Feel Better, Live More with Dr Rangan Chatterjee - The Best Foods To Nourish Your Brain with Max Lugavere #330

Episode Date: January 25, 2023

My guest today is on a mission to help people feel better, live longer, and maximise their brain health by optimising their diet. Max Lugavere is a science journalist and a New York Times bestselling author. He believes brain decline is not inevitable, we all have agency in how we age, and the secret lies in our food. This drive began following his mother’s diagnosis with Lewy body dementia aged just 58, and his frustration at the medical world’s ineffective, drugs-only approach to treatment. Years spent trawling the research and asking experts, “Why her?” has given him a wealth of knowledge that he is keen to share with others. Through his books Genius Foods, The Genius Life, and cookbook Genius Kitchen, as well as a long-running podcast, Max shares evidence-based principles that will help all of us protect our brains. And his passion, along with an encyclopaedic ability to recall and communicate the science, is why I really wanted to talk to Max on my show. Max talks us through the three food types we should think about cutting out – and why. We discuss ultra-processed foods and why it’s not in our nature to consume them in moderation. He explains the wholefood matrix, and the protective synergy that comes with eating foods, in a minimally processed state. If you’ve ever wondered about the healthiest fats to cook with, Max covers this in detail.   He also shares which specific foods he recommends we all include in our diets and what brain-healthy nutrients they provide. Perhaps controversially, we discuss the adage ‘Everything in moderation’ and why this might not be the healthiest approach. If we’re going to declare some foods good, says Max, other foods must therefore be bad. And within the context of a sick population, surely we should be bolder about advising people to quit the food types we know are unnatural and harmful?   Having experienced the trauma of his mother’s illness, Max isn’t bothered about the critics, he’s just really keen to help people. He’s an advocate for informed consent, sharing facts to enable us to make tailored, better food choices. Above all, his message is one of balance and realism. We can all make choices every single day that set us on the path to better health, even if we’re only taking baby steps. I immensely enjoyed my conversation with him. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Thanks to our sponsors: https://www.athleticgreens.com/livemore https://www.vivobarefoot.com/livemore Show notes https://drchatterjee.com/330 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider with any questions you may have. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

One of the biggest food issues related to disease is the preponderance of ultra-processed foods in the food environment. And these foods pull the trigger in many ways on our predisposition to chronic diseases. Every 10% increase in ultra-processed food consumption has been associated with a 14% increased risk in early mortality. And oftentimes, we feel a sense of moral failure when we're not able to moderate our consumption of these foods, but these foods are not designed to be consumed in moderation. So it's not actually a moral failure. It's something that these foods are quite explicitly designed to do. Hey guys, how you doing? Hope you're having a good week so far.

My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More. My guest today is on a mission to help people feel better, live longer, and maximize their brain health by optimizing their diet in line with the latest research. Matt Slugovit is a science journalist, New York Times bestselling author, and someone very much like myself who is dedicated to empowering individuals to take charge of their health. He believes that brain decline is not inevitable. We all have agency in how we age, and the secret lies in our food. Now, this drive began following his mother's diagnosis with something called Lewy body dementia, aged just 58, and his frustration at the medical world's ineffective

drugs-only approach to treatment. Years spent trawling through the research and asking experts why her has given him a whole wealth of knowledge that he is keen to share with others. Through his fantastic books, Genius Foods, The Genius Life, and his cookbook, Genius Kitchen, as well as his podcast, Max shares the evidence-based principles that will help all of us protect our brains. And his passion for doing this, along with an encyclopedic ability to recall and communicate the science, is why I really wanted to talk to Max on my show. Now there is so much actionable advice packed into this episode. Max begins by talking us through the three food types that we should think about cutting down on and why. We discuss what

constitutes an ultra-processed food and why it's not in our nature to consume them in moderation. He also explains the importance of the whole food matrix and the protective synergy that comes with eating foods, particularly fats, in a minimally processed state. And if you've ever wondered about the healthiest fats to cook with, Max covers this in detail as well. He also shares which specific foods he recommends we all include in our diets, and what brain-healthy nutrients they provide. And perhaps controversially, we also discuss the adage, everything in moderation, and why this might not be the healthiest approach for everyone. Max says, if we're going to declare some foods good, other foods must therefore be bad. And within the context of a sick population, surely we should be bolder about advising people to quit the food types we know are unnatural and harmful.

to quit the food types we know are unnatural and harmful. Having experienced the trauma of his mother's illness, Max is not bothered about the critics. He's just really keen to help people. Above all, I think Max's message is one of balance and realism. I immensely enjoyed my conversation with him. I hope you enjoy listening. And now, my conversation with Max Lugavere. I think many of us are aware now that the foods we're consuming are hugely increasing our risk of getting sick in the future. In your view, with all the research you've done, what do you think are some of those common foods or types of foods that we should think about cutting out or at least reducing to reduce the chance that we're going to get sick?

That is a great starting place. And if you would have asked me this question five years ago, my answer probably would be a little bit different than it is today. But at this point, what I've come to realize is that one of the biggest food issues related to disease and our predisposition for any number of non-communicable so-called diseases of civilization, including Alzheimer's disease and other forms of dementia, is the preponderance of ultra-processed foods in the food environment. So this is a category of foods

that has been classified as ultra-processed in accordance with the Latin American devised NOVA food classification system. And these are foods that you couldn't make in your own kitchen. These are foods that typically line our supermarket aisles. They're the foods now that make up 60% of the calories that Americans are consuming worldwide. And these foods pull the trigger in many ways on our predisposition to non-communicable chronic

diseases. Every 10% increase in ultra-processed food consumption has been associated with a 14% increased risk in early mortality and a 25% increased risk in the development of dementia. These are the foods that are typically shelf-stable. They have long ingredients lists. They don't rot, right? They're not the kinds of foods that have immediate shelf lives. And they typically have a number of different characteristics that make them in particular dangerous. There's nothing about them that is inherently toxic, but it's the confluence of variables that make them a driving, that make them a driver of this epidemic that we're talking about.

to describe a food that is so delicious that it literally lights up the equivalent of the 4th of July's fireworks. And sorry to drop an Independence Day reference on your podcast, Rangan, but, you know, on my side of the pond, 4th of July, that's when like you get the biggest firework show of the year, right? And that's when you consume these types of ultra processed, package processed foods that are hyper palatable, it pushes your brain to a bliss point beyond which self-control is nearly impossible. I mean, some people can do it, right? But I think a very common experience that most people have, you know, for example, with ice cream is that they open up the

pint of ice cream intending to have, you know, one spoonful. And before they know it, they're looking at the bottom of the pint. And oftentimes we feel a sense of moral failure when we're not able to moderate our consumption of these foods. But these foods are not designed to be consumed in moderation. So it's not actually a moral failure. It's something that these foods are quite explicitly designed to do. Yeah. One of the key points there for me was the fact that these foods are

hyperpalatable. We struggle to stop consuming them. And I think everyone who's listening to the show right now or watching will know that feeling. They've tried to embark on a new eating plan. They've tried to exercise self-restraint. Yet, if those foods are in their house, many people really, really struggle to stop. How do you tackle that though for people? Because they are everywhere. They're everywhere in America. They're everywhere in the UK. They're everywhere in the world, frankly, these days. And they're foods that are absolutely contributing to how sick many of us are getting. Yet many of us just don't know what to do about that. Yeah, there was actually a project done by a photojournalist. I'm not sure the name,

but people can go to Google Images and look for a week's worth of food, like a typical week-long shopping haul from both an American family, a family in the U.S., as well as in the U.K. In the U.K., it's a Caucasian family. In the U.S., it's an African-American family. But you can see the week's worth of groceries typically consumed in both countries. And you have to use a magnifying glass to find the fresh, perishable food. It's primarily ultra processed food or these mixed dishes, which combine fat, sugar, and salt, the so-called Dorito effect, that make foods difficult to, you know, not just difficult to consume moderately, but incredibly calorie dense. So as I mentioned, it's not that these

foods are innately toxic or innately fattening, but they are obesogenic, meaning they do drive obesity and metabolic dysfunction because we tend to overconsume them. When eating to the point of satiety, we tend to overconsume these foods. And this was proven in a very elegant study funded by the NIH, actually, led by a well-known obesity researcher named Kevin Hall, who found that when people are given access to ultra-processed foods and told to eat to satiety, as a human does, we like to eat to a point of satiety, of fullness, that when allowed only to consume ultra-processed foods, people ended up eating a 500 calorie energy surplus, right? So an energy surplus is the way that's how we store. That's why we store fat

essentially, right? It's like the law of thermodynamics. So these foods, by the time we've eaten to satiety, we've already over consumed them. But in this crossover trial, what they were also able to show was that when you give the same people access to minimally processed foods, these are kinds of foods that you are potentially able to cook in your own kitchen, depending on food access and availability, all important factors, of course, that they ended up eating to the same degree of satiety, but they came in at a 300 calorie energy deficit. So that's an 800 calorie swing. That is a significant amount of calories determined purely by the quality of the food that these people were eating. So oftentimes somebody who's overweight, they get told by

their doctors to just eat less, move more, right? To moderate the quantity of the food that they're consuming. But here's the kicker. The quality of the food that a person is consuming dictates, or at least influences, the quantity. Yeah, that's such a key point, isn't it, for people, Max? Whether it's, you know, to lose weight, reduce their risk of disease in the future, to help them lower their blood sugar, you know, whatever their health goal might be. You know, a lot of people these days, they want to find a way to eat less. They don't want to be consuming as much as they're often consuming. But a lot of people still don't realize that actually the quantity often is downstream from the quality. Get the quality bang on, then often, not always, I know it is possible, right, to overconsume good quality food. I've

certainly done it myself, but it's just a lot less likely, isn't it? It's a lot less likely. And we attribute that characteristic to the food matrix. So there are three factors. We're getting a little bit off topic, but I think this is important to the three foods, the types of foods that people should generally avoid. But I think it's really important for people to understand the qualities of the whole food matrix. So the qualities of whole foods contrasted to these ultra-processed foods that make a food satiating. And so the problem with these ultra-processed foods is, aside from the fact that they tend to be hyperpalatable, they are very calorie dense, typically, and they are minimally satiating. So the three factors that make a food satiating are one, it's protein

content. Protein is the most satiating macronutrient. So when we talk about macronutrients, what we're referring to is our protein, carbohydrates, and fats. But much more so than carbohydrates and fats, protein is the most satiating, meaning it's the most likely to fill you up and to turn off those signals and cues related to hunger, right? And so the problem with ultra-processed foods is that they tend to be diluted of their protein content. This is for, I think, many reasons. One is that protein just tends to be expensive. So when you remove the protein from a junk food, you increase the margins. So this is something that's very attractive to food manufacturers, right? This is why ultra-processed junk, you know,

the foods that your grandma would look at and say, that is junk food. These foods tend to be some combination of carbs and fat, right? They tend not to be high-protein foods. Protein is the most satiating of the macronutrients. So if you're hungry, you want to look for foods that are high protein, which tend to be whole foods. The other factor that makes a food satiating is its fiber content. So when food gets processed and processed and processed and removed from this food matrix. What you lose, among other things, is the fiber. And fiber, we don't have a biological requirement for dietary fiber, but it does seem to improve life. It does seem to be associated with lower levels of inflammation and increased longevity.

