is social connection and there's is full of things like that so um maybe it would be nice to sort of transition to the phase of the paper now where it was i think you had six kind of different areas of things you can take action on we've mentioned a couple of them but maybe you can just lay those out

and we can hammer through those in a completely unorganized and over-talking way that we do it. Yeah, yeah. Did you just describe podcasting? Can you stop talking so much? We have more questions. We're really getting in the way of our questions.

Yeah, so then to make this even more disorganized i'm going to go back and add something else to something um if we're talking calpain systems here and we're going to get there it's just going to get all the way up no it's not that it's so for both um time to diabetes peripherally insulin resistance peripherally as well as in the brain there are there are other things that modulate insulin sensitivity and one very important one is like systemic or chronic inflammation um and you see that so that again in the peripheral body there's there are some nice examples of this where um you're so your best buffer for energy uh like total energy is your fat tissue right because if you're in surplus it should just get stored in

fat it's fairly safe there no issues doesn't affect uh you know the rest of the body however you get to some point where your fat stores have taken up as much as they can and then you start to get issues elsewhere so like that that fat may have to end up somewhere else it ends up around your organs ends up in your pancreas like you're talking about earlier ends up in your liver ends up around your heart and and so there's this threshold that people have of how much energy they can accumulate before it causes downstream downstream effects and there are a lot of ways that we can manipulate how you know how how much you can accumulate so if you're physically active that probably means you can end up storing more because you've decreased systemic inflammation um and the best example of this is sumo wrestlers

who can accumulate huge amounts of fat mass without it really affecting their their physiology negatively right at the other end there are some um there are some like some pathologies some diseases that mean that we can't store much fat mass and it means that we get insulin resistant much more easily um and so one the the sort of the perfect example is something called lipodystrophy which means that you can't put any fat in at all these people get insulin resistant very quickly because there's nowhere to store excess energy um the one that's relevant to the point that I was trying to make is something like autoimmune conditions, like rheumatoid arthritis. Rheumatoid arthritis, right,

your joints are essentially on fire. There's this huge amount of inflammation that's affecting your entire body. And in general, if you think about somebody with rheumatoid arthritis, it's usually an older female who's very slim and quite frail so they're insulin resistant despite not having any having accumulated any fat and that's probably because the inflammation is preventing that process from happening um and so this something similar is probably happening in the brain in certain scenarios it could be in infections or other exposures where a high amount of inflammation is decreasing the amount of energy that the brain is willing to take or able to take up.

And so there are other factors that kind of filter into this. But yeah, sort of like from a supply and demand, that's probably most relevant to most people. But there are these niche cases where other things come into play as well. Okay, now can you finally answer my question? Now I can answer your question. Wait, what was it so um the the the six things that that i think we mentioned uh were so we mentioned physical activity um we mentioned uh so then other things we haven't talked about we haven't talked about

language uh music um there's a sensory input so that's really important. So you see people who have cataracts in their eyes or who lose their hearing, maybe even people who lose their sense of smell due to COVID. There's been a couple of papers on this. You lose a sensory input and then your global cognitive function starts to decrease because you're not providing that stimulus to the brain anymore. But it's reversible. So if you get cataract surgery or if you get hearing aids um then your cognitive function improves again and so that's what's

nice you can kind of it's this own controlled experiment to show that it's this reversible process yeah so to clarify you're not talking about getting your sense of smell back you're saying the loss of sense of smell means that sensory input into the brain is now going down so that part of the brain then starts to lose function. And so it's affecting your general cognition, whether it's impulse control or decision-making or memory, because you've lost a major sense of a portion of the brain that's supposed to function.

