1091 Optimize Your Brain Health & How to Prevent Alzheimer's w/Dr. Lisa Mosconi

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It's a really good question. And yes, I can definitely speak to women's brains and how they are and they're not different from men's brains. I think everybody has their own opinions on how women brains are different from men's brains. And there's certainly, I get asked a lot of Mars and Venus type questions and Barbie and Lego. And that's not my field of expertise, honestly.

You're not a love expert. Yeah, yeah.

No, no, I'm not a psychologist or a sociologist, but my background is in biology. neurology. They are like neuroscience, biology, neurophysiology. So we look at actual real row differences between the female brain and the male brain. And I think that the differences are not anatomical in a way. It's not like men's brains are lacking some parts that women's brains have, right? Or the other way around. The differences are more functional. And they're quite evident from the very moment of conception. And this is because we have different DNAs in part, right? Women have two X chromosomes and men have an X and a Y chromosome. And that matters even though they're not such huge differences, but the X chromosome has almost a thousand genes more than the Y chromosome. So from the moment we're born, women have almost a thousand genes more the men, many of which are really important for brain function, not just for reproduction, but also for brain function.

So what does that mean? What does that mean? So women have a thousand genes more than men. What does that mean? When they mean genes.

What genes are or what kind of function?

Yeah. What does that mean? Does it mean that they need more? nutrients to burn calories? Does it mean they have more functionality of thinking and memory? Like what does that actually mean? Right.

How does that relate to something interesting? Right? Yeah. So, I think the point is that the products of those genes differ and hormonal production is an immediate derivative of your DNA. So, from the very moment they were born, starting with reading when the baby is developing before birth, our brains are becoming wired a little bit differently and that's really hormonally based. Women's brains produce more estrogen like estradiol and progesterone and boys' brains make more androgens like testosterone. These hormones are really, really important because They're not just involved in reproduction and having children, but they're really incredibly important for brain functionality. These hormones, you need to think about these hormones as having superpowers, not just in the body, but also in the brain. In that, so estrogen for context, so estradiol, which is the most important form of estrogen, is incredibly important for immunity. It really boosts the immune system in the body and the brain for plasticity, stimulates the formation of neurons and synapses in the brain. It gives you resilience if you're a brain cell. Also, most importantly, it's key for energy production in the brain. At the cellular level, estrogen literally pushes your neurons to burn glucose, sugar, which brings me to your next question, to make energy. Testosterone does the same thing in men's brains, in boys' brains. the difference, though, is that these hormones differ in their longevity in their lifespan. So testosterone and androgens in general decline fairly gradually over time, which is wonderful because so many men are still fertile in their 70s or 80s, which is. It's great.

And.

Yeah, yeah, yeah. That's true. Think Mick Jagger. He must be 80. He just have a kid. No. It's crazy. And this is actually not uncommon. This is fairly normal. And it's great. And that means that these testosterone, these androgens are also supporting your brain at the same time. But for women, estrogens literally decline very fast in midlife during menopause, which is something that impacts your body, your overall functionality of your body, and also your brain as well. And that dictates why women's brains need a different kind of care than men's brains. It's not super different, but there are some things, some nuances that I think is worth really focusing on because we have different needs and different strengths and different risks. And that really is important for health.

What are the male brains really need for brain health and optimization? and what are the women's brains need for optimization for their life?

So the research.

What are the, what are the same things they need? And when then what are the different things?

I think, well, I think there's a lot of research showing that things like a healthy diet, solid exercise routine, enough sleep, low stress, stress reduction, avoiding toxins, these are all things that work really well for both men and women. But then there are things within these categories that are more specifically helpful to men or to women. For example, diet. I think we're all aware the diet is incredibly important for health. And we all eat pretty much three times a day. I don't know if you are fasting or...

I do fasting, skipping breakfast.

Okay, so we all eat at least twice a day.

But in the past, I used to eat probably six times a day.

There you go. But I would say most people eat about three times a day, right?

Correct.

So every day we have at least three chances to make the right choice and feed their body and brain with the right nutrients. They're really supportive of health and healthy cellular functioning or not, and really damage our body and their brain at the same time. Now, within a healthy eating pattern, there is some evidence that women really benefit from plant-based diets, perhaps even more so than men do, which is not to say that men should not be eating plant-based or enough veggies and fruit. It's just that the research points to plant-based nutrients as being especially supportive of women's brain health, especially starting in midlife. And that's for a variety of reasons that I'd be happy to share if you'd like. Sure, I'd love to hear. Thank you. so there's a lot of research, including my own research, where we do brain scans and we specialize. Well, I specialize in women's brains because that's what I've been doing for 20 years, ever since I could. And I'm really passionate about it. And just recently I launched the women's brain initiative, a wild cornet medicine in New York City. I'm the founder.

Yeah.

And director, which means I have to find all the support, all the funding and whatnot. But it's totally worth it. And we're really trying to find to better understand how brain health plays out differently in women than in men. And the way we do that is by doing brain scans and then measuring a number of things, including behavior, cognitive performance, but also we do diet questionnaires, we do exercise questionnaires and assessments, we look at intellectual activity, we look at sleep, we look at stress, we measure a lot of parameters in plasma, We measure everything we can possibly measure without stressing our participants too much. But then it turns out that there's a super strong correlation between antioxidant intake and brain energy levels for women.

For women?

Yes, for women especially. Whereas for both women and men, consumption of polyunsaturated fatty acids seems to be incredibly important. So fat for men also because testosterone is a hormone that makes men really incredibly great at burning fat. Whereas estrogen is a carb loving hormone. So women are inherently better at burning carbohydrates than fat. We tend to accumulate the fat for sure. Hold on to it. Whereas the average woman is excellent. physiologically at burning cards. And that might dictate why some very high fat diets work really, really well for men and not always so well for women.

Right.

And the other way around, there are some men who are incredibly on vegan diets, for sure, and some men would really hate them and they need their meat. You know, I think diet is very personal, but on average, A lot of antioxidants are good for your brain, in part because the brain is the most metabolically active organ of the entire body. And it runs on glucose. A lot of people might disagree, but it is true. I mean, the brain is literally wired to run on glucose, and glucose metabolism creates free radicals and oxidative stress. So the only way that we have to reduce oxidation, which is damaging to the brain in the long term is to up our intake of antioxidants from the diet. And plants are the best way to do so.

If you could recommend five foods that are the most powerful antioxidant foods that we should be consuming on a consistent basis, what would you say are those main foods?

I'm going to start with coffee. I love coffee.

Cheers.

Yay. I get the first right.

Really coffee is.

Well, coffee, yes. So a double espresso is the beverage with the highest antioxidant power of all beverages in the game. Yes. Now you're just speaking like a true Italian.

So this is science. This is real science.

This is actual science. Yes. So what a number of scientists have done. is to rate all sorts of foods based on their ORAC number, which is a measure of antioxidant capacity. And a double espresso really comes up on top.

Okay.

Coffee, yeah.

That's the number one beverage.

It's really rich in antioxidants like polyphenols and hydroxycinnamic acids. For what that matters, they're really strong plant-based antioxidants that are very protective. and really support your health overall body and brain. The point is there's an inverted U-shape between caffeine intake and gains, if you will, where the optimum benefit for your brain is basically, basically one or two espressos a day at the most. This is like two, three cups of American coffee.

Coffee, yeah. Not water, watered down coffee.

Also, the roasting is a little bit different. And I hear that light roasting of the coffee beans is actually better because it really brings out the antioxidants in the best possible way. You get the most out of your coffee.

So if you're going to get a coffee, do the light roast coffee or a double shot of espresso.

There you go. Yes. But no more than that. There's literally, otherwise your gains go down.

So one, one cup of coffee or two shots of espresso.

Yeah, pretty much around there. Rather. Yeah. Not too much. Just don't overdo it. And also, caffeine is very, you know, it's very personal again. So people do very well with coffee. Some people do not. For women, it depends on, on your time of the month. Yeah.

So your estrogen, should you, should you not be drinking coffee?

Oh, it's not, it's about being aware of what you're doing. So when your estradiol levels are high, which is in the first half of your cycle, you respond to caffeine in a much more sensitive way, but your response in the second half of your month, of the month is actually blunted. So you may end up thinking, oh my goodness, this coffee is doing nothing for me and just drink ten cups. Whereas it's just that your body just won't respond.

Oh, so in the second half of the month, you should.

Yeah, because the estrogen is down and the progesterone is up.

So should you not be drinking coffee as a woman in the second half?

