Change Your BRAIN & Lose Weight Using These FASTING SECRETS | Chris Kresser

After about age 40, all of us are suffering from neurodegeneration. The question is just to what degree? There are several reasons that it works for brain function. One is that it's the fastest way of getting into ketosis. So not only when you're fasting, you're not only restricting fat and protein, you're restricting carbohydrate, and that's what starts ketone generation. Second thing is it upregulates a process called autophagy, which is like a cellular cleanup and repair process.

Like the garbage truck.

The garbage truck of the cells. The interesting thing is, if you think about it from an evolutionary perspective, human beings often had periods of food scarcity where they were in fasting, probably involuntary, not something they were choosing to do. But we evolved in that environment, and so our bodies come to expect these periods of food scarcity and even depend on them, perhaps, for these important cellular repair and clean-up processes. So the third thing that fasting does is it it upregulates stem cell generation so it actually can create completely new cells. And if you're suffering from any kind of neurodegenerative condition, this is absolutely crucial. And the reality is after about age 40, all of us are suffering from neurodegeneration. The question is just to what degree? So if we do things like fasting and ketogenic diet, and it doesn't have to be all the time. I'm not, you know, obviously you can't fast all the time. You're not going to make it very long if you do. but cyclical periods of fasting and ketosis.

Do you mean completely no food?

There's different ways to do it. I don't generally recommend pure water fast because they can cause cramps and electrolyte imbalance and they're often really difficult for people to do. But a bone broth fast can be a really good option because the broth contains a lot of minerals, phosphorus, magnesium, things that can help prevent the the cramping and the discomfort. Another popular option these days is called a fat fast. So you eat maybe 400 calories per day of pure fat in the form of medium chain triglyceride or MCT or even exogenous ketones that you can buy now over the counter and supplement with. Or perhaps just some coconut oil in your coffee, like a bulletproof coffee type of thing. And this can help to take the edge off the hunger a little bit, but it also speeds up ketone generation because you've got more fat coming in and this fat makes it easier to get into ketosis so it can help you get through that uncomfortable period more easily.

So it's a fat fast that makes you skinny.

Absolutely. And it totally amplifies your brain power at the same time.

So there are different ways of fasting and talk about the concept, but let's get a little more granular about different ways of fasting. Most people are probably hearing this going, well, I'm not going to stop eating. You know, you do it for an hour, for a day, for a week.

There's so many different ways of fasting, but I'll cover the ones that are most popular and I think are most effective. So one is called intermittent fasting. There's been a lot of research and media attention on this lately. And intermittent fasting can take many forms. It could be alternate day fasts, so you eat one day, you don't eat the next day. But the form that seems to be most doable for most people is compressed food intake. So it means you only eat food in an eight hour period during each day. So you eat between 12:00 PM, let's say, and 8:00 PM, and then that means you're doing a 16 hour fast from 8:00 PM until 12:00 PM the next day. So you're doing an intermittent fast each day. You're skipping breakfast essentially, not eating until noon. But during that morning period, you could, if you wanted to, have some coffee, for example, or tea with some fat in it, just to help with the ketone generation and to help take the edge off the hunger. So that's one way.

So no more Haagen-Dazs before bed?

No more Haagen-Dazs before bed and no bagel with cream cheese when you wake up. Then there are more extended fasts. So these could last anywhere from one day to seven or even 14 days. And three-day fasts have become more popular. I see more and more people trying these. In some ways, it can be more difficult though because the hardest day when you're fasting is the second day typically. That's when you really start to be hangry, as you suggested. The hunger gets intense, especially if you're not used to it. can be really challenging. But by the third day, most people report feeling like elevated mood, height and clarity, focus, attention. They start to actually really enjoy it. So if you end on the third day, you're kind of like continually getting the hardest part of the fast and less of the benefit and the enjoyment from it. If people are going to do seven day fasts, it's generally better to do it under the supervision of a physician, because there are especially if they have kind of a low body mass index, because there are some issues.

You'Re skinny.

Yeah.

Like you and I.

Exactly. There's something called refeeding syndrome that can happen if you start, once you start to eat again, it involves an electrolyte imbalance and it's pretty rare, but it can happen in people who are really skinny who do an extended fast. If you're overweight, there's less of a concern and it can really help with weight loss, of course, too, because you can, you generally lose about a half a pound fat a day. when you're fasting. So that's another benefit of fasting is the metabolic reset. If we now are understanding brain conditions, not just for diabetes, for your brain, because now we understand that a lot of brain conditions, neurodegeneration is caused by metabolic problems. So if you're resetting, hitting the reset button on metabolism, that's gonna have big benefits for the brain. I mean, at a fundamental level, the brain is so important because it's the mediator of our entire experience of the world. Everything that we experience, every thought that we have, every feeling, every sensation that we have is mediated by the brain. So if the brain is not healthy, you know, nothing will work well. And I always start with the basics. The basics are really easy to overlook. It's easy to focus on supplements and all the sort of hacks and advanced tricks that you can do to support your brain, but that's all pretty worthless if you're not doing the basics. so diet is often the starting place, as you pointed out. And first of all, just a really nutrient dense diet is, I think, the most important thing because the brain needs a variety of nutrients to function properly. And these include B12, B6, folate, DHA, choline, zinc, copper. All these play a really vital role in the brain. And studies show that a significant number of Americans and people in the industrialized world and in the developing world are deficient in these nutrients. So we have a diet that's dense in calories and rich in calories, but really poor in nutrients. So that's, I think, the first thing. But then- yeah, I think that, you.

Know, people don't realize people have a very high calorie and nutrient poor diet. So it's calorie dense, nutrient poor. The question is, what is a nutrient dense diet?

Yeah, that's a great question because there's a lot of misconceptions out there. I think people, when they think of nutrient density, the first thing they think of is is vegetables perhaps. And certainly vegetables are very nutrient dense, particularly in phytochemicals, antioxidants and things like that. But when you consider essential nutrients like the vitamins and minerals that I just mentioned, as well as fatty acids, most people might be surprised to learn that animal products tend to be more nutrient dense even than vegetables in that case. And particularly organ meats and shellfish. Liver. Liver. you know, you always hear me talking about liver, but any organ meat and shellfish as well are super, super nutrient dense. So, just like three ounce serving of oysters, for example, one time per week will meet your entire dietary need for copper and zinc for that week. So, if you're talking about bang for your buck, organ meats and shellfish are super nutrient dense.

