Finding Mastery with Dr. Michael Gervais - Developing Your Brain for a Longer, Healthier Life | Neuroscientist Dr. Tommy Wood

Episode Date: February 9, 2022

This week’s conversation is with Dr. Tommy Wood, a UK-trained MD with a PhD in physiology and neuroscience.He received an undergraduate degree in biochemistry from the University of Cambridge before attending medical school at the University of Oxford.After working as a junior doctor in central London, he moved to Norway for his PhD work and then to the University of Washington as a postdoc, where he’s now an Assistant Professor of Pediatrics.Tommy's work and research interests include the physiological and metabolic responses to brain injury and how that impacts brain health across the lifespan, as well as developing easily-accessible methods with which to track health, performance, and longevity in both elite athletes and the general population.So, this conversation is far more than just how to “live longer” - it’s about first principles to work from, for health – over time – and we also dive deep into best practices to enhance and optimize your brain functioning._________________Subscribe to our Youtube Channel for more powerful conversations at the intersection of high performance, leadership, and meaning: https://www.youtube.com/c/FindingMasteryGet exclusive discounts and support our amazing sponsors! Go to: https://findingmastery.com/sponsors/Subscribe to the Finding Mastery newsletter for weekly high performance insights: https://www.findingmastery.com/newsletter Download Dr. Mike's Morning Mindset Routine! https://www.findingmastery.com/morningmindsetFollow us on Instagram, LinkedIn, and X.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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continuous glucose monitors are part of this, sleep monitors are part of this, is this kind of pathologization of things that should bring us joy you know there's interesting data this is you quantify something you start to lose the joy in it you start to objectify it and it's no longer a thing that can bring you joy in the same way all right welcome back or welcome to the Finding Mastery podcast. I'm Michael Gervais and by trade and training, I'm a sport and performance psychologist.

I love what I get to do and I am fortunate to work with some of the most extraordinary thinkers and doers across the planet. And the whole idea behind this podcast, behind these conversations is to pull back the curtain, to explore how these extraordinaries have committed to mastering both their craft and their minds. And our minds, it's one of the great assets that we have in life. It's amazing. We are capable of so much. And if you want to learn more about how you can optimize the way you work with your mind, this is just a quick little reminder here to check out our online psychological training course, where we have pulled together the best practices

to meet that unique intersection of high-performance psychology and the psychology of well-being. So we walk through 16 essential principles and skills for you to develop the mind that works for you. What does that mean? It's this ability for you to be at home with yourself wherever you are and to be working towards your upper capabilities. And when you end up doing that, you end up bringing other people along with you. It's an amazing thing. It's this flywheel effect when you're able to be grounded, fully present, and then able to work towards your upper capability. It's this unbelievable thing that takes place in your environment. So we'll share with you the same way that we share best practices with world-class athletes. And you can find all of this at findingmastery.net forward slash course. Finding Mastery is brought to you by LinkedIn Sales Solutions. In any high-performing environment that I've been part of, from elite teams to executive boardrooms,

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is with Dr. Tommy Wood, a UK trained MD with a PhD in physiology and neuroscience. He received his undergraduate degree in biochemistry from the university of Cambridge before attending medical school at the university of Oxford. After working as a junior doctor in central London, he moved to Norway for his PhD work and then to the University of Washington as a postdoc, where he's now an assistant professor of pediatrics. So what I just said is worth noting. He attended two of the most dynamic universities across the planet. He's got a deep understanding of biochemistry, physiology, and neuroscience, and he's teaching as a professor in the pediatrics. It's pretty cool. I mean, so that's a little bit of an indicator of where we went. Tommy is one of those rare

individuals that can really go deep into a subject. And then he also has the ability to go horizontal across many. And so there is a polymath nature to that ability. His work and his research interests include physiological and metabolic responses to brain injury and how that impacts brain health across lifespan, as well as developing easily accessible methods so that you can track health and performance and longevity in both elite performers and athletes, as well as the general population. This conversation is about first principles to work from for health over time. And obviously we're going to dive deeply into optimizing and enhancing brain functioning. And with that, let's jump right into this week's conversation with Dr. Tommy Wood. Tommy, how are you?

I'm really good. Thanks for having me. Oh, yeah. I've been looking forward to this. We have had a lot of people on to talk about longevity and brain health and human optimization. And I'm really excited to talk to you about you know some intriguing angles on longevity that go beyond eat well sleep meditate which are all important processes but you know right off the bat i came across a study um that you've cited that you know it says basically that when you retire people that retire die early. Can we just start there? Because this community, our community, are people that are switched on getting after it and considering the good life, whether it's during the work phase or post-retirement. So can we just start with that idea? Sure. Obviously, this is a very difficult

thing to study. You can't randomize people to retire earlier or later and see who dies sooner. So those particular studies that look at that, obviously, we just have to look at a population of people and try and understand what happens. there are a couple of studies that have done this and they basically show that those who retire seven to ten years earlier so early retirement versus normal retirement say those who retire earlier die sooner and that's after you adjust for a whole host of things that might contribute to this so maybe you retired for medical reasons and then obviously that health condition may contribute to you dying sooner, right? So adjusting for things like that. And the signal that kind of comes out of that, and I think it

really sort of brings together threads from multiple areas of both neuroscience and sort of, you know, general biology and physiology of longevity or health span, is that if, you know, essentially the simple concept is use it or lose it. And we know that tissues in the body respond to stresses or, you know, demands by strengthening, you know, improving their function, improving their regenerative capacity. And if we don't use them, then they will atrophy. And muscle mass is one that people may be familiar with, right? If you don't use your muscles, they get smaller, they get weaker. They are energetically expensive. So if you're not, if you don't need them, your body won't keep them around.

And we could probably think about that for pretty much any tissue in the body, and including the brain. That's the one that I'm the most interested in. But I'm also very interested in muscle tissue, because those things are intimately connected. And so if we're not using our brains, if we're not using our bodies, then they will start to atrophy. They won't repair as they would otherwise.

And in sort of a bigger picture, eventually that will lead to earlier loss of function and eventually death. And when you say use your brain, it's easy to think about using your body, right? We're talking about straining. We're talking about recovery. We're talking about range of motion. We're talking about stressing your system, your physical system, so that you build the right type of stimulus and repair for it to maintain a slower decline. I think that that's fair to say. So how do you do because there was i think it was probably like a decade ago maybe more yeah it's about a decade ago where there was a big

buzz on brain training and um you know technology to help support a sharp memory if you will yeah so i i'm not specifically asking about that but in general first how do you how do you strain and stress and use your brain according to some best practices it's a great question and i like the answer because depending on who you are and the things that you enjoy and prefer you have lots of different options essentially in order to bring context to it when I think about the stresses that are beneficial for the brain, I like to go all the way back to when you're developing your brain in the first place, which is convenient because I'm a neonatal neuroscientist. That's what I do for the majority of my day job. And think about what an infant does as their brain is developing and they are starting to learn about the world. They spend a huge amount of time learning how to coordinate very fine and gross movements of this

meat sack that carries them around, right? And it's incredibly difficult to learn those processes. Similarly, the process of learning language, right? Learning to speak, there's benefits we could talk about later from learning multiple languages at the same time. But just the act of learning a language, incredibly complex. Learning social interaction, again, something that's very difficult and needs time and effort and practice. Those three things sort of make up the majority of what your brain gets as inputs as it's developing. And those are the same inputs that can improve, strengthen the brain, the connections, you know, function essentially throughout the entire lifespan. So like I mentioned earlier, those who are bilingual

have better connections, better cognitive reserve late into life. Those who do some kind of skill based movement, particularly movement that challenges coordination seems to be particularly beneficial for preventing cognitive decline. So when they've done meta-analyses looking at all the studies of exercise interventions for preventing cognitive decline, dementia, those that have a balanced component seem to be the most protective. And it's probably because when you're challenging your orientation in physical space, it's a much stronger stimulus to the brain to try and orient itself and protect itself it's sort of like a almost like an existential threat if you're not you know fully oriented in space so co-ordinative and balanced movements they have a you know a