And so when you regain the smell, that part of the brain turns back on and now your general brain function goes up higher. So it's not just the fact that you can or can't smell or hear yeah exactly it's it's total brain function that is is what is then relaying to the brain in terms of that that demand of the brain if you don't again if you stop training or you're you're bedridden right or you put your leg in a cast the size and function of that of that muscle decreases right and the brain seems to be exactly the same. You don't provide that stimulus anymore. The brain is just going to like pare back that area

because it's not needed anymore. But then that also has knock-on effects. Yeah, this is also the place where like things like getting exposed to nature, like this is how this would potentially cause some of the things that sort of the woo-woo people talk about in terms of brain preservation. Like how the fuck is getting in nature?

It's things like this. It's changing vision, feel this change, like smell it's things like that, that are. Is there a difference in the activity and brain? Like me learning how to play drums has basically nothing to do with survival. But if I go learn jujitsu i'm gonna die if i don't figure it out quickly so there's there's like a a level or a scale does that scale of importance to survival matter in the overall or is it like we just need to have music in our lives because it shifts the way that we think about things and

perceive things does does the scale matter yeah there's there's a couple of really interesting things that that come out of that question so one is um the in terms of music that the the one thing that seems to be important or where we see like from from the research is that it has to be difficult right so it's the challenge that's important right so if you look at the brains of they've done this these studies where they use this machine learning algorithm called brain age where you do an mri scan of the brain and then you ask the algorithm how old does this brain look right you don't tell them how old the person is but you say, how old does this brain look? You don't tell them how old the person is, but you say, how old does this brain look? And then you can compare your biological brain age to your chronological age,

like how old you are in years. Musicians have younger looking brains than they are in terms of chronological age in years. But amateur musicians have an even bigger effect compared to professional musicians, with the hypothesis being that it's harder if you're an amateur right it's difficult to play the drums whereas if you're a professional drummer like no big deal you just i think about this lifting weights all the time all the time like i am doing nothing right now even though this may look cool to people like yeah it's no longer a challenge to it exactly so

so the challenge is important the other thing that you mentioned so particularly around music there's this like special thing about about social connection um which is that you know when we're socially connected to others it has effects on multiple things we've talked about so you're probably doing stimulating activities like social interaction just like conversation those are those are cognitively challenging but it also um we know it affects our immune system uh we know it affects other neurotransmitter production uh in the brain and there's this like kind of safety signal when you're well supported socially so like there's multiple bits that are potentially important from a social aspect from from music but the last bit with the comparison that you made is um the sort of there's an there's a greater drive for the

brain to change in the setting of existential threat um and and it doesn't have to be jiu-jitsu um but there's some nice data that says that if you do a physical activity that includes a coordination component that is more protective of the brain or it drives you know a bigger change than if there isn't a motor a coordination component even once you uh sort of match for the amount of like actual cardiovascular demand yeah right so if you if you match in terms of that how hard you're working if you've included a motor component you get additional benefit um and that's probably because um right your orientation in space is a very big like survival thing right if you can't orientate yourself yourself compared to anything else right you're

already in like massive trouble so things like yoga and dancing and probably jiu-jitsu and maybe slacklining and skateboarding, surfing, these things that have this significant coordination component seem to be more protective. And that's probably because your brain is detecting that you're oriented weirdly in space, and that's this additional challenge to change in order to get better at that.

On a similar note, I've made the recommendation many times to many people that it's good to have one physical activity that's reactive. So you could go do agility drills and ladder drills and cone drills and sprints and whatever you want to do, but it's all very proactive.

You know exactly where the cone is, you know where you're going to change directions as opposed to playing a soccer game or basketball or whatever it is where you, you don't know exactly where that player is going to go, what you're trying to steal the ball from them. Do you think that matters at all? As far as, as far as retaining brain function where you're not necessarily learning in that moment, but you're having to,

you're having to process in a different way than if you already know exactly where you're going to run and exactly when you're going to decelerate etc etc yes so we don't i don't have any nice randomized controlled trials to to tell you the answer to that question but from everything we see in these other spheres that we've talked about it would make perfect sense so that's a greater cognitive challenge even after you take out how like physically challenging that soccer game or whatever it is because you you're um processing multiple different multiple different inputs um and you can't uh you can't predict it and predictability is like the death for the brain because it just switches it doesn't need to need to function uh in the same way uh anymore so yeah

