Dhru Purohit Show - How to Prevent Brain Shrinkage and the Role of the Hippocampus in Chronic Disease with Dr. Majid Fotuhi

Episode Date: October 5, 2023

This episode is brought to you by BiOptimizers Magnesium Breakthrough, LMNT, and Rupa Health. Dwindling memory is thought to be a normal part of aging. But just because something is common doesn’t make it normal. There is a lot we can do to safeguard the memory center of our brain, and it’s never too late to get started. Today on The Dhru Purohit Podcast, Dhru sits down with Dr. Majid Fotuhi to discuss the top diet and lifestyle factors that shrink our brains and insightful tips on what we can start doing to grow and preserve our brain health today.  Dr. Fotuhi is a neurologist with expertise in the fields of memory, concussion, and successful aging. Through his 30 years of teaching, clinical work, and neuroscience research at Harvard Medical School and Johns Hopkins, Dr. Fotuhi has developed a multidisciplinary program for helping people of all ages improve their memory and attention. The results of his program have been published in several scientific journals and his three books. In this episode, Dhru and Dr. Majid Fotuhi dive into (audio version / Apple Subscriber version): -The top things that shrink our brains as we age (2:53 / 2:53) -How a big belly relates to a shrinking hippocampus (5:01 / 5:01) -Why trans fats are so bad for the brain (6:50 / 6:50) -Protective fats for the brain (11:12 / 8:15) -How a sedentary lifestyle shrinks the brain (16:01 / 13:10) -Dr. Fotuhi’s prescription for exercise (17:56 / 14:48) -How walking helps grow the hippocampus (20:48 / 17:30) -The role of the hippocampus in chronic disease (24:34 / 21:28) -A testimonial of a patient under Dr. Fotuhi’s care (31:48 / 27:25) -How snoring, sleep apnea, and stress impair our sleep (41:10 / 36:37) -Why sugar is so damaging to the brain (54:32 / 50:17) -The link between elevated uric acid levels and brain aging (1:00:59 / 56:27) -Key strategies to help us grow our brain (1:11:26 / 1:07:00) -Why having a sense of purpose is so important for brain health (1:12:26 / 1:08:00) Also mentioned in this episode -Boost Your Brain -The Memory Cure Get 10% off and a special bonus gift with your BiOptimizers purchase. Go to magbreakthrough.com/dhru and use the code DHRU10 at checkout. Right now, LMNT is offering my listeners a free sample pack with any purchase. Head over to DrinkLMNT.com/DHRU today. Access more than 3,000 specialty lab tests with Rupa Health. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com today. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

In the Alzheimer's conference this year in Amsterdam, research just showed that if they didn't have our eyes of the body and the brain at the same time, they could see that people have more visceral fat, have a much smaller brain. Did you know that after the age of 50, it's common that the hippocampus, the part of the brain connected to long-term memory formation and memory retrieval, shrinks in size by 0.5% every year? And just to be clear, that's not a good thing. If you're curious to know about what you can do to stop this shrinkage in advance and even reverse it by growing your brain, today's episode is for you. Welcome to the Drew Proet podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset.

This week's guest is Dr. Majid Fatoui, and he's here today to give us a list of the top most damaging things that actually shrink our hippocampus and our brain. and more importantly, the hopeful lifestyle tips that we can all start today to help us regrow our brains. And yes, his research and his clinical trials have shown us that you can regrow your brain. Now, a little bit more about Dr. Fatoui. Dr. Fatoui is a neurologist with an expertise in the field of memory, concussion, and successful aging. Through his 30 years of teaching, clinical work, and neuroscience research at Harvard Medical School

and John Hopkins, Dr. Fatoui has developed. a multidisciplinary program for helping people of all ages improve their memory and their attention. Dr. Fertui has published the successful results of his program for patients with memory loss, with aging, concussion, and ADHD in several scientific journals, and three books including Boost Your Brain, the new art and science behind enhanced brain performance. Dr. Fertui received his doctorate degree in neuroscience from John Hopkins University and his medical degree from Harvard Medical School. He now serves as an adjunct professor

in the Department of Psychological and Brain Sciences at George Washington University, and he also teaches at Harvard Medical School. Stay tuned for a fascinating conversation with Dr. Fetui on how to regrow your brain today. Dr. Fetui, welcome to the podcast. It's a pleasure to have you here. I want to jump right in.

Today we're talking about what it takes to regrow and protect the brain. You know, you've shared before that conventional wisdom is that as we get older, our brain is going to suffer. And also, we should expect aging, which means that we should expect massive shrinking of the brain. But you're here to tell us that it doesn't have to be that way. Before we get into what can help us protect and regrow the brain, can you give us a list of the top things that actually shrink the brain as we age? Yes. Again, thanks for having me on your podcast. I really appreciate it. There are many things that shrink the brain, and the more of those things you have, the more your brain shrinks. There's a part of the brain called hippocampus, which is the size of your thumb. One on the right, one the left. This part of brain is very important for memory and risk for Alzheimer's disease. This part of the brain is very vulnerable. It can really shrink by a lot of things, but it can also grow with a lot of things. So the things that shrink the hippocampus, are, number one, poor diet. You know, people who have high levels of trans fats,

they have a small head of the campus. The other thing is really bad is stress. Stress and anxiety, increase cortisol levels, and higher cortisol levels are very toxic to this part of brain. The other thing is really bad is a sleep apnea. If you snore and you feel tired and you may have sleep apnea that's not treated, that's really bad.

It really shrinks the brain. Having fewer than six hours a night is another bad risk factor. People who have poor sleep, unfortunately, they're a high risk of shrinking the brain, and the longer that they have insomnia, the smaller the hippocampus gets so it can go, so it gets smaller, smaller, smaller over 20 years. And the other thing is really bad for the brain is stress.

Stress increases cortisol levels, and that shrinks the brain by a lot. Finally, concussions are bad for the brain. If you've had one or two concussions, it's okay, but people have had multiple concussions, unfortunately, may have affected every campus. Let's drill into some of those. It was interesting that one of the first things you mentioned was people who eat a lot of ultra-processed foods, which is generally, you know, a lot of the foods that also make us obese as a society and a nation, that those are individuals. We'll get into the trans fats in a second. I was watching one of your talks, and you were saying that the bigger our bellies grow,

the smaller our brain gets. Is that true for the hippocampus as well? Yes, many studies have shown that. So, you know, I want to be clear that if you have a bigger belly, if you're obese, it doesn't mean you're doomed that you're going to get Alzheimer's disease. You know, it's one of the six main risk factors. However, on average, the bigger belly is associated with a small hippocampus on a linear fashion. So people who unfortunately have a big belly have a small hippie campus, and people who are otherwise fit have a nice big hippocampus.

Again, when it comes to a big campus, size matters. You know, you can make your hippocampus like big and swollen, or you can make your hippocampus decide. like your pinky. And it all has to do with your lifestyles. And food is one of the most important things that can affect your brain. So obesity is bad, the bigger belly, the smaller campus. This has been shown in the past by measuring BMI versus campus. In the Alzheimer's conference this year in Amsterdam, which I attended myself in July, researchers showed that if they didn't have our eyes of the body and the brain at the same time, they could see that people who have more visceral fat have much smaller brain.

So it's really bad. And, you know, trans fats, which are the things that are added to food to make them have a longer shelf time are bad. And higher levels of trans fats in the blood are associated with the epidermas. Wow. You know, you've mentioned before that there are bad fats for the brain and then there's good fats. We're going to get into the good in a second.

