BEST BRAIN FOODS For Brain Health: 7 Steps To BOOST YOUR BRAIN TODAY! | Mark Hyman

There are certain instances where light can actually act as a carcinogen.

Light? Yeah.

Air pollution can affect cognitive function and put us at increased risk for Alzheimer's disease.

With brain injury, don't wait to start exercising. Actually, when you start exercising sooner, you'll enhance recovery.

Going back to light, you know, I mean, there are certain instances where light, it's been proposed, and this is a, you know, a rapidly evolving science, we're just at the tip of the iceberg.

But can actually act as a carcinogen. Light. Yeah. What kind of light?

Well, artificial bright light at night that suppresses the hormone melatonin. Melatonin is a key gatekeeper to the process known as autophagy, which is when our cells clean house. And, you know, it's sort of like the KonMari method for biology that it uses to clean up old, worn-out dysfunctional proteins and organelles. It's also involved in DNA repair. So DNA damage is at the root of cancer, aging.

How we get rid of waste and how we repair our systems is regulated by melatonin in light.

Yeah, so I think that's kind of a bold statement and it's a hypothesis that certainly warrants further testing to know for sure, but there is a well-documented increased risk of certain cancers seen in night shift workers, which make up 20% of the global workforce. So getting bright light in through your eyes in the morning is crucially important for anchoring your body's circadian rhythm, which guides everything from how coordinated we feel, how much focus we're able to have, how much energy we're able to have, how well we digest and metabolize food. But in the latter half of the evening, avoiding exposure to extremely bright light, especially if it's on an ongoing chronic.

Basis, I think is-- Especially if we were all being with those goofy glasses with the, like Dave Asprey with the orange lenses.

Amber glasses, yeah, like amber colored blue light blocking glasses. I think that among all all the wellness biohacking gimmicks that are out there, I think that those are among the most useful.

Yeah. Yeah. And it's powerful because I remember reading a number of years ago about studies in animals where they would give them melatonin and it would suppress cancer. Yeah. And part of that has to do with the light, which actually inhibits melatonin. So if you're, you know, living as a hunter gatherer, the sun goes down, you maybe got a few candles. Maybe they didn't have candles back then. Maybe they didn't have fire when we start out.

Yeah.

And our bodies are designed that way. And now we have this incredible light. That's such an issue. I remember reading a book in a number of years called Lights Out. You ever come across that book?

By T.S. Wiley.

Yeah. Yeah. And, it was like an eye-opening book, literally. And, it was about how the invention of the light bulb correlated with all these chronic diseases we're seeing now.

Huh?

Yeah. I don't, I mean... Heart disease, diabetes, cancer. And, it talked about the biology of light. and how it impacted us and we don't even think about it. We just are on our phones all night or have computers in our beds. We have bright lights and there are ways to fix it. So, what are the ways people can fix the light problem? Yeah.

Well, I think there's two things. First of all, you want to make sure that you're getting good quality light early in the day, so preferably before noon. So, not only is that going to help anchor your body's circadian rhythm, but it's going to help protect you against blue light induced melatonin suppression later in the day. So, that bright light, Go outside, don't wear sunglasses. Go outside, don't wear sunglasses, or don't.

Wear sunglasses when you're driving to work.

If you have a half an hour commute to work. And then get through your windshield? Yeah, yeah. It's all about the light intensity. What you need is about a thousand Lux of light, and there's an app that I have no affiliation with, but it's called Lux, and there's some questions as to how reliable it is, but I think it could give you a good relative sense to the light intensity in your ambient environment. So if you download the app, you can kind of just Make sure that you're spending time in an environment that's at least 1000 lux in the morning because that seems to be the light intensity that the melanopsin proteins in our eyes are sensitive to that basically kicks off this 24-hour timer. So that I think is crucially important.

So in other words, to actually have good sleep, you need to get outside and get sunlight in the morning.

Yeah, 100% good sleep begins actually the morning of. and 1000 lux of light. These melanopsin proteins in your eyes that are sensitive, they act like a light switch. They're not super sensitive because as you mentioned, then a hunter-gatherer exposed to campfire or the stars in the sky would have their circadian rhythms all messed up. So it's not that sensitive. It requires again 1000 lux and you can easily achieve that by standing by a window for about a half an hour and even on an overcast day you're going to get at least 1000 lux. Now, the problem is maintaining that circadian rhythm has become one of the central challenges of modern life because that light intensity, which 150-200 years ago nothing would be 1,000 lux, there would be no artificial light source that would reach 1,000 lux, right? But today we have TV screens, we have smartphone devices, you can easily walk into a drugstore or a supermarket and the lighting inside those bright fluorescent lights are easily 1,000 lux. Yeah, that's true. So, it sends your circadian rhythm deep into the abyss. And, that's one of the reasons why I think and why it's been proposed that we see ill health associated with people's.

It's true. One of the founding father doctors of functional medicine, one of my mentors, Sidney Baker, wrote a book called, Their Circadian Prescription, which was all about exactly this circadian medicine. There's even things like chronobiology where there are different chemotherapy drugs that work better at different times, different organs are active at different times and they work better. And I think he even described in the book how in sports, if you look at the statistics, that teams that have to cross time zones typically lose more than the ones who don't and who are playing at home.

Interesting.

Yeah, so it's a huge factor. Besides light, what else have you found that was sort of unusual in your, in your targeting optimization of the brain and the body or the brain body or the body mind or the mind body? It's the same thing. There is no separation, is the point.

No separation. I talk about the relationship that we have with temperature and how important that is.

So cryotherapy.

Cryotherapy.

Yeah.

Saunas.

Yeah.

And I'm, I always try to make things like my recommendations achievable by average people. So you might not have access to a sauna, you might not have, have not have access to a cryotherapy. chamber. But just getting into colder water, taking a cold shower, or exposing your wearing your skivvies like on your terrace during the cooler months can all be a great way of activating these ancient thermoregulatory mechanisms that we all have in us that we've allowed to gather dust because we all live in a state of chronic climate control. And I think that by staying in that climate comfort zone all the time, it undermines some really powerful reparative and restorative pathways that we have in our body. So, what's the science of that? Well, I mean, being exposed to cold air boosts the proliferation of brown fat. So, I mean, we're all afraid of gaining even more fat on our waistlines and on our hips, but brown fat is actually something that we want to have more of. It's metabolically active. It's brown because it actually has a lot more mitochondria than normal white adipose tissue.

But it's the energy factories in your cells.

Energy factories in your cells, yeah. They give you more energy, but they also, this brown fat actually burns fat and it burns sugar. And we can actually increase the amount of brown fat that we have on us. It's not actually visible. You can't see brown fat. It only accumulates in a few parts of the body, in our armpits, around our collarbone, down our spines, shoulder blades. That's where you're going to see the brown fat. You can't actually see it because it's really relative to the amount of white fat that we carry. It's like a very small small in concentration, but it's really good for our metabolic health. So, whether that means turning down the thermostat.

You get more brown fat if you expose yourself to cold.

Yeah, because brown fat, it burns calories to generate heat. So, when you're in a cooler environment, this brown fat is burning calories to generate heat. Brown fat was actually originally identified in babies. Babies, when they get cold, they can't shiver. babies can't shiver, so they have this brown fat that basically acts like an internal heating pad. And for that reason, it wasn't known whether or not we carried this type of fat with us through adulthood. But now not only do we in fact carry this brown fat with us, which acts like an internal heating pad that burns calories, as I mentioned, but we can encourage its proliferation.

Yeah, well, the Tibetan monks knew this for years. They have a practice called tumo. You know about this? No. Oh, tummo is amazing. It is a technique called drying of the sheets. And so they train the monks to activate their brown fat through meditation. And they have them up in the Himalayas and the monasteries way up in the freezing mountains. And they practice by dipping cold sheets in ice water and they wrap the monks in the sheets and the monks have to dry the sheets with their internal body heat. and when they can do that, they send them up overnight into the snow with basically a loincloth.

Oh man.

And they have to stay alive. Wow. And they do. It's quite an amazing practice and we've had such a surge of things like saunas and cryotherapy. And, you know, we haven't talked about on the show but there's something called zombie cells. Zombie cells.

Like senescent cells.

Yeah, the things that tend to kill us where are these sort of senescent or aging cells and they just create a lot of nasty immune effects and inflammation in the body, and it's hard to get rid of them. Cryotherapy or cold exposure is one of the key mechanisms for getting rid of these zombie cells.

It's a must.

Extend longevity. And personally, you know, I found that when I was really sick, and even now it's a standard part of my practice, I go into a hot sauna or a steam, get really hot, and then I turn the bath. big bathtub, only cold water, and I jump in. Wow.

And it's pretty invigorating, but you feel.

Afterwards, like your whole nervous system is awake and you're alive and you're energetic and it clears your head. It's pretty striking. Yeah, it is striking.

It's.

And when I had chronic fatigue syndrome, it was one of the few things that gave me, like, a half an.

Hour, an hour of feeling some respite. Wow. Yeah. I use that, that therapy regularly for. I have low back issues. I think a lot of people do. I feel it's like a powerful analgesic. Like, I. It's. I get instant pain relief. What it does for my mental acuity and my mood is, I don't think that there's a drug as powerful as what that does.

Jump in a cold lake, it'll wake you up.

It'll wake you up, yeah. But I also want to mention before moving on from cold that there have also been a number of studies where they've taken people with type 2 diabetes, which is very common. Many people have blood sugar issues, you.

Know, pretty much every other human in America.

Yeah, and they found that when taking subjects with type 2 diabetes and exposing them to just mildly cool temperatures, I believe anywhere between, I think it was somewhere between 60 and 66 degrees Fahrenheit, which is not super cold. By making no other changes to their diets or lifestyles, they were able to achieve a 40% improvement in insulin sensitivity, which is an effect size that you would expect by putting these patients on a new exercise regimen. Just exposing them to cooler temperatures.

Wow, so you want to get out of your chair, you just have to freeze?

Just activate that brown fat. Yeah, leave your thermal comfort zone. Life begins at the end of your comfort zone, your best biology.

Well, that brings up the next subject, which is nature is medicine. Because we're so isolated from nature, both the light experience we have isn't based on natural light cycles. The temperature experiences we have aren't based on being exposed to the environment like we always have been. And it has really detrimental health effects. So, you talked about, you know, nature and how that is really The disconnection from nature is really a source of problems for us.

Major. Today, we spend 93% of our time indoors, in big cities, and there's a lot of this research now coming out of Japan on forest bathing. There's actually a Japanese word, I believe it's keroshi or keroshi or I could be butchering it, but essentially there's a very significant portion of the population that gets worked to death in Japan. And there, I mean 90%, 93% of Japanese people live in cities. So they are far removed from nature. And so this nature bathing line of research has really become a major focus.

Wow.

Yeah.

And it's now being studied, you know, increasingly around the world, the relationship that we have with nature, especially as our cities become more and more dense and more and more polluted. But in the Genius Life, I talk all about the how air pollution can affect cognitive function and put us at increased risk for Alzheimer's disease. 20% of Alzheimer's cases might be owed actually to heavily heavily polluted air. And today, 52% of Americans live in environments with heavily polluted air.

Isn't there like there's some like UV app on your phone where you can tell the air quality.

The air quality index. Yeah, you can, I believe you can actually, I think the weather app on an iPhone tells you the air quality.