Most people think that those meats are protein only. But they're actually very rich in minerals and vitamins and antioxidants.

They think they're protein or they think they're just big blobs of saturated fat that should be avoided because of all the fat phobia that we've had for so many years. Fortunately, that's transitioning, I think, at this point. Thanks to you and many other people. But these these foods are really nutrient dense and should be a part of a healthy diet that of course includes vegetables and fruits, whole fruits and nuts and seeds and a wide variety of plants. So that's number one. But beyond that, and beyond what I hope are the obvious steps like removing processed and refined foods and sugar and minimizing stuff that comes in a bag or a box, which really comprises the majority of what many Americans are eating these.

And it's not just because they make you fat, it's because they're neurotoxins.

They're neurotoxins and they're totally depleted in nutrients. Again, they're high in calories. We're well fed, but we're starving for nutrients. That's another way to put it. And the more empty calories that we eat that don't have nutrients in them, the worse our brain is gonna function. So that's the basic level, but then there are some tweaks or hacks that we can do with diet that can potentially prevent and reverse neurodegenerative conditions. So if someone is already starting to suffer from neurodegeneration, like early onset dementia, Parkinson's, things like that, and even for healthy people, these can increase brain function. So one of them is a ketogenic diet.

What is that?

So ketones are produced when we restrict the intake of carbohydrates into a lesser degree protein. These ketones substitute for glucose as a fuel source for the brain. There's quite a bit of evidence that suggests that the brain actually prefers ketones to glucose as a fuel source. That's especially true when people have conditions that inhibit the brain's ability to use glucose. This has been referred to as type 3 diabetes, where the brain's use of glucose is impaired. and then ketones can substitute for that glucose and make the brain function better. We have a lot of studies now that show that the ketogenic diet improves mitochondrial function in the brain. It increases GABA signaling, which is a major neurotransmitter. It increases the expression of something called glutamate synthase, which mops up extra glutamate, which is an excitatory neurotransmitter that can cause harm if there's too much of it in the brain. These ketones just have, in some cases, a pretty miraculous effect in conditions like epilepsy or again Parkinson's, dementia, and Alzheimer's. But when healthy people do a ketogenic diet, what they often report is increased feelings of mental clarity, focus, and attention, and just feeling a sense of alertness that they haven't felt in years or maybe have never felt in their entire life.

Yeah, it's so true. I recall, I'm a physician, see patients, and I've used this therapeutically in patients with dementia who came out of fog and were able to converse, remember things. I've done it with autism, kids who are violent and very disruptive, dramatically changed their behavior, and in Parkinson's, you just see the power of food as a drug. So most people think of food as just energy. I'm eating to get energy, but they don't realize by understanding the nuances of how to use diet as a drug that you can either help or treat or prevent or even reverse many common problems, whether from depression to anxiety to autism to Alzheimer's to, you know, Parkinson's. And, you know, we, we don't use that. I mean, it's being used in, in, in clinically in epilepsy, you mentioned. even it's being researched in Alzheimer's, even in brain cancer, it seems to reverse brain cancer.

-A giant diet for glioblastoma.

-Yeah, so very powerful tool. So, let's talk about something else you share that's not too common in a medical prescription, which is being in nature.

-Yes.

-And how, why is that important and how does it affect our brain?

-Well, again, if you think about it from an evolutionary perspective, human you know, humans have been around or hominids have been around for about two million years. That's 66,000 generations.

Way before they were skyscrapers.

Way before iPhones and skyscrapers and, you know, working inside, we spent most of our time outside and we lived in nature, natural environment with, you know, the natural rhythm of light and dark and slept outside and really you could say nature is hardwired into our DNA. Fast forward to today when the majority of people spend the majority of their time indoors, completely disconnected from the natural environment. What studies are showing now is that spending time in nature down regulates or dials down the prefrontal cortex, which is like the command center of the brain. It basically allows us to step away from that command and control kind of mentality and it relaxes that prefrontal cortex and allows the brain to rest. That's probably the easiest way to think about it. There's actually even a term now that's been coined called nature deficit disorder. It's rampant, especially in kids. It's thought to be a risk factor for ADHD and autism spectrum disorders and all kinds of other brain and neurodegenerative conditions in both kids and adults. I think it's really important and often overlooked.

It's great you were mentioning your kid goes to a forest.

She goes to a forest.

Where you go in the forest and you just play and have fun, you know?

Yeah, which is what kids at that age should be doing. She's almost six, so.

I mean, it had a huge impact on me when I was a kid. I went on two trips, was riding horses outside, was camping, was, you know, being in nature a lot of the time. And it really, I think, imprinted on me that as a therapy.

Absolutely.

And for me, it's kind of my go-to therapy.

And they're now doing that with kids who have ADHD and depression, anxiety, and other behavioral problems. They're sending them on essentially on camping trips where they don't take any technology. They're not allowed to play video games or disconnect from their phone. And the first few days are really hard for the kids, but then all of the kids almost unanimously report feeling a sense of calm and well-being that they haven't felt possibly ever in their life. And, they want to go back and they want to keep doing it. So, it's really powerful.

So, there's something else that you sort of talked about which is sort of related to this, which is this concept of circadian rhythm. And, how that plays a role in our brain and our hormones and our neurotransmitters, which is basically how we live in rhythm or out of rhythm.

So, can you talk about that in the brain? Yeah, this is really fascinating because it goes way back, way before humans, actually all the way back to the first single-celled organism that evolved on this planet. So we're talking about billions of years here. Every organism that ever came to be on this planet evolved in the 24-hour light and dark cycle that we have on planet Earth. So every cell of every organism is entrained to that 24/7 light-dark cycle. And we now know that in humans, that light-dark cycle affects every aspect of our physiology, from our endocrine system and our hormones, to our brain function, to our metabolism, everything.

Sleep.