particular benefit and music is another one there are multiple studies showing that musicians have younger looking brains compared to those who aren't musicians. And they also have these tighter connections throughout the brain later into life. And what's interesting is that no matter where you are on this trajectory of developing or trying to keep a brain, difficult things as you learn them are the important stimulus. So if you look at amateur musicians versus professional musicians, amateur musicians have more of a benefit from the music than professionals because it's harder for them to do. They're less good at it. And this could be the same for language. It could be the same for going out, making new friends, new social connections. It could be new movement for language it could be the same for going out making new friends new social connections it could be new movement strategies um it can be teaching others uh that seems to

provide you know teachers seem to have some degree of benefit as well so any of these things these challenges that you might use to develop your brain as an infant are the same things you can then adapt and apply as an adult okay so if So if we play it back, we're talking about language, music, balance and teaching. And what's underneath the surface is making sure that you're right up against that learning edge where it's, um, it's difficult to do the thing for an extended period of time. It challenges, you know, more resources, internal resources to be able to do it. Does that sound right so far? Yeah, exactly. It has to be challenging. Something, you know, and everybody, you know,

or people often ask for some kind of procedure protocol. You know, if you're right up against some, you know, learning barrier, we were trying to get better at a skill you know 10 15 20 minutes of that sort of frustrated application seems to be where people should spend time beyond that it probably becomes overly stressful that it's maybe not worth doing at that moment in time and then returning to it but it's that level of difficulty where you're challenging yourself and it's almost you know there's an aspect of frustration to it and maybe failure to then learn and adapt as part of it and where do you get the 15 to 20 minutes from and and again i just want to re not reframe but i want to say 15 to 20 minutes of deep you're calling it frustrating but deep practice where you're right at the learning edge and with that comes some frustration but where do you get the 15 to 20 is that i

haven't seen it or read it but i'm i'm super intrigued yeah it's it's an application of i guess multiple areas of neuroscience where that's probably the period of time where you can apply concentrated effort to any given thing you know it under underlies the timing of say the pomodoro technique for you know applied um focus so it's it just seems to be a period of time that people seem to be able to commit to and get some benefit from you know without you know either under or over playing and of course there's some individual variation but it's always like an average it seems to fall somewhere in that time period and can you just expand on the pomodoro technique so uh the pomodoro technique being one way to apply

focused periods of time uh to get some productivity done so there are timers that you can use this but it's usually uh 20 minutes say of focused application and then a five minute break and both are um necessary so even if at the end of 20 minutes you're like i feel good you know i'm going to keep going you take you stop you do your defined break and then you get back into it um and there are there are multiple reasons why this is potentially beneficial um task switching in smaller periods of time seems to be more cognitively demanding, but for less overall benefit. So when you're like checking your email and then doing something else for a couple of minutes, then something else, it takes a lot of cognitive demand, but you get less

overall productivity. So you feel busy, but the end output is probably more physiologically stressful and less overall productivity. So these small focused periods of time seem to result in better overall work on average. So what are you doing for some of these? Obviously you're in a learning mode, you're a student of neuroscience, neonatal neuroscience to be particular, but I know you're a learner, you're a great learner. I'm imagining you're applying these, but how are you applying the balance part or the physical movement part? Or what are you, are you doing anything for language or music or anything else that you might be doing? Yeah, that's a great question. And when I talk about these things,

then think about, well, how do I apply this myself? i do want to you know walk the talk so uh two main areas so in the movement area um in my movement practice i am an amateur strongman competitor um and so that involves a lot of skill based movements it's sort of like difficult to lift heavy loads and that kind of thing so So that's something that I practice in the gym. But outside of that, I frequently, it's right underneath my feet. I have a slack block, which is basically like a mini slack line where you can stand and balance for periods of time. And the reason why I have it under my desk is because then I don't forget to do it. It's just like right there. It's like the same thing with the chin-up bar under your you know under the doorway um so that's somewhere where i sort of do you know 5 to 15 minutes of sort of balanced practice per

day sort of just as part of you know if i'm on a zoom call or a meeting i'll i'll do that wait wait wait you've got a um you've got a wire you know like a standing wire underneath your desk that you can just stand on while you're taking a meeting it's not a wire it's a it's a block with with foam underneath oh god okay so it gives you the same i was imagining a slack a slack line no no no it's called a it's called a slack block so it's kind of like a pseudo slack line for one just just for one foot literally this is like what's the minimum effective thing that i can do that i know i'll improve in over time this is it but there are multiple different options anything that challenges your balance if it's just standing on one foot while you're brushing your teeth you know that's

going to give you some stimulus none of you know there you know if i had a proper slack line in the backyard and i spent 30 minutes of focused slack line work every day that would probably be the best possible stimulus but you know trying to just trying to fit these things in throughout the day are you more interested in health span are you more interested in longevity are you more interested in brain health like if you started to narrow in just a little bit what is the thing you're most interested in i think i would have to pick if i had to pick one it would be health span um which is essentially just the fundamental idea of wanting it's like life in your years rather than years in your life right um you know live long drop dead kind of thing and so i have no great interest or necessarily belief

that myself or humans in general can live to be 120, 150, 180 years old. You do not. I do not. But I have a number of family members who lived well into their 90s with good quality of life. That sounds pretty good. And so I'd like to do everything that I can in order to achieve that, if possible. So what are you referencing that idea, that kind of first position, if you will, about lifespan, healthspan and lifespan here, or longevity, we're talking about longer extending years, because there are so many quote unquote, and I'm going to have a hard time saying this out loud, there's so many biohackers that are convinced

that they are going to live to be 150 because the technology is better nutrition is better practices are better like we know more fill in the blanks and what are you looking at this is no i don't think that's going to happen in our lifetime. And I'm not sure it's going to happen in any lifetime. So when you look at, I guess, the science that underpins these projections, right now, there is no agreement as to what the limit of human lifespan is. If you look at the age that is relatively frequently reached, but not that frequently, it's maybe 110 ish to 120 years old. That seems to be like the common limit of human lifespan as we currently stand. When you apply statistical models to these data, some people will say, oh, that's a pretty hard limit. That's probably going to be our best lot. Other people will say oh that's a pretty hard limit that's probably going

to be our best lot other people will apply different statistical models to the same data essentially and say oh there's no physical you know there's no you know definite limit limit to Um, and so while that is up in the air, I feel like it's probably not a particularly useful strategy to say, oh yes, I'm going to live to 150 years old. Cause right now we have no evidence that that's even possible. It may well be possible in the future. We recently just lost the oldest person that's ever lived um a japanese woman that lived to be about 122 years old um i think her name is jean are you familiar with her um i did i i'm not familiar with the story but i remember just like seeing the headline of that yeah yeah jean or jeannie and i'm not sure i've only read it my My question is like, okay, so 122, she's the half percenter, the fraction of a percenter that's lived that long.

It would make sense though, as we get better and smarter and have better resources that we could move that 122 to 132 to 142. It does make some sense, that that might take 200 years to do so or 400 years to do so is is that more of your position that people are going to live to be older but it's probably not going to happen in our lifetime are you saying no i think it's going to stay at 120s oh no i am certain that we will slowly eke that number out as you know okay genetics and healthcare and technology improve. So all the models that we have currently, any statistical model is only based on historical data, right? So it's impossible to project into the future.

So yes, I'm sure that that number will continue to slowly increase. But I think it's very unlikely that on a large population level, we are going to frequently see the average lifespan be over 100 years old. Most of that is because of health inequities and societal issues rather than because we cannot do it. But for myself, I'm not convinced that in the next 60 years, we are going to dramatically extend human lifespan. Finding Mastery is brought to you by Momentus. When it comes to high performance, whether you're leading a team, raising a family, pushing physical limits, or simply trying to be better today than you were yesterday, what you put in your body matters. And that's why I trust Momentus.

