Dean and Ayesha Sherzai, M.D. – The Alzheimer's Solution: Prevent Cognitive Decline at Every Age

people unfamiliar with please tell us your names what your backgrounds are and what you've been doing for the last 20 years my name is iShares I I'm a neurologist and a scientist and along with my husband Dean I'm the co-director of the brain health and Alzheimer's prevention program at Loma Linda University Health I trained at Columbia University in vascular neurology which is you know treatment of and prevention of stroke and my research and my interest is in preventive neurology which is prevention of neurological diseases such as Alzheimer's disease and stroke especially when it comes to lifestyle my name is Dean chair's I am just husband first I'm a neurologist I'm a neuroscientist and I'm the co-director of Alzheimer's prevention program at Loma Linda University my research is again same thing prevention of neurological diseases we've been working at this for many many years and my special focus and my fellowship training is in dementia and Alzheimer's tell me what your book is about the Alzheimer solution a breakthrough program to prevent and reverse the symptoms of cognitive decline at every age the book is a book of hope and a book of science it has to be both so we're not just throwing hope without any true scientific backing this came out of years of work we did at Blue Moon Day University which is the only Blue Zone in America we chose to go there to study the population and then also do research outside to figure out the effect of lifestyle on specifically dementia there's this devastating tsunami that's overtaking our healthcare system and well actually in 20 years collapse the health care system how do we avoid it and what we have found is that lifestyles specifically a whole food plant-based lifestyle plus other things can significantly reduce your risk of developing dementia in general and Alzheimer's in particular so we thought that this was extremely important to come out it's a book of hope and in this book we're not selling any vitamin concoction or anything it's a much more comprehensive real-life approach to prevention in today's society is Alzheimer's disease considered an epidemic there there's rarely any family that hasn't come across Alzheimer's or dementia and that and that's going to increase much more in the next 20 years the fact is the fastest-growing epidemic in America or is in the last 15 years we are surviving diabetes better although the prevalence is increasing we're surviving heart disease and everything mortality from Alzheimer's has gone up by a hundred and twenty three percent and that curve is actually increasing faster so we have to do something about it and and the cure is not going to be in a pill it's too complex of a disease it's going to be in communities approaching this from a lifestyle perspective what is your background and day to day job and what made you decide to focus on Alzheimer's so we decided to go into this field of Neurology both of us because well we're fascinated by the brain the brain is an incredible organ but also because we have personally seen loved ones go through Alzheimer's Dean had two grandparents and I had two grandparents both from mother and father side who went through Alzheimer's disease and we saw how these incredible human beings lost parts of themselves slowly and gradually to the point where they couldn't recognize their children or their grandchildren and I saw the pain that my families went through and it was fascinating to see such intelligent incredibly amazing human beings you know lose islands of consciousness and that brought us into the field to understand the brain better and you know when we went into this field as trainees as residents and as fellows I think I'm going to speak for both of us the the field is so grim and hopeless that you get either dissatisfied you basically see people coming in with zees usually at end-stage and there's really no medication for it there's no hope for it and I recall during my residency and fellowship with brochures of nursing homes or end-of-life care on our tables ready to hand out to people when they would come in with dimensions and Alzheimer's disease but then through our throughout our residences and fellowships we started reading about a successful cognitive aging and about you know places where people have the least incidence and prevalence of diseases of the brain and that intrigued us and we started learning more about it and reading more about it that's how we came across dr. T Colin Campbell's work from the China study dr. esselstyn's work and then dread you know articles by Dan Buettner who's a good friend now about the concept of Blue Zones and we found out that Loma Linda University was in Southern California and we just jumped on that on that opportunity I even remember days when we wanted to go to to lifestyle to study lifestyle better and how that relates to neurological diseases and I remember our mentors telling us I don't think you're going to do very well in that field I don't think your grant is ever going to get accepted because it's it's a very vague field but I'm so glad we made that decision because I think that is the only hope that is the only solution lifestyle is the only solution for Alzheimer's disease and we've been studying it for the past decade and we've seen it over and over again in our clinic and our Hospital work of how wonderful the results are of instituting a healthy lifestyle early on we saw the negative approach to disease in really well-known institutions UCSD NIH I worked at experimental therapeutics branch of NIH doing all kind of molecular stuff and study after study you know clinical trial after clinical trial was a failure over and over again it was almost as if people just kept doing the same thing over and over again expecting different result we've heard that we needed to go a different direction we wanted to find out were there models of lifestyle affecting other diseases heart disease you know cancer and that's where we found out about Loma Linda we said the part that has not been studied so far was the brain so for the last 15 years we've been studying the brain in communities where they've had successful aging and now we lead a campaign in beach cities where the whole three communities are instituting this lifestyle perspective for us as a privileged I mean in life you want to do something that is of meaning and often it's challenging because it's often outside of the norm it's often outside of what people are used to and in medicine medicine is a very old system very patriarchal system in many ways so if you're doing things that are outside of the norm you're pretty much chastised grants are not given money is not supplied when we took