But yeah, my niece lives in Houston. She says every day they get warnings not to go outside.

I mean, it's scary. And our indoor home air can be just as polluted, if not more polluted, than outdoor air. But in regard to outdoor air, what I think is really the most pressing of concerns where brain health is concerned is what's called fine particulate matter. So airborne particles that are two and a half micrometers or smaller that are actually able to enter, we breathe it, we breathe these particles in, they enter circulation and they can pierce the blood-brain barrier and enter the brains. And they're doing studies now in very polluted parts of the world, like in Mexico City, where they'll take children and they'll actually see these particles like magnetite, which is made of iron in the brains of children. And what's very interesting, Mark, you know Rudy Tanzi up at Harvard doing all this research on viruses in the brain and how it can-- the microbiome of the brain. Yeah, the microbiome of the brain and how amyloid might be a response to.

An inflammatory insult in the brain. Amyloid is like gunk that clogs up your brain if you have Alzheimer's and it's sort of a response to inflammation, sort of like a Band-Aid in a way.

Yeah. What they're seeing now is amyloid presence in brains of people who have inhabited very highly air polluted areas with very high level concentrations of air pollution.

Yeah.

So, whether it's like magnetite or other fine particles or the herpes virus, amyloid is like this protein which may be actually coming to the rescue. But the point is that being in a place where there's a high concentration of air pollution might actually be creating this inflammatory insult to the brain, which is causing this very early presence of the pathologies that we associate with Alzheimer's disease.

So connect back to nature because you're saying we should all move out of cities and become farmers.

More connected to nature.

Yeah, that would be good. Yeah.

I mean, there are some things that you can do. So spending more time in nature, I think is super important, especially if you are at heightened genetic risk for Alzheimer's disease. So if you're an APOE4 allele carrier, making an effort to spend more time in nature.

That's a gene that increases your risk. If you have two of those genes, like getting Alzheimer's by 40.

14 fold.

Yeah.

So doing that, also getting out in nature is crucially important because of the exposure to the sun. So exposure to the sun, I think is very important. We were talking all about circadian biology. exposure to bright light, crucially important. Vitamin D deficiency is thought to be a risk factor for developing Alzheimer's disease. There's a review of environmental risk factors that I talk about in the book and vitamin D was one of the top.

Yeah, well, I mean, it's a big deal because, you know, depending on the data you look at, up to 80% of us are insufficient or deficient. And the way the reference range works is it's based on a population measure. you take a group of people, you measure the spectrum of the levels in the population, and then you look at sort of what's the average, right? And you have like two standard deviations from that, and you can kind of determine what's normal. But normal isn't optimal. If you were a Martian and you landed in America today, 75% of Americans are overweight. It would be normal to be overweight. It does not mean it's optimal. So the levels we often see in the laboratory ranges are not really where we should be hitting. The levels can be 20 or 30, but you should really probably have 45, 50, 60 at least. And I think, you know, probably 80% of us are deficient or insufficient. And that leads to depression, it leads to increase for Parkinson's, Alzheimer's, cancer, so many different things. And I think, you know, there's been mixed data about replacing it, fixing it or not. I think it's complicated because when you're like, you know, people are eating, you know, garbage and they throw a vitamin D in there, it's not going to help.

Yes, correct.

If they're not exercising, they're smoking, they're drinking a lot, they're eating crap, taking vitamin D is not going to do anything. But in all things being equal, people who are low in vitamin D have higher risk of this. And if you clean up your lifestyle.

And you're still low in vitamin D, it'll make a big difference. Yeah, I'm glad you brought up context because one thing that very few people know You could be spending as much time in the sun as you want, frolicking all day in the beautiful warming rays of the sun, or even supplementing with vitamin D, but if you're not getting adequate magnesium in your diet, which 50% of the population does not get adequate magnesium, the enzymes that convert the vitamin D that your skin creates into its active hormone form in the body, all are magnesium dependent. And magnesium, half of us don't consume adequate magnesium.

It's found in dark leafy greens, pumpkin seeds, dark chocolate almonds.

And a lot of things cause us.

To lose magnesium, stress, coffee, alcohol, sugar.

All those things we love.

Exactly, magnesium is like an anti-aging.

It's a macromineral, we don't consume enough of it and it's involved in all of the DNA repair enzymes. We're talking a little bit about DNA damage, they all require magnesium as a cofactor. It's involved in ATP synthesis, so energy production.

So true, I see so much of my practice and these patients come in with all these magnesium deficiencies. symptoms and they think I'm a genius when I give them magnesium, they go away. Things like migraines or headaches, constipation, muscle cramps, twitching, palpitations, anxiety, insomnia, anything that's irritable, twitches or spasms in any way, or cramps, is usually magnesium deficiency. And it's so easy when people take it, they go, my God, I didn't know I was so low. And I think you're right, it's so prevalent. I think as you age also your skin doesn't really convert magnesium, I mean vitamin D as well either, right?

Yeah. I make specific recommendations in the book for people no matter where they are in their life, no matter what age they are, it's important, you know, context is everything really, but you're right, people who are overweight, people who have darker skin complexions, people who are older, they probably are going to need to spend more time in the sun to create the same amount of vitamin D. Yeah.

So I once learned from Michael Holick who's a vitamin D expert. He said, if you really want to get adequate vitamin D without taking vitamin D, you have to basically be practically naked between 10 and 2 in the daytime for 20 minutes south of Atlanta.

Wow.

That probably isn't happening for 99% of people.

Yeah, it's tough. It's tough. I try to get into the sun as much as I can. Because the other thing about the sun, we as humans, I think that reductionist approach that we were talking about, I think we're hardwired to try to break everything down. And I forget who it was, maybe it was Michael Pollan, but in nutrition they call it nutritionism, where they like to break down foods into just the bare essentials to see if we can replicate it in a pill form, and that hasn't really... Or identify, or we.

Even do worse, we sort of identify the bad ingredients. like saturated fat or sugar or whatever. And so we focus on regulating those in food and then the food companies just kind of dial up or down different ingredients to sort of make it healthier, but it's not really. It's still junk food.

Yeah, exactly. And so I think we can apply the same thing to the benefits of getting sun exposure on our skin and in through our eyes. So, I mean, vitamin D is created when the UVB rays from the sun reach our skin. But, UVA rays might actually be useful in terms of creating nitric oxide and actually helping us lower our blood pressure. Yeah, that's pretty cool.

Yeah.

So, blood pressure is another topic that I talk about in the book because it's so related to brain health. If you want your brain to be performing well, if you want it to.

Age well, you really have to make sure that your blood pressure is in a healthy range. And, getting the right amount of sunlight can help. Now, what are the three basic food rules that you live by? -Me?

-Yeah.

-Well, you know, I always joke because I used to teach a lot of churches and I go, ask yourself one question when you're shopping. Did God make this or did man make this? Right? Did God make a Twinkie?

No.

Did God make an avocado?

Yeah.

Pretty simple rule. And you can even take that to its logical extreme. Did God make a feedlot cow? No. Did God make a grass-fed cow? Yes. Right?

Sure.

So you can kind of go down the line on all that. That's the first principle. Second principle is which we eating mostly plant-based diet?

Yeah.

We call it plant rich. I like call it plant rich. You got 80-20, right? Yeah. 80%, 70% of your foods on your plate should be lots of vegetables, nuts and seeds, fruit, whole foods. And the third principle is we need a lot of good fats, avocados, olive oil, I think there's controversies about some things, nuts and seeds are good, but then there's the whole saturated fat debate, which we can get into where refined oils. But essentially we need a lot of good fats, low starch and sugar, plant-rich diet, and stay away from processed food.

Yeah.

Now should that be true for everyone or does it depend on your body type, your blood type, your genetics? So I jokingly call this the Pegan diet, right? Because I was sitting on a panel with friends of mine, one was paleo, one was vegan, they were fighting, and I'm like, listen guys, you-'re pale, you're vegan, I must be a Pegan. And I was joking. And then it occurred to me that, you know, there was more in common.

Than there was different.

And we could come up with these general nutritional principles that nobody's going to disagree with, right? Nobody thinks we should be eating a lot of starch and sugar. Everybody thinks we should be eating more plants. Everybody thinks if we eat animal protein, that we should eat only sustainably raised or harvested or, you know, grass finished protein. That we should eat fish, but it should only be fish that's low in mercury and toxins. that doesn't overfish the oceans, that fits farm raises that should be sustainable. We should eat lots of good fats. I mean, there are a few outliers who still are holding on to low-fat dogma, but the train has left the station on that one. And so there's these simple that nobody thinks we should be consuming pesticides and herbicides and GMO, that we should be having three pounds of food additives per person every year. I mean, nobody thinks we should be eating those things. Like, nobody's gonna say, okay, I think you should have more butyrate hydroxytoluene with your salad. Right. Right. Red dye number 40, right? These are things that are sort of inserted into our diet. So those are principles that I sort of outlined and it's adaptable. What about grains and beans? Well, you know, some people do well on them, some people don't and it really is individual. But I talk about if you are going to, here's the things to know about, here's the grains to eat, here's what you should or shouldn't do. Gluten, why is it a problem? Who is it a problem for? Is our current wheat, the wheat we used to eat? No, it's not. So that has an impact. What should we focus on? Could you have rye, which is a has gluten in it, but it's probably, if you're not gluten sensitive, a much better food. So it goes through every single chapter. I go through meat, poultry, fish, eggs, vegetables, fruit, nuts, seeds, beans, grains. I talk about the controversies. What are the people fighting about? What does the science say? What do we know? What do we not know? There's still stuff we are learning, right? We're still discovering every day. So it's really kind of a foundational principle book. It's not extreme. It's sort of the middle of the road. This is kind of the Bible for you then. Kind of. All the things you've learned. Pretty much 40 plus years now. 14 books. Yes, it is. It's actually different than other books I've written because the other books are more topic specific. They're on the brain or on metabolism or diabetes or sugar. This is really, if you're an eater and there's about 9 billion of us, it's probably something that'll help. And I also talk about how do you eat, not just for your own health, right? But what is the overall footprint of the food you eat? What's the health footprint, the economic footprint, the carbon footprint, the environmental footprint? the educational footprint, the national security footprint, and even poverty and social justice footprint of what you eat. Because there are things we can't change as individuals. We can't end nuclear war. We can't, you know, single-handedly, you know, end climate change. But we can change what we eat because we do it all the time. And the choice we make matter. I mean, I was just with the Vice Chairman of Pepsi, who's my new best friend, You can imagine, we had a great time together and we don't agree on a lot of things. But it was fascinating listening to him talk about what's happening in the company as they're trying to shift to meet the consumer demand. Really? So they're like, how do we create special, and he introduced me to this engineer who was working for him, how do we create special types of packaging that's compostable but that keeps the food fresh, we don't need to use preservatives or artificial ingredients, and we can have whole foods that we distribute globally. I'm like, wow, that's a great thing to be looking at. Right? So they're thinking, and he said, I was also asked to talk to the USDA annual meeting, the agriculture department. And I'm like, ask Pepsi. But they, they, he's talking about regenerative agriculture. He's talking about how we're losing water by our farming practices. We're losing soil. We need to change that. And they have enormous power because they're, you know, count their bottling facilities.

Yeah.

That they out there.