No, no, drink it. Just don't overdo it because you feel tired and you're like, this coffee is doing nothing for me. I'm gonna have to drink 10 cups. Ah, you know, so you want to. I think what makes sense is to. It's. You probably don't need that much at the beginning, the first half of the month, and then you might need a little bit more to get the same effect, but you don't want to overdo it because.

Too much.

Yeah.

So what are the other. What other foods would you say are high in antioxidants that both men and women should be eating?

Right. Berries. Everybody talks about berries.

I don't eat berries ever.

Yeah.

I never eat berries. I don't like them. They just don't. I like the taste of them.

None.

Never.

Oh, my goodness.

I don't eat berries. I don't eat fruit except for bananas and apples. And I eat lots of vegetables. I do eat lots of vegetables. but I'm sure I don't have a range of my diet of probably all these foods that you're going to be talking about that are beneficial. So what can we do if we don't eat berries? What supplements or other foods should we be eating to support us?

Well, so orange juice. You know, something that is really helpful is lemon. Lemon juice.

Really?

Yes. And this is interesting. So as a scientist, I'm always, I'm a little sensitive about fads or trends. I'm always a little bit skeptical. But water with lemon first thing in the morning, that's actually scientifically proven to make sense.

What does it do for the body?

I'll tell you why. Yes. So, you know how people say if you drink hot water with lemon first thing in the morning, it kick starts your digestion?

Yes, yes.

It's a really nice way to say that it really supports elimination because Citric acid from lemon is one of the best laxatives on earth. That's true. It makes you go to the bathroom. It's a thing. And hot water is, so hot water is a vasodilator, whereas cold water is a vasoconstrictor.

Vaso?

Vasodilator. It makes your veins pop, whereas cold water makes your veins collapse.

What do we want? We want them to pop, I'm assuming.

You want your beans to pop.

So should we not be drinking cold water or cold drinks?

Yeah. Well, it depends on what you're trying to do. I think you want to drink cold water to cool down, but it would be better throughout the day to drink water at room temperature. Or in the morning, you want it to be warm because you're dehydrated from the nighttime that you haven't been drinking. and you want your body to really absorb the electrolytes that in the water and the citric acid from the lemon. Also because your whole muscles are relaxing because you're drinking hot water and that also supports a healthy elimination. So it is true that hot water with lemon makes you go.

Wow. Does it so lukewarm or room temperature or warm water, does it hydrate you more than a cold water?

That'S right.

It hydrates you more.

It hydrates you more. So pregnant breastfeeding women and pregnant women would benefit from drinking a lot of warm water or hot water because it really helps keeping hydrated. No, it's really important. So we do brain scan. I do brain scans. That's my background. And I strongly recommend to all our patients to drink a cup of want water, hot water right before we put the IV in or right before the blood draw, because it really helps your veins pop up. And that is so much, so much easier to get the line in. And that's, that's an immediate sign of rehydration. And the problem in the United States is that so many people are chronically dehydrated, not in a clinical way that you end up at the hospital, but it's mild dehydration, which is a real problem, and it can really impact your brain. So even two to four percent water loss, which is nothing, can cause neurological symptoms of dehydration from brain fog, which is something that everybody suffers from. Right? Brain fog is one of the reasons that most people come to work with us because they feel foggy brained and they're trying to find solutions. They're like, here a glass of water. Let's start with that.

So brain fog, meaning forgetting things, not having a clear memory, not Sure what they want to say.

Yeah, yeah. Like just feeling like your brain is not following.

It's not clean.

Yes.

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So just drinking 10 glasses of water a day isn't enough to be honest.

Because purified is not helpful. It gives you pressure. Like it, yeah, your blood pressure goes up. but you're not hydrated. You need to have electrolytes in the way. Yeah.

So how do you. I mean, how do you get electrolytes in the. How do you add, like, what if you don't have packets of electrolytes to add in there? How are you supposed to hydrate if you don't have access to that?

How about drinking water? Real water instead of purified.

How do you get real water? Tap water.

I wouldn't. Well, it depends where you are in New York.

Yeah, I've heard that top water is got so many. Chemicals and unfiltered.

It depends. But the city filters it. So, okay, this is what I learned because I care about water so much. And also just saying, spring water doesn't cost any more than purified water. So if you're buying purified water, you may as well buy spring water.

Spring water is better.

Yes, well, it contains the electrolyte. Okay. But what I learned is that you can call the city and they can come to your house and do an inspection. Yeah, yeah, yeah. And they give you a very decent report letting you know what kind of water you get from the species in the condition of your own pipes in the house. And then you get a full report and you can buy a filter that really addresses your own specific needs of your house.

Oh, wow. So you can put a filter on your tap water.

Yeah.

Make sure that it's what you need and drink the tap.

Yeah. And sometimes you just need a very simple filter. Sometimes you may need a much more powerful one. It depends on where you live. I mean, in Los Angeles, I think you, you, you're probably gonna get away with it.

Yeah, I think you, I think people are just so afraid of tap water because they hear these stories of, oh, all these chemicals or all this, you know, feces matter or whatever it is.

Or like, microplastic. Yeah. Yeah.

All the Plastics are in there, but it makes sense to say, okay, well, why don't you test it? Have someone from the city come and test it and make sure that it is. safe. They can give you a full report, I'm assuming, based on what you're saying. And then you can add a filter as needed and. And retest it with the filter if you want to make sure you're 100 safe. But, you know, there. If you're just drinking out of a thin plastic bottle, there's. That's probably seeping in some plastic and some. Some contamination as well. So it's like you gotta. Yeah, you gotta test all these things.

But, yeah, you choose what works for you. So we need one thing that is important to really drinking water is incredibly important with electrolytes. with electrolytes. Yes. So for me, the major reason to drink water is that nothing can happen inside your brain unless there's water. Water literally Powers every single chemical reaction that takes place inside the brain, including energy production. No water, no energy. So there is.

You're gonna have brain fog. You're not gonna. remember things.

You will not perform as best as, you know, as well as you can. There are studies, there are clinical studies that showed they have randomized people into, before taking a test, right? Two groups of people about to take a test. And this group is given water, like a full glass of water. And this group is not. The group that just drank a glass of water before taking the test, 20% better reaction times, 14, 15% better memory performance. and the only thing that was different was literally that they were hydrated. Now, it's not huge, 15% is not like 100%, but still, if you can improve your reaction times by 20% by just drinking water, why not?

So drinking room temperature water, drinking it off.

If you're dehydrated, you'll feel like you're dehydrated. You know, I have this little trick that is really, really helpful. If you're not sure if you're dehydrated or not, what you want to do is fill a bottle with warm water and take small sips once every 30 seconds. Just a tiny sip, tiny sip, tiny sip. It's annoying, but if after five, six minutes you really want the water, it means you're dehydrated. You just didn't know about it. You just had a big cup of coffee. you can try. Wow. Caffeine dehydrating, right?

Caffeine is dehydrating.

Yes, caffeine.

So once you have caffeine, you need to make sure you drink water afterwards as well.

Yeah. Which is why you go to a fancy restaurant and they bring you your little espresso with a glass of water. Real water. Spring water.

The European water. Yes. so if you have an espresso, if you have coffee, you must drink water with it. Yes. Before or after. Does it matter?

After. Before. I don't know. I mean, how long does it take to drink the coffee?

Yeah, it doesn't matter either way. Gotcha.

Yeah.

What are the other foods that can enhance the performance of our brain functionality?

There are many foods. They're really. Some foods are. Some nutrients especially are really important. And I think Omega-3s are really crucial for brain health. For a really long time, people were really scared of eating fat. And now we come to understand that fat is not just fat, but different fats have very different functions in the body. And polyunsaturated fatty acids, including omega-3 and omega-6, omega-9s are really important for brain health in a specific ratio. so it's a two to one ratio, so two molecules of omega-6 for every one molecule of omega-3. But the point is that depending on the circumstances, omega-6 fats are more pro-inflammatory, whereas omega-3s are anti-inflammatory. And the standard American diet really favors the pro-inflammatory types of fat. So it's helpful to keep in mind that we really need to increase intake of omega-3s. And that's easy to do for people who eat fish, for example. Fish is a fantastic source of omega-3s. But then there are a lot of plant-based sources as well. Like, so I'm plant-based and I discovered flaxseed oil.

Flaxseed oil.

Have you tried it?

Of course, yeah.

Oh, good. Okay. Here normally knows what it is.

Yeah.

So flaxseed.

Flax seeds or the oil?

The oil.

So not flax seeds.

Well, the oil is more concentrated.

Okay.

Right. So one tablespoon of flax seed oil contains almost seven grams of ALA, which is basically all the omega-3s you need for a day for your brain.

Yeah.

