Dhru Purohit Show - Alzheimer’s Isn’t Inevitable: The Science of Building a Stronger, Healthier Brain at Any Age with Dr. Majid Fotuhi

Episode Date: March 4, 2026

This episode is brought to you by Bon Charge, BiOptimizers, Momentous, and Branch Basics.   When we think about cognitive decline, it’s often framed as something inevitable, something that just happens with age. But this episode challenges that narrative, revealing that brain health is far more dynamic, responsive, and within our control than we’ve been led to believe. Today on The Dhru Purohit Show, Dhru sits down with Dr. Majid Fotuhi to unpack what it really takes to protect, strengthen, and even improve your brain as you age. Dr. Fotuhi explains why cognitive decline exists on a spectrum, how lifestyle choices can slow or prevent it, and what the latest research says about reversing early Alzheimer’s. He shares powerful patient stories, breaks down the surprising link between hearing loss and memory issues, and outlines his Five Pillars of Brain Health. Dr. Fotuhi also dives into Tau PET scans, cutting-edge brain training strategies, and why taking action now may be the single most important decision you make for your future cognitive health. Dr. Majid Fotuhi is a neurologist specializing in memory, concussion, and successful aging. With over 30 years of teaching, clinical practice, and neuroscience research at Harvard Medical School and Johns Hopkins, he has developed a multidisciplinary program to help people of all ages improve memory and attention. The results of his program have been published in numerous scientific journals and in his three books. Passionate about public education on brain health, Dr. Fotuhi also teaches in the Department of Psychological and Brain Sciences at George Washington University and at Harvard Medical School. In this episode, Dhru and Dr. Fotuhi dive into: (0:00) Intro (00:39) Can you slow cognitive decline (2:30) The overlooked daily habits that make or break your brain (6:56) Surprising patient results (17:50) Understanding the spectrum of cognitive decline (22:36) The surprising link between hearing loss and memory loss (30:54) How research on reversing Alzheimer’s has evolved (37:27) Why waiting for symptoms could be your biggest mistake (40:25) The Five Pillars of Brain Health (53:12) The most powerful brain reset you’re probably undervaluing (56:29) Brain-friendly nutrition: what to embrace and what to avoid (1:07:00) Purpose, mindset, and cortisol: the hidden brain chemistry connection (1:17:23) Tau PET scans explained: what they reveal about your brain (1:29:24) Can you train your brain like a muscle? (1:35:27) Inside the 12-week brain training protocol (1:42:42) Dr. Fotuhi’s most important brain health advice Also mentioned in this episode: The Invincible Brain: The Clinically Proven Plan to Age-Proof Your Brain and Stay Sharp for Life Is Eating Fish Safe? A Lot Safer Than Not Eating Fish! Seatopia Fish For more on Dr. Fotuhi, follow him on Facebook, X/Twitter, Instagram, TikTok, LinkedIn, YouTube, or visit his Website. This episode is brought to you by Bon Charge, BiOptimizers, Momentous, and Branch Basics. Right now, Bon Charge is offering my community 15% off their Red Light Cap. Just go to boncharge.com/dhru and use code DHRU to save 15%. Upgrade your digestion with enzymes! Go to bioptimizers.com/dhru now and enter promo code DHRU to get 15% off any MassZymes order and all BiOptimizers products. Right now, Momentous is offering our listeners up to 35% off their first order with promo code DHRU. Head to livemomentous.com and use code DHRU for 35% off your first subscription. Right now, Branch Basics is offering 15% off the Premium Starter Kit; just go to branchbasics.com and use the coupon code DHRU. Make 2026 your cleanest, healthiest year.  Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Mijid, welcome back to the podcast. It's a pleasure to have you here in person in Los Angeles. It's my pleasure to be here. It's so nice to see you in person, Drew. You know, so many people are deathly afraid, probably even more than the fear of death is the fear of cognitive decline. And we have you here on the podcast to talk about how there's so much more to the brain than most people know.

And with practical steps that everybody can follow starting today, there are so many things that we can do to. lower our risk of cognitive decline or even at the first sign of it intervene and start to see some improvements. Is that a fair promise to make to our audience? Absolutely. I think you can take care of your brain just the same way you can take care of your teeth or your heart. Your brain is an organ made of cells. It's not some mysterious black box. It's an organ. There are cells. And the cells in your brain have many things in common with the cells in your heart, your skin, your kidney, your liver.

And there are some principles that apply to all of them. And just like you can do things to take care of your heart, there are specific things you could do to take care of your brain. We know absolutely for sure that there are many things that could do to slow the cognitive decline that may happen with aging. Yeah, that's so important because you're somebody who has an incredible career, a great CV, you know, Harvard and all the institutions that are out there, and yet you even got so much criticism yourself

from some of your colleagues who said that, okay, you're getting results potentially or you might be on the right track, but you're doing too many things. And why I bring this up is that I think this important for the conversation before we get started is that if you read the headlines and you look at what people are looking at

in traditional medicine, they're looking for that magic one thing, that magic bullet that fixes Alzheimer's. They're looking for that pill that's created. They're looking for that one situation, one therapy, one intervention that intervenes and deals with Alzheimer's, cognitive decline, whatever it might be. And yet you took a completely different approach. How did you end up in this position where you found that combining multiple things was actually the right mix that made a huge difference to how well the brain aged? and if you didn't do them, how poorly the brain aged.

This began when I was a resident at Johns Hopkins. I had seen many patients who had cognitive decline and were diagnosed with Alzheimer's disease. But when I looked at the charts, they had diabetes. They had back pain. You were taking medications that were sedating. They had the sleep apnea. They had many conditions that we know for sure

reduce cognitive function. As I mentioned to earlier, your brain is a tissue. And if you don't take care of it, If there's not oxygen, it's enough nutrients, it will not function well. And I thought to myself, well, why are we labeling them as Alzheimer's disease? They have a super problems in their brain. This is back in 2002. And that's when I thought, we need to change things.

This is not right. We shouldn't put a given label of Alzheimer's because when you tell someone they have Alzheimer's, that's the end of it for them. They're just getting ready to have a miserable life. And I felt like that's not right. So I wrote my first book in 2002 while I was still a resident at Johns Hopkins, and the title was memory cure. And I talked about how high blood pressure, obesity, diabetes, sedentary lifestyle, poor diet can all affect the brain by reducing blood flow to the brain, increasing inflammation, and affecting the natural rinsing that happens in the brain. Back then, there were very few people who said the same things.

And in fact, very much my colleagues were critical of me to say things like, hey, you can't prevent Alzheimer's disease. In fact, I wanted to put the title, Prevention of Alzheimer's Disease, on a book as a subtitle. And that was too bold. And we decided not to mention it because a lot of people were super critical of saying that you can prevent Alzheimer's disease. Then I wrote several articles in peer-review scientific journals such as Nature. I wrote two articles in Nature. One about all the things that can shrink the brain.

And there are like 20 things. There are literally 20 things that can shrink the brain. And, you know, these are many of the metabolic things we just talked about, like high blood pressure, diabetes, obesity, insomnia, sleep apnea, too much stress. There's so many a thing. And I talk about the biology of how these things affect the brain. Another article about all the things that can reverse that, like how exercise can literally reverse that. Good diet can reverse some of the effects of the poor diet. In other words,

your brain has a lot of malleability and you can intervene at any age. Again, I published those in very good journals. But still, this was all hypothetical academic. In 2012, I decided, you know what, I need to put the program together and apply these to real patients. Talking in abstract and articles doesn't change people's lives. So I took a bold move. I decided to start my own neurology practice and put together this program, which I called the brain fitness program.

This was 2012. I started seeing patients in their 70s, early 80s, many of them in 60s, who had significant cognitive decline. They weren't diagnosed with Alzheimer's yet, but they were not normal either. They're in between. It's called mild,

cognitive impairment. And I put together a program that would address all the factors that shrink their brain and provide them with brain coaching that will help them to improve all the things that grow their brain. And, you know, I felt that it would take nine months to see results. So my initial program was nine months. Then I thought, you know, people are getting better faster. So I made it six months. Six months, twice a week, people come to our brain center.

We will take care of all the medical problems. I would act a cardiologist. I would send him for stress tests, and I would take care of the sleep issues because I felt that I needed to take ownership of the patient. And then I realized, you know, three months seems to be good. And I went to six weeks, and I realized six weeks is not enough. So that's why I made my program 12 weeks.

And then we saw patient after patient who came to me with the diagnosis of myal cognitive impairment who actually got better. Not only we slowed their rate of cognitive decline, they actually got better. Let me give an example. You know, this lady came to see me. She was early 70s, and she was sitting home watching TV all the time. And her sister said she actually doesn't watch TV.

The TV watches her because she just sits there. She doesn't talk much. She doesn't do much. And the sister wanted me to confirm diagnosis of Alzheimer's disease so that she could get power attorney, sell her house, and pay for her nursing home. And I thought, she's too young. I'm in the 70s. And she had many medical issues.

She had depression that was not fully treated. She had back pain. She was taking multiple pain medications, which were sedating. And she had a sedentary lifestyle. She was sitting there all the time. I remember the first time I saw her. She was, you know, an African-American lady wearing a very beautiful blue dress, blue jacket. But she didn't talk much.

The sister did all the talking. And her husband was there who had emphysema. and I was taking some oxygen tube. But anyway, I felt like I can't make a diagnosis of Alzheimer's disease in the patient because she has a lot of treatable component. See, when people get older, they have two sets of problems in their brain. What we call Alzheimer's issues, the plaques and tangles, these proteins that accumulate, and this non-quote Alzheimer's issues, medical things, metabolic things.

And if you take care of this metabolic, medical things, there will be improved blood flow to the brain, that would reduce inflammation, and it would be better cleaning and rinsing that happens in the brain. So I worked with her, and she started to perk up. I reduced her medications.

I treated her sleep apnea. We addressed her depression with medications and cognitive behavioral therapy. And she received brain coaching with our staff to walk five minutes a day, 10 minutes a day. And guess what? In six weeks, she was much better.