Sleep, of course, sleep.

Most importantly, sleep.

Most importantly, sleep. So what happens, you know, essentially our bodies are hardwired to expect a period of light and then followed by a period of darkness. And when we wake up in the morning, our bodies start producing cortisol, kind of like get up and go hormone. And then when night falls, it starts producing melatonin, which helps us to fall asleep and stay asleep. So the problem is now, you know, in the last 150 years, we've developed artificial light, which is awesome. It allows us to be more productive and, you know, entertainment and art and all kinds of things are possible with artificial light that weren't before. But the downside of that is now we can sit in our bed at 11 o'clock staring at our iPad, which is emitting blue light, the same spectrum of light that the sun emits. And that basically tells your body, oh, it's time to wake up. Time to get the cortisol production going. And then the melatonin drops totally messes with your circadian rhythm. And then that can have downstream effects like increasing the risk of obesity and metabolic disease, increasing the risk of depression and anxiety, seasonal affective disorder, We know even that flight personnel and people who do shift work are at much higher risk for cancer.

And heart disease.

And heart disease. So this just affects our immune system, our cardiovascular system, everything. So getting closer to that natural rhythm of light and dark is really important. It doesn't mean we all have to live in a tent in the backyard, but we can take steps to- Can.

We put a mattress in it?

You could do that if you want. I mean, actually it would be really good for you, but we can do things like, for example, if we have to use a computer at night, there are now glasses that you can buy that filter out the blue light that comes from those screens or even if you're watching TV. So if you came to my house at night, you'd see my wife and I wearing these funny glasses with kind of an orange tint that filters that light out. You can, you know, take steps to not try not to use electronic media within an hour or an hour and a half of bedtime because that you know, how's that effect that I just described? And then get some bright light exposure during the day. So if you work in an office or in an indoor environment, make sure to go outside for a walk at lunchtime or, you know, in the morning, take a walk. Make sure with no sunglasses, make sure you let that light hit your retina and stimulate that cortisol production.

It's basically like candle therapy. When the sun goes down, switch to candles, get off your screens. Absolutely.

And if you can't wear those funny glasses. Yeah, turn the lights down. some mood lighting and yeah, yeah. And then it's, you know, it's pretty widely recognized now, which is why even computer operating systems now, like the latest update for Mac, their latest operating system has something called Night Shift. So a lot of people might not even know that this is on their computer, but when you turn Night Shift on, what happens is when the sun goes down, the screen, the type of light that's emitted from the screen changes. it becomes warmer, which is meant to mimic more of a night, the kind of light that you would be exposed to at night, not during the daytime. So this is really well-established research. It's gone so far that computer makers are now incorporating this into the operating system.

Yeah, we have these LED lights and fluorescent lights that we're exposed to all the time that have a huge impact. You know, Cleveland Clinic, we created a clinic that is meeting environmental standards and also health so we actually change the lighting.

It doesn't look like a hospital when you go in there.

No, we change the air filtration, we change the materials that are in there to actually optimize well-being and we know we can actually access the brain through all these external inputs, light, sound, music, touch, taste, and environment. All these things are really powerful doorways that we can access the brain that we don't even utilize as brain therapy. So this is really pretty exciting research. So let's talk about ways of besides the obvious, which we've talked about diet, exercise, we didn't chat on, but it's a powerful tool, meditation. I want to get into some of the hacks you talked about, some of the doorways that given all the stresses of our life, given the deficiencies in certain activities or nutrients, how do we use substances that are available to us through sub diet or through supplements to actually optimize brain function.

Right, so this has been an area of pretty intense study and also experimentation within the biohacker community. So there's a new class of nutraceuticals, you know, supplements and herbs and nutrients that provide a kind of therapeutic effect called nootropics. And these are things that have been shown to improve cognitive function or have some aspect on some some aspect of brain health like mood. And I mean, it's a huge topic. There's so many potential things we could talk about, but I'm just going to mention a few of them that I found to be the most helpful with my patients and with my own experimentation. So one is choline. Choline is a very important substance found that we need in our brain. It's sometimes referred to as a B vitamin. has important effects in the brain, but it's importantly a precursor to acetylcholine. So acetylcholine is a neurotransmitter that is really heavily involved in attention and concentration and focus.

And by the way, it's what goes down in Alzheimer's.

Absolutely. It goes down in Alzheimer's and you see, and it's of course involved with memory and cognition in general. So we want to keep our acetylcholine levels high and take choline as a supplement is one way to do that. Of course, choline is also in liver and egg yolks and many other foods, but if all of that's not working and you need an additional boost, choline can be really helpful. There are many different kinds of choline and ways to supplement with it. For the brain, I think the most effective form is alpha-GPC, which is a form of choline that's been shown to very easily enter the brain and have a bigger impact on acetylcholine levels. So that's number one. Number two is there's a whole class of acetams like piracetam, which is similar to an amino acid called pyroglutamate. And what it does is it increases the activity between neurons. So neurons are always sending messages back and forth. And if you increase that activity, you increase the, you sort of enhance the cognitive function. of the brain. So, prasutam does that. And it's generally better. I found one side effect of prasutam that can happen is headaches, mild headaches. And those are generally mitigated or alleviated if you take the alpha-GPC or choline with the prasutam. So another one is nuopept, which is a peptide that inhibits glutamate synthesis. So glutamate is an excitatory neurotransmitter, or excuse me, it basically increases the availability of glutamate in the brain. And so glutamate is an excitatory neurotransmitter. It's one of those Goldilocks things. You don't want too much of it, but you don't want too little of it either.

One of the main drugs for Alzheimer's blocks the effects of glutamine because it's over exciting the brain.

Overexciting the brain. Overexciting the brain and brain damage. So I think you need to be, I should have mentioned this in the beginning, but all these things are, you know, they have different effects on different people. And I encourage people, if they're gonna do these things, it's probably best to do them under supervision if they can. But if they are gonna try them, to take it slowly, you know, start with a really low dose, try only one thing at a time. A lot of people will stack nootropics, so they'll take three or four of them together that all have slightly different but complementary effects and to try to get the best effect. And that's not a bad thing if you are already familiar with the individual effects of each of them. So that's a caveat I should have mentioned.