So according to research, although I think what you really want to maximize is DHA, which is a different form of Omega-3s and your brain needs to convert the ALA into DHA. And part of the fact is lost in the process. So you might want to have a little bit more. Like, I would shoot for like maybe eight, nine, ten grams a day just for optimal brain health.

I've. I take some DHA supplements now. What's the. what's the difference between the power of foods that contain these nutrients versus the power of the oils, concentrated oils, the concentrated supplements that we take? Is there a difference? Should we be adding supplementation to our foods if we don't have access to these Foods? What's your thoughts?

I have a lot of thoughts. I I should let you know that. So I'm part of the Global Council on Brain Health. It is. sponsored by the AARP, and we are over 30-36 scientists who have done a lot of research on this topic. And we were asked about supplements. And you should have seen it. Unbelievable. Even among scientists, like people literally split up into groups. They're useless, super helpful. It depends. And then, yes, yes, it was very, very interesting. Like scientists who read books. like pop science books and scientists who do not. And it was really interesting how the understanding of what people actually do in real life was quite different. Yes. So I think the overall consensus...

So scientists have a different point of view. It doesn't sound like there's a consensus.

There was that supplements... No, there was a consensus. it's breached at the end. But I think it was really interesting how there are scientists with just pure academics. I don't. I used to be one.

Don't. Don't apply it in there.

Yes. Yes. But also, I think it's important for scientists to know what people actually doing for real. Like, what kind of supplements do people take? What kind of supplements are people looking for? why are they doing that? What are the claims being made? Are the claims realistic? And so we went through a whole list of supplements and whatnot. And the consensus is that if you have a deficiency or if your diet is really low in certain nutrients that you cannot obtain from your diet, then supplementation has value. But supplements do not replace foods. So what you want to do is always try to improve your diet. so that your diet can supply all the nutrients that your body needs. And that is particularly important for antioxidants, which I was telling you before, they're just so important for brain energy levels and for protection against aging. There's a ton of research showing that antioxidant supplements, so taking vitamin C, vitamin A, vitamin E from a supplement is not nearly as helpful. as getting the same exact nutrients from foods. In part is then with vitamin E, we say vitamin E, but it's actually eight different isoforms, like alpha-tocopherol, beta-gamma delta. And from supplements, more often than not, you get the alpha type unless you go for a mixed tocopherol complex, whereas foods typically contain more than one form. and every isoform has slightly different effects in your body and your brain. Those clinical trials just keep failing. It's really strange. We know from observational studies that people who consume a certain amount of antioxidants are protected cognitively against dementia, against aging and whatnot. And then clinical trials try to replicate that and they just never find an effect. so it's, it's interesting.

So I'm hearing you say that food is number one. If you're unable to get certain nutrients from specific foods, then supplementation definitely supports, but it does not replace.

No, it doesn't.

So it actually adds value, it improves, it'll help you, but it's not going to be the best solution.

No. Yes. And those, I think sometimes supplements are used a little bit like an excuses.

Like, I'm gonna eat all the pizza and candy and sweets and.

But then I take my month.

But I'm gonna take some supplements so I have all the nutrients I need.

That's right. So I think the value is, if, if are, if taken in the context of a healthy, well-balanced diet, and then it depends, you know, if you're vegan or vegetarian, you might be deficient in some nutrients the same way as if you are on very high fat diets, you may need more fiber or more antioxidants, so. diets are personal. I think it's just really important to, to be aware that some restrictive diets can meet, can really deserve supplementation.

Have you, have you always been plant-based pretty much.

Yeah. So my mom is a very strict vegetarian. And when I moved to New York, I was very confused. Everything changed. My diet changed. Everything changed. And they I was.

Moving from Italy to New York.

Yes, there was quite a shock.

What was the biggest change in terms of the food choices?

A lot of things changed. Well, I was used to cooking at home and all of a sudden it was a lot of takeout and going out to eat in restaurants, not knowing what exactly I was eating and all these different Cuisines, and I'm curious. So I had never had five food before. I had never had sushi. Sushi in Italy when I moved to New York, which is a long time ago now. So everything was very interesting. But I think my body was just not ready for it. And the cookies. There's cookies everywhere.

Cookies everywhere. Oh, my God.

I was a student. They would literally shot, like, cookies down your throat. Okay, here's the coffee break. This much coffee, a plate. to cookies and seeing what she's seeing what she's saying, it was really strange. So that was bizarre. But I remained plant-based I think it was more like an 80 20 20 more fish, eggs, dairy. I'm not a big meat person. I've never been, but now I think I'm 99.9 plant-based and it's been a while.

Now, when you've learned, you know, the more you've studied brain foods and the functionality of optimizing your brain and. you know, living longer and having the function of your brain use, what have you, what would you shy away from? What would you say, you know what, that's probably the worst thing for your brain to have functionality and to function longer and live longer with your brain health? What are the main foods you would absolutely never touch? You never give your family or your kids because you just feel like it's very harmful.

Processed foods and any, any processed foods. And no, we, we don't eat pro, I don't eat processed foods. I, I really try to stick to whole foods.

So does that include like, that's a cooking, that's pastries.

I was just thinking, oh my goodness, this is maybe not true. I, I do eat crackers occasionally, but, we really, I really don't eat a lot of processed foods and they're mostly minimally processed. my doctor really loves this peanut butter covered banana bites. So I bought those. But I wouldn't call it a processed food. I mean, it's not fresh from the plant, but it's certainly not burgers or hot dogs or popcorn. And then it's just frozen pizza. I don't. Don't eat that. I just.

So what is the. What is processed foods due to brain health?

There is a lot of research showing that the standard American diet or the SAD diet is really, really, yeah, it's really, really bad news for, for your brain. And we have seen this many times using brain scans. We published this time and time again. Then this may sound biased, but we, we were using a Mediterranean pattern as an example of a healthy diet, which is what scientists would tell you. Most scientists really endorse a Mediterranean style diet as a healthy, as a brain healthy diet. And we were comparing the brain scans of people on the Mediterranean diet to those of people of the same exact age, educational level, on a Western diet or on a standard American diet. You could see the difference just by looking at the brain. so if you are.

What do the brains look like on the Mediterranean diet versus.

I wish I could show you sad.

The. The sad American process diet. What is it? Just like it light up, it's lit up more. It's more rich looking. It's just Fuller. What is the difference?

Yeah. So the difference is that the brains of people on the Western diet look older. It looks like. Yes. I wish I could show you. I have the brain scans. They shrink.

If you send me them then on our YouTube, we can put it up on the video right here. So people can see this if you email us afterwards.

Yes, absolutely. I'll send it to you. So just picture that in your mind if you can. And the brain of a 50 year old person on a Mediterranean style diet looks very full. There's very, the brain is composed of three different parts, but mostly just two parts. There's brain and then there's fluid. inside your head. And you want to have as much brain as you can and as little fluid as you can. I mean, you want to have some fluid because it's protective, but not too much. You have more fluid and less brain. It means your brain is shrinking. Like you're losing neuron and fluid is taking over the space. Oh, my gosh. If you compare the brain scans, you can tell that people on Western diets show brain shrinkage already in midlife. and that continues over time and worse than that, and we have published this, the Western diet is associated with the emergence of Alzheimer's plaques already in midlife. So people on Mediterranean diets are basically zero plaques, at least in our hands.

What do you mean by plaques? What does that mean?

Alzheimer's plaques. So Alzheimer's disease, which is the most common form of dementia, in the population is characterized by presence of these plaques inside the brain.

So it's plaque on your teeth that'd be plaque in your brain.

Yeah, they're lesions inside the brain that are considered the hallmark or the signature of Alzheimer's diseases. For a really, really long time, scientists, everybody thought that Alzheimer's was a disease of old age. And that's because the symptoms become evident when people are in their seventies.

Now people are getting them in their 50s, the plaque buildup.

That's right. So Alzheimer's disease starts with negative changes in the brain decades prior to anyone forgetting keys or forgetting names. That happens in midlife. In the very first signs that we can detect using brain scans are these plaques, these lesions that you can see building up inside your brain. And there's a very clear difference in the timeline.

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Wow.

So that's a really, that's a big flag.

Is there a way when, if you notice someone's brain scan is shrinking their brain, they're building some of these early stage plaques around their brain, they've got more fluid, less brain matter. Is there a way to reverse that so your brain can actually grow and expand and become healthier and reverse Alzheimer's plaque? Is that possible?

So, well, that's the hope with the vaccinations that we're working on. So scientists have been working on developing vaccines for Alzheimer's disease for a really, really long time. The idea is that if you remove the plaques, your brain will stop deteriorating. But so far, all the clinical trials failed, which is- In removing the plaques. no, they've removed the plaques, but they do not reverse dementia or cognitive impairment or the atrophy. So that's disappointing in, in so many ways. I can't even begin to tell you. But that's another reason why the entire scientific Community is not moving towards prevention. People say we're starting too late. We start treating this when people are younger.

