Feel Better, Live More with Dr Rangan Chatterjee - #18 The Best Foods to Nourish Your Brain with Neuroscientist, Dr Lisa Mosconi

Episode Date: May 16, 2018

Dr Chatterjee talks to Dr Lisa Mosconi, neuroscientist, Professor of Neuroscience & Neurology, certified integrative nutritionist and associate director of the Alzheimer’s prevention clinic at Weill Cornell Medical College. They discuss the links between what we eat, our brain and nourishing our brain for our future health. Show notes available at: drchattterjee.com/lisamosconi Follow me on instagram.com/drchatterjee/ Follow me on facebook.com/DrChatterjee/ Follow me on twitter.com/drchatterjeeuk Hosted on Acast. See acast.com/privacy for more information.

Hi, my name is Dr. Rangan Chatterjee, medical doctor, author of The Four Pillar Plan and television presenter. I believe that all of us have the ability to feel better than we currently do, but getting healthy has become far too complicated. With this podcast, I aim to simplify it. I'm going to be having conversations with some of the most interesting and exciting people both within as well as outside the health space to hopefully inspire you as well as empower you with simple tips that you can put into practice immediately to transform the way that you feel. I believe that when we are healthier, we are happier because when we feel better, we live more. Right now on to today's podcast conversation. I'm really, really excited about my guest today. This is somebody who my publisher Penguin actually put me in touch with a few months

ago when I saw an advanced copy of her book and it really grabbed me from the moment that I saw it. This is a lady who is pretty well qualified, if I'm honest. She is a neuroscientist. She is professor of neuroscience and neurology. She's got a dual PhD. She is a certified integrative nutritionist, and she is associate director of the Alzheimer's Prevention Clinic at the Weill School at Cornell Medical College. It's Dr. Lisa Mosconi. Lisa, welcome to the podcast. Morning. Thank you so much for having me. Lisa, it's a real honor for me to be speaking to you today.

I think in the health sphere that we live in now, where lots of people have got an opinion and are voicing an opinion, I think what you offer is real scientific rigor. You have been studying the brain you've been studying nutrition for a long time now and i think that's one of the reasons why i resonate so much with your work is because it's based upon real robust science thank you yes i i agree i'm a scientist i am a neuroscientist by training and like you said i, I have a dual PhD in neuroscience and nuclear medicine, which is really code for brain imaging. So most of my research is based on methodologies that allow us to visualize the brain, every possible aspect of the brain, the way the brain is aging, the way the brain is active or not active.

the way the brain is aging, the way the brain is active or not active. And recently, we've been able to visualize changes in chemistry inside the brain, which I think is fascinating. And I've been working in the field of brain aging and Alzheimer's for 15 years at this point. Wow. Yeah, it's a long time. But what's really fascinating is that we can see the onset of Alzheimer's in the brain when people are still very young, like in their 40s and 50s. And we can visualize how amyloid facts start to accumulate and then slowly progress over time so this is really fascinating

for us so this is years before actually people are getting the diagnosis you're seeing you know clues well more than clues actually you're seeing evidence that that disease process has started yeah like 20 years prior we can spot onset and emergence of Alzheimer's pathology when people are in their 40s and 50s. And the typical age of onset for the symptoms of Alzheimer's is more in the 70s. So there's like a 20-year gap in between changes in the brain and the onset of cognitive impairment and memory loss and dementia. And that's because the brain is a fighter.

The human brain is incredible. It can really stand a lot of damage before showing any behavioral issues. But there's something that happens inside the brain that is slow and protracted and that we are now able to track over time. And what our research has shown in particular, which is why I wrote the book, is that lifestyle and diet in particular really influence the likelihood of aging gracefully or developing cognitive impairment and dementia as we get older.

And it's really key to look at these changes when people are young. Yeah, Lisa, that's, I mean, it's, you know, interesting to hear that because I guess some people will be hearing that and getting worried at first saying, oh, wow, do I have this already going on in my brain? But the flip side is the fact that you can see it this early and the fact that you've got research showing how lifestyle can influence that you know the flip side is actually we can do something about it and there's plenty that we can do throughout our lives to prevent the likelihood of us getting a brain

problem or something like Alzheimer's disease when we are older which is something that I think is on many people's minds these days before we delve deep there though um lisa i just wonder could you share you know did when you started studying when you became a neuroscientist did you think that you'd become an expert on food i mean how did that come together you know is that yeah is there a story there potentially yes i did I did not. No, not in a million years. My background is biology, is neuroscience, is really hardcore chemistry, photochemistry and genetics. And nutrition was not a part of my curriculum when I went to school. Actually, most neuroscientists and most physicians, I think,

just don't study nutrition in school. And so I was in Italy. I'm Italian, as I'm sure it's clear from my accent. I'm from Florence in Italy, you know, born and raised. And I was doing my PhD there. And I moved to New York to complete my PhD. I moved to NYU. And I was working on the early detection and prevention

of Alzheimer's. And when I first moved, so about 15 years ago, maybe 12 years ago, everybody was asking about genetics. All my patients were like, well, you know, my mom has Alzheimer's or my dad has Alzheimer's. Am I going to get Alzheimer's? Is there some genetic marker that will make me get Alzheimer's? And little by little, my research was showing that genetics, the genes didn't really matter as much as I thought. And that was very disappointing for me in a way. And at the same time, my patients started asking questions about food. You know, the kind of questions really changed.