So start slow and build.

Start slow and use one thing at a time until you figure out how it affects you and then you can add other things in.

Are these medication or supplements?

These are supplements that are available over the counter. And then, you know, plain old caffeine actually, and coffee has been shown, they're both, they're not technically nootropics because they're stimulants, but they have nootropic effects. And caffeine, for example, I mean, has many effects, but one of the big ones is it increases dopamine production. Dopamine is another important neurotransmitter in the brain. and that one regulates what we call executive function. So attention and focus and even motivation are strongly influenced by dopamine. So those are four that fall into that neurotropic category that can be helpful.

Let's just talk about the caffeine and coffee for a minute. You know, there's evidence that it depletes adenosine, which is the energy in the cells. It depletes over time norepinephrine, adrenaline, so you get this spike in these stimulatory hormones or neurotransmitters and then you crash, which is actually my experience. You know, when I went to medical school, I started drinking coffee and I would notice every afternoon about three or four, I would just like, want to fall asleep. And I connected it to the coffee. And so how do you sort of explain that sort of phenomenon where you're kind of artificially boosting these things and then you crash?

So we can speak in general terms and then individual terms. I think that's always important when we're discussing any of these topics. If you look at the research on caffeine, overall it's very positive. I think there's some areas like you mentioned that raised potential for concern, but when you look at the research on a kind of net basis, you see positive outcomes with moderate mild to moderate caffeine or coffee consumption. Because it's not just the caffeine, it's also the antioxidants and the other compounds in the plant.

Yeah, I mean coffee sadly is the number one source of antioxidants in the American diet.

Yeah, so I think coffee on the whole can have a positive effect, but that's if it's well tolerated by the individual person. We now know that there are a lot of genetic polymorphisms and factors that influence how we metabolize caffeine. So one person might be what we call slow metabolizers. So these are the people like me and perhaps like you that if I have coffee after 12:00 p.m. My sleep is tanked for that night. I'm not going to sleep at all. And yet there are also fast metabolizers. These are people like my dad who can drink a cup of coffee after dinner and go to sleep and not have a problem. So there's a wide variation in how people respond to caffeine. And I think you don't necessarily need to know your gene status. You figure it out on your own. If you drink coffee and you're like this and you can't sleep and you're crashing in the afternoon, it's probably not going to work for you. And that's the same for any of the other nootropics that I mentioned. Some people take paracetamol and feel really jittery and amped up. It doesn't work for them. Whereas they do better with choline and for other people it's the opposite.

I always say that the best doctor is your own body. It's going to tell you what works and what doesn't work if you listen to it.

It's not the final word. You can have all the best theories, but if your body doesn't respond, it doesn't matter.

In my own practice, I've noticed that when I treat people's digestive system, that their brain gets better, whether it's autism or Alzheimer's or Parkinson's or MS. And particularly, we're now learning that depression and mood disorders, which we often thought were emotional, are maybe physical. And that the key doorway might be the gut. And depression particularly, we're learning that it may be an inflammatory disorder, like the brain might be inflamed from various factors. So talk to us about the gut and these mood disorders and how we can think about it, what we can do.

It's really interesting because I feel like a lot of what we're doing in modern medicine is rediscovering things that we have known for a long time. 2000 years ago Hippocrates said all disease begins in the gut, right? So all the way back then he knew something about that. And then even in the US in the 1930s there were a couple researchers, physicians that Duke University, Stokes and Pillsbury, who wrote a seminal paper explaining the gut-brain-skin axis, the connection between the condition, like disruption of the gut microbiome. That wasn't the term microbiome at that point, but they were talking about lactobacillus, low levels of lactobacillus and bifidobacteria, and conditions like depression or anxiety, and also skin stuff, which we won't go into. But this was in 1930.

It's like almost 90 years ago.

Almost 90 years ago. And then we lost that thread for, you know, many, many decades. But in the last 10 or 20 years, the gut-brain axis has been a really hot topic in the research literature. And even now in the popular media, I think a lot of people have heard that there's a connection between the microbes that inhabit our gut and our brain, that things like intestinal permeability or leaky gut, when the gut barrier breaks down, that can cause problems with our brain and it may be connected to conditions like autism spectrum disorder, ADHD. And then as you mentioned, the most current theory on what causes depression is known as the inflammatory cytokine model of depression. So that's a fancy way of saying that when our gut becomes inflamed, it produces chemicals that travel through the bloodstream, cross our blood-brain barrier and and suppress the activity in the frontal cortex and that produces all the telltale signs and symptoms of depression.

So should we take Advil for depression?

Absolutely not. That's actually going to make the gut worse over the long term. We know that Advil can cause ulcers and a whole bunch of other problems in the gut. But what we should be doing is attending to our diet. Diet is a crucial factor for gut health. if we eat a lot of heavily processed and refined foods, that causes a pro-inflammatory microbiota, which means it feeds pathogenic bacteria and bad bugs, allows them to proliferate, and then they produce compounds that can be toxic to the brain.

Let me stop you there for a minute. There's a fascinating research on the different types of molecules that get produced by bacteria. and in our diet we have high levels of propionic acid which is toxic to the brain and it's been linked to autism and many other conditions. And most people are not aware that any bread products they eat or flour products have high levels of propionic acid because it's a preservative that's put in there. So if you eat a fast food restaurant, you process bread, if you make bread yourself that's different but it's a very common ingredient huge levels and the.

Good.

Products that come from healthy bacteria called butyrate actually heal the brain. So we're not even aware of what we're doing to our brains by the food we eat and it's so connected and yet just cutting out all processed foods and cutting out all fast foods and refined grains can have a huge impact.

And then eating prebiotic foods, these are foods that can be fermented, by our beneficial bacteria, like bifidobacteria that produce that butyrate that you mentioned, is really important. And there's been a big decline in the consumption of these foods that can be fermented, fermentable carbohydrates. So these would be things like onions and garlic, Jerusalem artichokes, some starchy plants, some nuts and seeds. They're all whole foods. They're all foods with fibers that can be fermented by our gut bacteria. And these fibers are really important because we can't digest them. We don't extract any nutrients from them. But the gut bacteria living, you know, the 100 trillion bacteria or microorganisms living in our gut can. So every bite of food that we put in our mouth, we need to think of how it nourishes us and how it nourishes our bacterial community. Because feeding both of those systems is equally important.

