Dhru Purohit Show - The Hidden Cause of Alzheimer's That 94% of People Aren't Addressing with Dr. David Perlmutter

Episode Date: August 19, 2026

This episode is brought to you by One Skin, Puori, Fatty15, and Our Place.  Today on The Dhru Purohit Show, I sit down with Dr. David Perlmutter to explore why decades of brain health research may have focused on the wrong target. We dive into why microglial cells, not beta-amyloid, may be key drivers of cognitive decline, how they’re connected to metabolic health, and what you can do to protect your brain. Dr. Perlmutter also shares why many Alzheimer’s drugs miss the mark, the supplements with the strongest evidence, and the lifestyle habits you can start today to support your cognitive health for years to come Dr. David Perlmutter is a board-certified neurologist, Fellow of the American College of Nutrition, and six-time New York Times bestselling author, best known for Grain Brain and Drop Acid. He earned his M.D. from the University of Miami School of Medicine, where he received the Leonard G. Rowntree Research Award, and currently serves as an Associate Professor at the University of Miami Miller School of Medicine. Dr. Perlmutter has published extensively in leading peer-reviewed medical journals, serves on the Editorial Board of the Journal of Alzheimer's Disease, and lectures worldwide on brain health, nutrition, and longevity. In this episode, Dhru and Dr. Perlmutter dive into: (0:00) The Biggest Mistake in Brain Health (3:09) The Brain Cells That Control Your Future (5:01) Why Microglia Are Suddenly Everywhere (8:41) Dr. Perlmutter’s Controversial Claim  (11:51) Decline May Begin Decades Earlier (21:36) When Your Brain's Defenders Turn Against You (23:38) The Gut-Brain Connection (38:51) The Hidden Chemical Linked to Damage (41:58) Why Modern Life Is Rewiring Your Brain (45:30) Are Microplastics Harming Your Brain? (49:05) The Best Forms of Exercise  (59:37) The Key Biomarkers  (1:03:51) The Brain-Protective Diet  (1:16:04) Top Supplements to Support Brain Health (1:22:49) Building a Resilient Brain (1:31:08) Has the Science on Alcohol Changed? (1:36:38) What to Do If You're Already at Risk (1:43:13) Could GLP-1s Protect the Brain? (1:51:55) Final Thoughts Also mentioned in this episode: Brain Defenders: Harness the Power of Your Immune Cells to Protect Your Brain for Life Lichen Air For more on Dr. Perlmutter, follow him on Facebook, X/Twitter, Instagram, YouTube, or visit his Website. This episode is brought to you by One Skin, Puori, Fatty15 and Our Place. Quality protein matters. Get 32% off Puori Grass-Fed Whey Protein and a free shaker when you start a subscription at puori.com/DHRU and use code DHRU at checkout.  Right now, One Skin is offering my community 15% off; just go to oneskin.co and use the coupon code DHRU to save 15% and give your hair and skin the scientifically proven, gentle care it deserves. Fatty15 is offering an additional 15% off its 90-day subscription Starter Kit. Go to fatty15.com/dhru and use code DHRU to replenish your C15 levels for long-term health. Reduce your toxic load by upgrading your cookware! Go to fromourplace.com today and use promo code DHRU at checkout to receive 10% off any order. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. David Prowmutter, welcome back to the podcast. When it comes to brain health, one of the biggest challenges we have today is that we're actually focused on the wrong enemy. What are we focused on and what should we be focused on when it comes to Alzheimer's, dementia, Parkinson's, and other neurodegenerative diseases. I think that what Western medicine has done and it's really been a disservice to all of us is compartmentalized all of these diseases. saying that there's something very unique about these diseases.

There certainly are in terms of how they present. We know that Parkinson's is basically a movement disorder where we get rigidity and we get tremor. Alzheimer's more of a cognitive issue, front of temporal dementia, progressive supernuclear palsy, we could go down the list. But the part that we've missed, but now we fully embrace,

is that there is one unifying mechanism that underlies all neurod degenerative conditions. Can you imagine one mechanism involved in everything that we're seeing go wrong? with the brain. It's breathtaking. You're smiling because, you know, who knew? And it really goes kind of against the grain of my training because as a neurologist, we learn what is unique about this disease and that disease. The reason we learn why they're unique is because there are unique patented approaches pharmaceutically to treating each and every one of them. And the idea,

though, is that the treatments for these diseases focuses on their manifestations, on the smoke. And now we recognize that the fire that is underlying all of these conditions is exactly the same, and it's an issue related to the immune system of the brain. And I'm going to say this several times in our time together. Who knew? For me at this stage of my life, to recognize that everything has converged on this unifying principle for what makes a good brain go bad across all diseases is exactly the same. Different manifestations. I get that. You mentioned as well, we were chatting earlier that you interviewed Dr. Ray Dorsey, who talked about how in Parkinson's, he calls it a man-made disease

because it's related to exposure to toxins that target a certain part of the brain. But guess what? It targets the immune system in that part of the brain that makes dopamine that manifests as Parkinson's disease. The same immune, what we call dysregulation or screw up, if you will, happens in Alzheimer's, in all the neurodegenerative conditions. That is fascinating for a person like me at this stage in my life because it kind of unifies everything that I've talked about for years. Many of our topics that you and I have conversed about over the years.

The microbiome, gluten, high carbohydrate diet, refined carbohydrates all converge on one thing, how they affect the microglial cells. We're going to use that term a lot today. Those are these cells of the brain's immune system that become changed from being supported, to being destructive, from being friend to being foe. And that's a unifying theme across every neurodegenerative condition that you can think of. You actually say in the book that microgleal cells, these key cells that are part of the immune system

that you're talking about, they're actually maybe even more important than neurons when it comes to brain health. And of course, we all know that neurons are important, but what do you mean by that? Well, neurons have been getting in all the attention for years. You know, we don't want our neurons to do. degenerate, that's for sure. But the degeneration of neurons is way downstream. What happens first is

loss of synapses, the connection between neurons. That's easy prey for the microglial cells. So when these microglial cells, our brain immune cells shift from being, we call it M2 supportive to being M1 destructive, the first target are the synapses, the connection. So loss of connectivity. Secondarily, then the were horses of the brain, the worker bees, if you will, are threatened and are destroyed. So really what's in charge here are these microgleo cells, the immune cells. And ultimately, that makes sense because our entire immune system is really doing so much more now that we realize it than just being on guard and the firemen staying in the firehouse waiting for something that the immune system would do, like an infection or trauma or a stroke. They're actually involved

in upkeep in keeping the brain healthy and functional all the time. Yeah, they go into a, they shift in their configuration when there's a threat, but they're always involved in maintenance, in nurturing our synapses and neurons and really allowing us to grow more synapses and neurons to build a better brain. The important concept that we're going to unpack today is that we control that. Our lifestyle choices determine whether those microglial cells are working for us or they've turned our backs on us. That's what's so empowering. You know, there's a lot of people that are listening today that would consider himself, hey, I'm pretty smart or hip to a lot of the brain health conversation. Why have I not heard my doctor or looking around? Like, why have I not

heard this term, microglial cells? What's going on? Why is this the first time that I'm hearing about this? This is leading edge right now. This was in Science Technology Magazine, the number one development in neuroscience of 2025 was the discovery that these microglial cells are really the player, really what we need to pay attention to. In Alzheimer's, the focus has always been on what? The accumulation in the brain of something called beta amyloid. So we've had this amyloid hypothesis, and I'm glad we still call it that, because it's a hypothesis, which means it's not a fact. We've accepted the fact that the accumulation of beta amyloid in the brain is the cause of Alzheimer's disease, and let's be clear and make sure you read my lips, nothing could be further

from the truth. That's not what causes Alzheimer's disease. And how do I, why do I say that in Brain Defenders? Why have I been saying it for years? I was just validated. This whole notion that it's not the cause has just been validated. A Cochrane analysis came out a couple of, actually, several weeks ago in 26. And it was a review of all of the major recent. of the drugs that target beta amyloid, the theoretical cause of Alzheimer's, get rid of the beta amyloid and you should cure the disease, right? The Cochrane analysis showed that while the drugs do help reduce amyloid and brain, they have no effect on the inexorable downhill slide that Alzheimer's patients have cognitively, experienced cognitively, i.e., the drugs that target beta amyloid do not work.

According to the Cochrane analysis, this is 20,342 individuals that were evaluated in 17 studies, 18 months each study, the effect of these drugs in helping people slow their decline was, quote, trivial, end quote. And yet 25% of these individuals in general experienced significant, perhaps life-threatening. And in fact, sometimes people actually did die. changes like hemorrhage and swelling in their brains from using these drugs for me, as I call out of the book, this is a direct violation of the notion of premium non-nosaire, above all, do no harm. They're harming people, they're not benefiting them at all, and we can do better. So this is about keeping the brain healthy in the first place. And we'll talk about that today. How do you keep people from being in a situation where they are desperately seeking something to turn this around.

And as it relates to anything pharmaceutical, nothing exists, as you and I have this conversation right now, nothing at all in the world of pharmaceuticals can turn this around. And yet, we know that when we target microglia, when we talk about those inroads to helping our microglia return to being supportive M2 and away from being destructive M1, we can bring about change and can, in fact, reverse Alzheimer's disease with this type of intervention. Yeah. And we're going to get to that. The top things that hurt the microglia that are around in our modern day world, the top

things that help the microglia. Before we do that, though, just want to double tap on a couple things you mentioned. You had a pretty controversial video that you came out with recently saying that, even if I had Alzheimer's, I would not take any of the drugs that were out there today. 100%. I mean, I would ask you. I'm going to offer you, you have Alzheimer's. You've just been diagnosed. I'm going to offer you a drug, a monoclonal antibody to target beta amyloid. Its efficacy is minimal at best. And it might slow your decline after 18 months by a few weeks. But on the other hand, it's associated with about a 25% risk of brain hemorrhage and or swelling.

What do you want to do? Yeah, right? But I'm going to present it to you and say, by the way, researchers at Harvard, including Dr. Rudolph Tansy, joined by Dr. Dean Ornish, have recently published a study where they did lifestyle intervention on a group of 57 individuals, studied them for 20 weeks. They were actually early Alzheimer's diagnosed fully. diagnosed patients and not only was the disease arrested in these people, but they improved in their cognitive function. You know, the Alzheimer's drugs are designed to maybe slow the progression.