It was more like, okay, I understand that my mom has Alzheimer's, my dad has Alzheimer's. I'm at risk for Alzheimer's just because I have a family history, although that doesn't mean I'm going to get Alzheimer's myself. So what should I eat? And I was like, oh, I don't't know but you should have no idea what you should eat and so I went back to school of course right we're so much time to kill so I went I went back and I completed another degree in nutrition but mostly I realized that brain nutrition is really the same as brain chemistry. What I did not appreciate in school is that all the things that we learn about the brain, like glucose does this and that, magnesium does this and that,

vitamin B6 is mixed with choline to produce acetylcholine, which is a neurotransmitter, that's food. Those are nutrients. We neurotransmitter. That's food. Those are nutrients. We just don't think about it as food. We think about it... When did the penny drop there for you? Were you just in a nutrition lecture doing your thing, thinking, yeah, I've done my neuroscience training.

I'm learning about food now. What was that moment where you suddenly connected the dots and thought wait a minute this is food this is food i think oh for me it was when i was looking at the acetylcholine acetylcholine is a neurotransmitter so it's um it's a chemical that we have in the brain that the brain produces to make memories it's one of the neurotransmitters that we need to literally form memories inside the brain. It's very well started.

I just thought, oh, wait a minute. Choline, acetylcholine is basically a sugar plus a B vitamin. I never thought, I never questioned, where does the B vitamin come from?

It just never occurred to me to think about it that way. Then I thought, oh wait, that's not something that the body can make. It has to come from the diet. From there, it was just so so fascinating i just i just got my big textbook about neurochemistry and it was like this is all food wow this is all food you just don't think about it that way and i started talking to my colleagues and they also never thought about it that way and i don't know maybe you know i'm a little bit I really enjoy reading and studying and doing research I'm a little bit of a nerd if you want and so I just went for it and I I founded a lab

at NYU I started a new lab I was the director of the nutrition and brain fitness lab if you nutrition and brain fitness nutrition and brain fitness yes wow that's amazing i've never heard that name before that's fantastic yes i am it was the last three four years that i was with myu and what we did was really we would literally look at the chemistry of the brain using brain imaging so we would measure diet and quantify diet in our patients and also really measure all the nutrients inside their bodies, like in plasma or serum, and then correlate that with whatever we could find in their brains using brain imaging. And all our patients have followed over time. So slowly but surely, we can say how your diet is changing the way your brain is changing with you, which is fascinating to me.

I think it's wonderful. What's important, I think, to understand about the brain is that the brain has a very limited capacity to self-degenerate. Everywhere in the body, your cells die and regrow they we lose hair all the time but they get replaced immediately our red blood cells get replaced all the time our skin gets replaced all the time even our skeleton gets renewed at a rate of like 10 percent a year, your bones regrow in some way. Your brain doesn't. There are some spots inside the brain where we can regrow new brain cells, but that's very limited.

It's called neurogenesis. And that's very, very limited, especially as we get older. So our brain cells are born with us and age with us, which really means we need to take extra care. We really need to do everything we can to support them and make sure that they also age gracefully with us because we cannot replace them. And eating the right foods and really providing our brains

with the right nutrients is one of the best ways to do that. Well, I mean, it's incredibly exciting to hear that. So let's dive right in then. I mean, you've studied food, nutrition, you've had your own lab, nutrition and brain fitness, which I think many of us, I mean, certainly I wish I had a lab like that. That sounds superb. And I look forward to sort of learning from you what what you what you discovered there but if we go straight into foods what are those i think i think i've heard before you say that there's five top brain foods is that fair to say sure there can be as many as you like i think five is a good number to start with right well let's start what's what's the top

brain food or what are some of the top brain foods let's start. What's the top brain food? Or what are some of the top brain foods? Let's put it better. You know, it's a bit more accurate. I'm going to start with a food that is not necessarily

considered food, but it's super important. That is water. Water has been underestimated forever. And especially as far as brain health

is concerned. but the brain is probably made of water 80% of the brain's content is water and we cannot store water in the body or the brain so we really need to replenish it every single day

and we really need to have enough especially we need to make sure the brain is well hydrated because every single chemical reaction really need to have enough especially you need to make sure the brain is well hydrated because every single chemical reaction that takes place in the brain needs water just to be activated every single thing like even energy production will never happen unless you have water inside your brain and that seems obvious right well I just need to drink water. What is a little less obvious is that the brain really suffers when we are dehydrated. Even just

a 2% water loss, which is a minimal amount of dehydration, can cause neurological symptoms like brain fog, confusion, dizziness. But also also it was shown to um it literally makes your brain shrink and you don't want your brain to shrink the one thing you don't want right yeah exactly so just drinking water it can can really help the health of your brain and also there are studies showing that if you're going to take a test just drinking a glass of water prior to taking the test can increase your reaction time by 15 percent or more well it's incredible that on a personal level you know sometimes you get busy and you haven't drunk much water and you're running around and you feel really tired sometimes and sluggish and

you know you think you might need a coffee or you might need something to perk you up and it's amazing how you're drinking a large glass of water how many times that can sometimes just immediately make your almost like your brain switch on and you've got more energy and more more cognitive ability i think many people can probably resonate with that do you have any guidance in terms of how much water people should be drinking or does that get a bit more challenging to give that sort of recommendation no i i think the problem is that people don't drink enough water yeah so eight glasses a day should be a rule for everybody and i think it's very important this quality here at least in the in States, a lot of people drink purified water. Okay. Right.