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findingmastery20 at checkout. Again, that's felixgray. You spell it F-E-L-I-X-G-R-A-Y.com and use the code findingmastery20 at felixgray.com for 20% off. Are you familiar with the different regions or countries in the world and their lifespans yeah have you seen that yeah so you and i are both in the united states at this point i don't think you were born here though were you not with that actually i was despite the accent i did have i was born in emerson illinois and then how long did you spend in europe uh i was there from when i was five until I was 30. Yeah, that makes sense.

Okay. All that being said is the United States, we are not in the top 10% of healthspan, lifespan countries. So I think we're 85 out of 200 and something. It's just barely kind of middle of the pack and it's probably due to the stress quote unquote you know that i know that's a placeholder for a lot of words it's probably due to high stress and you can imagine the ones that um for most most countries where people don't live as long, you know, because Somalia maybe, or some really high stress environments. But can you just talk maybe a little bit about

two parts? What do you think the environmental, we're using this as a springboard to the environmental conditions that promote a good life. And then the second is I want to double click underneath and talk about what is what is actually happening to our body from both a brain and a body perspective as we get older you know what does the degradation look like so let's just start with the environmental conditions first a lot of people will have heard of the Blue Zones, I'm sure. So regions in Greece, Sardinia, Okinawa in Japan, a small part of the coast of Costa Rica,

Seventh-day Adventists in California. Groups where they have the highest proportion of centenarians and super centenarians, so people are to be 100 or 110 years old. Actually, following right behind that uh are places like hong kong um iceland which is where half of my family are from which are which are pretty close um you know they don't have that sort of blue zone moniker but in terms of overall average lifespan you know they're pretty close that, you know, into the high eighties or mid to high eighties. And so people have sort of fetishized the blue zones a little bit. And, you know, really focused in particularly on diet, everyone wants to talk about diet. But, you know, so dietary components, certainly useful, nutritious, whole foods, local foods local seasonal all that kind of stuff and i think that applies in the majority of of regions of the world but in iceland that's uh

fish not many starch carbohydrates um you know whatever deer meat um other things obviously they have a very animal uh animal rich. Similarly in Hong Kong, actually. And so that's one aspect. I think sort of overall nutrient density, food quality plays a big role. Then there's a huge, huge social component. So all of the areas of the Blue Zones, they have meals together. They have some kind of meditative or religious or community practice where they spend time in the moment, either together or alone or both.

And that seems to be consistent across a lot of communities that have longevity. Then, you know, this opportunity for rest and relaxation relaxation so a strong circadian rhythm being able to actually sleep properly rest and recover properly a frequent movement practice and that being part of the environment again that's that's that's common across all those um regions um and so that probably encompasses most of it so being able to have some kind of uh well i guess another thing that's important is be it meaning or purpose you have some function in society and you know that can be your job uh or it could be could be something else um and then that continues for your entire life right in a lot of those communities whatever it is your function you know maybe it changes but

you always have one you're not just like parked in a nursing home and left there um so you're always a part of the community and you have some meaning or purpose to your work or otherwise um and then the opportunity to rest and recover interact socially move frequently um and any environment that fosters those things i think provides the environment for a long and healthy human life. Now, let's just swing over to the brain really quickly, which is, I know, straight down your lane here. So what happens to the declining brain? What are we most concerned about? When you think about cognitive decline, dementiazheimer's disease um like most people like focus really hard in on the pathology the development of aggregated pathological proteins in the brain you might

have heard of amyloid beta now people are focusing more on tau and this does happen hold on will you explain both of those? Those are really important. Yeah, absolutely. So amyloid comes from a precursor, amyloid precursor protein. And as with many proteins in the body, it can be chopped up in different ways. And when essentially the brain is stressed, that's kind of my go-to term, some kind of neurological stress. And it could be inflammatory. It could be toxic, like a heavy metal exposure. It could be an infection. It could be persistently high blood glucose levels. These things, this protein can accumulate. And on the other side, you can normally clear it to a certain extent and sleep is really critical for that.

And so you wanted to put on the glucose thread more. Yeah, I do. Yeah. Okay. So now I don't really want to get too much into amyloid for one very specific reason, which is that the amount of amyloid in your brain doesn't correlate to your symptoms

or your decline we know they're associated but really poorly and that's the same in animal models as well as in humans however it's kind of an epiphenomenon of neuronal stress in my mind it's something that happens alongside as neurons are stressed over time okay and we do know that once you get enough then the aggregation or build-up of amyloid can become damaging in its own right so eventually you get to this feed-forward cycle but that's not where most people end up as part of this kind of build-up of proteins in the brain over time you also see a hyperphosphorylated tau which is another protein that builds up inside the neurons themselves and essentially it can get to a point where this um these the protein sort of clumps together and can actually like damage the cell itself because it's built up so much

in inside and that's sort of like the next thing that we're looking at in um in alzheimer's disease and these these things sort of happen on a on a cascade we think you know sort of like the next thing that we're looking at in um in alzheimer's disease and these these things sort of happen on a on a cascade we think you know sort of like happen over time one triggers the next um however uh like i said i'm not entirely convinced that this is the focus that we should take um and it comes back to i guess some of the things that we talked about earlier so we know that some of these activities are protective and maybe protective even in the context of having all those proteins build up right because those those things aren't directly correlated and we also if we look at animal models and this is where i'm going. If you want to create cognitive decline, there

are essentially three ways to do it. One is to decrease supply of necessary nutrients to the brain. You can slow flow from the carotid arteries, less blood, less oxygen is getting to the brain. So you decrease supply. You can also damage the actual process of producing energy. So one thing you see in Alzheimer's disease is a decrease in cytochrome C oxidase, which is one of the key proteins in the electron transport chain in mitochondria. And you can actually recreate this with a very small dose of cyanide, which essentially attacks that process. So you can create this sort of phenotype of cognitive decline by gently poisoning your mitochondria just a little bit. And there are multiple things that could potentially do this. And we see this process happening again in infections,

inflammation, maybe in response to hyperglycemia, some of these other things. So that's another one. You can decrease supply. You can decrease just the metabolic process. Or you can decrease demand on the other side. You just ask for less of the brain, and it will produce less. And there are ways that we can do that in animal models and it's you it's we like humans animals benefit from enrichment in the environment interaction with things

cognitive stimulation and that can be other animals it could be toys and things to play with and in any model of injury providing environmental stimulation environmental enrichment be that with other animals or with you know toys interaction in the environment it's neuroprotective the brain will recover better equally if you remove those things from the environment the brain will decline faster so this goes back to our retiring early we've removed the stimulus so for the declining brain or to prevent the brain from declining the three things we know we need are good vascular supply of stuff to get up to the brain so you don't want your carotid arteries or you know cerebral arteries to become you know atherosclerosed or you sort of clogged, for want of a better word.