But tell us what is it about trans fats in particular? You know, most of my audience knows that these fats have largely been outlawed in the United States, things like shortening, yet we still have a lot of loopholes for companies that if they're under a certain amount of percentage in the food, they can still be included. So give us a few examples of what trans fats are. And what is it about trans fats in particular that are so damaging to the brain? This episode is brought to you by bioptimizers. You know, I've had a bunch of experts on my podcast talk about the insane benefits of magnesium.

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That's right, eight single serving packets free with any element order. This is a great way to try all eight of their flavors or share Element with a salty friend. Get yours today at Drinkelement.com slash Drew. That's drink, D-I-R-N-K-L-M-N-T dot com slash D-H-R-U, Drew. That's me to get your offer today. This deal is only available through my link, so you got to make sure you go to drink element.com slash dh-R-U. Transpast are things that you're buying in like fried, you know, fried chicken that you buy in fast food or things like in hamburgers.

These are not real meats, you know, they're mixture things. and a lot of trans fats are added. The thing about trans fats that seems to be the link to cause brain shrinkage is inflammation. Trans fats trigger much more inflammation than the good fats. And that inflammation goes through the blood and reaches the brain is caused what's called neuroinflammation. And since the hippocampus is the most sensitive and vulnerable part of the brain, it gets affected more so than other parts of the brain.

Amazing. Let's give a quick teaser to the good fats that are there. As we start to go through this list of the things that shrink the brain, I think it's good to be hopeful for individuals, that there's a lot of things that are very protective. So talk to us about the protective fats that are there for the brain. Yeah. So there are a group of good fats called omega-3 fatty acids. And these fatty acids are the building blocks of the membranes of neurons. See, neurons are and the outer layer is made of fats and lipids. And about 40% of the membranes in the brain is made of omega-3 fatty acids.

So these are literally the building blocks of the brain cells. And that's why they're so important. And our body doesn't make omega-3 fatty acids. We need to get it from outside sources. And I consider omega-3 fatty acids is one of the most important vitamins. However, if you consume a Mediterranean diet,

and eat things like, you know, add olive oil and eat fish and follow things in these particular things, especially salmon. They have high levels of amino acid fatty acids, and many studies have shown that high levels of fatty acids are associated with bigger up a campus. I personally did a study myself. I did a meta-analysis of all published studies about the relationship between levels of amogatory fatty acids, in the blood and risk of Alzheimer disease. And I published that in nature, which as you know, is a very prestigious journal.

And I found that people who have higher levels of omega-gative fatty acids in their blood are far less likely to blow Alzheimer's disease compared to people who have low levels. So to me, that's a no-brainer. It's really good for you. I think you can get your omega-gative fatty acids from diet, as I mentioned, the Mediterranean diet,

things like olive oil and avocados and salmon. These are the things that are known to have high levels of these good fats. And nevertheless, I still do eat fish twice a week and I do use olive oil and I do like avocado. However, I still take omega-3 fatty acid supplements. I doze of 1,000 milligrams a day myself. And I recommend it to my family members. you know, I've seen lots of patients with ADHD, memory loss, concussion, and for them,

I consider that a prescription. They really need to take omega-2 fatty acid supplements because the amount they're taking their diet is not enough. Fascinating. So the minimum viable dose that you would share with the audience for supplemental, on top of a rich diet that you have, a Mediterranean diet, is you would advocate that people be taking 1,000 milligrams of, or 1 gram, right, of, you know. of fish oil supplements, which would be a combination of EPA and DHA?

Yes. And I think there's a little subtle but important distinction between these different types of supplements. There's fish oil supplement and there's omega-3 fatty acids supplements. The fish oil have other things in them above and beyond omega-3 fatty acids, which you don't necessarily need. You don't need omega-6, you don't need omega-9, you have enough of those. So you really want to get a supplement that says omega-3, fatty acids, D. EPA. You want DHA EPA, which are the two important omega-3 fatty acids. And the thing about these two is that they convert to each other. EHA gets converted to EPA and EPA gets converted to

DHA. So they're very similar. They're cousins in terms of it. And DHA is the molecule that's really important for the membranes of neurons. And EPA has a lot of benefits, such as antioxidant benefits and increased blood flow. And so, is advocate to be good for the heart. So I recommend DHA EPA because this combination is really good for the brain, for your eyes, for your heart, for your skin.

It's really good overall. That's great. That's a great clarification. Thank you for that. And I'd add in one more, which is that there's a lot of low-quality fish oil and also low-quality EPA-DHA supplements that are out there. So, you know, do your homework, ask around,

and make sure you're ordering from brands that are reputable. From my understanding, I don't know if this is your understanding as well, Dr. Fetui, but these oils are very sensitive to things like oxidation as well as light. So they have to be stored at good temperatures. And there's not every brand and company that's out there is doing the right thing. So people should do their homework a little bit and look for reputable brands. I absolutely agree with you. Let's go.

I'm going to jump around a little bit here. I watched one of your talks and one of the things. One of the things you said is that one of the top things that helps grow the brain is oxygen. And one of the best ways of us getting that in our lifestyle is exercise. So we'll get to exercise in a second, but let's take the opposite of that. If exercise is one of the best ways to grow the brain, could we also add a sedentary lifestyle as one of the top things that shrinks the brain? Yes, the thing about a central lifestyle is that it usually comes as a package deal. You know, people have a sedentary lifestyle also don't go out there and challenge their minds.

You know, they're not the type who would go to the museum or, you know, explore a new hobby. They're a type who probably would just watch TV a lot and have their beer and have their pizza and just, you know, sit around. So I think the centenary lifestyle is a marker for how a person leads his or her life. So I think obesity is more common in people who have a centered lifestyle. Diabetes is more common. I think to me, sitting is the equivalent of smoking, you know, and these studies have shown and compared the effects of sitting around a lot versus smoking on things like your heart function and your cardiovascular health.

And they have established that, you know, people who have a central health, lifestyle or sit around is equivalent of smoking. And so to me, sitting around is one of the worst things you could do for yourself. Yeah. Sedentary life has so many detrimental things that it brings to us. And on the flip side, as we mentioned, exercise has so many incredible things that it brings to us. What are your recommendations when you put together your 12-week brain fitness program

and you have your patients that of your clinic go through it? When you are taking somebody who is living a sedentary lifestyle, what is your prescription for them in terms of how much fitness they should be incorporating into their life? And then what are the ways that you help them accomplish that? That's an excellent question, Drew, because, you know, I don't blame people who have a sedentary lifestyle. I don't think they sort of sat down and said, you know, I choose to just sit around doing nothing. I think what happens is that as people have a lifestyle, and let's say they eat a lot, and then that eating spikes their insulin, and then they get hypoglycemic. And when they get hyperglycemic, they feel hungry, so they feel tired.

So they eat more. And the kind of things they eat, unfortunately, they have times sugary food, which make you tired. And then when you're tired, you really don't have energy to move around. and just sit around, whether it's at work or at home. So I find it helpful to consider this a shared problem with my patients. Like I tell my patients, we are in this together. I'm not going to blame you for being overweight or not doing things. You know, you are where you are and you haven't seen the joys of the other side.

So we're going to make a journey to go there on the other side where you exercise and rejuvenate your brain and your body. And I think the most difficult step for people to make that switch is the first step, from doing nothing to doing something. We had brain coaches who were trained to serve as like cheerleaders for our patients, and they would have them walk five minutes a day, just five minutes. We say, Smith, look, I know you're not a fan of going outside or doing things, but can you walk five minutes? You know, you're here for me to help you.

We have 12 weeks to help you. You obviously want to be better. You want to be sharper. So let's make a deal. Five minutes a day, four days a week. We'll see you next week. And I think when we give people a very small amount of exercise to do, they were likely to do it. If we told them exercise three hours a week, which I usually recommend to people,

they're likely to say, I don't have time, I don't have the energy. It's not going to work. I have to get a membership to a gym and so forth. So we help patients go from doing nothing to doing a little bit. And one of the things we found really interesting is that even five minutes or 10 minutes of walking makes you feel better. And we will also educate our patients. If you walk one mile a day on average, you cut your risk of Alzheimer's disease by 48%, one mile a day.