Or a seltzer or club soda. That's not water. It's not water. It doesn't contain the minerals and electrolytes that the brain needs for hydration. It's just fluids. So if that's the kind of water that people drink, it's not optimal. And they should really take a mineral supplement along with that it just doesn't do the same for your brain so what kind of water would you drink

for example spring water drink water mineral water you know sometimes it can be expensive so tap water is totally fine the problem is that uh in many countries, in many states, you have to filter it because it's not clean. The infiltration also removes a lot of the nutrients. So depending on where you live, you might want to check the stats on your water and see if it

contains minerals and salts and electrolytes. And if not, by all means, drink it, but then take a couple of minutes longer than that. Yeah, it's incredible that water is not just water. We're, you're talking, you know, which probably adds to a lot of this confusion that people have generally about what they should do

in 2018 about staying healthy with so much advice flying around the place. But, you know, one key thing you're saying is that the brain needs water. Make sure you're drinking enough water. I agree. I think eight glasses seems a pretty reasonable aim for most of us. You know, one of my patients actually said the best way he has found to do that because he couldn't remember to have eight glasses and our glasses are a bit smaller here than US glasses so if we have eight glasses in the UK it roughly is 1.2 liters of water a day and I think you guys it's about 1.8 liters yeah about two liters a day yeah and but and one of my patients said okay so he bought a 600 ml uh bottle and he would go to

work and basically by lunchtime he knew he had to finish that 600 ml bottle and lunchtime we'd fill it up and by the time he left work he'd also have to have he had drunk that bottle and it was just transformative for that for that person just that was that's all he thought about is can i complete that bottle can i finish it two times a day and you know he felt so much better in himself it was just incredible um so that was just a little tip that i learned from one of my patients actually yeah that's that's great that's a great way and there's also another super quick test to to find out if you are dehydrated or not great Great. Yeah, I'd love to hear it. So a bottle, like a one-liter bottle, you need to fill it with warm water.

Not hot, not cold, just warm. And then take very small sips every few minutes, like four or five sips of water every five minutes, and keep going. If after a little while, the warm water starts to really feel good you feel like you want more you're dehydrated right and you need to drink it all and then keep drinking it's a very simple test but i mean so many people are like this is actually good they start like oh this is really weird and after a little while like after 30 minutes they'd be like okay i need i need it this is good for me like my body's

responding really positively so we can go on for 30 minutes sometimes this well you sit every five yeah right so yeah 20 30 minutes got it got it so every five minutes yeah wow i've never heard that one so that's that's a great tip for people listening to give that a go and see yeah yeah exactly i wasn't expecting that okay so one of the one of the important things for us to think about is water what else in the diet should we be what should we be considering to to improve our brain function? Again, I'm a scientist, so I'm going to give you a scientist's answer, even though it's not super practical. Caviar. Caviar. Caviar or fish eggs. It's the best brain food. And the reason for that

is that the chemical composition, the nutritional composition of caviar basically mirrors the nutritional composition of caviar basically mirrors the nutritional composition inside your brain. If you look at caviar or fish eggs, you know, salmon, roe, or any fish eggs, but salmon or wild fish eggs that actually really matter so much better, they contain a very special blend of nutrients that are perfect for the brain. They're very rich in a special kind of omega-3 fatty acid that is called DHA. And that is the most prevalent fat inside the brain that needs to be replenished pretty much consistently.

It contains all sorts of lean essential proteins, so all different amino acids, minerals, and antioxidants. That's the super special thing about caviar because usually antioxidants, vitamins, like vitamin A, vitamin C, and those are selenium, and antioxidants, anti-aging, minerals, they're not usually found in animal foods, they're usually found in

plant foods, but caviar really has it all, they're all inside together and also B vitamins especially choline, that vitamin I mentioned that is needed to make memories in the brain caviar is better rich in that

and vitamin B6 and vitamin B12, they're needed pretty much for every single thing to happen inside the brain. So it's a perfect package. Now, it's expensive. I get it. It's not practical. I get it. So it's a great food.