And it does support the gut microbiome, which you've talked about many times on your podcast. But the reason why fiber is satiating is because it mechanically, it stretches out the stomach. So it turns off the release of a hunger hormone called ghrelin. And it does so by absorbing water in the gut. And then the third factor that makes a food satiating is its water content. Now, why are ultra processed foods deprived of water? Because water impedes on a food's shelf stability, right? The more moisture in a food, the less shelf stable that food is going to be, right? And so you remove water from an ultra-processed food, that just further depletes its satiety index, its satiety value. And water is satiating because we obviously, you know, we can

go a few days, weeks, maybe months for some of us without food, but only a few days without water. So water is of utmost importance to the, you know, physiologic functioning of the human body. But when water seems to be available for one of our hunter-gatherer ancestors, where would the next best place be, right, to find water? It would be in food. So a lot of times our thirst cues, or our hunger cues rather, are just the crossed wires of us just requiring a little bit more hydration. Yeah, Brilliant, Matt. Super, super useful. So one food group that we want to think about avoiding are these ultra-processed foods. Any other foods or food groups that you would encourage us to look at and go, just be careful there? Yeah, definitely. So this is a bit more controversial, but I think

it is probably worthwhile to minimize your consumption of grain and seed oils. Now, this is controversial because the nutritional and medical orthodoxy still loves and encourages the consumption of these types of fats. In fact, I identified by going to the, at least in the United States, the MyPlate paradigm, which is sort of the predecessor to the, or the successor rather to the food pyramid, which, you know, was the first paradigm that really told Americans how to eat. So now we have the MyPlate. And if you go to myplate.gov, I believe is the URL, it still implores us to consume more of these types of oils, these unsaturated grain and seed oils. And specifically what I'm talking about are industrially produced, refined, bleached, and deodorized grain and seed

oils like canola oil, corn oil, soybean oil, grapeseed oil. And I think it's very much worth, in accordance with the research, swapping these oils for extra virgin olive oil, which has a ton of evidence on, you know, being cardioprotective, being neuroprotective, being supportive of metabolic health. And so I make that recommendation for a number of reasons. One, the preponderance of evidence really does support that extra virgin olive oil has myriad health benefits yeah right it's anti-inflammatory it's got a very cardio uh cardio protective fatty acid profile so it's rich in heart healthy monounsaturated fat it's chemically stable which is not that you can't say the same thing about these refined bleached and deodorized grain and seed oils

so you can actually cook with it you can use it it as a sauce. And we have, whether it's animal research, observational level data, like looking at people who adhere to a Mediterranean dietary pattern or the MIND diet, which is protective of brain health. Extra virgin olive oil is the only oil that's recommended in the mind diet and in the Mediterranean dietary pattern. This is, I think, crucially important and tends to be overlooked. They're not recommending that people ingest more canola oil in these dietary patterns that are associated with reduced risk for dementia, for Alzheimer's disease and other chronic conditions. Yeah. I mean, even when you describe those oils, you use three terms,

refined, bleached, and deodorized. If we just take a step back for a minute, those are three terms that I don't think many of us want to associate with the food that we're putting inside our bodies. You know, it's that stark when you describe it. Do you think this is more of a problem in America than, let's say, in Europe? Like, where does sunflower oil, for example, fit into this paradigm here? Yeah, great question. So there are different types of sunflower oil. You can actually find on the market a variant of sunflower oil,

because sunflower oil typically is one of these kinds of oils that I'm suggesting that people minimize their consumption of. But you can often find, especially now, a variant of sunflower seed oil called high oleic sunflower oil, which I think is actually okay to use. It's still not as good as extra virgin olive oil, but it is primarily oleic acid, which is a very abundant type of fatty acid found in nature. It's chemically very stable. And so it actually has a fatty acid profile that looks quite similar to avocado oil. And so I think that that's fine there I think manufacturers are becoming wise to the fact that some of these earlier iterations of of these grain and seed oils are just very chemically unstable they're prone to oxidation they're prone to chemical degradation rot essentially that you

can't see it's not visible to the naked eye but oxidation to an oil is essentially rot yeah so sunflower oil hyolaic sunflower oil i think is a fine um alternative but but yeah you're you i it was so great um rongan that you that you tease this out because we know that ultra processed foods as i've mentioned is associated with all the bad things that you don't want right that we should there's no health expert um out there no nutrition expert that would say we need to consume more ultra-processed foods, right? Everybody's saying we need to consume less. So why do these refined, bleached, and deodorized grain and seed oils get a pass?

They are the very definition of ultra-processed. You couldn't make them in your own kitchen if you tried. They didn't exist in the human food supply prior to 100 years ago. That's a really key point for me when we're looking at these modern foods or certainly these modern food-like substances. If there is any doubt with evidence, if there's, you know, conflict, if there's debate on both sides,

I think a reasonable thing to look at is how long has this been in the human food supply for? It's not the only thing, but I think it's a pretty reasonable thing to look at and go, well, it didn't exist 100 years ago, 150 years ago. I think that note of caution is pretty reasonable because it is really, really divisive at the moment, this whole vegetable oil thing. Some people are saying there is no evidence at all for people to be reducing this in their diet. Other people are saying we should never be touching these things at all. And, you know, I think you're making a very strong case that I think for most of us,

we should absolutely be limiting them. This is where eating out sometimes becomes problematic for people when, you know, they're changing their diets, because these are typically the oils that are used when we're eating out, aren't they? Because they're cheaper. Yeah, they're dirt cheap. In fact, many of them are byproducts of the food industry. It's like their, you know, grapeseed oil, for example, which is now commonly used. If you go to the supermarket, most commercially produced salad dressings are going to use grapeseed oil as the primary oil. It's just, it increases the margins of food, of these food products, these food-like products. But grapeseed oil was actually, grapeseeds were thrown away. And grapeseed oil today is a byproduct of winemaking.

Until one industrious wine manufacturer realized that you could take these seeds, you could press them and extract this oil from them. But these oils tend to have noxious aromas and flavors. They're very bitter. I mean, if you've ever chewed on a grapeseed, it's not a pleasant taste, right, that they impart. And so they were thrown away until we realized that we could take this oil and we could run them through. And the same with corn oil, with soybean oil, you could run them through all these different steps and end up with a tasteless, bland product that could be used in any number of food manufacturing processes, whether it's, you know, the creation of cereal granola bars, you can roast nuts in these oils, you can use them in the restaurant setting to fry

foods in. It's a food industry's equivalent of the witness protection program. You take an oil that's otherwise noxious and you rob it of any character. But in so doing, you're also robbing it of the protection that that fat had in its whole food form, right? In a grapeseed, you have antioxidants that protect the fat. In, for example, soybeans or corn, you have antioxidants that protect these fats. But when stripped of, again, going back to the food matrix, you deprive these very unstable fats of the antioxidants that would otherwise protect them. And it allows them, it gives them this characteristic of vulnerability

and then you put them in the restaurant setting right where they're kept in a plastic jug exposed to oxygen right which is what um catalyzes this oxidative process for months on end right because restaurants love to buy in bulk and then you put them in the in the fryer yeah right and you keep it there at temperature, at frying temperature for days at a time, sometimes in restaurants. And that's where these oils really become dangerous. So, you know, I think like the moderate message is that, you know, the dose makes the poison. And if we're talking about the oils that you're bringing into your house, I suggest not doing that, but it's not going to kill you, right? Necessarily to have a little bit in your house here and there. Most people, when they cut these oils out, in fact, they end up cutting out

ultra processed foods in general. And so they see they'll inevitably see a health benefit to doing that. But in the restaurant setting, as you mentioned, I think this is where these oils become particularly pernicious and that's because they're kept in the fryer, right? And you just don't know how they've been treated. And so fried foods, we know that fried foods are actually quite unhealthy. Again, the dose makes the poison a little bit here and there is not going to be a problem, but they did a very interesting, and this was a mouse study just to be clear, but where they took oil from the fryers, this lab took oil from the fryers being used at local Mediterranean restaurants that was used to fry

falafel in, right? And they fed it to mice in doses that were reasonable to assume that a human could be exposed to, right? Oil literally taken from the fryers of a restaurant. And what they found was that it increased colonic inflammation and it increased gut permeability. So leaky gut, the translocation of dangerous, for example, endotoxin or lipopolysaccharide, which is quite inflammatory into the circulation of mice. And it accelerated the growth of tumors in mice that were genetically prone to developing tumors. Wow. And so mouse study, just to be very clear. But yeah, I think that's where we have to be

particularly vigilant in avoiding the oils in the restaurant setting. Yeah, I appreciate what you said there about the dose making the poison. I think that's one of the things, Matt, I've always loved about your approach. You are very clear about what you think based upon the research you've done. But I've always found you to be very nuanced. There's always context. There's always, yeah, but look, on balance, this is where you should put your focus. And I really appreciate what you're saying there, because frankly, it's very hard for people to avoid those oils 100% of the time. Unless they're going to just stay at home, cook all their meals with

extra virgin olive oil, it's going to probably be impossible to avoid those things all the time. So it's just about when can you have control over that oil? What can you do? I'll tell you, something I do, which again, some people will probably regard as over the top. which again, some people will probably regard as over the top. Now, a bit of background, I'm actually very sensitive to foods, which you may regard as a curse or potentially a blessing, because I get an immediate reaction to certain foods and it comes in the way of mucus, where I feel that my sinuses are clogging up. So I rarely get that at home because I've sorted out my diet so I know what agrees with me, which is basically a whole food diet. But when I'm out, of course, it's a lot more variable.

Even if I feel that I'm ordering something that I think I'm going to be okay with, it's not like a life-threatening allergy, but I can feel it afterwards. I can feel it when I'm lying in bed at night that there's mucus being produced. And there's a local Thai restaurant that we really like. And over the past two years, if we ever go there, I just take my own oil. It's just down the road. I could never feel like it. And I know them there. I said, hey guys, can you cook it in this for me? And they do. And when they cook it in the oil I provide for them, I don't feel a thing. So I get to enjoy it. I'm not kidding myself that it suddenly makes it really, really healthy, but I'm sure that's purely down to the oil. And I think that really speaks to the point you're

making, right? Which is these oils can be problematic for us if consumed in large amounts. So I don't take that oil with me everywhere I go. This is in the town I live, a local restaurant that we like eating in. If I'm in London or I'm traveling, I don't take my own oil with me. I take the hit. And I know to some people, it's an extreme thing to do, take oil with you. But for me, that works for me. I'm very happy with that. I feel I've got that sort of balance, right? Yeah, I love that. And, um, and I think, you know, you're somebody who's like clearly taking, taking his health into his own hands, which I think is really important.

You know, wellness and healthcare is something that we, we need to realize is something that we institute in ourselves when we are negotiating with ourselves, for example, to get off the couch and go to the gym or when we're pushing our shopping cart around the supermarket. I think it's super important to take an active role in this, as you clearly do. But there's one other aspect of seed oils that I think is worth talking about.

My passion is food and brain health. Yeah. And, and specifically dementia prevention. I think this is like a really important topic and we don't know the long-term brain health outcomes of regularly chronically ingesting these types of fats. These fats are primarily polyunsaturated. So it's some combination of linoleic acid or the omega-6 dominant fatty acids and alpha-linolenic acid, which is the plant-based form of omega-3s, which is incidentally even more prone to oxidation, more vulnerable than linoleic acid. And the brain is primarily composed of these kinds of polyunsaturated fats. And these fats have easy access to the brain because they're what constitute

our brains. And we don't have any long-term data on this mass public experiment being played out on a public stage where we're consuming three times more of these kinds of fats than we did at the beginning of last century, right? And so we don't know the implications. And so that right there, that looming question mark about what these kinds of fats do to the brain, which, by the way, lipid peroxidation is a major, so the fact that these oils are so prone to damage is a major driver of brain disease, right? It's a contributing factor to Alzheimer's disease. It's a big problem. So we don't know.