And this is not a study from results from, One study, multiple studies have shown that walking, it really helps reduce risk of Alzheimer's disease. And walking helps to grow hippocampus. So when people walk 10 minutes a day, five minutes a day, when they come back the following week, they're often excited. It's, oh, my God, I feel so much better. You only walk 10 minutes, five minutes. And yet, their report feeling better.

And then we said, well, how about 15 minutes? And then we gradually built on it. Once they walk half an hour, then they start seeing the benefits themselves. They start feeling better. They feel more energetic. And that's the rest is downhill. The biggest challenge is the first part. Fantastic.

So even if somebody's living a sedentary life, they should feel inspired to know that even starting with five minutes a day is starting to get them in the right direction. And then ultimately, let's say somebody is, you know, pretty active but wants to die. in and a little bit more, your ultimate recommendation of where people can shoot for to get, you know, in the optimal category as related to the benefits of exercise and movement, is that about that sort of 150 minutes a week that people often talk about, you know, with exercise research. I make it simple for people.

I say three hours a week. And, you know, one of the things I find interesting is that there's a linear relationship between your fitness and the size of the campus. And that applies to kids, teenagers, adults, older people. They did study where they looked at the hippocampus of 12-year-olds, kids, elementary school, 10-12-year-olds. And they found that the more fit kids had hippocampus that was 12% larger than the kids were not fit. Wow. And the same applies to teenagers and older adults.

So you want to be fit. And I find that exercising about three hours a week is just about the right time, the right amount of exercise. Now, you know, a lot of people ask me, you know, should I do 30 minutes a day, 45 minutes a day? I think that as long as you three hours a week, I'm happy. If you want to do like two 90 minutes sessions where you play tennis and you do something else, that's fine with me.

You'll hit that three hour mark. Generally speaking, it's good to get at least half an hour at any one sitting. You know, your body metabolism changes after about 17 minutes. And so I find that half an hour is the minimum of beneficial exercise. If you do five to ten minutes, it's a good way to start. It's a good way to start a new habit. But ultimately, you want to set a goal for three hours a week.

And, you know, you could do like 45 minutes, four days a week, 30 minutes, six days a week. and you know, just to figure out what you like to do. You know, I found it interesting that when people enjoyed what they did, then they didn't look at the time. They just did it. And one of the things we did to help our patients to figure out why they liked. So if something like ping pong, then go play ping pong. If you like tennis, play tennis.

If you don't like to go to the gym, don't go to the gym, you know. Take a Zumba class. Do something you enjoy and you should just enjoy the process and exist. exercise is a part of it. The fact that you're getting the benefits of exercise is secondary to the fact that you enjoy that activity. And that I think is very important. Talk to us a little bit more about the hippocampus. You know, that's been a big area of your focus. What is the role of the hippocampus? And why is you, how did you become so passionate about helping people protect the health and the size of the hippocampus? You know, I did my medical school at Harvard and I went to do my

residency at Johns Hopkins. When I was a resident and later toward my senior years, I worked in the Alzheimer's Disease Research Center at Johns Hopkins, and we were monitoring patients over time. These people were coming there for 20, 30 years. Every year they came and we monitored them to see how their lifestyle was affecting their brain, how diabetes affected the brain. We did cognitive testing, brain MRIs, the blood tests, we monitored them. And I noticed that many of them who had obesity, diabetes, sleep apnea, things I knew that shrink the brain, were diagnosed with Alzheimer's disease. And I said, wait a minute, these people have a good reason for being forgetful.

Why are we labeling them as having Alzheimer's disease? It makes a big difference to say to someone, sir, you have Alzheimer's disease, or sir, we have multiple treatable vascular risk factors, and if we work together, you'll get better. It's a huge difference in what happens to the patient, how they feel about themselves, and what happens to their families. And so when I looked at their brain MRIs, many of them had smaller cortex and particularly smaller hippocampus.

And I realized that hippocampus is the same part of the brain that shrinks with Alzheimer's disease. So two different things can shrink this part of brain that's so critical for learning and memory. And so if there are things that we can grow it, we can literally prevent Alzheimer's disease. And that's such a huge message.

And I wrote a book about that in 2002 called Memory Cure. And, you know, what's interesting is that still, that book still selling, still got the realities for them at all. I don't expect it because it's been, you know, 22 years now. But apparently people find that interesting and they're reading it. So over the years, after I published that, I monitored the field closely. And I published a paper in, again, nature about all the things you could do

to grow your hippocampus. And I provided the scientific evidence as to why. Like, you know, we're talking about sleep is good and exercise is good and diet is good. And I provided the molecular biology of why these interventions are so important. And again, I've seen in my clinical practice that when we do these things for our patients, the hippocampus grows. You know, I have been running a small neurology practice in Northern Virginia. where we had patients do our 12-week program, which involved three things,

lifestyle modifications, brain training, and biofeedback, and we did testing beginning, halfway, and the end of the program. And we published the results of this 12-week program for people in their 60s and 70s who had remarkable improvements in their memory and other cognitive functions. And one of the things we measured was the MRIs. And half the patients grew their becampus by 3% or more. The hippocampus growth shrinks by about 0.5% per year after age 50. So 3% growth in hippocampus in three months is a equivalent of brain that's six years younger.

And so I think I find these things amazing. I find these things incredible. If any drug did that, it would be a blockbuster drug. Imagine a drug that would grow your be a pecanpus by 3% makes your brain about six years younger in three months. How much would you pay for that? How popular would that medication be? You know, by the way, things work, a program like mine is not something that gets media attention

and, you know, people's attention because it requires work. People have to, you know, follow a diet. They need to exercise. They need to do brain training. However, I think it's incredible that this part of brain really, really, you know, determines our faith, you know, whether you're going to end up in nursing home, your 80s, or whether in your 80s you're playing tennis and going to book, reading clubs, and you're traveling on your own depends on how you leave your life that would impact the

size of the campus. And the things required are not that hard. If you start doing this, it becomes a habit. Like, you know, I have a habit that, you know, I sleep at number of hours, my exercise and you have a routine. I don't have to think about it anymore. I just do it. And it's not that hard. You know, watch what you eat. Don't stress too much.

You know, exercise. Do some meditation. You know, explore the world. These are not, you know, that hard. You know, you take out your teeth. You know, you brush your teeth. You know, you brush your teeth. You sit down to six months.

You know, you do something every day as a routine. And people who do that are at a far lessly, less likely to lose their teeth when they get older. You know, they have still their own teeth. I remember, you know, 40, 50 years ago, everybody had dentures. Because, you know, by the time people got to 60s, 70s, you know, most people's teeth were not good enough and they need to get the whole dentures. And that's not happening anymore because average person has learned that they need to brush their

teeth twice a day, every day, and that's a part of their daily routine. And people who do the kind of things that are coming for growing the size of your people, campus. They do it routinely and it's not that hard. This episode is brought to you by Rupa Health. Let me tell you why I'm such a huge proponent of functional medicine. Number one, it gets to the root cause of a patient's symptoms. Number two, it looks at the body as a network of connected systems. And number three, it utilizes specialized laboratory testing to identify and address functional imbalances at their source. But from what my practitioner and doctor friends tell me,

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All you have to do is go to rupahealth.com. That's rupa health.com to sign up for your free account today. You're right. It's not that hard, and you've really built an incredible program to help people do that, and you have so many fantastic testimonials of individuals from your clinic. I was wondering, you know, first of all, those are incredible results. Is there a testimonial you want to share with our audience of a patient that came to you? Maybe some of the stuff that they were either diagnosed with or some of the decline that they were facing, whether it was in their health or their mind and how they went through your program and then kind of what was possible for them.