Probably the number one food company in the world, up there with Nestle. And they are interested in doing this. And I'm like thinking, wow, here's the Vice Chairman of Pepsi talking about regenerative agriculture. I'm like, holy cow. That's pretty cool. Yeah, it does make an impact. Yeah, they can have an impact, but they're responding to the demands of the culture. They're responding to people who are voting with their forks. So it's a hopeful message. You not only get to change yourself, but you're going to It impacts everything. I mean, imagine if everybody in the world for one day had an eat-in where they only ate real fresh whole food and they didn't shop or buy anything in a package that's processed in any way and didn't go to any fast food restaurants and just ate at home and cooked a meal together. -It's a game changer. -Totally. Just for one day. Imagine if we did that for a week or a month.

The whole system would change.

-Wow. -Yeah. Now as a functional medicine doctor, I believe that you're more of like a therapist for a lot of people too. They come to you with all their challenges. They feel pain in one thing but there's something that's affecting them, right? Yeah. What do you think is the main thing that they're feeding themselves? Maybe that's not food. Yeah. That affects them on the pain or their body or... Yeah. I think people are feeding their feelings a lot of time. I mean, it's a... You know, food has such an effect on mood. It's so connected to how we think and feel. And so when we're feeling sad or depressed, we can stimulate our biology through food, whether it's caffeine or alcohol or sugar or other chemicals in food that actually stimulate our brain to sort of feel better for a minute. Right? And so we do that and we're human and we don't understand the difference and we don't know what's going on. We don't see we're in this vicious cycle. And it's tough and people have hard lives and hard situations. But I believe in the power of community. I believe in the power of each other to help support the change. It's got to happen that way. And that's what we do. We work with communities. We work in churches. We help people. become empowered in schools to actually start to do this together and it's so much more fun. It holds people accountable, it inspires people to change and it works. And if we look at behavior change, which is the biggest thing we're talking about here, the hardest thing to do is on your own. I always say friend power is far more powerful than willpower. It's way easier to stay consistent with someone else supporting you, an accountability partner or a coach, whatever it may be, than trying to do it on your own. Absolutely. It's almost impossible to do it on your own. Right, and that's why people listen to your podcast and seek out these things because they're looking for some connection to something that they can hold on to that inspires them, that uplifts them, that gives them an idea of how they can be better. What's the biggest challenge you face in your life right now that you could improve on or get better at? Health-wise, anything. You know, you're this top expert, super credible doctor, Cleveland Clinic, seems like you got it all figured out, but what's the thing either personal or fitness or emotional or... Yeah, I mean, I think... That you can improve on. Well, I recently got married and I have the most amazing wife and I'm just growing and growing and learning and how do I be like the best version of myself? How do I be fully expressed and honest and in integrity and like value what's actually happening? And I think that's like my most important work. A lot of my career, I just focus on my work, work, work. And I'm like, wait a minute, you know, something else here going on. Right. So what's the biggest challenge you face with this new chapter? I think my phone. So I actually, I'm giving her for our anniversary present a box, which is a little like sealed box that I'm gonna put my phone in. When we're together. For what, an hour? No, for a weekend. Wow. Or longer. Okay. You know, and I'm gonna tell my assistant if she needs anything to call her phone. It's an emergency. Yeah. But I'm like, it's a symbolic, but it's like, and it's sort of invasive. And I'm like, you know, nothing is that important that should interfere with our human connections.

Right, right.

There's one other thing though I'm working on. It's struggling. It's a struggle for me. because I feel like I've been lucky enough to see the emerging patterns that are changing in medicine and how we've come to think about disease quite differently based on the science called functional medicine. But it's taking a long time to get it up to running in scale. And that's a challenge to figure out how to do that well. And the second thing is the food system because I feel like if we can all get how powerful we are, as individuals, as communities, when we band together to do something around the food system, it's bigger than anything we could ever do. Because, you know, for example, civil rights, that affects one group of people. Women's rights, a large group of people. Gay rights, a large group of people, but small. Food affects everybody, and people don't understand how our food system is keeping them down and is limiting our ability to thrive and succeed. as individuals or as a society. And that's my real, I think my next phase of my work is figuring out how do we empower people around the food system to understand these connections, to understand how to become empowered, how to activate movements and communities to sort of change the way we do things and to then inspire policy change. Because all has to come to that. Right now our food policies, I mean just a farm bill alone, which is every 10 years it's about a trillion dollar bill, There's 600 lobbyists that spend half a billion dollars funding and lobbying congressmen on this farm bill. And I remember when I went to Washington during the Obamacare era and I was advocating for funding for lifestyle interventions so we could incentivize doctors to do the right thing, not just do medicine or surgery. And everybody was like, this is the greatest idea, greatest idea. you know, they would say, what lobby group are you from? Like, who are you from? I'm like, nobody. It's just, I'm here for the patients and the science. Like, I'm lobbying for the science. And it was flabbergasted. All these staffers and the congressmen, the senators we met with, they were like, they didn't understand it because they don't experience individuals advocating, not as part of some big massive lobby group. Right, right, right. That's interesting. I'm curious now, when did you become a doctor? When did I go to medical school? 40 years ago. When you graduated medical school? 31 years ago. 31 years ago. 31 years ago. I graduated from medical school. Yeah. Graduated. But you got into it 40 years ago. Yeah. Well, I got into nutrition when I went to college. Okay. So, 31 years you've been, is it called licensed doctor or what do you call certified doctor? I got my MD degree 1987. Okay. 31 years ago. I'm curious, what were the beliefs that you had going in 31 years ago that was industry standard? That was like, this is the belief of medicine or food or the body. A lot of that is that you believed in so wholeheartedly but now you've realized 31 years later is completely false. Well, actually, I have ODD. You know what that is? What's that? I'm odd. I was weird from the beginning. I was a vegetarian in college. I was a yoga teacher before I was a doctor. I studied systems thinking in college. I studied alternative systems of healing and medicine from around the world. My thinking was already there. I was studying herbal medicine. I wanted to go to China. I spoke Chinese. I was going to go to China and study Chinese medicine, but I didn't want to grow up in a communist dictatorship. basically said, I'll try medical school and see if I like it. And I was fascinated with the body, and I really never went away from it, although I did really take it all in. I had to suspend all my criticism, disbelief, and just learn it as a system. Then I could unpack it. And so then I began to sort of unpack it and discovered functional medicine early on. And since then, I've just been focused on that as the new model for thinking about the body as a whole dynamic system. Was there any belief that you had after you learned everything from medical school where you realized you believed in something that became debunked over the last 31 years? Yeah, I mean, I really believe that there were these diseases that we label and name and that they were real things. Just like, you know, when you get TB bacteria, that's a real thing that you get tuberculosis. just when you have TB, TB bacteria exposure. But chronic disease isn't like that. So we've created these categories of disease like dementia or diabetes or cancer or rheumatoid arthritis or irritable bowel or whatever it is. And we group people according to symptoms, not according to causes. You know, I was just with Thomas Insel, who was the former head of the National Institutes of Mental Health. And I'd asked him before, I said, What do you think of the DSM-5, which is the diagnostic category for psychiatric illness? He says, I think it has 100% accuracy, meaning it groups people according to depression or anxiety. It's very good, but has 0% validity. I mean, it's not valid because it doesn't describe the why, only the what. And that was a big aha for me to understand that all these diseases I learned about in medical school as these finite things They weren't something you get. You don't get heart disease. You don't get diabetes. You don't get dementia. You can get a cold, but you don't get these things. And it's a very different way of thinking about disease. It's a systems problem. It's how the body is out of balance. It's a way of working with the body that looks at the body as a whole dynamic interacting ecosystem that you can change by taking out the bad stuff and putting in the good stuff. But that was a belief you had early on through medical school because that's what was taught. Yeah. Now, is there anything now that you believe in that you think will eventually be debunked in 30 years or 10 years or five years that you're like, this is the truth, this is the facts, but who knows, maybe there's not enough research or science or proof in that. And in 30 years, I think it's going to turn out that our genes aren't as important as we think. Because that's where a lot of this stuff is coming from, the genes, all about your genes. Because we were in the genomic era, in the omics era, and genomics and proteomics and metabolomics and all this stuff. In terms of genes aren't important in terms of disease or in terms of like... I think that for that the diseases we're seeing. So yes, if you have Huntington's chorea or you have Down syndrome or you have, you know, some horrible inherited genetic condition that's a dominant disease, which is we call autosomal dominant. It's a type of genetic single gene mutation that's kind of fixed, although you can modify how those people do. I'm talking about the rest of the chronic disease we have. And I think, you know, it turns out looking at the research that your zip code turns out to be more important as a determinant of your health than your genetic code. That your friends and your social network is a bigger determinant of your health than your family. So we know from Christakis' work at Harvard looking at obesity, that people who are obese, they're more likely to be obese if they have obese friends than if they have obese parents, right? Or siblings, because these are social connections that drive our behavior. If you're eating, you know, fries and soda and burgers and watching TV all day and all your friends are doing that, you're more likely to be overweight. If you're going to yoga and drinking green juices, you're gonna probably be healthier if all your friends are doing that, right? So if your friends are modeling healthy behaviors and we live in a totally peer, socially driven world. I mean, look what happened with the MeToo environment. All of a sudden, it was okay to say the truth. And then you had like millions of women speaking up because it was okay, it was socially acceptable. The peer group said, Yes, you know, that's how powerful. And I think I'm hoping for that kind of change around food. Right. So you think genetics don't play as much of a role as we do? No. I think we're gonna be disappointed by the human genome project. It's already failed to give us a lot of what we hoped it would give us. Really? Yeah. Powerful. I mean, there's something called the exposome, which is how our genes are exposed to different factors, right? So we call the exposome what you eat, what you think, what you feel, your stress level, exercise, sleep, environmental toxins, your microbiome, all that is the world you're exposed to. It's what your genes are being washed over with every day. Turns out 90% of chronic disease is determined by the exposome, not the genome. Fascinating. Yeah, pretty amazing stuff. Which is very empowering because you think, oh, it's my genes. My dad had Alzheimer's. My dad had heart disease. My dad had diabetes. My mom was this. You're like, okay, what can I do? But the truth is, it's a very empowering message because people can change. They can change your gene expression. You can't change your genes, but you can change which ones are turned on or off and how they work. Now, did you believe at one point that the genes did play a big role? Oh, yeah, for sure. All of us did. Yeah. Powerful.

I love it.

Couple questions left. Make sure you guys get the book, though, before we finish up. Food. What the heck should I eat? The no-nonsense guide to achieving Optimal weight and lifelong health. make sure you guys pick it up. New York Times bestseller, it's crushing already. This is called the Three Truths. I don't know if I asked you this last time. You might have, maybe, but we'll do it again and see what comes up. So imagine your final day. You live till you're 300 years old. Okay. Because you're the founder of youth right now. Almost 60, right? Almost 60. 58, is that right? Not bad. Yeah, almost 60. I'll be 60 next year. You look like you're 25 and on the book, I love it. Sixty this year? Yeah. Wow. 2019, I'll be 60. I hope I look like you when I'm 60.

But you're gonna live for as long as you want.

And imagine it's your final day. You choose the day, you've done everything you want to do, you've done it all. And you say, you know what? It's time for me. I'm ready to go. Yeah. You go on your terms. You've written 75 New York Times bestsellers. God forbid. You know, every topic you could imagine, there's a book out there that you've come out with. You've done everything you want to do. But for whatever reason, you have to take it all with you. So no one has access to any of it. You got to take it all with you. It goes with you in the grave. But you get a piece of paper and a pen to share your final three truths with the world. Your final lessons and truths. And that's what would stay behind, but everything else you take with you. So they don't have access to anything else. But these three truths that you would write down, what would you say are yours? I would say the first thing is don't take yourself seriously. Show up with love in every interaction and everything you do and have fun.