We want to maintain good mitochondrial function. And so that's providing adequate nutrients, also maybe avoiding certain toxins. So there's interest in pollutants in the water, air pollution, other things that may contribute to this. Heavy metals. Heavy metals, exactly. then uh on the other side you need to maintain demand so those three things i think uh you know and for different people different combinations of those will be important but but that's kind of the framework that i would use uh in the context of a brain that you want to keep functioning for as long as possible

so on the supply side um we're talking about nutrition. We're talking about exercise on the supply side. Is that right? Yeah. And maybe it's not so complicated to think about. We're increasing oxygenation across the system, the ecosystem, so that our brain is being fed properly, right? From good nutrients, but good oxygen as well. So we need our heart to be strong. We need to stress the system in a more challenging way, call it acute stress rather than a chronic stress to be able to have that supply. Okay. And we should probably, before I go on the other two quickly, let's go back to the blood sugar levels. Let's talk about that for a minute because I think that, I think we're confused about, I don't think anyone's really confused about what good nutrition is, apple and an apple pie. We know the apple is the right choice for the most

part. You know, I mean, we have to work pretty hard to say the apple pie is the right choice. So most people know what good nutrition, health nutrition is but i don't think most people really understand the damage that takes place when our glucose system is out of whack so can can you speak to that specifically from a brain perspective there i mean there are multiple ways that you can attack this we could go into like deep mechanism um but one of the most compelling things for me in this arena um well first if you think about alzheimer's disease one of the one of the one thing that's pathognomonic it is like a hallmark of the disease is that if you inject a glucose tracer less will be taken up into the brain uh the brain is less metabolically active from a glucose utilization perspective i don't understand yeah so i'm lost

here so you can do something called a pet scan yep um which basically is it's a measure of different you can depending on the process you're testing you give some kind of molecule that you're interested in the process of and you tag it usually with some kind of radioactive tag and then you can see where it goes in the body we use it to look at different types of cancer we can use use it to look at the activity of the brain um in alzheimer's disease okay great and one thing you see is less uptake of glucose into the brain in somebody with age-related cognitive decline specifically in areas that seem to be affected um and it's thought that there's been some kind of generation of insulin resistance in the brain well basically

the the brain is no longer listening to the signal of the insulin signaling of glucose. Glucose isn't getting to the brain. The brain's kind of turned down that signal. One of the potential reasons for that, and there are multiple, is a continuous over supply of signal, right? We know of everything that happens in the body, there's some kind of feedback loop. So if you have some kind of glucose signal,

and it's consistently high, so your glucose is always high you might turn down the volume a little bit to try and protect your cells and that's essentially what the process of insulin resistance is those cells are trying to protect themselves from that signal so that seems to be part of this process and when you look at brains of so this is the study was done in people with diabetes but when you look in brains of people with diabetes those who have the highest fasting blood sugar level have the oldest looking brains and there's this nice algorithm called the brain age algorithm easy to remember it's basically an MRI scan that uses a machine learning model to guess essentially how old your brain is so people may have heard of various measures of biological age chronological age this is the same thing but using a brain scan and within those who were in this one

study they applied this to those with diabetes and one of the strongest signals was the difference between those who had lower and higher blood sugar on how much older the brain looked. So there are multiple reasons why persistently high blood sugar may cause problems, but you can also just, you can see it. And we know that the faster your brain ages, the worse your decline in cognitive function. It wasn't the same study, but a different study using the same procedures. So some people genetically have a challenge with what we're talking about. Most people have earned this problem.

They've eaten themselves or sat themselves into this problem. Is that fair? Yeah. And I would even say when it comes to genetics of, say, type 2 diabetes, because that's kind of, you know, if you're thinking about or metabolic syndrome, which is sort of one of the later stages of insulin resistance or persistent high blood sugar, those two, and they often come together. Even those at genetic risk requires an environmental setting that promotes that. If you go to the Bolivian Simenei, which is a hunter-gatherer tribe that's been studied for

multiple different regions because it's still relatively close to its original hunter-gatherer type lifestyle, they have a genetic predisposition to diabetes were they to be put in the modern American environment, but they have a 0% prevalence of diabetes in their home environment. And so people like to talk about genetic risk, but I'm a big fan of saying there are modifiable things that are probably more important for the vast majority of people. Finding Mastery is brought to you by Cozy Earth. Over the years, I've learned that recovery doesn't just happen when we sleep. It starts with how we transition and wind down.

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They can't believe it. They're trying to do their very best. But for whatever reason, and she's always had a sugar tooth, her brain is craving sugar. And she is not on the decline. Certainly, there's compromises at 96 from a cognitive functioning standpoint, but can you just speak to that for a moment? Cause I'm not so, I'm not okay for the 30 year olds or the 40 or 50 year old listening here, 60, 70, even. Yeah. The main message here is like, get your, get your glucose in order, right?

From a cholesterol standpoint, from a heart standpoint, from a brain performance standpoint, from an overall quality of life standpoint, get your glucose in order. Put down the sugar. But I'm not so sure that's right for her. So can you talk to like, because I do understand that, and this is straight down your lane, folks that have had concussions crave sugar. So I think that there's something here that I can't quite stitch together, and I'm hoping you can. Unfortunately, or fortunately for me, because it's interesting, unfortunately for those who would like a defined answer,

one thing that we've learned, or the main thing that we've learned about blood sugar in the last five years is that it is impossible to predict so far how one individual will respond to a certain diet or food there you know maybe the original studies or so this sort of really brought this forward um were done by the Weissman Institute in Israel, where they took nearly a thousand individuals, they put continuous blood glucose monitors on them, so like measuring their glucose all the time, 24 hours a day. And they fed them a whole bunch of foods.

And, you know, you take two individuals and they have these nice graphs in their papers. So you take two individuals, one gets a banana, one gets a cookie, or they both or they both get banana they both get a cookie in one individual the cookie no change in blood sugar looks great but the banana causes this big blood sugar spike in the other the exact opposite thing happens so the first thing to to point out at this point is that if you want to know how somebody will respond to a given food, you have to test them. And, you know, there are, you know, so those guys, they started a company called Day Two,

where they can try and predict which foods you will respond to based on a stool test, you know, maybe we'll end up there. There's Tim Spector in London and his Zoe group are doing something similar. They've done similar studies, you know, and they. And they've said, if you're trying to predict how somebody will respond to a given meal in terms of a blood sugar response, things that matter include obviously the meal itself, genetics, the timing of the food, which meal of the day it is, how do they sleep, have they exercised recently you know all this you know how what's their general health what's their normal blood sugar regulation if you measured their hba1c or other things so all of these things play into that um and so to say you know this person is eating a lot of sugar but they're you know they seem to be great for them it may not be causing any issues um in terms of say from a pure blood sugar regulation

standpoint. It's perfectly possible. So that's the first answer to your question is that any given individual, I can't tell you do or don't eat this food because it's bad for your blood sugar, because honestly, I have no idea. So let me pause you right there before you get to the payoff on this. I love this. By the way, all the measures, the markers that you've been describing, I've done most of them. And I would encourage most people, I would encourage everybody to have some understanding of glucose monitoring, have some understanding of some of the, your insulin profile, you know, so your glucose profile. So you can understand like, how does your body metabolize and work with, um, choices that you're making. So, and they're not that

complicated. Like I think Boston heart has a really good panel. Um, I'm not sure which panels, um, that are, uh, commercial grade that you're using, but Boston heart was one that I used that was, it was awesome. And so was awesome and so and listen I'm speaking now right to the audience anyone that would like some recommendations or referrals let me know I'm happy to share those resources with you and we can put them in the show notes or whatever but do you have any go-to's that you have found to be useful in terms of panels or panels for individual tests um so i've used the wide um a wide range at one point uh i had a lot of people doing true health diagnostics while that still existed it doesn't now uh boston heart um is obviously very popular most of the tests that i would generally recommend

you can get from quest or lab court you might be able to get them through your uh healthcare provider and get them reimbursed through insurance because you know if you're talking about basic blood sugar tests maybe you know maybe a fasting insulin hba1c all of these things you can get pretty much anywhere or they're even super cheap uh direct to direct to consumer so i mean if you really want to delve deep into your you know different uh you know into an advanced lipid test then yes you know you could do like some of the boston heart things your you know different uh you know into an advanced lipid test then yes you know you could do like some of the boston heart things but you know for for an overall quick look you know usually the basics will do a good job okay let's go back to um let's go back to your