However, there was a 2021 randomized control trial in humans led by the first author was Ramsden. And it looked at people who are prone to migraine, right? So migraine is interesting because there's a neuroinflammatory component to migraine, right? And it's something that you feel, like you feel with unmistakable certainty. And I actually personally myself occasionally suffer from migraines a couple, you know, once or twice a month. And what this randomized control trial found was that they took three groups. One group was left to their control diet, you know, whatever diet they had been consuming. The second group was given more omega-3s to consume, so about a gram and a half a day of omega-3s.

And we know that omega-3 fatty acids are great because they resolve the inflammatory process. And most people under-consume omega-3 fatty acids. So the thinking was that that would be enough to maybe bring the symptomology down on these migraineurs, people who are suffering from chronic migraine, right? But then the third group, what they did was they gave them also the omega-3s, the one and a half grams of omega-3s to consume daily. And they also told them to reduce their intake of linoleic acid, which is the primary fatty acid found in these grain and seed oils that we're talking about, right?

And what they found was that in terms of headache frequency and severity, the group that was told not just to increase their omega-3 intake, but to also reduce their consumption of these polyunsaturated fat-dominant grain and seed oils, the kinds of oils that we were talking about, right? Canola oil, corn oil, grapeseed oil, soybean oil. They saw twice the reduction in migraine frequency and severity when they were ingesting more omega-3s and also concurrently reduced their intake of these

grain and seed oils. So very telling. The study involved about 200 participants, you know, certainly should be replicated, you know, to confirm those findings. But I think very interesting. And again, there's a neuroinflammatory component here to migraines. And the fact that these oils are, according to this study, likely contributing in some way in this 16-week trial, I just think very interesting and worth paying attention to.

Yeah, that is so interesting, Matt. It makes me think about my clinical practice. And you know full well that medical doctors like me are not really given much training in nutrition or lifestyle interventions and how they can help our patients. If anything, we may hear a little bit about it for weight loss and type 2 diabetes, but beyond that, you know, depression, anxiety, migraines, all kinds of other conditions, really there's nothing around food and how it can help. Now, what we do get

when we get taught about migraines at medical school is we get told there are some foods, red wine and cheese, that may be contributing to migraines. So most doctors, if we have a patient who is struggling with migraines, we may inquire about red wine intake and cheese intake and potentially recommend our patients reduce them. and cheese intake and potentially recommend our patients reduce them. And sometimes, you hit the jackpot and you're like, okay, great. And other times, it doesn't seem to make a difference. But probably for about 10 years now, with pretty much all of my migraine patients, and frankly, pretty much all of my chronic disease patients full stop, I will go through a process of helping them completely change their

diet. Certainly for a two, three-week period, just to see if you go all whole foods, if you cut out all processed foods for two to three weeks, what happens. And more often than not, there is some improvement, but often there is complete reversal or some of the symptoms just go away. Now, I've seen that in migraines. Again, to be really clear, not with every migraine, but with many migraine sufferers, I found that after this two, three-week trial onto a whole food diet, their migraine frequency would go right down. Now, I didn't know what exactly it was in the diet that was causing it. And bit by bit, I helped them sort of reintroduce foods to see what it potentially might be. But this trial from 2021 now is making me think, well, maybe for a significant proportion of those patients, it was actually the fact that their oils changed.

They weren't eating those highly processed refined oils that are in ultra processed foods. But also, I would always encourage them to cook their food with extra virgin olive oil and pour extra virgin olive oil onto their salad. So that's really, really interesting. Absolutely. And extra virgin olive oil has an anti-inflammatory aspect to it. It contains a compound called oleocanthal, which is as anti-inflammatory as low dose ibuprofen, which is incredible because ibuprofen and all other non-steroidal anti-inflammatory drugs, chronic use of those types of drugs,

as you know, Rangan, are associated with cardiovascular. Yeah. That's right. So with extra virgin olive oil, you get all the upside of taking tiny doses of this category of drugs, but none of the downside. And I'll also add that Ramsden 2021 study, the patients who were on this intervention of simultaneously increasing their omega-3 intake

and decreasing their intake of industrially refined grain and seed oils. They also, I believe they were able to cut their usage of NSAID drugs in half. So they were able to take less drugs, right? So this clearly proves that in a way, food is a form of medicine, particularly if you're a migraine sufferer. Yeah, yeah, really, really powerful. Okay, Matt, so far, ultra processedprocessed foods, we want to reduce as much as we can. People have heard that on the show before. I hope each time they hear it, they just reduce it a little bit more in the context that their lifestyle, what they feel is achievable for them. You mentioned to really be aware of these refined seed oils,

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I mean, I think it's always important to underscore the insidious nature of added sugar today in Western diets. So I would say that added sugar is something that people need to become as well more mindful of and to do their best to minimize. Today, your average adult consumes about 77 grams of added sugar. So this is sugar removed from the food matrix again, and sugar for which we have no biological requirement. 77 grams of added sugar every single day. So just to visualize what that looks like, that's about 19 teaspoons of sugar, added sugar that adults are ingesting every day.

That's way more than, you know, even if you were to look to the dietary guidelines, for example, like, you know, in our country, we have the USDA or the American Heart Association, even. This is way more, almost double the recommended amount. And when you consume that amount of sugar, first of all, sugar, again, dose makes the poison, as with most things. It's not inherently fattening, but it does contribute empty calories to the diet. And it also contributes to the fact that

it contributes to the hyper palatable characteristic of most ultra processed foods, you know, the added sugar component. It's insidious, as I mentioned, so you can't, you know, it's just, it's, it tends to be hidden, um, whether it's in commercial bread products or sauces, um, added sugar seems to be everywhere. We know that glycemic variability, um, is associated with increased feelings of hunger. So eating a high sugar, um, snack or meal could actually perpetuate feelings of hunger as opposed to, uh, satiate, um, you know, and then to reduce feelings of hunger, which is, you know, kind of ironic and counterproductive. We know that high sugar boluses, meaning, you know, in one single meal consuming a very high amount of sugar has been

associated with a drop in testosterone by about 25%. We can see that high sugar boluses increase systolic blood pressure, and this seems to persist for hours after ingestion. We know that high blood pressure is a risk factor for not just stroke and cardiovascular disease, but also for dementia. You know, we rely on the healthy functioning of the blood vessels that supply fuel

and nutrients to the brain. And so they've shown this in, actually, these are oral glucose tolerance tests where they'll use 75 gram boluses of glucose. And they show that when you give this to a patient, you see an elevation in their blood sugar, right? Now, this is just in one setting, but we tend to consume that amount of sugar on a daily basis. So I don't know if there's a threshold effect that occurs, but it tend to consume that amount of sugar on a daily basis. So I don't know if there's a threshold effect that occurs, but it's reasonable to assume that, you know, consuming that level of

sugar on a daily basis isn't good for our blood pressure, isn't good for our hormone health. In fact, we see that added sugar consumption is associated with reduced testosterone in men. And so, yeah, definitely being mindful of the added sugar and doing your best to minimize that, I think, crucially important. And one of the big problems, I think, and contributing to this insidious nature of it is that sugar tends to go by many different names in the food supply. Yeah, I think this is certainly a huge problem in the UK and Europe, no question. My feeling is that it's even more of a problem in America. And you can see on the labels here in the UK that there is added sugar. It sneaks in everywhere. Whatever you buy, if you're not careful, you will be having

more sugar than is good for you. There's no question about that. But I actually think it's worse in America. I know you've traveled to Europe many times in the past. I know you've, you know, reading your books, there's a lot of research that you've done over in Europe, in Finland, in Berlin, all these kinds of things, fascinating research studies that you've outlined in your book. What's your take on how the land lies in the rest of the world compared to America? Well, yeah, we are now exporting our obesity epidemic. And it's become our number one export, in fact. And it's unfortunate because, you know, there are many traditional diets around the world that are associated with longevity.

Like in the medical literature, we love to harp on the benefits of adhering to the so-called Mediterranean dietary pattern. But we know that there are other dietary patterns that are associated with robust health, like the Japanese dietary pattern, for example, which is very high in fish, contains white rice. But again, foods that take into account the whole food matrix. And now this preponderance of ultra processed foods with added sugar has really become a massive export for, you know, and contributor to the growing pandemic of obesity and associated conditions. So it's a big problem. I think it has to do with the fact that sugar is cheap. Again, it contributes to hyper palatability, which makes repeat customers for the food industry. And yeah, we just, and yeah, we just, you know, we love we love sugar. I mean, we've, we've evolved to like sugar. When sugar

is in the body, it causes the hormone insulin to become elevated, which tells our body to store fat, right? It not only tells our body to store fat, but it keeps our fat, it keeps our fat siloed away, so that we burn sugar instead of our hard-won fat stores, which back prior to the ubiquity of food stability, right, when food scarcity was a real problem for most people, being a better fat store was actually an advantageous physiologic phenomena, right? And sugar is the primary food ingredient that tells our bodies that essentially it's summer. Fruit is ripe. Gorge yourself on fruit and store fat. And so that today has become hijacked by the modern food supply. And it's not to say that sugar is the primary driver of obesity. It's not. It really comes back to ultra-processed foods, hyperpalatable

mixed dishes and the preponderance of these oils and the like. But sugar, when consumed, especially in the quantity that it is consumed today, it contributes. It's, again, empty calories, and it's a huge problem. Yeah. So, yeah. And it's now, you know, all of these, like, it's hard to find now populations that are adhering to their traditional diets, which is quite sad. So, we have covered these three big categories of foods that if we can reduce them at least in some way from our diets, we're probably going to experience benefits straight away and reduce our risk of getting sick in the future. Now, of course, if we are going to cut those things out,

we have to think about what we're going to bring in, right? And I know that's a huge part of your focus in all your books. The new cookbook, Genius Kitchen, is fantastic. Loads and loads of fantastic recipes in there. One of the central underlying principles, I think, Max, in your work, certainly what I take from it is that we have agency over what happens to our brains as we get older, right? And that's something that I don't think is the prevailing narrative in society. I think a lot of people accept that as I get older, my brain is going to get slower, I'm going to get duller, I'm going to lose my memory. All these kinds of things are just accepted as the narrative, whereas I think your work is really challenging that. I want to talk about food today, foods that we can bring in. And there's a line that I really like in Genius Foods.

We deserve better brains and the secret lies in our foods. Expand. Absolutely. I just got, I mean, is it weird to get goosebumps from your own The secret lies in our foods. Expand. Absolutely. I just got, I mean, is it weird to get goosebumps from your own writing? I hope not. But as you read that back to me, you know, because it's been some years since I've written and released Genius Foods, but it's so true. And the more research I do, the more that statement is confirmed by the research coming out from our most trusted medical institutions.

And I think it's so crucial, crucially important to, for people to realize, you know, back when I got started in this, there were not many rooms where you could use dementia and prevention in the same sentence. And I'm sure you know this to be true from your training, Rangan, like dementia was not previously thought to be a preventable, potentially preventable condition. And I think this is for many reasons. One, there's just the mystique of the brain, right? We know more about space than we know about the workings of our own brain, which I think

is unfortunate, but it's just a, it's a tribute to the elegance and the complexity of the human brain. And also the brain was thought to sit in isolation from the rest of the body. So it's fairly easy to draw blood and to see what's going on, for example, in the body of a patient with, for example, type 2 diabetes, or to look at lipids and see how that relates to cardiovascular disease. But the brain was thought to sit in sort of the ivory tower of the body, guarded by what's called the blood-brain barrier. It was also thought previously that you were kind of stuck with the brain that you were born with and that the brain reached a level of maturity in about the mid to

late 20s, past which it would just sort of decline, right? Begin this slow, gradual decline toward the inevitable decrepitude that tends to be associated with aging. But we now know that dementia is not a normal aspect of aging. We have certainly genetic risk factors, but the vast majority of dementia cases are not attributable to deterministic genes. For example, many people carry what's called the APOE4 allele, which is the most well-defined genetic risk factor for Alzheimer's disease. About one in four people carry one copy of the APOE4 allele, and a smaller proportion carry two copies, which is inherited. You either get an APOE2, 3, or 4 allele. You get one copy from your mom and you get the other copy from your dad.