Any patients come to mind that you might want to share? I can think, you know, when I see my patients, I bond with them. And so I can easily mention 100 names because, you know, I know my patients, I remember them, and I connect with them. One story I was really touching to me was a young lady, actually. A young woman from Chicago had come to see me. And she just got married. And then shortly after the wedding, they had a car accident, and she had a concussion. And because of the concussion, she couldn't think straight.

She was sensitive to light. She was irritable. Her sleeping pattern had changed. And, you know, the family said, oh, can you get better? You get better. They saw this doctor, that doctor. Every doctor recommended something different. And she was frustrated because she was not getting better.

And she came with her, you know, husband who clearly loved her, but I was frustrated. You know, by then, by the time they came to see me, maybe six or eight months had passed. And unfortunately, the guy had. decided it's not working and they have to get divorced because as much as he loved her, she wasn't a woman. She married. So sad. She was not interested in doing things.

She had given up on things. She wasn't exercising. She was frustrated. She just leave me alone. Just leave me alone and just go. And I remember them so vividly, both of them. He was such a nice guy, you know, such a nice gentleman toward her. And he was hating the fact that he was leaving someone he loved because she's not the woman

he married. He was not talking. She was not talking. She was not doing things. So I said, listen, you know, you had one concussion and your young person, you're a young woman, you must get better. Not getting better is not an option. I've seen thousands of patients like you. There's no reason for you not to get better. One reason you have not gotten better is that you can receive care from multiple specialists who do their own things. So for example, if you're sensitive to light and you have headaches, you see neurologists who would prescribe medications for migraine. If you have anxiety, irritability, depression, you see a psychiatrist and they prescribe antidepressants. Now, antidepressants cause weight gain and reduce libido, which means you get fat and you're

not interested in sex, and that can affect your relationship with your husband, which then affects how you lead your life. And then she had dizziness, and she had seen a vestibular therapist, physical therapists, were giving her exercises which were making her migraine worse. And she was so irritable and frustrated she couldn't sleep. So she was receiving sleeping medications on top of that. So sleeping medications, antidepressants, migraine medications, given up on life, not working, and, you know, her parents were keeping her in their house because things were falling apart.

And to me, that was a tragedy because, as I explained to her, had to get better. She was a healthy young woman. One concussion doesn't devastate the brain. She must get better. So I provided her with our multi-distance program. I made a list of all the issues she had. And I went one by one in a holistic, comprehensive program all under my supervision, not under four or five people who do their own things, independent of the other specialist. And so one of the things we did with our brain coaches was to help her start walking. We said, listen, let's call her Janet. Janet, you need to walk five minutes a day.

You can do five minutes. Don't tell me you can't do five minutes. And I just one of the things I told her, I said, I promise you, I'll get better. There's no reason you will not get better. I promised you that. And she reluctantly agreed. And I helped her reduce some of our medications. You know, migraine medications are great, but they can cause fatigue.

And if you're fatigue, you have no energy to do things. So instead of that, I told her some meditation techniques. I told her husband to be sympathetic toward her and don't do anything. Just hold off on getting divorced for now. And then she came to our program twice a week, and we did some brain training with her. We just said, listen, let's memorize 10 words. You can do 10 words. He says, I can.

So, okay, five words. So we showed her to memorize five words. She started walking five, ten minutes. I reduced off her medications. I usually see patients, you know, beginning, six weeks at the end of the program, but people are complicated, have multiple issues. I see them over two weeks. So I saw her again, and I said, okay, well, not taking the sleeping medications

have actually made you feel better because you're not as groggy. And started to walk better, she made her feel better. And so she gradually was coming out of her shell. she started seeing the light at the end of the tunnel. At times she thought light was not worth living. But she started to realize that something is changing about her. And so when I saw it at six weeks, she was already getting better. And I took away some of the antidepressant medications from her.

Because the reason she was not doing some things and she was tired all the time, wasn't that she was depressed. That was the side effects of the other medications. So I took those medications off. and I felt that, you know, the side effect of the medication is actually affecting her. Weight gain and a young woman is not good and not having sex with your husband affects you and your relationship. So as the medications were off, I think they started being a little more lovey-dive toward each other. And so by a time she came back at 12 weeks, she was like 50, 60% better.

Talk of divorce was forgotten. Wow. When they came, they were so levity to each other. I never forget how they were just, you know, mingling and touching each other. very good chemistry. And so she was starting on like 30, 45 minutes a day. She was actually smiling. For the first time, I saw her smile. And she said herself, said, I know your program is 12 weeks. I'm not quite done. I want six more weeks. And I said, I agree with you. So she came back six more weeks. Six more weeks. So she had done 18 weeks, the program. She was a new person. She was back

to the person she was before the wedding. She was smiling. She got a job. Love you. with husband, they were taking having a kid, having a baby, and her life would totally turn around. And when she came back, she had tears in her eyes. She said, you know, you changed my life, you saved my life. This was the best thing I ever did. And that story was not, no, once a month. That kind of story of people came to me and saw such reversal in their life was almost once a week. If you look at the Google reviews we have, you know, we have Google reviews for neurogrow, brain fitness,

the name of my practice and they have Google reviews under my name, Dr. Futui. And both of them are five out of five. And there are several hundred of them. We didn't have any single patient who was unhappy or felt that this is not working for her. And that's really a testimonial to the fact that lifestyle changes and biofeedback and brain training have a huge impact. We didn't do any exotic things with them. We didn't do any special medications with them. I find that most people don't appreciate how powerful simple lifestyle modifications are.

Most people don't appreciate that diet, exercise, sleep, stress reduction are powerful interventions. I think if they were expensive, more people would take them. If they have to see someone and they had to pay $1,000, they probably would find it more helpful than the fact that it's free. and I have to remind people that, you know, these interventions are simple, readily available, but powerful. They're powerful. You know, taking a baby aspirin is a very powerful intervention for reducing a risk of second heart attack, yet it's so cheap and readily available.

It's probably one of the most powerful medicines there is for reducing risk of second heart attack, and it's so cheap. And so you don't always need fancy, expensive things to see good results. Yeah, that's a great reminder. These interventions are so powerful. And yet, I'm sure much of what you run up against is that you are really on an awareness journey. Your goal is to raise the awareness of people who read your books as well as your patients, that the things that they think are normal are actually not normal.

This is not how we were designed to exist in the world. One of those clear examples are today, almost everybody, as you've written about in your book and you talk about in your lectures, has some type of sleep disturbance that prevents them from regularly getting a good night's sleep. It's not just once a week. It's multiple times during the week and many people have it every single night. Can you talk about some of the top sleep disturbances that are there, you know, all the way from the lightest things that people deal with that regularly cause sleep disturbance and prevent them from getting a good night's sleep, all the way to full-blown sleep apnea, which many people have and goes undiagnosed for years and ultimately ends up impacting their brain. A very important point you mentioned is that a lot of people think it's acceptable. It's okay. You know, I have some patients say, yeah, I have insomnia.

Who doesn't? The second problem is that people think that if you have had sleep problems for a long time, it's not going to be fixed. It's just you, and this is the way things are. And that's a wrong assumption. So we need to challenge people with their own understanding that everybody has sleep problems, and that's okay. It's not okay.

