Groundbreaking Approach To Preventing Alzheimer’s Disease | Jim Kwik & Dr. David Perlmutter

Welcome back, Kwik Brain. Today we're going to talk about treatment and/or prevention of something that's really near and dear to my heart and my mind and so many of you, which is Alzheimer's. And we're delighted to have on this show Dr. David Perlmutter, MD, board-certified neurologist, 5-time New York Times bestseller, author of a brand new book called Drop Acid. Welcome to the show, Dr. Perlmutter.

Well, Jim, I am so happy to be with you today.

Thank you so much. Now, we had a conversation previously about uric acid and the contributions, how to be able to mitigate that and the effects on its brain. I wanted to go a little bit into Alzheimer's. As you know, I lost my grandmother when I was going through my traumatic brain injury and my learning difficulties starting at age 5. from my accident, my primary caregiver was my grandmother 'cause my parents were working lots of jobs. And I saw her between age 5, 6, and 7, you know, do call me by my father's name, say something she just said, you know, and at that age that I was, it was very impressionable. So really what took me on this path was my inspiration was my desperation, you know, 'cause I just didn't understand. And so, you know, I wanted to have this question, this conversation with you to our readers, and I encourage everyone to get your book new book, you know, is when we're talking about treatment and prevention, are we— should it be the smoke or the fire? And I've heard this metaphor also that Alzheimer's, and I don't know if this is accurate, maybe you comment on it, is it like genetics loads the gun and it's our lifestyle or environment that pulls the trigger? So, you know, how do you approach this? You've written so many books, you know, on the power of brain health.

Well, what I'm about to tell you, I think, will be ultimately looked upon by your viewers as a really important source of empowerment. And, you know, as it relates to the whole genetic question with respect to Alzheimer's, I think that the— that genetics probably plays, you know, the typical answer is about 5%. But I'm going to tell you that it's 100%. And I'm going to need to explain that our genetics is such that we are deeply genetically programmed for survival. And as part of that genetic programming, our bodies are very thrifty, meaning that we make the very most out of the foods that we get, the water that we get, etc. Because until only quite recently, we never knew if we'd have enough food. Our bodies didn't know, nor nor water. And so over tens of thousands, hundreds of thousands of years, our genome has been shaped to allow us to survive during, let's say, food scarcity, meaning that we have mechanisms in place that will help us make more body fat, store more body fat, and actually ramp up inflammation because in the day, inflammation was a very powerful protective mechanism, allowing us to have the ability to heal from bacterial infections and trauma, you name it. The problem is that today we're seeing an incredible mismatch between the environment of our ancestors and these mechanisms to the extent that now we eat all the time, we're eating higher amounts of fructose, which becomes uric acid, which amplifies inflammation even further. So these mechanisms that were protective over us are now being exploited by our environment and paving the way for degeneration of the human brain. And the entire rest of the body as well. But let's stay cerebrocentric for just a moment based on your question. And in that regard, this mismatch then between our current environment, meaning the foods we eat, the sleep we get or not, our exercise, our time out of doors, our socialization, there's this incredible mismatch with respect to those variables and this very thrifty inflammatory genome, such that the outcome is one that's paving the way for the brain now to degenerate. And it's very unfortunate that so much effort is directed towards finding the cure for Alzheimer's disease. And we all saw what happened in 2021 with the launch of yet another drug that's targeting this protein, beta amyloid, the Aduhelm Fiasco. We all saw what happens when we just take this monotherapy approach. Monotherapy is predicated on there being one cause, one cause, one effect. It's like Newtonian physics. Well, that's not exactly what's going on as it underlies Alzheimer's. There's plenty of data that indicates that Alzheimer's is an inflammatory issue, and this increased inflammation in the brain is what is causing the beta amyloid to accumulate as a response element. So having said that, I would be thrilled if there were a cure, a medication that we could administer that would help Alzheimer's patients. It does not exist. I would— I think the billions of dollars spent on the research is wonderful. I mean, if there were a medicine, I would have used it with my own father who passed away from Alzheimer's. Before my very eyes as a neurologist. How ironic is that? I would have used it, but it doesn't exist. Therefore, the, you know, the 4th century— in the 4th century BC, the Yellow Emperor stated that prevention is the ultimate principle of wisdom. To cure a disease after it has manifest is like digging a well when one feels thirsty or forging weapons When the war has already begun. So it's really all about keeping people healthy metabolically, and that creates the environment for the brain to be happy and resistant to the degeneration that characterizes this disease that we call Alzheimer's— senile dementia of the Alzheimer's type. People are demented, by and large it's Alzheimer's, the most common cause of dementia. There are other causes that, you know, we could probably talk about, but this Alzheimer's that, you know, now affects 6 million Americans, with that number going to triple by the year 2050, is devastating. You know, we're talking about right now in our world pandemics, and, you know, this isn't talked about. This is a huge pandemic. If you live to be age 85 right now in America, your risk of having Alzheimer's is 50/50. And that is the most rapidly expanding part of our population right now, that age group. So, you know, our mission, as I choose to accept it, is to look at the underlying mechanisms that are the fire, as you've characterized, that are causing these problems. And yeah, do our best to put the fire out, but even more importantly, keep that fire from lighting itself in the first place. You know, putting in the smoke alarms, making sure the wiring is good like a person would in building a house, making sure that we do everything we can to reduce the risk of that fire from happening in the first place. And think about it, the word inflammation comes from the Latin inflammare, inflame, meaning flame, catch on fire. So in a very real sense, you know, this is more than metaphorical, this is literal.