And depending on whether or not you carry an APOE4 copy or 2, your risk for developing Alzheimer's disease increases anywhere between 2 and 14 fold. but that's risk, right? So we're talking correlation. We're not talking causation. A very small proportion of people have deterministic genes, but this makes up only two to 3% of Alzheimer's cases. So I want the people that are watching this, listening to this, to know that you have a degree of control in terms of your cognitive destiny and food plays a major role here. And so it was, uh, only very recently that we started to see real evidence come out, showing us that dementia for many, for the majority, in fact, is a potentially preventable condition. And it was the 2020 Lancet commission on Dementia where they actually made a statement that also gave me goosebumps when I read it, that the potential for prevention is high.

And in this paper, they stated very clearly that 40% of Alzheimer's cases are attributable to what are called modifiable risk factors. attributable to what are called modifiable risk factors. Now, these modifiable risk factors that they listed, and we can talk about them, were not, in my view, all-encompassing, right? So, they didn't comprise the full breadth of ways that people can be affected by environmental variables that can ultimately predispose one to developing this condition. So, in fact, I think that actually the majority of cases are potentially preventable. But nonetheless, this paper, you know, we have to take baby steps. And this paper listed 12 modifiable risk factors. So these risk factors are, as the term modifiable suggests, they fall within your control. You have the reins of these different variables, right? And just to contrast them for a second, the non-modifiable risk factors,

just so people know and get a sense of the science, the non-modifiable risk factors would be age. You can't modify your age. You can't modify your gender. That's the second non-modifiable risk factor, right? If you're a woman, your risk for developing Alzheimer's disease is double that as compared to males. Your age, your gender, and your genes, right? So your genes would be the last non-modifiable risk factor. You can't modify your genes. But as we've already established, genes are not destiny, right? Your genes may load the gun, but it's your diet and lifestyle ultimately that pull the trigger on this condition for many. And so the non-modifiable risk factors, when you go down that list, you see things like obesity.

Well, we've just been talking about how food so strongly contributes to obesity, right? You see type 2 diabetes, which is a form of advanced metabolic dysfunction, right? Many people today, about 50% of adults are either diabetic or pre-diabetic. One in three adults is pre-diabetic, and most don't even know that they're pre-diabetic. And this is a condition that is largely, if not completely, lifestyle mediated, right? Hypertension, that's another modifiable risk factor. We talked about how consuming an excess of added sugar can contribute. Just one factor here, right? There are others, but how excess sugar consumption contributes to hypertension. Hypertension is a modifiable risk factor.

This was actually shown very elegantly in a study. We don't have many long-term randomized control trials that we can draw on in nutrition science, especially where dementia prevention is concerned. But the SPRINT-MIND trial was a seminal study that showed that when people with hypertension were aggressively treated for their high blood pressure and were given pharmaceuticals to bring their systolic blood pressure down to about 120 millimeters of mercury, that they saw a dramatic risk reduction compared to controls or compared to rather those that were being treated less aggressively for their hypertension, where their target blood pressure was 140 systolic blood pressure, that they saw, compared to that group, a dramatic risk reduction for mild cognitive impairment, which is considered pre-dementia. So we know that hypertension,

that fixing your hypertension, it goes a long way towards helping protect your brain as it ages. And that's why it's one of these modifiable risk factors. And so there are about nine others. But yeah, I mean, we can definitely start there. Yeah. It's funny how once we know something as a society, it's almost crazy to think back, you know, maybe one decade or two decades ago, oh, we didn't know it back then. Like we didn't know it. I know that's how knowledge moves on and we all evolve, but it's crazy. I think I spoke to Professor Russell Foster from Oxford,

neuroscientist, one of the world's leading sleep researchers for decades. And I'm pretty sure that conversation, he said that back in the 80s, I think he was at an event, he was lecturing and talking about how light influences the circadian rhythm and people can't know it doesn't. It was so new. I'm pretty sure that was it. And it's something that we all, you know, in adverse commas, know now and take as facts and take as a given, but it wasn't that long ago. So I think it's really fascinating that the knowledge you're putting out there is now slowly starting to infiltrate the mainstream. I know that's one of your big goals is to try and get that knowledge out there. I know you have a very personal

reason for doing that with, you know, what happened to your mother. reason for doing that with what happened to your mother. I just want to cover on genetics a second. You mentioned ApoE4. And I think there is this slight misunderstanding with genes across society where, oh, I've got the genes for this condition. I've got the genes for type 2 diabetes. Oh, I've got the genes for dementia. As you have already described, many of us will have those APOE4 genes, right? We'll have that. But I've also heard you talk about how someone living in Nigeria with those same genes doesn't have any increased risk of dementia.

I wonder if you could just expand on that and explain to us what conclusions we can draw from that. Right. So it's really important to realize that when we talk about a gene increasing your risk for a condition, usually what we mean is that that gene increases your risk here, right? Where that study is being run, right? So for example, the APOE4 allele here in the United States increases your risk anywhere between two and 14 fold. But if you were to move to a part of the world where perhaps the diet is less industrialized, perhaps sedentary behavior is less prominent, right? Like in Ibadan, Nigeria. So in Ibadan, Nigeria, the frequency of the ApoE4 allele is just as common as it is here

in the United States. But there it has little to no association with Alzheimer's disease. So what that suggests is if you're genetically at risk for developing Alzheimer's disease here in the US, you might simply move your body to another part of the world and see that risk abolished, which to me is insane to think about, right? Genes are not destiny. And as I mentioned, the APOE4 allele is the most well-defined risk gene, but there's also this concept of polygenic risk, right? Which we're just at the very tip of the iceberg in terms of understanding how this plays out in terms of our overall risk for a given condition, you might carry genes that cancel out the activity of the

APOE4 allele, which by the way, affects fat transport into the brain, among other things. But yeah, genes are something to, I think, be mindful of. But with the recommendations that I make, I don't necessarily, I mean, there might be slight differences in terms of the recommendations that I make for a carrier with the APOE4 allele, for example, but they're not dramatically different. I think for most people, it's really the low-hanging fruit. Make sure that your diet is less industrialized. Make sure that you're exercising regularly. All the things that you've talked, that you so elegantly cover on this show. All super important, regardless of what gene variants you carry. Let's get into some specific foods, Max. Nutrition, as you well know,

is a pretty divisive topic these days. And I know you've taken your fair share of hits from different sides of the dietary tribe spectrums. But I want this conversation, and I think you're the perfect guest for this, to help navigate through the confusion for people. Because ultimately, the people who everyone's trying to help are actually the ones who are getting caught in the crossfire. They're the ones who are going, oh, well, this doctor or nutritionist who I follow is saying this, and I love all their other advice, but it's in complete contrast to this other person who I follow who's saying something else. I think it gets really, really confusing. So the aim of this conversation is to help people, empower them so they can make some

positive changes afterwards. You mentioned beautifully three key things that we can think about cutting out or at least reducing, right? In terms of things we can introduce now, let's start with the less controversial, right? So let's start with plants at the start, right? You've done extra virgin olive oil. I thought we might go next to the wonderful avocado. Why are you such a big fan of avocados when it comes to our brain health? Oh, great place to start. And avocados are very non, uh, the, the people love avocados, especially here in California, which is where I live. So it's a, it's a great way to ease into the conversation, certainly, that can be so embattled so often.

But avocados are great because among fruits and vegetables, they contain the highest proportion of fat-protecting antioxidants. Now, this is important because we talked a little bit earlier about how the brain is a crucible for oxidative stress because it's composed primarily of fat, but not just any fats. The brain is composed primarily of polyunsaturated fats, right? Like docosahexaenoic acid or DHA fat or arachidonic acid, right? These polyunsaturated fats are the most unsaturated among fatty acids and therefore the most prone to oxidation, which is essentially, again, chemical damage. And oxidation is in many

ways a driver of aging, right? It's an inevitable aspect of life, right? Like just living generates oxidative byproducts and free radicals and the like, and exposure to oxygen catalyzes this process, right? If you slice an apple and you leave it out on the counter, you watch it go brown, that's aging, that's decay. And this process is happening at all times in our bodies at varying rates, but we have antioxidants in our bodies that protect us ultimately from this process. And aging in many ways could be thought of as the process of oxidation outrunning our antioxidant defenses, right? And getting ahead of us. And so that's why it's so important to eat an antioxidantrich diet. And there are many antioxidants. And you find many of them in the produce section of the supermarket. But where the brain is concerned, it's the fat

soluble antioxidants that are of particular relevance. So when I say fat soluble antioxidants, what do I mean? Well, vitamin E is one of the most important of these fat soluble antioxidants. And the best way to ingest vitamin E without question is from food. Because when you say vitamin E, what you're really talking about are eight different forms of vitamin E. And you tend to get all eight when you ingest them in whole foods. When you take a vitamin E supplement, for example, you're only getting one or two forms, maybe a handful, right? example, you're only getting one or two forms, maybe a handful, right? But in an avocado, you're getting all forms of vitamin E, which all serve similar but different roles in the body, in particular, the brain, where vitamin E helps to protect the brain against oxidative stress,

against aging, crucially important. Another category of antioxidants, fat-soluble antioxidants that avocados contain, are carotenoids. Carotenoids are crucially important when it comes to brain health. I've talked about, I think I was one of the early, if not the first people talking about the value of lutein and zeaxanthin, two non-essential carotenoids that are found readily in produce, in fresh produce, that we've known for decades help support eye health. They help to prevent age-related macular degeneration. But it's now become very clear, no pun intended, to us that our eyes are an extension of our brain.

Our eyes are neural tissue. So what's good for our eyes is very directly and explicitly going to be also good for our eyes is very directly and explicitly going to be also good for our brains. And so these same carotenoids actually also accumulate in the brain where we're starting to see emerging evidence show that lutein and zeaxanthin, these two carotenoids, are associated with reduced cognitive aging, reduced risk for dementia, and even when given supplementally to young, healthy college students, for example, like what was done at the university of georgia that supplemental lutein and zeaxanthin can actually

lead to a boost in visual processing speed by about 20 so you can actually improve the performance of your brain with these with these with the ingestion of these carotenoids so avocados literally to me i like to look at them i almost see like uh they're actually almost in the shape to me of like a bomb, like a bomb being dropped on oxidative stress in the brain is how I like to think of an avocado. It's again, the highest proportion of fat protecting antioxidants. It's literally almost a perfect brain food. And so, yeah, it's one of the foods that I consider to be a quote unquote genius food. Why do you use the term genius food in your book, in your work?