Right. Not when they need it, but it's.

Like when you're, it's preventative. You know, we want to, we want people not to get those plaques. I think that would be ideal.

So when you get, when you start to build up these plaques, what I'm hearing you say is you can remove the plaque potentially.

Yeah.

But you'll, you still cannot reverse. dementia or Alzheimer's? Are you able to reverse Alzheimer's in some way?

Is that possible? It depends on what you mean by reversing Alzheimer's. So there's Alzheimer's disease, which is the actual pathology, the lesions and plaques and tangles and a bunch of other things. And then there's dementia, which is the clinical syndrome with the symptoms. We can reverse Alzheimer's by removing the plaques, But the problem is that the symptoms don't go away.

Really? So we were unable to reverse the symptoms of dementia currently. Is that right? Certainly. No one's had dementia and then reversed it.

Not in clinical trials.

Not in real life. Has someone done this that you're aware of?

I don't think so. I think it would know about it.

Is there a way to slow it down?

I think it would know about it.

Is there a way to slow this process down so it doesn't get worse? And it's kind of like a manageable symptoms where it's like, okay, I'm, you know, I'm forgetting or I'm losing memory, but it's not worse and worse and worse every day. Have we seen that?

Yeah. So there are some medicines that we have. There are Alzheimer's drugs that slow down progression, like donepezil or Aricept, like the most common. Well, we only have four. medications approved for Alzheimer's disease. We have acetylcholinesterase inhibitors, which are the most common. We have memantine for some cases. They do slow down progression, but they do not fix the problem.

Where is Alzheimer's the most prevalent in the world? Is it in the USA? Is it in Europe? What countries or regions of the world has it?

Yeah. The United States are quite on top, and then there are other countries as well, in Europe, some places in Asia. I think industrialized countries in general experience higher rates of dementia. And one thing that I would like to point out that is, again, it's my work, said Alzheimer's disease affects women more than men, or affects more women than men. say more correctly.

Why is that?

One thing that people don't realize is that almost two thirds of all Alzheimer's patients are women. So for every man suffering from Alzheimer's, there are two women. And that's one of the reasons that I started looking into Alzheimer's disease is that I have a family history of Alzheimer's disease that really affects the women in my family. So if you can't believe it, My grandmother was one of four siblings, three sisters and one brother. All three sisters developed Alzheimer's disease and died of it, whereas the brother was spared. So for me, that was terrifying for my mom as well. And I started asking questions. I was like, why does it matter? Is it just my family, number one, my crew?

Is it a gene that your parents have that then you're gonna have no matter what? I think that's a fear for a lot of people, like my grandfather had it, my dad's got it, you know.

Yes, for a really long time, most people understood Alzheimer's disease has some kind of inevitable consequence of aging or bad genes in your DNA. But we now understand that no more than 2% of all Alzheimer's cases are genetically inherited. 2% at most.

So you could have five people in your family have it and you are still have a 2% chance of getting it from them, the gene, is that right?

Well, this is in the whole population. I think if five people in your family have Alzheimer's disease, you want to get tested for genetic patient.

Now, is it because of the diets they've been eating? That's the reason why they're getting it? Or is it because you're going to get it no matter what?

Well, for 2% of the population is genetically determined, for 98% of the population is multifactorial. There are a number of factors that really matter, including your genetic background, not in a causative way, but more there are genes that give you blue eyes and genes that give you brown eyes, and there are some genes that negatively impact brain health and genes that are protected. It's a combination of things. Medical history is supremely important. Lifestyle is huge and environment, they really all matter. And what we have found is that hormonal aging, your hormones, are also incredibly important, especially for women. So it's what I was telling you. So for a really long time, people would say to me, women live longer than men and Alzheimer's disease is a disease of old age. Obviously, more women than men have Alzheimer's disease. But what we have shown is that, yes, women live a little bit longer than men, four and a half years on average.

Four and a half years.

But we tend to develop Alzheimer's disease at a younger age than men. And this is, why is that? Is you think that's more, it's menopause. Well, one of the reasons, at least the reasons that we are looking in to much all the time at this point is menopause. And it's literally that during menopause, we lose the superpowers of estrogen and the brain goes through quite a transition. You can see how brain energy levels literally change in women's brains. Connectivity changes, the white matter volume changes, blood flow changes, everything kind of changes. And for some women, It's just, it's just a phase. It's just a transition. The brain adjusts. There's a new baseline. There's a new normal. We move on.

It's a what? Some women would, how long does that transition take? Is it months? Is it years?

I know it's years. It's years.

So you might feel this brain fogginess for a couple of years and then it should balance out.

Yes. For some, for some women, however, the symptoms of menopause, don't go away, it may turn into something more serious, including a higher risk of Alzheimer's disease. So basically we start developing these Alzheimer's plaques, not all women, this is not universal, but some women, women with a predisposition to Alzheimer's disease, start developing these red flags for Alzheimer's disease in their 40s and 50s. So much earlier than we have thought before. And then of course, Think about it. So you're going through menopause and your brain is changing and it really needs support and you're eating poorly, you're not exercising, you're not sleeping, you have a ton of stress. Those factors all really work together against you in a way. So I think it's really important for men and for women. I would say women really need to start thinking about that in midlife that our brain is like a muscle. There are things that we can do to make it stronger and more resilient. We can exercise it properly, we can feed it properly, we can take care of it properly, and your brain will perform so much better for you at any age. And men and women need to do slightly different things.

What are the two?

But not so slightly. So, for example, for some women, we have a lot of patients who come to us, they learn so much more about their brains and the risk factors and then some women will start taking hormones, hormonal replacement therapy.

Is that in the hand?

It's per. It's really case by case. Some women swear by it. Some women swear at it. They really hate it. It does not work. It helps. Doesn't help at all. For some women is a godsend. And I think it's really important to have a conversation. with a doctor, not just your menopause specialist, but I think also brain doctor. And we're not there yet. We're not there yet. I, I, I now work at the intersection between neurology, neuroscience and women's health, which is a very unusual space, a very interesting space, but it's also very challenging space. And I think my hope for the future is that we'll start looking at women as organisms. as a person, right? Not like you go to the endocrinologist to look at your thyroid, you know, you go to the OBGYN to look at your ovaries, then you have to go to a brain person to look at your brain. I believe in integrative medicine. I think that we're moving in that direction.

It's all connected. It's, yeah.

Yeah.

Might be a problem here, but it's affecting something else. You know, it's all, it's all connected.

Yeah. Yes. So I think that is really, really important, but. However, hormone replacement therapy really doesn't work for all women and there is no recommendation to use it for Alzheimer's prevention. Yet we're working on it. We're hoping that we'll find a good way to help integrate these therapies into in a safe way. But, yeah, sorry, I just made this point.

Go ahead.

I would say that, you know, the point of hormone replacement therapy is that you want to give women the estrogens that the body is no longer making. But where are these estrogens coming from? Because plants make estrogens. So estrogen is the most ancient of hormones and that means that they can go across species. So plants make estrogens, animals make estrogens, women make estrogens and estrogens from a plant, phytoestrogens, enter a woman's body. And if you consume this plant-based foods often enough, that's effectively a very gentle hormonal replacement therapy over time, which is one of the reasons that people think that a Mediterranean style diet that is more plant centered is beneficial for women's health, because women on this kind of diet have a much lower risk of a number of things, from cardiovascular disease and stroke to depression to Alzheimer's disease. dementia, and also they have huge heart flashes that they don't suffer from menopause the way that so many American women do.

Now, I've heard from different scientists and nutritionists about meat being a complete protein and having, like, these nutrients, nutrient dense within the meat.

Yeah.

How. But I'm hearing you say that. plant-based is has just as many nutrients and proteins and antioxidants and all these other things. What are the, what are the benefits or the, or the, the cons against eating quality meat, let's say, for brain function and brain health? Are there, are there things we should look out for if we do have a lot of meat or some meat in our diet?

It's a, it's a really interesting point. I think so many people right now are eating a lot of meat. There are, there are a lot of diets out there that really support and encourage eating good quality meat, but quite a lot of meat. I, I would say the research points to plant-based diets as being healthier overall and more protective for the brain. I would say Yes, for the brain, but I think also in general, there aren't that many diet high recommendations that include a lot of meat. I think every person is different, but to your point, there's no need to eat meat to obtain complete protein. It's an easy way. It's definitely convenient for you if you're not an animal. It's a good way to obtain complete protein just in one small amount in a small portion of food. To obtain the same amount of protein from plant-based foods, you need to eat more of those. But there are some plant-based foods that are actually quite rich in protein, which are interesting, like hemp seeds, complete protein, tempeh, complete protein, nutritional yeast, complete protein, and also a good source of vitamin B12. so I think it's a bit fish is a good source of complete protein. There's actually, that's actually been linked time and time again with a lower risk of dementia by almost 70% for two servings of fish a week.