These people improved. What do you want to do? Your choice. Absolutely a lifestyle. You bet. Yeah, you talk about in the book that a lot of times these drugs, there's all these politics around them, especially with the Alzheimer's drugs, that they're approved because even though the bodies that are out there, the government bodies that are out there, know that the data is not good. They're saying, well, we need to have encouragement for the industry to at least keep on progressing in the right direction, but it gives people a false hope is what you're saying. Yeah, I feel like I should fan the back on my neck right now because whenever I hear this, it just gives me a bit of the willies because, you know, originally the first amyloid targeting

so-called Alzheimer's drug was, they had a, panel of 12 experts review it. And the vote was, one abstained, one voted in support, and 10 said, no, it doesn't work. We're not going to prove it. What did the FDA do? They approved it. And I'm not, you know, making this stuff up. I wish I were because it wouldn't have been true, but it is true.

That's how it's how it played out. I'd rather light the single candle than curse this darkness. You got to curse the darkness a little bit so people get what's going on. But the study I quoted to you earlier from Tansy at Harvard, who's heard of that, right? And yet these amyloid drugs are promoted on television every evening with the evening news. You know, if mom or dad has been diagnosed early Alzheimer's, there's hope for you. And it's one of these beta amyloid targeting drugs. They should say that there's a drug available for your mother or father, but they don't work.

Call it like it is. That's what their data published in the New England Journal of Medicine, shows us that the effect is trivial. The Cochrane analysis that just came out said the drugs basically don't work. Those are the facts. It's not like your guest on your program today has to make this stuff up. You know, there's another super important part of the conversation that we need to address is that we have a lot of people who are listening today who are in their 30s, 40s,

even, you know, early 50s. And they think, wow, okay, I'm interested in this topic because I want to make sure that my parents age healthy. But a super important part of your book and your narrative is that this damage that expresses itself in terms of a disease that we diagnose, maybe at a later stage in life, and give it a name like Parkinson's, Alzheimer's,

or even some other brain immune diseases like MS that are out there, which do impact a lot of young people. We think of them as diseases that older people get. But the fire starts in our 30s and in our 40s. What do you mean by that? Let's unpack what you just talked about. You know, and I've quoted the book, John Kennedy said that the time to fix the roof is when the sun is shining. I've probably used that quote on your podcast and it past as well because I love it.

Because we can't wait for it to start raining because in Alzheimer's, what does that mean? Okay, you know, somebody comes to your office as a neurologist and says, you know, I'm forgetful. We do neurocognitive testing. We say, well, you have mild cognitive impairment or even early Alzheimer's. that disease has been making its way for 20, 30, perhaps 40 years. So it takes us to a topic called immunometabolism. The immune system is highly influenced by our metabolic health, immunometabolism. And you'll recall what we are talking about today is the brain's immune system,

these microglyle cells, that are so deeply influenced by their metabolic health. and their metabolic health is a reflection of your total body metabolic health. So when our metabolism isn't where it needs to be, when our blood sugars are rising, when we're gaining body weight, when our blood pressures are out of control, when we have dyslipidemia or issues with our blood lipids, these are all characteristics of metabolic syndrome, then the microglia respond and what do they do? They shift from being friend to being foe,

and this sets the stage for brain degeneration. That doesn't happen quickly, but this is the events that begin, these are the events that begin in our 30s and 40s when the seeds are sown. So that's why what you just brought up is fundamentally important for people in your generation to realize that you've got to remain metabolically intact now because you'll be 70 before you know it. And if you weren't metabolically intact throughout these decades, then you will begin to have these issues.

and it goes for heart disease, it goes for cancer risk, and it goes for brain degeneration as well. So the message is too full. Number one, that people in your generation, 30s and 40s, need to rein in their metabolic health and get away from what I call this metabolic mayhem that is so pervasive. You know, in America, 94% of people have at least one marker of metabolic dysfunction. It means what? 6% of American adults are metabolically intact, meaning the rest are set in the stage for every issue I just described. The other issue that I think is really important is that it's not just

about risk of Alzheimer's decades from now, it's about how your brain is working right now as well, that everything we are talking about today is going to influence the functionality, the efficiency of your brain function today, allowing you to engage the world with the highest level of interaction or not. So if you want to perform at peak performance, then you will pay attention to everything we will talk about in terms of metabolism, in terms of what threatens not only the brain in terms of its destiny, but your brain in terms of its functionality right now. What are like two, three, four examples of things that people might be dealing with in their 20s, 30s, 40s, that is an indication that your brain is actually maybe not working as

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I've noted that I'm not as sharp as I used to be. I can't multitask as if the brain actually does multitask, but I can't be involved in too many things going on at once. I know I'm supposed to do something, but I forget why. Walk into a room and wonder what I'm supposed to do when I get into this room. You know, people's names, Wi-Fi codes, you name it. And, you know, these are complaints that we're hearing from younger, and younger people. And I think it's a manifestation of a lot of things converging.

Metabolic health being at the top of the list. But certainly, I think the threats are, overall, people are sleeping less and not only less from a time perspective, but in a less restorative way. I think life is certainly more stressful today. And we'll talk about that a little bit later. What is the effect of stress on our microgleal cells? everything that we talk about, we can look through the lens of the microglial cells. Stress, not getting them asleep, not getting enough exercise.

What does our diet look like in America today? We used to, you know, the joke was sad, standard American diet. That became the Western diet is now the global diet. You know, here in America, 60% of adults' calories are coming from ultra-processed foods. Why is that a problem? It's a problem because a recent study came out and showed, Now, this is a study that followed 1,375 individuals for 12.7 years. These were individuals who weren't necessarily, they're adults,

average age 68, not necessarily metabolically intact, but didn't have dementia. And demonstrated that in those individuals who had one serving as an average, one handful of chips per day of ultra-processed foods, their Alzheimer's risk increased 13%. 10 or more servings a day, risk increases 2.7 fold, 270%. So food is an issue. So all of these inroads do what? They target the microglial cell, shift them from being supportive brain defenders

to being the biggest threat our brain could imagine going around and destroying things, creating free radicals, increasing neuroinflammation. Think about what I just said, that these, cells, once they shift to being this M1, increase inflammation in the brain, and that inflammation, those chemicals of inflammation called cytokines, go back and threaten more of the M2-support of microglia and shift them. So it's like, it's like night of the living debt, you know, it's like the zombie cells that are creating more and more of themselves, and it spreads to the brain like a cancer. So it's crazy for people to understand who are listening. They're thinking

And this part of my body that's so crucial to keeping me healthy has gotten out of whack and now can become your biggest enemy, so to speak, internally. It's turned against you. And it starts attacking your own systems, your own cells, and you are being broken down by something within. Is that right? Is that accurate? Exactly right.

I mean, we do need the activation of our microglial cells at times. We need them when we have a brain infection or brain trauma. But the key is that once the firemen have done their job, they've got to go back to the firehouse and polish the fire engine, do good things. But they don't. And what keeps them being destructive after an event, after mild head trauma, for example, is the fact that we're metabolically targeting them or there's inflammation elsewhere in the body that has targeted them.

That's a great place to go next because that can come from the gut. inflammation that keeps them in their destructive modality, not allowing them to resume being supportive. And that is the fundamental. Let me give an example. Chronic traumatic encephalopathy. What in the heck is CTE? Well, that is the almost uniformly fatal brain disease

that people involved in contact sports get, like football players. Multiple blows to the head, shifts the microglia from being supportive M2 to being destructive M1. and now they're not playing football anymore, but that destruction continues. No more blows to the head,

but the destruction continues and ultimately proves fatal. So, you know, the mission in this situation, we see other things that keep our microglueal cells in M1 destructive like long COVID. We know that's what's going on in Alzheimer's. So the mission is to shift these microgluelea cells back to being supportive.

That's the reactive mission, but the proactive mission is to keep them from shifting in the first place. Yeah. You mentioned sleep and exercise, which of course, when we don't sleep well, all sorts of things go wrong inside of the body. When we don't eat well, most of the people are hip to this podcast that all sorts of things happen to the body. And it goes even a little bit more deeper and specific than that. We're going to get into that. You mentioned the gut. So let's get into the gut. How can our gut health either help or hurt these glial cells and in turn impact the brain in the body?

This is, it's a revelation because I wrote a book years ago called Brain Maker that was describing the so-called gut-brain connection. What the heck? The gut, are you kidding me? And I mean, now we all talk about it like, oh, of course, the gut-brain connection. But back in the day, in this book, my colleagues said, you know, this is ridiculous. How could the gut have any influence on the brain? Now, of course, it's self-evident. But when we experience changes in our gut bacteria brought on by the foods that we eat,

or the medication that we take, whether we're taking proton pump inhibitors or non-steroid anti-inflammatories or certainly antibiotics inappropriately, which is certainly quite common, we change the function and diversity of our gut bacteria. So one of the fundamental tasks of our gut bacteria is to maintain the lining of the gut. In addition to many of the things that we will talk about that actually influenced the microglia and even gene expression in the brain, who knew, but let's just focus for a moment on the maintenance of the integrity of the gut lining. And, you know, for years we've been talking about the so-called leaky gut.

And, again, you know, that was laughable years ago. Now, again, as part of the modern parlance about what goes on. But the main issue is when we threaten our gut bacteria, we can threaten the lining of the gut, therefore things get out of the gut that shouldn't. This challenges the immune system and what does it do? it increases the production of inflammatory chemicals called cytokines, interleukin-1-beta, 2m, tum endocrinicin factor alpha. These things make their way to the brain,

and there are receptors on our microglia cells. When they are stimulated by these cytokines, they say, whoa, we need to shift. So inflammation anywhere in the body is a powerful way of triggering our microglia away from being brain defenders to being ultimately brain destroyers. that finally allows us to understand why is it that we see these significant changes in microbial diversity, for example, in the gut that relate to Alzheimer's, that relate to Parkinson's, can almost fingerprint the microbiome now to predict Alzheimer's and predict Parkinson's. We're almost there. Some researchers are claiming to be able to do that now, or at least significant risk. And, you know, this is a very straightforward, powerful connection between what's going on in the gut and what's going on in the brain.