You know, how did you come up with that? Well, it's, you know, I guess it's borrowing from the term superfood, which is not a scientific term, to be clear. And often is used to just sell foods, like to market overpriced things in the supermarket, in the health food section of the supermarket. But I thought it was very sticky to me. And I wanted to really surface foods that people could easily buy on loop, like buy regularly. we're going to supply, that we're going to give people the most bang for their buck in terms of the nutrients that are going to support metabolic health, brain health, that are going to be the most accessible, the most cost effective. And I was actually inspired by a study that came out of Tufts University that found that, you know, we're always told, told Rangan to eat all things in moderation, right? That's sort of

the mantra, uh, in many ways, nutritionism, right? And the, and the junk food industry, that all foods fit to just eat everything in moderation. But actually this, what this study from Tufts university found was that people who more closely adhered to that advice tended to, uh, include more junk foods in their diet, more confectionery products, more bakery products, more, they tended to consume more sugar sweetened beverages. And in fact, the healthiest people tend to buy a much narrower range of foods and they just buy those foods on loop. And so I was like, if I were going to come up with the perfect brain health shopping list, right? Brain and body metabolic health boosting shopping list, what would be on that list? And so

those are the foods that I call the genius foods. And it's about 10 foods. And avocados are certainly at the top. Yeah, I really like the way you have written genius foods. You know, it's fun to read. There's a lot of research in there, but you've kind of interwoven it with these genius foods. And I think it's a really great structure to help bring the science to life for people in terms of practically, well, what can I do now? Based on what Matt has just taught me, what does that look like for me? And I think all the foods that you do mention are commonly available. They are things that people can get on loop. What you just said there made me think that this whole moderation piece, you've already covered ultra-processed foods right at the start of this conversation.

It's pretty hard to moderate our consumption off those foods. By definition, it's just not possible to do. And something I've been thinking a lot about, Matt, and I will put this to you in just a moment, is whether it's more important for people to focus on what to eliminate versus what to bring in. And of course, that's quite black or white. Of course, they're both important. But certainly in the UK, there's been a tendency for people now to say, don't worry about exclusion. It's all about what we are including in our diets. And I understand it.

I think people want to hear that message. I think it's a more palatable message. And I understand the rationale that if you are filling your plate and your diet with the things that you should be consuming more of, there's going to be less room for the things that we're trying to avoid or limit. I understand that. My bias is that I have been a clinician for over two decades. I've seen tens of thousands of patients, and I'll be completely honest, Matt, I have found more benefits in helping people cut out of their diets the problematic foods in the modern

food environments, the modern food supply, than by actively focusing on what to bring in. It's not a popular opinion that you can put out there these days, but I underlined this section in the introduction of genius foods, which I thought was really powerful. And again, these are your words, Max. You'll see that actually slowing the aging process, including cognitive aging, is just as much about the foods you omit from your diet as those you choose to consume. So I've said quite a bit there. I'd love your perspective on that, Max. Before we get back to this week's episode, I just wanted to let you know that I am doing my

very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to

drchatterjee.com forward slash tour, and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision making and reduce symptoms of anxiety and depression. It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are of course many different ways to journal and as with most things it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three

question journal. In it you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel.

Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of the questions within the three-question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. Yeah, it's I mean, I think it's it's it's definitely we have to lift the veil for people. Definitely, we have to lift the veil for people. This idea that all foods fit, right? That all foods are good foods, that there's no such thing as good or bad foods. I understand, like you, of cultural attitudes about food preferences and the like.

And I think that, you know, we have to be able to remove the morality from food and be able to talk about food in terms of its empirical value, right? Especially in a time where people are sick, right? So context is everything. And we have to understand that we're talking to a population that is unwell. A study came out just a couple of years ago that found that about only 10% of people are free of metabolic illness, meaning 90% of people in the US have some degree of metabolic illness. So this is a sick population. And I think that it's the responsibility of, you know, the healthcare provider to consider context, right? And so this idea that all foods fit, indeed, that is the mantra of the junk food industry.

Because what that says is it's not our fault. It's not, you know, this sugar sweetened beverage that crams 30 teaspoons of sugar into a 16 ounce serving. That's the problem. It's your problem because you weren't able to moderate your consumption of these foods. Well, it's not innate to our biology to moderate our consumption of those kinds of foods, right? There is something wrong with drinking 50 grams of sugar, you know, in a beverage in one sitting. There's absolutely something wrong with that. There's not something wrong with you if you decide to indulge every now and then. That's a very human characteristic. It's a human universal, in fact. And I think that's where we have to be

able to separate morality from this conversation about, you know, what makes a food good or bad. I think that in an environment where 66% of people are either overweight or obese, and where we are trending toward a population whereby the year 2030, one in two people are going to be not just overweight, but obese, right? We're talking about clinical obesity here. That obesogenic foods like sugar-sweetened beverages, like these hyperpalatable ultra-processed foods that drive you to overeat,

which we've already established, right? Which we have good data now to say that these foods drive you to overconsume. That it's hard to argue that those foods are good, right? Yeah. You would argue that I think a strong case could be made that those foods are actually not that good, right? That they are counterproductive to good

health. And I would also argue that if you can't say that certain foods are bad, then we can't have double standards. You also shouldn't be able to say that certain foods are good. And so does that mean that we shouldn't say that like broccoli is good? Does that mean that we should be censored when trying to say that like whole eggs are good? Whole eggs are great, right? We should be encouraging people to eat these foods. So I think we need to get back to a certain degree of logic and common sense and reason when it comes to talking about food. And again, I understand that everybody's different and some people have fractured relationships with food, right? Which is super important. And we have to talk about that, but not every message is for every person. Yeah. i completely agree with that max and as you say everyone's different everyone's

got a different relationship with foods i think practically if people have never ever done two or three weeks where they are literally only eating whole foods, right? The sort of foods that we're talking about. I think people will genuinely be surprised with how good they could feel. And that's why my approach as a clinician has always been, let's have a two, three week period where we cut everything out. Of course, you have to eat something in that. So it's not as if I'm starving people, they're eating real whole foods in that time. But the focus really is on what not to eat. And then what I find, like I mentioned with those migraine patients, is that people experience their life in a way that they haven't done before. They have more energy, they're sleeping better, their skin feels clearer. Often, joint aches start to go. You see this so often, and then people can go,

okay, right, this is getting a bit bland. What can I introduce? Bit by bit, they start expanding their diet again, very intentionally to kind of figure out, ah, you know, I'm not so great when I have that type of food. But, you know, that sort of education piece, when we're tuned in to how a certain food makes us feel, for me, that's the gold max, because then it doesn't matter what I say or what you say, right? Then they've become their own expert. Like they've used maybe me and you as their guides to help them get going. But ultimately, it's like, yeah, I know Max has to eat that food or Ron says to eat that one. But when I eat that food, I get sinus-y.

I can't breathe properly. I get itchy. And I think that individualized component is so important. I kind of feel that many people have really outsourced their expertise to other people. And I think there's value. And obviously, we're trying to help there. We're trying to help guide people with our podcasts and our books and our work. But I really feel that at some point, the reader, the listener has to go, no, okay, I've taken that on board. but now I'm going to be my own expert.

I know what works for me. Yeah, absolutely. I think we need to, yeah, this notion of self-empowerment of agency and podcasts like yours, all the work that I'm putting out, you know, my intent is that people use the advice that I give as a template to do their own research and to iterate and to tinker and to see what works for them. I mean, we could talk all day long about, for example, the benefits of kale. I happen to be a fan of kale, right? But not everybody is going to be a fan of kale and kale is not going to digest well, for example, for some people. Right. And so I'm not saying that you have to eat this food, right? But generally, when I'm talking about a food, a specific food, it's to represent really a food category. And for example, kale represents dark leafy greens for me, which I think is one of these

foods that you would think would not be controversial, but of course today is, right? I posted about the value on my Instagram of dark leafy greens and how researchers out of Rush University found that people who ingest on a daily basis about a cup and a half of dark leafy greens have brains that perform up to 11 years younger, right? So this is really interesting insight, which is correlational to be clear. It wasn't, that wasn't determined via randomized control, multi-center trial, right? But, you know, carnivores come out of the woodwork now, people who only eat meat and they're, you know, and they have a problem now, a bone to pick with dark leafy greens. But dark leafy greens are, I think, a wonderful food. And for most people,

can be very well tolerated and provide a number of different important nutrients, some of which essential, some of which non-essential, but which we see is associated with better health and to me should not be controversial. is that people should ingest a fatty salad every day, just as a general rule of thumb. So a box that people can easily check off every day to consume a fatty salad every day. So that, you know, if this Rush University finding holds true, that you could prevent brain aging, and in fact, reverse brain aging by up to 11 years, to me should be non-controversial. What do you mean when you say a fatty salad so many of the um the phytonutrient the phytochemicals in dark leafy greens are fat soluble but greens don't contain a lot of fat and so there was a very interesting study that looked at the absorption of uh actually these carotenoids that we've talked about,

lutein and zeaxanthin. And what the study found was that co-ingesting them, these two compounds, which are abundant in dark leafy greens, particularly kale and Swiss chard and spinach, these greens are rich in those two compounds, that if they're not co-ingested with a fat source, they essentially flow through you. Whereas consuming them with fat dramatically increases their bioavailability because they're fat soluble. So the fat generally that I recommend people using liberally in their salads is extra virgin olive oil, which increases the bioavailability, basically the way in which your body can, the capacity for your body to access these very valuable phytochemicals. And so, yeah, so that's a, that's a, I think a great tip, but then there are all, there are other aspects to dark leafy greens that make them valuable as well. For

example, arugula is the top source of nitrates, dietary nitrates, which we know helps support our body's nitric oxide pathway, which is important for maintaining healthy blood pressure, which again, we've established super important for good brain health. In fact, one high nitrate meal of, for example, arugula or beets, which are another very food group rich in nitrates, can potentially boost cognitive function because it has the capacity to boost blood flow to the brain. And so you get that in dark leafy greens. You get compounds called flavonoids. There is a very interesting study. And carnivores, which is funny, I don't know how many gravitate to your work, Rangan, but I seem to be a magnet for people on all sorts of extreme diets, not least of which carnivore diets.

I do. I have some views on that. I wanted to talk about the carnivore diet with you at some point later on in this conversation. So I do have experience with it on a variety of different levels. But please continue. We'll definitely get there. Yeah. So there was a randomized control to actually multiple randomized control trials where they used compounds called flavonoids, which are abundant in dark leafy greens, another aspect of dark leafy greens that make them so valuable and add scientific plausibility to this finding, right? That regularly consuming dark leafy greens is associated with reduced brain aging. This randomized control trial, which is the kind of trial required to prove cause and effect, right, so that 11-year reduced brain aging was a correlational finding, but this randomized control trial used compounds called flavonoids, which are

abundant in dark leafy greens. And flavonoids are quite literally plant defense compounds, which carnivores love to say are toxic for us, right? That these kinds of compounds should be avoided. But in fact, what this randomized control trial found was that it's these very compounds that have the capacity to boost BDNF, which is brain-derived neurotrophic factor, sort of thought to be like a miracle grow protein for the brain, supports neuroplasticity, supports the suppleness of your brain as you age, right? So they looked at levels of BDNF and serum and also cognitive function with cognitive tests, right? And what they found was that when compared to low flavonoid foods, high flavonoid foods actually boost BDNF and support and enhance, in fact, cognitive function.

And so you find these compounds, flavonoids, in coffee, in tea, in berries, in citrus, and in dark leafy greens, right? So again, these are a food category that I refer to as genius foods, dark leafy greens. They also were surfaced in a study by Beale et al 2021, I believe as being one of the most nutrient dense foods that we have access to because of the concentration of folate that you get in dark leafy greens. So not a food group to be avoided. You mentioned fatty salads and I was flicking through Genius Kitchen today. This is your cookbook, Matt. And I'm going to find it now. There was a salad towards the end, which I thought, right, I'm making that this weekend. You may remember it had blackberries in.