Two servings of fish a week will lower your chance of dementia by 70%.

Yeah. So let me say that again. There's research showing that there's, there's solid research showing that eating one to two servings of fish a week is associated with a 70% lower risk of Alzheimer's disease.

Wow.

Yes. 70% is a lot.

But you don't eat fish though, right?

I haven't in a long time and I'm going to say that I kind of miss it, but I really like it. I'm Italian.

What's the reason why you're if you know that two servings of fish a week will decrease the, the dement of the Alzheimer's or the dementia risk. Is that what he said?

I think the science is like the dementia.

So if you, if you as a neuroscientist and researcher know that, then why haven't you eaten fish?

I can obtain the same nutrients from plants, from plant-based foods. And I, it took me, it took me a minute. to get to that point because I really care about my brain. Yeah. And I always associated eating fish with supporting brain health because of the research. Yeah. So I really wanted to make sure that switching to a plant-based diet would not endanger my brain in any way, shape or form. And I did a lot of research. I really looked into all the different foods, the supply the Omega-3s the fish provides. I wanted to make sure the protein intake was more than adequate. I wanted to make sure that my B12 was also totally fine. I did not want to become deficient in any nutrients by choosing one diet over the other. And I'm very happy with this. I'm happy I made the right choice for me personally, and I'm very careful with my nutritional intake. I even do blood tests. to make sure that I have the right levels of nutrients from my diet. I want to see the antioxidants. I really, I check, I really check. Also, I'm getting my brain scanned really soon, so I'm excited about that.

What are the, if you could only eat five foods every single day for the rest of your life.

Oh my gosh.

To optimize brain health, brain functionality, longevity, support memory, all those things.

Yes.

What would those five foods be on a daily basis?

I would say, well, you don't like berries, but I would definitely go for berries because they're rich in fiber, they're low in sugars, and they provide really an enormous amount of antioxidants for a small serving size. And there's evidence that consuming two to three servings of berries per week really slows down cognitive decline in both men and women, and especially in women. So you might want to try some.

Man, I gotta start.

Which.

Which berries? Which two or three are the best?

Blackberries actually have more antioxidants than even blueberries. That's an interesting type of berry. They're. They're not as easy to find as blueberries, but you can get them frozen and they're still quiet. intense.

Now, is it. If it's. If it's a modified Blackberry where it's frozen, it's put in a smoothie and blended, it's in, you know, liquid form. Does that all still matter, or do you need it? No, I didn't think in raw form or is it. Doesn't matter.

No. Cooking. So cooking destroys vitamin C. Vitamin C. All the antioxidants are really easily damaged by heat. so freezing shouldn't reduce the antioxidant capacity by too much. Obviously, I don't want them to be frozen for 10 years. I mean, you know, sure.

So we got blackberries, blueberries.

Blackberries are great. Goji berries. Goji berries are one of the most concentrated sources of vitamin C. There's a kind of plum that I. I haven't been able to find. It's a kakadu Plum, which seems to be. this, the most powerful concentrated source of vitamin C on the planet. I know they have been in Australia and Pacific Islands. I've never seen it here, but I would like to try it.

Okay, so we got berries number one. What would be the second?

Mulberries are really good.

Mulberries.

Sorry.

I actually had mulberry tree in my backyard in Ohio growing up, and I would eat some mulberries every now and then. So maybe I'll get back into mulberries.

That could be nice. You can also find them dry.

Okay. Oh, dried mulberries work too.

Yeah, they're very good. They're very tasty.

You still have the nutrients when they're dried?

Yes. Yes. A little bit less than the fresh ones, but they're sweeter when they're dry.

Okay.

I grow them in the garden. Yeah.

And those are high in antioxidants. Those are high in antioxidants.

Yeah, they're high in antioxidants.

Okay, great. Awesome.

Okay, so we got berries is what you get. I get the berries. And I would go for dark leafy greens. Okay. Because they're really important. They contain a ton of phytonutrients, which are really good.

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And a lot of fiber. And fiber is really important for a number of reasons. The most obvious being that it supports gut health, obviously, and 70% of the immune system is in the gut. So eating fiber also supports immunity, which especially now is a huge concern for everyone. But also fiber has a really important modulatory function on sex hormone binding globulin, which is what regulates flow of hormones inside the body. And so it really helps support hormonal health as well. So I would say two reasons to eat fiber and go for your leafy greens. And there's a ton of greens and we don't have to eat kale all the time. there are so many other varieties that are just spinach and arugula, all those.

Yeah.

All the lettuces, all the different microgreens. They're color greens, if you like them, but also cruciferous vegetables like cauliflower. Now is the season. So cauliflower, broccoli, Brussels sprouts, Romanesco. They're yummy. I'm sure you eat veggies. I eat those.

I eat a lot of veggies.

Yeah. There you go.

Okay, so we got.

Those are the first two. Well, I. I would throw some polyunsaturated fatty acids there. That the Omega-3s whether from fish. Do you fish? Yeah.

Right.

So in that case, for those who do eat fish, then the smashed fish. So salmon, mackerel, anchovies, sardines, herring. Smash.

Smash fish. Yeah. All right.

So there's a really good source. It's very concentrated sources.

And if you didn't, and if you didn't get that from fish, what would be the substitute you would do plant-based.

Well, for me, plant-based so omega-3 is from hemp seeds, for sure. Flax seeds and flax oil, walnuts, almonds, chia seeds, and also seaweed. I don't know if you like seaweed.

I actually love seaweed. I eat those little.

The nori sheets.

Yeah, the little sheets. I can eat those for days.

I know. So good. Yeah. Yes. Yeah, yeah. For sure. Iodine. They're a good source of many nutrients, many minerals. This is a chlorella is another one. That is really good. You can put in your smoothies. It's very dark green. You know, sweet peas. I didn't know that until recently. Sweet peas are actually good sources of phospholipids, which is a lipid attached. to other compounds that are good for you. And some are very rich in Omega-3s as well. So green peas, sweet peas, edamame, soybeans. Those are all beans. They're good.

Okay.

And they also contain fiber and some antioxidants at the same time. Hemp seeds are a really good source of protein as well. Vegetable protein, a little bit of fat, the fiber.

That's great.

Yeah.

Okay, so that's the third part of the plant-based. What's the most?

Then I personally would go for complex carbohydrates from things like sweet potatoes. Those are really good for you because it's a source of it's high in fiber, but also provides the sugars that the brain really needs. Actually, I'm going to take a step back and go for phytoestrogen-rich foods, especially for women, because we don't talk about this enough. that are foods that have estrogenic properties. They're very mild, they have a mild effect in the body, but they really support health for women. I'm gonna go, I'm a woman, I want to talk about women because we never do, and it's true. And these foods are very similar to the ones that we're just talking about. They include flax seeds, sesame seeds, chickpeas, all sorts of beans, dried apricots and dried figs, really good sources. berries at another source and tropical fruit. And going back to fruit, maybe is they're eating fruit. But there's also evidence that women in particular who consume one serving of tropical fruits per week have better fertility and the later also the menopause.

Yeah.

And the studies look the mango, pineapple and papaya as good sources of phytoestrogens. support fertility.

Okay. Wow.

And the important thing, I think, is to really delay menopause as much as you can or make sure that you don't get the symptoms because that can be really, really unpleasant.

Okay.

Yeah. And then my number five would be water. I always think electrolytes. With your head. Yes, it could be herbal tea if you like that.

So teas have electrolytes as well? Is that what it is?

It depends what kind of water you use. Yes, if the water you use contains electrolytes then so does the tea. Okay. Something that is really nice, especially in this season, is to use medicinal herbs to make your tea. Like thyme, it's so good. You just boil the water and put it over like a couple of sprigs of thyme of rosemary or sage because those plants, they're good sources of antioxidants, but they also double up as anti-inflammatory. So you drink your little tea and this potion.

Are these all the things that you do on a daily basis or?

Oh, for sure. For sure. I drink my lemon water every morning. I drink noni juice. first thing in the morning.

No need juice.

No need juice.

And no, no, no need juice.