But then second best would be fatty fish. Fatty fish. Okay. Yes. Like fatty fish contains many of the same nutrients as in caviar, not as packed, but still it's a fantastic green food, especially for all the omega-3s that it contains. That could be nice fish like salmon or hammming or bluefish trout but also very inexpensive fish like anchovies or sardines you can buy a small can for maybe a dollar i think in a store if not less

and that's an excellent way to yeah yeah lisa it's it's it's great that you just presented that contrast there because um you know many people say these days that it's hard to eat healthily and it's very expensive and too expensive. And that's a separate topic, probably not for this podcast today. But as you say, caviar is perfect, the perfect food, but at the same time, it's expensive and not going to be accessible for for many people but wild fish well fatty fish absolutely is accessible because as you say you know you can get a a tin of what anchovies for about a dollar out there in the states you know i've been in my local supermarket there's wild wild salmon tinned, 50p, 55p, very, very cheap. And, you know, it's wild salmon in a tin and anchovies in a sort of canned anchovies is a staple in my kitchen.

It's just there. So, you know, sometimes if I'm hungry or the kids want a snack, you know, we'll just get that out. It's a cheap, healthy snack for us all to have. Yeah, absolutely. It's also a staple in mediterranean cuisine and everybody knows the mediterranean diet is very protective against a lot of things like dementia against cardiovascular disease against diabetes and fish is a real big component of the diet. It doesn't have to be expensive. There are many ways to get fish in your kitchen that is totally convenient. And would you say the main, this sort of fatty fish, is the main reason behind the benefits of fatty fish? Is it to do with the omega-3 content, would you say? I would say that, yes. You can get the omega-3 in many you say i would say that yes um you can get omega-3 in many different ways

and from many different sources but the one kind that the brain really needs is called the bha it's a very special kind of omega-3 so omega-3 is a polyunsaturated fatty acid and they can be short chain medium chain and long chain the brain really needs a long chain polyunsaturated fat like DHA. And DHA is really pretty much only found in fish. Fish, shellfish. Yeah, fish and shellfish. So omega-3s can obviously be found in some non-animal foods like flax seeds and various nuts. But, you know, not all of it gets converted in the same way that it can do with animal foods.

But just to really drill down on the brain, you're saying that the human brain needs DHA, this type of omega-3. that the human brain needs dha this type of omega-3 is it is that something that let's say a vegan or a vegetarian might need to be careful about if they're choosing to eat that way i think so i think it's good and i tried being vegan so many times that i really i really looked into that for for personal reasons as well so what happens, there are animal sources of omega-3s and plant sources of omega-3s. Like you said, flaxseed is a very good source. Extra virgin olive oil is a good source. What happens there,

this is a different kind of omega-3. It's called ALA. And it needs to be converted into DHA in the brain, which is perfectly fine. The brain can do it. It's just that up to 75% is lost in the conversion. So you need to start with a lot more in order to reach the same amount in the end.

So you just need to be mindful of that. Yeah, so you can do it. You just need to be very, very on so you can do it you just need to be very very on your game and looking very carefully at this okay that's super interesting okay so we've got um got water we've got uh caviar and fatty fish what are some of these other top brain foods that we can be thinking about um berries berries. Berries are great. Berries? Berries, yes. So berries are basically, this is not a beautiful way to put it,

but it's like that part of the plant that is actually engineered to produce a new plant. So it really contains, the berries really contain all the efforts of the plant to make sure that that particular plant will ensure the survival of the species. So the berries are that part of the plant that are really, really taken care of. You know, they're optimized.

They took millions of years to become what they are. And they're really optimized to make sure that the next plant has all the nutrients it needs to develop wow and so the berries are that part of the plant that is the most rich in all the essential nutrients that the plant needs to grow and be strong and healthy and fight disease and fight predators you know and also be inviting to birds so that they can be disseminated everywhere. And so the berries are really rich in a lot of nutrients, including antioxidant and anti-aging nutrients. It also gives the berries that very beautiful color, right?

Like cherries are very rich in anthocyanins. Anthocyanins are pigments. They have a very strong antioxidant capacity and those make them very appealing. At the same time, they contain a good amount of sugar, glucose, natural glucose, that is very important for the brain.

The brain relies on glucose for energy pretty much all the time. They're also quite rich in fiber. That's a really good combination of glucose and fiber because um it doesn't impact your insulin level as much it doesn't impact your blood sugar level they actually help stabilize it so they're sweet but they're also good for you at the same time then another food would be dark leafy green dark leafy green vegetables okay veggies which

seems obvious perhaps but it's really important to recognize that these greens especially wild greens greens with very very deep beautiful green colors are so rich in phytonutrients or nutrients from plants that have a really strong disease-fighting property. Many are antibacterial, for instance. Many are just protective. They protect the plant, and as you eat the plant, they protect you as well. Fantastic. Okay.