the smoke or the symptoms or actually addressing the fire itself.

That's right.

And preventing that and managing the fire. And I also wanna just commend you and thank you for bringing these issues to light. Lots of times when people see, I always point to my brain or there's a brain on the screen or a brain on my shirt, it's really because what we see, we take care of. We see our car, we see our skin, our hair, our clothing, but we don't see the thing that's like the most important thing, which is It's the human brain. And so, so thank you for bringing it up.

It's true. And we're not aware of inflammation in the brain. I mean, if you get bitten by a mosquito, it becomes inflamed. Why? Because it becomes red, it becomes swollen, it becomes painful, uh, you, and you lose function. These are cardinal features of inflammation. Um, and, but yet the brain, you're not going to feel the pain, you're not going to notice that it's swollen. You're not going to see the redness appear, and so you don't know that your brain's inflamed. And you know, so many factors lead into that inflammation, like elevation of the uric acid, like we talk about in drop acid. That's for sure. Elevation of blood sugar, elevation of blood pressure—these things all trigger inflammation. Having an elevated BMI is a trigger of inflammation. You know, I've often said that. And people say, well, how do I measure my inflammation? Should I get my C-reactive protein, tumor necrosis factor alpha, interleukin-1-6? What is it? And I say, well, the easiest tool you have to measure inflammation in your body is called a tape measure. And what you do with that is you put it around your waist and it gives you a number. And based upon that number, we can determine— it's a surrogate— we can determine what are the chances that you have upregulated inflammation in your body. Setting the stage for coronary artery disease, diabetes, and even Alzheimer's. We have to rein in this cytokine drizzle. Now that people are aware of this term cytokines, you know what that's all about. It's not that inflammation is all bad. I mean, inflammation helps us deal with infection. It helps us deal with healing when we have trauma. But it's this unbridled or persistent elevation You know, the Grand Canyon wasn't created in a day. It was just this slow wearing down by the Colorado River of the land that ultimately forms the Grand Canyon over millions of years. Well, it's, you know, it's a bit of a stretch, but it's the same thing that happens in the brain. This chronic elevation of inflammation ultimately leads to dysfunction of the brain, from multiple perspectives. Interesting study was published a few years back, and the study looked at a group of individuals who were in their 30s and 40s and measured various blood markers of inflammation and created an inflammation composite score. It then looked at these people 28 years later, And found that those people who 28 years prior had the highest level of inflammation markers had a dramatic increased risk of now having cognitive dysfunction or being fully demented based on what it was 28 years ago. The best time to plant the tree, right? And so it really, I think, solidifies this notion that we've got to pay attention to these factors a lot earlier than when people start to forget their grandchildren's names or the Wi-Fi code. By then, you know, we're already in trouble. And yeah, there's things that can be done at that point that can help slow down the decline, but we don't want to get to that place even in the first place. Well, let me make it a little bit more personal if I can.

Yeah, please.

And, you know, in our time together prior to the interview, you had mentioned what it was like to go through watching your grandmother with Alzheimer's.

Yes.

Uh, similarly, um, I was with my dad when he passed, passed from Alzheimer's. A brilliant brain surgeon. I watched what it did to him. Uh, you know, my primary focus in life is brain health, uh, and functionality. And when I quote the statistics of an overall 80% increased risk of dementia and specifically a 55% increased risk of Alzheimer's, I want people to, to think about those statistics in light of the— or at least through the lens of the notion that that's a situation for which we have no treatment whatsoever. That's, that's very difficult to deal with in our modern world where there are— we are given the promise of, you know, live your life however you choose, and when you've got a problem, we can fix it.

Right.