Do you know what it is? No. No. So it's a. It's a fruit that comes from Tahiti in the Pacific Islands. That smells awful, the actual fruit, but it can be juiced. And the juice is incredible. It really has incredible benefits for. skin for digestion and contains over a hundred vitamins and minerals and phytonutrients in general that are strong antioxidants. And it also has some anti-inflammatory properties. And I wouldn't mention it in general because it does sound a little bit more wellness than science. But the point is even the NIH talks about noni juice. There's a whole page where they go over all these nutrient dense foods. And they have a whole section about these, which I found many, many years ago. And I was like, well, I'm going to have to try it. And they had it at the health food store. That was so exciting. And it doesn't taste good, I'll be honest.

It doesn't taste good, but you know it's good for your brain and your body and everything.

Actually, yes.

Wow.

I noticed the effect.

Really?

Yes. And my friends do too. When they come over, it's fun to just go over my fridge and my pantry because they have all these very weird, unusual things. And now most of my friends are drinking oni juice and it really helps. It really, really helps. If anyone has digestive issues, it really changes a lot of things for a lot of people, which is remarkable. I was very interested in the antioxidant situation, but it's really interesting that we only drink water at home, herbal tea a lot. We grow herbs in the garden. Yeah, no processed foods in the house unless the occasional pastry or cookie.

No pastries.

No. What?

How do you live without a pastry?

I bake. I say I bake. I mean bread. We buy bread from Whole Foods.

Okay, so you eat bread?

From the farmer's market. We do eat. Yeah, I do eat bread. I like it.

But you don't make cookies. You don't bake muffins and cupcakes.

I'm not able to bake muffins. I've never done it. I could, I think. But cookies, yes. I bake them. I don't buy them. I'd rather make them. Do you cook?

I can cook. I actually enjoy when I want to cook. I actually enjoy it, but I love the convenience of having healthy food just delivered to me or given to me or I like to use my time with other things. So it's not that I don't cook, it's just I choose not to.

Okay.

I choose to learn in other ways, but so you will cook cookies, but you'll make them yourself.

Yeah.

Better ingredients and with better.

Yeah. Yeah. I guess sometimes for my daughter, I get snacks from Whole Foods, but mostly she's happy with strawberries. And I mean, she literally asks for goji berries for a snack. I'm just, that's amazing. Yeah, things will change. Who knows?

Yeah, okay.

I used to make, so I grew up eating Nutella.

Oh gosh, Nutella is so good. So you make it, you home make it?

It's really not healthy. Yes, I make my own version.

What's in it?

With hazelnut. So there's hazelnuts, hazelnut oil, ro cacao. Yeah, a little bit of coconut oil, and dark chocolate chips and Sweden.

That probably tastes.

And then a little bit of maple syrup. It's so good. You need to have a food processor. Like a good one. I think I have a Cuisinart. So it's not like a crazy thing to have. It's very helpful. You can make.

But this doesn't sound healthy still. Is it healthier?

No. Yeah, of course. They're all whole Foods. Hazelnuts are actually really, really healthy. They contain monounsaturated fatty acids that are good for the heart. They have antioxidants. They have a little bit of vitamins and minerals. They taste so good. They're wrong. They're not processed at all.

They're just... You should have an online store where you're selling organic Nutella, you know? Healthy Nutella.

It's so good. It's really yummy. Wow. I make a lot of things at home. I make banana ice cream for my daughter. It's the quickest thing. You like bananas. So this is very, this is. So you freeze the banana, like two bananas, then get two medjool dates, take the, you know, take this. What's it called? The thing in the middle. Yeah. Get it like that. So. And then you want to soak the dates a little bit so they get really soft and put everything in the vitamin. and just blend it up with a little cashew milk to give it a little creaminess. You don't have to. It just. It turns out perfect. The bananas need to be frozen, and it's great. That's what she wants for a snack. So I'm like, great. Why not?

What foods do you think men should be eating differently than women?

Men can tolerate fat, animal fat. in larger quantities, the women. And this is very on average, right? It depends. There are some women who do wonderfully well with animal fat and some men who don't. But on average, I think men's metabolism supports fat breakdown in a way that is more efficient than women's bodies. And this is research. I mean, there's a lot of research on that is in part the hormones, it's in part body composition, muscle fiber, you know, men are more wired for explosive performance and high intensity interval training. And of course, many women can do all of that and more. Absolutely. It's just on average. So I think, I think these foods are good for everybody if you want to eat them, you know, and then, then there's all these different diets out there. But I think as long whole foods are really the focus of the diet. I think that is the most important thing. Don't stay away from processed foods. There's just so much research showing that all these different chemicals that are part of the foods, it used to be trans unsaturated fats or trans fats, but now there's all sorts of guns and emulsifiers and a ton of refined oils and a ton of pro-inflammatory nutrients. And we know that diets that are rich or high in processed foods increase your risk of heart disease by over 30%. They double your risk of dementia, they double your risk of cancer, they increase your risk of depression, they increase your risk of hemorrhagic stroke. Why? They don't even taste good. Those foods. I mean, that's the bottom line. Yes, they're convenient. They're cheaper, but they don't taste good. They do nothing for your energy levels, and they are very harmful to your health. I think it's really unfair that healthy food is so expensive. But other than that, it's a matter of really making a choice. And I think it's important to know this because as a society, we're aware that what we eat really changes the way we look and that the foods that we put into our bodies will dictate what kind of clothes we can wear, what kind of performance we can have. But the foods that we eat really also impact how our brains work. So they really make a huge difference in the way that we think, that we feel and remember. So in a way, the same, you know, the same way that we save for retirement, that we would like to save for retirement, we should also eat for retirement. We should think of as food as information, food as function, and food as something that is protective and can really help you live your life to the fullest. It's a tool. It's an asset.

I 100% agree. and I'm curious, what are the studies shown? I know all about the blue zones, but what are the studies shown about the areas of the world where there's the least amount of Alzheimer's and dementia, where people live long, but they also remember long, I guess, as well? Are those the blue zones as well? Are they other regions that you're aware of?

So, the blue zones are very well characterized and they're about five six parts of the world than the National Geographic has done such incredible work just characterizing and describing the lifestyle of these populations. But there are other hotspots, like other longevity hotspots all over the world. There's one beautiful, beautiful place in China that I'll never remember the name of. It's by, ah, this, I need to find out now, it is this gorgeous river and the valley that it looks like just came out of a dream. And people there should qualify for the blue zone. And then there's some part of rural India with the lowest rates of dementia in some other parts, some other parts of Europe as well, where people lived really long ages and do not experience cognitive deterioration, dementia, diabetes, obesity. they're really protected. And what all of them have in common is very low stress, a sense of belonging and being part of the community and being supported. Exercise, not going to the gym, but just moving your body on a regular basis, good sleep, like prioritizing sleep, taking naps, and plant-based diets.

Really?

Yeah. I know meat is a luxury. Meat is a luxury in many parts of the world. And that's the way that, yeah, it's.

A once a month type of thing. In some places it's like, okay, let's, we got some meat today. It's like a celebration type of thing.

It's a celebration, exactly. It's a special treat. Like when I was growing up, which is not a hundred years ago, but even when I was growing up in Italy, and then I was in France for a while, eating meat was really Sunday special.

Really?

Yes.

Not in every meal.

Oh, no, absolutely not. And also the meat was coming straight from the farm, not factory farming. Like the actual traditional farm with the farmer who knew the chickens by name and kind of cried a little bit.

Oh, man.

I'm telling you, my mom was like, that's it, we're done. No more.

Oh, man.

Yeah, my mother, my mom has been a vegetarian for over 30 years. I mean, I was little when she, yeah, she said, that's it, no more. And my dad was like, Ah!

Does your dad keep eating meat?

I know. Well, occasionally when they go out to the restaurant or when they see friends outside, but not in the house, no. Fish. She'll tolerate it.

Yeah, the fish doesn't have a name, so it's okay. It's like, yeah, wow.

Yeah. Tradition.

This is fascinating stuff.

So, yeah, but also, you know, one other reason, and I'll keep going back to women until you put up with me, but there are studies with hundreds of thousands of people showing that diets high in processed foods really are strongly associated with a higher risk of cancer, whereas diets that are high in whole foods and minimally processed foods, especially veggies and fruit and whole grains and legumes, are associated with a much lower risk of cancer, especially in women. Like breast cancer after menopause is much lower for women who eat healthy whole foods. And also, especially eating legumes and fish is associated with a later onset of menopause and better hormonal health.

Eating legumes and fish, remember more longer.

Or go through menopause later and not have the symptoms, whereas diets that are high in processed foods and refined foods and sugar and refined carbs are really said in that, in that regard, they really anticipate the onset of menopause and even in women who have no genetic reason to go through menopause early, they accelerate the aging process.

Educate me on the female experience.