I remember one day I was sitting in my office and I saw this lady that passed by. I said, wait a minute. Was that Carol who just passed by? This lady came to me in a wheelchair, sitting there not walking. And here she was walking. And by the time she finished the program, she was back to her church. She was participating in community activities for a church.

She was looking for a job. She was back to her usual self. Now, this was one of our best case that we had. That was such a huge black and white difference. The other thing we did for her was we obtained a problem. brain number I at the beginning and then at 12 weeks. And her hippocampus, the part of brain from memory, which is the size of your thumb, had increased by 8%. This was incredible. I was so excited to see her. And I was so excited to meet this wonderful lady. She was actually pretty interesting

and feisty and talkative and she asked me a lot of questions. Anyway, she came back to see me every three months. The following time she came, she was doing well. The following three months, she was sad. I said, what happened? He said, oh, my husband died and I'm sad. But when she came back three months later, she was unusually happy. So, Carol, your husband's died. What are you so cheerful about? Says, you know, Dr. Futui, there was this kid I liked in high school,

but I never told him anything because, you know, I was shy. It turns out that he had moved to California. Since my husband died, I decided to just give a call, see how he was doing. And he told me that he always loved me, and he was shy. to come talk to me and his wife had died. So then they got together and he was such a cheerful, happy kid. She was like a teenager in love. And I never forget her.

The thing that she did said, Dr. Fuduille, a year has passed since I did the MRI. Do you think my brain has stayed the same or gotten worse or better? We obtained another MRI and we saw that her hippocampus had grown one more percent. In other words, even though she was not doing our program, because she had picked up good habits, her hippocampus had grown one more percent. We provided that program for 129 other elderly patients with my car impairment, and 84% of them improved. And half of them grew the size of hipocampus by 3%, which is equivalent of brain that's about three years younger.

And that's when I realized this stuff works. That's when I was really confident that we can provide this program. And I started providing this program for other patients who had brain problems, patients with brain fog, patients with persistent concussion symptoms. You know, people have had concussions and they had still symptoms six months, nine months later. And we provided patients who had ADHD because the principles apply to all brains. If you optimize brain functions, anybody will improve. and we published several articles in peer-reviewed scientific journals.

And now the program has been very successful. In past a few years, we had so many patients that our office was opened from 8 a.m. to 8 p.m. 7 days a week. I had 25 brain coaches. And our schedule was packed every hour, 7 days a week, 8 a.m. 8 p.m. People were coming from different states, people were coming from all over the place, from Massachusetts. You know, Boston is a big city. You don't need people to come here, you know, Washington, D.C., where my office was. And, you know, California, Arizona, Florida, because there were so many good reviews for us.

And, you know, the world has gotten around. And this is when I realized, you know, this program is too good for me to be providing it for people in Washington, D.C., and some people who come from other states. I need to provide this program for everybody. After all, we don't give some magic supplements to anyone. We don't have some miracle device that we do anything to people. We go with the principles of neuroplasticity, which means your brain has a capacity to grow and rewire at any age.

And the lifestyle interventions are simple but powerful. And you need to have a systematic approach to establish what are things for individual patients, and then provide treatment for them based on their specific issues. And as you said, because people have multiple issues, the treatment needs to be multidisciplinary. We know this about the heart. If somebody has a heart disease,

you're not just going to check the cholesterol and fix the cholesterol and expect that they would get better. You're not going to just take care of the hot blood pressure, fix the hot blood pressure, and I expect that they get better. You wouldn't take care of their sleep apnea and just say we're going to fix out sleep apnea and everything gets better. You need to have a multidisciplinary approach to prevent heart attacks and if somebody has a heart disease to make them get better.

Same principles apply to the brain. Yeah, that's so important. You know, zooming out is that you're so passionate about this. You had your center. You're taking people on. You're seeing results. And that led to, hey, let's teach everybody this because so many of the principles, which we'll be talking about today,

are largely things that people can be doing at home. The question that I have for you, before we go into some of those details here for my audience, is you talked about mild cognitive decline. Set up the spectrum when it comes to cognitive decline, and is it, you know, super early, mild and very late, and then full-blown Alzheimer's, give us the spectrum in terms of where people could find themselves.

So many people listening today have had a family member that's been touched by cognitive decline or Alzheimer's dementia. So give us the spectrum and help us understand where people could find themselves on that spectrum or somebody that they love. We spend so much time thinking about hair from the outside, shampoo, serums, stylings. But hair health starts at the follicle at the cellular level. And for a lot of people, hair isn't just cosmetic. It's tied to confidence to how you show up, to feeling like yourself. That's why I'm excited to tell you about the bond charge red light cap. It uses clinically study. 650 nanometer red light, which passes through 125 LEDs to gently deliver red light to the scalp,

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And use the code Drew. Again, that's me, D-H-R-U at checkout to get the best deal on mass signs and all. Buy Optimizers products. Go to buyoptimizers.com slash true and use the code D-H-R-U for 15% off today. Eating clean is important, but absorbing your food is everything. There are three stages in cognitive decline as people get older. There's a stage called age-associated memory impairment. This is when you forget your keys, you may miss an appointment,

you send someone an email and you don't remember that you send that email. or you were in a meeting and you said something and people took notes and you don't remember saying that. These are your things that can happen as people grow older. And there are usually very easy fixes for them. It could be lack of sleep, it could be working too much, could be tiredness. Not everybody has memory problems, has Alzheimer's disease.

So this is age-associate memory impairment is very common and is often fixable with minor things. And you know, forgetting your keys, your garage, not knowing why you went there, are so common that I look at them like gray hair. It is what it is. But is there also some part of them that could be if you're dealing with other health issues, canaries in the coal mine, that they're sort of, if they're happening more frequently, they're a sign that something is going on?

It could be something going on, but the mistake that people make, the biggest mistake people make is the thing is Alzheimer's disease. Yeah. See, I cured a lot of people Alzheimer's disease because they came to me thinking they have Alzheimer's disease and they had depression. And I fixed their depression and their Alzheimer's disease went away. I didn't fix their Alzheimer's disease. They thought they had an Alzheimer's disease. That is the biggest mistake that people make. Especially because they feel like it's a destination that's set in stone and there's nothing they can do about it. Exactly. It's like somebody has nausea

and think that I must be having cancer. I mean, nausea could have 20 different reasons. Sure. Of course, somebody may have nausea related to cancer at some point, but a middle-aged person who has memory elapses is extremely unlikely to have Alzheimer's disease as the cause of their memory relapses. Often are simple things, working too much, not enough sleep, stressing too much, poor diet.

There's so many vitamin deficiencies, B-12 deficiency, vitamin D deficiency, kidney problems, liver problems. There's so many bread and butter, simple things. that cause age-associate memory impairment. The brain is good. The brain is not tuned. It's like a car that needs an oil change, and the tires need to be changed,

and you need to change some of the fluids, and you need to change the brakes. It's not that car has fallen apart. It's just maintenance issues are overdue. So the stage of age-associated memory impairment is fixable easily. And my recommendation to your audience is that if you are a young or middle-aged person,

age person or if you're an older person who has these typical memory lapses, which I mentioned, don't think of Alzheimer's disease. Ask yourself, what are the possible things that can help you? I mean, in my book, I have a list of 40 questions that help people navigate. Simple things, hearing loss. In fact, this is one of the most common factors for memory impairment. You know, I had a family member whose father had early signs of going to go to Alzheimer's disease. He was withdrawn. He wasn't participating in conversations.

He was repeating himself. And the family was convinced that he had Alzheimer's disease. So I talked to the guy. I mean, I know him and I talked to him. And while I was talking to him, he wasn't quite hearing me. I had to speak really loudly. And I said, how long have you had hearing loss? He said, oh, for a long time, I hate hearing aids.

And I said, we're saying, we're talking to him. And I said, wait a minute, we have to fix that. And this was 20 years ago. They went and they got a hearing aid and he felt much better. He started participating conversations and he started doing things, skiing, fixing things around the house. And everything is gone perfectly. Crazy. And this was 20 years ago.

And he is now in his 80s looking great. No memory loss. So there's a simple thing. Vision laws, hearing loss, air pollution. You know, people who live in dense areas with air pollution, the air pollution can affect the brain functions. There are so many little things that can affect brain function. And unfortunately, unfortunately, people jump on the A word.

Yeah. And also, too, if you live a long time with, you know, lack of good hearing, that's one of the risk factors that could contribute to Alzheimer's disease because what I've understood and you know the science, your brain has to potentially, the theory is that your brain has to work a lot harder to understand what's going on. Is that the idea that if somebody lives for a long time

with hearing loss and doesn't address it? When you have hearing loss or vision loss or these other things, you don't participate in conversations as much. You're withdrawn. And those two factors, the fact that you don't challenge your brain and you have withdrawn, you have an isolation, you feel isolated. Those two factors can literally shrink the brain.

Because you don't stimulate the brain, and because you're lonely, those factors shrink this part of the brain. I told you about the hippocampus. Hippocampus is size of your thumb. You have one on the right, one on the left. And this is ground zero for learning and memory. And it needs to be stimulated in order to function well. And when you have many things, heart disease, lung disease, hearing loss, vision loss, anything, anything causes hippocampus shrink. And this is the paper that I mentioned to you that I wrote in 1999 about all the factors that can shrink your brain.

All the different things. So then there are three stages. The stage one is when you have age-associate memory impairment, and it's very easy to fix. It's very easy to fix. Then you have a stage called mild cognitive impairment. At this stage, a person may ask the same question five times. Let's say you ask your wife, honey, what are we having for dinner tonight? And she says, oh, we have me spaghetti.

And our letter says, honey, what are we having for dinner tonight? And she says, spaghetti. And then 10 minutes later, what are we eating tonight? Spaghetti. So it's that obvious. It's very obvious. A person asks the same question multiple times and having zero clue that the information was provided to them. Now, when that happens, and I've had many patients, many, thousands of patients in that stage,

then hippocampus must have shriveled. This is not just, you know, depression anymore. It's not just vision loss or air pollution or vitamin efficiency, although they can contribute. All factors that could contribute. Yeah. Now, this is now a little bit more serious. Your hippocampus may have shriveled by 20%, 30%,

40%, because you're not registering the new information. Hippocampus is a part of brain that grabs the information this information is worth keeping and puts it in the fall to be remembered for the future. Like you had a baby recently and you remember everything about childbirth and what happened that day.