that would make perfect sense yeah so you can you can compare this in terms of like thinking about cycling this is like the one i go to all the time there's a difference between getting a bike and putting it in your garage and listening to music and doing your 20 minute 60 minute workout right and you compare that to riding your bike outside same exact workload done now you're making decisions you're watching the traffic you're doing all these things you've added just a little bit of layer of cognitive function right like a little bit of challenge you compare that to like i don't know if you guys ever been to like a spin class yeah those things are those are gnarly like you actually like you have to make a bunch of decisions and the timing is important you're supposed to do

this thing on that like there's a lot of mental load that goes into staying like on pesky if you compare those things if you have the option perhaps a little bit better to choose the ones that have a little bit of decision making or a little bit of stimulus coming in in addition to the workload so it's just like a very simple switch that you can make of just like instead of doing all of your things this way without adding extra time to your day, just getting a little bit more of a brain challenge and your physical activity stuff, which would be amazing. So there's other ones that we sort of talked about, Tommy. We mentioned this before, but the one I think we forgot to list,

there was social connection and all that stuff being relevant. Not going to be hard to sell us all in the room here on why you need to train why you need to lift weights like for your brain health we're sold there but sell me on the rest of this stuff man um the other thing i want to get to is sleep we've heard some terror stories about if you miss x amount of minutes and this is gonna increase your alzheimer's risk by 200 thousand trillion percent like oh yeah let's talk about that i want to let's do that first thing like tell me the real jam here without mentioning yeah fucking names if you want i don't really 200,000, a trillion percent. Oh yeah. Let's talk about that. I want to, let's do that first thing. Like tell, tell me the real jam here without mentioning fucking engine names,

if you want, I don't really care, but like how terrified should I be if I'm missing six minutes of sleep a night? Do you know what I actually, so I was, I was just down in, and that's totally not a loaded question,

by the way. Like it was a very, clearly I don't have a position on this. I can disagree with you if I want. Yeah. So I was just down in Austin for the it was the the US Grand Prix so I was down meeting with the the coaches the the people I work with um and actually I got this question so many times right because people are just like now super interested and deep into tracking their sleep and lots of people are worried about long-term cognitive function and it's true if you look at you know there are these very nice big meta-analyses that look at multiple studies probably dozens of studies that look at both quality and quantity of

sleep and risk of alzheimer's disease or cognitive decline and if you have reduced sleep quantity and reduced sleep quality and there are various ways of looking at that you can ask somebody subjectively how they think their sleep they sleep versus do you need uh some kind of drug or some supplement to improve your sleep right that suggests lower sleep quality and and both are associated with with cognitive decline if you look at um some studies where they do something like what we call a meta regression which is basically like if we look at all the different amounts of time that people sleep in different studies and look at their risk of of dementia like where is the risk

and it seems to be those who consistently sleep less than six hours on average right which is probably different from what you've been told um And that's where the risk sort of significantly increases. So in my mind, as long as you're sleeping in six hours, that's probably enough for most people on average. And different people need different amounts of sleep, and that's fine. Again, so if somebody's told you you need to sleep eight hours to prevent dementia, there's no reason why that would be true right because different people have different amounts of sleep requirement um and the data don't really

suggest that that that's the case uh the the cutoff point is somewhere between five and seven hours is probably around six on average so there may be other reasons why you want to sleep more but it's not you don't have to worry about. Exactly. And the thing that I've gotten really worked up about more and more is how hyper-focused people have become about sleep and the negative effects that that has on them. So there are some really nice trials. trials there's um so a lot of work looking at how your expectation uh affects your health and your physiology has been done by a psychologist called ellen langer at harvard and she's done multiple studies um which we could talk about um including if you expect to get a higher blood sugar spike after a certain meal you will get a higher blood sugar spike even if you're eating the same meal both times right so your expectation drives your blood sugar, not just what you've eaten. And

similarly, in a study that her and her team did, they took people and they had, they manipulate, she loves to manipulate clock time. She's done that in multiple studies. And so if you have people and you randomize them to sleep either five hours or eight hours, or, you know, that's how much sleep opportunity you give them. But you manipulate the clock in the room. So they think that they've slept either five or eight hours. So you have like four groups, those who slept eight hours and think they slept eight hours, and then a combination of all those.