Yay. Yes. Let's talk about women.

When, when does menopause usually happen for women?

51.

51.

So the average age is 51.

Why does it happen earlier for some? and why does it happen later for others? And does every woman go through it at some point or is there a way to, I guess, extend this process so it doesn't?

Yeah, it's a really good question. So all women go through menopause in their lifetime. The average age of menopause, the median age of menopause is 52 in the United States. The latest you can go fully through menopause is around 58. in the United States, the earliest you can go through menopause is in your 30s.

What happens? Again, educate me. What happens when you go through menopause? What happens to the female body, to the brain, the DNA? What is happening?

I love it. I love how you ask. What is going on? Well, a lot of things are happening. So it depends. There are different reasons. to go through menopause. For most women, you go through menopause spontaneously and the age is in part genetically related. In part it really depends on your lifestyle. So for many women it's important to ask your mom, what was your mother when she went through menopause? Because there's a strong link and that my mom went through menopause in her late 50s. so I'm hopefully also targeting late 50s. However, I have a lot more stress in my life than my mom used to have. And that's one factor that may accelerate the onset of menopause. Smoking is the number one risk factor for early menopause. Really?

What about the studies of smoking, vaping? Is vaping affected as well?

I don't think so. I don't know. I'm not sure that there's research around it. I look it up. I don't know. But smoking is the number one risk factor for early menopause in women who are not genetically wired to go through menopause early.

Okay.

And then lifestyle seems to be really, really a huge, either protective factor or damaging factor for so many women. And some women go through menopause earlier than they would spontaneously because of medical interventions. And this is something that we don't talk about enough at all. But one in every nine American women gets a hysterectomy or an oophorectomy, which is the surgical removal of the uterus and/or the ovaries for a number of reasons. However, that precipitate, you basically go through menopause basically overnight. Yes, yes. If your ovaries are removed, if only your uterus is removed, that can still negatively impact blood flow to the ovaries and can also lead to early surgically induced menopause, which is something that we don't talk about enough. And especially we don't talk about the fact that those procedures affect your brain. Not in a, not in, not in a, there's something wrong with your brain, but this is something that also impacts your brain. And we know from a number of studies that women who receive hysterectomy, more so an oophorectomy, have a higher risk of Alzheimer's disease as compared to women who go through menopause spontaneously is not causative, it's a correlation. So getting the ovaries removed and perhaps the uterus as well is associated with a higher risk.

So if you can prevent getting one of those surgeries or getting those removed, try not to, is what I'm hearing you say.

Well, yeah, so it depends. There are some situations where surgery is a lifesaver.

Of course, of course.

In some cases though, I wonder because the main reason for a hysterectomy is having fibroids. Now, fibroids hurt. There's no sugar coating that. But I wonder if we had more of a conversation around the link between the reproductive system and the brain, I wonder if surgeons or doctors would be able to come up with different Solutions rather than I'm just going to take out the uterus. Just get rid of it. And also for so many women, the question, you know, they just ask you, do you want to have kids? Do you have enough kids? So you're planning to have more? No, then let's just remove the ovaries as well, because it's a cleaner surgery. And that makes sense if you're just thinking reproduction. But the point, we're not thinking brains, we're not looking at a woman. as an organism where the brain speaks to the ovaries and the uterus and your reproductive system and gets feedback from it and the health of your reproductive system, the integrity of that system is important to the functioning of your brain. So if there's no way around it, obviously some women need the surgery. I'm not saying that we should decline these procedures. What I'm saying is that we should find ways to protect our brain especially for women who go through menopause because medical.

Right.

Proceed.

Because I was, I was doing an interview with Andrew huberman, the neuroscientist out of Stanford, and he was mentioning briefly, I don't think we went into it that much, that, that an orgasm happens in the brain, that it's connected down the spine and your brain has I guess, I don't know what they're called, a little synapse or something that's connecting all the way down into your sexual organs. And so, if you're removing a sexual, the uterus or something from the female body, that's connected to the brain.

That's right. That's exactly right.

So, there must be, so if you're essentially, there's a pathway, there's a pipe that is going through your body and then you cut the pipe in half. and remove something, it's not able to flow back and forth from the sexual organ to the brain as naturally, I'm assuming. And so what does that do to the brain by inducing menopause early? How long does that take? And what does that mean until you can truly balance out brain functionality? What do women typically go through mentally and physically?

Well, I wish that we had more research on that so that I could answer your question in greater detail. We have been looking into that. We're starting now to, we're trying to do brain scans prior, before and after the procedure to really understand what's happening and what the long-term effects are. What we know for sure is that the effects of surgical menopause on the brain are more acute than the effects are natural or spontaneous menopause. Because when you go through Not spontaneous is a better word. Spontaneous menopause takes years. For some women it takes a couple of years, for some women it can take 15 years. So the brain has a chance to adjust gradually. If you're plunged into menopause or perimenopause, so quickly that comes as a shock. Your brain needs, and this is just a figure of speech, but your brain needs to adjust much faster. And in that case, hormonal replacement therapy is indicated. I mean, if you're getting these procedures before menopause, then it is helpful for many women to go the hormonal therapy route. And this is a conversation that needs to happen with the doctor because it depends on why you had the surgery. If we're talking about cancer, then that may not be a good option, but there are other options for sure. And it's, it's really important to explore that. And I, I have to say that the more I talk about this, the more feedback I've received from menopause Specialists and OB/GYN doctors and surgeons who really honestly don't know about that. Yeah. Brain people do. OB/GYNs do not.

Because they're not. They're not studying the brain. They're studying.

They're studying a different part of the body. Yeah. But that's what drives me crazy about Western medicine, is that we're so trained to just look at one thing at a time. Right? If you're a brain person, you look at the brain, you know nothing about menopause. I. I had to really get smart, really fast about that. And if you're an OB-GYN or a menopause specialist, you don't really know much about brain. You know about brain function, but not in detail. Right. You just, we're vertical. We're very vertical in our knowledge. And they think that a more horizontal approach is also needed as simple. You need to go vertical first so that then you can go horizontally really and the person in front of you.

I'm curious. I've got a few final questions for you, but I'm curious about the correlation between our brains and mental health disorders, mental health. is a big topic, especially in the US right now and a lot of people saying that they're going through depression or having mental health disorders or mental health challenges, diseases, depressions in mental health. How much of that is associated with the foods we eat? Obviously the environment, the stress, sleep, I'm a huge believer that all those things will support the way you think, the self-talk, the healthy relationships you're in or lack of healthy relationships all affect mental health as well. But how much have you noticed food has a direct impact on depression, anxiety, or mental health disease?

There is strong evidence that food has a strong impact. on mental health. And there's a whole field that is growing. It's called nutritional psychiatry. It really looks at this. It started many years ago at Harvard, where there's this group. There are a lot of teams that started looking into that and how specific foods literally support the formation of neurotransmitters in the brain. For example, serotonin is a neurotransmitter, is a neurochemical that is really important for happiness and sleep and appetite. And is the neurotransmitter that is deficient in a way in depression, in many patients with depression. So the drugs that we have tend to improve the action of serotonin. And there's a very strong association between serotonin foods, especially an amino acid that is called tryptophan in production of serotonin because the brain takes tryptophan and vitamin B6 and transforms that into serotonin inside the brain. So you need to have this essential amino acid in your diet. And chocolate is a good source, by the way. Yeah. And so there are a number of plant-based foods, including bananas. So that's really important. And the other trick is that consuming carbohydrates together with the tryptophan source really helps because tryptophan usually takes a backseat to other amino acids. They compete for entry inside the brain. But for reasons, I don't know, maybe some magical reasons, if you have a little bit of carbs together with your tryptophan, that pushes the tryptophan inside your brain. so did you have this growing up as a kid that my mom would give me milk, like warm milk with honey?

With honey?

For bedtime?

I used to have a tall glass of milk before bed every night. Not with honey, though, but just, I would drink milk all day, whole milk.

Okay.

And I think it, I think it, I think it's what made me grow so tall. But it also, you know, I was always saying this stuffy nose. I was always feeling tired, like when I was working out in practice or in sports. I always felt like it was just like my body was drained.

Right.

And I felt kind of lethargic because I. But I was, you know, I was drinking so much milk. Probably. Probably.

I mean, gallons.

Gallons a week. I mean, I used to. This is when I was in Middle School. I went to a private boarding school, and I lived in. dorm with an all boys dorm.

And.

There was a milk dispenser in our dorm, like the five gallon kind of commercial grade milk dispensers from a cafeteria. I literally had them move it in my room. It was five gallons of milk that I was drinking most of it. Other boys in the dorm would come in and drink it as well. But I was probably consuming a couple gallons a week, I'm assuming.

