The ROOT CAUSES OF Cognitive Decline & How To PREVENT IT | Mark Hyman

In order for me to get better, I had to get to the root causes, which were, in my case, mercury and all the consequences of that. Well, one of the things we've been learning over the last few decades, in addition to the brain science of how we can increase our brain connections and build new brain cells, is that inflammation is a common denominator across a whole spectrum of diseases, pretty much all chronic disease, whether it's heart disease, cancer, diabetes, obesity, of course autoimmune and inflammatory diseases, but also brain disorders. We know that dementia is inflammation of the brain. We know that autism is inflammation of the brain. We know that depression is inflammation of the brain. In fact, they're recommending anti-inflammatory drugs to treat depression. That's the wrong idea, but it shows you where the science is going. So what causes inflammation? Well, guess what? It's the usual culprits. It's our diet. We have a very inflammatory diet, high in sugar and processed foods, low in the good fats that are anti-inflammatory like omega-3 fats. It's low in phytochemicals, which are plant compounds that are anti-inflammatory in our food like vegetables and fruits and spices like turmeric. And all of these really promote inflammation in the body. Sugar is probably the worst. And then of course there's other insults. We have things like Lyme disease and tick infections, viruses, and we have gut dysfunction. Gut dysfunction is probably the other major driver of inflammation because when your gut's inflamed, like most of our guts are, it creates inflammation not just in your gut but throughout your body and in your brain. Toxins also play a role in driving inflammation. Stress plays a role in driving inflammation. Lack of exercise is inflammatory and exercise is anti-inflammatory. So all these insults and all these factors are driving inflammation in the brain that leads to autism and Alzheimer's and depression and mood disorders and more. Well, about 35 years ago, the government told us we should be eating a low-fat diet. They had the food pyramid, which showed us to eat six to 11 servings of bread, rice, or pasta a day, which are low in fat, and fats and oils only sparingly at the top of the food pyramid. What that's done is create A trillion dollar food industry promoting low fat salad dressing, low fat cakes, low fat cookies, low fat processed food, and everybody is afraid of fat and is eating egg white omelets and avoiding fats. That's led to a huge problem because our brain is made up of mostly fat and requires fat to function. It's made up of omega-3 fats, saturated fat, cholesterol, all the things we thought were bad actually turn out to be very good for the brain and critical for its functioning. We also know that low fat diets promote pre-diabetes, which also leads to brain injury. So all of these factors are driving brain dysfunction and the science has really flipped. The US Dietary Guidelines in 2015 said for the first time in 35 years that we should no longer worry about restricting fat in our diet, that we no longer have to worry about cholesterol. They still suggested reductions in saturated fat, but I think that data is gonna be transformed in the next guidelines because the evidence is so clear that saturated fats are really not linked to heart disease or any serious illness. There are a number of fats that are mission critical for your brain function. The first are omega-3 fats. These are derived from fish, from wild fish, from algae. They're in some plant foods like walnuts and flax seeds, and they're very powerful for regulating inflammation, but they're also critical as they make up our cell membrane, and your cells are the interface where your body communicates with itself. So in order for your cells to be working well, you have to have good healthy membranes, and omega-3 fats are critical. Also, saturated fats, in fact, a very specific kind of saturated fat called MCT oil stands for medium chain triglycerides, is derived from coconut oil and is very powerful as a fuel for brain cells and a fuel for your mitochondria. So when you consume these fats, your brain is going to work better. You're going to be more focused, more clear, more energetic, and you will help prevent dementia, depression, autism, and a whole host of things, ADD, all of which are very effectively often helped by these healthy fats. In addition to eating these healthy fats, which come from grass-fed meats and grass-fed butter, from a coconut oil, from avocados, from nuts and seeds, you also want to avoid the refined vegetable oils, which have been shown to be linked to depression, to violence, homicide, suicide, poverty, and these are refined vegetables that we never consumed in human history. We've gone A thousand-fold increase in our intake of refined soybean oil. That's 100,000% more of these refined oils than we had 100 years ago. And they're not really designed to be consumed in those massive quantities. As long as they're in your foods, eat the soybeans, eat the nuts, eat the seeds, but avoid the refined vegetable oils because they're bad for your brain. Most of us have heard of mind-body medicine, which means the mind affects the body. That stress can impact almost any illness. And we know that and that's well accepted. But what we don't know or don't think about very often is that the body can affect the mind. Everything from depression, anxiety, ADD, dementia, all these things can be affected by what's happening in your body and that's pretty much ignored by most psychiatry. There's this whole field of psychiatry that's very descriptive but it's not talking about causes. So basically they think your body is disconnected from your head. except for the stress response, and that we shouldn't be looking for treatment for depression in your gut or treatment from autism in your immune system. So we have a very different way of thinking in functional medicine, which is actually looking at how the body affects the brain. And that is really a fundamental insight that I had once I started treating patients for their physical problems. Their mental problems got better. Their ADD went away. their autism improved, their depression went away, their anxiety went away, their panic attacks went away. And I thought, wow, this is something that nobody's talking about. How our body affects our brain. And the first thing to do when you have mental illness, when you have ADD, when you have depression, dementia, any of these things, is to start to treat the foundation. There may be psychological issues, there may be trauma and stress, but those things are much easier to deal with once you've build the foundation of health. Our approach to disease in general and to brain disorders is descriptive. So we say, oh, you have memory loss, you fail these neurocognitive testing, you have these symptoms, you must have dementia. Or you can't focus, pay attention, and you have, you're distractible, and you have all these symptoms, that means you have ADD. And our entire diagnostic and statistical manual, which is what's used by psychiatry is descriptive. It's basically here's this list of symptoms you have, here's what you have. But just because you know the name of the disease doesn't mean you know what's causing it. And you can have 10 people with depression or 10 people with autism or 10 people with dementia and all of them have different reasons for those symptoms. I always say your brain has only so many ways of saying ouch, but there are a lot of things that can hurt it and if we identify those we can really help people. So, The fundamental problem with conventional medicine is that we describe disease by symptoms and not causes. You know, so we often think that our brain is separated from our bodies by something called the blood-brain barrier. We learned this in medical school, which means nothing gets above our neck. But nothing can be further from the truth. Everything we do and think and eat and what we're exposed to all affects our brain. Nutrition is probably the most important fundamental thing that's driving brain disorders. including sugar, which is a potent brain neurotoxin. It's addictive. In fact, it may be more addictive than cocaine. And it's deliberately pushed into our society where we're eating 152 pounds of sugar and 142 pounds of flour, which acts just like sugar in your body. And that's been linked to everything from depression to ADD to even dementia, which is now called type 3 diabetes. So we have to take this very seriously. So our high sugar, high starch diet is key. The other problem with our diet is we've been told for decades to eat a low-fat diet, which essentially is really bad for your brain, because your brain is made up of mostly fat. In fact, 60% of it is omega-3 fats. It's rich in cholesterol, it's rich in saturated fat, and without adequate fat, you have trouble with your brain. We also know that all the chemicals in our food, additives, preservatives, also potentially have negative brain effects, and they've studied this in children where they give kids colored water with additives and colorings versus colored water from pomegranate, and the kids who have the colored water from the additives all get