We live in a toxic world, right? It's not a matter of, you know, do you have toxins? How many do you have?

Right.

You know, persistent pollutant toxins that will just camp out in your fat and just leach into your system on alter how your mitochondria work, alter how your immune system works.

Yeah.

Great case that I had. It's a gentleman who has Alzheimer's. He was seen at a very large institution in Boston, and he was diagnosed at the age of 56 with, you know, moderately advanced Alzheimer's. He was, he had a basic evaluation with a spec scan, and he was told he had Alzheimer's. He was given a pill that we know doesn't work for more than 18 months to stabilize it, right? Yeah.

He was given a, It doesn't work.

Even for 18 months. Yeah, he isn't even months.

I was just trying to be generous. And then- that's not our opinion. This is basically in the major medical.

Journals, the pills for Alzheimer's don't work. They don't work. So then he was given start behavioral therapy and cognitive therapy again, hasn't been proven to do anything to slow the progression or improve cognition at all. So he's at a major institution given those two things to do. He is a very, very active gentleman with a great deal of huge responsibilities in his life. very dear man. And he comes here for the first visit, and he's, he's, you know, he's, you know, he see these, these issues. And so we start talking and I start testing. So we do the test. Let's look at the gut. Let's see if there's toxins. Let's find out about your hormones. Right? Let's see if you have any autoimmunity. Let's do some. We do some, you know, we do specific. autoimmune testing to see if your body is making auto antibodies against brain tissue. So why would you do that?

Because Alzheimer's is what?

Alzheimer's is a multifaceted, multi-causality disease.

It's inflammation of the brain.

It's inflammation of the brain. That's what's driving it.

Right.

And there's lots of things that can cause an inflammation. So we're gonna look for everything that can cause inflammation and there's also disruption of normal function. that might be distant. So, what effect does having a low testosterone have on the brain? Testosterone has a big impact on the brain. It can have an impact on inflammation. It can have an impact on how the pituitary and the hypothalamus is secreting other hormones, how those hormones will work, how your neurotransmitters may work. So, here are some of the things we found with this gentleman. He had a mercury of 120.

Oh, wow.

Now, put it in perspective. like zero is normal.

Zero to four.

And anything over 10, I worry about 20 is bad. And like 120 is, you know, a handful of people.

Yeah.

That you see over the course of decades have 120. Yeah.

Yeah. Very, very few people. Mercury level, testosterone level from where? Fish, water, air. But, you know, he was a fish eater in his lifetime. And again, you know, he wasn't like an extraordinary fish eater. but if you look at his detox genes, he had a lot of, on his genes, he had a lot of variants that made him susceptible to not being able to detoxify as well as he should. So, you and I could go eat sushi the whole week. Not me, I got those same genes. Okay, you got this.

That's why I got mercury poisoning.

All right, all right. So, I could eat it, I don't have an issue with mercury. My mercury wasn't high at all. And, I love fish, I eat a lot of fish. So jealous. Okay, well, so, So, Mercury, his testosterone level was 150. So, at his age, his testosterone level should be 600 on average.

800.

600-800. Yeah, right.

So- 150 is like- Nothing. About what a woman has almost.

Exactly. So, he had his testosterone as though his Mercury was bad. And of course, there was SIBO and he had dysbiosis. So, not only did he have- His.

Gut was all messed up.

His gut was all messed up. And then, and finally on top of it, he tested positive for Lyme disease. So that's another thing that we do here at the Ultra Wellness Center is you can't practice functional medicine without coming across Lyme disease almost every day. You know, stealth infections, Lyme disease and the co-infections that can be found with it along with other viruses are a big part of what impacts people. He had Lyme disease.

So we had four strikes against him.

And so, so here's what's really interesting. We arranged for him to get some really intensive Lyme disease treatment at another clinic in, in Germany and where they do hypothermia.

Yeah.

Hypothermia. And they, and they give IV antibiotics when you're, you're, by making somebody really warm, you are able to, that's when the bacteria can be most susceptible to antibiotics. And so at that really high temperature, about 105, 107 degrees, they're going to put an IV infusion of an antibiotic in and fight the infection.

I did that. I went to San Diego and I had hyperthermia and I had Lyme disease and Babesia and I had night sweats all the time and I did the treatment and it kind of went away. And, I've seen this case after case. Now, it's not something that's available in.

The United States, but it can be very powerful treatment.

Yeah.

So, in his particular case, we chose that direction because of the degree of the severity of what he was facing. So we wanted to let's just hit this hard, hit it fast. It was something we really believed in. So we arranged for him and I worked with his doctors at the St. George Clinic. And then we treated his mercury. We started treating his testosterone using first getting him to sleep better, working on his nutrition. I always like to work on lifestyle before I start treating directly with hormones. Then we added in some hormones that would benefit his testosterone levels. And at six months, he had stabilized. So he had not worsened at six months, actually about the eighth month mark when we saw where he was at, he was still working and he noticed that his memory had not gotten any worse than it had been. And so we're continuing to work. It's a story that's ongoing, but really, really exciting because- and that's important to.

Say that this is a progressive disease because usually a year later, people are a lot worse. Right.

I was thrilled that at eight months, he wasn't worse.

And where his numbers better?

Right.

Oh, absolutely. His testosterone levels were up to like 500 at that point. Mercury level was coming down. Mercury can be hard to come, you know, bring down. It can take a period of time. But I do like to remind people, he was very excited to know there are things I can work on. See, he left a large institution with things to do that weren't going to work. sort of hopeless.

So, this is a really important point with functional medicine. Alzheimer's is a diagnosis, it's not the cause. No. And functional medicine helps you figure out what that is. Doesn't mean everybody with Alzheimer's has those things, although they're common, but tick infections, heavy metals, hormonal issues, gut issues, things you can actually treat. And I think this is such a big difference between functional medicine what we do here at the Ultra Wellness Center in Lenox, Massachusetts, and what people get when they go to a traditional physician. They're not having somebody pull back the hood and look underneath and see what's going on. They go, oh, I know what's wrong with you. You have Alzheimer's. No, that's just the name of the problem.

Now let's start to figure out what's going on. And that's beautiful. We see everything here. We see autoimmune diseases from Hashimoto's thyroiditis to ulcerative colitis to, Rheumatoid arthritis, we see Alzheimer's disease, ADHD, autism. We see people with- It doesn't matter.

What diagnosis you have because we treat the system, not the symptoms or diseases. And when you do that, whatever they have has a chance of success.

And that's the point I want to make. We see everybody with everything from every age and we end up being able to help them more than the specialists did because we're looking at everything and we're getting to the root cause. And so in a course of a week, I can see a two-year-old or a three-year-old with autism, and I can see a 62-year-old with ALS. I can see a woman with depression, no libido, fibromyalgia, and it's all in my purview. It's a really important point.

People say, well, do you treat this? Do you treat that? I'm like, I treat things I've never seen. I never had a patient with vestibular migraines before. I mean, I don't know that much about it other than, you know, the basics, what I learned in medical school. But I know how to treat the body. I know how to treat the system. I know how to treat a human being and look for the root causes. And when you do that, even if you don't exactly understand the disease, it'll often dramatically improve or reverse completely.

Absolutely. You know, but, you know, I like to let people know it's hard work. It's good work. It's really good hard work.

It's never not like take this pill in six months, right? Change your diet. You have to take care of your lifestyle issues. You have to take things to help reset your system. Yeah. Get your gut.

Do the hormones. Treat the Lyme. Right. Like example, I think is a good one is my own daughter. She went, you know, she started having, I have permission from my daughter, actually. She said, Are you gonna say my name? I said, you, want me to? She said, yeah. So my daughter, Isabel. So my daughter, Isabel. So she started having her period. and about, you know, in the first year of her cycle, she was very irregular and she was really getting more and more fatigued. So it was around school time. It was August. She goes to a pediatrician. Yeah. So, no, no, no. Because, you know, my wife goes with her. And at, you know, my wife is, she, she's very attentive to these, these health issues and nutrition, and so she sat in the visit. and she came back and she shook her head, George, she said, I am done. I am so done. I told him that Isabel had fatigue, never once asked her what she eats, then talked about nutrition whatsoever. Basically said, you know, barely asked her about her period other than to know that it was irregular. And really basically said, you know, you just started your period, give it some time, you're an adolescent, you know, you sleep more, you're going to be fatigued. It's sort of the natural process. so I'm like thinking, nope. So I wanted to know, I know my daughter's diet as hard as we try in our home. My wife and I eat whole foods. She will tend towards carbs and sugars outside the home and even inside the home. So I had a lot of suspicion from watching her in our house that she was having issues around her diet and nutrition. So the first thing I wanted to do was find out if she was having any food sensitivities. So, we did some IgG antibody testing, which looks at food sensitivities, not necessarily food allergies. So, IgE looks at food allergies.

That could be a peanut allergy.

Peanut allergy. That's anaphylaxis.

You'll know it. You eat it, you turn blue. But IgE is like, you might not know.

You might eat that on Monday and on Wednesday you got a headache.

Right.

Strawberry on Friday night and Sunday you have red cheeks. That's sensitivity. Now, you can have sensitivities and you never make the connection to food. My daughter had huge sensitivities to gluten. Gluten is a really bad thing. We're gonna talk about it in a second. Milk, egg, and then multiple other foods, which gives that whole leaky gut syndrome.

She had a leaky gut.

She had a leaky gut. Checked her thyroid. Your TSH should be, in general, if you look at numbers 4.5 or less, hers was 5.8.

Yeah, that's low thyroid.

I checked her thyroid antibodies. When the body begins to make antibodies against self tissue, my daughter had antibodies against her thyroid.

Wow.

Again, 14 years old, right? And she was told.

Most doctors don't check anybody. They'll just check a TSH.

If it's around normal, they'll just say it's fine.

Right.

And her CBC, her blood count, we have hemoglobin, hematocrit, or two numbers you look at to see if you have enough blood. blood carries oxygen, oxygen is required to make energy, energy gives you energy, and if you don't have it, you're fatigued. And she was fatigued. These tests were done. She was anemic. Her hemoglobin was 9.9.

Oh, that's really low.

It should be 13 to 14.

Yeah, right? That's like down like three pints.

Now these lab tests were available at the conventional doctor. So now here's my daughter, with all this going on. So the first thing we're going to do is we're going to change your diet. But here's the key thing, the gluten piece. See, that gluten sensitivity triggers everything. As we know, gluten is what triggers the, you know, can be a trigger for your gut to make something called zonulin. And zonulin is the molecule that opens and closes those gates in that membrane that protect the lumen, you know, your body from what's in the lumen of your gut.

In the intestines.

Right, in the intestines. so when you're sensitive to gluten and you start to trigger that, you create this leaky gut, that's when you really open up that door, as we talked about, for autoimmunity and malnutrition. And then on top of that, she was having these bleeds. The last thing I checked, Mark, was her hormones.