And if I ask you what happened that day, you will go on and on and on about every little detail what you did that day. Because things that are emotional really make an impression on our brains. But you don't remember what you did the week before.

If I asked you the Wednesday before, what did you do? You probably won't remember. Or that Thursday or Friday. you won't remember the details of the previous days. We don't remember every lunch we ever eat, every dress we ever wear. We don't.

And it's a good system. We only remember things that are really important to us. That's thanks to hippocampus. Hippocampus is the point where either information is discarded or kept for the future. And when somebody asks the same question multiple times, it means that hippocampus is not doing his job. And this is where I told you that I helped my patient

improve. Now, next level after that is when somebody not only asks the same question multiple times, but they start having behavioral problems. They have other character personality things that they did not have before. Or they may get lost in their own neighborhood, or they may forget names of family members, or they put the keys in the fridge. This is when the brain has suffered significantly beyond the hippocampus. Now you have problems with the front of the brain, the back of the brain, size of the brain, and that's what we call Alzheimer's disease. Now, technically, Alzheimer's disease is a form of dementia.

Dementia is an umbrella term, which means that you've had so much brain atrophy that you cannot function independently. And there are many different subtypes of dementia. Could have vascular dementia, where many strokes, cause a dementia, you can have alcohol-related dementia, where a bottle of vodka for 30 years shriveled your brain, or you can have Parkinson's-related dementia, frontal temple dementia. So there are, you know, like six, seven main types of dementia, and Alzheimer's disease is a subtype of those dementias. So you have age-associate memory impairment, malacogic impairment,

and let's just like all-alzheimer's dementia. Those are the different stages of cognitive decline. And so because there's a lot more content on this now, largely people building on a lot of the work that you and your colleagues have done over the years, I think before we go into some of these details that you've seen that really work for that early stage and that mid-stage, that mild cognitive decline, I think it's worth addressing. So that severe cognitive decline, Alzheimer's that's there. We don't have any treatments for that right now that have proven on paper to reverse full-blown Alzheimer's, or is it more nuanced than that? Everyone wants more energy, better recovery, sharper focus.

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You can find them at Target, Target.com, Amazon, and of course, branchbasics.com. Tossing the toxins has never been more convenient. And for anyone grabbing their premium starter kit, you can still get 15% off at branch basics.com with our code, Drew. That's D-H-R-U for 15%. percent off the premium starter kit at branchbasics.com. After you purchase, they'll ask you where you heard about them. Please give us some love and make sure to mention the Drew Perowitz show. We are at a revolutionary stage when it comes to memory loss and Alzheimer's disease. I've been in this field for 30 years. You know, I've been teaching at Hopkins and Harvard.

I've seen thousands of patients. I've participated in doing clinical trials. I've looked at microscope slides. You know, this is my life. This is my life. This is my life. You live it and breathe it. And never have I been disexcited in the past 30 years of being in this field. Because for the first time, we can actually reverse the early stages of Alzheimer's disease. Remember we talk about normal memory, age-associate memory impairment, malacogic impairment, and an Alzheimer's disease. But Alzheimer's disease itself has mild, moderate, severe.

And a border between MCI and early-stage Alzheimer's disease is kind of gray area. The recent studies have shown that if you provide people who have mal-cogniz impairment or early stages of Alzheimer's disease, and you provide them with a multi-disciplinary program that combines the five pillars of brain health, that you reverse that amyloid build up in the brain. Remember, I mentioned earlier that there are two bag of things when it comes to brain shrinkage with aging that eventually results in Alzheimer's disease. One bag is the plaques and tangles. It's add these proteins that clump together. And when they come together, they cause inflammation and brain shrinkage.

And a whole bag of things that are due to lifestyle-related factors, poor sleep apnea, too much stress, poor diet, and all those things. Now, usually people only look at the plaques and tangles as a marker of Alzheimer's disease, even though these other factors are equally, if not more important. What's exciting and is thrilling is that the multimodal lifestyle interventions have been shown to reduce the amount of flags and tangles in the brain. The amyloid and tau levels drop with these lifestyle interventions. One study was done here in California, Dr. Ornish did the program where he provided a randomized control trial

in which one arm, patients who had malacogic impairment or early stages of Alzheimer's disease, received brain training, diet, socialization, exercise, and the other group was told to wait. We're going to provide this program for you in six months. And then they monitored them, and they had obtained levels of amyloid in the blood as a marker of how much amyloid in the brain

at the beginning at the end. And guess what? the amyloid levels dropped in these patients. Now, there are many other similar studies ongoing now to replicate this study. There are also new drugs that have reduced amyloid levels in their brain, and they have shown only modest benefits. The program, similar to Dr. Ornach, the 12-week program that I put together, have been shown to improve cognitive function.

Like a person, remember four things out of 12 things before, and now they remember six things out of 12 things now. So there's improvement in cognitive function. With these new drugs, the rate of decline has been slowed. So if you don't do anything, they were remembering four things that are 12 things. And usually if you don't do anything, two years later, they remember two things. Yes, so the drugs are only slowing things down.

They're not actually making people better. Yes. But a program like yours, based on these five pillars, that's actually where people are not only not getting worse, but they're getting better. Exactly. And this was what I think, you know, this was the most exciting part of my program.

I love seeing patients because, you know, when somebody has been told you of Alzheimer's disease, it's like a death sentence. As you mentioned, it's like worse than death sentence. And I would tell them, listen, there are two bags of things that cause problems. You have the plagues and a whole lot of reversible things, even though we're beginning to realize that even plaques and tangles can be reversed.

But these other things are definitely reversible. I'm going to work with you. And I'm going to have you to memorize five words. And I say, Doc, I can't do that. I say, listen, we have these brain coaches and they're going to work with you. You can't memorize five words. And it will five words. And then seven words, and ten words and twenty words.

And then people who are mal-cog impairment, these people who had, people were repeating themselves. many of them would remember 100 words, forward and backwards. This was incredible. You know, when I was running the program, we put these people on Facebook, and they agreed to show off that they memorize 100 words, and we put them on our Facebook page, showing off that they came with not to remember anything,

we were told that they were early stages of Alzheimer's disease, and here they were memorizing 100 words. And those are things that cause a lot of people come to our brain center. That's huge. That's really huge. This is really a revolutionary time in field of memory in Alzheimer's disease. It's revolutionary and there is a little bit of a split where so many people are still on the one magic bullet. And then there's a growing group of people that are out there that are now saying, hey, hey, there's more of the story.

We need to have this multiple layers of intervention. And I think that multiple layer of intervention is a great place to go next because if you look at these individuals and you look at your five pillar program, which we're going to talk about, second and some of the things that contribute to shrinking your brain and then what it looks like to do the opposite. Many of these people that ended up with, you know, mild cognitive decline all the way to full-blown Alzheimer's. And then within that, you have different stages, as you mentioned, right? There's the mild medium super severe.

And you're talking about how even people, if you catch it early enough with Alzheimer's, you're seeing programs like Dean Ornish's, programs like yours, being able to actually address things, improve things for those folks. When you look at the lifestyle that many of these individuals have had, I think a big part of your point here today for people like me who are in, you know, my mid-40s is that, hey, don't wait till you have that decline that's there. Audit your lifestyle now and see, are you doing a lot of these things? How is your lifestyle compared to these key five pillars and a lot of the behaviors that are associated with them? Is that fair to say? Absolutely. Let me give an example.

A hundred years ago, most people in the 80s would have dentures. And over decades, these days, you don't see too many people in dentures. There's still a lot of people, when they get to the 70s, required to remove all their teeth and put dentures. But because people have been taking care of their teeth, we don't see too many older adults requiring dentures. Because they took care of the little things along the way. They brushed their teeth.

They did the flossing, they saw dentists two, three times a year. And if there are any issues like a cavity, they took care of it right there. And as a result, people nowadays have their own teeth. They didn't need to have dentures. Same applies to your brain. You take care of your brain and you will see that it will stay in good shape. If you wait too long, then you have too many problems to take care of. Your brain may have too much inflammation.

much damage. The blood vessels may be too clogged up. The rinsing mechanism may be profoundly affected. We still can change. We can still improve things. But I tell you, I'm in my 60s, and I definitely plan to be sharp and independent when I get to my age 90. Because having reviewed the literature every day, I don't see any reason why I shouldn't.

Of course, I can get hit by a car. I may develop cancer that I don't know about. But, you know, considering that those are small possibilities, there's no reason for my brain to decay and decline just because I go to my 70s and in my 80s. And you know, in Washington DC, I have a circle of friends. And many of my friends are in their 60s, some of their 70s, some their 80s, and many of them, almost all of them

are sharp, independent, you know, play golf, travel, cook, work, consult, They have a full, meaningful life in their 70s and 80s. 90s is a different story, but I think it's very reasonable to become a brain super ageer, someone who reaches the age of 90 and is sharp and independent. In fact, I plan to start a community of people who are interested to set a goal of becoming a brain superager. So let's talk about these five pillars. We briefly touched on them, but that podcast was such a long time ago.

There's a lot of people that are listening here. They don't know about that. They didn't get a chance to hear it. And they want to know what are the key things here that lead to preventing our brain from shrinking? And in many cases are applying this idea that you've talked about for years, which is if you don't use it, you're going to lose it. And not just with intellectual games, but also your body because your body and your brain are connected. So let's go through these five pillars. Which one do you want to talk about first?

So the five pillars are fitness, optimal sleep, a brain healthy nutrition, mindset, and brain training. Exercise is by far the most important factor for keeping your brain healthy and strong. By far. By far. Like if you ask me, what is the one thing that I must do as the most important thing to take care of my brain? I would say, improve your fitness. You should be able to go up 10 flights stairs without stopping. You should be able to easily walk three to five miles.