But even more so allows us to understand why it is that there is such a dramatic risk, for example, of Alzheimer's disease and people who chronically use acid blocking drugs that are called proton pump inhibitors. Now, we've known that data for an awful long time, but we didn't know how it worked. there's a 23% increased risk of Alzheimer's and incurable disease with respect to pharmaceutical intervention in people who chronically think they got to pop this over-the-counter acid blocking drug because they don't do well when they eat sausages. My vote is don't eat sausages or whatever the food may be. There's a 32% increased risk of stroke. Think about that. So why does it happen? And we've puzzled over that for years. It happens most likely because of the changes in the microbiome that occur, that not only changes our body's metabolism, but again, because of this

disruption of the lining, leads to increased inflammation in the body. And guess what? The brain is part of the body. These cytokines, inflammatory mediators, do very readily cross the blood brain barrier and target the microgleal cells. They're on guard. They're waiting to be clued in as to what's going on, and they shift, and they begin this process of neuroinflammation. As I mentioned to you earlier, that inflammation further targets otherwise supportive microglial cells and shifts them to the dark side. It's crazy. You know, in the book, you have a breakdown of some of the things that can impact that, right? So ultra-processed foods are definitely things that can impact that.

But you also talk about environmental factors that can disrupt the gut and impact the lining and cause this overreaction. So that would be things like pesticides that are there. even like additives inside of food ingredients, different gums and carageneans and other things like that. You know, the data's mixed, but when it comes to animal models, you know, it seems like there's a very clear understanding that these disrupt the gut microbiome. What are some other things that are there?

Yeah, you bring up the animal model idea, and sometimes it's the best we have. Yeah. Above all, do no harm. If all we have, as it relates to anything you've mentioned, so far happens to be an animal model, then, or at, or epidemiology, that doesn't mean we shouldn't pay attention to it. And it takes me to glyphosate.

And glyphosate, as we know, is an herbicide. It helps get rid of weeds. And it's also used on a variety of crops now to help them dry out more quickly so they can be brought to market more readily, even crops that might not necessarily be genetically modified. So a lot of the research that raises the red flag as relates to glyphosate is animal research. And it's profound. I mean, it's not as if you're,

you're going to do a double-blind interventional trial, and half the group gets a dose of glyphosate, and the other half doesn't, right? Who's going to, you know, it's like, we say it's probably a good idea to wear a parachute if you jump out of an airplane, but we can't really do a double-blinded trial. It wouldn't be even blinded.

You'd pretty well, well, you could wear the pack with nothing in it, I guess you wouldn't know when you jumped out of the plane. But we know that people exposed to glyphosate from the epidemiology research, there's a significant increased risk of Parkinson's. if they live near agriculture where glyphosate is being used. I have a significant increased risk of Parkinson's, and children born to mothers living near these agricultural concerns

where glyphosate is used have a significant increased risk that their child will develop autism. So that's not an double-blind interventional trial in humans. I get it, but I sure as heck can't turn my back on that information. And it's got to be part of my messaging as I put in this book. People need to know that. And it's been part of the way that we've explained science throughout the history of medicine.

People forget that the research that smoking causes cancer is from strong epidemiological studies that are there. It came from that. And I've been challenged by this so many times that, well, there wasn't a double-blind placebo-controlled trial, which is the gold standard. Well, I think it's the gold standard in the context of using certain. medications to treat a problem to bring about some benefit to a patient, does this drug work to benefit a patient or not? I get it. That's when you would use a double-blind placebo control interventional

trial. But for looking at the threat of something, that doesn't, that's not what you do. You look at history, look at epidemiology, and you look at the animal research. And that to me is good enough for me to testify, as I will be testifying in the next couple of weeks, that glyphosate happens to an issue that we should be paying attention to. Well, let's spray glyphosate on our crops because glyphosate targets a certain metabolic pathway in plant cells called the shikimate pathway. And it destroys plants that are using the shikamate pathway metabolically. And therefore, if we can modify these plants in such a way that they don't have this pathway, then they won't be damaged by the glyphosate, but the weeds will. Okay, great.

But it turns out that it was discovered that the Shikamate pathway also is in bacteria. What we were told by Mount Montana, who was the manufacturer at the time, was that, well, to be clear, human cells don't have the Shikamate pathway, so we're good. We're good to go. Well, yeah, but we are 10 times more bacteria than we are human cells. Are we not? Answers, yes, we are. And it turns out that many bacteria living within your gut, have the shigimate pathway.

And the idea that glyphosate has already entered your body, and I can say that it has drew by about 93% certainty, and that it may be affecting your gut bacteria, I think is a clear and present danger that we've got to pay attention to. Again, above all, do no harm. And, you know, the idea that we need glyphosate right now as a matter of, to keep, you know, the ability to grow crops,

It was deemed important to national security of our infrastructure of food by executive order. You could see I saw that it kind of came back a little bit on that, so it wasn't offensive to certain. Having said that, what's interestingly observed in America now is that our incredible overuse of glyphosate for the past couple of decades has led to the development of order called Roundup resistant crops. What does that mean? It means that these, actually the, actually the Weeds are developing genetic mutations such that they are no longer dying in the presence of glyphosate, roundup-resistant plants. So what have we done?

We've had to pivot away from using glyphosate to something more threatening called paraquot. Now, paraquot is really interesting. Back in my day, the government was spraying marijuana fields with paraquot. And so people who were buying marijuana were talking about, oh, we don't know if this has been, they called it laced or contaminated by Paracquot. It was a subject of conversation back in the 70s that many people would have.

Is it Paracot laced, right? So Paraguad is now being used as an herbicide on our crops. And why does that rub me the wrong way? Paracot is used in the experimental laboratory to create Parkinson's in the laboratory animal to study Parkinson's disease. You need to induce it to a laboratory mice. This is what you use.

And we're using it on our food. Something's very wrong with that picture. That we're using what scientists used to create Parkinson's in the primate model on our food. So I've actually made a slide that I used in my presentations of these aliens. It's animated. They fly down.

They land and their UFO lands and they're talking to scientists, and they're asking the science, you spray poisons on the food that you eat? Big question mark. Yeah, that's what we're doing. You know, the book is called Brain Defenders, and you're really talking about the microglia, but in a way also this conversation is like,

as individuals who are being proactive with our health, that are seeing the trends of Parkinson's and other neurodegenerative diseases on the rise, how do we become defenders in our own life to protect ourselves from all these insults that are impacting our gut and then making their way up to the brain because they're turning our immune system against us. And so you're really teaching us through this book of,

hey, we got to be part of the conversation is we have to know how to play defense to avoid these things that are hurting the brain by hurting the microglia. Every organ, every muscle, every part of your body depends on your cells doing their job well. The question isn't how long you'll live. It's how well your cells.

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The threat of Paracquot and how it causes Parkinson's in the laboratory animal and I promise I will segue back. You probably want to, how are we going to connect this? I'm going to connect it through the notion of immunometabolism, our central theme of the day. And that is that the function of these immune cells, friend or foe, depends their immune cells, microglia, depends on their metabolism,

how their mitochondria energy producers are working. Paracot is a mitochondrial toxin. That is how it ultimately leads to Parkinson's in the laboratory animal by threatening the function of the mitochondria in the microglial cell, threatening their metabolism that changes their, we call it their phenotype, whether they are friend or foe, M2 or M1. So anything that threatens mitochondrial function will polarize our microglia away from being supportive to being destructive.

now that allows us to unpack your question. Because then what threatens your body metabolism will threaten the metabolism of the microglial cells, their mitochondria, and therefore set the stage for brain degeneration. And as I mentioned earlier, not only brain degeneration in the long run, but in the short run, compromise your brain function today. This is the relationship that we've been long wondering about between lack of restorative sleep and feeling goofy the next day, making bad decisions the next day,

having elevated blood sugar and insulin resistance that next day, having higher levels of inflammatory cytokines in your body to threaten your microglia that next day. It is this relationship between eating the ultra-processed foods and Alzheimer's risk. Why? Because this ultimately threatens metabolism, threatens the mitochondria, the energy producers in your microglial cells because the M1 threatening microglial cells are no longer using mitochondria

to make energy. The mitochondria quit working. You use another form of energy production, much less efficient, called glycolysis. So as opposed to producing a little technical here, but it'll be on the quiz, as opposed to producing 32 molecules of energy ATP

for unit of glucose, fuel, You're only through glycolysis producing two. So the energy failure of the mitochondria is what induces these microclioc cells to shift. There's a lot of things going on here, a lot of moving parts, but suffice it to say that all of the things that you mentioned, the diet, didn't mention lack of doctors, but a huge player, lack of restorative sleep, lack of socialization with our fellow person, fellow individuals, leads to ultimately changes in the metabolism of our microglia cells,

shifting them to being threatening to the brain. Some of these things have existed throughout history, right? We've had very stressful times throughout history. We've had periods where people throughout history, you know, people have become parents, they don't get a lot of sleep. Some families, you know, I think my grandmother, my great-grandmother had like 11 kids, you know, some people have been their entire life.

So these things that we're talking about here, they've existed previously. And, but something unique is going on in today's environment where not only we have the things that we normally dealt with as human beings, like stress that can come from major life events, like losing a family member, stressful, you know, situations, etc., you know, lack of sleep, even some environmental exposure of toxins that came from

just cooking outside by the fire and charge. your food and, you know, whatever it might be. But today, there's a whole new level of insults that are on top of those that we're used to. And it seems that those insults, you mentioned some of them in the book, obviously poor diet, alcohol, medications like these proton pump inhibitors, which have all these downstream impacts, accelerated aging through exposure to environmental toxins and pesticides. So did I get that right that? Sure, we've had some of this stuff, and there have been pressures on our body and our brain in the past.