Now, the common things I see that affect people who sleep is too much anxiety. You know, if you are stressing out about your work, if you're stressing about your relationships, you can't expect you just go sleep and that's the end of it. Your mind, do things that provoked anxiety are with you when you put your head on a pillow. And the solution for that is, well, yes, you have challenges. Let's write them down. You know, you write five or six or seven things that are on your mind and you decide how you're going to handle them.

for every problem there's a solution. And if there's no solution for it, it's not your problem. You know, like, you know, if there's too much spending for the government, yes, that's a problem, but you go vote. And once you've done that, you've done your share. Or, you know, you have concerns about your family members not doing what they're supposed to do. You do your part. And if they don't do their part, you've done your share.

So you need to realize that, you know, you've done your part. and you're done with it. So writing down the list is helpful. And if you think that there's so many things your mind, it helps to pour it out. Sometimes you need a therapist not to tell you what to do with your life, but you just listen. You know, these days, everybody's busy, everybody's on their phones, and friends where just somebody who just listens to you for an hour are not as commonly available as they used to be, you know. So number one thing, I find that it affects people's difficulty falling asleep. And now the thing that wakes about 3 o'clock in the morning is that they have these

recurrent thoughts, R&Ts, repetitive negative thoughts. If you think about the same thing and you find that you're thinking about the same thing again and again and again, you need to hit the pause button. And I find it's helpful to write them down. You just make a list of the issues and what you can do about them. So you offload things from your mind onto a paper. And if you in a little night wake up and say, shit, it's going to happen. Just wake up.

Go to the agenda or whatever you do on your phone, whatever, and write it down so that is done. The other thing is that when people have difficulty sleeping, that alone prevents them from falling sleep. So they say, damn it, it's 2 a.m. I'm still not sleeping. Damn it. It's 2 o'clock. I'm still not sleeping. To that, I say, chill. You know, if you're not sleeping tonight, it's not the end of the world. Don't make not sleeping worsening your insomnia. It's okay. You will not die.

I mean, in the long term, it's bad for you. It's true. Like any other thing. But if you don't sleep tonight, you won't. It's not the end of the world. It's okay. It's okay. Just get up and read something.

I mean, I don't like the idea of going on your phones, but if it helps for you to read something and it helps you fall asleep, it's okay. So that's one of the other things that I find worse than people in somnia. The fact that they're in bed, they toss and turn, they keep looking at the phone at the clock, 2.15, 2.45, 315, 4.15, 5. And they keep saying, damn it, I'm still not asleep. If you're not sleeping, get out of bed, go sit somewhere, and smile, it's okay. It's okay.

I mean, write down just the thing that will bother you and then do something productive. You know, if you have to work and, you know, the thing that bothers you is the project that's not done at work, who sit down doing? You know, I think that is really helpful to offload the fact that, oh, damn it, I'm not sleeping. Tomorrow I'm going to be a mess. You probably will be, but that's okay. You know, you will catch on. Don't worsen the process.

These are defined the subtle things that I found very important that usually you don't hear about them when you know, Google, what do I do to sleep better? Now, the bread and butter things that people do to affect their sleep, that is not a good idea is if you have caffeine beverages in the afternoon. Some people are sensitive to caffeine. So if you drink coffee at 2 p.m., that could linger in your mind, your brain,

and you still have difficulty sleeping at, you know, 12 o'clock. And so no alcoholic, no, no caffeine beverages in the afternoon. Now, another common problem, which is more difficult to handle, is pets. You know, I have many friends and family members who have a pet, and I said, oh, my dog wakes me up at 4 a.m. every morning. And, you know, or, you know, my cat comes and goes with me and I can't sleep. That is a tricky one because, you know, your pets are part of your family. You can't give them up.

However, you need to figure out a system. You need to figure out a system because if you don't sleep every night for five years, your hippocampus will shrink. It's not, if maybe it will shrink, it will definitely shrink. We know that. We know that for sure. Sleeping few nights here and there is okay, and your brain recuperates. But if you don't sleep every night for five years, your hippocampus will be smaller.

And you will increase risk of Alzheimer's disease. I'm sorry, it is what it is. You know, it is the fact. Now, you need to figure out the system. You just figure it out. You will sign. you train your dog to sleep in a different room, you fear you. You know, that's a tough point.

So those are the common things. You know, some people who exercise in the evening have difficulty falling sleep. So if that's the case, don't do it. And the worst thing, a worst thing is if you have sleep apnea and you snore at night. It's not funny. You know, a lot of people joke about, oh, my husband's sleep, sending snores all the time. and doesn't let me sleep, I throw him out a bit and something. That's not funny.

Sleep apnea is toxic. Increases cortisol levels. It causes hypercoagulation. I mean, people don't think of that. When you have insomnia, you know, if you have sleep apnea, if they change in your blood, make your blood more coagulable. You are more likely to get blood clots. And blood clots cause strokes and heart attacks.

So there's nothing. funny about sleep apnea. Slipaphymia shrinks the brain. Studies have shown that it shrinks the cortex and the campus by about 18%. If you have treated sleep apnea, if you have treated sleep apnea, you're okay. And in fact, treating sleep apnea with a sleep apnea with a sleep apiece has shown to grow to the hippocampus. So sleep apnea strikes at the campus.

Some clever people say, well, what if we give people CPAP, and we do MRI's beginning and three months later to see the hippocampus grows back? And it does. You can see parts of the campus grow back before and after just by treatment with CPAP machine, which is a treatment for sleep apnea. Yeah. It's amazing how many people walk around and are regularly snoring. And we've had many dentists that have come on this podcast who fall into this category of functional dentistry that are constantly on the, you know, educating their patients that if that both the shape of their jaw, There's a lot of people that are not the classic sort of obese or overweight male who snores at night. You know, there's even young, thin women that often have sleep apnea because of the shape of their jaw. And even something as simple as like mouth taping can be supportive so that they're not breathing through the mouth and they start breathing through the nose. And that's a trend that's been very exciting to see.

My dad snored for years and we would kind of joke and it was funny in the family. And then as I start to get educated about all these topics and talking to individuals like your I went to my dad and I said, dad, I think you have sleep apnea. And for a lot of people, a sleep study can be a little bit of a tough thing, even though there's great home devices that are available now for people to order and do it home. And many physicians order those. For a while, my dad wasn't excited about the idea of going into a clinic, sleeping somewhere different and getting measured. And so one of our physicians that was working with them said, you know what, I'm just going to put you on a CPAP because 90% I'm pretty sure you have sleep apnea.

of your snoring. And immediately, my dad within a week noticed that his brain was functioning better. He was not nodding off in the early evening after dinner, how he typically would be and kind of having really a hard time staying up. And he even noticed that he lost a little bit of weight after just making a change of including a CPAP machine. So how powerful these interventions can be. And now he feels like he has so much energy, which is even up until the evening until he goes to sleep, which is very much not the life that he grew up in. And he didn't put on a CPAP and get treated for sleep apnea until he was in his 60s. So anybody who's listening today, it's never too late to get started in addressing some of these core issues.

And your brain will thank you for doing it. Yes, that's an excellent example. And you know, one of the things that I mentioned earlier is that I don't blame patients for not doing the right thing. So if your dad was tired and sleepy during the day, it wasn't like he chose to be that way. Correct. It's because the sleep apnea was affecting his brain and he was groggy during the day. You know, when people have sleep apnea, they may stop breathing five times a night, but some people stop breathing 40, 50 times an hour during the night. And imagine, you know, imagine you just put somebody, choke someone, put their head out,

choke someone, put them up, every time go like that, it's like they're being choked and they're being pulled out of water. 40 times an hour through the night. So it's no wonder to wake up feeling tired. And, you know, unfortunately, when people tired, they eat something because they feel like they need energy. so they eat something. And eating something obviously worsens the obesity,

which worsens the sleep apnea. And that's what I mean by educating the people and don't blaming them for the way they are, but have a more open mind and a solution-oriented approach to interacting with them. You know, it's unfortunate when people, like your dad, would get blamed. Come, I'm lazy, man.