payoff here of the story i think there is obviously some neurological basis to craving or desire for foods, right? And some of it is going to be energy supply. The majority, I think, of cravings that we have for food in general are more socially or environmentally driven right it's not that you're at a point where your brain is so desperate for nutrients that you know you're striving you're you're craving for sugar because the majority of us are you know privileged uh enough to not have to to deal with that in the setting of something like an acute brain injury, obviously, there is going to be some kind of increased energy demand, particularly in the recovery phase. sort of change of a time in terms of what is demanded you know versus what's like increased energy demand say for for repair versus ability to produce energy so in some of the the brain injuries that i study particularly like there's acute um significant vascular type brain injuries so it could be a stroke um or you know a cardiac arrest or something like that. There's this dip in mitochondrial function early on in the injury

that potentially recovers later on. So there's a continuous, again, changing supply and demand. But as you recover, you will have increased energy requirements in order to institute some kind of repair. So that could drive certain cravings. In particular, concussion, well, actually any acute brain injury,

we can see again from animal models as well as as much as possible from the human data, if you have persistently or swinging high blood sugar levels, that seems to be associated with a worse outcome so a good example being that if you have type 2 diabetes and you have some kind of acute brain injury you probably are going to have higher blood sugar levels and you may have a worse outcome than somebody who didn't have type 2 diabetes but is otherwise similar has a similar injury same with a concussion um so even if there are cravings for glucose ensuring stable blood sugar levels is an important aspect of concussion or brain injury recovery which is where you know nowadays um and the randomized clinical trials

are being done currently but nowadays i might might talk about other alternative fuels that you could use in that setting that don't cause high blood sugar spikes like lactate or ketones which seem to support the metabolic requirements of the brain without you know causing any issues with blood sugar so it is that achieved by reducing sugar intake um a carbohydrate indoor sugar intake completely i don't think it needs to obviously you can institute ketosis by going on a low carb ketogenic diet so you can produce the ketones yourself um i think what's more important is just maintaining stable normal normal blood sugar levels, you know, 80 to 100 milligrams per deciliter of fasting, and then after a meal, spikes no more than 120,

130. How you achieve that, I don't think we really know what's best. But again, if you were to measure your glucose and how you respond to foods you can maybe tailor that appropriately so it doesn't necessarily mean you have to eliminate carbohydrates but maybe focus on those that don't cause large swings in the setting of an acute injury it's uh true in brain injury broken bones and you have some kind of inflammatory response different parts of the body become insulin resistant so you are more likely to get elevated blood sugar or large swings in blood sugar so again it's just something that you need to to keep an eye on and i see you raise your eyebrows one of the reasons for that is that you are diverting so tissue some of the peripheral tissues become insulin resistant in order to divert

glucose to the immune system as part of the immune response. So you get higher blood sugar levels, so more blood sugar is available to those immune cells to do their job. That is amazing. Okay, very cool. All right, so if we make this super applied, super behavioral for just a moment, what I'm hearing you say is, listen, on the nutritional side here, just keep it pretty steady, right? Like anytime you're going to have a swing, which could be a banana or cookie, but you need to, you need to measure it yourself. This is why those constant, consistent glucose monitors, am I saying it right? Continuous glucose monitors. Continuous. Yeah. Thank you. Continuous glucose monitors are really something of interest so that you can learn about your individual responses to to food choices one thing that i'm really i guess concerned about in the biohacking community continuous glucose monitors are part of this sleep monitors

are part of this is this kind of pathologization of things that should bring us joy being sleep and food um so yes wear a continuous glucose monitor test it against things that you eat frequently if there's something that you eat frequently that causes a big blood sugar spike consider swapping it for something else and i think that's as much as most people need to do because then and then you're armed with that knowledge right so so maybe the thing that causes a big swing is ice cream but you know every once in a while you're like hey i'm going to enjoy this ice cream i'm not going to worry about the blood sugar spike because worrying about that blood sugar spike is probably more of an issue than the blood sugar spike itself and there's even data uh suggesting that your expectation of a blood sugar spike causes a bigger blood sugar

spike um regardless of the meal that you ate so this is a done by ellen langer who's you've probably heard of this amazing psychologist at harvard and she's done multiple studies looking at glucose control in diabetics yeah and i i've had some good conversations with her she's let's done some really interesting work around just expectations and exactly yeah it's really remarkable and so in this one study is one of the more recent studies they took diabetics and then they ran they sort of did a crossover study so they got both conditions where a low sugar milkshake and a high sugar milkshake and you got to read the new the nutrition label you know understand how

much blood sugar is coming in that's important for diabetics particularly if they have to give insulin right you need to know what's coming in and so in the high sugar condition obviously they got a bigger blood sugar spike than the low sugar condition the thing was this was the same milkshake both times so thinking that more sugar is coming in is going to cause a bigger spike which is which brings me back to people who have continuous blood sugar monitors all day every day for everything they eat you're going to get to a point where you're expecting a big spike because of the pizza you're about to eat and then you're going to get a big spike because you're expecting one so there's a lot that kind of comes into this but yes the things you regularly eat understand how you respond to them be armed with that knowledge but don't then you know as soon as

you quantify something you know there's interesting data this you quantify something you start to lose the joy in it you start to objectify it and it's no longer a thing that can bring you joy in the same way so have the necessary knowledge but don't then you know over complicate or over focus on it very cool and then um super pragmatically here, like if somebody is going to have a cookie or an ice cream or something, would you recommend that they also balance some of that, save a little bit of room, if you will, for a handful of nuts or something that's got some, you know, I don't know, maybe it's, um, some sort of protein, um, ice cream and eggs doesn't sound right to me

but ice cream and and you know nuts sounds uh actually doable like would do you recommend that for uh stabilization uh yeah and as much as is practicable uh there are a number of studies on uh meal order so say if you have a meal that has three components, you have a protein component, a vegetable component and a starch component. Eating your protein and vegetable first followed by the starch, and that could be eating your eggs before you eat your ice cream, causes a smaller blood sugar spike. So yes, in general, I often, just because it's not something that people always focus on, it's it's easy to not eat enough of if you focus on protein either around or before something that might cause a

large spike and again i don't want you to become super obsessed with it because i think that defeats the point but in general you know eating some of those things before something with a with a higher glucose or carbohydrate component or something that might cause a blood sugar spike can then blunt the later response you know i think you'll just find it fun is that maybe it's a glimpse into my family too it's a best practice for us to eat protein before we're going to eat protein veg vegetables and then we'll eat the carbs and like the challenge is when you go to restaurant they bring the bread out first or they bring a glass of wine out and you're like, hmm, you know, I got to wait. Do I really have to wait? You know, but maybe a little, I don't know, shrimp cocktail does the trick beforehand,

but yeah. Okay. So can we talk, can we get back to a bit of the mind brain connection here for a minute? And I'm curious your take on how expectations are actually creating a physiological response that doesn't quite make sense to just the property alone. So the expectations that I might get sick, the expectation that this is going to be fun, the expectation that this is going to raise blood sugar levels. So can you maybe just speak to that a little bit on how you're understanding that? It probably depends. It may depend a little bit on the individual context. So if we talk about everything about the blood sugar one, I actually discussed this study with Dave Rabin, who's a mutual friend of ours. So I think in that context context so say you're a diabetic an insulin dependent diabetic the

process of eating carbohydrates is in itself it's an arduous one right it's something every day requires cognitive input you need to decide how much insulin you need you know there's this whole process that most of us don't have to go through so in this setting in that study there is some degree of potential physiologic stress associated with knowing that there's in this incoming carbohydrate this glucose load that i need to deal with so um any kind of physiologic stress itself through the release of cortisol um uh catecholamines you know adrenaline increases blood sugar so i think that one is potentially relatively easy to to explain away they didn't measure those things so i can't tell you that's exactly what it is but in my mind i can certainly i can see people who have continuous glucose

monitors get stressed about the food they're about to eat and how it's going to affect their blood sugar level like you can physically see it as they you know and often they document it on instagram for some reason um so there's there's that aspect um then there are more complex things and again i talk about this particularly because it's um interesting to me from a genetic standpoint when you tell people so this is um i'll wind back a little bit there was a study where they took individuals and they put them on a treadmill the 30 minute treadmill test how far can you run in 30 minutes this is a great study you know this yeah no you know what i've had uh almost 400 interviews, three something. Not one person has brought up this study yet. Great. I'm so glad.