You should be fit. Now, there are ways to actually measure your fitness and then monitor it objectively, but you can also just do it by your own measures, that you're one notch better every six months, that you can do a little bit more every six months. Yeah. And if we look at it on a global level,

even in countries that largely had not crazy levels of Alzheimer's or had low levels of Alzheimer's, we're seeing these rates increase and they're going in the opposite direction is we have people becoming more and more sedentary, especially obviously in Western society. So it's no surprise that we're living in a more sedentary life and people are literally not getting any steps,

especially as they get older, except maybe to the fridge or, you know, to the bathroom. and you have this explosion in cognitive decline Alzheimer's that are there. So fitness is number one, really paying attention to that, and taking a look at where you stand, whatever age you are, and seeing like, can you do the things that healthy people your age should be able to do when it comes to fitness? I must add that there are parts of the world where people are more active than they used to be. many high-income Western European countries

have seen a drop in the incidence of Alzheimer's disease, in places like Denmark, Norway, Sweden, where people are active on a regular basis. You've seen a drop of 20% in the incidence of Alzheimer's disease in the past 20 years. I was in Amsterdam for the Alzheimer's conference two years ago, And I love that these older people, they clearly looked like they're in 80s,

were biking and their bikes had a little basket in front and the grandchildren, like two or three grandchildren, were sitting in front of the bike. And here was this older grandpa who was biking through the city. And I'm not surprised that they have a lower incidence of Alzheimer's disease because these people are being more active. And as a result of not only activity, but interacting with the grandchildren,

many of them eat right, many of them do the things that those five pillars of brain health is a drop. One study in Framingham showed that the incidence of Alzheimer disease in Framingham area has also dropped by 13% in the past 20 years. So in places where people are doing these five pillars of brain health, especially with more activity, we are seeing a drop.

It's not everything is doing gloom. Yeah. If you, and this is like a live experiment in countries where people are just doing it. Yeah. They're not necessarily. Natural experimentation. Natural. They are not necessarily have signed up for a 12-week program.

They have learned that this good habits are good for them and they're doing it. You know, I was doing a triathlon a couple of years ago and I was so proud of myself. I had done like a mile and a half of swimming in the ocean and I have done like 26 miles of biking. I was doing 10 miles of running. I was toward the end feeling good about myself. Like, I love this. And I was reaching the finish line. I saw this gentleman who was like clear on his 80s.

He was going to pass me. I said, wait a minute. No, I'm not going to let you do that. At the one hand, I loved it that this gentleman was in his 80s and was about to hit the finish line, good for him. And I thought, you know, I want to be like human on my 80s. And I think that's the way I like your listeners to think. think about themselves when they get older.

We need to change the way people perceive aging. A lot of people think with aging, you fall apart, you know, you slow down, you sit by the pool, you do crossword puzzles, and, you know, you're older after you age. No, you need to set the goal that I'm going to be in my 70s and 80s. I'm going to be happy. I'm going to be active. I'm going to be doing things. I'm going to travel.

I'm going to work, I'm going to do things. There's no reason for you to not do things just because you get your 80s. And as you said, you can't start doing these things necessarily when you turn 80. The best time to do it is when you're younger, 20s, 30s, 40s, 50s and 60s. And you know, the more problems your brain has,

the more interventions you need to reverse it. It is reversible, but why not start in early midlife and that way you'll be. on track to have a sharp brain when you get older. Yeah, it's an important message. It's never too late to start, but the early you start, regardless of what age you are, which means that there's things that you can do today to give love and attention to, you can radically help your brain not shrink and actually even get a little bit better.

So you said fitness is number one, not living a sedentary lifestyle, auditing your level of activity. You know, if you're only getting 4,000 steps, try to double it is what a lot of people have recommended. what do you think about that advice, at least as a starting place? Or there are other things for people who are like, you know what, I'm really not as active as I'd like to be? I don't want the five periods of brain health become another source of stress for people. I think we need to be reasonable.

The best way to improve your brain functions is to do a little bit on a regular basis. So I think it's too ambitious to double how many steps you get every day. because, you know, if you have a desk job, it's hard to get 8,000 steps in a day. Let's be realistic. What I recommend is to do one notch more. Just do one little bit more. Unless you want to really see great results in 12 weeks,

then, yes, you know, set of ambitious goal for yourself and go for it. It's doable. The same thing with your body. Let's say you have some extra pounds. You don't feel quite right. You could definitely turn things around in 12 weeks. If you go to a gym regularly, eat right, exercise, sleep well, you will see noticeable differences in your body in 12 weeks

and your brain is not different. But my advice for your listeners is don't make the five fluids of brain health and other source of stress. Make small changes. Small lasting changes. Small changes on a daily basis and then build on them. Don't set a goal that I'm going to double what everything I do

because then you won't and then you feel like it didn't work. Yeah, that's great advice. Is there also to a level that if they don't eventually get to that place, we're not going to see the improvements that people are looking for or that just depends on their age

and how far along they are and how much damage they've had, specifically talking about fitness. Your brain health is a spectrum. Your brain could be super duper fresh, strong at its peak, or it could be at its worst condition where you feel tired all the time

you're not in the mood to do things you can't sleep at night that little sleep you get is interrupted by your sleep apnea you're grumpy you're frustrated with your work you're frustrated with the world like that's the other end

is a whole spectrum and in that spectrum you can intervene to improve things one notch so if you feel like you're the worst shape you've been in a long time, then set a reasonable goal of one year and say every day I'm going to do a little bit more

and realize that you will improve. People who walk 3 to 5,000 steps a day, reduce the amount of tau in the brain, the marker of Alzheimer's disease in the brain. People who eat a Mediterranean diet on a regular basis have brains that are up to 18 years younger than people who don't eat a Mediterranean diet. These simple lifestyle choices make a huge difference.

So, you know, I appreciate that if somebody has sleep apnea, they're tired. They don't pretend to be tired during the day. They're tired. They just have no energy. They take naps. They have to keep drinking coffee to stay awake. You need to take care of your medical conditions first.

There are two things you have to do. lifestyle interventions and taking care of your medical conditions. An example of medical condition is sleep apnea. When people snore at night, periodically stop breathing during the night, and during the day, they're tired, they can't think straight, and they're diagnosed with sleep apnea. Sleep apnea can shrink your brain by 18% and treat it to sleep apnea. So you have sleep apnea, and you set goals I'm going to do.

this, do that, but you have no energy to do it, then you're not going to get very far. So if you have sleep apnea, if you have depression, if you have hearing or vision loss, take care of those medical things first because you need to have the energy to incorporate these five pills of brain health. Again, we know for a fact that these interventions can produce huge results in short period of time. However, you need to do. do them. And if you do a little bit at a time, you're more likely to stick with it. So be reasonable, be nice to yourself, you know, just add a little bit. Let's say I'm going to walk 500 steps more today. And stop taking the elevator, take the steps. You know, if you have, you know, choices throughout

the day that you know are healthy choices, do a little bit. Like don't, and we're going to talk about the second pillar, third pillar soon. But, you know, if you see junk food, don't eat it. Or if you You must eat it, eat half of it at first. Just do interventions little by little over time, and you will see that the results will compound over time. That's great. And on the sleep apnea, no, we've had many dentists and upper airway individuals come on this podcast, and they remind people that, because there's a lot of women that are listening whose husbands are snoring. Not that sleep apnea doesn't impact women as well, too.

Snoring is essentially choking at night. And so it's a good opportunity to either get a sleep study or talk to your doctor and see, is this person dealing with sleep apnea. There's so many people that are running around. You know, my dad snored for years and had no idea that he had full-blown sleep apnea. And then as soon as he got a CPAP after doing a sleep study, which, by the way, insurance, you know, usually covers for that. His entire life completely changed.

He wasn't falling asleep and kind of nodding off like around 8 o'clock after dinner. He had more energy throughout the day. My dad has a lot of energy in general, but he had way more energy. So his life completely changed for the better. I also have a dear friend of mine, younger guy, who, you know, was in his 30s and would snore every so often and had a little bit of weight that he wanted to lose and lost some of that weight, but still would snore on a regular basis. And after my dad went on his CPAP and his life completely changed, I mentioned him. I was like, talk to your doctor because you might have some mild sleep apnea. He went in for a sleep study.

He had heavy sleep apnea, way worse than we imagine. And he did a few different things on his journey to lose some of the extra weight that he had. He went on, he got a CPAP device. He started getting more energy. So he was more motivated to eat better throughout the day because if you sleep better, you crave less sugary foods and carbohydrates, multiple studies on that that are done. He started having more energy to work out. And in doing a few different things together, he lost an additional 20 pounds that he wanted to lose.

And it was the sleep that was the next big pillar for him. It is, you know, we talked about fitness being number one. Would you put sleep as number two? Yes. Okay, great. So we've already talked about it, and sleep is number two on this list of five things, five pillars that are part of this 12-week program. One thing I find interesting in talking about sleep with people is that many people assume sleep problems are part of life. Many of my patients say to me things like, well, everybody has sleep problems, as if, well, it is what it is.

You need to make sleep a priority. Most sleep problems are treatable. If you have difficulty falling asleep or if you wake up in the middle of night, there are six, seven different common causes, number one being too much stress. And if stress is keeping you up at night, then you need to realize that you are producing your own stress by your own thoughts. You are the one who's a source of distress. Of course, you know, people have financial problems, people have medical conditions, people have children, or children, parents who have medical problems. So stress exists. I'm not saying stress doesn't exist.

However, so much of stress is self-generated is when you worry about things that can happen in the future or you have high expectations that are not being met. And so you are creating your own stress and it's time to rethink what is causing your stress and have a plan to address it. You can't have same old, same old for another 20, 30 years because that is a problem. Other common issues is that people may have spicy food or caffeinated beverages in the afternoon. And some people are very sensitive.

So the coffee you had at 4 o'clock may affect your ability to sleep at night. It's important to keep the bedroom for three things. You have to sleep, read, and sex. Nothing else. Don't take the treadmill to your bedroom, Don't make your bedroom, your office. Keep your bedroom as a serene, quiet place.