Very good. And then the last one for me would be extra virgin olive oil. I think, I mean, there are many more healthy foods, but extra virgin olive oil is a little bit magical, if you will. And again, I'm Italian, but from a scientific perspective, it's really, it's a very magical food. It's a beautiful blend of omega-3s that are so good for you, vitamin E, which is a really strong anti-aging compound,

and also monounsaturated fatty acids. And if you put them all together, it's good for your heart and it's good for the brain at the same time. So it really protects you, you know, 360 degrees protection. Yeah, fantastic. Well, that's super exciting to hear that from a from

a scientist perspective we've got water we've got caviar we've got fatty fish we've got berries dark leaf greeny vegetables and extra virgin olive oil and you know what's interesting for me as I go through your list is that you know you say dark leafy green veg is obvious but you know I'm not sure these things are as obvious as we've thought them to be and even if they are obvious a lot of the time we're not doing these things and as a population we're not eating enough of these foods so I think it's it's really good that you can highlight specifically that these foods are good for our brain and these are the reasons why and therefore it would be a good idea to focus on those so i'm hoping that this conversation helps

focus people at the end on actually these things are going to be really good for my brain so if you're not eating them for any other reason you know who doesn't want a better brain basically and yes and i'll say you know sometimes sometimes we tend to eat the same things over and over again. Like if I say berries, everybody will be like, oh, I'm going to have a blueberry smoothie. And then my question is, why blueberries? Why do they become the number one berry on the planet? Just because they're available or because they're really the best ones? And so I looked into that and blackberries are actually better.

Wow. Blackberries, or here they say black raspberry, but actually blackberries. Yes, they have a stronger antioxidant capacity as compared to blueberries. So why not try that too? Well, that reminds me of something that the very first podcast, episode one I did was with someone called professor tim specter who is probably one of the uk's uh leading researchers in the gut microbiome and one of his tips for people is something i very much share is the importance

of diversity in the diet yeah yeah so that's some one of his top tips is you know try and eat different foods each week. And you're talking about berries. You're talking about how good they are. But why only stick to blueberries? Why not try, you know, blackberries, raspberries, strawberries, you know. And if you see a new berry that you've never tried before, give it a go. Try it.

Yeah. Yes. And I remember we were talking about gooseberry. Oh, yeah. Because actually, Am were talking about gooseberries. Oh, yeah. Because actually, Amla, the Indian gooseberry. Oh, yes. Yeah, it's their one fruit with actually the highest antioxidant capacity on Earth, as far as research, as far as we know for now.

And I was never able to find it. And then more and more people are saying we have gooseberries they're in the bush outside in the garden and i never tried them but i really i'm trying to get them shipped here again small berries but they're not they're not the indian gooseberries that you were telling me that your mom was doing it to you yeah i remember i remember as a as a kid that we'd have these now and again i really like the flavor i don't think i'd ever thought about it since we had this facebook live conversation a few weeks ago and you mentioned it i just had this memory this really vivid memory of when i was a child having it so yeah I didn't you know maybe you know maybe

my mum was trying to get me into medical school or something like that by giving me those berries so okay so yeah mama knows best exactly um so you've you've told us some of these top foods that are good for the brain what about if we contrast that with what are some of the foods that are good for the brain. What about if we contrast that with what are some of the foods that are bad for the brain or cause issues with our brain? And you've had a very interesting way that you can actually look at the structure of certain brains in your lab to see how food affects the structure, which is really interesting. Yes, yes. really interesting yes yes um we look at brain structure function in chemistry and how specific diets and specific foods and nutrients influence the health of our brains from a very um

comprehensive perspective you know we can look at all these different parameters and in our research and in many of my colleagues research a western diet is really bad news for your brain. So the more processed foods, deep-fried foods, fast food you eat, but also if you eat a lot of fatty foods, this kind of diet combined with an overall lack of fresh fruits and veggies and whole grains and fresh water and healthy oils it's really it's really bad for your brain and we can see it on brain scans like i show you the scans of two people uh contrasting a healthy diet like an indieterine style diet in america but whatever the means more like um uh it's a relatively high carb diet but mostly based on veggies and food and whole grains and fish and nuts and seeds and

healthy oil and the absence of highly processed foods i'm guessing yeah probably just as important i guess absolutely yeah of course and the absence of processed foods and fast foods, especially. If you compare brains of people in these two different diet patterns, you can see that those on the Western diet show accelerated brain shrinkage as compared to the brains of people on healthier diets. And this is for people who are middle-aged, like in their 40s, 50s, very early 60s. But in midlife, you can see these really big changes that are happening in the brain and how the brains are literally shrinking. The hippocampus, which is the memory center of the brain,

is getting smaller and smaller and thinner and thinner. You don't want that, especially when you're 50 year old that is that is a very that's a red flag for future dementia when you're in your 70s what's what's the earliest brain scan that you've done on someone where you've seen this do you do can you recall at the top of your head yeah yeah 35 35 so you've seen a 35 year old's brain showing signs of atrophy and shrinkage so actually at that age i think the most obvious sign is a reduction in brain activity you can see that the brain hasn't shrunk yet but metabolic activity is depressed so you want your metabolic rates to be really high when you're 35 right and if they're not as high that's that's really concerning yeah absolutely that

makes me think you know i wouldn't mind getting my own brain scanned and seeing what's going on it makes you think you know hey what is actually going on at an early age? You know, are there signs that you need to change something? But I guess that's a wider point in terms of medicine. And, you know, this sounds very interesting for the research setting. But I wonder if we'll ever get to the point in the near future where for real prevention, we can actually be picking up this sort of, you know, decreased brain activity, you know, years beforehand and actually then target that person with some recommendations. I know it's probably not here for quite some time, but it's just interesting the way we could...