ADD and hyperactive. So we have really good evidence that these chemicals are having a negative effect on our brain. So our high sugar, high starch, low fat diet, along with all the processing in our diet, is extremely harmful. In fact, we now know that omega-6 fats, refined omega-6 fats from processed oils, not naturally found in nuts and seeds and food, but processed oils have been linked to depression, to homicide, suicide, violence, and even poverty, in very well done studies by the NIH. So I think we underestimate the impact of food on our mood. In fact, I got a letter from a prisoner from a maximum security prison. It was a murderer. He said he wanted to thank me for writing a book which he was able to follow in prison that got rid of all the junk, all the sugar, and he said he realized he woke up like Rip Van Winkle from a bad dream where his mood and his behavior and his attitude was driven by the processed food he ate. and now he felt like a new human. So I think these are very powerful insights about how our nutrition affects our health. When I received this letter from the prisoner whose life was changed by eating real food in prison, which was probably hard to do, I realized two things. One, that I was happy for him and angry at our society for driving our industrial processed food system at our population. Our government creates policies that drive disease through supporting our processed food industry, through tax breaks, through subsidies, through lack of control of marketing to children, through poor recommendations from the government on what our diet should be, not based on science, but based on industry interests. That our FDA regulates food based on lobby, not science. These are areas where our government is actually propagating poverty, violence, and more by Continue this vicious cycle. Why do we spend $7 billion on food stamps for soda when our government's also telling us to cut down on sugar? These hypocritical policies are actually driving a lot of what's wrong with our society. I first began to discover the mysteries of the brain when I personally got sick. And I went from being very healthy, riding my bike 100 miles a day, being able to memorize 30 patients' charts and dictate them all flawlessly at the end of the day, to barely be able to walk up the stairs and not remembering where I was at the end of a sentence when I got there. And it happened almost overnight. And it happened as I realized because my whole system broke down from a number of insults that I wasn't aware of. The main one was from being in China, where I was exposed to huge amounts of pollution from coal burning, which releases mercury and lead and many other toxins. And as it turned out, I ended up having mercury poisoning, which essentially shut down all the systems in my body, my immune system, my gut, and my brain. And it was pretty startling to be highly functional, highly capable of operating in the world, to being almost debilitated. I was really unable to function in any real way, and my brain wasn't working. I had trouble with remembering things. I had severe ADD, I couldn't focus on anything. I had memory issues. I literally was like I had dementia, ADD, and depression all at once. And because no one had really figured out what it was, I sort of struggled from doctor to doctor to doctor. And I went to see the psychiatrist who wanted to give me antidepressants. I saw the neurologist who wanted to give me other drugs. And it was just like a whole series of different doctors and a whole series of different drugs. And I realized that I wasn't really depressed, I wasn't really demented, I wasn't really having ADD, that something was wrong and that I needed to figure it out. And that's when I discovered the world of functional medicine, which is essentially a model for getting to the root cause. And in order for me to get better, I had to get to the root causes, which were in my case, mercury and all the consequences of that. It turned out I had many other things that I didn't realize. I had mold exposure, I had been exposed to Lyme disease and had Lyme disease and so I would basically peel the onion of my story and I was able to get to the bottom line of how to get better. And it was really a powerful process for me to discover a whole new way of thinking about the brain. I got all sorts of diagnoses but no identification of the root cause. I was told I had Chronic Fatigue Syndrome, which means nothing other than you're tired and feel lousy all the time. I was told I had depression. I was told I was stressed and was recommended to take anti-anxiety medications. So I was given antidepressants, anti-anxiety medications, ADD medications, and none of them really helped because I didn't deal with the root cause. And so I was very frustrated because they gave me all these labels, but they didn't actually tell me what was wrong with me. It was like I knew that something was real and it wasn't just depression or stress because I was fine one minute and I wasn't the next minute. So when physicians said that to me, when my doctors told me I was depressed or had ADD or I needed medication or I was anxious. It made me angry because I felt that I was given these labels, but I was given no roadmap to get better. And I realized that as physicians, we're trained to actually label people and often tell them it's psychological when it's very physical. 'Cause we don't know what to do and we don't know how to find the answer and we don't know the questions to ask. So we just assume, well, if you're having all these vague symptoms, It must be in your head. And I knew it wasn't, although it was affecting my head, it wasn't in my head. I struggled for a number of years going to doctor after doctor, specialist after specialist, to Columbia to Harvard, to all the greatest minds in the country who I thought specialized in what I had. And I got no answers. And then one day a nutritionist at Kenyon Ranch invited me to a lecture by a doctor Jeffrey Bland, who's a nutritional biochemist, studied with Linus Pauling, and I listened to him speak and he painted an entire new view of medicine, an entirely new view of disease. And I said to myself, either this guy's crazy or he's a genius. And if what he's saying is true, then I owe it to myself and my patients to learn about it. And that's when I took a deep dive, first applying everything to myself and incrementally I got better and peeled the layers of what was wrong with me using the roadmap of functional medicine, which doesn't really just look at symptoms, but looks at causes and understands the body as a whole dynamic integrated system where everything affects everything and everything is connected. So because my brain was affected, the problem wasn't in my brain. The problem was in my body and all the inflammation and the toxicity and the gut dysfunction that was then feeding back up to my brain. And once I understood that, I was able to apply the principles of functional medicine and get myself better. This was a really slow process because I didn't know what I know now. And if I knew what I do now, I'd get better a lot faster. But I essentially had discovered I had mercury poisoning. And it was by meeting a naturopath who listened to my story and said, oh, you lived in China, you might want to check your mercury level. And so I had a level that was off the chart. If I see a patient with a level of 30, 40, 50, I think that's serious. Mine was 187. So I was extremely toxic and I needed to figure out how to undo that. Getting the mercury out of my body, I slowly, slowly got better. There wasn't a moment where I just was better. It was a very slow process and I'm grateful that I was able to learn the things I did to actually help myself. So in functional medicine, we deal with root causes. So I had to find all the causes. There's a principle that if you're standing on a tack, it takes a lot of aspirin to make it feel better. You got to get rid of the tack, whether it's mercury or whatever it is. And the second rule is if you're standing on two tacks, taking one of them out is not going to make you 50% better. You have to find all the tacks. So it turns out I had many tacks and I had to deal with all of them. But I also knew from functional medicine that you have to create a healthy soil, that you have to create a foundation so that your body can reset and heal. And that foundation is really based on very simple principles. Nutrition, exercise, stress management, sleep, and relationships and connections. All those really form the basis of creating a healthy human, and if you don't have those sorted, the rest of it may not work. Because my gut was so disrupted from the mercury, I went on an elimination diet. And for months, I ate turkey, broccoli, and brown rice, and that was it. And I modified all sorts of things to try to get better, but it took a lot of time for those things to work. For some people, it's very quick if food is the issue, but my issue wasn't so much the food as it was the mercury. And then I learned how to do gentle exercise and yoga and meditation and learned how to sleep at night in a regular rhythm, which I'd never done in my life. And all those things really formed the foundation. And then I had to deal with the real issues, which was mercury. And