Wow.

Just drinking it like it was water. Just. Just drink, drink, drink. Yeah.

Okay.

I don't know what that did for me. The negative effects long term, but I don't drink any more milk now. Okay. Only nut-based milks I have now.

Which one's your favorite?

I'm a big fan of macadamia nut milk.

Oh. yeah.

I mean, I I like oat milk, but it's got a lot of, you know, calories in there and sugar. It tastes sweet. Yeah. But I feel like I've drinking too much almond milk, and I feel like it's affected me in a negative way. So I try to pull back on the almond milk because I just started drinking all almond milk and.

Yeah.

So it's trying to have that balance.

Yeah. And. Mhst is really good. If you tried the brand. Yeah. Only almonds and water.

Okay. Amherst. I gotta come by your fridge someday and just eat some of your food and just be like, ah, the organic Nutella, all these other things, the dried berries.

Yeah. Amazing. Yeah. To answer your question, I think you just provided a great example of how. perhaps too much of something considered healthy can negatively impact your performance and your mood for sure, right? Like we know that so many foods have a strong effect on mood. We all know that intuitively you're tired, you drink a cup of coffee, you're sad, you have some ice cream or a piece of chocolate in my case. And that's really because we all intuitively know the some foods have an impact on our mental state. Yeah. The reason being that the nutrients in the foods really do have an effect on the chemistry of the brain, which I find very beautiful in some ways, right? I mean, we're kind of caught up in this marketing experience where we're consumers and users rather than people who really appreciate the food and understand it. I think there's a disconnect. between the way the food is grown and what kind of uses and benefits you can really get from certain foods and what ends up being in your fridge or on your plate. But I also think that we're going back to the roots more and more. The more and more people are really interested in learning what kind of functions different foods can have and how to use them for the best. Yeah. So we'll get there.

I love it.

Yeah.

This has been fascinating. I could dive into this stuff more and more and hopefully we do more stuff in the future, but I want people to get your books, Brain Food, the Surprising Science of Eating for Cognitive Power, if you just want to learn about the foods to optimize your brain in general. And then you also have a new book called the XX Brain, which is the groundbreaking science empowering women to maximize cognitive health and prevent Alzheimer's disease with a forward by my dear friend Maria Shriver on there as well. She's amazing. She's been a big champion of this disease in preventing and helping to overcome this for many years for all human beings. So, it's been inspiring to see her mission on this. But, both these books I recommend and you've got my other buddy Mark Hyman on the COVID of this book here. Yes. Lots of great research. lots of great science, lots of recipes in here as well for things you can do for your brain, health and optimization. So I highly recommend getting both of these. I'm going to get this one, the ExacBrain, I'm going to give it from my mom who is about to turn 70 this year, I think 69 or 70 this year. So want to make sure and luckily she's got great memory and she's sharp and and healthy, but want to continue to you know, prevent that from happening in the future for her as well. So I want to make sure people get the books and also they can follow you on social media. What's the best place to connect with you? Where do you have?

Instagram, for sure. I'm way too sensitive for Twitter. So my handle is DoctorDr. Mascony. Okay, great. And on my website, lisamoscony.com.

We will have all that linked up in the show notes as well. And if you ever want to brain.

Scan, come join us. Yeah, I would love to come do one.

I mean, Dr. Eamon, I'm not sure if you're familiar with him. He's been trying to get me to do a brain scan down here in California for a while. And part of me is worried. Like, part of me doesn't want to have the liquid. Like, don't you have to drink something.

Or you have to put something in your veins to, like, scan it or how this sir? Well, it depends. We have some brain scans that we don't touch you. We just go in the machine. Yeah, those are MRI scans, but we also use the same machine to look at blood flow to the brain, brain energy levels in the brain, connectivity of the brain. So we look at a lot of different things without really. You just. Nobody touches you.

You don't have to put like an IV in and put.

There are no IVs. for that. No, I've.

And what will you see if you do a brain scan? What will you be able to see and understand about your brain?

So we look, we look at so many different parameters in, I have different protocols that really target different interests of mine, but also different needs and tolerant, different tolerance profiles. Like you're saying, I don't want the IV good. So we can only do MRI and that's fine. And in that case, we look at the anatomy of your brain, we look at the structure, we see if there's any shrinkage, we see. we look at inflammation, we look at things like if you have any gliosis or any signs of an inflammatory presence in the brain, demyelination, strokes, aneurysms, tumors, we do everything clinically, but then we also have the research data where we look at connectivity between different parts of the brain, we look at brain energy production, we have this new technique that looks at ATP levels in brain, like energy, literally mitochondrial activity in the brain. We look at blood flow, we can do resting state fMRI, like we have a lot of different sequences. And then if you feel comfortable, you're like, okay, you can also give me the IV. Then we can look at brain glucose metabolism and we can look at amyloid plaques, Alzheimer's plaques. Delusions and now we can also see it.

It's probably worth doing that then. Have you done a lot of brain scans on yourself?

No, I'm scheduled. I'm scheduled to do it. Yeah.

After you do it, after you do it, you let me know the experience. But then we'll see.

I'm gonna try. So at first I was too young for my own protocols. Then we changed the age range and now I fit.

How old do you need to be?

35.

Okay. So I'm 37. so.

They again, I fit it. Perfect.

Perfect. Amazing. Well, I've got a, I got a couple final questions that I ask everyone on the show, and this has been powerful, Lisa, so I appreciate you opening up and sharing your, your years of experience and wisdom on this. I think it's gonna be really helpful for a lot of people. This is a question I ask everyone at the end called the three truths. So I'd like you to imagine a hypothetical situation where it's the end of your life many, many years from now, and you've lived as long as you want to live. and you've accomplished every dream. You've done everything you want to do, but for whatever reason, it's the last day. And you have to take all of your work with you. All of the interviews you've done, your books, your TED Talks, your research, everything, anything you've ever said ever has to go with you to the next place, wherever you go. But you have a piece of paper and a pen, and you get to write down three things you know to be true about the experiences, the lessons you've learned in your life that you would share with the world.

Okay.

I call it the three truths. What would you say?

Is it only work related?

No, no, about life.

About life.

Life in general.

Yeah.

What would you be your three lessons or three truths that you would share with the world about your existence?

Well, the first thing is not scientific at all, but I would say the love is by far the most important thing that you can have in your life. and really cultivate it and appreciate it because we always make time for other things and we deprioritize what really matters in the end. I think the second part is that I would, I hope that I might be remembered as somebody who really helped other people, somebody who had integrity and worked very hard. And I think number three, I think for me, number three or perhaps number one at this point is really that right is right, even if nobody does it. And wrong is wrong, even if everybody's doing it. Live your truth, because that's really the most important thing overall for me as a person.

Lisa, I want to acknowledge you for the commitment you have to improving people's lives, the deep research that you've been working on for 20 plus years, the care you have about people living a healthier life through brain optimization. We need more people like you who are in the constant exploration of improvement of our health, of our minds, with so many more people going through mental health challenges, dementia, Alzheimer's, it's a horrible to watch loved ones lose their ability and their function. So, I'm very grateful and acknowledge you for your ability to help as many people as possible with this cause and mission. And again, I want to make sure people check you out online, get the books. And the final question I have for you is what is your definition of greatness?

Honesty. I think that's really the most important thing, just being honest and helping others. I think that would be my definition. I think that real leaders are people who really help others and lead by example.

There you go, Lisa. Thank you so much for being here.

I appreciate it. Very dramatic ending.

I love it. My friend, I hope you enjoyed this episode. It blew me away. The information, the research, the science that Lisa shares is so powerful. If you enjoyed it, please share this with a few friends. Text a couple friends right now. Post it on your social media. Make sure to tag me and Lisa over on Instagram or social media and get the message out. People need to learn this information to help increase the quality of their health and their life. Again, lewishouse.com/ 10191 to learn more on the full show notes and information. You can send people to that link as well to listen or watch this interview. And if you enjoyed this, please click the Subscribe button over on Apple podcast and leave us a rating and review of the part you enjoyed the most from this episode of the part that inspired you. Just leave us a comment and review over on Apple podcast. And if you want inspirational messages sent to your phone every single week from me, then text the word podcast right now to 614-350-3960 to get on my texting list. And I want to leave you with this quote from athlete Julius Irving who said, if you don't do what's best for your body, you're the one who comes up on the short end. It is time to take care of our health, to be educated, to research, to test things, to see what works for us, and keep diving in to exploring, optimizing our body and our minds. And I remind you, if no one's told you lately that you are loved, you are worthy, and you matter. And you know what time it is? It's time to go out there and do something great.

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