If you sleep for five hours, but you're told that you sleep for eight hours, that doesn't negatively affect your cognitive function, or the reaction time and some other cognitive function and ask them how tired they were. So if you think you slept eight hours, you don't feel tired. If you slept for eight hours, but I tell you, you slept five hours, then it affects your cognitive function and you feel sleepier. So if you're using garbage sleep trackers,

which lots of people are, then this random data generator, which is on your phone, telling you about your sleep will actually affect your mood and function the next day. So, and we see this in multiple other studies, like if you tell people about their genetics, it affects their performance, even if it's not true. Right. I'm sure you guys have talked about that. So I think the stress of worrying about the fact that you're not sleeping enough is worse for your dementia risk than actually whether you slept seven hours or not. And the funny part is that's the difference between eight hours and five hours, right? Yeah. Most of these people that are getting so worked up or getting worked up about like 715 versus 745 like which is an unbelievably small and unimportant yeah completely completely unimportant the stress of that worry

is by far out outweighing any different that that 30 minutes of sleep absolutely have you seen the couple of papers now out on orthosomnia um no oh i oh i saw one related to to like trackers and stuff a couple years ago yeah i'm sure there's more because like the more and more we look at it like our sort of hyper focus on these things is more detrimental than measuring the thing in the first place yeah you're basically seeing things cases of folks developing um orthosomnia being the idea of you're developing a sleep disorder based on watching your tracker yeah just like i mean you you see disordered you see disordered eating due to continuous glucose monitoring all

the time you just like go go and watch biohackers on instagram yeah yeah so just just just be very careful here um of how you deploy these things so yeah um cool you want to move on to unless you guys have more sleep stuff no we gotta go on to some of the other stuff um so i want to i want to get into yeah the the social um side tell me on that piece tommy i don't believe it i have my friend this guy this canadian guy named named wan i won't say his name his name is wan warner and he believes he can live in his basement by himself and not talk to anybody and be just fine um so can you tell dan i mean in a non-sarcastic way a lot of people are living in their office at their house and not talking to people and that it's a very real thing right now back to what we just said though if that guy lives in his basement

and he thinks he's just fine is he just fine based on what we just said a second ago um so so again i think we can come with this from multiple ways if you look at uh like these big um studies of multiple studies these meta-analyses both lack of social support the lack of social support and feeling socially isolated is associated with an increase in all-cause mortality but also um cognitive decline dementia and there was a um caroline holt lundstad has done a number of these of these studies and she did she published this study um it's 2010 um yeah i think it was in plus medicine where they looked at all these different risk factors for death and includes like blood pressure and diabetes and and all these kinds of things and like being socially isolated was by far the,

the most important. Uh, and of course, like that's a proxy for a whole bunch of other things. Um, but it seems to be that like when we feel isolated and alone, it has all these knock, knock on,

knock on effects. And there's multiple studies. You look up a guy called George Slavitt. She's looked at like, what's the physiology, what's the biochemistry of what's happening when you're isolated, it changes immune function, increases increases inflammation all this kind of stuff so there's a there's a reason why we think this is happening um and we also see on the other side

if people have strong social connections um you know feel socially supported they have they live longer and they have a decreased risk of of dementia um how does something like this play into it though like we're having a conversation right now i'm hanging out with with anders and andy two great friends of mine but we're not in the same room i'm not seeing them in real life but we're having a thoughtful conversation we're not sitting checking our phones like we're actually engaged but it's all virtual does that play into it uh how much does that play into it rather Rather? Yeah. So I think, like, you're replacing some of normal in person, social connection. The best way that we can kind of answer that question is maybe