Well, before you jump to, I just want to recap that because that's important. So gluten basically damages your gut lining, which then causes leaky gut, but it also prevents iron absorption. Yep. which is why she was anemic. It also triggers autoimmunity, particularly thyroid autoimmunity. So, a lot of people have Hashimoto's caused by gluten. So, when you sort of dial back, you can get to the root cause and see what happens.

Okay. And then on top of that, as a quick aside, I checked the hormones and you can do this ratio between your progesterone and your estrogen. When a woman's irregular like that, you should really check that because if you have a relative elevated estrogen compared to progesterone, that's called estrogen dominance. and estrogen dominance can impact your cycle. It can make it irregular and it can make it very heavy. It can lead to a lot of PMS and depression and it can last for half the month.

Yeah.

Okay. So all this was going on.

By the way, 75% of women have PMS. That is not a normal condition.

No, it's not.

It's because of our diet, our stress, our lifestyle, our gut, our food, so many things drive it.

So, food that has hormones in it. the whole issue with hormones in our food.

And guess what's the biggest driver of high estrogen levels? Sugar.

Sugar and hormones in our food.

It's starch.

Exactly. So my daughter is a perfect example of the modern diet, despite believing, I gotta say this, parents who eat really well have a garden in the backyard and do this.

Teenagers are temporarily psychotic.

It's part of the point I wanna make, and this is the point. is that she is fortunate to have me as her dad because if she didn't have me, she could have gone a decade or two decades thinking, that's just me. Only in her 30s after a baby or before a baby or in a stressful time to just completely break down and all of a sudden have Hashimoto's or rheumatoid or some other immunologic disorder that could have been prevented.

And this is what happens, right? I've seen this over and over in patients. so start out and you can track their history. We call it the timeline in functional medicine. We track, okay, this person was born by C-section, their gut doesn't get developed in the microbiome. They had antibiotics early on because of ear infections, disrupts their microbiome. Maybe they develop some acne or maybe they got some allergies and then they get maybe thyroid issues when they're 20. Then they get when they're 30s, they start getting autoimmunity like rheumatoid arthritis. And it's the same fricking story almost every time. All the time. And you can track it back. So the fact that you got your daughter early, is a huge thing and that allows her to then maybe develop normally and not develop these autoimmune diseases and so forth that we see in so many people.

Here's one of the things I want to say about functional medicine. Applying everything that we discover as we ask those questions why we do this advanced testing that you're not going to get at another center, it's not easy. And, I know firsthand what it's like to have to change a lifestyle. not only my daughter's but in my own when I dealt with my brain injury, but with my daughter having to help her sleep better, create a sleep ritual, help her to learn how to meditate, help her to make good food choices. That is not easy work. And so, you know, at the Ultra Wellness Center, we also have coaches. So we have coaches that will come alongside you and will hold you accountable, will work with you to help you devise strategies over a long period of time to change these lifestyles. We know habits don't change for at least three months. How can we anticipate that some of the most critical things that are going to make you healthy are going to happen in two weeks, six weeks, or eight weeks? It could take three years. Yeah. And I like to remind people that.

What's fascinating too is that what I see here is that it's not as hard as you might think because when we put people on a regimen, and I do this pretty aggressively to get them feeling better fast. Because I figure if they can have the experience of feeling good, even if there's more work to do, they're going to do it. In other words, in 10 days or two weeks by changing your diet and doing a few simple things, you often see profound differences. What would be the major reasons that we're seeing this pandemic of brain dysfunction and brain fog today?

So, brain fog is really a symptom, sort of like cough. So cough can be caused by a cold, bronchitis, pneumonia, postnasal drip, asthma, a whole bunch of things. So you've got to figure out, okay, what's driving it? And there is no ICD-10 code for brain fog. You might call it altered mental status, but oftentimes it's transitory and that's the really interesting thing. And I've seen patients where they'll get brain fog when they're in a certain building, they'll get brain fog after after they've had a certain meal, certain foods may trigger brain fog. And it is something that I think is intimately connected to the gut. I think the, and we'll talk about that in this particular case, is gut fermentation is oftentimes a cause for brain fog.

I mean, it's like bugs fermenting the food you're eating, creating all this nasty.

Byproducts that you can't see. Yeah, and I don't know, Mark, if you've had patients who've had, this is a really interesting thing because I have patients come in and they say, I feel like my gut is just bloating and I'm fermenting and that's exactly what's happening. So, there is a condition, I just recently had a patient who had auto-brewery syndrome.

Yeah.

And I've seen that. So, you have your own beer factory. Exactly. So, when you want to make beer, what do you do? You take sugar and you add yeast to it and you can actually produce alcohol. And I've had a couple of cases where it was missed and it's actually not just the recent findings is not just yeast in the gut that do this, but also Klebsiella bacteria. So both bacteria and yeast can actually produce these compounds which are toxins. Alcohol is a toxin. That's why when you get drunk, you're intoxicated. And you'll actually produce alcohol and other toxins which affect your brain.

It's interesting. I never really had that insight before you said that word intoxicated.

You're toxic.

Toxic.

Yeah, toxic.

Exactly.

That's right.

Intoxicated.

Okay.

That's how I explain it to the patients.

It took 60 years to figure that one out.

Exactly. Exactly. But I think that what you're saying is very true. I mean, I've had two times in my life when I've had severe brain fog. One was when I had mercury poisoning 25 years ago, and my gut was a mess then because the mercury poisoned my gut. I had terrible bloating, distension, diarrhea, and the second time was more recently when I had mold toxicity and I had C. diff and I also had colitis and gastritis and my whole gut was a mess and I had severe brain fog. And it was pretty debilitating. You could barely focus, answer an email, talk to somebody. You can't concentrate at all. And people think, oh, that's just sort of in your head. It's not in your head, maybe in your stomach.

Well, it's manifesting in the head. That's the whole thing. And we have these artificial boundaries between the brain and the body and the mind and they're all interconnected and brain fog is a real phenomenon. And then you have to sort of figure out what's doing it. The other thing that is interesting that I see with some people with brain fog is just gluten and dairy. And I tell patients that one of the most addictive foods is pizza. And the reason for that is that pizza has gluten in it.

It's true. You can eat a whole pie, right?

Oh yeah, I tell you. It's one of the foods that I'll occasionally indulge in. I don't have it that often because it's not the best food for you.

You have my cauliflower pizza with goat cheese.

You can make a healthy pizza, exactly. The two foods which are interesting is that gluten and dairy both get broken down. The proteins in those get broken down into caseinomorphins and glutamorphins. And caseinomorphins are the ones from dairy and glutamorphins are from gluten. And those have morphine-like effects. So you literally become you get a little high, you get a little high, you get a little foggy in the brain, and it also can cause cravings and it can sort of make you sleepy, you eat it and then you get a little sleepy from it also. That's when children drink breast milk, they go to sleep after they conk out. That's because of the morphine-like action in milk.

Yeah, so that's true. I think it can be our diet, it can be food sensitivities like gluten and dairy, which are really common and often people going on elimination diet will have an immediate relief of brain fog, which is something that you don't know you have until you don't have it anymore. Sometimes people just think this sort of slow decline of their cognitive function. They're not realizing that it's actually something that can be reversed and it can be reversed very quickly. So, yeah, the second thing is, you know, the, the factors that that are in the gut, right? Bacterial overgrowth, yeast overgrowth, we call dysbiosis. That can also lead to a lot of cognitive issues because your gut's connected to your brain and that causes this effect when the bugs are out of balance and it drives inflammation and then you get inflammation in the brain essentially.

Is what causes brain fog. Absolutely. Well, the other important thing, and I think I talked about this last time, is that the blood flow from the gut has to go through the liver. And the reason for that is to filter all of the the toxins that are there. So there's a lot of immune cells, the Kupffer cells in the liver and a lot of filtering processes and detoxification takes place in the liver prior to the blood from the gut then going into the systemic circulation. So sometimes you'll have, in addition to leaky gut, you'll have problems with detoxification in the liver itself. And that's, you know, an example of that is the condition hepatic encephalopathy, which is brain fog. That's essentially-- well, talk about that.

What is that for people who don't.

Know what that sounds like a big word? I learned and I think I mentioned this before and it was one of the things that really stuck with me is when I worked at the VA hospital, there was a lot of alcoholics and when you're an alcoholic, you basically.

Turn your liver into a pickled liver.

You trash your liver, yeah. You trash your liver and then you're not able to detoxify and I would typically see this over and over where patients had they had cirrhosis of the liver and their liver was not able to detoxify and then when they would eat foods, especially high protein type meals, they would get hepatic encephalopathy and literally go into a coma.

So they would literally get delirium, confusion, brain fog. Brain fog.

That's when they get brain fog on steroids.

And the reason is it was coming from their gut and what I found so striking when I started learning about functional medicine was that here was a condition in medicine that we knew how to treat by fixing the gut. We gave people antibiotics to sterilize their gut to kill the bacteria that caused all these byproducts that made people have basically delirium or encephalopathy and brain fog. So, it was like, wow, the gut is connected to the brain.

Totally connected to the brain, absolutely. And in some cases, there have been cases cases of people actually having psychosis from gut dysfunction.

Yeah, you mentioned Auto-Brewery Syndrome. I remember reading a case of a woman who was arrested for driving under the influence and it turned out she wasn't drinking, but she had a high blood alcohol level that was coming from her gut.

Yeah, it is. It's a very real phenomenon. You have to think about it and the way that you actually test for that is you can, it's actually quite simple, is you just have somebody do what I call a pancake challenge. You basically some pancakes full of carbs, but throw some maple syrup on it, eat it, and get a blood draw at point zero. You know, eat the meal, and then.

Half an hour later, check your alcohol level. That sounds like a fun medical test to perform. Pancake challenge. I call it pancake challenge. So we've talked about the gut, we've talked about gluten, dairy, food sensitivities.

There are other reasons too.

Infections.

Infections can do that. Another one that is- Tick infections. Oh, absolutely, tick infections. Yeah, I would say that in addition to brain fog, you get a lot of cognitive dysfunction too, memory issues.

It's more severe.

It's much more severe. The one thing that I see a lot is allergies. I call it the allergic brain. And you can have food allergies that can potentially do that or even environmental allergies. or mold and the high levels of histamine, because histamine actually acts as a neurotransmitter. And I've seen this in a number of patients. I've had some patients with another condition which we're seeing more and more of, is mast cell activation syndrome. It's sort of a diagnosis now. But it's a very real phenomenon and is related to the mast cells, which are the types of immune cells in the body, in the interstitial sort of the spaces between the cells where they reside and they release lots of histamine. And if anybody has ever had hay fever, you see that the typical picture of a person with hay fever, they're like this, half asleep and they're walking through a fog. Hay fever is an example of brain fog. And antihistamines can actually have a benefit with that. Naturally, things like quercetin and nettles can be also would be very helpful. And you probably have used it. This is something that I've been using more is the drug, chromal and sodium, which is, I've had some amazing success with that in more difficult cases. I wouldn't necessarily go to that for my first choice.

What Todd's talking about is this drug that's used for asthma and allergies that is usually inhaled.

Yeah, usually inhaled.

But there's a version you can take orally that before you eat. inhibits your white blood cells from releasing histamine and creating an allergic response. And I often found it extremely effective for some patients. Exactly. So, Todd, talk about this patient that you had that had really bad brain fog. This is a guy who'd come to see you who worked a lot and was a little bit stressed. And that could be, you know, easily.