Historically, we ate a lot of fermented foods because that's how we preserve things. Sauerkraut and kimchi and these foods that are ways of preserving foods that otherwise would go bad.

That's right. And if you look at hunter-gatherers, they consume on average, in many cases, over 100 different plant species. For Americans, it's like six or seven. Tomatoes and lettuce on burgers, maybe carrots and a few others, and that's it. so when you have that lack of diversity of fiber and plant foods, your gut bacteria isn't gonna work as well.

Historically, the original data on this was from Dr. Dennis Burkert who went to Africa and found that the average hunter-gatherer stool weight was two pounds and the average stool weight of the industrialized group that was living in the cities was like four ounces. We eat about eight grams of fiber on average, maybe 15 if you're good in America.

We eat over 100 grams grams of.

Fiber, which is a lot.

They're eating over 100 and most of the dry weight of stool is bacteria. And that's exactly what explains why their stool weighs more because it's full of this beneficial bacteria. So then there are other conditions. We know that infections like H. Pylori, parasites, there's now been some peer-reviewed published studies connecting fungal overgrowth in the gut, which used to be looked at as a sort of wacky, wacky condition, but there study associating it with inflammatory bowel disease. And I recently saw a study connecting it with worse outcomes in alcoholic liver disease. So, they're starting to come out and say, okay, everyone does have yeast in the digestive tract, that's normal. But what happens when the bacteria that protect against the proliferation of that yeast become depleted? Or if you have an infection or you're eating foods that that that yeast thrives on, then this yeast becomes, yeah, exactly. And that's how wine is made, you know, we know this.

So.

If you have an overgrowth of yeast in the digestive tract, that's when things, you know, can become problematic. And yeast produces aldehydes and other chemicals that can literally make us feel like we're drunk. Yeah.

There are actually case reports of, you know, people who had high blood alcohol levels from eating too much sugar and flour that led to the fermentation of starches in their gut that really produced alcohol and they absorbed it and they got arrested for drunk driving.

Right, right. And I know you see this in your practice, but I see a lot of kids with yeast overgrowth because kids are these days are eating a lot of sugar and processed and refined food. They're not eating whole nutrient dense foods. And guess what? These kids have behavior problems. They have mood issues. They are not able to even attend school in many cases because of this. And when we treat the gut and we deal with the fungal overgrowth and the dysbiosis, you can see remarkable changes. You can see kids going from being almost non-verbal to speaking. Physical contact becomes a possibility where it wasn't before. They look in your eyes. They look in your eyes, you get kids getting off of these Ritalin and and other stimulants and being able to actually participate in their lives. I mean, it's amazing.

It is.

And it's all just with the gut, you know, the diet and focusing on the gut.

Chris, you're a practicing clinician and you treat patients.

Yeah.

And you're not just making up all these theories, but you're connecting what you see in the clinic with the research and then you implement therapies that aren't typical. And I'd love you to share maybe a few case stories of patients who you approach this way through a different doorway into the brain and what kind of outcomes you see.

Yeah, so a couple of years ago, I had an 86-year-old woman who was, she had a diagnosis of dementia and early onset Alzheimer's. Her family members brought her in. She was living with her daughter and her daughter's husband and they had kind of reached the end of their rope. you know, they went through what most patients with Alzheimer's go through. They have a really expensive battery of tests and then the doctor says, I'm sorry, there's nothing we can do. Here's a drug. And by the way, that drug has not been proven to even slow the progression of Alzheimer's, much less reverse it. And good luck. You know, I mean, that's essentially the plight. Yeah, get your affairs in order and, you know, seek out some help for the family members and that's it. and these people didn't want to accept that, understandably, and so they were seeking out other approaches and they came to see me. And first thing I did was I put her on a ketogenic diet, which is what I often do in patients with neurodegenerative disorders. And she, until that time, was eating a pretty standard American diet, a lot of flour and bread, she loved cookies and cakes and things like that. So it was difficult for her to make that transition, but her family, since she was living with her family, they made that easier. And within, I got a call from her daughter a couple weeks later saying, I don't even recognize, this is like my mom used to be. You know, I haven't seen this person in 10 years. And she was, her memory was better. She could actually, you know, her short-term memory improved. She was able to function in a way that she hadn't been able to. She was able to take care of herself. And this was just by doing ketogenic diet. And then we started to add some additional cognitive supports in some of the things that we talked about earlier, as well as some herbs like Ginkgo and Bacopa and Ashwagandha that increase glutathione levels in the brain and are neuroprotective and actually can reverse amyloid, you know, can actually get rid of some amyloid. formation. And then she started to improve further. So she was already fairly far along the progression. She didn't recover completely, but she's still doing well. Years later, she's still doing that program and she hasn't progressed any further.

Which is unheard of.

Unheard of, completely unheard of. The second case that comes to mind is a child with pretty severe behavioral disorders, he would basically have, you know, it was really, really hard for his parents. Like, even something like not his shoes not being tied correctly would send him like into a complete fit, spasm, you know, tantrum on the floor, beating the floor, you know, which was really problematic if they ever tried to go anywhere. and then he wouldn't use the bathroom anywhere outside of the house. So that it's really limited. He couldn't go to school for that reason or they had to go pick him up at school and bring him home during the day. He was very sensitive to any kind of contact. This is now referred to as sensory processing disorder. So certain types of clothing on his skin or even physical contact would send him into a tailspin. and I did a whole workout mostly focusing on the gut and found that he had significant fungal overgrowth. He had a condition called SIBO, which is an overgrowth of bacteria in the small intestine where it shouldn't be. He had, you know, disrupted gut microbiome. He had a lot of food intolerances. He was gluten intolerant. He was still eating gluten, but he was also intolerant of dairy and eggs and other, other food proteins. So we cleaned up his diet. We treated him with herbs. and supplements for the fungal overgrowth. We use prebiotics and probiotics to support beneficial protective bacteria. And within, you know, a month and a half of that, he was already coming off of the psychoactive drugs that he was taking. His psychiatrist called and said, you know, what did you do to this kid? I don't even recognize him. They got a call from the teacher at school saying, you know, this kid, you sent his twin brother because they had never seen him operate in this way and be able to get along with his peers and actually go use the bathroom at school and start to be able to function like a normal kid. And this was just with some simple, pretty simple dietary changes and some supplements and botanicals that you can buy over the counter and probiotics and prebiotics to support gut health. So again, this kid would have been on a lifetime of medications. He was already in the situation that a lot of people are in where they take one medication that causes side effects. So then they need to take another medication to deal with that, the side effects of that drug. He was already starting that treadmill. And most kids, unfortunately, in that situation are facing a lifetime of that just escalating more and more and more. It's so sad. But it's like the the most rewarding part of my work is being able to help a kid in that way.