But why all of a sudden are we seeing these explosion in these neurodegenerative conditions is we have a whole bunch of new things on top of it that are really putting us in this perfect storm of brain diseases. The fundamental here is something I call environmental evolutionary mismatch. And you're right. I mean, as hunter-gatherers, sometimes we wouldn't be able to find food or they'd be stressed. We'd be challenged by an animal or another tribe. There were stresses. But it wasn't this constant bombardment of our entire physiology to various stresses, whether

they are emotional, social, or chemical day in and day out. And some of them are, you know, certainly just part of living in the 21st century. Life is stressful now. A low level of stress is a good thing for the human body, as a matter of fact. But it's this constant bombardment of our physiology, the likes of which we've never experienced, that is leading to the microglial cells and immune cells throughout the body, not being able to recover. So a little level of stress is good. We experience a stress.

We call this hormesis, the upside of stress. When you exercise, that's a stress to your body, and yet then you're done and your body can recover. But the bombardment by chemicals for which our detoxification systems are not going to provide us an out, the lack of restorative sleep, the constant social stresses that we impart upon ourselves by, you know, the constant comparisons to what we think are our goals via social media, it's relentless. And our bodies don't have a chance to recover. and our microgluele cells do not have a chance to revert back to being supportive. So we do have the ability to deal with stress,

but the 10,000 chemicals that our bodies are exposed to all the time that are brand new, we don't have, through evolutionary perspective, that detoxification ability, for example, to deal with the glyphosates of our world. There was one example that you had where you talk about, you know, everybody's now thinking about or at least heard the term or focused on microplastics. Talk about microplastics and these glial cells, these microglial cells. Like what is some of the stuff that you found out about that? This is a very leading edge kind of discussion.

I mean, we don't know what the downsides are going to be when 0.5% of the brain is plastic. This kind of puts a new spin on the term neuroplasticity, right? That your brain has plastic in it. Think about that, that the amount of plastic in your brain is about the same as you'd see in a plastic spoon. Somebody would give you a plastic spoon. You have that much plastic in your brain in the form of very, very minute particles that are irritating just from being particulate matter in your brain, on the one hand. And on the other hand, are made with chemicals, plasticizers, etc., things that are endocrine disruptors that are now exhumated. in your brain doing, we don't really know what.

So the research has demonstrated much higher levels of plastic in the brains post-mortem after someone has died and they're looking at their brains in individuals who have Alzheimer's disease. And so there's a direct correlation between their cognitive function and their rate of decline of cognitive function and the amount of plastic in their brains. So we really don't have the ability right now to measure the amount of plastic in somebody's living brain, though we have the ability to measure how much is in their blood, and these studies are ongoing right now. It cannot be a good thing.

Are there ways to filter out plastic, microplastics from your blood? There are. There are filtration plasma fresis techniques to get rid of, or at least significantly lower the amount of plastic microplastics in your blood. Do you offload the microplastics in your brain with that type of treatment? I don't think it works that way. I wish it did. So I think for now we've got to drink out of, and I'm very happy to see a glass cup, not a plastic cup, and opt for ways that I describe in brain defenders to reduce our exposure.

And it's very, very challenging. Yeah, they're pervasive, but there are things that we can do. I think that, you know, not getting takeout in plastic. When you get hot food that arrives in plastic containers, I think there's a 30% increase in these thallates and other ingredients that are plasticizers that are part of bisphenol. Reverse osmosis filter, right?

A lot of, you know, big municipalities. They don't have the ability to remove plastics. But do it in your home. Yeah, do. Put in R.O. system. We do. And we live, you know, in the two places we live, both have, well, one is on a boat. We have an R.O. system. So we make fresh water from the ocean through R.O. and drink it right out of

tapping. What could be better than that? Good quality air filter. That helps out too because a lot of these nanoplastics are floating to the air. Are they collecting dust? EOCs, you're right. And these PM2.5 particles that we'll talk about in a moment. But, you know, we have an air filter in our bedroom that not only filters the air in the best way possible, but is monitoring the air. So if there's suddenly a wildfire nearby or where we're getting the smoke, it doesn't even have to be nearby. That's an important point. This air filter will tell you that suddenly you're, you're,

air quality has declined, and it turns itself on at a higher rate. Amazing. Do you want to give a shout out to the brand? The brain is called lichen air, L-I-C-H-E-N, like the lichens in the forest, lichen air. All right, we've talked a lot, and we probably still have a few more things to do. When it comes to things that can insult the body and hurt the brain by impacting our immune system and then confusing these glial cells that we have, these microgleo cells. but let's talk about things that we know

that genuinely can move the needle forward. And I think the first one to put a little bit more pull the thread on is everybody gets it. Okay, exercise is important. It's important for your heart. It's important for your metabolism. But we often underestimate how much we need. And sometimes there's people that overestimated.

They think they need to be in the gym every single day lifting weights. And that's the way to get there. So talk to us about neuroprotective exercises. What is the mechanism of how they end up supporting the body and the immune system that you've been describing? And how much of it do we need to actually stay healthy? Well, let me answer the last question first. How much do we need to actually stay healthy?

The very important point is that any exercise is going to immediately benefit the brain. That means that if walking to the mailbox is something new for you, that's going to actually help your brain. One study published in Journal of the American Medical Association looked at, followed people for a number of years, giving them in those days was a pedometer. It was a tempest you'd wear that would click every time you took a step. And it found that the benefits began by just taking a few steps a day, adding that to your program. The sweet spot in that study was just close to 10,000 steps a day. We've heard that number before. It turns out it's been validated.

So now to answer your first question, then we'll get to number two in just a moment. and that is we have to look upon muscles as being endocrine glands. You know, we think of our endocrine glands, the pituitary, the thyroid, the adrenal, and the definition of an endocrine gland is one part of the body that secretes a chemical that influences another part of the body. It turns out that that's what the muscles do. They create various types of chemicals called myocines. Kinds means that they travel somewhere.

Mayo means muscle. and these chemicals make their way throughout the body and influence metabolism. They improve metabolism. They actually target something called AMP kinase, which is how metformin, a drug for diabetes actually works. And in so doing, allows our insulin to work better. We become more insulin sensitive, less insulin resistant. Our blood sugars tend to normalize.

We burn more fat than we would have otherwise, simply because we're exercising. So the notion that exercise is good because it burns calories, therefore we're going to lose weight, is a bit myopic. It's also good for us because it's targeting metabolism. It's turning on our mitochondria. It's helping us to use fat as a fuel source. It's balancing our blood sugar.

It's balancing our body metabolism. And recall earlier that the metabolism of the microglyle cells, the brain's immune cells, mirrors your body metabolism. So already you see how exercise benefits the brain and targets the microgleo cells, right? But they also do other things. So there's another chemical secreted by the muscle called irisone. ERISN makes its way into the brain,

and when it gets there, it triggers the brain to produce something called brain-derived neurotrophic factor. So for a long time, we've mentioned that, well, when you exercise, you increase BDNF, it actually is not BDF from the muscles that makes its way of the brain. It's BDNF that's secondarily made in the brain. What does BDNF do?

First, it helps keep our microglia in their M2 supportive configuration. Second, it nurtures the growth of synapses. Connection, that's what we really need in the brain. It nurtures the growth of new brain cells. Who knew? We can grow new brain cells. And importantly, it shores up the blood-brain barrier. So this really sets the stage for the discussion

as to why exercise is one of the most important things you can do for your brain every single day. Can you overdo it? I think that was question number two. Yeah, you can. I mean, when you overdue exercise, you get to a point of increasing that stress that we mentioned earlier, or medic stress being good for you, to the point that it's a little higher on the stress scale and can be more destructive rather than supportive. So I think what is too much for a person, and I can't make that recommendation. It's a very personalized recommendation. So, you know, for me, running a marathon today

would be over the top, too stressful because I'm not trained for it right now. But for a person who's running, you know, 18 miles a day, and you say, okay, tomorrow you're going to run a marathon. That's not too much out of range for that individual. But by and large, you know, we want to have about 180 minutes of exercise a week for the general population. And again, these are recommendations you should talk to your health care provider about.

Now, what type of exercise should we engage? It turns out what's best for the brain is a combination of both aerobics and resistance training, i.e. weight training or bands or using machines. And, you know, that means probably about an equal division. I tend to do a little bit more aerobic than weight training. I do weight training about three times a week, three to four times a week. And now I'm actually doing both pretty much every day. That's one of the most important things you can do for your metabolism and for your brain,

which certainly depends upon your metabolism, because again, your metabolism is picked up by your microglyle cells. If you're metabolically intact, they're going to be on your side, they're going to be brain defenders and you're going to dramatically reduce your risk of Alzheimer's disease, a disease for which there is no pharmaceutical fix by simply exercising every day. It may reduce your risk of Alzheimer's, in addition to engaging other lifestyle factors, by as much as 50%. Think about that. Cutting your Alzheimer's risk in half by simply looking at lifestyle choices.

That was published in the journal The Lancet, looking at 14 variables, exercise certainly being one of them. So this notion of being sedentary or being just sitting on your rear end for the course of your day, because you're working or you're just lazy, sorry to say, is not good for your metabolism and therefore not good for your brain. So what I see interestingly, and you know exactly what I'm talking about, people that I'm working with or interviewing me are on a treadmill while we're on a virtual call. And I think that's just over-the-top fantastic.

You know, we're seeing that more and more, right? People get it, that spending time, it's called sedentarity. Sedentarity is the new smoking. It's a huge threat. And, you know, as connected we are these days and the ability that we have to simply open a laptop and do your work, it makes it so easy just to, you know, say in this position all day long and not do the exercise bar. You know, we as humans were very active in our quest to find food, to chase animals or

find food on the ground. It's been part of our evolutionary imprinting on our genome for as long as we walk this planet. Now suddenly, you know, we don't have to do that to get food. We don't even, we don't even have to get up. We can order online and have it delivered and put, brought on to the table just about. So it's a big issue, but, you know, this is a hugely important part of the Brain Defenders program. An interesting study was published last year in the Journal of the American Medical Association. You know, not really an out-there journal, right? JAMA. And it was called the pointer study. The pointer study followed for two.

years, 20,111 individuals showed that these individuals who did not have cognitive impairment, but did have some metabolic challenges. So these people are cognitively intact and never had a stroke. And what do they find? Well, they developed two groups. One group with the interventional group met with a counselor or somebody to help them intervene in their lifestyle choices during the two-year period, I think it was 36 times, and most of those were virtual, guiding you in terms of how to cook your dinner, what you should buy at the grocery store, how to eat those foods that you prepare, how much exercise are you getting, how are you managing stress, and how are you socializing with other people?