Dismissed as though you're just stressed and tired, but you went deeper. What did you find? Well, he actually came into me and he had already seen a variety of different doctors. And the background is that the gentleman as a child had lots of allergies and asthma. So he had ear infections, bronchitis, also developed some sinusitis type symptoms. So he had multiple rounds of antibiotics. And I always emphasize to patients that when you have an immune dysfunction, look for the gut because 60 to 70% of your immune system is in the gut. And just like with what's going on with the COVID virus or the COVID-19 syndrome that we're seeing by coronavirus is it's not the virus or the bacteria itself that causes the problem, it's our immune system's response to it. And in general, we want to have a, I call it a balanced immune system. So we want our immune system to be idling. So basically just sort of sitting there and okay, we're enjoying planet Earth, we're going out for a walk, we're not reacting to this.

Underreacting or overreacting.

Exactly. Underreacting or overreacting. And when you overreact, we call that an autoimmune disease.

When you underreact, we call that AIDS.

So AIDS or cancer.

AIDS or cancer.

Or overreaction is allergies or autoimmune. And I think we talk about a weak immune system or strong immune system. It's really, I think, an intelligent and a balanced immune system. That's how I like to think about it. related to immunotolerance, which is what the gut does. So when we have a healthy gut, we have an immune system that is tolerant to lots of things. And you can eat certain things, you can go out in the environment, you're not going to react to dog dander and all these other things. There are some genetic, some people have genetic predispositions towards being more atopic or allergic, but having a healthy gut, especially early on in life, the priming of the gut is so critical. Having a vaginal birth, being breastfed, not introducing certain foods like gluten early on in the-- Living on a farm. Living on a farm, exactly.

Being exposed.

Exposed to a lot of-- and crawling around in the dirt and literally putting dirt in, I call it your body's immune system samples planet Earth. Planet Earth is a very dirty place. There's lots of bugs and all kinds of things. your body learns to be immunotolerant. And one of the things that is really, I also focus on, is part of this immune system is called the T-reg cells. The T-reg cells are like the conductor in the Boston Symphony Orchestra. So you've got the wind section over here and the horns over here, and they keep everything in balance. And the T-reg cells are really, really critical. And what we're finding-- They regulate, they regulate the whole balance of so the immune system. And the T regs that we find out, the two things that are really simple that people can use to upregulate your T regs to keep things in balance are fibers. Fibers in the diet. Fibers are the key things that help with regulation of that. And then also, which I use quite a bit in the patients that I see, is vitamin A. Vitamin A helps to downregulate the immune system and helps to keep the T reg cells in place.

So this guy came in with brain fog and he had a lot of stress, but he also had other things. He had mold exposure.

Yeah, he was working in a building and they found out that he was in a water damaged building unknown to him and he had mold exposure, which you've been experienced yourself.

Been lucky enough to have that.

Yeah, exactly. And we live in, you know, a lot of people are in older buildings and you don't know you might buy the building water damage, you don't even know it's there.

I mean, 50% of buildings have water damage in America. That's a lot. Really?

Yeah. Wow. That's a lot. Yeah. So he was actually, he came to me and he had the diagnosis of mold toxins. In fact, he actually learned about this through one of your podcasts. I think it was, you were talking with David Asprey.

Oh yeah, I was trying.

Exactly. It was a moldy podcast. So that's how he sort of went down that road and he got treated. with a variety of different therapies. He got some IV glutathione, he got some ozone therapies and other interventions, and he got about 50% better. And then within several months, he sort of went back to where he was. He was also, again, not sleeping much because he was doing a lot of litigation. It was a lot of stress. He wasn't sleeping well. The big thing that I see with patients with conditions like immune dysregulation is stress and lack of sleep is a stressor, probably the number one stressor. So if people aren't getting a deep restorative sleep, that is a stress to the immune system. And I was trying to sort of emphasize that you can't, you know, you can do that for like one or two days, but you can't do that on an ongoing basis. So really, really important. I always emphasize getting good deep restorative sleep with patients. so I emphasized that with him. So when he came in, he also had a lot of digestive symptoms. He was actually on a whole bunch of inhalers. He was on like Brio, Spirova, Ventolin, on Zolair injections, Flonase for his sinuses. He also had Zolair is a very.

Expensive, like $20,000 a year, intense immune suppressing medication. Yeah. And he still wasn't better.

He still wasn't better. No, exactly. And that actually worked by stabilizing mast cells, which you can actually naturally do. Quercetin actually can help high-dose quercetin can be very helpful for a mast cell.

Also great for COVID.

Exactly, yeah. So, when he came in here, I did a thorough workup on him and I did retest him for mold and he did have some mold, but I compared it to his previous labs and it wasn't that bad. So I empirically treated him with some binders to sort of help. But he had already moved out of the moldy building that he was in.

He got out of the moldy environment and then use these binders to help get the mold toxins out of your system.

Right, because the mycotoxins, they do tend to recirculate in the body, the enterohepatic recirculation, so they'll get reabsorbed by the body. And what are the kind of binders you use? In him, I actually use very natural things. I used clay, Medi-Clay, and I also used activated charcoal. That was pretty much it.

These are things that don't get absorbed that suck all the bad stuff out.

Oh, yeah, exactly. And you worked in Meridian, right? We used to, somebody would overdose on drugs, we would give them charcoal.

That's right. We make them drink black charcoal.

It was terrible. And every now and then they would vomit up on you.

We've been there, done that. Yes, right. Yeah. this guy had also other stuff, right? He had gluten issues.

Oh, yeah.

A lot of gut issues.

Yeah. And unfortunately, when he went to the previous doctors who did help him out, they didn't go deep enough. They didn't sort of, you know, get all the pieces of the puzzle. So, they did not check him for gluten sensitivity, which he markedly was gluten sensitive, and also did the Cyrex testing on him for gluten and Cyrex for leaky gut in both of those were markedly positive.

So, those are tests that we use at the Ultra Wellness Center that are a little bit different than traditional food testing that looks at antibodies that aren't true allergy, but there are reactions that our immune system is having against foods and we can tell what you should and shouldn't eat based on this what's.

Causing an immune response. Exactly, exactly. And then I also did stool testing on them. I did the, what I think is sort of the state of the art, the GI map test, which which does quantitative PCR for the DNA of bacteria, yeast, viruses, parasites. And he had probably one of the worst cases of dysbiosis I've ever seen. That's imbalance. Yeah, imbalance. Yeah, a lot of imbalances. You know, I tell patients that everybody has, you know, hundreds of different kinds of bugs in their gut, and they're a little bit like weeds in the garden. No garden does not have weeds. You just don't want too many weeds. And the interesting thing about the digestive tract and bacteria is that there is a phenomenon which is known as quorum sensing. And quorum sensing means that when certain bacterias reach a critical level, they start acting as bad actors. An example of that is like Clostridium difficile. So when patients get antibiotics and they wipe out the good guys, the bacteria, the C. difficile somehow or another sense that there's not enough cops around and they take over the place and they start producing toxins. Same thing happens in this particular case. He had one of the highest levels of pseudomonas bacteria that I've ever seen. And we typically see that in patients with cystic fibrosis. So he had bacterial dysbiosis, that organism plus other organisms.

And he had a lot of gut symptoms, right?

Yes, exactly. A lot of mucus. In my opinion, that mucus, that sticky mucus is a biofilm. That's where the bacteria live. They live in that biofilm layer. And antibiotics and such are very difficult to penetrate that.

You're not having a smooth log that just comes out clean.

There may be some problems in there. Exactly.

Yeah.

And, he also had yeast overgrowth, which was not unexpected.

Because of all the antibiotics he had.

Oh yeah, absolutely. Absolutely. And the acid blocker he was taking?

He was on a proton pump inhibitor. That's one of my, you know, I hate them.

They are good and bad.

They can be helpful, but I remember when I was in medical school, we talked about this on the podcast, we were told they just came out and they were like, these are very powerful drugs. You don't want to give to any patient more than six weeks. It shuts down acid production. It's risky long term. And now everybody's on it. They're over the counter. They're over the counter. Over the counter and for life. And it causes all sorts of disruption in the gut. It causes you to not absorb your nutrients. It causes overgrowth. of yeast that changes the pH. Leaky gut. Leaky gut. I mean, it causes irritable bowel. Osteoporosis. Osteoporosis, pneumonia.

Small bowel deficiency.

Yeah, there we go. Keep going. It's not. It's a great. It's a great way to keep the business going.

Yeah. Yeah. I wrote a textbook chapter on reflux.

And it was like, looking at all the data, it was like, holy cow, this is not good. Exactly. Yeah.

And.

And unfortunately, they're handed out like Pez candy. Yeah. I have a whole list of super superfoods, but today I want to discuss five that I enjoy almost daily now. The first category of superfoods I want to discuss are seeds. Not just any seeds, but three seeds. The ones I like are chia, hemp and flax. Now, chia seeds are a great source of omega-3 fats. They have more calcium than milk and they're a great source of anti-inflammatory compounds and they're great for glowing skin, and mental health and clarity and much, much more. Chia seeds have 10 grams of fiber in one ounce. The fiber in chia seeds is insoluble fiber. It's the kind of fiber that feeds friendly gut bacteria and that promotes gut health and it gets fermented into short-chain fatty acids which are super important for your gut. Feeding friendly intestinal bacteria is super important to keep your gut bacteria well fed for good health. Chia seeds are a great protein source too and they're higher in protein content than most plants. I also love hemp seeds, which are another great source of fat, and they also pack a good amount of protein, B vitamins, as well as magnesium, zinc, and iron. And flax seeds are another great source of omega-3 fats and dietary fiber, as well as essential vitamins and minerals. They have powerful, powerful anti-cancer hormone balancing compounds called lignans. When someone tells me they're having trouble with constipation, I usually recommend adding ground flax seeds to their smoothies to encourage healthy bowel movements. So all three of these seeds can be added to your smoothies or you can make puddings, chia seed puddings awesome, or add them as toppings on berries or coconut yogurt. Options are endless. Okay, my next superfood is MCT oil. That stands for medium chain triglycerides. triglycerides. Now, these are a type of fatty acid that's derived from coconut oil. See, MCT oil is a super fuel for your cells because it boosts fat burning and it increases mental Clarity. MCT oil can also help you lose weight because it gets quickly burned and metabolized and speeds up your metabolism. It also gets absorbed directly from the gut into the liver and doesn't get stored as fat, but rather burn quickly and turn into energy. You can add it to your smoothies, your coffee, you put it up to dress on your veggies, you can put in salad dressings, whatever you like. The next superfood, or shall I say super fiber that I use almost daily is called glucomannan. You need to get fiber in your diet to keep healthy from top to bottom as well as provide food for the healthy bacteria that are inside of you to promote health. See, most of us have about 8 grams of fiber. We used to have about 100 grams or 150 grams of fiber. as hunter-gatherers and our bodies really need that. I mean, the African average hunter-gatherer poop is about two pounds, whereas the average Westerner is about four ounces. Fiber can actually prevent obesity and all chronic diseases of aging. Now, this is because fiber slows the rate at which food enters your bloodstream and increases the speed at which the food exits your body through the digestive tract. Fiber keeps your blood sugar and your cholesterol in ideal balance and also quickly eliminates toxins from your gut because it kind of think of it like a scrubber brush that cleans out all the toxins and reduces your appetite. So it's like a win-win-win. Glucomannan is soluble, it's fermentable, and it's a highly viscous fiber. It's like sort of soaks up 50 times its weight in water, and it comes from the root of elephant yam, also known as cognac. No, it's not the kind you drink. Okay. The cognac tuber has been used for centuries as an herbal remedy, and it makes traditional foods like. cognac jelly, tofu and noodles. I like the Shirataki noodles because there's almost no calories and they're all fiber and they taste like noodles. There's a great way to take glucomannan and it's the form of a supplement known as PGX. This is a lot of research on it, $20 million research looking at diabetes and weight loss and cholesterol and you basically stir it into your water every day as an easy and effective source of fiber. Next, I want to talk about mushrooms. It's a whole class of foods actually, not just one mushroom. When I went to China, I realized that the average Chinese person knows more about medicinal properties of food than I do after years of research. Medicinal foods are part of their everyday diet. And one of the staples in Chinese medicine are mushrooms. Reishi, shiitake, maitake, cordyceps, they all have powerful healing properties that boost your immunity and support your hormones. And they're antiviral, they're anti-inflammatory, they're anticancer, they can even help you heal your liver, they can lower cholesterol. The list goes on and on and on. if you have an experiment with mushrooms, I highly recommend it. I love to make reishi tea or kokuwitsutake mushrooms or even maitake, you can put them in soups, they're awesome. Finally, let's talk about the superfood that you might be having today and you don't even know it, and that is plant foods. Yes, that's right, the vast array of colors in veggies represents about 25,000 chemicals that are super beneficial. These are called phytochemicals. There's evidence that the interaction between the colors provides additional benefits, so that's why you want to eat the rainbow. It's important to have a whole diverse diet full of lots of different colorful fruits and vegetables. Fruits and veggies are historically and biologically super important. Our ancestors, the hunter-gatherers, ate over 800 varieties of plant foods. Today, we don't even consume anywhere near that amount, so we need to make extra effort to include more of a variety in our diets. I always say eat the rainbow. And no, I don't mean Skittles. Each color of fruits and veggies represents a whole different family of healing compounds. For example, red foods like tomatoes contain the carotenoid lycopene, which helps get rid of free radicals that damage our genes and can prevent cancer like prostate cancer. Green foods contain the chemicals sulforaphane and isothiocyanates. These are all so powerful, they also contain indoles, all of which help ward off cancer by inhibiting carcinogens and getting rid of them in your body. So I want you to try them all. Purple, yellow, orange, red, white, blue, green, whatever. They all have amazing benefits. I encourage you to eat your medicine every single day. Remember, the power of what you put at the end of your fork is far more powerful than what you'll ever find in a prescription bottle.