look at what happened early on in the pandemic. When people were first, you know, isolated, told to stay at home, there was this massive uptick in like Zoom calls whatsapp calls whatsapp groups like people facetiming people around you know their loved ones around the world and similarly early on in the pandemic there was much more resilience to that to the lockdowns mentally than we expected right everybody expected this really early like decline um in everybody's mental health during lockdown but early on because of this we think because of this uptick in how much people communicated with others actually right because you're reaching out to friends you haven't talked to for ages because you just had a bunch of like didn't like you couldn't work or whatever

so that probably provided some resilience which to me me tells me that this provides some of the benefits. It doesn't mean that it'll provide all of them. But part of this signal of safety is not necessarily are we hanging out, having conversations. It's like when I'm in dire need, right, when I'm really stressed or I have a a health problem or you know i have this really difficult problem can i call one of you guys up and you'll come and help me like that's there's this there's this signal of am i part of a group that will help me in times of need um and so some of that can be provided online right so yeah you might do most of your, your calls on zoom, right? But if Anders calls Doug, he's like, I really need you here right now. Like he's going to jump on

a plane is going to get there. Right. So I think that's, that's part of it. That part of that safety signal. Um, however, there's probably some other bits that we know that like direct social interaction, physical touch has a number of benefits. You can get that from other places. They've done studies with dogs that show that like interacting with a dog increases oxytocin release, increases HRV. Right. So you can kind of piece these things together. But you mentioned jujitsu earlier. Like I tell people all the time, like if you do like the, you know,

if you bind to like the five love languages thing, i'm like a physical touch person like through and through and i think when i go to jiu-jitsu and you know i have an hour's worth of of course like completely non-sexual physical touch like hugging you yeah yeah like dude all my my biggest hairiest sweaty friends like it just it does it actually really does make me feel good like there's the physical there's the physical fitness component of it etc like there. There's the physical fitness component of it, etc. There's definitely the learning component of it. I watch an hour or two of videos every day, seven days a week, and I've been doing that for

years. That's a deep rabbit hole, of course, and I love doing it. But really, the physical touch aspect of it, I feel like it's very mentally healthy. It's the equivalent of giving lots of people hugs every day it's just it for me especially i i can anecdotally say it's it's a healthy thing like

um psycho-emotionally but um i think for i think it would that would be a very common experience for for many people if they really reflected on their experience after practice yeah and and so like obviously people don't have to go out and and uh get thrown around by big hairy sweaty guys um maybe they should yeah maybe they should they can but there's there's definitely so so i guess there's multiple parts of it and you can get it from different places um but so say you're still not convinced um one of the things that's really telling to me right go back to my day job i do animal studies i do animal research in neuroscience and with multiple different types

of animals um and one of one of the things that you unless you have a really good reason for ethical reasons one of the things that you cannot do to an animal is socially isolate it um because they will die faster they will that their mental health decreases they'll they'll depending on the animal they may like self-mutilate um but we do that to humans all the time like we put them in a nursing home and lock them in a room and just leave them there um and but regardless of of the species of animal if you socially isolate it it has massive negative effects on their health and that they live they like they have higher disease high cognitive decline earlier mortality um and again this isn't just like one strain of mice in one lab right this

is just across the board like ethically you're not allowed to do it because it's so bad for their health yeah you know we we seem to quibble over whether this is important for humans but you know if you just look at like across species plus all these other bits of evidence it just really is critical to our long-term health yeah i know we're getting super short so uh tell me to kind of wrap up like obviously you're not going to be able to do all of these areas so nobody has the time to work out and do jiu-jitsu and play music and like do all these things every day yeah um is there a hierarchy of importance between these two or is it pick three of them or pick one like if you just did one if all you did was learn new cognitive tasks um like give me an idea of like what about