Oh, have you done it? Yeah, so I am the Associate Director of the Alzheimer's Prevention Clinic, the Weill Clinical Centre, and that's exactly what we do. So our patients... Oh, wow. So that's happening. Go on, tell me. So what sort of patients come in?

Our patients are... We work with people of all ages. I think the youngest is 20-something and we go all the way to 90 years old. And these are people who have a family history of dementia or Alzheimer's disease or other genetic-based factors for Alzheimer's, like an A4E4 genotype, which is something that increases your risk of Alzheimer's without necessarily causing Alzheimer's for you.

They are usually cognitively intact. They have no cognitive symptoms, but they're interested in preventing Alzheimer's with every possible tool at their disposal. Some patients instead are showing cognitive impairment of some form. Sometimes it's subjective. It's more like an awareness that you're not performing as well as you used to.

Some people actually have some degree of cognitive impairment that really shows up on cognitive evaluations. Some people have dementia. But for prevention, we really try to work with people without any cognitive impairment and

many of them receive brain scans. And they, of course, get all sorts of evaluations from labs, neuropsychological evaluations. We do very thorough genetic testing for a lot of markers that show an early predictive

capacity. We look for the lifestyle in deep detail. Exercise, physical activity of any sort, intellectual stimulation, stress reduction, of course, diet in detail. Vascular risk management is also really important. When you say vascular risk management, are you talking about things like blood pressure? Are you thinking about sort of certain blood markers, so oxidized cholesterol, these sort of things?

Is that what we're talking about? Yes, hypertension, all markers for metabolic disease, so BMI. But we also use machines that can really quantify, like, percent body fat, percent muscle mass, percentage water inside your body. And are you tracking the brain scans in these people at all? Yeah. Yeah, so you're seeing someone, inside your body and are you tracking the brain scans in these people at all or is that yeah yeah so so you're seeing someone you're you're getting a baseline of where their brain is you're doing

all these tests you're then making the recommendations on the nutrition on the lifestyle um and then what you you recheck them in a year or two to see what the brain looks like every six months we don't repeat the brain scans every six months because that would be too soon to see anything um but every year so they come back for clinical evaluations and follow-ups every six months actually i would love to do the brain scans every six months but it's so expensive yeah it's really so expensive so we're we're doing a year because it's a good time frame to really, you know, the cost to benefit ratio is actually a good one for everybody. What I find incredible about that is just, I don't know if you're,

you know, have there been any stories where you've seen a brain that maybe wasn't performing as well as you would like it to at that person's age, you've made some recommendations, and then you have seen an improvement at all on a brain scan? Or has that happened? I'm going to let you know in a couple of months, because we're now analyzing the data from the clinic. That's quite a new clinic.

Yes, it's a new clinic. I joined a year ago. Wow. Yeah, yeah, yeah, yeah yeah so that sounds like another podcast conversation in a few months to find out what's happened that's what it sounds like to me what i can tell you is what happens when you don't make recommendations because when i worked at nyu um we followed patients for 15 years and we had the diet information over time, the physical information over time

physical activity, intellectual activity, we really followed them for a long time and if you follow the diet, it is high in processed food, fast food, deep fried food and a lot of meat

and dairy, very high fat diet, your brain declines, your brain deteriorates over time. It's a fairly large effect we're seeing. It doesn't mean that everybody will. There's always

the amazing person who smokes, doesn't move and eats a candy bar for breakfast and is doing fantastic and then you have the person who is super careful and still is not doing as well as they would

of course, but on average on average your brain sucks and I think this is a really important message for people people for everybody to really know because i think there's so much confusion about brain and diet well why why is there that much confusion do you think i i find um i find in part because food is not regulated i think the government is also really confused and there's not a lot of

research done that shows causality. There are some studies that say one thing and some studies that say another thing and everybody has an opinion, especially nowadays what happens is that scientists do the

work and then talk about this work with other scientists and not with the public. And we publish our work in scientific journals that nobody has access to. And so we have an understanding and an agreement over what a healthy diet is. And nobody ever hears about it.

Yeah. Right? And on the other hand, there's the internet that is not subject to peer review. There are no scientists checking what anybody said on social media.

And the information travels at a speed that is much faster than anybody's ability to check it. And you can just say whatever you like you know anybody with a twitter account is an expert in nutrition yeah which is amazing especially in nutrition like nobody really talks about i don't know kidney failure nobody cares but everybody loves food

yeah it's because everyone eats right everyone loves food everyone eats you know what people interested start to see the impacts that food has on the way that they feel and then they share that. I think, yeah, you're right. It's a tricky one because on one hand, what social media and the internet has done is it's made information so easily accessible to the world. to the world. But the flip side of that is there's no regulation on that. And so anyone can say anything. And I, you know, I'm in, I've got a real clash with that, because I think on one hand, that the whole point of the internet, that it is free, and it is available to everyone. So I think that's one of its strengths. And if that starts to get regulated, then I think, of its strengths and if that starts to get regulated then i think yeah it's a challenging one because you're right you know a lot of these journals are behind paywalls and so people that some great research is being produced but people aren't able to read it absolutely i completely i completely agree and i i i love the internet i'm so happy that people are free to say whatever they want, it's wonderful

the problem I think is when we start treating science like fashion yeah a couple years ago everybody was vegan and now everybody's eating fat that is human, we have a tendency to humanize

science and biology we have a tendency to take sides, right? Today we're not touching brain and tomorrow we will not touch meat. But biology doesn't work that way. Any scientist, I think, will tell you that biology is about harmony. Everything in a living organism really strives to achieve balance and equity and homesteads. Everything tends to stay calm in many ways. And it's a very human tendency that we have to try and just stress the system in every way we can.