that risk and it's paying off because what we saw was that lifestyle actually prevented dementia and I'll tell you there is nothing bigger in healthcare than that right now is sleep a factor in the prevention of Alzheimer's and how about exercise as well I think when it comes to sleep there's nothing more important for cleansing of the brain than that it sounds funny but sleep is probably the most important time of the day I know we're knocked out and were unconscious but two very important things happen when we're asleep the first thing that happens is our memories get consolidated so you all the information that comes to us during the day gets placed in the metaphorical file folder and cabinet and that's how we can retrieve them later without any you know spending too much energy that happens when people go through the deep stages of sleep the second thing that happens is the brain cleanses itself we have these cells microglia or the janitor cells that get activated when we sleep and they go and they start eating up the garbage material that is produced during the day remember the brain is the most active organ in the body it never sleeps we sleep but the brain never sleeps so imagine the amount of garbage and the byproducts are produced so the generator cells get rid of them but when people are sleep-deprived or if they have a broken pattern of sleep these cells go nuts they go haywire they start eating at the healthy parts of the brain and that's why chronic sleep deprivation actually shrinks the brain people have smaller brains and they have memory problems so the way we say it in our clinic you know forget about all the spas and all the detox programs just work on getting a good night's sleep you know the best spa in your life is your bedroom make sure that you actually Institute sleep hygiene as early as possible because otherwise your memories are going to get affected and it actually you know causes a lot of other health issues like cardiac issues too in shrinkage I mean we spent thousands of dollars on on all kinds of health measures in world in Los Angeles people would come in all kinds of detox from every pore you can imagine gruesome at times but we tell them there's only two types of detox we know of one is water people are not drinking enough water the second is sleep the ultimate detox for the brain is sleep so if you're going to invest in any spa any detox make your bedroom into the ultimate spa noise cancellation light cancellation temperature regulation making sure that you know you know about foods that interfere with sleep making sure that you know about the environmental factors that interfere with sleep and making sure that you know about the behavioral bad habits that you've developed throughout the old years that will interfere asleep if you take care of those you won't need the massive amounts of medication that people are using so sleep to us is a probably the most important eight hours of the day ironically speaking so the the brain has two major drivers the limbic system the emotional brain which actually deals with the past a lot it gets information the past is given in different kinds of weight of emotion and the frontal lobe that projects forward it's not independent of each other but but they're projecting forward so do you see the connection there one is pulling it forward the other is pulling you back you never in the present so what sleep does is calm those systems down and actually takes it out of the formula and what's left is the pure you I know that we're getting a little soft but scientifically speaking it actually allows the brain to function as a whole not as one part pulling forward one part pulling back it almost is a tearing a part of the egh of the other person and sleep does that so part of that was consolidating in memory you know into the file the other part is just that allowing the frontal lobe to rest allowing the limbic system to rest so what comes out is the totality that's critical sleep is is a high energy state so people think you sleep the brain just calms down it's working in fact the most important part of its work is it has to go through those phases of sleep and if it doesn't go through those phases of sleep you could be out for 10 hours yet the brain is fatigued overwhelmed in fact they found that people who would sleep 9 to 10 hours they actually are poor in health why because they didn't they needed to sleep 9 to 10 hours because during those nine satara 10 hours they weren't getting those deep sleep cycles that makes sleep the most important part of your day for all the things that we said consolidation ego consolidation calming the mind down as well as detoxification so invest in sleep does mental stimulation really make a difference in preventing Alzheimer's favorite topic yeah as much as we would like to say nutrition is the most important again it is how could it not you're putting things that are making and breaking the brain every four to five times a day as much as we would like to say exercise and exercises and we'll talk about how important exercise it but the most protective thing for the brain is mental activity throughout life we call it cognitive reserve the bank account there's the brain reserve which is the brain you're left with after the age of five whatever happened before the genetics there's actually apoptosis programmed cell death where there's actually you lose more cells at that time than ever afterwards and then there's infrastructure that's left is the reserve that's pruning clearly of the bringing yet cleaning up then after five whatever knowledge you've acquired whatever challenges you've put your brain and creates connectivity that connectivity is protection profound protection let me give you an example when people compare the brain to a muscle it's such a disservice to the brain biggest guy you know is three times bigger than average let's give the numbers on the brain you have about eighty seven billion neurons now they could make a couple of connections each neuron or as many as thirty thousand connections that's no muscle that's not even Hulk that's a massive growth and how do you achieve that mental activity throughout life we use education as a as a bystander for that because it's easy to say three years of college for exertive but actually the more important thing more than people who have actually maintained cognitive challenge be it wanting a challenging business that they loved be it being a musician a violinist for Orchestra be it you know linguists you know multiple languages being a writer complex behaviors that actually challenges your brain continuously repetitive behavior is not that things that continually change and the second factor is third factor actually is it has to be Purpose Driven because if it's not