Make sure the mattress is comfortable. Make sure the room is dark. All the curtains are really good about keeping the room dark. These are simple interventions that can really help people sleep well. So if you have sleep problems, talk to your doctor or if you have access to a sleep specialist, see a sleep specialist. This is a fixable problem. You can't just have poor sleep on a regular basis for a long time because that shrinks the brain by a lot. Let me give you one study.

They looked at people who have been sleeping fewer than six hours a night. Some people had only like one or two years of not sleeping enough. Other people had 20, 25 years of sleeping fewer than six hours a night. And when did the MRIs and they looked at hippocampus, it turns out that people who have chronic insomnia has a hippocampus that's almost half the size of people who sleep normally. I mean, that alone is a major risk factor for Alzheimer's disease. Because Alzheimer's disease eventually means where the hippocampus has shriveled a lot. That's what Alzheimer's is.

And so if you're sleeping as poor for years and years, you're creating your Alzheimer's disease. Okay, what comes after sleep? So we have fitness. We have sleep. What's the next one you want to talk about? Nutrition. Okay, great. We talked a lot about nutrition on this podcast, but from a brain standpoint,

and nailing the most important things, what do you wanna say are the top do's and don'ts when it comes to nutrition? Let me start with don'ts. There's a lot of controversy about different types of diet, and some people wonder, it's a keto diet, but then a vegan diet and so forth. But there's something that nobody argues about.

I don't think anybody ever said that highly processed food are good for you. Nor has anyone told you that sugary drinks are good for you, and nobody said that trans fats are good for you. So there are certain people, principles that are unanimously agreed upon. There's no controversy that junk food is bad for you. What we've learned is that people who eat the standard American diet,

a lot of fast food, French fries, hamburgers, they have a smaller brain than people who don't. And many studies have shown that when you have a poor diet, you have more inflammation in your brain. So poor diet literally dirty is your brain. To put it simply, you have a lot of inflammation that happens when you eat junk food. Now, this is something that's not controversial. You must avoid eating junk food.

I recommend that look at junk food like smoking. It's bad for you. It's really bad for you. I feel bad when I go to any like a ball game or if you go to a food fair or if you just go anywhere. most food that is available is bad food. It's really hard. Ultra-processed. It's really hard to get healthy food most places, unfortunately.

But it is what it is, and you have to look at it as smoking. You should avoid eating junk food. That's the biggest part for brain health, because the junk food, increased inflammation in the brain, reduced blood flow in the brain, is bad for you. Now, when it comes to what's good for you, You want to eat food that increase blood flow to the brain,

reduce inflammation, and increase the natural cleansing that happens in the brain. There's no miracle food. I mean, there are some fruits and vegetables that are particularly good, that leafy green vegetables are amazingly good for the brain because many of them have a lot of high levels of antioxidants. Some of them have iron and zinc and many other things. So leafy green vegetables are particularly good for the brain. My favorite fruit is blueberries because in addition to having a lot of antioxidants, they also have something called BDNF, brain drive, neurotrophic factor. BDNF is like a miracle growth for the brain. The best way to increase your BDNF is actually exercise. But the blueberries help to increase BDNF as well, and that's one of my favorite fruits. Almost every day have a bowl of blueberries.

Now, there are no other fruits that are really swear by. I try to have a variety of fruits every day because, you know, citrus fruits have their own advantages. And, you know, watermelon, I love the taste of it. I don't know if has any vitamins in it, but I just love the taste of it. So fruits and vegetables are great, leafy grain vegetables are good. When it comes to meat, I leave that up to you. I personally eat like red meat twice a week maybe and I eat fish about two or three times a week

and I have chicken the other nights at the week so I try to have a reasonable diet I don't feel there's a need for me to go all the way to have a vegan diet or a keto diet and I know that there are advantages of each of those diets I think you need to enjoy life and food is a great source of enjoyment So eat the healthy food you enjoy, and whether it's keto or a vegan or a Mediterranean, enjoy it.

There's no harm in those diets for the brain. It's controversy because people have different genetic makeup. And while keto diet may work well for one person, it may not be ideal for another person. So that's my approach to eating. Don't eat junk food and everything else is good. Simple. Eat a lot of whole foods. Does fish get any special attention because of all the data that's out there?

Yes. Salmon, sardines, and several other fish are high in omega-3 fatty acids. Omega-3 fatty acids, the best supplement for the brain. You need about 1,000 to 1,200 milligram of DHA-E-PA per day. And then when you eat a piece of salmon, you may get 300-millimeter or 400-migram. Flaxseed may have 40 milligrams, 50 milligram. And in general, I recommend omega-grathy fatty acid supplements at a dose of 1,000 milligram per day.

This is what I take myself. Other than that, I don't recommend any other supplements. There are many, there are at least 1,000 supplements with claims that it helps the brain, and I'm sure they do. But why would I take supplements when I can take, you know, love in a lot of fruits and vegetables? There was a study that just came out a couple weeks ago using the UK Biobank study. It was the folks, Dr. Bill Harris, who's been on this podcast.

He's a big researcher in the omega fatty acid space. And I think he's also the founder of a company called Omega Quant as well. I did their testing a long time ago, no affiliation, to help me understand, like, what is my omega index? Like, how much do I have in my body for my omega-3s? And this was the first test that I did years ago. Like, it must have been 2012 when I first moved to Los Angeles. And prior to that, I had been, I had chosen to go vegan for, like, I was vegan for eight years. And I had felt great for, like, the first, like, six years.

And the last two years, I started to feel like, okay, I don't feel so great. In the last year of that eight years, I was feeling like, I don't feel like my brain is super sharp. And I had just gotten to the world of meeting a lot of, like, functional medicine doctors and things. And one of them was like, hey, you know what? this is actually this really simple test. It's like 60 bucks, 99 bucks. It's called an omega quant test. Just look at your omega three levels in your body, right?

You know, because you don't really convert all the, you know, from hemp and all these vegan sources. They don't, and some people are better at converting, you know, and some people are not good at converting, even though if you're eating all these different plant foods. So I did it and I was so low on my, I think my, I think I was like on the percentile. If 8% is considered optimal, I think I was like 3 or 4% somewhere around there. I was quite low. And after doing that test, that's when I made a decision.

I'm going to start eating fish. And when I did, just me sharing my end of one story, I felt like my brain started to turn on again. I'm proud to say that the last test that I did, I do take fish oil, but I do eat a good amount of, you know, salmon, sardines, other things like that as part of my diet. my last test that I did from omega-quant I was like 8.3, 8.5 and my goal is obviously to maintain that over the years. The study that I was mentioning was released by Dem. Observational study looking at the UK Biobank study of blood levels of omega-3 for individuals. Again, correlation, you know, this is not a causation type things. But the individuals had the highest optimal levels of omega-3 had the lowest, level of cognitive decline in that sort of UK Biobank data that they had parsed out.

So just interesting data points to pay attention to. And then you see cultures like Japan and other places that are out there that have a lot of fish in their diet. And I think there's lessons to be learned from that. Anything that I got wrong? Anything you want to add to what I had to say? No, absolutely right. Omega 3 index levels of 8 or higher or better.

And you can definitely easily check your omega 3 indexes. It's readily available, many places. And I actually published a study in 1997 where we looked at individuals with low versus high omega-3 fatty acids and their incidence of Alzheimer's, and we found that people who had high levels of omega-3 were less likely in Alzheimer's disease, very similar to the biobank data you just mentioned.

One interesting study is in France to look at the incidence of Alzheimer's disease and omega-3 index in towns near the ocean, versus town, the center of France, and they found that people who live near the water and eat fish more often had high lows of hookah, fatty acid, and they had lowered instead of Alzheimer's disease.

Yeah, that's great. And, you know, people always worried about, what about mercury and heavy metals and other things like that? And yeah, you know, our oceans are polluted. There are problems that are out there, but it's a very nuanced topic. And I'll link to an article

that was written by a friend of mine who's a researcher, a clinician, and sort of, I would say, citizen scientist in the field of assembling all the data that's out there and making an argument. His name is Chris Cressor. He used to run the California Center for Functional Medicine, and he publishes very regularly. And he's making the argument that, you know, even though you do have fish that has, you know, high levels of, can have sometimes higher levels of like mercury, certain fishes, or other potential

heavy metals that are out there, as long. long as there's a certain level of selenium that's inside of the diet, naturally that those heavy metals, selenium can offer a protective effect against them, and they're sort of transient. They kind of come in and they go out. They're not sort of absorbed inside of the body as the argument that's made. It's a super nuanced topic, and I know people have all sorts of different feelings on that. And there are many companies that are out there that are sourcing better quality. There's a big one, Again, no affiliation with, I'll link to it in the show notes, where they specifically source from areas where they have different fish that have been tested in the supply chain of having lower levels of heavy metals, plastics, and other things that people are worried about. So there's a lot of solutions that are up.

Yes. And also there is the vegetarian version of amygdraithic fatty fatty acids from algae. Algae, right. So there's a form called Algal DHA that is for people who are vegetarian. Yeah, great. All great options. Okay, fitness, sleep, nutrition. We're now on to four and number five. What's number four we want to talk about?

Mindset. We just talk about stress and the effects of stress in the brain. When you stress out, you increase levels of cortisol. And cortisol is like a poison for hippocampus. When you increase cortisol levels, hippocampus shrinks more so than other parts of their brain. And there are literally a dozen studies that have shown in humans that when you have high the cortisol levels, your hippocampus is smaller. One study in Japan looked at people in their 60s,

and they did baseline cortisol levels, and they did the baseline MRI, and then they looked at them seven years later to see what happens to people with different level of baseline, cortisol level, baseline stress, baseline high stress and high cortisol level versus those who have low stress and low cortisol levels.