I did what we call chelation, which means to bind to metals. So we bound up the metals with various medications and then supported my body's own detoxification system. with things like glutathione, with a lot of cruciferous rich vegetables such as broccoli, collards, through various supplements like lipoic acid, all of which are designed to help boost my detox system and get rid of the mercury. Another thing that drives brain dysfunction is gut dysfunction. We're now learning that your microbiome, this ecosystem of bugs in your gut, has been linked to depression, to ADD, to autism, even to Alzheimer's. So we always thought the gut and the brain were how to disconnect it. Maybe if you're stressed you'll get diarrhea, but the fact that your whole gut environment is driving changes in your brain is a very new discovery. It has broad implications about what's wrong. And why do our guts get so messed up? Because we have a gut-busting culture. We process food that's low in fiber, high in sugar, low in nutrients. We are exposed to inordinate amounts of antibiotics, even at birth. We're exposed to things like C-sections. One-third of all births are C-sections, which don't allow you to develop a healthy gut flora. We take gut-busting drugs like acid blockers and anti-inflammatories like ibuprofen. We take all sorts of other drugs like hormones, which all drive changes in our gut flora that end up affecting our brain. So we've been exposed to 80,000 new chemicals in our environment and our food supply and our house care products and our facial and body care products and our air and water and food since the last century. and these are having serious effects. We know from studies on infants when they're born looking at their umbilical cord blood, there are 287 known toxins. Over 200 of them are known neurotoxins, phthalates, PCBs, flame retardants, mercury, lead, and on and on, pesticides, DDT, PCBs. All these have broad implications and we often study them one at a time, but we're seeing these as collective synergistic toxins. 287 in a newborn before they even took their first breath. So we have to rethink our environment. We have to rethink what we're exposing ourselves to. And these, for me, my broken brain was caused by mercury. And it is, for many people, I've had patients with Parkinson's and dementia that we've reversed through using heavily focused detoxification approaches and getting rid of heavy metals and other toxins. So these are really, really important insights about the role of environmental toxins, food toxins, our household products, our body care products, our water, our air, all of which can be remedied by very specific strategies to reduce your toxic load. Stress also has a negative impact on the brain. We know that physical stresses will cause emotional stress. We know that emotional stress will have physical effects. So we know, for example, that if you're having an infection or if you have heavy metals or if your gut's not working or if you have infections with Lyme disease, this all affects your brain and can lead to all these broken brain issues. But we also know that stress itself, psychological stress, can have a serious impact on the body but also on the brain. We know that when you have high levels of sustained cortisol, which is the stress hormone, that that shrinks the memory center in your brain. That you literally have an increased risk of dementia and cognitive issues as you are more stressed. We know the opposite is true, that when you meditate or do yoga, These practices actually reform connections in the brain. We call that neuroplasticity. They help recreate new brain cells. We call that neurogenesis. We know that they increase stem cells. They decrease inflammation. So learning how to regulate stress is really important. All of us are exposed to stress. And sadly, most of us have far more stress than we ever did a thousand years ago with the advent of TV and internet and all of our devices and on our constant workload. All these things are pretty abnormal. In fact, the average hunter-gatherer tribe spent about 20 hours a week actually working, trying to get food. The rest of the time they just hung out and chill. We don't do that. We just go all day long and all night long sometimes. And this creates really serious consequences for our health and our brain. I think less than 8% of Americans get the recommended daily exercise every day. And why is it important? Not only because it prevents heart disease, not only because it helps with weight, but because it has profound effects on the brain. We know that vigorous exercise three times a week is a better treatment for depression than most antidepressant drugs. We know that if you just take a walk every day, you dramatically reduce your risk of Alzheimer's and dementia. We know it's important for kids with ADD, we call that nature deficit disorder, where they're not out playing and enjoying their bodies and stimulating their nervous system in a positive way. They're overstimulated through video games and addictive behaviors. So these are really profound effects of exercise and across the board. In fact, one of the most powerful things it does is increase BDNF. That's called brain-derived neurotrophic factor. It's like miracle grow for your brain. And what that does is it increases new brain cells and increase the connection between brain cells. So you can remake your brain at any age. And exercise is one of the most powerful tools to do that. We're seeing an epidemic of isolation and disconnectedness. But we know that being part of a group, that being connected has profound effects on your health. Even if you're part of a bridge club or a bowling club, we know that those people live longer and are healthier. We know that from an extraordinary study in Rosetta, Pennsylvania, where they looked at a group of immigrants from Italy who maintain their close-knit culture. They had a range of socioeconomic status within that group, but they all were together. They celebrated holidays together. They celebrated weddings and and marriages and deaths, all as a community. But they actually started eating the horrible American diet. Even when they were eating the horrible American diet, they still had dramatically lower rates of heart disease and death than everybody else who lived in the communities around them. So those social connections are powerful and it's one of the ways that we maintain our health for so many reasons. In fact, altruistic behavior stimulates the brain in the same way as cocaine or heroin or sugar. so it's a much better way to get your high. We've seen a revolution in brain science in the last 20 years. We went from believing that the brain was fixed, that you had a certain number of brain cells at birth, if you damaged them that was your tough luck, to now understanding that even at the moment of death you are creating new brain cells and you are creating new connections at any age. And this revolutionizes our view of what the brain is capable of. We know that these brain disorders are not fixed. This is one of the most powerful discoveries of the last 20 years is that we can actually modify these what we thought were fixed brain disorders like depression and autism and ADD and even things like dementia and Parkinson's. The body has the capacity to repair, the brain has the capacity to repair and heal when the insults are taken away and the right ingredients are put in the system. So it's really a revolutionary time in brain science and sadly conventional medicine is just not caught up We are now at Cleveland Clinic doing a research program looking at how we can impact early dementia by using all these approaches, dealing with the root causes, infections, toxins, diet, and then helping put in the right ingredients for health. And it's a very powerful model. And we're seeing people actually starting to reverse dementia and reverse common problems that we thought were not possible, like autism and ADD. We now know that sugar is a brain toxin. and it's been linked to a whole host of brain disorders from depression to anxiety. In fact, I remember a patient who came in with panic attacks and he was terrified he was having a heart attack and thought he was dying. And I listened to his story and he said he basically drank a Coke all day long and then he would stop and then his blood sugar would crash and he'd get a panic attack. So the problem was the sugar was raising and lowering his blood sugar so much that it was an emergency. But we also know that it's been linked to what we call type 3 diabetes, which means that the brain becomes insulin resistant and that causes inflammation, it causes damage to your brain cells, and it leads to dementia. So we now know that sugar is a big cause of dementia. I first began to realize that dementia was not a fixed problem when I had a patient come into me named Bud. And Bud was about 70 years old. He ran a large corporation of his own family business. And his wife said he was increasingly dysfunctional. He had to stop working. He was highly depressed. He couldn't remember anything. And he was told he had dementia and was on a slippery slope to death. And that he should get his affairs in order. And I said, well, maybe there's something else going on. And it was