The other group had only six interventions with the group, the counselors, but got the same information. They gave them the printed information that, here are what you should do, basically good luck, but we're going to touch bases with you, I think it was four or six times during the two-year study. And what do they find? So these individuals average age, I think, was 68.7. In two years, you expect those people, if you're carefully checking them cognitively, are going to experience some level of decline.

As we age, we generally see in people, especially those metabolically not where they need to be, to decline. The people who had the very vigorous hand-holding intervention, had a dramatic improvement, not stabilization, improvement of their cognitive function. And here's the part of the pointer study, and for people who want to find it, put in JAMA and pointer study

and its open access, you can read about it. The group that did not have the handholding wasn't really guided in terms of what they should do. What happened to them? They improved dramatically. Think about that. They were just given the information and basically said, good luck, hope you do well, whatever,

we're around if you need us a couple times a year, check in. They had a dramatic improvement, not stabilization, improvement as well. You look at the two curves, they're pretty closely aligned. And that, to me, is so empowering. It means that you can write a book or you can do a podcast, give people information, and for those who embrace the information and feel empowered by it, and implement what you're talking about, look at what they can achieve.

Look at the gift that they can receive. If somebody listening today wanted to get a snapshot of like where they stood, blood test, you know, different analysis, whether a physical exam, what would be the best things that you would look at? You're not practicing at the moment, but if somebody came into your door and said,

hey, doc, okay, I don't have Parkinson's yet or Alzheimer's, I don't want. I want those things, but I also know that I need to catch the stuff early because it could start in your late 20s, 30s, 40s. What should they be taking a look at? Can you walk us through that? Sure. Well, here's the first and most important thing to do, and that is to shift your mindset away from the notion that is so inculcated into the brain. And that is that you should live your life however you choose, and when the problem arises, then we'll fix it.

it. That's job one. The job one is to say, that doesn't work and I'm going to be the architect of my brain's destiny. That's the most important thing. You know, when I'm interviewed people say, what's the one thing? Is it exercise? Is it sleep? Is it diet? And that's what I lead with. Because that, if you don't do that, nothing else matters. That's number one. That's number one. Embrace the idea that the ball got hit to your side of the court. How are you going to return that serve? So, once that happens and people realize, that, you know, the things I do today are charting the course of my brain and my heart and every other organism of up and my body in terms of my health destiny and my health span.

That's huge. So then the question is, well, how do you know? Where do you stand? And one of the most important tools that people can get is something called a tape measure. It's very, very complicated, very expensive. put a tape measure around your belly and see what your waist size is in comparison to your hips. And we talk about waist-to-hip measurements in the book.

So that doesn't sound very sophisticated, but right off the bat, do that with a 30-year-old or a 40-year-old and realize that depending on that measurement is setting the stage for where your brain is going to be in 20, 30, 40 years. The next thing would be a little bit more technical when we talk about certain laboratory studies, but we actually do unpack some pretty sophisticated exotic laboratory studies, which we can get now even without a prescription,

which I think is hugely empowering. But the simple things, what is your fasting blood sugar right now? Importantly, what is your fasting insulin, which predicts what your fasting blood sugar is going to be? What is your A1C? You want to take it through a little bit more sophistication where it continues glucose monitor and see, what is your blood sugar doing

not just when you're fasting and preparing for your annual lab study and being really careful the week before, but what is it as an average? What is your blood sugar doing? How is it spiking after meal? What does it do in response to not getting out sleep? And having said sleep, what is your sleep like?

Who follows their sleep? Who metricizes their sleep? You probably do. I certainly do. And a lot of influencers talk about the fact that, well, last night I got X amount of sleep, but not how much sleep did you get? Yeah, that's important.

But beyond that, what is the quality? Did I actually enter deep sleep? The time of sleep, the type of sleep that allows your brain to clean itself up, the activation of your glymphaticism to take out the garbage. Why is that important? Because it's the retention of that garbage

that doesn't go away if you're not sleeping well that activates your microglial cells. that sets the stage for brain degeneration. It turns on neuroinflammation. So it all feeds back to this notion of your brain's immune system. So that's why these levers are so important to pull first to understand and then to actually activate.

Everything has, for me, in my life, converged professionally on this whole understanding now. Now I look at everything through the lens of what is it doing to the brain's immune system? And what can we message? What's our outgoing message so people can understand this? You know, diet is a big part of this conversation.

You've written books about, you know, brain-friendly diets. And this next book builds on that and also takes it a step further. So tell us, what does it look like to have a brain defender diet when it comes to protecting our brain, our body, our glial cells, not confusing our immune system. Hey, y'all, it's Kelly Clarkson with Wayfair. Ever order furniture online and wonder, what if? Like, what if it doesn't hold up? That sofa was four days old. You should have ordered from Wayfair.

With Wayfair, there's no what if. Just style you love and quality. You can trust. Visit wayfair. Wayfair, every style, every home. Well, I want to get away from that term diet. There's so many names associated with, I'm on paleo, I'm on primal, I'm on Atkins, I'm on this or that diet.

And it's compelling because those diets are kind of hard to follow. You know, if you say, well, I'm on this specific diet, I bought the book and I'm going through it. So what I wanted to do is really understand our food choices. in terms of what they're doing for your body, in terms of the big things that influence the brain, i.e. inflammation, production of free radicals, things that influence the microglia.

So I did my very best to simplify, and let me see if I can do that for you right now. First, I want the food choices to be such that they don't spike your blood sugar. So that means right away, well, I don't have any idea what this is doing in my blood sugar. You need to. You need to understand what your particular choices in food are doing to your blood sugar, i.e., you need to have your blood sugar measured once in a while. Either do it at home with a finger sick, go to the laboratory, or in an ideal world,

from time to time, get a continuous glucose monitor, which you can do now without a prescription. It's very revealing. It's very empowering to have that level of information. I never knew that cashews spiked my particular blood sugar. They may not do that for you, but they did for me. Like a lot, a lot or like a little bit or like how much? It was in an unfavorable way. It wasn't, it wasn't, you know, a bag of chips kind of way, but it was enough that I said,

because then it was going to raise my average on the CGM and I didn't want that. You know, I was getting training for the final here, you know. And so it was enough that I didn't think I still eat cashews, but I'm really careful about how many I eat. There were a lot of things I learned. I learned that when I run, my first mile was really associated with a significant elevation of blood sugar, which I knew to be what we would expect because you're tapping into your glycogen stores.

You're creating glucose through gluconeogenesis and blood sugar should elevate. But, you know, I'm running along and we're in the CGM looking at my iPhone and suddenly, you know, it's one, you know, 110, 115, 1, 120. I'm thinking, I better stop running. I don't want, it's going to affect my average. And I, you know, my finals coming up, I want to look good. So that's what happens. And it's, it's the normal thing.

But, you know, these are revelations, I think, to understand about your blood sugar. So what I'm saying is figure out what your dietary choices are doing to your blood sugar. That changes everything. It's not eat this, don't eat that. It's eat this if it's not spiking your blood pressure sugar. and don't eat that if it is. So now suddenly, you know, it opens a door to anything you may want to eat,

but let's see how it affects your blood sugar. The next thing is I need a lot of color on the plate. You've heard that before. Why? If there's color on your plate, it means you're eating a fairly plant-forward diet because that's where the color comes from. It means you're going to get a lot of dietary fiber,

dietary fiber to nurture your microbiome for reasons that we discussed today. Nurture these bacteria. reduces inflammation, less targeting of your microglial cells. But also, you're going to have higher levels of polyphenols because that's what the color is coming from. Polyphenols are important for nurturing your bacteria to programming them in terms of what they're going to do in terms of their metabolism, what products they're going to create, which influence things throughout your body, which actually change gene expression, your DNA activity in your brain, and the DNA activity of your microgleal cells,

imagine that you're changing DNA expression in your neurons and in your microgleal cells based upon the foods that you choose through the lens of the microbiome through chemicals that they produce that make their way into your brain. The food that you're choosing changes your DNA, your life code expression.

It's heavy, right? And the next, so again, lots of color means lots of fiber, nurturing microbiome, and lots of polyphenols. The third thing I think is really important is adequate amounts of good fat. And I think if people are reading labels seeing that this particular food or that particular food contains X amount of fat, they have generally been schooled that, well, you know, the more fat, the worse it is for me. And nothing is further from the truth. Your dietary fat is really very, very important for your body in general, through your immune system, since the immune cells have

a, you know, their membranes are made of fat. The membranes really control everything in terms of whether your immune cells are going to work or not work. That's where they get their signaling. And guess what? The microglueal cells are immune cells. The brain is 70% fat and is not made from the air. It's made from the fat that you eat. So we need good sources of fat. And first of all, if you're reading the fat content on a label, something's wrong with that picture, first of all, because that label means likely that fat is on a product that has shelf stability, being that the fat has been modified in some way to increase its shelf stability, because the main reasons package food goes bad is because the fat becomes rancid.

So they use the types of fats that are modified in such a way that they don't increase the risk of rancidity, so they have a long shelf life, i.e. higher profitability. So things that are in packages that give you a fat content are things to be avoided. But there is a label on extra virgin olive oil that gives you the fat content, the sugar content, protein content. So, you know, again, I make my statement based upon ultra-processed foods and that type of fat. So more and more fat, extra virgin olive oil, avocado oil, Those types of fats are what we really want for our bodies, the omega-3s to have higher levels of DHA by eating fatty fish, or if not, then using a good omega-3 a supplement.