Yeah, this is very fun. Yeah, I'm stoked for you to introduce it. This is a great study. I think it was in Nature Human Behavior, if I remember. And yeah, so they did a treadmill test and then they did a genetic test. And then they told people, you either have a good gene for endurance exercise or a bad gene for endurance exercise. And then they had them redo the test. Those who they told had a good gene did the same, on average. Those who were told they had the bad gene did worse.

Except for the fact that it wasn't true. They randomized people to be told whether they had the good gene or the bad gene, regardless of what gene they actually had. so this is when we talk about genetic risk and when we talk about you know these tests that people are doing in terms of genetics you have a risk for this i worry that you are creating like almost manifesting that in your mind regardless of whether the gene is having an effect what's super interesting in that same study they looked at a different gene the fto gene which is the single snip that in a westernized population is most associated with being overweight

or risk of obesity even though the effect is teeny tiny on average um and then they gave people a test meal and they looked and then they measured their satiety and they looked at their physiologic response in terms of hormones that respond to a meal and are associated with satiety. And they did the same thing. Said you either have the high risk gene or the low risk gene for FTO. And again, it was randomized. It wasn't actually true. And those people who were told they had the high risk gene, it changed how their physiology responds to a meal.

You can measure it in the hormones right it's not something you could explain away with some kind of like magical thinking or they told they had a bad gene so they just gave up right you can measure it in the hormones which is incredible um so there is this process whereby the mind can physically change physiologic responses in a way that can measure and this is this is part of that expectation so i don't have a great answer for you but we're seeing these amazing things in the literature that i just i love to talk about it's complicated i mean and this is where you and i have spent our life efforts trying to understand interaction between mind, brain, environment, choice.

It's remarkable that the way that we think can fundamentally change our neurochemistry, our neuroelectrical, our behavioral response we get, but it changes something at a structural level that is like, are you kidding me? So the shorthand of this is placebo and nocebo. And placebo, if you think something's going to work, we find that or that a change will take place, that, yeah, that alone can account for some of the change.

Nocebo, which doesn't get enough credit or talked about even in literature frequently enough, is that if you don't believe something is going to create change, sure enough, there's an output commensurate. So I think it's really fascinating that the way that we perceive and interpret and use our mind has a direct impact on our physiological condition. So, you know, we're just getting started, I think, in this very specific lane about how to optimize thinking relative to one's health spin. And so, yeah, the easy kind of horseshoe that we're going to toss out there is optimism. Yeah, it's good. There's good research. Positive thinking, if you will, it's a little overrated. It makes me, oh gosh, it makes me kind of gag a little bit, just thinking,

I'll just be positive. You'll be good. But there is something that's taking place on expectations and the way that we use our mind. I was going to ask you about, I mean, whether you read the work of Gabrielle Otigen on positive thinking. Yeah, it's good. It's really good. I just find it interesting because you mentioned positive. Yeah, because when you mentioned positive thinking,

I immediately think of her and how if you always imagine yourself achieving something through positive thinking, you can almost trick your brain into thinking you've achieved it without actually ever having to put in the effort to do it. So it's just an interesting other side of that yes i always think about when people mention positive thinking one of the one of the positions to consider when you're thinking about saying your

goals out loud or doing mental imagery and or having a dream board or vision board or whatever is that there can be that confusion to your brain where it's not sure if it's actually already happened, so that there's a decrease in volitional effort. And I'm shorthanding a bunch of work here. I find it interesting, but I've also found that it's, there's a better return when we are precise and clear about what it is that we're working toward. And so I've found that as an interesting conversation, I love the work that she's

introducing. And from an applied standpoint, I'm far more interested in people actually doing the alone work to get incredibly clear about what a future state or condition that they're working toward is and could be and is beautiful and amazing and compelling get clear with that and then don't live in a fantasy land like actually you know like be really grounded on a day-to-day basis about what you're working towards so anyways um that's a good conversation we should probably um get gabrielle on i think she's she's done some really good work okay awesome sorry i sidetracked you what were you gonna no no no i want to get into um so i want to go back upstream you talked about supply you talked about demand and you talked about metabolism is that correct those. Right. And you can either

increase or decrease and some sort of downhill effect will take place. And we're in the game of trying to increase those, right? And I just want to thin slice quickly is that there's a difference between acute stress and chronic stress. And chronic stress is the one that we're most concerned about from a debilitation of uh of resources acute stress is necessary and needed yeah right and you're calling acute stress challenge yeah um yeah exactly so okay so you might um yeah i would call it in this context um i'd call it i'd call it a challenge but i mean you you could also call it an acute stressor a horm hormetic stressor, any of those would, would, would apply. Okay. And an acute stress also is not to be confused with what you're talking,

like an alarm bell that goes off, like a fire drill that goes off as an acute stress, but it activates the system in a very different way than a challenge. And I'm not going to parse those two things out right now, but I like the sensitivity between challenge acute and chronic. Okay. There's also in between acute and chronic. There's a phase of like midterm stress. Subacute might be the, yeah. Subacute is what you're talking about.

Right. Okay. All right. Okay. So let us, let's get into some of the application here. Subacute is what you're talking about. All right. Okay. All right. Okay. So let's get into some of the application here from a brain perspective is that I want to do a great job of taking this vast science that you've been fascinated with and saying, okay, how do we make it simple for me to live a quote unquote healthy life for as long as I possibly can? And then there was a bunch of research around telomeres a number of years ago. And I saw some controversy maybe two or three years ago that maybe long telomeres, and maybe

you can coach us up on this, is not the thing. It's not a bit of the holy grail that we once thought. So can you explain telomeres? Can you explain that? And then can you also get into some very applied things that we can do to increase the quality of a healthy life? Telomeres were essentially probably the first big way in which people thought we could measure the pace at which cells were aging. And telomeres are essentially the caps on the ends of chromosomes, which hold the majority of your DNA. And every time a cell replicates or is damaged, those telomeres shorten. And once they are gone, essentially all very short, you can no longer replicate or split that cell, replicate that DNA. That's particularly important

for stem cells, of which we have pools for different organs and functions throughout the body and eventually you will exhaust those pools of stem cells they will become something called senescent people may have may have heard of that particularly in the longevity arena it basically means they are no longer able to replicate um and often once pools of cells become senescent they also become kind of chronic inflammatory. They kind of sit there and they're grumbly and not very, very happy. And they can create this sort of systemic and local sort of inflammatory condition, which is associated with this process of aging. And so measuring telomeres became this big thing that was going to be part of telling you how old you are. The problem is

that telomeres is mainly the way that we measure them, not necessarily that they're not useful, but each different tissue and each different cell type has different lengths of telomeres and different rates at which telomeres shorten. So if I wanted to measure your telomeres and assess your rate of aging, I'd probably have to do it multiple times over time. And I'd have to do it in multiple tissues. So I'd have to do like a liver biopsy and a muscle biopsy. And maybe I'd do a brain biopsy if I wanted to know how fast your brain was aging. We can't because we're not going to do that, right? Because other telomeres that we can easily measure, either from white blood cells in your blood, or from usually we do a cheek swab. So just from epithelial tissue inside your mouth. Those aren't reflective of telomeres across your entire body.