really the first case I'd seen. Then I said, well, let me just try some of the principles based on the theory of how the body actually works. So we started looking for problems. First, he had pre-diabetes, which no one had diagnosed. And we know sugar and pre-diabetes are linked to dementia. If you're diabetic, you have four times the risk of getting dementia. We also found out he had high levels of mercury. He lived in Pittsburgh. which is a terrible place to live because they coat the streets with coal ash, they fertilize the fields with coal ash, and they have all the residue from the steel plants in the environment, which produced all this mercury. And we also found out he had a number of genetic issues that affected his brain, leading to less likelihood of getting rid of mercury, higher risk of B vitamin issues, we call methylation problems, He also had problems with glutathione, which is detoxification hormones, and he also had terrible gut issues. For 30 years, his gut was not working properly and had severe irritable bowel. And so we addressed all these factors, not just one thing. We addressed his nutrition and his sugar in his diet. We made sure he had adequate levels of B vitamins. We made sure we got rid of the mercury in his body by getting rid of his fillings and getting the mercury out of his system through chelation and IV therapy. We also gave him treatment for his gut and got his gut functioning again. So all these things were dynamically interacting and we corrected all of them. And it was like Rip Van Winkle. He came back to work, he was functional, he was happy, he has memory back. It wasn't 100% but he was really back into a normal functioning life and you wouldn't know anything if you talked to him. So that case inspired me to really ask the questions of if that's true for one person, could it be true for more? and what else could we learn about this pathway that people go on towards dementia without actually having to give them all these drugs? And what's really frightening is that we've spent billions of dollars over 400 studies on dementia and really none of them have worked. A couple have had some slight benefit. What I mean benefit is, I mean, they delayed their going into a nursing home by three to six months, which is not really a benefit. So we have to completely rethink our approach and that's what's exciting about what we're doing at Cleveland Clinic, what people like Dale Bredesen are doing in reversing dementia. So all these things are really key. And what we're doing here at the Ultra Wellness Center to reverse chronic disease, including dementia. So most toxins are also neurotoxins. And we pretty much ignored their effect or if we haven't ignored it, we don't do anything about it. We know, for example, that there's been links between various Environmental toxins and dementia. We also know very well that environmental toxins are linked to Parkinson's. In fact, conventional doctors all accept this because the data is so strong. We know that farmers have a much higher risk of dementia than the average person because they're exposed to pesticides. We know that if you work in tannery factories that tan leather, also exposed to toxic chemicals. We know that pesticides, all these things are driving brain dysfunction. And so We have to be very serious about identifying these toxins and helping people eliminate these toxins as a treatment, not just saying, oh, well, you've been exposed to toxins. Tough luck. I recall a patient who came in with early Parkinson's, who was 50 years old, which is very young to get Parkinson's. And when I listened to her history and her story, she grew up in the Bronx and she had cockroaches and rats crawling all over her in her bed every night, and she had a terrible pest phobia. So when she moved to the suburbs in Long Island, she was obsessive about getting the exterminator to come every month inside and out spraying her house and her garden. And then she was so terrified she also had a big vat of chlorodane, which is a actually banned pesticide from decades ago, was in her garage for decades. And so she was exposed to very high levels of these pesticides and ended up having Parkinson's. And we were able to treat her by helping your body detoxify. When you actually deal with the root causes and then you optimize the body's function with Parkinson's, people can have dramatic improvements in their well-being. I just talked to a patient today who has Parkinson's and he was exposed at very young ages to all sorts of pesticides. When he was a kid, he used to have the pesticide trucks spraying the neighborhoods and the kids would run through the pesticide fog and he had exposure and occupational exposures. many, many other exposures, and he had Parkinson's. And so we found he had exposures to organophosphate pesticides in his urine. We found DDE, which has been banned for decades from DDT, and still he had these in his system. So we were able to actually treat him, and within a very short time using saunas and mitochondrial nutrients and things to help him detoxify, within a few days he said he was very much better. So what we see as aging in our culture is really abnormal aging. It's really pre-clinical disease or breakdown in the system of the body. So we see people decline as they get older. We see people have memory issues as they get older. But that's not normal aging. In fact, we now know that you can maintain a healthy cognitive status well into your 90s, 100. I have a friend who had his dad who's 105, still sharp as a tack and lives by himself. So the body is capable of that. The question is why are some people able to do that and others not? It's because of the number of insults and stresses and toxins that we're all exposed to, poor diet, that affects our brain function dramatically. So at any age, we can reverse cognitive decline. We can improve our brain function. If you look at some of the work of Dale Bredesen, he's actually showing reversal of testing that shows dementia. He's showing reversal of the brain size. Literally, you can grow the memory part of your brain called the hippocampus at any age and even start to begin to to change your brain trajectory by these interventions. So we really have to think about our whole process of aging in a very different way and understand that we have the capacity to regenerate and heal and repair at any age. It's interesting, as a doctor who treats both autism and Alzheimer's, they're very much the same. The brain is responding to a number of insults and they're really the same disease at different age spectrums. So again, and we look at their diet, We look at their gut, we look at exposure to toxins, we look at their nutritional status, we look at their immune system, foods they're reactive to, and we optimize all those areas and the patients often will get better. We don't treat autism, I don't treat Alzheimer's, I treat humans who have bodies that are out of balance. And that strategy works to help reverse this brain dysfunction. So I've had many, many patients with autism, one comes to mind, who was a little boy, two or three years old, who was quite dramatically affected. He had regressive autism, he had a number of insults, antibiotics, infections, vaccines, all these things affected his capacity to actually develop normally. And his parents were told by the doctors, and by the way, his mother worked for a large pharma company, but they were told you need occupational therapy, you need behavioral therapy, good luck, you'll probably end up in an institution and we're sorry. And that message unfortunately is something that parents get all the time and it makes me angry because I know there's so much we can do because autism is not a brain disorder, it's a disorder that affects the brain. We now see dramatic amounts of inflammation in these children. We see exposure to toxins, we see all these gut dysfunctions in these kids and dysbiosis, we call it imbalances in the gut flora, all these things drive brain dysfunction. So by fixing those things, often the brain will recover. So I see this one young boy came in and he had terrible gut issues. They all have stinky, smelly stools, gas, diarrhea, horrible bowel movements. He had severe nutritional deficiencies, B vitamins, folate, B6, B12. He had mercury in his body. And we were able to fix all these things. one at a time, and he recovered. He went from not being able to speak to being fluent, from being an autistic class to being a normal kid in mainstream school, and now he's about 10 years old and he's completely normal, completely lost his diagnosis, happy, normal, well-adjusted kid, not even on the spectrum at all. Depression is just the name we give to people with a set of symptoms. You're hopeless, you're helpless, you're sad, you have no interest in life, sex, you don't want to eat, these are symptoms of depression. When the doctor sees you with those symptoms, they go, I know what's wrong with you. You have depression. But depression isn't the cause of those symptoms. It's the name of those symptoms, which can have many, many causes. So for example, it might be because you have a gluten sensitivity, an autoimmune disease related to that called Hashimoto's that causes low thyroid function. Or maybe it's because you've