exercise it's like well i'm not gonna learn any music i'm not gonna learn language but i i'm gonna do different types of exercise is that enough for like long term or should i make sure i have two of the three like so so we to be honest we don't have a good answer to that question however what you see is that if you if you have some ongoing cognitive challenge and skill development in one area it seems to translate right so even if you're just doing like online brain training uh brain hq if people want to do online brain training that's the thing that you decide you want to do brain hq is probably the best one that's been used in like hundreds of clinical studies at this point um but you like you do these abstract games on your computer um like reaction time challenges and memory challenges and stuff and it seems to then relate to improved function out in the real world

like executive function decision making stuffmaking, stuff like that. And so I think the most important, there is some specificity, right? So if you only do a memory challenge, then you get really good at memorizing stuff. And those areas of the brain actually get bigger on MRI scans, even in adults. But you may decrease function elsewhere because you're putting everything into memory. and they've done some studies on that but as long as it's um these are like generalized

inputs so like music is great language is great um uh coordinative movement is great like we talked about if you do just one of those and it's something that you're continuously getting better at and continuously challenging yourself out that's probably enough so it means that you get to pick something that you want to do, you're excited to do, and then you can keep doing it. The downside is that once you get really, really good at it, you have to pick something else because it's no longer, it's no longer a challenge, but no. So you don't have to tick off all six things, like pick one and, you know, really work on that. But then maybe you have to, you have to change what you're doing over time. Yep. Cool. So what you're basically saying is I can tell my wife to eat shit for all of the crap she gives me for playing video games all the But then maybe you have to change what you're doing over time. Yeah, cool. So what you're basically saying is,

I can tell my wife to eat shit for all the crap she gives me for playing video games all the time. I'm doing it for my health, Natasha. As long as you continue to play new games. You've got to switch it up. Yeah, if you get really good, then at one game, you have to switch it up. I never get to play video games, but I wish I could.

You have a lot of things that you can pick from. But maybe, right, I think we hypothesize this briefly in the in the paper if you if you got something that like ticks off multiple boxes at a time maybe that's better right so if you do a dance class right which has been um is a really popular intervention in older adults as a dance class but if you're doing dance you have music coordination physical activity and social connection all in one right and what multiple boxes ticked at once so maybe if you combine lots of them at the same time you'll get a bigger effect but sort of you know just grasping at straws like my very last in that example in

that example does listening to music is that important at all? Or is it just learning to play music? It does seem to be. If you're listening to me, again, these are some studies done. This is part of an intervention done by Ellen Langer. If you listen to music that's from your youth, it seems to be beneficial. So yes, listening may be enough to get a bit of a benefit. But playing is probably, in a hierarchy hierarchy playing is certainly more than listening but there seems to be some benefit from listening as well okay cool last specific question um you're

talking to one of us right so somebody who's between 30 and 50 uh has like a somewhat cognitively demanding job they already strength train Like they already do that stuff. Great. Is there like one other specific task you'd say like, Oh, you maybe add this in. Cause you feel like you're already getting cognitively challenged at work. You're already training.

And any things you can recommend is like one thing that like I could throw in or Doug or somebody who's an avatar. I mean, we're basically avatar. Yeah. So, so the first thing I'd say is, is your job actually cognitively stimulating

or are you just busy and stressed? Or are you just reposting other people's hard work? I feel so triggered. So if your day is just finding other people's work and reposting on instagram um sending it to joe rogan then maybe that's not cognitively challenging really um it's not my fault joe rogan appreciates my work and brings it up on a show okay i'm not taking i'm not getting insulted for that um so so i think that's an important question because most people are like you know my my brain is really busy at work but they're probably just doing the same thing

answering emails sitting in meetings like i don't think that's like cognitive stimulus as i think about it is skill development that you can probably just do for like 20 to 30 minutes right and then you need some period of rest and recovery right like most language classes you probably only do like 20 or 30 minutes of like actively learning new vocabulary and stuff like that and it's probably the same in jiu-jitsu class right after you've warmed up and the warm down like how long are you spending really learning a new skill right it's that kind of period of time because that's how long humans can really focus on new skill development so if you're not doing stuff like that as part of your work i would question whether your work is cognitively demanding or as cognitively demanding as it could