I mean, I take it every single day. Why? Because DHA is the most widely represented fat in your brain. It is also an anti-inflammatory. It's a Cox 2 inhibitor. And DHA also stimulates the production in your brain of something called brain-derived neurotrophic. factor. I touched upon it earlier. It's why we exercise, which stimulates the growth of synapses and the growth of new brain cells. So between the fat and the colorful plant-forward vegetables

and, of course, metrocyzing to see that this food that you choose isn't going to spike your blood sugar, we are left with one important question, that is dietary protein. And I would bet that most guests on your podcast have to go to dietary protein at some point and how much should we be consuming. Well, what do we need protein for? We need protein because the amino acids that our proteins are broken down to build various proteins in our bodies for our immune function and for other proteins that float around in our bodies. Importantly, we need protein to build our internal pharmacy to make chemicals for the brain called muscles. So we want to have protein on board such that we get the most bang for the buck out of our exercise.

We need to build muscle. The biggest threat, I think, to growing older is loss of muscle mass, sarcopenia. And it's because of two reasons. First, as we have less muscle, and we are overall weaker by definition, we're at more risk for injury. But recall what I said earlier about the muscles being the endocrine glands, creating these wonderful chemicals for your brain. The bigger the muscle, the more of that stuff we create. So you want to have bigger muscles as you get older and not let them waste away. And it means paying attention to

leg day because your leg muscles are your biggest muscles in your body. So like it or not, you're going to have to do squats or use the leg press machine or whatever you want to do and really work on building muscles in your legs. So we've covered a lot in the discussion of what we should eat. But in a way, It's a very broad stroke recommendation. Control your blood sugar, a lot of color on the plate, eat good fats, and make sure you're getting enough protein. Yeah. How important do you think it is to identify the foods that in particular don't work for you

when it comes to this whole conversation about gut, immune activation, you know, people who are like, okay, I'm not celiac, but I think still gluten causes an issue for me or other types of foods. How important is that? And any new best practices you've written, you've talked about this topic over time. We've probably chatted about on the podcast. Any new best practices around how to get to that answer? You know, I'll revert back to why it is.

I mentioned as far as what food should I eat. I should look at my blood sugar. I think we're now in a place where we can really see the effects of what we eat. In other words, if you feel crappy after you've eaten a certain food, then you shouldn't be eating that food. And, you know, this is a great segue with the alcohol congenit. But anyway, if you wake up the next day after you've eaten a certain food and you don't feel, you know, 100%, you should say to yourself that maybe that's something I shouldn't be eating. But beyond that, but good technology now to look at diet, there are foods, studies that we can do that measure our antibody production, for example, to, you know, a wide variety over 100 different types of foods that we may be consuming.

So, you know, people, I think, should be considering using good technology to look at food. Look at the new studies that allow us to understand our microbiome in terms of how it changes based upon the foods we eat. The microbiome will shift dramatically in as little as three days. A recent Harvard study made that very clear that in as short as three days of a dietary change, we can see marked changes in the diversity and even the metabolomics, even the product. that are produced by our gut microbiome in a very short period of time, we have the ability to look at what our microbiome is doing in response to the foods that we are eating. So I think we have the ability now to go beyond,

well, I didn't feel great this morning. I don't know if it's because they didn't sleep well or maybe because I ate pizza last night or whatever it may be, to a level of science, applying science to these decisions. But I think there are, again, some broad stroke recommendations. everybody knows what is good and what isn't good in terms of their food choices. I mean, I think the ultra-processed food narrative has really struck home. I mean, here we are in Los Angeles, and it's so easy here to find good food.

And everybody seems to be not everybody, but in general, when you go to a restaurant and you walk to your table, you see what people have ordered. And I always do that, and I almost half the time will tell the person's eating at, Don't interrupt her, but I won't want what that person is because it looks so good. But that's part, I guess, the LA experience. But I think more and more we're seeing that. And food is getting better. And despite efforts to, I think, make us really think that we need to eat these foods that everybody knows are not good for us.

I think the trend is much more positive these days. You know, you talked about omega. any other top brain supplements that you would add. And you've written about this before. I think you've posted about it on social media. Generally most people, especially if they're not eating enough fatty fish, and you can get your omega measure.

There's an omega index. You know, there's companies like Omega Quant and other ones that are out there. I think even Boston Heart has it as part of their panel. If you order that through your cardiologist. And you can get a snapshot of like, where do you stand when it comes to your omega index?

And most people, even if they eat fish, fish, like there's a lot of people in my family that are like pescatarian, they're even amazed at how low they are on the omega index. You know, they're not hitting eight, which is like an above, which is an optimal. They're often like a 6.5 or a 7 or other stuff. So many of them end up having to take omega supplements, you know, or allergy supplements or other stuff. Is it like that? Are there other supplements that you think that generally are very helpful for this immune brain health conversation? There are, and you know what, most of them are not very exotic.

You know, what are the fundamentals? And I think I love vitamin D, plain old, very inexpensive vitamin D. Yeah, it's great, get out in the sun. I think you make plenty of vitamin D when you've had sun exposure, but we don't want to burn, and I think most people are indoors an awful lot of time. So, you know, back to your point about measuring your fatty acids, your omega-3 versus omega-6, getting the vitamin D level is there's nothing to it.

Just next time you have your physical, say to your doctor, I would like a vitamin D and she will order for you. Or these days you can go to a laboratory and get your vitamin D level up. The point I want to make is that it's really vitamin D is very important for your brain. There are vitamin D receptors on our microglial cells that help regulate their gene expression, whether they're going to revert to being non-supportive M1 and increase inflammation or not. And I want to just get away from the so-called in the normal range that relates to vitamin D to putting forth the idea of in the optimal range.

So I'm really hoping people will check with their health care practitioners, but consider getting their vitamin D levels up to around 60 to 80. That said, another very straightforward approach is to take a good B complex every day. And how do we know we have adequate amounts of B vitamins? well, you can certainly test your blood for them. But one important metric we talk about in the book is measuring a blood test called homocysteine. Homocysteine is an amino acid

that when it accumulates, because it's at a higher level in your blood, in the brain, is significantly threatening, can lead to shift of your microglial cells, and we know that elevated homocysteine is certainly associated with cardiovascular disease and Alzheimer's risk. So we all need to know our homocysteine levels.

That's something else you might ask your doctor about and is generally not something along with vitamin D that is part of your typical annual blood work. Ask for it. The lab will gladly do it for you. We want to have a homocysteine level around 9 or maybe 10, not 15 or 20. About 20 to 25% of adults in the Western world

have a little quirk in their genome, little genetic issue that they may know about it. if they've had their genome sequence, they've had their 23 or 3x4, and they know that's the one I've had on myself. And I, in fact, have this. It's called MTHFR. It seems complicated, but MTHR simply means that you don't methylate your B vitamins appropriately.

There's a pathway in your body called methylation that, in my case, and 23 to 25% of Americans, isn't working as well as it should. it means that I, along with those other individuals, I'm at risk for having a higher homocysteine level, and I did. I had a homocysteine level of 12, which for me was not good enough, not ideal. And it means that when you buy your B vitamins, they can't be just regular B vitamins, they have to be methylated B vitamins, like methylated, methyl B12, methylfolate. So that's what I take every day.

And it drove my homocysteine down to the last count was around 8.2. So so far I haven't really gone, in addition to the DHA that we talked about, I haven't really talked about anything really exotic. But there are a few interesting players, Coenzyme Q, Q10. There's a product I like to use that's been validated from research called mitoQ. And there's another product I use that has been validated for mitochondrial upregulation called Eurolithin A. These are kind of new players on the scene.

I take them myself every day. I'm not affiliated. I don't work for these companies. And yet, I think their products are great, and I want to talk about them. The other product is made by various companies. It's called creatine. And it comes in the form of something called creatine monohydrate. There's also now creatine hydrochloride, which some of the claims are that it's better absorbed.

But creatine monohydrate directly targets mitochondria. And that is the home run. I don't know why anyone would not be taking creatine. You don't taste it. It's cheap. There are, unless you have renal issues, kidney issues, there really is no risk of taking creatine. And importantly, a new interventional trial demonstrated that a big dose of creatine, bigger

than most people, take 10 grams twice a day. I take around 5 to 10 grams a day, actually was generally quite beneficial in patients with existing Alzheimer's disease. A small study, but a human interventional double-blinded trial. So that's huge. Again, targeting the mitochondria. So I think that a good probiotic for the gut is reasonable. Supplementing your diet with a good prebiotic fiber to me makes a heck of a lot of sense.

And, you know, these are the fundamentals. There's a product that I'm very interested in. I talk about it in brain defenders called dihydromericin, D.HM. Many of your viewers may have heard about it in the context of helping them with hangovers. But it turns out that it reduces neuroinflammation and helps reduce the action of reactive oxygen species or damaging molecules that are produced in the brain. So this is going to get a lot more attention, I think, moving forward. That's amazing. Well, we'll have all that, you know, different links that you mentioned in the show notes.

other things, Dr. Promoter, that you feel that are important part of helping the brain step into an immune system, which is directly connected here, helping it step into its highest potential of protecting the body and not getting overreactive or confused in a way that it turns on us. Well, let's get to that overreactive part in terms of how our day-to-day lifestyle influences that overactivity. And you talked about it earlier that we're kind of being, you know, that life is stressful, we're being bombarded left, right and center day in and day out, and night in and night out too, which I think is really hugely important. And I think that we can appreciate that when we shift our body in what's called the

autonomic nervous system, when we shift the body towards more of a sympathetic nervous system activation, fight or flight activation, that sets the stage for, higher levels of cortisol production, cortisol in and of itself when chronically elevated, directly threatens the brain, directly targets the cells in the hippocampus, the brain's memory center that was discovered by Dr. Robert Sapolsky in the 1980s for, it's been around a long time, higher levels of cortisol from chronic stress, sympathetic activation, damages the microbiome, increases gut permeability, what does that do, increase levels of inflammatory chemicals in the brain, So we want to shift to more kind of a rest and digest,

calming part of the autonomic nervous system called the parasympathetic nervous system. So that's the part that comes on board when we're no longer being threatened or we no longer perceive any threat, whether it's real or just perceived. Even a perceived threat activates our fight-or-flight sympathetic nervous system.

So talking about ways then to activate the parasympathetic nervous system kind of get us out of this constant sense of doom, you know, that we imparted upon ourselves by doom scrolling and watching the news and just living, you know, in the times that we live in. And, you know, there are techniques of deep breathing, of meditation that have been so validated. And we have technology these days that allows us to push our bodies.