been taking acid blockers for reflux because your poor diet for decades, and you have B12 deficiency, which can cause depression. Or maybe because you live in the Northeast, you have vitamin D deficiency, and that can cause depression. Or maybe because you take antibiotics that change your gut flora, that can cause depression. Or maybe because you love sushi, too much mercury, that can cause depression. Or you hate fish and have omega-3 deficiencies, that can cause depression. Or maybe a lot of sugar and a pre-diabetes, that can cause depression. So I begin to look for all these things and more, and by treating those things, People often just recover. So one of the things we discovered in the last few decades is the importance of energy. And I don't mean energy that you feel, although it's related. I mean energy that your body produces from oxygen and from eating food. And that gets burned in your cells in a little organ called the mitochondria. They're like tiny little energy factories or power plants. When those power plants start to become dysfunctional, which can happen from anything that causes inflammation, from toxins, from your gut, from nutritional deficiencies. When those little energy factories and power plants start to wind down, that's when disease occurs. And what's striking is we found this link to autism, to Alzheimer's, to Parkinson's, to obviously things like diabetes, depression. These are all common pathways through which these diseases are affected. And a leading autism researcher, Suzanne Goh, is studying mitochondrial therapy in autism. where she provides the nutrients to help the mitochondria work better in a certain subset of kids with autism and they recover. Things like CoQ10 and carnitine, lipoic acid, N-acetyl cysteine, ribose, these are just mitochondrial nutrients that we're often not having enough of that can help reverse this. We see this in Parkinson's. We know Parkinson's is a mitochondrial disease that happens from insults like toxins, infections, inflammation, poor diet, and that when you to support the mitochondria, you can help these patients feel better, function better, and stop their Parkinson's. We know that it's linked to Alzheimer's. So all these conditions that we never really paid attention to, these mitochondrial dysfunction conditions, which are not particularly a disease, but they're actually dysfunction that comes from all the insults in our life, they have been linked to all these horrible diseases that we now can do something about. Hormones are critical for your brain, and they affect almost every function. And we often ignore treating these problems because they may not be a true deficiency, they might just be an imbalance. And as we age, we see a number of different hormones go out of whack. One, insulin goes up and that causes pre-diabetes, which we know affects the brain. Also, we see cortisol go up as we age, which is the stress hormone. We see growth hormone go down, which helps our brains repair and grow. We see estrogen and testosterone, the sex hormones, decline. all of which are really critical in regulating our health. Melatonin for sleep. So all these hormones are delicately balanced and when they're interrupted or dysfunctional because of all these insults in our lives, lack of sleep, stress, poor diet, toxins, infections, etc. Gut dysfunction, then we start to age fast and we start to break down. So it's really important to optimize hormones. For example, thyroid. I had a patient who had Alzheimer's who just had a slightly dysfunctional thyroid. She wasn't full-blown hypothyroid, but when I gave her a little bit of thyroid hormone, it was like she had energy, she woke up, her memory got better. And we see, by tweaking these hormones as we age, particularly in things like dementia or dysfunction, we see really significant improvements. There are very few genes that will lead to a specific disorder. So there's been 30-something genes identified that relate to obesity, And if you had all of them, your weight gain would only be 22 pounds. There are genes connected to Alzheimer's, but they don't predestine you to Alzheimer's. They are risk genes. Now, there are some that are very strong, like the presenilin genes that are linked to early Alzheimer's when you get it in your 50s. That's a different condition. There's later-onset Alzheimer's, which is maybe something you might be predisposed to by certain genes like APOE4, but they're not going to determine that you get it 100%. and that's the good news because we know now that you can't change your genes, but you can change your gene expression. You can change which genes are turned on or off and how they affect health or disease. And so the way we do that is what we call the exposome. The exposome is the sum total of things we're exposed to, primarily our diet, exercise, sleep, stress, environmental toxins, our gut flora. These are the things that are influencing our gene expression and turning them on or off turning up or down every single day, literally minute by minute. So we have tremendous capacity to change from being predetermined, which many of us think we are, to being predestined to get something, to actually being able to actually change that and actually not have to get those conditions. We talk about trophic factors in the brain. What are the things that help it grow and develop and function and connect and to be honest with you, the most important is food and contained in the food are nutrients. And some of us have large variations in our needs. Some of us need a lot, some of us need a little, but there are a few basic nutrients that are really critical for brain health. One of them is omega-3 fats. These are the fish fats that help form much of your brain structure and help it function properly and help prevent Alzheimer's and ADD and autism, and even depression. And then there are other nutrients we need, the B vitamins. We call these methylating nutrients, B6, B12, folate, critical for the brain. And without them, you end up with increased risk of dementia, increased risk of autism, ADD, and depression. So easy to get, the complex of B vitamins. And then we need vitamin D. Vitamin D is a critical brain nutrient and has been linked to improvement in cognitive function, and delay in many chronic brain disorders. So those are really critical. You add in that a multivitamin and you pretty much have everything you need. If you're interested, you can add in probiotics which help your gut flora and lots of fiber which also acts to fertilize the gut flora and help your gut function and of course your brain function. So those are foundational nutrients that I recommend everybody take who's worried about their brain. You know, we have Facebook, we have social networks, but There's never been a time in human history where we're more disconnected from one another in the human contact. It's actually face to face, not Facebook. And that makes a huge difference in the functioning of our brain. We know, for example, that there's an emerging field called sociogenomics, where your genes are changed when you're in relationship with someone. If there's a hostile interaction, disease genes are turned on. When you're in a loving, happy interaction, health genes are turned on, immune system benefiting genes are turned on, inflammation is turned down. So we know in a very real way, scientifically, how this works. And when we have an epidemic of disconnection, it's creating more disease. When we have strategies for connecting, whether it's in faith-based groups, whether it's in social groups, whether it's friends, whether it's parties, whatever it is that you can do to bring real connections with people, your health will dramatically improve. We learn through play. That's how we learn. That's how our brain develops. And it's important at every age to encourage the development of play in your system, whether it's playing a game like bridge or checkers or chess, whether it's learning to play tennis, whether it's learning to actually have other things that you enjoy that challenge you, that you learn from, it's going to help your brain actually become more dense in terms of its connections and also help bring about the development of new brain cells. The first thing you can do to optimize your brain function, a simple take home, is change your diet. Get rid of the processed foods, get rid of the starch and sugar, increase whole foods, plant-based foods, and increase healthy fats. Omega-3 fats, avocados, nuts and seeds, healthy grass-fed animal protein, healthy grass-fed butter, coconut oil, all these things will help dramatically improve your brain function almost overnight. And then exercise is the other powerful thing. We know it benefits all sorts of brain disorders from preventing Alzheimer's or depression and of course much more. And then lastly, I would say sleep. Most of us underestimate the power of sleep and the reason it's important is that we've discovered a brand new system in the brain called the glymphatic system. It's not lymphatic, it's the brain's version of it, which is these glial cells which detoxify your brain every night. And if you don't clean out your brain every night and reset it, it will start to accumulate waste and end up causing damage to your brain.