Yeah, I see this all the time. What's striking is that we often think of these things as behavioral disorders, but they're biological disorders that are caused by various insults irritating the brain and inflaming the brain. And when you take away all the stuff that's bothering them and you put in some good stuff, it's dramatic. It can happen very quickly, like in days or weeks.

Absolutely.

And, you know, I do recall a number of my patients who had the same story. One little girl was a beautiful little girl, was like nine years old, was violent. And she would attack her sister, she would get kicked out of class 10 times a day, she'd have to stop the bus, and she would cut her, you know, family out of pictures that she was in. It was just really, powerful. And she didn't have any gut symptoms. And I found that she had terrible overgrowth of yeast, terrible bacterial overgrowth, like you mentioned. And I treated her gut and it was like the same story. Where is that kid? And she was sweet and loving and kind and never disrupted school anymore, ran on the bus home. And how many of these kids are sort of struggling like this that really we can impact through these doorways to the brain?

I think you raised a great point that all parents should be aware of, which is when the problems in the gut don't always cause obvious gut symptoms. So that's tricky because when a parent sees the behavioral problems or the doctor for that matter, they don't think about the gut automatically. They don't think this could be a gut issue. So that's the message that we need.

To get out there. They just think it's some troubled kid or something.

Exactly. And I mean, consider the fact on the kid. The kid spend their whole whole life thinking there's something wrong with them. They're bad, they don't fit in, and there's some fundamental defect, which is just horrible for the child's development and self-esteem. When they understand that there's actually something physiologically that's contributing to this and causing this, it doesn't just improve their symptoms. It totally shifts their awareness, their self-awareness, their self-concept, and can really dramatically change the outcome of their life for that reason.

Extraordinary, what you're talking about, Chris, is reversing conditions that are irreversible, Alzheimer's, ADD, autism, depression, that people suffer with throughout their life. And this is relatively simple, changing your diet, changing your lifestyle, a few supplements, fixing some problems that occur that are common like the gut. And we are looking at an epidemic. of brain disorders in this country and around the world. And it's something we actually know what to do, but it's sadly void in conventional therapy.

Yeah, we've been searching for the magic bullet, you know, a single drug that's going to treat each of these conditions. And that's just not the way it works. They're all multifactorial, which means they have a number of different causes and all of those causes need to be addressed instead of just trying to slap a bandaid on the problem, which clearly isn't working, but has been our approach in this country to chronic disease for the last several decades. With one in two people now having chronic disease and one in four having multiple chronic diseases, and that just expected to increase over time, we're in big trouble if we don't make a shift in our paradigm and how we approach chronic disease.

No, it's so true. So true. We just, Kind of missed the boat on this.

Yeah. Well, you know, our medical system evolved in a time where the top three causes of death were all acute infectious diseases like typhoid and pneumonia. So, it was like you had one disease, you see one doctor, you got one treatment, and you were either better or you died. Those are pretty much the outcomes. But today, you know, people have multiple diseases. They see multiple doctors, usually a different doctor for every different part of the body. Those doctors are not communicating with one another, not seeing it holistically, and you end up with this sort of patchwork approach that is not only ineffective, it's actually harmful. Yeah, we talk about evidence-based medicine, which.

Means you've had to have something studied single agent against a single disease, randomized controlled trials. The truth is that when we practice medicine, we're not practicing evidence because we might have five drugs for five different diseases all in the same patient that's never been studied.

And most of those drugs are being used off-label in many cases anyways for indications that they were never actually studied for. Or approved for. Abilify, for example, number one selling drug right now used for depression and behavioral issues. It wasn't actually approved as an antidepressant.

It's true. And some of these practices of pharmaceutical companies to put push these drugs for off-label indications has been found to be criminal and they've been actually fined billions of dollars. But if they do, they don't care because they're making more billions. They made me find a billion, but they made 10 billion, so who cares?

It's only the oil industry that makes more than the big pharma. So they got deep pockets.

And just one last thought, you know, sort of remind me what you're saying, that functional medicine has a saying, which is based on the thinking of Sid Baker, which is called the TAC rules. If you're standing on a TAC, it takes a lot of Astra to make it feel better. Get rid of the TAC. And so you're talking about like bacterial overgrowth or yeast in these kids, you can give them psychotic drugs or anti-depressant drugs or all these medications, stimulant drugs, but they're not going to work unless you get rid of the cause.

And then the other issue is there are many causes. So if you're standing on two TACs, taking one of them out doesn't make it 50% better. So you've got to find and remove everything. Yeah, another analogy that's similar is like if you're in a boat and it's got a lot of leaks, you can bail water out and that might help slow the sinking, but ultimately you have to plug all of the leaks, not just one for you to be able to stop bailing water. So great. It's really important and I think we see some positive signs that things are shifting, moving in a direction thanks largely to work from people like you at the Cleveland Clinic and all of the pioneers in the functional medicine community. But I'm just hoping it moves quickly so we can prevent unnecessary suffering, especially in kids.

That's really the take-home here is that there's millions of people suffering unnecessarily and that we can end that suffering.