Maybe we use the term biohack our bodies more into a state of being calm, less activation of the sympathetic nervous system. And we can measure that, and we'll get to that in just a moment. But these techniques are things like Apollo Neuro, which is a device you wear on your wrist, that vibrates and through its technology is allowing you to basically calm down. We know that vagal nerve stimulators

are several on the market accomplished this goal. And, you know, there's reams of good science showing improvement in various measured metrics. One of them is heart rate variability, which you can measure at night when you sleep or during the day, wearing an Apple Watch, a whoop, or an aura rings, one that I use, and look at your level of heart rate variability, adjust it for your age, what is a good level, not just a normal level,

what's ideal for your age. And I can tell you personally, using a device, I was able to significantly increase HRV, which is a good thing for you, higher parasympathetic activity, ultimately lower activation of your microglial cells, that's the payout, by using an intervention,

by using a polonoreal, wearing a device on my wrist that vibrates. Who knew, right? Well, were some of the things that it got you to do or not do, for example? I think in and of itself, it did it for me. I mean, what are the things that you can do? I think, what do you want to do to elevate your HRV,

better sleep, certainly deep sleep, physical exercise and mental exercise. I think socialization does that. Even dietary enros can help with that. But I think importantly, let's call it like it is. Put the phone down. I interviewed an individual who wrote a book about, I think it's called You're Pooping Wrong.

Does that ring a bell? It's a great title. And I said, if it isn't a book, it should be. Yeah, no. I think it's the name of it. And I said, what's the one thing that we should all do as relates to having better poop to poop better? And the answer, it was great. She said, don't take your phone into the bathroom.

She talked about how people who are scrolling while they're on the pooper have a much higher risk of developing hemorrhoids. And that's an indication of increased having to push. So I'm not exactly sure how we got that. to this part of our conversation, but nonetheless, so we need to all go back to reading air fresheners and the other bottles. Oh, my God, I hope there's no air freshener. Joking. Let's get them out of the house.

I was going to get me started, but we're going to have to go there. We're going to have to get air fresheners just a moment. No, how we got here was doing was spending so much time on social media. Yeah, and HRV and our nervous system. And all the things. I mean, you know, a lot of what goes on when we're scrolling is comparing ourselves to what people want us to believe is ideal for us and we never measure up.

That's a real threat. I think putting the phone down, it's incredible. I mean, go to a dinner party, and that's the rule. Try it. That, okay, we're going to either turn our phones off, we're going to put them in a basket like we used to do with car keys, so people, you know, if they had too much alcohol, we have the keys. So put the phone out of reach and we'll have a conversation.

That's good for your parasympathetic nervous system. It's good for your cortisone. level, it's good for your microglia. So that takes us to socialization. So when you look at Blue Zones data, you look at their diets, look at their sleep, look at their physical activity, look at the verticality of their lifestyle,

meaning how many stairs these people are ramped or roads they have to go up that are vertical? They have more incline, so it's good for them. But one of the features, aside from what the diet looks like, being colorful and mostly Mediterranean, is that they're doing things with each other. They're not just sitting on their phones. They are interacting socially with their brethren. And why is that associated with a decreased risk of brain degeneration?

I mean, how can you connect the fact that I play botchy ball with this group every Thursday, and that lowers my risk of brain degeneration? It does. and we can talk about cortisol, and that's probably a big player here. There's physical activity involved, but what is the hormone that we are producing when we're experiencing love,

when we're experiencing this great feeling that we all know that we're experiencing a really cool time with other people, this love that you feel? It's oxytocin, right? Oxytocin's produced in your body, a little pivot here. We tend to pigeonhole hormone,

as being involved in one thing. Oh, testosterone, that's for building muscle. No, it's women need testosterone for libido. We need testosterone for brain health or progesterone, named because it's pro for gestation, progestation. No, men need progesterone. I mean, you know, we're pigeonholing these hormones as doing one thing. Oxytocin is milk letdown,

this allows women to produce milk when they're nursing. Well, I produce oxytocin in my body when I'm having this great relationship with you today, and it's important because there are oxytocin receptors on our brain's immune cells, our microglial cells. When those receptors are stimulated because there's more oxytocin in my body, it keeps them in their loving, nurturing, supportive role of being M2, being brain defenders. So while for years we've understood that, yes, it's important, you've heard people talking about it. I think we talked about it before that when we socialize with people, it's good for their brain. But I couldn't tell you why.

Now I can tell you why. Only because you mentioned it and you said it will come back to it. Okay. Alcohol, right? We've seen and our community is very aware of the different stages of the conversations. We went from, for those that are old enough to remember, hey, red wine, resveratrols, great, you know, your doctor says, have red wine, but if you aren't a drinker yet, don't start, which was always really confusing to people. Then it was like, hey. What if you are continue?

Yeah, yeah. It was, it was basically, right? And then, you know, the sort of wellness light, hey, it's a Mediterranean sort of approach, like, you know, a little bit of red wine, socialization, you know, it's a good part of it, you know, you can have it regularly. And then I think it was like Two years ago, the most popular podcast on Apple Podcasts was Andrew Huberman's breakdown of how alcohol is not good for you at all. At any dose that was there, you had a lot of people and this whole movement of, you know, Gen Z and millennials are basically saying, all right, we're getting rid of alcohol. Alcohol sales tanking between GLPs and that sort of conversation. And now a little bit of a return of some people saying, hey, hey, hey, wait, like, you know, the market. assistance of the world, other people of Dr. Vene Prasad, you know, saying, well, look, like,

are there certain things that you get along with this, the socialization piece that's there and other things? It's always an argument. So where do you stand on things? What we talked about three years ago, when we talked about drop acid, I think, and it was really in line with the metabolism of alcohol, was that the data was showing that one glass of red wine per day for women, two glasses of red wine per day, for men was at the bottom of the U-shaped curve in terms of Alzheimer's risk,

that one for women, two for men, was actually associated with lower risk of Alzheimer's than none. And then the curve comes back up. So higher than that would be, again, increased risk. And say that again, that was a drink a day? This was specifically red wine. Red wine. So you're absolutely right that the messaging has changed,

and Andrew Huber was actually in his positioning, quoting a new study that really looks at the idea of alcohol out of context. The context of the earlier studies was really in the context of the red wine part of that story and red wine being sort of part of the Mediterranean diet. And so we ask ourselves then, and you're right, the new messaging is clearly that alcohol in and of itself is neurotoxin. So we have to, I think, pull alcohol out of the idea that we connect it with will therefore drinking X, Y, Z, it's fine.

It's context-dependent. Have a conversation about coffee and we'll immediately say, well, what does caffeine do? Well, it's not fair to talk about just caffeine in our coffee discussion as it isn't fair to talk about just alcohol in the wine

discussion, the red wine discussion, because red wine does deliver polyphenols that happen to be good for the body, good for the brain, good for the microbiome. But the alcohol content per se is a neurotoxin in and of itself, no matter how you slice it, no matter how you contextualize such that people were getting these polyphenols, but why not get the polyphenols in another

delivery mechanism without the neurotoxin, i.e., the number one source of polyphenols in human diet globally is coffee. So have coffee. That's a great source of polyphenols. It's a common sorts of polyphenols. I wouldn't say it's a great source in terms of the quality and quantity of polyphenols. We will look elsewhere. We'll get to that discussion moment. Let's finish off the alcohol part. But I am, like you, watching this incredible tanking of the alcohol consumption now coming back a little bit. And I think it's based upon what influencers are saying, not so much is what the science is saying. And influencers by definition have influence and they're moving the needle. In this case, I think it's probably not the appropriate way that the needle should move.

I agree that the socialization part is positive. But, you know, I would hope that we can push through that. There is a, you know, will I have a glass of wine at the right time with people? Absolutely, I do risk benefit and I'll hopefully make it up elsewhere. You know, I have that polyphenol rich Himalian Tartary buckwheat or whatever other is my source of polyphenols, dark chocolate. You name it. But I think that less is better in this regard. And I am as guilty as the next person of saying, yes, one glass of wine per day for women, two men.

I did say that in the past. It's not part of the messaging in my new work. Because then there's also some data that more than three drinks a week or four drinks a week increases a woman's risk of breast cancer. Breast cancer. And now... I don't think that was exclusively on red wine. I think that was looking at all...

That's alcohol in general. I mean, so again, are we talking about red wine? Are we talking about Jack Daniels? And I think that's a very important distinction. You know, at least, you know, there isn't a, the polyphenol part of the alcohol in the red wine delivery system is the upside. Is it a complete offset?

I don't think so. There are non-alcoholic wines, red wines that contain polyphenols, so go for that. Yeah, you can try that out, see how it tastes. I want to zoom out big picture here, right? We're talking about giving our body, our mitochondria, these glial cells, our gut, the right tools to defend themselves so that ultimately our brain and our body benefits.

And you've laid out the roadmap for that in your book. The link is in the show notes. The book is fantastic. Please pick it up. And most importantly, pick up a copy for somebody in your life that may not be listening to a podcast, may have not come across this information, but could genuinely use this to protect their brain, you know, today and tomorrow.

What is possible at different stages so that we stay within the possibilities of what exists right now, but that we're not over-hyping what's out there. So I'll talk to you about different stages of where somebody might be in their health journey, and you give us a sense of what's possible within it. Somebody has full-blown Parkinson's. You have a family member, a close friend of mine,

her dad has full-blown Parkinson's, and has been diagnosed with it for over 15 years now, are doing these lifestyle habits, paying attention to these things, is that something that can move the needle forward in one shape or another? In Brain Defenders, I wanted to really amplify and extend the toolbox.

And in so doing, embrace whatever it could be helpful, again, through the lens of above all doing to harm. And let me take our conversation back to the idea that what's making the good brain go bad in all of these conditions, including what we'll talk about Parkinson's, is metabolic. Is a shift from the micro-Gleo cells being supportive to being destructive. And so if we can target metabolism, might that be something that's helpful in Parkinson's?