We're disrupting whatever balance is in the body. We're disrupting whatever balance there is in the body. And I think it would be very important to instead try to support it. Which means really, first of all, understanding how we work in terms of physiology. What does the body need to really be happy at the cellular level rather than at the emotional level? For the brain, the brain is even more difficult to understand because, you know, when you eat certain foods, you can tell immediately I'm gaining weight and losing weight. You know, I can run five miles. I can't do this. I can't take the stairs you can tell it's obvious

but you don't have the kind of feedback immediately from the brain it takes it takes other tools to show what's happening inside your brain and i think that's that you know would you say that's probably where some of the confusion also comes from is that people i think don't think about the foods that they eat in their brain you know people think about food and as you say their weight or how much energy they've got but the brain seems to be this separate organ that's kind of locked away in our skull that you know does its own thing but but what your science is showing is that that's just not the case at all and literally the food arguably the food the same food that's good for

your weight is the same food that's good for your heart is the same food that's good for your brain you know how many times have we heard about the benefits of omega-3 fats and fatty fish and olive oil and dark leafy green veg and berries i mean that is not you know we i think we've heard that before haven't we that these things are good foods for our health. What you're able to do is show us how they are also not only for our overall health, they're very good specifically for our brain health. I think that's what's really exciting for me. Yeah, I think so.

You know, we have, as a society, I think we're comfortable with the idea that they will feed their body, but we're less aware that they will feed their brain as well in the process. The same way that we tend to diet for the present, like I'm going out on a date, I want to look good, I'm going to a wedding, summer is coming, I have to slim down. This is all very good and reasonable, but it's for the short term. I think we need to start thinking about the future and the long term. And in a way, in the same way we save for retirement, we should start to eat for retirement. Because a food shortage today will make an enormous impact not necessarily tomorrow

but when we are 30 years from now yeah i love that in the brain for 30 years and then you can't bring it back you know you have to really protect it now yeah that's it's a really great way to think about things and i think listeners to this podcast know that i'm always talking about these four cornerstones of health and you're saying eat for retirement I would I would add move for retirement sleep for retirement and de-stress and relax for retirement as well because it's not only going to impact the way you feel today tomorrow next week it's going to really have a huge impact on how well you live and you know as as you age um Lisa finally I just wonder you know I'm a I'm a father of two young children and so the more I learn about this kind of stuff um in

my own practice but talking to experts like yourself the more I want to change what I do at home with my children so that you know why wait till they're 40 or 50 or 60 before they start thinking about brain health you know food and brain health um you know i know you're a mother has you know has the research that you've come that you've been involved with has that influenced you think how you feed your child or anything you do with your child a lot a. A lot, yes. I think what's obvious is that when kids are very little, there's a critical window of opportunity

to really help their brain grow and develop in a very optimal way. And that is usually between birth and when they turn three, three to four, like when they're infants to toddler. That's really where you have to put an effort

into feeding their brains with the nutrients because when they're so young, their brains are literally like little sponges. Whatever you put in the system gets inside the brain, almost all of it, except some nutrients, but a lot of the nutrients really get inside the brain almost all of it except some nutrients but but a lot of nutrients really get into the brain and become incorporated into the very fabric of the brain when we're older the brain kind of shuts down the gate you know there's um there's a protection around the brain

it's called the blood-brain barrier that literally shields the brain from pretty much anything you can put inside your body. There are gates inside the brain that open and close when the brain needs to eat. And so, let's say you're low energy, your brain needs glucose, the gates will open and the glucose will flow right in. And then when the brain has enough, it shuts the gates down and that's it. But when you're little, these mechanisms are not as strictly regulated. And for instance, there's a lot more fat that goes from the diet inside the brain.

When we're older, only the omega-3s and omega-6s that we were talking about, the polyunsaturated fats, can get inside the brain. All the other fat is pretty much left outside, just can't get in. But when kids are little

and all the way through adolescence, the brain is still needing fat from the diet just to grow more nutrients and more maternal connections. So the quality of the food is incredibly important. Like you said, I'm a mom, and my daughter is two and a half. And we do not have sugar in the house we just do not have it the only sources of sugar is like honey maple syrup molasses coconut nectar you know natural sources um we do not allow processed foods in the house we do not do fast foods we don't really do takeout which means

i have to cook a lot a lot but it pays off it really pays off like she can write her name two and a half wow you can actually write her name i mean i don't know if it's about you know i i won't take credit for it but i think i think what we're doing is not having bad consequences, let's say. It looks like it's going okay. And my daughter eats fish all the time. She loves it. She actually really likes caviar or salmon roe. Oh, fantastic.