So getting adequate sleep is critical. By the time somebody walks into my office with memory loss, they've had disease changes in their brains for two decades.

And we understand that biologically now, so.

You'Re seeing now a and you can.

See that on imaging scans.

We can see that on whole imaging scans. So we're now seeing now a big push to move the calculus beyond the time of symptoms to much earlier and try to find people and identify people at risk. Along the way, but most of that research has been focused on drug interventions to prevent, delay or forestall the onset of symptoms. Along the way, of course, if I'm in my 70s and I know my disease started in my 50s or 40s, we can change beyond drugs. We can change to say lifestyle interventions have benefits and there's now a whole new area of research. Exercise has really emerged as one of the areas that has grown with real biological evidence that it can prevent and improve brain function and brain health. And beyond that, we see now people are looking at things like diet and supplements and other ways to manage the disease. And so I think this is an area that's just relatively new, but very exciting.

Yeah, I mean, there was a recent study called the Finger Study.

The Finger Study is one of the ones we're going to talk about. Which I talk about in the book.

Yeah, I know. And this study was done in Europe, and it was a very large study where they did an intervention with diet and exercise and stress and stress and stress.

And cognitive stress.

Yeah, addressing cardiovascular risk factors. And tell us about the study. What do they find?

Yeah, so this study is done at the Karolinska Institute. The geriatrician, her name is Mia Kivipelto, a really, really sharp, very thoughtful physician scientist. And she said, we're going to create a multimodal intervention, including diet changes, managing health conditions, improving exercise, improving all their parameters. And one group was randomized to the intervention, and one group was randomized to just kind of passive intervention. And in an objective way, followed for over two years, with aggressive intervention, the treated group did much, much better over the two years. Not only did they not get a decline, they actually got better.

Wow.

And so, and these are people not young. They were starting in their late 60s into their 70s. So these aren't people in the middle of their life. They're kind of in the senior, running into the senior age, and they actually got better. And this has been published in the journal Lancet.

So it's a very respected, you know, peer-reviewed scientific journal. Well, this is really remarkable. I just want to pause here because what you just said is pretty radical. Now, like I said, we spent billions of dollars on hundreds of studies, and none of them show this. We can't slow or reverse it. Now you're saying just by eating better, exercising, optimizing your health, we literally can slow and even start to reverse the disease.

That is correct. In fact, the US is taking the finger study and in 2019-2020 there will be the US version of it called the Pointer Study. Pointer Study, yeah. Which is being rolled out in about six sites in the United States this year.

And the government has to pay for it because there's no drug involved.

The government, well, this is to be very clear, the point of study so far as I know is being funded by the Alzheimer's Association. I don't know if there will be federal dollars behind it, but the fundamental issue is- But it's not a drug company. It is not a drug company. But the fundamental issue is we want to answer an important question. Do these things objectively work? The signal, the way the evidence suggests the answer is yes. And so having more evidence, because I have to tell you, you and I are both physicians. Part of our day job is taking care of people with disease.

Right.

So here we are saying, let's step back from that. Let's say instead of treating disease, let's treat health.

Yeah. Did you take the course in medical school called Creating Health?

I did not. I did not take that course. We didn't learn that. We did not. But the advantage of that is that it's not prescriptive, then you can give health recommendations that come out from consensus panels and then it can have effect change at a larger level. This is actually easier to roll out if we can prove there's a signal than it is by just writing a prescription.