[The Hapiness is important for the synthesis of serotonin, which is a neurotransmitter involved in mood, a lot of happy chemical. It's a happy chemical.

That's what Prozac does, it increases serotonin, right?

Increases serotonin, SSRIs, selective serotonin reuptake inhibitors. can boost serotonin at the synapse, which is, but serotonin is also involved in focus and attention and executive function. But yeah, so vitamin D is important in the synthesis of serotonin from its raw materials, one of which is tryptophan, an amino acid. So making sure that your vitamin D levels are in a normal healthy range, important. And you can easily get your vitamin D levels tested from a doctor. It's a very cheap test. The recommendations that I make in the book are to make sure that your levels are somewhere between 40 and 60 nanograms per milliliter, which seems to be a range where we see the lowest risk of all-cause mortality.

Yeah, I remember reading a study that was incredible. Women who had vitamin D levels less than 45 had a 60% higher chance of having preterm labor. And when you think of the cost of neonatal intensive care and taking care of preterm babies, it's staggering. And you're talking about pennies for a vitamin that can literally prevent preterm labor. So it's really connected to almost everything. And the differences with vitamin D is that not everybody needs the same amount, right? So what should we be taking?

Correct. Not everybody needs the same amount. Before you start taking vitamin D as a supplement, you ought to get your levels tested. When we synthesize it from the sun, our skin basically makes what we need and it breaks down the rest. It's almost impossible to get too much vitamin D from the sun.

Although lifeguards can have levels of 150.

That's amazing.

And that's not toxic.

Right, I mean it could increase, it increases calcium absorption. So I always like to recommend vitamin K2 for people that are in, I mean especially at those levels. But with a vitamin D supplement, I think generally there was a research calculation that suggested that for the general population 2,000 international units a day would be ideal to get the average, you know, the average person to an optimal level. but people again have different, you know, they're people who are older might need to supplement more people who are overweight might need to supplement more to get the same Improvement. And also you, again, yeah. People who are overweight tend to be low in vitamin D because it's a fat soluble vitamin.

So it all gets sucked into the fat and it doesn't get into their system that we need.

Yeah, it gets sequestered by fat tissue. The same also can occur with other fat soluble vitamins. like A, E, K. Yeah.

I don't know if you read this morning, this morning, probably not because you probably don't read the JAMA Pediatrics journal every day.

Not pediatrics, no.

But I do. And I read this paper this morning that showed that women when they were pregnant took 2,800 units of vitamin D compared to 400, which is in the typical prenatal vitamin, that there was a dramatic reduction in the effects on, bad effects on bone when their kids were born. In other words, their, their kids, their babies had much higher bone density, and then their risk later in life of osteoporosis was dramatically reduced. So, and that, you know, that's almost 3, 000 units, which most doctors don't even think about recommending. And, and some people, you know, may need up to five or ten thousand if they're not good absorbers. And there's genes that affect that. So people might need only a thousand, but I, I think a thousand is minimum for most people, and it takes about 1,000 units to raise your blood level 10 nanograms per deciliter. So if you're 20, you need at least 3,000 to get up to 50, right? And then you can see how you do. But I think people need to measure it, they need to check it, and they need to make sure they're okay. And if not, take the right supplement. And not the kind that you often get from your doctor, I hate to say, which is vitamin D2, which is not an active form of the vitamin, but vitamin D3. And you can get that over the counter now. you can get thousand units and others. But you wanna make sure you measure it, right?

Yeah, I mean vitamin D2 is the plant-based form of vitamin D and vitamin D3 is the animal-based form. It's bioidentical to what we create in our own skin. So you always wanna make sure that you're taking vitamin D2. I mean, sorry, D3.

Okay, so that brings up a sticky question. So it's usually made from lanolin and other things that you can get it from sheep and stuff. they're fat. So what if you're vegan? What do you do? That's a good question.

I've vegan sources of vitamin D3. It's hard to get. Yeah, right.

Yeah.

It's just one more of those nutrients.

That you're just not really optimizing. Yeah.

And often people don't convert vitamin D2 to D3.

And if you're a vegan, you want to make sure you're, you're checking vitamin D3. And you can also check D2s because you might have a really high D2, but a very low so it's important to make sure. I once took care of this Hasidic rabbi and he had a really bad thyroid problem. And I said, you really need to take this combination thyroid, but I don't know if it's okay. He said, why? Well, it comes from, you know, pig. It's a whole thyroid extract from pig, and it's not kosher. It's fine as long as it's for your health, and as long as you're not eating it and it's a medicine, it's fine. So I thought that was very interesting. perspective.

I don't know.

So, you know, the other thing you talk about in your book, sort of connected to this whole circadian biology and how we can reset our clocks is this idea of when we eat. Because we often focus on what we're eating, how much we're eating, but we really don't focus that much on when we're eating. And there's a lot of interesting research lately on the when. on fasting, intermittent fasting, time-restricted eating, all kinds of ideas that people are having that extend lifespan, that reduce the risk for many diseases. So, tell us more about the importance of when. Yeah, well, it seems that there's this.

Eating paradigm that's emerging in the literature and it's being called early time-restricted feeding. So, basically eating an earlier dinner seems to be associated with improvements in blood pressure, in blood sugar independent of weight loss. So a lot of people online will say that intermittent fasting is really only useful insofar as it's, you know, it has an ability to help us control the amount of calories that we consume. But it seems to be the case that by not eating too late at night, you know, because as I mentioned, light is a major time setter that the brain uses to know what time of day it is and optimize its processes accordingly. But food is another time setter and it's a time setter for the periphery. for the clocks that are in our metabolic organs, you know, in the organs of digestion and what have you. And so eating too late at night might actually negatively affect things like blood pressure, blood sugar.

So people like do intermittent fasting or when we call time-restricted eating, they'll eat at noon and they'll eat to eight at night. Is that a bad idea? Should it be more like eight in.

The morning till four in the afternoon? I mean, that might be ideal. The thing, the issue is that we're not waking up with the sunrise and going to to sleep with the sunset like our ancestors might have used to do. We, I mean, wake up a lot later, we go to sleep a lot later. So I think that to try to recreate the optimal eating paradigm for our, you know, for the bodies that we've inherited might be a futile effort. So the recommendations that I make are to not eat for an hour or two after you wake up, especially if you wake up with an alarm clock. Because the problem is a lot of people who wake up artificially with an alarm clock to, you know, wake up, get ready for work, their melatonin levels actually haven't properly, it's likely that their melatonin levels haven't come down. That's why they could be groggy when they wake up. Groggy, but also less insulin sensitive, you know? So if you're eating a, if you're.

Drinking a glass of orange juice or eating a bran muffin or whatever, first.

Thing in the morning. You probably shouldn't do anyway for breakfast. Right, that's not a genius breakfast, right? Well, your listeners are savvy and they're not eating like that, right? But, I hope you're not. But, no, I mean, that is a mechanism by which your blood sugar can stay abnormally high, whereas if you just perhaps are to wait an hour, and also a way that you can make sure that your melatonin levels have come down is again to get that bright light in through your eyes in the morning.

So, eat light for breakfast.

Eat light for breakfast. Yeah, eat light, especially if you have to wake up early. And then to eat a, I mean, I would say that if you were going to eat a heavy meal, do it in the daytime and then eat a lighter dinner. Of course, you'll be wanting to take.

A siesta in the afternoon. So, the Spanish had it right, that's right? Yeah. But, you know, the thing is, I agree. I always said you shouldn't eat three hours before bed because your body's getting ready to repair and heal. If it's digesting, it doesn't do such a good job. And if you want to gain weight, best way to gain weight is night eating. It's the best way.

And it's not because, here's the thing. Sometimes I have these confrontations with people in the fitness world who say, well, a bagel isn't magically going to be 200 calories at 8:01 p.m. if it's only 100 calories at 8:00 p.m. And that's true. The calorie content of food doesn't change from one time to the next. but it might actually the disruption of your body's circadian rhythm might negatively affect hormones involved in energy metabolism, in hunger. So, eating late at night could actually make you more hungry the following day.

My favorite study I read when I wrote my book, Ultra Metabolism, like 15 years ago, was they fed people the same calories in three meals over the day or they fed them one meal at night and the ones who had the one meal at night with the same amount of calories gained weight. Wow. Compared to the other group, even though they eat exactly the same amount of calories. Yeah.

So because it might reduce leptin, which is the metabolic throttle, essentially, that dictates, you know, our resting energy expenditure, it might actually increase levels of ghrelin, which is a hormone involved in hunger. so these are all the indirect ways in which late night eating can actually make you gain weight. Whether or not.

And leptin also actually causes reduction in inflammation.

It's anti-inflammatory.

Yeah. Yeah.

So, the system that we've inherited is very complex, but there's a great way of expressing it that I was able to glean from my interview with Satchin Panda, who's one of the leading experts experts on circadian biology. At a certain point in the evening, you have to kind of consider the kitchen having closed.