So let's talk about this idea of time-restricted eating. because it's a fast. There are many ways to quote fast. There's what we call intermittent fasting, which is maybe not eating for a whole day or three days or a week sometimes. There's time-restricted eating, which is only eating with a certain time window. There's fasting-mimicking diets, which are eating less calories for a number of days to stimulate the same pathways. There's ketogenic diets. They all do a very similar thing. What is the biology of how this works? We know that these things do work, looking at animal studies, human studies in terms of improving metabolism and the longevity biomarkers. But what are we seeing in how these methods actually work and what is the most effective? What should people be doing in order to take advantage of this new science?

Right.

So, what they're doing, I mean, the way I explain to patients, which I think is doing a number of things. It's triggering your body's own self-cleansing mechanisms. After you haven't been eating for a certain amount of time, 14, probably more 16 hours, your body's self-cleansing mechanisms kick in, which is very important with the aging process because one of the factors in aging is your body, once it goes back to functional medicine, the functioning of these systems don't work as well. So the fasting actually starts putting that autophagy system into play. So I think that's probably one of the most important aspects. It also will improve mitochondrial function, which also decreases as we get older. The consequences of fasting or what happens in your body are often the opposite of what happens as you get older. So that's why I think it's so important. Which way of fasting is best is the way that you'll do. I mean whatever works easiest for a person is what I encourage. And I think the easiest one for most people is to eat dinner earlier and eat breakfast later. which is what I do and what I recommend. Now, if people want to do a day of just water fasting or three days or even more, that's great. That's a little bit more complicated and most people won't do that, but if you can do that, that's fine. There's also this fasting mimicking diet where you do five days a month of very low calories and no animal protein and low carbs. We've actually created some shakes or My health coach has some recipes for people. If they want to do it themselves, you can buy the ProLon shakes as well. You should bring out some shake. I mean, it's a no-brainer to bring out a five-day program of because it works. We've done it on patients. There's no question you get the same results whether you do a fasting mimicking diet for five days, you do intermittent fasting, we're seeing positive results. across the board with biomarkers and different types of fasting. So I don't think there's one way. I think the way is to find the way that you will do and that works easiest for your lifestyle.

Dr. Yeah, you know, people say, Dr. Hyman, what do you eat for snacks? And I'm like, I don't. I think snacking is the worst invention. Snack foods are typically really unhealthy and they're a modern invention and we used to not have to be eating all the time. And that's the problem where you're eating all the time. And I think, you know, just to underscore what you said about these different approaches to time restricted eating, intermittent fasting, fasting and refeeding diets is they activate a set of mechanisms in the body that improve blood sugar control, that get rid of belly fat, that increase muscle synthesis, that build your bone density, that increase testosterone, that increase brain function and cognitive function, that improve your stem cell function, that help your immune system. and they clean up all the debris in your cells. It's called autophagy, which is the same sort of self-cleaning mechanisms. There's mitophagy as well that comes from the same process. These are things that we actually can take advantage about without actually changing what we eat. Now, if you change what you eat, you get a double benefit. These are very powerful things that we should be paying attention to in the science. I think you just feel better. You feel more energetic rather than being.

Sluggish from eating food all the time. Right, and you nailed it, thank you. All those mechanisms are what actually start, their function decreases as we get older. It becomes harder to keep your blood sugar under control, the muscle synthesis, all brain cognition and brain function. Fasting is like a magic pill or eating less is a magic pill. To me, that's probably the most important thing you can do.

It's true. You mentioned the meat thing. To me, the science is still controversial. I talked to my friend, Walter Longo, who's one of the leading longevity scientists, and he's from Italy. He's the guy who developed the fasting mimicking diet. He's been on the podcast. He said, he knew this woman, Emma Morano, who lived to be 117 years old. and she was anemic when she was young lady and her doctor told her to eat three eggs a day, which she did for 100 years, literally. And then when she was in her 90s, I think she was getting frail and weak, and her doctor told her to eat a pound of meat a day. And she did, and she lived from 90 to 117. So I wonder, you know, how true is this and if your other lifestyle factors are good if you're eating animal protein and getting adequate muscle benefit from it as you age. Where is that fine line in terms of animal protein?

Well, I think this is the dilemma, not really a dilemma, but I think we all need to find what works for our bodies. But I think it also points out a factor that in Western medicine we always try and look for the one thing. It works and everything works together. We have this complicated system and the mTOR issue may be one small part of it. I think you've got to find that balance. I agree. I don't think... I mean, I know vegetarians who get cancer, the idea of animal protein causing cancer. Vegetarians get cancer. Vegetarians don't do well. You've got to find out what works for you. Once again, I'm not trying to blow smoke up. yeah, but the Pegan concept, the Pegan diet, I think, and finding your own type of Pegan diet, I think, is if we're looking for a solution, not that there is a solution, the Pegan diet in terms of... Thank you, Frank. Intermittent fasting, eating within that content of time-restricted eating, a Pegan diet is the way we all should be eating.

Yeah. I think the other thing that is important I've noticed for aging is muscle. I think we have a neglected organ, which is our muscle, that we don't pay much attention to. This condition that we get as we age, it's inexorable. If you don't do something to stop it aggressively, you will lose muscle. You could be the same weight at 65 than you are 25, but your body be twice as fat. and it literally looks like a ribeye marble steak as opposed to a filet mignon, which is what you want for your muscle with no fat rippling through it. That's all related to our diet and the lack of exercise.

Right.

Dr. Pompa:And so, the two things I want you to talk about is the other side of the coin because protein you need and you want to get enough but not too much, but it's actually sugar and starch that drive this aging process. and that combined with muscle strengthening and building as you get older seems to be some of the most important factors. Can you talk about those and how they relate to aging? Sure.