I think it had avocadoberries in. I think it had avocado in it. The imagery was just absolutely beautiful. I thought, I'm definitely making that. Do you remember the one? I think that would definitely qualify as one of your fatty salads. I think it had in some of the genius foods we mentioned so far. Extra virgin olive oil, mentioned so far, extra virgin olive oil, avocado, dark leafy greens. I think it had, was it walnuts or almonds? Pecans, I believe. Yeah. I know, again, those are another one of your genius foods, right? The category of nuts that specifically, I think you mentioned almonds in the book, but would you broaden that out beyond almonds? Yeah, definitely. Nuts, I think, are great. Here's the thing, because nuts are rich

in fat, but not just any fat, polyunsaturated fatty acids. They also contain an abundant source of vitamin E. Wherever you find polyunsaturated fats in nature, you also find vitamin E. So this is actually another nuance that we didn't touch on in our discussion of these grain and seed oils, which I think is very important to bring up. Wherever in nature you find polyunsaturated fats, you find a proportional amount of vitamin E because vitamin E in nature exists to protect polyunsaturated fatty acids. And in fact, the more polyunsaturated fatty acids you consume, your requirement for vitamin E actually increases because it's vitamin E that protects these fats in our bodies. Unfortunately, today we're consuming more polyunsaturated fats than ever before in human

history, thanks to the preponderance of these grain and seed oils. But we tend to under consume vitamin E. About 10% of people consume the RDA for vitamin E, at least in the United States. But when you consume whole food sources of polyunsaturated fats, they're actually incredibly healthy, right? Like nuts are incredibly healthy. They're a rich source of polyunsaturated fats, but they're protected by a commensurate proportion of vitamin E. So almonds, great source of vitamin E. Also magnesium, which is a macro mineral that about half the population doesn't consume adequate amounts of, which contributes to everything from ATP synthesis to DNA repair.

DNA damage is at the root of one of the root causes of aging and possibly even tumorogenesis. And so magnesium is an incredibly important mineral and you get about 25% in just a handful of almonds. Every nut has its own sort of array of benefits. So if you don't like almonds, no big deal. I'm also a huge fan of pistachios. In fact, what gives pistachios their characteristic color are carotenoids, lutein and zeaxanthin. Pistachios contain these carotenoids, which you won't find in any other nut. So if pistachios are your jam, go for it. Macadamia nuts are great, good source of monounsaturated fat. And we see time and time again that nut consumption is associated with reduced risk for neurodegenerative disease,

for cardiovascular disease, for respiratory diseases, for kidney disease. So they're a great food group. Yeah, they really are. Of course, nuts are something that is easy for some of us to overconsume. I know I've been guilty of that before. Nuts are great for my brain. They're great for my health. Before you know it, where did that pack of nuts go? I totally agree. They're a fantastic food to focus on. Again, like I mentioned right at the start, even some whole foods, some of us certainly can overeat.

Certainly, I particularly find I have to be quite careful with my intake of nuts. I can easily go a bit crazy if there's a bag of nuts in the house, certainly for me. Yeah. So here's a good hack for that, because I completely agree that nuts are very, they're among the most calorie dense whole foods that exist. And I think they become particularly easy to overeat. Now, again, sort of a byproduct of modern industrial food is that you can now buy them without shells, right? And they come salted. Oftentimes they have added sugar. So just contributing to the hyper palatability of these nuts and making them ever so easy to overume. So actually my hack for nuts is I very seldom snack on them. I don't use them as a snack. I use them in recipes where they're portion controlled. So a lot of my recipes

will integrate nuts, but they integrate them in a very deliberate and portion control way. And so to me, that's a great way to moderate my consumption of them. Also, you know, when you get them with flavor, as I mentioned, it just, you know, they become all the more easy to just like eat by the fistful. There's other kind of plant-based genius foods in your book, of course. We, you know, mentioned a few of them. There's, I think, dark chocolate and broccoli and broccoli sprouts and blueberries and all kinds of things. But I want to move on to animal foods because I think dark chocolate and broccoli and broccoli sprouts and blueberries and all kinds of things. But I want to move on to animal foods because I think it's really important. You've touched on the carnivore phenomenon, which is growing at the moment where people, well, many people are

going to meat only or certainly meat heavy diets and are reporting huge health improvements from doing so, certainly in the short term at least, but some, to be fair, certainly over three, four years. And as an open-minded physician, I observe that. And because I think like you, Matt, I'm not wearing my dietary affiliation as my identity, I feel I'm able to observe and stand back a little bit and go, well, God, this is really interesting. Because I kind of feel, and maybe this speaks to why you can post about dark leafy greens and maybe someone from the carnivore community can be quite vocal. I don't know because I don't know who that person was, but my theory at the moment is if you have struggled for years with your health,

joint pain, skin problems, allergies, and you've been to doctors and you've tried to empower yourself, you've listened to podcasts, you've read books and you've tried to empower yourself, you've listened to podcasts, you've read books, and you've tried everything, and your life has been really, really negatively affected. And then you have stumbled across, for whatever reason, the carnivore diet, and you've gone onto it. And suddenly a lot of those complaints have vanished, or certainly got a lot better. I get it. I get it that it's like, oh man, this is it. This is the elixir that I've been waiting for. And I get it. It's like if someone goes suddenly vegan and they've never done it before. And suddenly, you know, if they're going from a standardized Western diet to a whole food vegan diet or plant-based diet and feeling better, we've all got biases as humans. And we often feel,

I mean, that's it. That's the magic diet. It worked for me. And certainly my clinical experience has taught me that there is no one diet that works for everyone. I've seen people following paleo diets thrive. I've seen people following vegan diets thrive. And I've come to the conclusion that the right diet for you kind of depends a little bit on your previous health, what your goals are, where you are at your life at the moment. It's like all these things factor in. And so like you, I have these frameworks and guidelines. But within that, I think people need to play around a bit and personalize them. So my view on the carnival diet is, I know we don't have any long-term data yet on it,

but I never want to make someone feel... Someone who's transformed their lives by changing their diet i get it like i really understand and again my bias max is i've seen sick patients for over two decades so when that person finds something that works them i get it i get why they're potentially even resistant to hear anything else it's like if i had pain my whole life and suddenly I went carnivore and it healed my pain, you know what? I don't think I'd listen to anyone. I'd be like, you guys say what you want to say, but I know that this diet works for me. So that's just a little bit of my perspective. I don't know if any of that resonated with you at all. Oh, a hundred percent. I feel the exact same way. A lot of people tend to be down on what they're not up on, right? So people

that have that, that bring to the field of nutrition, their biases, you know, maybe they are, they're on a vegan diet, but more so than their dietary choices, they are, there is a side of them that is actually an activist for various aspects of, you know, maybe it's animal rights or environment, you know, planetary health and the like. And so people tend to get very heated when confronted with facts that challenge their own biases, right? And I think that's a big problem because people, as you mentioned, are just out here trying to see what's going to work best for them and to cure, to heal them sometimes, or at least, you know, mitigate symptoms with regard to some

very pressing, I think, health challenges today many people are suffering from. And so, I think that it's definitely something that we need to study more. I know that they are trying to do that research. I think it's David Ludwig at Harvard, or I know Sean Baker is always on his, like, Instagram trying, who's a prominent, you know, carnivore personality trying to recruit people for his studies and the like. So I think that the research is, you know, probably going to be coming out because of the number of anecdotes that you're seeing on social media. But I think a lot of the people who are seeing the greatest improvement of symptoms, they're coming from, they're coming from sick places, you know, they're, they're coming from places of, you know, having crippling, you know, gastrointest're coming from places of, you know, having crippling, uh, you

know, gastrointestinal disorders, autoimmune conditions and the like. And I think there, there is some plausibility to the fact that when you cut out, you know, certain plant materials that can instigate what's called molecular mimicry in the body, um, to somebody who has a dysfunctional immune system or a, an impaired gut microbiome, for example, gut dysbiosis, that you're going to see a reprieve from these symptoms. And, you know, meat at the end of the day is a very nutrient dense food. So I've always considered myself to some degree carnivore adjacent. I definitely like to promote the value of plant foods. I think it should be almost like a 50-50 mix. I think, you know, my message is one of balance. I think that we

have to embrace plants, but we also have to embrace animal products. And I think that, you know, that can sometimes be the hardest message, the hardest line to toe is that message of balance, right? Because you offend both parties. Yeah, I agree. I think we're touching on something that's really important, Max, if we're going to truly cut through this and help people. I have real sympathy and respect for that individual who has found something that works for them. And if that's a carnivore diet, I get it. I understand that. But at the same time, that working for that person doesn't necessarily mean that the research you are sharing about leafy greens is invalid. That's the kind of unlogical leap from that.

It's like, okay, cool. For you, maybe at this moment in time, maybe you've got a damaged gut. Maybe you've, okay, cool. For you, maybe at this moment in time, maybe you've got a damaged gut. Maybe you've got molecular mimicry. Maybe you've got leaky guts. Maybe at this moment in time, you cannot tolerate a lot of the plant foods that Max is recommending. But I mean, look, you live in America. It's probably worse there than here in the UK, but it's reflective of everything, right? Whether it's food or politics, like this kind of nuanced position in the middle, it almost doesn't exist anymore. You offend everyone when you take it. You almost have to nail your colors. You either are hardcore vegan or hardcore carnivore

because your approach, I really like it, Matt. It's very balanced. I'm not going to out of the gate recommend a carnivore diet to one of my patients, right? It's very balanced. I'm not going to, out of the gate, recommend a carnivore diet to one of my patients. It's not going to be my starting point. But just as with, let's say, a patient with Irritable Bowel Syndrome, IBS, a lot of the dietary recommendations people make often don't work for them if they've got severe IBS. They have to be very careful initially, maybe reduce their FODMAPs with the help of a nutrition expert whilst they are healing their guts, dealing with their stress levels. And maybe in a few months down the line, they can start to introduce foods that they couldn't tolerate.

You know, my own health journey, Matt, I can now bring in foods that seven, eight years ago, I couldn't tolerate because I've repaired everything. I've gone back to basics. I've healed. I've addressed all the areas of my lifestyle that you talk about, you know, in your second book, The Genius Life. So yeah, I kind of, how do you find it as someone who is putting out nutrition information regularly with the aim to help people, you know, do you sometimes just sort of bang your head against your computer and want to throw your phone against the wall? I mean, how do you handle it?

Oh man, lots of coffee. And it's, no, it is, it can be, it's grating and it can be tiring. But my North Star is, I've never, thankfully, knock on wood, had any major health problems of note, other than the occasional migraine, which has been an annoyance, to say the least. But the reason why I got involved in this is because my mom was very sick for many years. She, at the age of 58, started to display the earliest symptoms of what would ultimately

be diagnosed as a rare and progressive and curable form of dementia called Lewy body dementia, which is akin to having both Parkinson's disease and Alzheimer's disease at the same time. And so she had that for eight years, and it was a real struggle. And when she was initially diagnosed, actually even prior to her diagnosis, when she was initially prescribed drugs for both Alzheimer's disease and Parkinson's disease, I had a panic attack for the first time and only time in my life, Googling the drugs, right? Which is what any millennial with a data plan would do. They would just, you know, go to Dr. Google.

you know, go to Dr. Google. And when I saw that, that her condition would get worse and that the drugs had no disease modifying effect, they were mere biochemical band-aids. To me, that was like a turning point in my life, really, where I, I, I became obsessed. I was going to say I dedicated myself, but it wasn't even conscious. I just became obsessed with trying to learn everything I could about diet and lifestyle and how all of these different variables play a role in terms of our predisposition to developing conditions like dementia, like Alzheimer's disease, like Parkinson's disease, which we know even less about. But, you know, I, like you, have seen, I'm not a medical doctor, so I haven't seen it from the standpoint of a, of a clinician, but I've seen real sickness, like real sickness that very few people, um, have, you know, have the, have the ability to, to see. And in many ways it was

kind of a privilege because, you know, I wish I could give it all back and have my mom back in good health. But it really got me to see the world in a new way. And it really cracked open my perspective on all of the different ways that we could be living better, living more healthily. And, you know, I think it's an insight. It also helped me have empathy for people and people's struggles, right? Like not everybody has access to the same kind of food that I have access to. Not everybody has the same kind of, you know, whether it's, you know, nutritional wherewithal or food access or financial privilege, right? So it has made me very conscious of the fact that everybody is coming to this topic from a different place and to do my best to spread a message that's going to do the most good for the most people.