It's dry, and she likes the caviar. But she actually really likes it she eats goji berries for his neck um i only have super high quality fat in the house so like sweet cream butter organic um unrefined vegetable oils i don't have any refined oils in the house she'll have extra virgin coconut oil good for the brain when they're little she eats eggs she eats whole grains she eats tons of veggies and food she's the food monster we say she's the food monster she's constantly eating food that's good it's so Lisa it's so great for me to hear that because it makes me feel like less of a special case with my family and my kids because I'm very much like that with the kids.

You eat better. Yeah, they, you know, I've got to be honest, I'm very lucky they eat very, very healthily. My son is seven, my daughter's five. But I think the learning point for that, I think, is that, you know, I had some, you know, quite dramatic reasons to change children's diets. When my son was very young, he got very unwell. But, you know, I found that if your kids are used to eating

whole wheel foods, right, that's what they want. That's what they crave. But if they're used to eating lots of high sugary foods and refined foods and packets of sweets and actually their taste buds uh so you know that their taste buds adapt and therefore that they want those flavors again so if if you if you think a sweet taste is a packet of haribo sweets right and that's what you're having five six days days a week. Actually, you know, a ripe peach in the summer is no longer going to have the same appeal that it might have done. And I know it's hard if your children are already used to eating lots of junk. I think it can be incredibly challenging for parents to shift them over. But I certainly feel very lucky that I've

come into all this knowledge as my kids were very young particularly for my daughter who sort of grew up in a very nutrition conscious household and I've got to say I'm very proud of how they eat but that's also because we prioritize that at home I don't keep junk in the house and I think that's a good rule for adults as well is that there's a lot of temptation in the world anyway. And so I say keep your house safe zone, make that a safe zone, because then if you want to treat now and again when you're out, OK, fine. But I think it's really hard when you've got that sort of unhealthy stuff at home, because when you're feeling tired and stressed and it's very easy to open the cupboard and go for it so i like your approach which is keep it out the house yeah yeah it's easier and also

but i would suggest to actually cook with the kids like i cook really we spend a lot of time making things together so she really enjoys the process that once she said to me she's in a pink phase everything has to be pink and so of course and so she wants strawberry ice cream because it's pink and I said okay let's go to the market we'll get fresh strawberries and then I got coconut cream and I got honey and we made something that I said was ice cream and they got honey and we made something that I said was ice cream and it tasted like it and it was pink and so she was so happy that she had strawberry ice cream and I was so happy that she was eating something healthy and that she was happy about and she's starting to connect the dots right she's now oh I want that I've been with my mother to the market we bought the fresh foods that we need and then we've made it and that's

you know I think that's going to be invaluable as they grow up and I you know I do the same with my kids and they're involved even my four-year-old daughter she's chopping stuff in the kitchen and it's I know sometimes I post photos on my Instagram about it and people go be careful with a knife and I understand that but you know what are pretty smart. If you teach them how to do it and they've done it a few times, they're pretty, you know, I don't know. I'd like them. I don't want to overly protect them

so they can't use a knife until they're 12 years old. I kind of feel let's, you know, there is a balance, but I, yeah, I think that's, you know, a tip for people listening about how to get your children to eat better is try and involve them in the kitchen if you can. I think that's a great tip. Look, Lisa, whenever we chat, I have a million other ideas and I think we could chat for another two or three hours, but I'm very conscious of your time.

What I try and leave the listeners with at the end of each podcast is some take-home either tips or things that they can think about so if we're thinking about our brain health have you got some top line tips that you can give people I mean it may be things we've already covered that they can just now as we come to the end of our conversation have on their mind as they go about their everyday tasks and think about improving their brain health yes um take care of yourself and take care of your brain just just think of your brain as something that eats sleeps drinks and moves with you because everything you do has effects inside your brain so really try to focus on everything you know that is good for you and good for your brain and make sense and just treat yourself to quality.

I think what's lacking a little bit nowadays is the quality. For instance, foods are just no longer foods. They're some kind of chemical manipulations of real food. They're just convenient and cheap and easy to find, but they're not healthy. So I think what we're learning is that our destiny is not in our genes or our DNA, that aging is not or losing your mind and losing your memory is not a consequence of getting older. There's something, we are accountable for what we do and we have more power than we

realize. And so we should really take our destiny into our own hands and get educated and get smart about things and talk to our doctors and find a way to really be the best version of ourselves that we can be, especially our brain. Yeah, Lisa, thanks. That's really, really insightful to leave people

thinking about things that they can do to help their brain. Lisa, you have written a fantastic book called Brain Foods. I'm going to put a link to that book. I'm going to put a link to all the things that we've spoken about. And also if we can get that brain scan, I'll put a link to that as well. So people can actually see that in the show notes of the podcast um I hope we get the opportunity to talk again very soon I'm tempted to jump on a plane and go on the waiting list at your uh your your Alzheimer's prevention clinic and get my own brain scan so you might see me at the front door very soon um but yeah thank you very much for your time I hope people enjoyed that and I'll see you again very soon thank you so much thank you for having me it was a pleasure take care

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