Get up your butt. Do something. They are not the ones experiencing what, he has been experiencing. And there are new devices that are the major oxygen saturation on your wrist. So there's no equipment on your face. It's the oxygen desaturation, which is a marker of your snoring. So while it's helpful to go to a steep lab and get very accurate results,

by how much you stop breathing, how many times you stop breathing per hour. But ultimately, what matters is the desaturation. of the blood, the oxygen and saturation, which you can measure with devices that measure oxygen saturation from your wrist. Fantastic. You know, going back to this original list that you started off with, you know, you mentioned that there's these top things that shrink the brain, especially as we get older, but even they can start when we're younger. Just as you had mentioned, there are kids that have shrunken hippocampuses because they're playing sports like football and repeatedly having sort of mini concussions that are there that damage the brain, right?

Or they also could be exposed to a lot of ultra-processed and highly-processed foods, which gives them exposure to trans fats. One of the ones that we didn't touch on is also in that category of food, which would be not following in line with the Mediterranean diet, which you recommend, would be people who have a lot of sugar in their diet. You've repeatedly talked about how excess, and continuous exposure to sugar is something that is quite damaging for the brain. Now, we all enjoy and have a little bit of a sweet tooth that's there, but what you're really

talking about is a pharmacological dose of sugar, which unfortunately many people are getting today primarily through sugar-sweetened beverages, things like Coca-Cola, Pepsi, etc., as well as exposure to a highly refined carbohydrate diet that also comes with sugar added into it, like the frappuccinos that people order at their favorite coffee store that comes in at 40 grams of sugar, you know, so on and so forth. So why is it and how is it really that sugar can be so damaging on the brain at these heavier dosages that we seem to be seeing here in the United States and increasingly export it to the rest of the world. Yes. So there's a big difference between simple carbohydrates and complex

carbohydrates. Sugar is an example of glucose. It is an example of a simple carbohydrate. And when sugar goes in your blood, the insulin levels go up and they take that sugar from the blood and put in the different organs where they belong. What happens is when people have a lot of sugar is that the cells become resistant to insulin. So the process of insulin helping sugar go inside the cells doesn't happen as much. And in result, the sugar floats in the blood

and the cells are actually starving for the sugar, which they need for production of ATP, which is a fuel for cellular functions. that extra sugar that floats in the blood can then bind to random proteins where they shouldn't be. And it's called glycation process where the sugar molecule binds to something in your nerves.

And when a sugar molecule binds to a protein, it changes its three-dimensional structure. And when the shape of the protein is changed, it cannot do its functions because its functions depends on the three-dimensional identity. And that's how it gets, you know, glycated proteins in your eye, in your skin, in your nerves, in your heart, everywhere. And that's what hemoglobin A1C measures

and measures the amount of glycation that also happens to hemoglobin in your blood, which we use as a marker for how bad things are. So that's one way that sugar is bad because over time, it leads to insulin resistance and diabetes, and it causes too much sugar around to damage the proteins. The other thing happens is that when you sugar, you cause a sugar spike. When you have things that are a donut or cookie, things that are a lot of pure sugar or just drinks you're talking about, they spike the sugar level.

The sugar level when you have an apple or carrot or fruits and vegetables, it increases the group of level up and down. slowly, and that gives time for insulin to go up and come down slowly. When you have a spike of sugar, the insulin level needs to spike along with it. So when insulin spikes, the sugar is taken away, but there's a lot of extra insulin still in the blood, even though sugar, that acute sugar was taken away, and then you become hypoglycemic. you become actually, the sugar levels are below baseline, which makes you hungry, which you eat again. And then the process continues.

And that sugar that spikes has been shown to be toxic, especially to the campus, which then, over time, can damage the decampus. Now, it's interesting to me that animal model aging is to give people a high dose of sugar. You know, the animal studies for aging involve infusion of sugar, equivalent of one of those repercussions you're talking about. So they do that over time. And in the brain, there's damage, there's damage to bones, damage to skin. And then they want to try to see if this medicine or this supplement works on reducing effects

of aging. That's the animal model. So just to clarify, so when they're doing trials, specifically in mice, often. If they want to induce aging, they give these large dosages of sugar to the animals. Exactly. And do you know is the breakdown, is it like fructose? Is it glucose? Is it a little bit of combination of both? Yes. The one that I was teaching about actually was fructose that they infused. And, you know, they look at the bone. I mean, the aging happens in the brain, the skin, and the eye, in the heart everywhere. So they actually,

cut the skin cells under microscope, they look at the bone scans, and similar things we see in human aging, we see in this rats and mice, which have been going through an accelerated aging process with high sugar alone. So if you want to see, for example, Mugati fatty acids help or not with the process of aging, you give rats a lot of sugar, the brain becomes an aged fat, aged brain, and then you're omega-3 fatty acids, and omega-gative fatty acids help to reverse some of the aging that happened to this case. Wow. Yeah, that's wild. I didn't know that that was one of the mechanisms of aging. And that makes sense. We've had different experts like neurologist Dr. David Perlmutter, as well as researcher, one of the top nephrologist,

Richard Johnson, who wrote an entire book about uric acid and how fructose in particular particular is something that accelerates uric acid and how uric acid is one of the elevated uric acid seems to be one of the things that's connected with brain aging which goes back to you know everything that you're talking about over here absolutely you know again i was an awesome conference in afsadam in july and we had a nephrologist you've one of the lectures to you know five thousand neurologist neuroscientists and what she was talking about dr gupta was how things that have the kidney, affect the brain. And so if you have had problems with your kidney and if a blood rea or nitrogen is high, that if you do standard evaluations of those people versus people

who don't have kidney problem, you see that there's a difference in the brain and brain function. And then the studies that people who have end-stage renal disease and people who don't, and the brains of people with renal disease is smaller than people's brains who don't have disease. So kidney, liver, bone, and the heart, these things below the neck can have a huge impact on the functions of the brain. And that's one of the things that I focus in evaluating my patients. So someone's kidney problem is very relevant to whether or not they have memory problems.

If somebody has liver problems, you know, liver detoxifies ammonium and makes, you know, clotting factors and storage of vitamins. And if your liver is not functioning, your brain will not function. And, you know, people don't always connect it to. One criticism I have of my neurology colleagues and physicians in general is that when they see a patient with member problems, they just focus, you know, is it Alzheimer's or is not Alzheimer's? They do not necessarily appreciate that the person's diabetes, obesity, kidney problems, heart problems, liver problems, are the culprits for why this patient is not as sharp as he or she used to be. And correcting those things will make these people much better.

And so to see someone with memory problems and then say, okay, you don't have Alzheimer's because you're still not lost when you're driving, so you're okay and go. or worse yet, tell them, you know, we do have a lot of memory problems. You have been forgetting things. Your wife has noticed. So I think you do have Alzheimer's disease. And then that really makes a person less likely to do things because they think life is over anyway. And they don't participate in activities because they're discouraged

because they're going to lose their marble soon anyway. And that expedites the process of brain shrinkage. and the culprits remain and changed. The diabetes, obesity, kidney problems, liver problems continue to worsen the brain. And now you have an element of giving up hope and not using your brain, which expedites the process. And then you will become a compliment it. And I think that's a tragedy. That's really a tragedy when so many people who have treatable, reversible issues end up experiencing worsening of the

symptoms because of what the doctor told them. Yeah, it's so sad when that happens. And obviously, through the work of yourself and individuals like you, you know, the goal is to put out a different vision, have a different vision of what's possible and help us go back to what would be considered normal aging. Aging is normal. We should all age and we will all age until maybe there's some nanobot prescription in the future, but at least for the time being, we're all going to be aging. The question is, are we aging in accordance to way that nature designed us to? And can we live a long, healthy life, regardless of our lifespan, of course, we want that to be as long as possible. Can we have the best health span that allows us to make sure that we're not dealing with chronic disease and premature brain aging?