Later in my mom's health trajectory, she actually developed pancreatic cancer and she passed away about three years ago. And so, yeah, I mean, what I've seen is just like, I don't even know. Sometimes when I think about what I experienced with my mom, I don't even know how I am able to walk on two legs. Like after that experience, it was so incredibly traumatic, but, um, but it's motivated me in a way that I've, I've never experienced with anything else in my life to, uh, do what I can to help separate fact from fiction for, for, to help dispel nutritional misinformation. And getting back to your question, to keep my eye on the prize, right? I have what psychologist Jordan Peterson has called a noble aim, and that's to help people. So when people come at me, whether it's carnivores or vegans attacking me and my work, it literally, it's like, you know, vegans attacking me and my work it literally it's like you know it's like rain on my windshield like it falls off because because i know that i'm motivated by helping people and that that that

that you know my truth is something that um is really motivated and will always be motivated by um understanding what it was that happened to my mom and the desire that I have to prevent it from happening to myself, others that I care about, and ultimately the public at large. Yeah. I mean, thank you for sharing that, Max. You know, very, very powerful,

particularly that message about having a clear North Star. I think that helps to insulate you and frankly all of us in our lives if we have that, if we're truly aligned, if we have something that we value that we're following and we're focusing on, and we can bring our actions to align with that. Actually, a lot of the noise then just starts to dampen down around it, but it doesn't matter anymore. It's kind of like, okay, cool. You know, you've got different perspective. Great. No problem. Maybe my message isn't for you. Okay. You know, and although, you know, very different because this was your mother and I know your mother unfortunately died a few years ago. One of the things I think I've always resonated with you is that clear passion and drive. As you know, Max, my son, when he was

six months old, nearly died. He was very sick. And I've spoken about that on the show before. That drove me, use the word obsessed. That was me. I was obsessed. I didn't care about anything. All I cared about was how do I get this little boy who I felt I had let down back to full health as if this had never happened. That was the only thing that drove me. And it came at a cost that, you know, that certainly I had a lot of guilt as a father for a few years, which I don't think helped me, and I don't think helped my son. He didn't want a guilty dad. He just wanted a present dad to be there for him. But the point I'm trying to get to is, I've reflected on this so much,

and I've now got to a point, Max, where I see the illness that Jayem had when he was six months old. I've come to see it as a gift. And it was really hard for me initially to kind of sit with that. But I really do now. That was a gift. That was his gift to me because without that, I wouldn't be doing all the things that I'm doing. I wouldn't be recording this show. I wouldn't be writing all these books, making TV shows to help people. I know because I've heard that the work I've done like UMass has helped hundreds of thousands of people, if not millions. I know that. And so I've come to the point now where I think, no, what happened to my son was a gift. He gave that to me and he gave that to the rest of the world. And I know it's not how everyone wants to see their life, but that's the story that sits really well with me at the moment. Yeah, it's beautiful. I mean, there's no stronger of a motivating force than when a loved

one is sick. I mean, it's a stronger motivator, I think, for people than even when we get sick, right? Like, like if I were to get sick, I don't know if I would have gone on this journey that I went on to potentially, you know, save my mom, which I was not able to do. But, um, but yeah, when, when a loved one gets ill, it's just that there it's, there's, there's no greater, uh, tragedy or, or motivating force, you know? And, and so you've experienced that. I've experienced that. And, um, and yeah, so when, when, for example, the vegans come at me, um, you know, it's just, uh, I'm just, I'm just helping people, you know, that's, that's what it's all about. And, and, you know, I, I find that there's actually a lot of undisclosed bias in the world of nutrition, um, particularly with

regard to, uh, you know, the, the more vocal, uh, advocates for the plant-based diet. There's a bit of covert activism that's not always disclosed there when you receive their nutritional advice, for example. And so I think it's just a big problem. And the reason why I think it's particularly, why that is particularly like resonant with me is that my mom was on a more or less vegetarian diet. She wasn't 100% vegetarian. She would occasionally eat lean chicken breast and fish on occasion. My mom was very attuned to the messaging surrounding cardiovascular disease prevention,

diet as it relates to cardiovascular disease prevention. So she was by and large on a, you know, very low fat diet. I never saw her ever eating red meat. And, you know, she never ate eggs because she was afraid of dietary cholesterol, which we know now has very little impact on serum cholesterol. So she was like, she was on that kind of dietary pattern. And on top of that, she was a big animal rights activist herself, which God bless her, you know, she was like she was on that kind of of dietary pattern and on top of that she was a big animal rights activist herself which god bless her you know she was an incredible advocate for um for for animal welfare but in my view you know we have to be able to separate our view of how the world should be with what we know to be true about human nutrition. And to me,

the most virtuous thing is to eat in a way that's going to bring you the most health and to bring the most health to your loved ones. You know, I'm not about martyrdom. I think it's, you know, we can invoke the cliche of putting your mask on first, right? I think it's really important to take care of yourself so that you can show up best in the world as your best self and then have impact, you know, elsewhere. Yeah, I completely agree. My philosophy, you know, is very much, you know, the quote that's attributed to Gandhi, you know, be the change that you want to see in the world. You know, if we want to change the world, we want to save the world. Let's save ourselves first. So, you know, nourish yourself, eat properly for you so you've got energy and vitality, and then you're going to

have more empathy. Your relationships are going to be better. You're going to do more things for other people because you're going to feel fantastic in who you are. But when you're struggling with ill health, you know, it's hard. It's hard to motivate yourself. It's hard to do things. It's hard to change the world. You know, I was chatting to someone earlier today who literally said to me not long before this podcast started that they're vegetarian by choice for ethical reasons. But recently, they've had a blood test done where, you know, there's a low B12 come up and the doctor's given some advice on what that person can do about it. And the chap said something really interesting to me. He said, you know what? I've said I'm going to do it.

I'm going to be vegetarian unless I get evidence that it's not helping me with my health. And I thought, okay, that's a pretty reasonable take. I understand that. So that's the kind of backdrop here, Max, right? Animal products. Why should someone consider bringing them into their diet if they don't currently? Oh man, I love this topic. I think it's so important because you see this shame about the consumption of animal products and you see all this misinformation about where animal products fit within an optimized diet. And to me, it's an uncontrovertible fact that animal products provide some of the most nutrient-dense foods available to us. You can go to any town in this country and find a pack of ground beef or a can of tuna, for example. So let's start at the high level.

When it comes to the brain, fish is, and cardiovascular health ultimately, fish is at this point the least controversial animal product, right? Fish provides a bevy of important micronutrients from preformed omega-3 fatty acids, like, as I mentioned earlier, docosahexaenoic acid or DHA fat, which is one of the most important structural building blocks of the brain, as well as EPA fat, which is icosapentaenoic acid, really important for an anti-inflammatory effect, for reducing triglycerides and everything like that. So fish is great.

Also a wonderful source of protein. Moving on from that, you've got dairy. The research seems to be very supportive of dairy, particularly full-fat dairy, as being beneficial to cardiometabolic health. It's a great source of protein. Now, granted, 75% of theriad micronutrients, minerals, and healthy fats. In the whole food matrix, dairy fat seems to be, even though it has by proportion, the highest proportion of saturated fat of any other natural food source, seems to be neutral from the standpoint of blood lipids. So dairy fat,

perfectly safe to consume. In fact, healthy, it seems to consume. And so I'm a huge fan of dairy. The one exception to that, which is going to anger some paleo followers. See, I can't give an interview without offending at least some group. The one exception to that would be butter. So it seems that butter and ghee, unfortunately, because ghee is so tasty, seems to be actually distinct from whole food dairy because in the process used to create butter, you disrupt what's called milk fat globule membrane. So they've done studies where they feed people either heavy cream, which is the original product, right? Before it becomes, before we churn it to make butter or butter. And you see that butter actually leads to an adverse effect on blood lipids. Heavy cream does not. So butter to me is more of an indulgence food. Um, it's more of a YOLO food,

if you will. Uh, I'm not afraid of it or anything like that, but I don't think that butter is as good for you, um, relative, relative to other dairy products. Yeah. But, but I regularly use, you know, I'll, I'll eat Greek yogurt, um, all the time. I think heavy cream is a wonderful thing to add to your, um, to your coffee in the morning and even whole milk. You know, I've started for a long time. I wasn't, I was avoidant of, of whole milk and I would opt for these ultra processed plant-based milk products that are filled with gums and thickeners and all the like. And I've actually started using, you know, whole milk again. And I think it's a, it's great. It's a good source of protein. So,

so there you've got like, those tend to be the least controversial of animal products. Yeah. I'm a big advocate of the consumption of eggs, of beef. Eggs to me are one of nature's multivitamins. An egg yolk contains a little bit of everything required to develop and sustain a healthy brain. It's rich in cholesterol. That's, that should be no surprise because the brain is rich in cholesterol. In fact, despite accounting for two to three percent of your body's mass, 25 percent of the cholesterol in your body is in your brain. You don't need to eat cholesterol for better brain health. Certainly not. Your brain produces all the cholesterol that it needs. And so too does your body, primarily your liver. But where you see cholesterol in the supermarket, you also tend to find a bevy of brain supportive nutrients. And this is certainly the case with eggs, which are an amazing source of B vitamins.

You get beta carotene, which is a fat protecting carotenoid. You get choline, which is crucially important to the developing brain, and myriad other micronutrients. Also, a wonderful source of protein. Animal products contain the highest biological value protein in nature. This is, you know, whether looking at the animal protein digestibility or by looking at the amino acid profile, animal protein is just, I mean, it's great. And then I guess the most controversial food item would be beef, grass-fed, grass-finished beef, ideally. But even grass-fed grain-finished beef is one of our most nutrient-dense foods. You could, again, look to a paper published by Beal

beef is one of our most nutrient dense foods. You could, again, look to a paper published by Beale et al. I believe it was 2022, I think this year. Animal products, including beef, consistently at the top of our most nutrient dense foods. A great source of protein, dietary creatine, which we know supports brain energy metabolism, taurine, carnitine, carnosine. It really is a wonderful food. And I think a lot of the problems that people have with beef is the fact that it contains saturated fat, right? It also contains dietary cholesterol. But as I mentioned, we now know we need to be able to separate these two when talking about them because dietary cholesterol has no effect on blood cholesterol. But saturated fat can have an effect on blood cholesterol. But we now see that red meat consumption is not associated with any of the bad clinically relevant health outcomes that we ought to be mindful of right

like there was a paper that was just published for example this is hot off the presses in nature medicine that found that red meat consumption had there was very weak association with red meat consumption and various types of cancer colorectal cancer cancer included which tends to be the type of cancer most closely associated with red meat consumption and no association with stroke, both ischemic stroke or hemorrhagic stroke. So, you know, in this idea that red meat is bad for the brain, no association with red meat consumption and stroke. There was another paper that came out, again, controversial because you're always going to get controversy whenever you have anything that supports red meat consumption

called Nutri-Rex, where a global consortium of experts came together and said that when looking at all the highest quality evidence, there's no good evidence to say that people should reduce their consumption of red meat. It's a very nutrient-dense food. And for some people, going to be the most nutrient-dense food that they have access to. In fact, on that, Max, in your first book, Genius Food, you mentioned this really powerful study, I think, of children in Kenya.