Sugar and starches are the devil. It's not even a debate. You've got to get as much of that out of your diet as possible. You want to eat the protein is a harder one, how much protein you eat. As you get older, maybe decreasing animal protein, increasing a bit of plant protein, but still keeping those carbohydrates as low as possible, or the sugars and the starches. I think the muscle issue is interesting. Because I've been doing acupuncture for so long, and I really got into the functioning of the muscles. It's not just about building muscle. You want those muscles to work efficiently. What I see a lot of, especially as we get older and we have injuries, certain muscle groups tighten up. When certain muscles tighten up and they don't fire, your body compensates and starts using other muscles. Let's say you have a tight hip or you have an ankle problem. Your back muscles have to work more and then you start getting back pains and then maybe it goes up to your shoulders. Not only do you have to improve muscle mass or watch the loss of muscle as you get older, you've got to watch that functioning because as we get older, the muscles tighten and the fascia tightens that thin layer that surrounds the muscles. When you cut open a chicken and there's this fascia around the muscles, that surrounds all our muscles in our body. And that, as an acupuncturist, paying a lot of attention to that for the last 30 years, I've seen it becomes a problem, especially as we get older and as we injure ourselves, and especially as we get older and we injure ourselves, we don't tend to recover as well. So it's really important when you do injure yourself to get some bodywork, to get some acupuncture, to get those muscles working efficiently again, and not just letting injuries sit there and not treat them. So I think it's not only building muscle mass and not losing or not losing muscle mass, but it's improving the muscle efficiency and that's keeping those muscles long and limber and watching that the fascia doesn't tighten.

That's a really good point, Frank, because I've had back issues my whole life from back surgery when I was 30 and recently had another back surgery. and now I'm getting treated by this physical therapist who's going into the fascia and rewiring things and then giving me exercise to do that compensate for the inactive muscles, exactly what you were talking about. And it's been only like three days of working with this person and I feel like a different human being. My body feels limber, lighter, opener. It's pretty amazing. So, I mean, not everybody can access that, but it's, There's ways you can do it yourself with foam rollers and other things to really help. Okay, so let's talk about something that is—.

In the book, I talk about foam rolling. I just have to mention foam rolling because I think that is a lot of people can't afford going to some bodywork who does deep tissue work, but foam rolling is sort of the closest you'll get to going to someone who can do that. I really can't stress this enough. recovering from injuries, recuperating, don't let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently. It's one area of functional medicine that we didn't really get into in functional medicine. We talked about most of the other organs but we didn't really talk about the functioning of the muscular skeletal system. I think that is really important.

Well, it's definitely one of the nodes on the matrix, which is structural, but if we don't get into it enough, I agree. And actually, we're talking about building a whole course on structural modules. So, I think that's very important. All right, let's talk about something that is a little abstract, but is really central to aging and that is impacted by our diet, light, by exercise, by environmental toxins. And it's something called our mitochondria. And we've talked about that on the show a little bit before, but it's really important. So, what are mitochondria? Why are they so important in aging and disease? And how do we improve them? Because it seems to be the central feature of aging is the dysfunction and the loss of mitochondria.

Right. So, the mitochondria are just the energy powerhouses in the cells and you have many in all our cells. And as we get older, their number decreases, and their function decreases. So optimizing their function and trying to increase their number is one of the most important things you can do for aging. And interestingly enough, most of the things we've been talking about improve mitochondrial function or increase the number. We'll mention it.

Yes.

Others we haven't, but it's a low carbohydrate diet or, you know, fats are what the mitochondria thrive on. Fasting is particularly good for mitochondria. Exercise, in particularly high intensity interval training, is really good for it. Strength training as well. Sleep, a lot of the lifestyle changes, to me, the mitochondria are what we in Chinese medicine talk about, chi. We talk about the energy and how do you boost To me, the mitochondria are the western equivalent to chi. That's your body's energy. All these changes we talk about actually work with the mitochondria. One of the things we haven't talked about and which actually seems to work well or stimulate the mitochondria is this concept called homeostasis. which is...

I love that concept. What does that mean? What does that mean? I love that concept.

So, homesis means sort of what doesn't kill you makes you stronger, basically.

Ah, that's perfect definition. That's the best definition I've ever heard.

That's a little bit of stress is actually good for the body. Chronic stress, we know, is a problem and creates all these problems and it will help won't help you age well, but a little bit of stress, hormesis is good. And that's what fasting is. Fasting is physical hormesis. It's a stress, a little bit of mild stress on the body and your body's response to that and we talked about resilience, but your body's response to.

That.

Is a positive response which stimulates all these factors that are good for aging. So we talk about fasting, we talk about a little bit of interval training where you push yourself a little bit more than usual. Going from hot to cold, so even just having an ice cold shower after a hot shower. I love going from a sauna, I've become obsessed with my sauna, going from my sauna jumping into some freezing cold water. So temperature extremes are another way of stimulating homeostasis.

I love that. I love going from my steam or sauna right into an ice bath.

That's good for aging. That's good, that's homeostasis. Anything that's a little bit of stress on the body is good. Actually, what's interesting, I remember years ago, Jeff Bland talking about this, or someone at one of the functional medicine conferences. with phytonutrients. A lot of the homesis is really good for plants. So plants develop more antioxidants and protective phytonutrients to protect themselves from whatever they have to deal with to survive. So spraying them with herbicides and that doesn't actually help them develop these phytonutrients to protect themselves, which actually end up being good for us too.

Yeah.

The first time I heard about homesis was years and years ago at one of the functional medicine conferences where someone, I think it was Jeff, who talked about the importance of homesis on plants and developing, you know, phytonutrients that would then benefit us.

Yeah, you know, it's really important to understand this idea because when you look at, for example, organic versus conventional plants or even wild plants, even versus organic plants, the wild plants have way more by hundreds to thousands of times more antioxidant potential, phytonutrient compound, and they also taste better. And what's interesting is that flavor goes along with phytonutrients. So the flavor profile of a food is directly related to the nutrient density and to the phytochemical content. So if you go to a garden, which I did the other day to a friend of mine's garden, and you pick a really ripe tomato that's just ripened on the vine, you stick it in your mouth. and it's an explosion of taste and flavor and phytochemicals that is so different than these cardboard store-bought tomatoes that don't taste like anything. So that's really the power of the little stresses. And I think the strength training, the hit interval training, the fasting, the phytochemicals, these are all ways to actually improve this. If you loved that last video, you should check out the next one. for sure on getting to the root cause of all disease.

We're actually creating this environment today where we have inflammatory foods as a normal part of our diet. We have a high level exposure to chemicals that are not being tested and they're being.