It's unbelievable. Yeah, I think, you know, what you said is really remarkable that we need to focus on how do we create health rather than just treat disease or symptoms or pathways or some pathology. And that's essentially what functional medicine is. It's asking the question, how do you create a healthy human being? What are the factors that knock you off that path? And what are the things that actually help create health? And those studies, the finger study and the pointer study, are looking at those factors. And there are more, right?

There are more. And I think that's the exciting thing is that I think, you know, I have to tell you, I've been involved in all these clinical trials. Every time there's a failure, it breaks everybody's heart. Yeah. There is no, there is no ego involved. It's not like haha, I told you so. Because I will say to you whether the drugs work or not, I'm going to clinic tomorrow or the next day, and I still got to look at these people in the eye and say, you know, something good is coming, we just kind of hope that it's coming soon. And so I say this to you because if I can see a path forward, whether it's a drug, a device, a lifestyle intervention, any way forward to help my patients either prevent, postpone or delay.

Well, let's talk about the disease a little more in a medical way, because the understanding was, from my training, was that the brain seemed to be disconnected from the rest of the body. We learned about this barrier called the blood-brain barrier, where nothing except some nutrients got in.

That's correct.

It was like this thing, disconnected our head from the rest of us. Turns out that our body is one system and then our brains are connected to everything else that's happening in our gut microbiome, in infections, what we eat, everything is actually influencing our brain function. So can you share a little bit about how this understanding has changed the way we think about the brain and how some of these factors that are driving inflammation are actually causing this disease? Because it's a disease of brain inflammation.

It is. So the conventional wisdom that we're trying to look at is that Inflammation is a response to an injury, or is it the injury itself? At the end of the day, a lot of people think that there's an amyloid triggered event and then the inflammatory events occur because of the production of the amyloid.

And amyloid is this sticky gooey stuff that gums up your brain.

That is correct. And importantly, but we used to think, as you said, there was north of the neck and south of the neck, right? And that everything in the Alzheimer's was north of the neck and nothing south of the neck was related to it. When in fact now we know that things like gut microbiome can alter your immune system and having a healthy microbiome can keep you healthy and by the innate and you can boost your innate immunity which might reduce inflammation across the body including the brain.

Yeah, and exercise helps reduce inflammation?

And BDNF. So the exercise, I have to tell you, I hated running.

Oh no.

But I've taken up running. because of BDNF. So what is that? That's brain-derived neurotrophic factor. It's like miracle growth for the brain. Miracle growth for the brain. And the funny part about it is almost neuroscientists are runners. They don't do anything but run. They have to have something to it. It's the fastest way to raise your BDNF levels.

Which is basically this growth factor that connects your brain cells together. So it calls neuroplasticity, which increases connections, and helps neurogenesis, which is the development of new brain cells. That is correct.

So we never thought that was possible. We never thought it was possible. it was possible. They said once you're born with your neurons, you're gonna get it. But we now know that the brain.

Is making neurons throughout their life. Yeah, I mean, I read a study where they studied terminal cancer patients and they gave them this dye that only goes to dividing brain cells.

And they found even at the point of death, they're making new brain cells. That's correct. We did a, when I was in Sun City, Arizona at the Banner Sun Health Research Institute, we had a brain and body donation program and we had scientists that could take brains of patients who just expired and culture out, bring out the stem cells that were still left alive in dead brain.

That's unbelievable.

That's pretty cool stuff.

So these things like diet and exercise and optimizing your gut microbiome and stress reduction, they all in a sense work by regulating this inflammatory process.

That's correct. That is correct. The inflammation, of course, is the unifying common pathway that we can manage. and you know, at the end of the day, that's what we want to do as well.

The studies taking Advil never really worked.

They tried it. Well, COX inhibitors have not worked. So then the questions are scientifically, is it that pathway of inflammation? People are now looking at different pathways of inflammation. Now looking at TNF-alpha, which is tumor necrosis alpha, they're looking at the fact that TNF-alpha might trigger enzymes related to Alzheimer's called base. So we think that there's a link that inflammation is not just a broad category, but there are specific segments that seem to work and others that we've tried, like you said. We tried anti-inflammatories for years to treat or prevent Alzheimer's. It didn't work worth the darn. Right.

Well, that sort of goes back to the thinking in functional medicine, which is what's causing it in the first place. So if you're standing on a tack, it takes a lot of aspirin to make it feel better to pull the tack out. So it's not necessarily the best logic, but it's it's something that we have to sort of begin to wonder about. I'm talking to one of your colleagues, Rudy Tanzi from Harvard, who said to me that they've done studies of patients who had brains full of this amyloid, but they had the gene somehow that didn't let them create inflammation and they weren't cognitively intact.

They didn't have dementia. Right, and that's the amazing thing is that you can go to your grave with a brain full of amyloid and not develop dementia. And we wanna study those people 'cause there's something that's protecting them against the development of symptoms. and of course they may have just less inflammation as you commented. Rudy Tanzi would be the guy to figure that out.

Yeah, and he talked about the microbiome of the brain. I don't think they're still trying to figure it out, but they're finding microbes in the brain. We thought it was sterile up there, but turns out it may not be.

It may not be. There's a new one that you probably have just hearing about. There's a company out of the Bay Area that found there's oral bacteria called P. Gingivalis, which creates a protein called gingipain, which may be a neurotoxin and neuro trigger of neuroinflammation. And so, they're looking at a drugs to stop that. Maybe brushing your teeth, flossing, getting them.

Clean is a good idea. Not just good for the heart, it's good for the brain as well. That's right.

I mean, people probably know that, but.

One of the biggest triggers for heart disease is gum disease, right? That's correct. So, let's talk about the genetics here for a minute. So, most people think you get your genes, they're fixed. your fate is sealed. There's nothing you can do. It's not actually how genes work. You can modify these genes expression, which ones get turned on and off and how they work. I remember having this patient years ago, who was a 90-year-old woman. She was a dentist. She had APOE double four, meaning she had two of the worst genes you could have that are triggers or maybe predisposing to Alzheimer's. And she was 90 years old. She was still working and she was completely cognitively intact. and she was a health nut her whole life. She ate a perfect diet, she exercised, she never smoked, she never drank, she took her vitamins. I mean, it was remarkable to see that.

That's impressive.

And this is what you talk about in this book with this woman, Jamie, she came to you because she had a family history of Alzheimer's and you checked her genes and she had that dreaded APOE4 gene, which many people are afraid to test because they feel like it's just a, why bother? So you talked about why bother. Tell us why bother. So.