You know, when you go into a restaurant after an hour. I had me last night. I was in Washington, D.C. and I went with my friend Congressman Tim Ryan. We tried to go to a Miss Mexican place. It was like this healthy vegan kind of taco place and they were shut.

Kitchen closed.

Yeah.

We had to find some other place.

Yeah.

So, I mean, if you just think about your body in the same way and, you know, it's, it's a little bit of term of art, you could digest anything at any time of day. Does that mean it's going to be optimal? Not necessarily. So at a certain point, I would say give yourself an 8 p.m. or 9 p.m. cutoff and say the kitchen's closed in your body and that's it. You're winding down, you're getting ready for bed, you're not going to be as insulin sensitive in the evening as you were during the day. Also, metabolism, especially when eating lots of carbs, can cause insulin to spike, which can negatively affect hormones like growth hormone. It can affect the way that your brain cleans itself up because of an interaction with insulin degrading enzyme, which we know dismantles the plaques that are associated with Alzheimer's disease.

Which is often called type 3 diabetes. Alzheimer's is basically diabetes of the brain. If you're diabetic, your risk of Alzheimer's is four-fold higher. That's 400% higher. staggering. It's a great. We also talk about a couple other things that are really great for the brain, like exercise, which I think 80 plus percent of Americans don't get enough of.

I know.

So, what's the connection between brain health and exercise?

Well, exercise is such a big topic and a lot of people are talking about it. I just think that it's really important to underscore that exercise is, you're always talking about how food is medicine. Exercise is medicine.

Yeah, I always just say if exercise was in a pill, it would be the most powerful drug ever invented.

It really would be. It really would be. So I'm a big fan of resistance training. I think this is something that not enough people are talking about. Women, I see, can be afraid of weight training. They don't want to get too big and too bulky. I've been trying to get jacked for 20 years. It's not easy. It doesn't happen overnight. Resistance training, going to the gym, getting stronger, building muscle, prioritizing protein at every meal, it's going to cause a recomp of your body, essentially. and I've been trying.

I started about 60 years old. I'm in the gym. It's struggle Street, but I. I'm starting to like it, but I think it's working. I can see a big change in my body, and I feel stronger and less pain, and it's good. Yeah.

I mean, at the. If nothing else, having more muscle on your body provides a sink for excess energy, for excess glucose. Excess starch and sugar that's gonna make its way onto your plate inevitably, as much as we try to abide by the blood sugar solution and others who have told us to really... I wrote that. I mean, great book. It's important to note that like a New York City apartment, and I know you know this Mark, there's not a lot of place to store stuff. And that's especially true in the body of sugar. We have very limited, there's very limited options in terms of where we can store the sugar that we consume.

Muscle.

Muscle is one of those places. And by growing muscle, by getting to the gym, you provide a sink basically to soak up extra sugar that you might consume or starches or what have you.

That's good because yesterday I went to a class called Yoga Sculpt, which is basically yoga with weights.

Oh, wow.

Which is hard as heck, but I, you know, I, I told myself it was good for me. Max would be happy with me if I, if I did that.

You're looking, you're looking lean. I mean, I know, I just, I.

I didn't want to say this. I probably shouldn't say this, but, you know, I eat healthy and exercise. It's like, I, I, I have to make sure I don't lose too much weight. Well, you know, so, yeah, there's also something happens with exercise. It's really cool, which is that it stimulates this chemical in your brain. It's like miracle grow. Can you tell us about that?

Yeah, so exercise stimulates a protein called brain-derived neurotrophic factor or BDNF. Or miracle grow for the brain. Miracle grow for the brain, yeah. It promotes the survival of our existing brain cells. It promotes the growth of healthy new brain cells.

So it makes new brain cells and it increases the connections between your brain.

Cells so your brain works better. Yeah, you can actually I believe there's a YouTube video where BDNF is sprinkled on dendrites, which causes them to sprout.

Those are like parts of your nerve cells.

Yeah, it's like the physical correlates of memories, actually. And so it's like a Chia pet. And we can cause this upregulation of BDNF in our brains by exercising. And I think for a long time, the emphasis was on aerobic exercise. And aerobic exercise is great. We know that aerobic exercise can cause growth of the memory center the brain, the hippocampus, which is vulnerable to Alzheimer's disease and aging. But we now know, thanks to new research, that whatever the exercise modality is that you enjoy doing, even resistance training can boost BDNF.

So just being more active. That's great. So you talk about this thing in the book, which is like a marathon in 10 minutes.

How do I do that?

Yeah.

How do you basically get the benefits of running a marathon in just 10 minutes? It's high-intensity interval training. so along with resistance training, I think HIIT training, H-I-I-T, crucially important.

Which is basically exercising as hard as you can until you're about to throw.

Up and then stopping, is that it? Pretty much. But here's the good part. You only have to do it for a few seconds, like 10 to 20 to 30 seconds, pushing yourself to your max effort and then recuperating and then doing it again. And so what the study found is that when you take subjects and you have them do this HIIT, about a two-minute warm-up and then four or five cycles of all-out either cycling or swinging around the big heavy battle ropes, which is something that I enjoy doing or doing sprints up a hill, that people are able to achieve the same boost to their cardiorespiratory fitness as people who are doing like 30 to 45 minutes on of a steady-state cardio on a treadmill.

That's really, there's some great studies that I reviewed about this where if you do high-intensity interval training, you literally can exercise a fraction of the time and get far more benefit than if you ran an hour a day. You burn nine times percent more fat and you actually increase your metabolism. And what's incredible about it, it's not, it's not just the calories you burn when you're exercise, because you're gonna burn more calories if you're running for an hour than if you're doing high intensity interval training. But it speeds up your metabolism so that when you're sitting down or you're on your computer or you're watching TV or you're sleeping, you're burning more calories. And people who are fidgeters also tend to burn more calories too. Yeah. People who overeat tend to fidget more.

And fidgeting is a great way to burn calories actually. Fidgeting falls under the category of non-exercise physical activity that I talk about in the book that can burn.

It's called neat, non-exercise. Yeah.

How neat is neat? You can burn anywhere between 300 and 1000 calories every day just with with fidgeting, with chasing your cat around the living room.

Yeah, I used to be that guy in medical school who kept knocking the kid in his seat in front of him.

It wasn't very popular, but I was always bitching. He probably loved you. But yeah, going back to high intensity interval training, what's amazing about it is it kind of does to your cells what calorie restriction does. And calorie restriction we know is one of the few ways of extending lifespan in smaller organisms, right? high intensity interval training, the way that it works is it creates a momentary energy crisis for your cells where your cells basically say to one another, we've got to keep up or we're going to die. And what they do to keep up is they create healthy new mitochondria.

Yeah. They.

There's a process called mitophagy. It's sort of like autophagy, where old, worn out mitochondria that have become dysfunctional basically get gobbled up.

Yeah.

And this is one of the, I mean, Mitochondria that don't function well is at the root of aging, at the root of neurodegenerative conditions. So by doing high intensity interval training, we basically get to, it's like the fountain of youth for our cells and our mitochondria.

Number one, I better make sure my gut's in order because I just had inflammatory process in my brain that's going to affect lymph drainage, it's going to affect the blood-brain barrier which protects my brain. If I have leaky gut, I've got leaky brain. And after trauma, you have an autoimmune response. And that autoimmune response, if your gut isn't healthy, could be quite dramatic. And now on top of your brain injury, you're having autoimmunity which is going to prevent you from healing well. So I started doing some different things. You know, one of the things that you really want to try and do is you want to make sure that you, again, you go to the gut, make sure your gut's healthy and you're eliminating any inflammation that you can have. So I really cleaned up my diet. And when you're sick, you begin to realize, eh, maybe my diet wasn't as good as I thought it was. And I made some significant changes. I went gluten free and all of a sudden, that bloating I'd get occasionally, that, you know, some of those GI things I'd been ignoring went away. So I went gluten free, really a big deal. I started using really high dose fish oil because there are studies that show higher doses of fish oil can really help in the brain injury, improving neuronal regenesis, membrane Omega-3 is very important for membrane integrity. So I went up to 10 grams per day.

That's like 10 pills almost.

Yeah, I was taking a lot of fish oil. The real first inflection point though was my sleep. Brain injuries definitely impact your ability to sleep. So I needed to really find ways to work on my sleep. I tried melatonin, which will trigger your body into the right rhythmic pattern, but it just triggers you to get into sleep. It won't necessarily maintain it. I was really having a hard time maintaining sleep. So I started working with a advanced medical provider who grows organic hemp. And he was able to create a combination of CBD, THC with Botanicals specifically to help me sleep. When I started using that, I started to sleep. That was the first time I started to feel like I might get better. Because up to that point, I was depressed, flat, really had to work hard for memory recall. Everything I did took me so much longer to get done. Yeah, I mean. I was working 24/7 just to keep up with stuff that should have been done in six hours. So that was the big first inflection point. And I also started taking lithium orotate, which is known to increase BDNF, which is miracle growth for the brain. So BDNF helps with neuroregenesis. It also helps your neurons speak to each other. It makes those transactions occur faster. and allows more neurons to combine at a junction to talk to each other. So I started using that. But the next big major inflection point was when I started meditating. I had never meditated. And I came across a book just serendipitously. I use Amazon Books as a library and I was just flipping through different things. I look up some things on Amazon and I found a book. and I started using this technique. And I started, as can I mention the book? Sure. Yeah, so it was Stress Less Accomplish More by Emily Fletcher. And I think, did you write the forward for that?

She's been on my podcast. Did you write the forward for that?

I did.

Right.

So that's what I thought. So I opened the forward. I'm like, oh my heavens, Mark wrote.

The forward for this.

It must be a good book.

So I started listening to it.

You're my meditation teacher. Yeah, so I started listening to it. and she narrates her own book, it was just amazing. And she went through the science of meditation and what it actually physically does to the brain. It increases the thickness of the connection between the right and the left brain called the corpus callosum. It increases the size of your hippocampus.

Decreases inflammation.

Decreases inflammation, it decreases the size of your amygdala, giving you more control over your anger and frustration. When I started meditating, that was a huge inflection point. My focus became clear, my worries, my negative self-talk resolved. I was able to take a huge step forward. And then it's not just for people with brain injury.

No, it's for everybody.

I mean, we all sort of have.

Chronic brain injury from chronic stress, so.

That as a way to actually. So there were things that I could actively do, but the critical pieces were get the sleep, get the nutrition in order, get the sleep in order, and then, you know, I did things that were known to enhance healing. And I will say, and I will have to emphasize what you just said, meditation isn't just for injury. Meditation should be taught as part of basic life hygiene for your entire physiology. Yeah, it's huge.

And.

Then I was able to have enough energy to start exercising. And so I started running. running is probably of all the exercises increases BDNF, miracle grow for the brain, more than any other exercise. So, running is not something I've done for a long time, but my wife encouraged me to do it and I've been running and that is just really gives me a lot of mental clarity.

So great. The truth is you can heal from brain injury. Absolutely. I think our traditional approaches are lacking and- Right. I think- I love the next one. Click on it to check it out today. clear that diet, and particularly sugar, sweetened beverages kill more people than smoking, war, and terrorism combined.

Well, you know, experts are now saying.

That the leading cause of death worldwide.

Can be traced to diet.