You know, to put a button in the sugar conversation, because a lot of times, especially on social media, on YouTube, it's easy for people to find advice of things that can kind of feel a little bit extreme. And then people who are listening are trying to make sense of it and trying to see what it makes. sense for them. So they'll often hear people that say, hey, sugar is poison. Not knowing that like every carbohydrate that we all eat, it all turns into sugars inside of the body. Now, some of these carbs that you mentioned earlier are better because they're packed with fiber and they slow down the absorption of these sugars. Things like fruit, for example, like you're eating an apple. You're not going to get that big glucose and then eventually insulin spike that ends up happening the way you would have it with liquid calories, which is a

many guests have talked about. So everybody has a different range of their interpretation of, are they eating healthy or are they eating too much sugar? Too much sugar for one person might mean a liter of Coke a day. And for somebody else, you know, that might mean, you know, more than one soda a week is too much sugar for them. But generally, what I found to be very helpful from talking to clinicians on this podcast and I'd love to get your thoughts on it is that, you know, there's some very cheap tests that, you know, there's some very cheap tests that, individuals can do, and they're not always ordered by your doctor, but they're quite cheap. And if you ask nicely, you can get a sense of things. So one of them would be to get a look at your fasting insulin

levels. And unless of your doctor suspects that you are at a certain age or that you might be somebody that's dealing with diabetes or ones that are very educated that are sort of on the lookout for pre-diabetes, they aren't always looking for things like fasting insulin as a routine part of your blood work. And within that category, you'd also have, as you mentioned earlier, your hemoglobin A1C, which is a little bit more common from what I see than fasting insulin. And just by looking at those two and seeing and making sure you're not in that pre-diabetic range that's there, those are two measurable ways to get an understanding of essentially how much sugar you're regularly consuming in your life.

Not to be overly simplistic. There's other categories that also affect those two markers. but what are your thoughts of those two as being markers that people should make sure that they include in their regular blood work? I agree with those and also baseline sugar level, just baseline glucose level is also very helpful because a baseline glucose level of 110, 120 is really bad. It's below 100. And also important to notice that then appreciate that not everybody who has prediabetes is overweight.

There are people who are not overweight yet, and they do have insulin resistance and their baseline fasting insulin levels may be higher than anyway should be. So I do check, I don't, I usually check the baseline glucose level, and I do check the chemical A1C, and I check for evidence of inflammation, the ESR and CRP. I don't routinely check insulin in my patients myself because I feel that the information I gather from talking to them and looking at them and examining them and looking at the collection

of all the blood tests that I get from them is enough. Now, somebody who may not be responding or may be other issues in those people, I go to the next level and I order another round of blood tests. One of them would be based on insulin levels. I would check the Lyme disease. And I check for the second layer of things to do. But usually for me, baseline sugar level and a chemical open A1C and listening to people's lifestyle,

I asked them, you know, what do you eat? How much do you eat? What's your favorite food? And, you know, you get a very, you know, and people are honest because they're here to see me because they want to get better. they don't usually lie. There's no reason to not give, you know, the correct information, which they usually do. And I find those information very helpful.

So if they too tell me that they eat fast food three times a week or they have sodas, you know, every day, things like that, that to me is what needs to be corrected. That's great. Dr. Fikwi, while we are winding down for today's episode, you know, we talked a lot about the things that go wrong that make our brain say, Ouch. And we did hint and talk about a few things that help our brain and protect our brain. And to recap on some of those, we mentioned about exercise and you gave your recommendations for where you'd want people to be ultimately. I would like to add in a plug that I've seen a lot more people talking about that kind of links the conversation of blood sugar, insulin levels, and exercise together, which is there's so much emerging research that's coming out now. about how adding lean muscle mass, which is not only important to prevent sarcopenia, is something that also improves people's metabolic health. So adding in resistance training on top of, you know, somebody playing tennis, which is great, you know, playing tennis,

ping pong, all these things. Any way to be active is great. But if you can get resistance and strength training in, which is so key, especially as we start to age, generally we've seen, I saw this in myself. You know, I come from a South Asian Indian background. And, a lot of people that are in my category and ethnic minority, there's a lot of individuals that are in that skinny fat category. And even though I was quite active, I fell into that category and I turned 40 last year and I got very serious about wanting to make sure that I added lean muscle mass to my life. And the byproduct of that, I pay attention to what I eat. But I saw that my overall metabolic health improved because I was able to utilize, you know, these free flowing sugars in

my body better by simply increasing my muscle mass, which muscle is the number one consumer of, you know, these free-floating sugars inside of the body. So you've talked about exercise. We can add in strain training inside of that as well, too. You talked about the protective aspects of EPA and DHA in the context of also having a lot of these mono-unsaturated fats like olive oil as part of a Mediterranean diet. Are there anything else that you want to add in that are these key things you include in your program. Of course, you mentioned fixing sleep that are part of helping us grow the brain no matter how much damage people have done to it over the years. Yes. And I want to emphasize the fact that your brain can grow a lot in a matter of three

months. You know, I find that in my experience of dealing with patients, growing the brain is actually easier than growing your muscles. I mean, you know, you can make your biceps bigger and you do you know, you do have to put a lot of effort and you see results. But I think the kind of things we're talking about in terms of growing to hippocampus seems to me is easier to achieve that. So the efforts that you put to grow up at hippocampus can show results within 12 weeks easily. Well, we did talk about diet, exercise, sleep, stress reduction. The one thing that I'd like to point out that we haven't talked about is having a sense of purpose in life.

Please, yes, talk about that. You know, many studies have shown that people who have a sense of purpose in life are less likely to get Alzheimer's disease, even if they have Alzheimer's footprints in their brain. The brains of people who have a sense of purpose is more resilient against effects of aging or Alzheimer's disease. Now, what is having a sense of purpose in life? I think it means that you're clear about what you want to do in your life, what you want to accomplish in your life. what you want to accomplish in your life. What is it that you do that makes you happy from deep inside?

What is it that you enjoy doing if nobody's watching? And that's the sense of purpose. And I find that there are times that people have a job, they don't necessarily enjoy, they have a relationship that hasn't been working for a long time, but still stick with it. And they're just doing things to pay the bill and pay the mortgage, and, you know, they go on occasions because everybody does.

But deep inside, they're not happy. They're not happy with their job because they say, I'm doing this to pay the mortgage. I'm not doing this for the point of it. And to them, I say, you know, get yourself a one year or two year transition process. Find what is it that you enjoy from deep inside your heart? You know, if it's art and music you like, then go for it. If you're an accountant, but deep inside you like art and music, well, listen, you have 20, 30, 40 more years to work.

Why don't you find something you enjoy? And you can combine, maybe you can work for an art company and do accounting for them and then do more of the art that you like along with some accounting. But you need to make a conscious effort to align your data activities with what you find enjoyable deep in your heart. Those two need to be on the same line, in the same direction. And that is very helpful for your state of mind, for your daily experiences, and for your brain health. You know, they did studies, for example, of elderly who studied on Hopkins, where they monitored, I think, about 2,000 individuals.

I don't know the exact number of, but it's a large study. It's a large inquiry study in Hopkins. and they had one group of LLE, just doing their urnsings, and then get another group who enjoyed teaching and mingling with people to do teaching for an elementary school in their neighborhood. Just, you know, for kids that difficult with math or reading. They would just go to school and mingle with the kids and just do things because they enjoy doing it.