And then seven years later, they saw that people who had high cortisol levels, they had this much small hippiecapacity, campus, then people had low cortisol levels. And lots of other studies have shown that if you just bring, let's say, 200 people and do a questionnaire about the stress level, and do a blood test for cortisol, and just do MRI, those with higher cortisol levels have a small hipacampus. That is well established. Now, mindset is one thing is to manage your stress. I think that you have to realize that if you're stressed out, I'm sorry to say.

it's your problem. Many people blame other people for their misery. And I understand that, yes, other people who do things that stress you out shouldn't do those things. However, it's you who's getting stressed out. You are interpreting what these people said. And it's your problem. If somebody does something that stresses me out, let's see somebody is chewing,

loudly next to you. And it's stressing you out. Listen, it's your problem. They shouldn't be chewing loudly, but if you stressed out, it's your issue. And it applies to people you live with, your coworkers, economy, the world. If you have the mindset that I own my problems and that if there is something wrong, I am the one who's going to do something about it, you will feel a lot less stressed. After all, why should people do the things that are convenient for you?

Why? Because you are not exactly perfect. Let's face it, we all have our shortcomings. A lot of people make the mistake that only if my spouse does A and B, my life would be so much better. Only if my boss was more understanding, my life would be better. They always have assumptions and expectations of how other people need to be different in order for them to be happy. And of course, every 10 years, their new issues are becoming a new source of stress for them. I think realizing that stress is a poison for your brain, you should minimize things that stress

you out. Let me give you a little story. I have two daughters in college. And my younger daughter has both of my girls come to my lecture sometimes ever since they were little. My younger daughter was in second grade. and she was supposed to read a simple book and write a little review about the book, second grade.

And I realized that two days later, the book was due, her homework was due, and she hadn't started working on it. I said, sweetie, you haven't started reading the book as due in two days. And she said, Dad, you're stressing me out and that's not good for my hippocampus. And I think that's a good way to look at things. is the stress that happening to you

worth this damage in your brain? Are you, can you diffuse the situation? Can you lower the expectation? So that's one mindset. The mindset that stress is bad for me and I'm going to take care of my, I'm going to take ownership with my problems, and I'm going to try to reduce my stress as much as possible.

Obviously, there's a leak in a basement, there's a car accident, family members with medical problems. There are real houses on fire. They're real stresses. I'm not saying there's no stress. But I would argue that more than 80% of stresses that people feel on a daily basis are self-generated.

Their own mind generates the stress they're experiencing. There's a much easier way to say, I'm not going to stress about this. And you have to really put the pause button and say, Is this worth my hippocampus? You know, is this worth my epicampus? That's one mindset.

The other mindset is growth mindset versus a fixed mindset. A fixed mindset means, you know, other people are smarter, and I'm not as smart as A&B, or other people have better memories, and I don't have as much. And a growth mindset means I can be good at anything. I have the brain, which is healthy, and I can't learn anything.

I can learn languages, I can learn to ski, I can learn to cook, I can learn to be comedian, I can do anything. And it's true that our brain is made such that we can do anything. Anyone who does anything for 10,000 hours will become quite an expert on it. So you need to have a growth mindset, realizing that you could be better at anything. Don't say I'm not good with names. Please don't. Just think about this.

What if I give you $10,000 for every name you memorize in a day? How many names would you memorize? A bunch. I mean, people always say, I'm not good with memory. They meet someone. They tell themselves, I'm not good with memory. Ten minutes later, they don't know the name, and they reinforces their concept, their understanding that they're not good memory.

They say, see, I'm not good with memory. I just forgot it. So it's a self-fulfilling prophecy. So realize your brain can be able to be a good memory. be good at anything, including memory names, or learning anything new. And so the third mindset is to have a purpose in life. Ask yourself, why do I want to have a better memory? Why do I want to have a healthy brain?

Why? Establish the why, and that really helps to guide you as to where you're going. For example, you know, again, I have a family, and one of the things that I feel passionate about is to make sure that my family is healthy and a lot. that my daughters will become successful and happy people in their lives. That's something that's important to me. I feel passionate about educating the public about how they can prevent Alzheimer's disease. I love it.

I love giving lectures. I love doing this podcast. I love the fact that I just finished writing my fourth book, and I will continue doing it. So establish what it is that is meaningful to you. And that will help you to have motivation to then pursue the things that are good for your brain. You need to establish in your mind what it is that excites you, what it is that you feel passionate about.

There was a section in the book where I just wanted to highlight it. I screenshot out of my phone. And you tell me if it's accurate, I got this correctly. So purpose reduces dementia risk by 19%. Absolutely. Having a clear life goals builds neurite density. Is that how you say? Neurite density, creating biologically younger brain.

So this is not just like, you know, know, loving advice from somebody who's there and, you know, nice little, you know, sayings. This is actually shown. These are not philosophical concepts. These mindsets actually change the anatomy of your brain. There are questionnaires to establish a sense of purpose in life. And you answer like seven or ten questions and you get a score on how much sense of purpose

you have in your life. And then you can use those questionnaires and ask the question of, how having a sense of purpose can change things. So having a sense of purpose reduces the risk of dementia by 19%, reduces risk of heart attack by 12%, reduces the risk of strokes by 50%. In other words, you look at two groups of people. One group has high score for a sense of purpose in life.

One group has low score. And then look at their brains, the people with a higher sense of purpose have 50% fewer strokes than people who don't have a sense of purpose in life. Crazy. You live longer. You have less stress. You sleep better.

Your brain is sharper. Here's another thing. If you look at two groups of people with the same load of plaques and tangles of Alzheimer's disease. So person A, let's say from 8 to 10, one to 10 has six out of 10 plaques and tangles in their brain. And person B has six out of 10 flex and tangles in the brain. And then you do cognitive testing on them

to see how well they perform on a test of cognitive functions. People have a sense of purpose in life perform much better in tests of cognition than people have a low sense of purpose even though both groups have plaques and tangles in their brain.

There is something magical about having a sense of purpose in life. It has biological differences. And the study in Wisconsin showed that if you look at MRIs and look at the number of neurites, how many synapses they have, people with a sense of purpose in life

have actually more synapses than people who don't. You know, this is interesting because we can't have animal studies. We can't have, like, mice who have a sense of purpose in life. So it's hard to do hardcore scientific studies. But for sure, we know that people who have a sense of purpose in life have better brains, better hearts, better quality of life. Quick question. You were talking about testing like these plaques and tangles, you said?

Plaques and Tangles. What do you think about, you know, just taking a little, little pivot, it, you know, people and companies offering testing for tau is becoming more popular. Worth it, not worth it, buyer beware. What are your thoughts on that? I think. And if you could explain tau in its role in everything with cognitive decline. So there are two proteins in a brain that accumulate over time that eventually becomes

significant enough to shrink the brain and cause Alzheimer's disease. You and I have some amyloid in your brain as we're sitting here. Amyloid has a natural function. the brain and tau is also part of the microtubules the scaffolding inside neurons neurons have these long axons and the tau is a part of the structure of these neurons amyloid levels increase when you get your 60s and 10 years later or 5 years later then tau goes up in parallel to it so if amyloid comes first tau comes second and these are toxic people are of early onset Alzheimer disease, people who develop

Alzheimer's in their 50s, have loads of plaques and tangles, and for them, that's the main source of brain shrinkage that causes Alzheimer's disease. Older adults, people in their 70s and 80s, have plaques and tangles and a whole lot of other things, as we talked about earlier. Their brain may have a lot of inflammation, the blood vessels are mostly clogged and they're stiff,

the rinsing mechanism has not worked, Inside the brain is kind of dirty, actually. I just don't want to have that brain. I've seen pictures of, I've actually cut human brains after they pass away, and I can look at it. It even looks bad. And looking at it, it's gray, dry, shriveled. Whereas a healthy 80-year-old brain looks fresh, looks vibrant.

The plaques and tangles accumulating the brain, and these things that are happening too. We don't have biomarkers for inflammation, blood flow, and lymphatic system, the rinsing in the brain. but we have biomarkers for those things. So should you get testing for amyloid and tau? My short answer is no. Why? Because your lifestyle changes are going to help reduce these anyway.

And if you have amyloid and tau on yourself, by yourself, if you obtain it on internet, on these companies that provide it in-home testing, you're getting a test that tells you your higher risk for Alzheimer's disease and you have no one to talk to. And that is a horrible thing. I mean, I'm an expert, and I know that there are things I can do about these things, and I'll probably be more proactive.

But I'm going to do those things anyway. I don't need to have the extra source of stress. There are other people, however, who want to know, who do want to know their levels of Amelway in town. I feel very motivated to see that, that they know their lifestyle isn't dialed in, and they see something like that. It's like, whoa, we got to really take this seriously. There's a spectrum of differences. I have seen many people who, once they're told about Alzheimer's disease, the whole life is upside down.

Because every time they forget their keys, every time they forget the conversation, it becomes a huge problem for them. Yeah. Again, there are people who want to know and they want to be proactive about it. I'm proactive about it without necessarily knowing it. I think it would cause anxiety for me. you should check amyloid and tile levels if you're, let's say, 60s and 70s and you have significant cognitive decline, and we want to determine how much of the plaques and tangles are causing your brain, causing problems of your brain, and look at your brain MRI to look at other things that cause your brain, and then put it all together.