Um, it's not really true. I mean, for example, You watch television, you see these ads left, right, and center for controlling your diabetes with this or that drug. I got my A1C below 7, I'm happy. Well, the reality is those drugs are not treating diabetes at all. It gets back to something I mentioned earlier, my frustration about being a mainstream neurologist early on in my career, because those drugs treat the smoke, they do not treat the fire. They do lower blood sugar and A1C, But the diabetes hasn't been treated, so these are not treatments for diabetes. It's not a treatment for high blood pressure. It's not a a way of of keeping your brain healthy when people tell you you should be taking this or that drug. That's what this is all about. This is targeting a healthy metabolism, which will help you know that you've reduced your risk for diabetes, cardiovascular disease, dementia. Various forms of cancer, and all four things I just mentioned, and so many more, are issues for which you know our bag of tricks is not very full. We don't really have aggressive treatments for reversing or certainly curing those problems. So it's all about prevention. It's all about reining in your metabolic health right now today, and keeping yourself healthy such that when you get older. Your risk of these situations is dramatically improved. You know, as it relates to Alzheimer's, the stage begins to be set for that outcome in our 30s, and even in our 20s, and even during our adolescence. We begin to sow the seeds that will either bode well for the brain and its functionality or not. That's the mission here. The mission is to add a very important tool To that metabolic toolbox, recognizing that you know this is the seat of the issues that are then, as I mentioned earlier, the number one cause of death on our planet—not an infectious viral agent, not in any way, shape, or form. What is killing people worldwide are these chronic metabolic degenerative conditions. And you know when we take a step back and ask. Well, what keeps the brain even moment to moment from functioning as well as it should? Another study out of Japan showed that people with highest levels of uric acid have a fourfold increased risk of having right now memory issues on standardized testing, a dramatic increased risk for actually falling into the pre-dementia category, again, on standardized neuropsychological testing. So that you're— the promise then, uh, to get back to the original phrasing of your question, is this level of confidence that you are now doing as much as you possibly can. And, you know, I get that every, every year we're layering on something else. You know, now we have to, uh, think about wearing a continuous glucose monitor and, you know, looking at our sleep, wearing a ring or an Apple Watch, whatever it may be. Uh, and yeah, that's why people watch, uh, pay attention to you, uh, Jim Kwik, because you're giving them this information. They're not tuning in here because they don't want to know this stuff. They're turning— tuning in because they want it and they want it desperately. And I think it's really quite clear that we have to take the reins of control as it relates to our health, both physical and mental and cognitive, uh, and be our own advocates. And That's what this information is about. It's about empowering, uh, to be your own advocate.

Yeah, our audience definitely doesn't bury their head in the sand. They want to look at their data so they can make intelligent choices for themselves and also, also their families. Dr. Perlmutter, how do people get your new book, uh, Drop Acid? Where, where can people best go to stay connected with you also as well?

It's everywhere. The URL for the book is dropacidbook.com. That should be pretty straightforward.

Drop Acid Book. And I encourage everybody here not only to go and get the book at your favorite retailer or local store, but take a screenshot of this and make sure you follow Dr. Perlmutter, tag him, tag myself on it so we get to see it. And tell us that you're up to this challenge. You know, what's one simple step that you're gonna take because of this conversation? Maybe it could be, you know, getting the book. Maybe it's adding some avocado and some olive oil into your diet. Maybe it's the time-restricted eating. Maybe it's something. This episode was such full of— chock-full of instruction and usable practices. Share that. I will repost because you're going to tag us in it, some of my favorites. As always, in the show notes, jimkwik.com/notes, we'll put all the links and the highlights of this episode as well. And make sure you get this book. Because it is that important. You mentioned the power of prevention, that when's the best time to plant a tree? It was 20 years ago. When's the second best time? It's today. And so get started. Don't leave this conversation without taking some kind of small, simple action so you can take that knowledge and turn it into real power. Dr. Perlmutter, thank you so much for being on our show.

Thank you, Seth. I really appreciate it. You know, truthfully, I did have the opportunity to watch a couple of videos about your work before our time together today to get to know you a little bit, and it's phenomenal. And, you know, I'm working on this from, from one end, and you are bringing incredible tools to bear for people on the other end in terms of, you know, performance. And I think it's terrific.

You know, I always tell people, our listeners, they know this, but it's, you know, there's 2 parts. And metaphorically, it could be like the hardware and the software. We teach more of the software— how to remember names, how to learn languages, how to focus, how to read faster, understand what you read, make good decisions, be more creative, innovate. But if you don't take care of the hardware, if that's full of the uric acid and the inflammation, everything, then if you're not getting sleep, if you're not doing these things to take care of that, then you're not going to get the kind of results that you really desire and that you really deserve. So thank you for—

So true. Thank you.

Thank you for your work. Hi, Kwik Brain. It's your brain coach. I want to thank you so much for watching this video. 3 things to do. Number one, make sure you share this because when you teach something, you get to learn it twice. Update your learning so you can update other people's learning as well. Number two, make sure you subscribe to this channel so you don't miss a thing because if you miss a video, you miss a lot. And finally, make sure you hit that bell so you're notified and you find out when we put out the latest and the greatest. One extra thing, if you want really close attention, then text me. Here is my phone number.

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