Control group, just they did what they used to do, you know, going to church and mingle with their friends, but not necessarily this activity that they enjoyed. And so they looked at them a year later, two years later, and after two years, they didn't MRIs beginning and the end. The normal group, the control group, had the usual 0.5% per year shrinkage in the brain that happens to everyone. But the group that had this extra activity they enjoyed

did not have brain shrinkage. The brain did not shrink, which it usually does. And now this is not necessarily a control study for sense of purpose because not everybody has that. It's a good sense of engagement and engagement enjoyable. And the people who did it, enjoyed it. If they didn't do it, they would stop. I find it's very helpful to ask yourself, what is it I want to do with my life? Which part of things I do I enjoy, which part of the things I do, I do not enjoy.

and then set it a goal in one year or two years to align your day-to-day life with the more of the things you enjoy. Obviously, you may not be able to 100% change life. But if you do change it 100%, you're a happier person, and a happier person has better brain chemistry. And one of the things that happens, your brain is that it has a pulsation, your heart has a pulse. your brain has two types of electrical activity. One that's action potential, which goes along the axon of like 200 miles an hour. That's an action potential electrical activity. But on top of that, your brain has a pulsation.

And it could be delta, theta, alpha, beta, different frequencies. It could be 1 hertz or 2 hertz or 30 hertz and so forth. And so people have a lot of anxiety, people who do things that are stress. to them are on the fast end of things. And people who have a sedentary lifestyle and they're bored and tired all time are too much sluggish brainwaves. There's the people in the middle who have good brain waves. And when the brain waves is healthy, your brain functions better. You're in a better state of mind. You're less stressed. You're less overwhelmed. You're less tired. You're just happy. You're just feeling good. You're not necessarily laughing, but you just have a good state of mind.

And that is why your brain functions better because it's not stress, it's not strained. It's just harmonious with nature. It flows with magnetic feel of the earth or whatever else is not there. You just feel in the zone. You know, I don't have a scientific way to say that, but I believe in it that when you are in line what you do, you're in that zone that makes you happier. And I know that people who are in that zone are having to have a lot. lower levels of stress hormone cortisol.

And cortisol is toxic to the brain and the campus. So that's the least benefits that I can definitely account for why that cinnamon is good. You know, like if you enjoy going to a church and go to church. If you enjoy playing golf or if you enjoy helping people or if you enjoy getting rich, you know, if you enjoy being entrepreneurial and you feel like if you were in business, you would make a lot of money, but you don't want to risk it because you want to make sure you pay your mortgage, well, take a chance. Get out there and do it. Do what you think is the right thing deep in your heart. Most things you do, it doesn't matter anyway. You know, the life goes on.

You're a minuscule person in, you know, five, six billion out there. So, you know, you're a minuscule person in, you know, five, six billion out there. So it's not, you know, just put things perspective, take it easy, you know, as my daughter would say, it's not that deep, you know. You don't take life too seriously. You just decide what is it that makes you happy. It's you and the world. So enjoy that. Set the things that you really love from the bottom of your heart. And when you're when you're aligned with what you feel passionate about, we know for a fact that your brain will be healthier. The exact mechanism, maybe cortisol, maybe your protective factors, maybe be DNA, maybe the fact that your brain waves have an effect, maybe there's more blood

flow. When you're tense, their blood vessels, your brain intense, you don't get as much blood flow. There are many physiological reasons why these things are helpful. So that's the one thing that I would add to my list. If you want to have a big, thick hippocampus, and if you want to have good brain health, if you want to reduce your risk of Alzheimer's disease, define your sense of purpose and then pursue it. Incredible advice. Our lives are a drop in the ocean, but let's make them the biggest and most bold drop by self-actuating and going and out there and doing what we want to do. Exactly. I love it. Dr. Fatui, this has been fantastic. I want to thank you for coming on the podcast.

If you wouldn't mind, give a little bit of an overview of your world, if you could mention some of your books and then also your clinic. It's out there. Is it taking on new patients? Can people sign up today if they want to check out your programs that you have available? Yeah, I have a thing three books. The most recent book is, Those Your Brain. And I do have YouTube channel and do post on Instagram and Facebook,

so people are interested that can follow me there. You know, we're talking about things we feel passionate about, and one of the things I always felt passionate about was teaching. And as much as I love my practice of seeing patients, this year I decided, you know, I am 62 years old, and I want to do more of things that I love that I've been not doing, which is teaching. So now I'm a professor at George Washington University here in Washington, D.C., and I also be teaching at Johns Hopkins. and I have turned my neurology practice in an educational center. I really want to educate the physicians along with patients about the importance of these lifestyle modifications we're talking about. I think physicians need to appreciate it so that they can convey that to their patients.

Right now, a lot of physicians follow the guidelines, which is depression, antidepressants. ADHD, take this drug. Insomnia, take this drug. And, you know, these 10, 15 minutes in and out. But I know patients, most patients want the best outcome for their patients. They want their patients to be happy and functioning well. And if they realize that these things are so important, they will have a conversation with their patients. And I think these interventions will have an impact in our economy, you know, when people's productivity goes up, when people's brain functions are better, when we have fewer cases of Alzheimer's disease, our economy will benefit from it.

So these are an important concept, both at an individual level and as a societal level, and I feel passionate about educating the whole public and physicians about that and teaching. So instead of seeing, you know, 12 patients a day and saying the same things, to, you know, 12 people every day, I've decided to follow my passion, which is, you know, educating the country, your goal. I feel passionate about these things as you can tell, and I want to spread the message, so I don't see patients anymore. That's fantastic.

But the center's still there, and they do the coaching and the training for individuals? Can individuals go there? Our website has a lot of information. Okay. You have a brain fitness calculator, so there's a tab on our website called Brain Profitfolio. You can hit a tab that tells you what your brain fitness is. There are 15 questions you answer, and it tells you the areas that are good, that you're not so good.

And then it has guidelines on what to do to improve those areas. Great. So it's a resource center. It's a resource center. I do not have brain coaches who work for me anymore. I spend most of my time teaching and public education. Well, the great thing is that your books are, quite detailed, which will link in the show notes, that people can pick them up. And many of these

interventions, sure, you might need to assemble your own team, but you can use the books as a roadmap to help do that. Maybe with your existing physician, maybe you find also a trainer or somebody helps you out a little bit and sort of a working out piece. Maybe a health coach, if you have access, and if you don't, generally, if you are willing to roll up your sleeves a little bit, a lot of these changes can be done at home, you know, and they're, they don't have the side effects that a lot of these major drug interventions do. So the side effect is your waistline is going to improve and you're going to feel healthier. And the positive side is that you're probably going to end up growing your hippocampus. Yes. The book, the most recent book I've written,

The Boost Your Brain Book, is very prescriptive. It has a lot of graphs as questionnaires, like what blood tests I recommend for patients. So you can take that to their doctor, ask them to order those blood tests, the checklist from head to toe, all the things that can affect your brain, you know, whether you have anxiety, hearing loss, vision loss, the hormone problems, there's a checklist of things. So, you know, it does have that information. I have a lot of that information on our website, Dr.Fatui.com as well. Beautiful. Dr. Fatui, this has been fantastic. We'll put all the links to the show notes below that people can find in the comment section and show notes section on the podcast. I want to

appreciate you and acknowledge you. for all your work over the years in this space, you have made the difference in a lot of people's lives and your message continues on. And my hope is that, you know, the world is in a really tough place right now. And we need more individuals following these things and being an example for those around them that this is possible. And you are definitely helping people do that. So thank you for coming on the podcast and thank you for spreading the word about what you're up to. My pleasure. It's been a pleasure talking to you. 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.

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