So that's kind of been the issue with telomeres is actually they're not that reflective of the aging process of the body as a whole. Another part of it is if you look at the white blood cells of telomeres, the number and proportion of different white blood cells that you have circulating in your blood at any given time changes all the time. And different types of white blood cells have different lengths of telomeres, and that is a massive confounder as well. So there's just multiple reasons why telomeres aren't a useful thing to look at there have also been studies where people have given telomerase so synapse for a while people took telomerase which is basically an enzyme that sort of adds back to telomeres and they don't seem to be particularly beneficial either. And I think one of the most important things to think

about in this longevity arena is what's sort of the output, what's the epiphenomenon, what's the thing that you measure versus what are the factors that are contributing to this process? So if you have, if you're exposed to a lot of things that cause your telomeres to shorten just adding an enzyme that's just going to be continuously working to try and add on telomeres it doesn't make any sense right you haven't removed the environmental factors that are stimulating the aging so that doesn't slow down the process and i know there was a whole boom in the nutrition supplement industry around this yes so i think ta65 is is the telomerase product that i believe is still on the market some people take it some in high doses it's

very expensive there is no evidence that it works in humans i think it it works in animals but there are a million things you can do to it to to make a mouse live longer, almost none of which have translated well to humans. And there are multiple processes that we could maybe dig into. But basically, so another one may be cellular NAD, you may have heard of. There are lots of different supplements and processes you could do to replenish that

because it does decline as you age. NAD plus. Yeah, so NAD plus being the, the main sort of electron carrier throughout the cell, it moves energy throughout the cell essentially. And it declines with age. And yes, you can replace it. And there are supplements that do seem to improve levels of it in humans, as well as in animals. But I don't really want to focus on that the more important thing in my mind is what are the processes that cause you to lose nad in the first place i get you yep um and so when you damage your dna and that could be through again

toxic exposures we talked about heavy metals it could be chronic inflammation um caused by i don't know a dental problem or some kind of infection um dna or oxidative stress dna damage or anxiety i just want to add that to the oh yeah any kind of physiologic stress that is chronic can can do that absolutely um through stimulating those same pathways um and so when you damage your dna the process of repairing it uses up NAD. And also at the same time, chronic inflammation, chronic stress blocks the pathway through which NAD is regenerated. And finally, you regenerate NAD at least partially by activating enzymes that are on a circadian schedule that requires adequate sleep so where a lot of people are focusing on the supplement that replaces nad i myself would be

interested in well what's the process that's causing you to use it up not produce it not recycle it adequately and that includes anything that you know chronic psychological stress inadequate sleep inadequate nutrition all those things that's where i'd focus first personally okay i i love this i feel like i could go on and on and on with you and i i wonder if you could just take us home on purpose and as it relates to the brain and i'm thinking about kids i'm thinking about folks our age i'm thinking about you, I'm thinking about folks our age, I'm thinking about, you know, folks that have retired as well. But can you talk about purpose from either an applied and or a scientific standpoint?

When you look at the, I guess, the literature in that arena, and I know the psychologists and you if you know if i use purpose and meaning interchangeably they are not the same thing but in general if we think about things like that where you are committed to or feel you're committed to something outside of yourself some process ideally that contributes in a greater way to society other individuals that seems to be like one of the best predictors of long-term health and even interestingly healthy aging so there's a there was a study that's kind of related where they asked people about their thoughts on aging and those who were you know sort of scared to age had this sort of negative thought process about the process of aging actually ended up with worse

health mental and physical health outcomes than those who are like aging is something we all do i embrace it it's part of who i am as you're right so just thinking about how you connect all these things individuals and within yourself has a big impact and there are multiple different ways to to think about this um but in general i think it comes back to this feeling of connection or demand which is that humans require interaction with the physical environment and that's your movement singing music language and social connection. And so there are multiple ways that you can think about it, there are multiple ways that you can apply it. But our purpose, if we have one, you know, it could, you know, you can think about, so if you think about it from a reproductive standpoint, we are often told that you're just there to pass on your genes and then after that there's no

evolutionary pressure on you as an individual and you will rapidly die off and you're essentially just a useless husk that's taking up space um and it's just your genes that will continue in your children but i don't feel that's necessarily the case because as, you know, in the reproductive standpoint, as you get older, you have a purpose, which is to support and look after your genetic line as it comes behind you. So there is some evolutionary drive to live a successful longer life so that you can assist backwards in that way um and that you know for a lot of people traditionally was their purpose as you become you know the the matriarch or the patriarch of the family and you look after your children and their children and that is kind of one very you know easy to imagine example of this purpose whether you're contributing to and it has some kind of

you know evolutionary aspect as well but it obviously doesn't need to be, it doesn't need to be that, you know, people may get that through church, or CrossFit, or volunteering, you know, there are all these things that seem, that I think have the same benefit, because they are the same connection to society and something, more than just looking after yourself. so that's how i think about i think i think that's how i think about purpose um and when you look at the research on purpose it seems to be protective of a whole host of things and i think you know you can boil it down to that you are telling your body your brain that it is useful that is required that is meaningful you know and that has a distinct physiologic effect that you could measure

if you wanted to. I love it. That last line is really powerful because it relates back to what we're talking about for blood sugar levels, even sickness, you know, like if you expect something or you have a standard that this is happening, that this is important, that it's sending a whole host of signals that we're not sure exactly how it's working. But what I love about this idea is that purpose is 100% under your control. And so it's one of the great predictors of quality of life. And this is something that you can completely, you don't need to go outside of yourself to determine your own purpose in life. And the three components, it's bigger than you, it matters to you, and it's got some distance between when it can be experienced now and in the future. So it's future oriented.

So very cool. And then, you know, I just would love a little summary of if I knew what you knew, if we knew what you knew, what would be some of the best practices on a regular basis that maybe you just kind of consider like to be, I don't know, uninteresting, but what are some best practices that you employ? And it can be anything from supplementation to the way that you wake up, the way you go to sleep, the way you prepare for meals, whatever. Like, what are some best practices from just a good old quality of life standpoint? I think it's funny because, I mean, my answer is not very sexy. And I think my answer is also going to be what everybody knows already.

And my personal journey through all of this has gone from, you know, optimization, measuring everything, supplementing everything, you know, continuously trying to tweak every biochemical pathway, which I have done in countless athletes who are trying to get that competitive edge, and people with chronic disease who are trying to improve their health. And I've become increasingly interested in, well, how can we just like distill that down into something that hopefully, I wish everybody could apply. And I say that because the things that I do and the things that I would recommend require some aspect of privilege, time, money, resources, access, to some degree, because there

are individuals who have to work three jobs, so they're never going to get the time to sleep, or maybe prepare the food or be able to afford the food that I feel every human should have the right to eat. So that's always going to be an issue that I struggle with. But best practices are regular sleep and wake time, as regular as possible, the same every day, as much as possible. And again, before I go into all of this, the most important thing I think of all of this is not to worry when this doesn't happen because i i worry about that i worry about that worry more than the process of that happening you know once or twice um or occasionally so regular sleep and wake time so that includes being exposed to bright light in the morning, darkness at night. Real whole food, whether that's paleo, keto, Mediterranean, whole food plant-based. I think only you know what makes most sense for you.

And then maybe you do some tracking along the way to figure out how you might optimize that. That would be ideal. Frequent movement. And I don't think you need to go to the gym and lift weights. Although I do think everybody should. and i don't think you need to go to the gym lift weights although i think well i do think everybody should but i don't think you have to um and so resistance training 30 minutes twice a week i think that's like the baseline that anybody can do walk at least 20 to 40 minutes a day between those two things that's probably the majority bang for your buck exercise cognitive function you know cardiovascular fitness if you build in some balance ideally that's it um and then you know

all that social connection stuff that we talked about and again you can find it in in any place and through that you're probably going to get a lot of that cognitive stimulus that we talked about learning new skills uh maybe teaching others um you you can build that into it. And frequently people do. That's essentially it, I think. Basically, you're saying build the base. Yeah. Build the base. And I, right now, am not 100% convinced that there's anything else the majority of people need to do it's very cool super clean super crisp um i love that you can you can go wide and deep which is um really fun for me so i wanted to say thank you for i hope we didn't i hope i didn't do a disservice to the brilliance of your understanding of the brain by staying horizontal too much.