I don't know if you remember it or not. I know you wrote the book a few years ago, but again, showing the potential benefits of meat consumption, right? Yeah. Led by Charlotte Newman. I tend to remember that I have a... The way that my memory works, and certainly eating genius foods on a regular basis helps, but I tend to have a photographic memory for this stuff just because I'm so obsessed with it. So yeah, that was a UCLA study, a randomized control trial led in Kenya where they found that. So yeah, that was a UCLA study, a randomized control trial led

in Kenya where they found that, now granted, this was a population that tends to be undernourished in general, right? So animal products for that population are particularly valuable, right? So I think that the debate, and granted for people who are older, right, for elders, even in the Western world, this tends to be an issue. So, yeah, this paper, what this paper showed was that for children in Kenya, it was the supplementation of meat, not necessarily dairy and not an equal amount of plant-based protein. It was meat that led to an improvement in cognitive function, which I think is crucially important, especially for children, right? Children today in the Western world tend to consume ultra-processed foods more than adults do, right? About 70% of a child's diet today

is ultra-processed. Red meat is an amazing source of nutrition for children. Given the time we've got left, there's so much now we've opened up that kind of needs exploring. I just want to make a couple of things really clear for people listening and watching. We're not covering the environmental aspects of food at the moment. That is a longer conversation. That's a nuanced conversation, which I think I do plan to have on the show at some point in the near future. We're not typically talking about LDL cholesterol and its role in heart disease. If we had more time, we'd definitely go there, Max. I just want to make that super clear

so that people understand that we're aware of that. We've just not gone and explored that. I always think what you said about that Kenya study was really important, that that. I always think what you said about that Kenya study was really important, that this was an undernourished population. And that kind of speaks to what you're saying, which is animal products are very nutrient dense. So in an undernourished population, it may have an oversized effect potentially compared to in a well-nourished population. That sounds pretty reasonable. But let me put this to you, Matt. With your views on animal products, as you've briefly tried to quickly outline for us, is it possible, in your view, for someone who chooses not to eat any animal products, is it possible for them to have a healthy brain now and in the future?

Is it possible for them to have a healthy brain now and in the future? Definitely. Well, any animal products? Yeah, it's certainly possible. But I don't, you know, I can't say with certainty that a person who is subjectively, seemingly thriving on a plant-based diet wouldn't do better with the integration of, you know, some, some form of animal protein. So we always have to ask compared to what, right? When, when making these recommendations, but is it possible for somebody to, to do well on a plant-based diet? Yeah. It just has to be well calculated and well planned, right?

So there has to be a level of attention given to one's diet if one chooses to adopt a fully plant-based diet. I don't think one needs to eat beef. I don't think one needs to eat eggs or anything like that. I think as long as you're, you know, if you're integrating fish on a regular basis or even dairy, you know, there are ways to get all of the different nutrients provided by different, you know, animal products into one's diet. But it's just going to make it, I think, a little bit more difficult. And I think that it should be informed consent when one is choosing to exclude these nutrient-dense foods from their diet. And I think the issue that I take sometimes is that it's not always informed consent. People make these decisions based on misinformation, right? They maybe have

seen a documentary on Netflix or something about, you know, going fully plant-based. And then based on that, they exclude this huge food group from this huge and valuable food group from their diets. And I think that's a big problem. But should you have all of the information that you need to make an informed choice and you want to make that choice, or perhaps you just don't like eating animal products, then by all means, go for it and work your way around that. I think informed consent is important for every aspect of medicine.

It's also very important here regarding diet, isn't it? Because with the information that you've shared, someone may go, hey, you know what, Max, I hear what you're saying. I understand the scientific rationale for introducing animal products into my diet, but I feel so strongly that no animal should be killed in order to feed another human being. This is not my perspective, just to be clear, but that person is absolutely entitled to say,

I live by this principle that's very important to me. That's informed consent, isn't it? That is, give the information, and then we're all entitled as individuals to make the decisions that we want to make, right? Yeah, absolutely, 100%. I mean, I'm all about personal freedom. So at the end of the day, yes, I support anybody in their health journey. But I'll add that it's not always clear the effects that our

choices have on the welfare and well-being of others, right? And I think a great example of that is, you know, yes, by abstaining from, for example, we'll just use beef. And I have no affiliation with the beef industry or anything like that. I mean, I guess my bias is it's a food that I enjoy and I think that I derive value from. But you could say that avoiding meat, beef specifically, you are mitigating the suffering amongst cows, right? But if you're shopping in a modern supermarket and you're buying, you know, greens that come in those plastic boxes, triple washed and partaking in modern agriculture, there's still unfortunately blood on your hands because modern agriculture today leads to the death of billions of animals,

whether it's field mice, squirrels, birds, fish that are victim of chemical exposure due to the spraying of herbicides and pesticides, microorganisms in the soil um insects so unfortunately today in the modern you know incredibly complex web that is modern agriculture there's blood on everybody's hands and so where do you what is going to lead to uh the the lowest area under the curve of suffering, right? The lowest area under the curve of suffering. And to me, if you can find a local rancher and partake in maybe the sharing of a cow, which can feed an entire family for months, to me, that's just one, not to minimize it, but it's one life lost compared to, you know,

there was an estimate that 7 billion lives are lost annually due to plant agriculture alone. So these are all, I think, interesting questions. I'm not telling anybody how to think about this, but my intent is to share that it can be sometimes opaque, the downstream effect that our choices have. And it's not always so clear and so cut and dry as I'm going to abstain from animal products. And therefore, the area under the curve of the impact that I'm having is zero. That's not necessarily the case. Yeah. I mean, thank you for sharing that, Max.

I agree with you, Max. I think there's a lot of evidence suggesting that at least having some animal products in your diet is probably, if you are hedging your bets, probably going to help you with your brain function. I think we can say that. I believe it is possible for some people to have really good brain function without. I've got some patients who I think, from what I can tell, and their blood work are thriving, as I say, on vegan diets, but also on meat-heavy diets. I think supplementation can help fill in the gaps for people. And again, I don't mean to be so vague that we're not giving anyone any clear advice. I just want, do you know what I'm tired of, Max? I'm tired of all the fights in this area. I'm tired of all the camps. And it's like, people just want to have more energy and more vitality. People don't want to get dementia if they can help it, right?

That's kind of it, right? And all I'm trying to do on this show, and I think all you're trying to do is help people say, well, if you make these small changes, you're going to reduce your risk. Amen. I would underscore that a thousand times. It's absolutely true. It's, yeah. At the end of the day, people show up to their doctor, and you've seen this, you've been at the opposite end that I've experienced, where you're actually giving the diagnoses. But when a person shows up to their physician and receives that diagnosis, oftentimes the question that arises is, why me? You know, why? And many times these conditions take years, if not decades to manifest. Like if you have a heart attack and you show up to your cardiologist or the emergency room, it's not the night before that those conditions began to

develop that led to you having that heart attack. And in my world, dementia, this is a condition that takes decades to manifest, right? So this is not overnight. You have decades of agency to change the course of your cognitive path. And I think what's so crucial about that is that, you know, you have choices that you make every single day, right? Like we eat three times a day, if not more. And why not make a decision that is hedging your bets to some degree, but also makes sense through the lens of evolution, right? These are conditions that for the most part were rare in antiquity, right? Throughout human history.

And now they're increasing in their incidents, right? So I think, um, you know, take what you hear on these podcasts, integrate them, tinker and experiment, but also always be willing to challenge your assumptions and your beliefs about this, whether it's through the lens of planetary health or animal welfare. Always be willing to challenge your assumptions and don't take your dietary ideology to the grave. That's not what you want to do. Don't let your ideology take the reins of your biology. Because when that happens, it seldom works out well. Matt, it's been such an honor talking to you today. I really wish we could have done this in person. But I think we have left a lot of unfinished business there, which absolutely

needs a part two face-to-face conversation. Either next time you're in the UK or next time I'm in LA, for sure, we'll make that happen. You've got three fantastic books out. If someone's new to your work, if someone's inspired and thinks, hey, listen, Max, which one should I start with? Where would you point them? Great question. I always recommend people start with Genius Foods, which is my first book.

Still, everything is fully sound in that book. In fact, the research that comes out continues to underscore the ideas put forth in that book. And I'm very proud of the fact that my books make up a trilogy and they don't have to be read in any order. But for me, the journey in my life of writing them, you know, was fairly chronological. So yeah, I like people to pick up in any order. But for me, the journey in my life of writing them, you know, was fairly chronological. So yeah, I like people to pick up that book first. But, you know, my latest book, Genius Kitchen, is a cookbook. It's more, it can be a bit more user-friendly and, you know, it's packed with recipes and the like and the more high-level takeaway notes of my recommendations. So whatever you choose, you can't go wrong. But yeah,

there's always going to be a place in my heart for the first, and that is Genius Foods. Yeah, I know that feeling. And I'd highly recommend, guys, you follow Max on Instagram. He's a really great follow, posts regularly, loads of practical, super helpful information. Max, just to finish off, final question then. This podcast is called Feel Better, Live More. When we feel better in ourselves, we get more out of our lives. And I think that really speaks to all the work you're doing. It's helping people to feel better so that they can live more. With all your experience, from all your podcast episodes, from all your books, if you were to share just a few final practical tips to my audience to help them start living better lives immediately, what would some of your top tips be?

Wow. Well, I think we can't let perfect be the enemy of the good. I think there is this tendency to want to live perfectly and to adhere to some, oftentimes somebody else's ideal of what perfection looks like. And I think this can be perpetuated by, you know, whether it's social media or Netflix documentaries or the like. I think we have to be really kind and gentle with ourselves. We live in crazy times and many of us have lots of obligations on a day-to-day basis that we have to tend to, whether it's our social lives, our romantic lives, our professional lives, and these are all important, right? But for me, sometimes, you know, even being able to pull myself to the gym for a 20 minute workout, right, is better than not having gone at all. Right. So I think we have to not be perfectionist about this and be able to recognize that, you know, sometimes it's the little gifts that we give ourselves over the course of the day that ultimately will add up to make a big impact, right? And it doesn't have to be these extended hour and a half long workouts, for example, or a complete revamp of one's diet, right?

Incrementally, if you, for example, reduce your intake of ultra processed foods, even just a little bit, or up your intake of protein, even just a little bit, even just a little bit or up your intake of protein even just a little bit you'll see a benefit and so i think that that's um i think a a solid place to leave your your audience especially because we've talked about so many different topics but you know if it's integrating you know more whole eggs or um reducing your intake just a little bit of the you you know, the grain and seed oils or the added sugar that we were talking about, or maybe using a little more extra virgin olive oil or, or even just, you know, a fatty salad every day or five days a week. Even I think, you know, all that will go a long way. At the end of the day, it's baby steps, baby steps.

Yeah. Love it, Matt. Keep up the great work and looking forward to part two at some point in the future. Thank you, Rangan. You're the man. Really hope you enjoyed that conversation. As always, do think about one thing that you can take away and start applying into your own life. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice,

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