I'll answer the why bother second, but Jamie is like your dentist patient. She's a 4-4. She found, her story of course, she found out her genetic risk by accident. Now you and I know that if you are two copies of the APOA4 gene, your lifetime risk is 91% that you're going to develop it. It's almost a matter of when, not if. And the problem is that fortunately there's only 2% of the population that are double copy, 20% of the population is a single copy of the APOE4. But people are now finding out because there's commercial genetic testing by accident.

23 and me.

23 and me, right? And then they go to Dr. Google. It's me and my friend Dr. Google. And they're like, well, what does this mean? And they go and they... so the Jamie's of the world are finding out day in and day out by accident, and they're trying to figure out what does this all mean? So the story is, on her half, how she found out by accident and how it affected her. My half of the book is, is it a good idea to be tested? What are the consequences of being tested? What does it mean? And so that's what my half of the book is. It's a nice convergence of two storylines that help people to become informed because this is happening every day of the week.

It's happening anyway. But what your book, Fighting for My Life, suggests is that by knowing that it can motivate people to take control of their life and their lifestyle and address the modifiable risk factors.

That is exactly right. And I want everybody who reads the book to be like your dentist patient, right?

Yeah, she was.

I have to say to you, I had one other.

Not sure I would go to her at 90 years old to clean my.

Teeth, but... Sure, but... She got to 90. She was, right?

Yeah. And working, still working.

And I've seen only one other elderly person get to late 80s, 90s, a 44 who was unaffected. in my career, I've always said that if you have that genetic profile, it's almost a foregone conclusion you're going to get Alzheimer's dementia eventually, but there was one exception to that. So we want everybody to be the.

Exception, not the rule. Now, one of the things we haven't really talked about yet is the role of sugar in the brain. And many people may remember Ronald Reagan's favorite food was jelly beans. And he got Alzheimer's. Now, maybe there's a correlation, but it turns out that diabetics have four times the risk of getting dementia. That is correct. we sometimes talk about Alzheimer's as type 3 diabetes.

Yes, this is Susan Delamonte from the University of Rhode Island.

Brown, yeah. Yeah, Brown, yes. And the truth is that we all have control over whether or not we get diabetes. This is almost 100% preventable and reversible.

Disease by changing our diet. Right. And do you know that insulin resistance, of course, is the hallmark of type 2 diabetes and that we can see insulin resistance in the brain and that's what the type 3 diabetes, even if you're not having insulin resistance in the rest of your body, and we think that of course, and I strongly believe like you that that's a modifiable risk factor. We can alter that. We can alter it, of course, the epigenome, which we're going to talk about, I hope we're going to talk about epigenetics, but the diet and reducing the sugar intake and the diabetes risk is something we can alter and have a positive effect on.

So we all learned, I mean, I learned in medical school that your brain uses 25% of your glucose and it needs sugar to run.

Yes, it does. And the PET scans show that you need sugar to make your brain light up. So the rule of thumb on a PET scan is you want your south of the neck, you want to be dark. North of the neck, you want to.

Be bright on sugar PET.

Because if it's dark below, you got cancer. If it's bright below, you got cancer. If it's dark, that's why you put it. But in the brain, you want it to be nice and bright.

You want that brain to light up because it can consume much of the sugar metabolism is in the brain. But you also say in your book, in patients who have Alzheimer's that people are exploring the role of ketogenic diets, which means no sugar and lots of fat and the brain running on ketones instead of glucose.

And the issue that people are trying to decide is can you bypass insulin pathway mechanism? So if you're relying on insulin and pathways related to insulin to nourish your brain and you have insulin resistance, either you can pharmacologically improve that or you can dietarily improve that.

Yeah, I mean, you know, I remember this patient I had at the Ultra Wellness Center, my practice in Lenox, and she came in to about 78 and she started having what we call MCI or mild cognitive impairment, and she had a whole bunch of things wrong with her. Fibromyalgia was bad. She had gut issues. She had low vitamin B12. She had heavy metals and mercury, but she was able to fix a lot of these things and do a lot better for many years. And then she started to decline, and I'm like, well, let's try a ketogenic diet. and we got someone to work with her and cook for her. And it was like the lights went on again. It was pretty dramatic. And I think there are some preliminary studies that are showing that.

And people have been looking at, so the ketogenic diet all starts with the whole coconut oil conversation, which is coconut oil is controversial by itself. But the story behind ketogenic diets is that we do understand there's insulin resistance. NIH actually funded a study looking at the ketogenic diets. So I think the science is there. It's just a matter of being able to prove it and more importantly to adhere to it. Ketogenic diets, not easy. Not easy. It's not new to neurology. We've been using ketogenic diet to treat childhood epilepsy for 30 plus years. So it's new to Alzheimer's but it's not new to brain disease. It's been used to treat other brain diseases for a long, long time. But fundamentally it's really hard to diet to stick to.

Yeah, we're finding more and more people are doing it. It's one of the hottest diet trends out there. If you look at all the best-selling books, it's not mine, it's the keto books. And we're seeing much more interest and we're running keto programs at Cleveland Clinic. They're our most popular programs, which is pretty amazing.

So, people seem to be willing to try it. I know you had Dan Pompa on a few weeks ago and Dan and I have- David Pompa. David Pompa. He and I have had an internet debate about this. And I will say to you that I think it's more nuanced. I think that ketogenic diets that are insulin sparing make more sense in the symptomatic phase of the disease. And I have to tell you, I look at Alzheimer's disease in a dichotomous way. There's the pre-symptomatic and then there's the symptomatic. Symptomatic disease means mild cognitive impairment and dementia. and I think there is some logic to a ketogenic diet in the dementia phase.

I agree. I think, you know, an ounce of prevention is worth a pound of cure as Benjamin Franklin said.

Correct. I think, you know, the ketogenic diet is a pound of cure. It's a pound of cure, but I would not necessarily advocate for it in the mild, in the pre-symptomatic phase.

I'm more advocating for the Mediterranean diet in the pre-symptomatic phase. And that's the beauty of your book, is you talk about how to create resilience and health. So you don't need the pound of cure.

Correct.

Because the hope for life isn't to be restricted and restricted, it's to actually be more resilient, healthy. So you actually are resistant to these diseases.

That's correct.

Right. So it's actually exactly the right idea. If you love that last video, you're gonna love the next one. Check it out here. So when you look at brain inflammation, it's really susceptible to any, anything that triggers an inflammatory response, whether it's chemical exposure. food reactions, and inflammatory disease, blood sugar elevations like diabetes, all those things tend to turn on the inflammatory.