Absolutely not. Yeah, Tommy, I love this. So maybe a last takeaway on any concerns you have about COVID in the brain. Anything there that you're paying attention to? Yeah, super tricky, to be honest. And there was so many potential things that could come out of this. Obviously, the virus itself and how it may affect the brain, I think that is a component that we will see aspects of. Certainly, athletes, high stress, physical and um emotional or psychological individuals

are probably those who are the greater risk for long covid which obviously has a cognitive component uh that's certainly what what i've seen like almost all the long covid people that i know or have worked with are runners like high volume runners um and i think and it's interesting now before i don't want to go on too much of another tangent but some of the changes that you see in the immune system in individuals who have metabolic disease which is another risk factor are you also see an overtraining in athletes um even though sort of from a metabolic health standpoint they're completely completely separate um so that's one component but i'm also i think right at the beginning uh there was this really

interesting resilience that the population showed everybody was worried that you know the social isolation was really going to affect people's mental health but there seemed to be this like you know the blitzkrieg mentality we're all in this together um and people were like connected with it um family members even if it was over zoom like early on there was this nice response that i think created some resilience but we've lost that now so and now we're at a point where family members, even if it was over Zoom, like, early on, there was this nice response that I think created some resilience, but we've lost that now. So and now we're at a point where mental health is declining, seems like infant development is being slowed, we're no longer able to apply social skills, social interaction, we're no longer able to communicate. You know,

I'm thinking, obviously thinking, speaking very broadly, but you know, be able to communicate um you know i'm thinking obviously thinking i'm speaking very broadly but you know be able to communicate with with others you know who have different opinions from ourselves be it face to face or or online so i'm i'm mainly worried at that aspect now much less about the virus in the brain and more about how the response is affecting social development more interest in the social psychological as opposed to the biological um yeah so the long covid stuff let me just make sure i'm playing this back as you're seeing it with folks that have metabolic disease and or over training conditions like ultras and or maybe any athlete minded person who is in the overtraining syndrome having more complications

for long haul yeah no so the the metabolic syndrome seems to be a greater risk for acute you know hospitalization and death with covid okay long covid seems to be more in high volume endurance athletes at least from those that i've interacted with obviously others have gotten long covid too but that's the group that i've interacted with um but from a like physiologic or immunologic standpoint some of the changes in blood cell marker and white cell function that you see um you are similar in those two groups um and that may be part of the you know in high volume in uh endurance athletes you can actually create this sort of physiologic metabolic stress localized insulin resistance that kind of stuff which is similar to the other side even though these people are ostensibly healthy so in that kind of high

volume endurance um athlete group i think you're seeing some of those changes that are then predisposing them to long covid and is long covid a? I don't know anyone that in my life that has it. And so I hear people talk about it, but I haven't, I haven't worked with a client and I haven't, I don't have anyone in my circles that have it. I do hear people that have had COVID maybe more than once and saying, Hey, I'm kind of got a fog, but that fog is maybe, um, it could be attributed to a lot of things. And then, so you're saying you're nodding, like, yes, it is a thing, dude. Right. Oh, no, no, no. I'm, I'm not, I'm, I'm nodding that like to everything you're saying, just because I appreciate your, like the world that you existed in that you just haven't

interacted with people. Yeah. I don't see it't see it which which i which i completely understand i have met and worked with several people who i have no reason to believe that it isn't a thing and everything lines up and makes sense with them and their their symptomatology and their previous risk factors and like i said they often you know the story is they're usually fairly lean very high volume endurance exercises probably chronically under eating a little bit in that sort of high volume exercise setting get covid you know test certainly test positive you know have like the acute phase and then just never recover from like a fatigue and cognitive function standpoint and obviously lots of parallels in other post-viral syndromes which are very common and do exist and can go into you know fibromyalgia chronic fatigue when we measure it you know some

of the tests that you've done they've you know some uh like bob bob navio has done similar studies in patients with chronic fatigue you see this sort of like down regulation of the mitochondria hypometabolic type picture so there's some kind of like down regulation the mitochondria hypometabolic type picture so there's some kind of turning down of the metabolic system as a result that's long term that you need to sort of build back from so from my experience i do believe long covid is a thing and post-viral syndromes you know in general and are how are you treating it how are you helping folks sort it out so there's a number of there's a number of uh approaches that that people are taking uh there's actually a sleep get your blood sugar pretty i'm trying to not i'm trying to not give you the same answer because

that's that's that's yes so that so in general these are over stressed overworked over exercised individuals so all of that nutrient dense calories sleep rest and recovery that that obviously has a role um some people are getting interesting results particularly by focusing on na nad like we mentioned earlier so uh protocols that include uh niacin quercetin which prevents the breakdown of niacin some people have found some benefit um in in that arena there was actually a south african group that sort of first focused on that they published that as a hypothesis paper some people have found benefit from that um part of it and it's the same in sort of chronic fatigue type settings is essentially a graded return to activity and what is very common is that on a good day you want to do a whole bunch because you haven't done very much

and you overstress the system and you sort of set yourself back so doing just a little so again it's is that very graded what's challenging on that, you should continue to do that and make it the same and slowly build it up. And it's frustrating for a lot of people because you're like, I'm a runner. I want to get back to the running that I was doing previously. But actually, it's better to do the same amount on days when you feel good and when you feel bad and slowly build back up. And there's a theory, and I won't say that i believe it's true or not but it's an interesting theory the central governor hypothesis which tim noakes has talked about which basically the brain controls the physiologic output of the body um as a protective mechanism um and he's and

in chronic fatigue so so you don't overheat to borrow borrow an analogy from an engine, right? Yeah, exactly. It kicks on to say, hey, slow down, slow down. And what the endurance folks understand is that you got to push right past that thing. Yeah. Ignore those signals. And part of it is, and this is, you learn the same thing with like the traditional attritional approach in endurance exercise training. You, you know, one of the reasons why you do like these really lengthy sessions at threshold is to train your mind to know that you can do it.

And threshold is that really difficult, to hard to function standpoint like it's a it's a just it's not undoable it's the place where it's like really just hard on the treadmill or on a run but then you stay in that at tempo for an extended period of time like never gets better but yeah it's painful it never gets better but you can keep doing it for 30 40 minutes an hour if you're if you can get your mind around staying in that boring uncomfortable oh i just love that apple pie right now you know like it's just dealing with that thing right yeah or just stopping is and so so part of that training is that you're teaching your brain that you can do it and i think teaching your mind or your brain? A bit of both. Yes.

And so I think there's some unconscious aspect, but there's obviously a conscious aspect as well. And so I think in the setting of chronic fatigue, post-viral syndromes, part of it, and it's not the case for everybody, so I don't want to generalize because each individual experiences it differently, but part of it is retraining your brain that it's okay to exert yourself um in this way and taking the brakes off but it that's a slow process because it's a self-protective mechanism that you need to sort

of retrain over time yeah same with concussion like the protocol to come back is super gradual so the brain doesn't go whoa whoa whoa whoa we've been here before and we're not going there again it's a retraction that's taking place. Okay. It's a little bit like a balloon. You've got to blow it up slowly to get the real full expansion. Yeah. Okay.

Brilliant, dude. Like I know we're way over time and I've really appreciate it. I could go on and on. So maybe we'll just get around to of all things fun and exciting, you know the brain health lifespan healthspan standpoint and then best place people couldn't learn about and watch your thoughts and kind of be part of you your your world where do you want to drive them uh probably the best place is instagram if people use that at dr tommy wood uh if i do podcasts i'll post them on there uh very you know randomly i'll have a thought about life and the world and they'll result in a post. Or maybe it'll just be my stories where I'm smoking brisket or pictures of my dogs.

But you'll get all of that if you go to Instagram. Tommy, you're a legend. All right, brother. Take care. Appreciate you. You too. Thanks so much. Okay.

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