Let me give an example. We know that cholesterol is bad for you when it comes to heart disease, right? If this is well-established, heart cholesterol is bad for heart function. I mean, some people argue with it, but generally it's accepted that heart cholesterol is bad for you. So let's say I do a blood test on you and you have high cholesterol. But just because you have high cholesterol, it doesn't mean you're going to have a heart attack. In order to have a heart attack, you have to have a heart attack, you have to have high cholesterol, you have a sedentary lifestyle, diabetes, obesity, smoking, poor diet,

a whole lot of things have to come together in order for you to have a heart attack. the cholesterol by itself would not necessarily cause heart attack if this is the only risk factor you have. So imagine you get a cholesterol level and you see that your cholesterol is high and that you're going to get a heart attack. Of course, with cholesterol, we have so many medications to lower it. When it comes to plaques and tangles, the lifestyle interventions, early studies have shown that you can reduce the levels. and there are some new drugs that have potentially helpful. But there are no standard guidelines of what to do with these things. And there's no standard guidelines that shows that if you have high tau levels

and you do this, this, this, this, your towel levels will drop, the same way we have for cholesterol. I think that kind of information will become available 10 years from now. It needs to be researched a little bit more. We need more specific guidelines. Yeah. But would you suspect, if you were a betting man, right you know your program for people that have gone on it which is detailed inside the book which is fantastic but if you were a betting man and somebody had elevated levels of towel i've never

done the test so i don't know what the range is and and how it kind of comes back but they had elevated levels of towel if that person followed in a sustainable way for them over the course of you know it's a 12-week program but let's say you know these are meant to be lifestyle changes that you adopt they followed that over the coast of six months into a year would you if you were a betting man Would you suspect that their towel levels would have been reduced at the end of a year if they were Slightly elevated at the beginning of the year? Yes, but let me give you an example. Yeah, I recently talked with someone who is 63 years old. He's fit as it can be. He's doing everything right and his towel levels are high. It's tough when people say that they're doing everything right and they're super fit

because do they have sleep apnea that's there? Do they have air pollution exposure? No, no everything checked. Yeah. So then he could be genetically at a higher risk that's there. I still feel that my audience, not that I'm advocating one direction or another, I have a tendency to think that a lot of people who listen are to this podcast, they're in that forward-thinking area. Just like there's new innovation that's available that still is not standard of care in traditional cardiology. I've had a few cardiologists talk about it. You know, we've had, you can get your calcium score, but that looks at hard, that looks at calcified plaque, right? Hard plaque. But, increasingly,

Increasingly through the evidence, people understand for cardiovascular disease that even a bigger risk is this soft plaque buildup that's there. Now, there's some questions about do soft plaque and hard pack correlate together, and so looking at hard plaque is good enough? But now that there are more abilities to do CCTA and companies like clearly no affiliation that can use AI imaging to get a snapshot of your soft plaque, I've gotten it done for myself. I've heard from many of my friends and podcast listeners. Listen, insurance is not covering it out of pocket. It's like $1,000, $1,000. It's not a cheap test that's there. But for somebody like me who has a history of cardiovascular disease,

South Asians, Indians are at the highest risk for any ethnic minority. I actually want to know is the lifestyle that I'm doing at the age of 43, 44 years old, am I really going in the wrong direction? Because I am a hyper-reabsorber of cholesterol. all. So untreated, my APOB is probably around like 160, right? And it's through taking things like ZETIA and having like a high fiber diet and other stuff that I've been able to bring it down to more like, you know, 80, which is still a little bit high, you know, it's a tiny bit high, but definitely back in the normal range. So I'm feeling that a lot of people on my podcast are the

people who feel like I want to know and I want to go on the journey to try to find the right resources, but I do agree that it's not for everybody. You know, you have to decide what that journey is for you. But I am so curious about that because I had a grandfather who had dementia. And I have other people in my family who maybe it wasn't diagnosed properly, but, you know, probably had Alzheimer's at some point in time. So I'd love to know where I stand on that spectrum. I agree. I give a lecture, I give a teacher course at Johns Hopkins called advances in neuroplasticity and its applications in neurology, where I give you know 26 hours of lectures about all the things. And of course, I have plenty of time to explain everything to my students.

I'm usually not in favor of doing the test. So having taught them all stuff throughout the course, toward the end, I asked them, okay, class, how many of you would like to know your Plex and tango levels thinking that hardly anybody would raise their hand? Guess what? 80% of the class raised their hands. Yeah, people are curious, especially now that they've been. empowered by all this information that you've given.

Yes, I think it's a personal matter. It's certainly personal. It's a personal matter. I personally, I am a type that I worry about it. And I have seen people who are perfectly healthy and they don't everything and they still have high towel level. The high towel level is a bad thing. Because remember I told you, you have the bag of things for plaques and tangles and a basket of things for these other things. And these other things can actually be more important than plaques and tangles.

Sure. So you can have high towel levels and if your brain is perfectly healthy, you'll be fine. The high tile level, even if it stays high, it's not going to kill you, it's not going to cause problems. Let me give a study. There was a study called the Nunn's Study by David Snow. Nuns. Yes, the nuns study is. The nuns study showed that if you look at elderly women in their 80s,

who pass away and then look at the levels of plex and tangles in the brain, many of these ladies who had very high, stage six, like Alzheimer's from 1 to 6,

they have stage 6 plaques and tangles in the brain as bad as it gets. Yet, these older women did not have cognitive symptoms because their brain were healthy otherwise. So if they had done a test

and they had saw that they had seen at high tau levels, many of them would have stressed out about the fact that high tau levels, even though when they died, they still didn't have significant cognitive decline. We have an incomplete picture. And I am concerned about having a piece of the number,

like, you know, you have a panel of blood tests you can do, and you only have like one or two, and then that's incomplete information. Ideally, you would like to go check it out and address it, but I think it will cause unnecessary stress for people like me, realizing that I'm in minority. My lovely wife, I told her, honey, do you want to do the test? Of course I want to know.

So everybody around you, including your students, wants to know. I want to know. But, hey, listen, I respect your decision. I don't want to know. Because I think you are also, like, look, I am doing all the things that are there. and it's so personal it's so personal yeah i will say that if you look at sort of medical history it was standard of care back in i think in like the late like like in the in the early 60s it was up to the doctor to tell the patient whether or not they had cancer and a lot of doctors

would advocate that you shouldn't tell them because it was a death sentence at that time and obviously we didn't have the levels of treatment i don't know exactly the year that was there and you know that changed over a period of time as more treatments came came about so i get how it's a Okay, let's come back to these five pillars. We have one last one that we didn't get a chance to talk about after mindset. What is that? That's brain training. Your brain is like a muscle, and the more you stimulate it, the better it will function,

and the more it will grow. There's a layer of the brain on the outside that's like a blanket that covers all other brain structures. It's called cortex. And then you have this hippocampus, which is the size of your thumb, is deeper in the brain, one on the right, one on the left, near your ears. Cortex an epicampus are the brain areas that are most important for your cognitive abilities, whether reading, writing, typing, driving, doing your taxes, do everything you do. All the cognitive things you do emanate from cortex and hippocampus.

And different parts of the cortex and the campus form networks for various things you do. So can network for language and network for attention and network for executive function and network for doing nothing, you know, just sitting there doing nothing. And when you stimulate your brain, you activate these networks and the more active they are, they literally grow in size. For example, if you learn a language in three months, the parts of the brain for language literally grow, literally, like three millimeters larger, five millimeters larger, significant, so much so you can see on a brain MRI. So brain training is an important part of, of brain health maintenance.

Now, many people say, oh, but many studies show that brain training doesn't do anything with Alzheimer's disease. And that's true, why? Let's say you have sleep apnea, sentry lifestyle, diabetes, obesity, stressful life, and then you do, let's say, 10 minutes of brain games. Is it 10 minutes of brain games are gonna change all these problems you have in your brain?

Probably not. Too much damage. You need to work your brain on multiple fronts, anyone at the five pillars of brain health contribute to brain functions, optimal brain functions, and brain training is one of them. So does brain training improve your brain functions? Absolutely.

Does brain training improve the size of the parts of the brain you use? Absolutely. Does the brain training by itself, in the absence of everything else, prevent Alzheimer's disease, maybe a little bit? It's one part of the puzzle. Yes, so you can't, I do things every day to challenge my brain,

whether it's taking dancing lessons or, you know, work on my French to improve my French or do different things. Every day, so you're Sudoku's and every day I find little opportunities to challenge my brain. What I'd like to emphasize for your listeners is this. You need to make some things a routine part of your life. Like, tend to walk more every day. Pay attention to your sleep. Find out the common things and fix your sleep.

Don't eat junk food. You know, have a mindset that everything is okay. Life will work out. Don't stress yourself. And any opportunity to get to stimulate your brain, stimulate your brain. You don't have to do anything dramatic. You don't have to buy any new equipment.

You don't have to go anywhere special. Just make a simple mindset of checking these routines every day. Now, if one day you don't walk, it's not the other world. That's okay. You can do more next day. Like if you had a bag of french fries today or you went somewhere there was a lot of ice cream, you ate more than ice cream that you're supposed to, that's okay. Just make a habit of doing a little bit every day toward your brain health,

realizing that benefits compound over time. See, if you have financial decision making, you will put your money in certain stocks, and then you bring in new investment all the time. Like a regular basis, you put money in that, investment so that it will grow over time and it will compound over time. And you also reduce things that are like negative income or a source of a tax, such as no stress that's really bad for your brain or nutrition is bad for your brain. So just like you can have a financial portfolio and you can expand it, think of your brain as a brain portfolio and plan to expand it for your

retirement years. Yeah. What I love about this one is that if you look at brain training, also a big part of what you and so many other people are advocating is even things like fitness was number one on your list, like doing something new, playing pick a ball, learning how to do resistance training, learning how to do coordinated activities at the gym that you might work with. You know, a lot of these trainers will have you do things that are more coordinated, will be a new movement. These are all different versions in addition to Sudoku or crossword puzzles or whatever else people might want to do learning a language.

These are also different ways to stimulate the brain and have it try new things. One you could do to optimize doing the fire pillars of brain health is to combine them. For example, if you go hiking with a bunch of friends and you talk about different things and you'll learn in the process that, you know, about stock market or about science or anything else, you've learned something and you have exercise and you've been in nature, which is also a great thing. And you're getting sunlight. You're getting sunlight. Actually, the important thing to get sunlight and being in nature.

If you take a dance lesson, you're exercising, you're socializing as a stress reduction. You know, so you want to combine these things as much as possible because that way you don't have to do six different things. You could do three things that combine things. Yeah, I love that. So in the book, you know, we have these five pillars and it's all about how, in addition to these incredible stories that you share out there, like the first woman who mentioned Carol? Carol? Carol? Carol. There's also like, okay, great, there's all these things that are there. But talk about the 12-week program aspect of it, right? You've mentioned that a couple times, is that is 12 weeks the minimum commitment? Is 12 weeks the snapshot of like, what can people see in 12 weeks?