So we don't need to go through all the metabolic inroads levers that we can pull right now because I want to take this conversation to an interesting place that may be surprising for your viewers. And that is, what is the metabolic fixed du jour? What's on everybody's minds in terms of helping their metabolism? Let's say their weight control, their blood sugar. What's everybody going for these days? GLP-1s. So a GLP-1 drug is a powerful way of reigning in metabolism.

Call it what you will. It works. It works. Absolutely. We don't know long-term what it may do. But let's just talk about the fact that JLP-1 drugs have been shown to improve mitochondrial function, obviously improve blood sugar, that's what they were designed for, a reduced production of reactive oxygen species, damaging chemicals from mitochondrial activity.

So might a GLP1 be a drug that would be useful in a metabolic disease like Parkinson's? Whoa, what do you mean a metabolic disease? It's the metabolism of these microglial cells that has been shifted that caused them to lead to the destruction of the dopamine-producing cells in the part of the brain, the PARs compacta of the substantial Niagara that won't be on the quiz. So Parkinson's is a disease characterized by loss of cells that make dopamine.

Let's leave it at that. The reason these microglial cells are digesting away these neurons is because their metabolism has been shifted. Could we target their metabolism by giving them a GLP1 drug? Think about that. people want ag and his drug. Well, I mean, that's far-fetched. No, as a matter of fact, it was published in the New England Journal of Medicine in May of 2024. This was a trial of 157 individuals with full-blown Parkinson's

disease, a progressive disease that over a period of a year has measurable decline in functionality requiring more and more medication. That's what happens. Everybody who has Parkinson's or has a loved one knows how things go. And it's tragic because all we've done in the world of neurology is treat the symptoms, just the smoke and ignored the fire. This study said, you know, as a matter of fact, we're going to pay attention to the fire. We're going to target the microglial cells, brain metabolism, and see if that helps these Parkinson's patients. Again, published in arguably the most well-respected medical journal on planet Earth, the New England Journal of Medicine. that's been around since the 1800s.

So what did they do? They gave half the group a GLB1 agonist drug, lixocinitide. The other half got a placebo injection daily. And at the one year point, the group that got placebo had, as expected, a significant decline in their functionality as measured in a standardized score called the Unified Parkinson's Disease Rating Scale, UPDRS. The other group measured on the exact same score

stabilized. The disease was fully arrested. That's the first time in, well, second time in history that's ever happened. These people actually stabilized on the UPDRS score. Holy Toledo. I mean, it's breathtaking. It's breathtaking from the perspective of, you know, it's landmark. It's also breathtaking that the Parkinson's community doesn't know of this, doesn't know about this research. You know, I'm telling you this, and I know, this is likely the first time you've heard it. What do you need to be convinced? Published in a peer-reviewed study?

Done. A double-blind placebo-controlled trial, that's gold standard. Done. Risk-benefit ratio analyzed? Done. All of these things done. And yet, where do we go with that? Now, let's be clear.

I'm not suggesting every Parkinson's patient should be on a GOP1 agonist drug. The drug that was used in his trial is not available in America. And to be fair, about 40% of the individual taking delixocinotide, did in fact have gastrointestinal side effects. My point is, though, that A, it demonstrates that targeting metabolism is the home run

for treating the fire while you're treating the smoke, while you're treating symptoms with drugs for the tremor and drugs for the rigidity, we can now embrace the idea that disease may be arrested by targeting brain metabolism by keeping microglial cells in their M2 supportive brain defender configuration. There's a great story behind how that was identified if we have time. And number two, that let's keep our eye on this evolving research, because this could be the home run. Now, there's a lot of talk about, well, if you start taking a JLP1 for weight loss or whatever, that you're basically saying you're going to take it for the rest of your life, because when you stop, you're going to get this awful rebound, gain back all the weight, and we don't know what

are the long general consequences. But It's important to realize that diseases like Alzheimer's are pretty much considered a death sentence, call it like it is, that it's now considered the third leading cause of death in America is dementia. So, you know, the idea of using a drug that may have side effects in the long run for a disease that might well be uniformly fatal, I think is looking at risk-benefit ratios. So it's not as if we're going to take people off of them or if we're going to take people off of them or if we do there's a consequence, and there probably would be.

But there is deep investigation right now of the use of GLP-1 agonous drugs that target microglia in the areas of Alzheimer's as well as Parkinson's. So what would we say to these people that, first, there's great future in looking at GOP-1-aginous drugs. But second, more importantly, these drugs validate a metabolic-centric approach to treating the disease and not just focusing on. on the smoke, focusing on the fire. So even though the research isn't fully there, if you had Alzheimer's disease today,

switching from Parkinson's to Alzheimer's now, I'm hearing from you that you would be more likely than not to be on a GLP1 drug looking at the cost benefit, knowing that a huge part of all these brain diseases is the metabolism component. I would give it strong consideration. That's exactly right. Let me give an example related to Alzheimer's.

There is plenty of research showing that in individuals who have type 2 diabetes, which increases risk for Alzheimer's by as much as threefold, that those diabetics taking a GLP1 agonist versus those diabetics taking other types of drugs that are not JLP1 agonists, both keeping their blood sugars under control with drugs, that the group using the GLP1 agonis had a 40% risk reduction

for even developing Alzheimer's disease. It's huge. Massive. Why don't we? design a study using OZempic and treating patients who do have Alzheimer's disease. The, you know, what you just described asking me the question, what would I do now that I've been diagnosed? I haven't been diagnosed.

But if I were, if hypothetically, would I take this drug? So this study used oral semaglutide, OZemPEC, basically. And it was multi-centric globally. I think 56 centers study this. So it was an interventional trial looking at Alzheimer's patients. treating them with the drug. They did not reach their clinical endpoints, meaning that there was no significant effect

on rate of cognitive decline, but their C-reactive protein, measurement of inflammation, was reduced by around 30%. So what does it tell us? Tells us that oral delivery doesn't seem to work, that maybe the next trial, which is underway, of injectable GLB1 agonists, may have better results, that may be not using semi-glutide,

but a smaller molecule G.L.B.1 agonist may be the way to go. But I can assure you there are pharmaceutical companies globally that are looking at not just targeting metabolism, but targeting the microglyle cells themselves. There's technology looking at transplanting microglial cells into humans. There's technology looking at transplanting mitochondria into the brains of humans. So, focusing on this notion of immunometabolism and looking at the mitochondria, the microglia, is front and center.

So I have not been asked this question before, but what would I do? I've been diagnosed with Alzheimer's, what do I do? Step one is I would be more aggressive using 40 hertz light. What do that means a flashing light at 40 times per second into my eyes every day for an hour a day. Why would I do that? Research done by Dr. Lee Way-Sai at MIT discovered that in humans that this is good for the brain,

that in laboratory animals, flashing a light of all things at 40 hertz and playing a sound at 40 hertz, which is really low, you need a subwoofer for it's really a low level. It reduces beta amyloid in the brain and it helps polarize microglial cells back to being supportive.

A light, crying out loud. I have one on my desk already, but I, you know, I use it when I'm working on my computer, but I'd be staring into that thing for an hour a day. She's done that trial in humans. They have had a remarkable success and they're entering phase three, and we look forward to seeing what that's going to look like. GLP one, I would certainly think about it. I'd be taking some leading edge supplements. I think that I would be eating more lion's main mushroom. I'd be certainly much more aggressive about my biometrics.

And I think I could win the battle. I really do. Well, that was my next question is that it seems like there's a lot of potential that's here, especially the best thing that we can all do is we start well before going back to that quote that you had, you know, the time to fix the roof is when the sun is out. Look, Ornish and Kansy in their study we talked about. They won the battle just by lifestyle intervention. So this isn't anything unique that I think I could do.

It's already been done. It's already been done. It's already been done. This has been an incredible conversation. And it really lays out this next frontier that this idea that this plaque that was in the brain is the cause of especially things like Alzheimer's and it's so reductive and it's been disproven. Well, it needs to be replaced with the next mental model of what is at.

out there and what's the potential. And you've done that inside of your book. And you've laid out a step-by-step plan that anybody can follow, ideally way earlier, before they have to think about making these really tough decisions. I really think that's a messaging for me that has taken shape over, you know, very recently.

And that is that, you know, with obesity rates in young children, you know, in the 1970s, 5% of children were characterized as being obese in America in 2001, that number was up to 20%. So that's a four-fold increase. That sets the stage for obesity and midlife, setting the stage for metabolic issues and ultimately dramatically increasing your risk

for what we're talking about, Alzheimer's. So earlier, the better. Yeah, you know, if anything, this mass adoption of GLP-1 drugs and the obesity rates that are coming down for adults, you know, mostly, doubled down and proven so many of the points that you've been talking about for years,

that when you improve your metabolism, all sorts of things get better, but especially your brain. But whether you're on GLP1 drugs or not, there's a whole host of things that you should be doing additionally. And that's really what today's conversation in your books about.

Yeah, there's a lot to be learned from the GLP1 experience. That's for sure. I mean, you know, aside from the conversation about potential downside risk for in the long run or acute issues with respect to side effects

or dependence and what happens when you stop. What have we learned? And we've learned that when we target metabolism, so many things seemingly improve. Cardiovascular risk, addictive behavior, significant depression. Active cancer. I don't know if you saw the Eli Lilly results that just came out,

people who had active cancer saw a massive reduction in their tumor size. In tumor size, not necessarily long term, but in terms of life extension in patients, with aggressive cancer, that's correct. And here we're seeing, as I described, this positive effect on existing patients with Alzheimer's, I mean, with Parkinson's, and what we've observed as it relates to Alzheimer's risk in diabetics.

So, you know, the downside issues are worthy of discussion, but what are we learning? We're learning that when we target metabolism, some incredible things are happening. So that's an important message. It's an important message. message. The book is probably out by the time this conversation is there or the pre-order link. You can find all that in the show notes. Dr. David Perlmutter, super appreciate your work. And

you have one of the best YouTube channels. I think that the interviews that you do with people, you're so thoughtful. I love your introductions for them. And you take even subjects that I think, oh, I'm not sure if I'm exactly interested in that topic, but then I listen to your intro and I'm like, I am definitely listening to this conversation. So please everybody follow Dr. David Pearl Motor on YouTube as well. Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast.

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