be so that's the first question i'd ask but then beyond that um the thing that i think you know pops up again and again that this group um you know guys like you would would appreciate is movement with some kind of significant coordination components so say gymnastics or slacklining or picking up some kind of board sport um or you know even um uh like a ball sport right so this thing where you're reactive maybe there's you know there's some you know disorientation of your body and physical space that kind of stuff i think might appeal most uh to this kind of group but again um you know could could be learning a language you know maybe you and your partner want to go and learn a new you know musical instrument or language together that's something again you could do together if that if that fits in um but if you know the sort of the a high octane group of people our age may prefer to do something physical and then that kind of that kind of challenge, I think, could be easy to add in.

It sounds like you basically described every 10 year old, Tommy. Let me get this straight. Hang out with my friends, play sports with them, play music and listen to music with them and then play video games with them. Yeah. Yeah. And I'm giving you excuses to do all of those things because it's good for your brain. The problem is most people are too lazy to do what their 10-year-old self would like to do. It's like the ideal world for a 10-year-old. I know.

Well, it sounds like also, we hadn't specifically said this yet, but traveling to other cultures where things are radically different would play into this very well. Absolutely. Yeah. And again, there's a novelty aspect.

There's a challenge aspect. There's also some of this like existential aspect, right? Having to fit in, adapt to a new culture. Yeah. So when I've talked about this, people have said, well, what happens if I go to a country where I don't learn the language or I don't know the language or you know they have entirely different customs from my own you know again i think that that fits in very well i think we need to do a part two on this because we haven't even gotten into like lifestyle choices like alcohol and marijuana and just endless endless things uh

somehow we didn't even talk about nutrition so um we're gonna do part two again on this thing and uh this has been phenomenal super great meeting you where can people find uh more information about you your research everything you have going on yeah if you follow uh at dr andy galpin on instagram fantastic you nailed that i didn't find that funny that's how you become the most published researcher you just share as more than everyone that's great uh at dr tommy wood on instagram is probably the best place uh to find me and and i'm pretty good at answering dms because i don't have very many followers so if you have any questions or any

follow-up uh shoot them there and i'll i'll make sure to get back to you yeah we're absolutely going to do another round of this too uh galpin uh at tommy wood that's dr tommy wood that's that's where you go you want to see the post a week earlier, just go to that one. Tommy sucks at social media. He absolutely sucks. If I don't put his stuff up, he doesn't put it up. It's 100% true. I have no social media game at all.

I don't feel bad for him. You also have, to throw it in there, is it broresearch.com? Yeah. Is that with Ben House? Yeah, with Ben house. Yeah. With Ben house. Ben house is,

uh, is a very good friend of mine and colleague saved my life. And I got bitten by a snake in the Costa Rican jungle. That's we'll, we'll have, we'll do that story on party. Um, I love that.

But we, um, we have a advanced blood test course for athletes, um, that we made. It's like 50 hours of videos of us, like going through a thousand papers. So if that's your jam,

yeah, you can go and sign up for that course. Yeah, it's great. I took it. I bought it. I paid for price for it. It's great. It's great. Yeah, incredible.

Awesome. Come on. Doug Larson. Very cool. Right on. Tommy, dude, I really enjoyed this. Appreciate you coming on the show and good to finally meet you. You can find me on Instagram, Douglas E. Larson. Tommy, dude, I really enjoyed this. Appreciate you coming on the show and good to finally meet you.

Finally on Instagram, Douglas E. Larson. I'm Anders Varner at Anders Varner. We are Barbell Shrugged to Barbell underscore Shrugged. Get over to RapidHealthReport.com where you can see Dan Garner, read my labs, get me all fixed up from all the things I had going on. RapidHealthReport.com. Friends, see you guys next week.