You can see dramatic improvements in 12 weeks. Just like if I put a person who has a luxury weight and, you know, not the best diet and then put them in a 12-week intensive program, 12 weeks later, they're going to look buffed. They're going to have more muscle, they're going to lose weight. They're going to look really much better. It is possible to look significant better in 12 weeks. What we did in our program was to combine the five pills of brain health at the same time that I took care of the medical problem. So when a patient came, I took care of their sleep apnea.

I did blood tests for the vitamin D level, B12 level, thyroid level, iron levels. And I took care of the medical things while my staff worked with, with them twice a week for about 90 minutes each time to do brain training and to monitor the five pills of brain health. And as a result, we saw dramatic improvements. The point is this. Your brain is an organ. Your brain is like your muscle. If you do things, it can have noticeable improvements in 12 weeks. Not so much in six weeks, but definitely in 12 weeks and definitely in six months. And so if you really want to improve your brain functions, if you feel like you are brain fog, you're tired of being tired all the time, then you could really do the assessment I have in my book.

I have a whole bunch of assessment for brain portfolio to establish your brain portfolio to find the gaps. See, every person is unique. They're like eight sections in my brain portfolio, and every person will have different answers or different results for each of those eight sections. In other words, every person is very unique. And to see the best results in a short period of time, you want to be very targeted in the interventions that you provide for people. And so I have these questionnaires and forms that people complete and a picture emerges that these are the things they need to work on. I also have an app that you can put all the information in the app,

and the app says you need to work on these three pillars of brain health, and these are the things you need to do. But you can expect significant improvements in your memory. For example, you can easily memorize 100 words in three months. in five weeks. People 50, 60, 70s can memorize a list of 100 words, forward and backwards in that period of time, definitely. It's not that complicated.

What I found exciting about my work was people will come in, we do these things, and then they couldn't believe I'm the same person. So, Doc, I can't believe. I just memorize 100 words. I couldn't memorize five words. And they can't believe they just did this. And when patients came in and I told them, you know, sir, I'm going to work with you.

and your memory will improve because we know, this is we do all the time. And they would say, Doc, I don't want to disappoint you, but I can't remember what I ate for lunch today. Don't expect me to memorize 20 words, little 100 words. One person I never forget is, it was this heavyset gentleman,

he was like 300 pounds, who came to see me. I started my brain center back in 2012. And I told him, sir, you will definitely memorize 100 words. He says, Doc, there's nowhere I'm gonna do this. I said, sir, I've done this before. You will. He says, look, I bet you $100 I want. I said, sir, you don't have to pay me, but we've done this everything.

You're only in 60s and you will. So no, I want. I say, okay, fine, $100. I bet you $100, you will memorize 100 words. And in 12 weeks. So then he went to start our program, obviously, at obesity and a lot of vast metabolic things. And he started to work. And then five weeks along the way, I was in between patients.

I said, Doc, can I talk to you for a minute? But I said, sure, coming. He put a $100 bill and slapped on the death. So, Doc, I can't believe it. I memorize 100 words, and this is the best $100 I ever give anyone. I said, sir, thank you very much. I don't take the money. He insisted.

I say, fine, we'll just get money. We'll get some food for the staff. But here's an example of someone who was so convinced that there was no way he could memorize anything, little hundred words, forward and backwards. And he got there in five weeks, not even. 12 weeks. So I think if you want to be ambitious and set high goals for yourself, you could. You could. You should read all the stuff I have in terms of making your full assessment. For example, I recommend people do a fitness testing, their V-O-2 max, to establish their fitness

and try to improve their fitness. I ask people who your role model is. You need to have a role model and then use that person as the guide of where you want to be. And then, I recommend a blood test panel of 20, 30 different things that will help to identify what are the issues. I recommend to do some kind of questionnaires to establish is a memory problem, attention, concentration, processing speed, and do you have anxiety or CD, fatigue, brain fog, to establish exactly what the issue is. And if you do all those things, you can expect huge improvements in your brain functions in 12 weeks. But if you have a full-time job and you have kids, and your life is already pretty full

and you really don't have time to spend specifically on these things, you can decide to make small changes and get to improve brain functions in six months or 12 months. You know, you're going to live a long time. There's no hurry to get everything done in 12 weeks. If you want to, you could. You know, like there are so many programs for building muscles in 12 weeks intensively,

or you can just do it gradual over a year. So it's up to you. That's great. What's the name of the app? The Invincible Brain. Okay, got it. Same as the book. And are there still centers that are out there that you know of, that do this type of work

that people can go to? You know, the way that you had your center as well as your center is still around, do people there are there other centers that you recommend for people? If people are looking for like more of that medical help and the interventions, what's your recommendation there? I'm working with some large health systems to provide this program. for national healthcare systems. They're not available yet.

Okay, so stay tuned. Yeah, and I couldn't do everything I do now in terms of writing a book, giving a lot of lectures, traveling, doing everything, writing blogs, and have a full-time job. Yeah, I'd be too much. So I decided, you know,

I'm going to focus my energy to do public education than to have my own office. But the program structure is spelled out detail and detail of my book. All the details, all the little, little small, minor details happen, including my book. And hopefully a year from now, there will be centers nationally available. Amazing. Well, I look forward to that day. The Invincible Brain, that's the book, prevent and

reverse cognitive decline and get smarter at any age. Any final thoughts you want to leave our audience with now that you've shared this incredible five pillars that people can turn into a 12 week or a little bit longer of a program, depending on how motivated they are, to see massive changes, especially if they start early and catch some of these things that could be shrinking and damaging the brain.

Any final thoughts you want to leave our audience with? I think it's important to set the goal to be happy. Many times we talk about preventing Alzheimer's disease, longevity, and losing sight on the fact that we need to be happy today. Now, I don't want to say I'm happy to eat my hamburger and french fries and soda because I'm happy because, you know, those are major risk factors for strokes and heart attacks

and that's not a good way to be happy. The cancer, like, I love smoking and it makes me happy. I mean, if that's your choice, then fine, do it, but that's not a good idea. But if you can find ways to enjoy your day-to-day life, and one way to enjoy your day-to-day life is to improve your brain health.

It's your brain that makes you happy or unhappy. It's your brain that determines if you're satisfied with your life. And it's your brain that you can improve upon. It's so interesting to me. Our brain makes us who we are and how we think and what we do, but it has malleability.

We can control our brain to make it such that we're happier, we do more, and we enjoy our lives more. But I think it's important to make that a goalpost for yourself, that I want to do things to have a healthier brain. And when I have a healthier brain,

I'm going to enjoy life. I'm going to wake up every day, looking forward to the day I'm going to have. When I go to bed at night, I'm going to look back and say, what a great day it was. And plan for the next day. Ultimately, you want to be happy.

I mean, I don't want to add stress to people. Like, they already hear so many things about their taxes and economy and how to raise children. There's so many things to do every day. I don't want, you know, taking care of the brain to become one more source of stress. So don't make it into a huge project. You know, make it something that you do a little bit every day. But overall, though, when you wake up in the morning, ask yourself, what am I going to do today to have a better day? And I was once in Tanzania

we were traveling with my daughters. And it was a post on a tree. and in a hotel and said, today is a great day to have a great day. And I think that's a good principle to wake up every day and make that day a better day. And when you go to bed at night, look back and be grateful

for all the good things that happen, realizing everybody has problems, everybody has problems. You're not the only person with problems. And be humble about the life you have. The life you have is a dream life for billions of people. Billions of people. The life you have is a dream life for billions of people around the world.

Just have some humility and a wonderful life you have. And don't little things bother you damn much. You're lucky to have the life you have. That's a great reminder. And I would argue that, you know, looking at this work for many years and having a chance to meet you and see everything that you're up to and how so much of the research that I came across a while ago was your research that got me excited about brain health, is that, yes, life is stressful. and yes, the doctor is here not wanting to add stress

with this list of things to pay attention to, but investing in all these things, fitness, sleep, nutrition, mindset, and, you know, brain training, investing in them makes you more resilient to the stresses that are there. People are already stressed out anyway. They're stressed out because they're so sedentary,

their brain is going nuts because they're not doing anything with their body, they're not using their body that's there. They're stressed out because they're dune-scrolling social media. They're over-watching TV. They're eating food. foods that have a ton of additives or spiking their blood sugar all over the place and they're getting a blood sugar drop so they feel hangary all the time so you're already stressed out if you're

not paying attention to your brain so when you invest in these things and you follow these five pillars and take care of your brain you're going to be so much more resilient you're going to be anti-fragile so to speak to life stresses that are out there absolutely it's your brain that determines if you're happy or unhappy it's your brain that determines if you're sharp or you feel overwhelmed. And if you make your brain a healthy brain, you'll function better. Let me just say one thing. You can think of your brain as a garden. You know how you take a garden? You have to like water the plants and remove the weeds and do trimming once in a while. And you can have a beautiful garden or you can have a messy looking garden full of weeds and things growing all over the

place. And if you do a little thing every day, you can have a beautiful garden. And think of your brain as a garden. Is your brain a beautiful garden right now or a lot of weeds and a messy situation? I wish there was a way we could have an imaging to show the pathology in the brain in a way that people can relate to. In fact, maybe that's a project I can do in the future

that show how bad or good things are. We can look at someone's skin and see whether there are wrinkles or how much damage there is, but our brain is inside our skull, we can't see it. But you could, imagine what it would look like. If you're happy, content, on top of things, you feel sharp, you have a beautiful brain. If you're stressed out, can't think straight, always running around,

you know, being behind, you feel frustrated with everything. Your brain is probably not the most beautiful place. But the point is, it doesn't take major renovation to fix this garden. It doesn't. A little weeding, a little watering, a little trimming. Three months you can see. results if you do it all at once. But six months or a year, you can see significant results if you do a little bit every day. I love it. It's a powerful reminder. Our brain is so much more resilient than we know. Let's start taking care of it today. Exactly. Dr. Majid Fatui, thank you so much for being back on the podcast. It was my pleasure. Thank you very much for having me. Hi everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast.

If you haven't already, subscribe, just hit the subscribe button on your favorite podcast. app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend, share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity,

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