enjoyed it actually does the opposite it damages a brain that's so imagine you're doing some job that you love and it's challenging continuously because you're making a challenging your brain is so protected that kid would stand even the pathology of Alzheimer's and a big study that none study showed that yeah you are so the nun study these nuns several hundred of them volunteered their writings their body their blood even their brain after death to this study so when when they died they did autopsies of the brain and they collected their writings and what they found was there was a group that had lots of pathology of Alzheimer's the brain was shrunken lots of amyloid plaques and everything yet during the life they had no Alzheimer's this threw everybody for a loop but another group that had minimal pathology the brain was pretty nice looking not much em had profound Alzheimer's during life what happened so let's look in their blood let's look at their writing everything when they looked at their writing of course nuns mostly have the same level of education so education is out but they looked at their writing the ones that were protected despite the pathology had much more sophisticated language much broader covers and vocabulary much more well read and they were much more involved in their communities so a task that that involved them in the communities their language actually protected them even against the pathology of Alzheimer's that was the beginning of a complete different paradigm so it's not just because you developed some amyloid or some vascular factor how much have you challenged your brain that determines the greatest amount of protection and tell them about the taxi driver study which is a very cool study it's it's it's related to the importance of cognitive activity for the brain so there was a study that was done that's actually called a London taxi driver study and scientists wanted to find out what was the effect of intense cognitive activity like memorizing a test for becoming a taxi driver in London did to the brain if people who have lived in London if you've visited London you know that the streets are nothing like in Chicago or in New York there's no rules them it's like somebody just you know glued a bunch of yarn on a on a paper there's no pattern to it some other I could be very happy with you I love you Londoners but your roads are incredibly difficult to memorize so London taxi drivers have to go through this gruesome test of memorizing the different paths back then of course and and they go through a test and you know the percentage of people who pass is not very high so they compared to people who scored very well on this test versus those who didn't score very well and versus people who actually didn't even take it and they found out that people who took the the test and went through learning for this test and getting their license actually had a bigger brain after learning and they also did very very well as far as their memories concerned in neuropsychological testing and we're talking about individuals 50 years and above so even at that stage in life it is quite possible for one to expand their areas of memory and to get better scoring in their memory test by putting their mind through you know challenges like learning you know the map routes or anything for that matter so if I'm hearing you it's almost never too late to start using your brain if you haven't already been regularly absolutely not only is it never too late it's critical because the connectivity happens throughout life you don't grow many new neurons although there's some controversy are we growing your neurons or not even if we are and there's some evidence it's nominal but what we are doing throughout life is connections and that happens at 90 100 or beyond and and it involves mental activity challenging mental activity how does sitting at a computer all day affect Alzheimer's I think in several ways one is if you're just sitting on a computer doing something that's stressful but not Purpose Driven and it's repetitive by itself is damaging if you're just sitting it's incredibly damaging there's studies that show that people who do half an hour of aerobic exercise throughout the day yet then go sit for eight hours it just negated all that benefit in fact the three things that we say for exercises one is more aerobic exercise than you thought 25 to 30 minutes of aerobic exercise to the point where you're tired four to five days a week the second thing is move throughout the day don't just you know you've done the exercise then you set four hours every hour get up stretch walk you know do that kind of stuff and third is leg strength if you're going to do any weight training exercises and if you have no time for any other exercises leg strength because the leg strength seems to be associated with brain strength so but all of it comes back to legs stand up move don't just sit in front of the computer for hours at a time it actually has significant long-term harm is there a correlation with the legs and the brain because of the circulation that's one factor yes so the biggest pump is in our body or our legs it's not even the heart we have the biggest muscles in our legs and when we exercise them certain growth hormones like BDNF brain-derived neurotrophic factor and others are secreted and these growth factors are responsible for the connections that Dean was talking about earlier for making connections between neurons brain cells and giving brain that resilience if needs later in life so it's incredibly important for the legs to be stronger and we tell people you know if you had to choose an exercise for brain health focus on your legs focus on making your legs really really strong to sunlight help prevent Alzheimer's from all the vitamin D it's ironic that we work in California and we check all kinds of vitamins and and about 10% of our patients have vitamin D deficiency so because people don't just they don't go out anymore or they put too much Sun and sunscreen and they should put sunscreen but sometimes too much and and we're not getting but it's mostly because people don't leave home as much especially elderly vitamin D deficiencies is is one of the things that we're seeing associated with many neurological diseases ms is one of them multiple sclerosis dementia is potentially one of them it's very beginning stages so we can't you know expand on it too much but there seems to be an association and whatever we see vitamin D deficiency we definitely tell the patients to supplement and and also go out more and get more Sun because it's good for you and regardless of the vitamin D deficiency association is sunlight solid in itself especially being exposed to sunlight earlier during the day sets your circadian rhythm people actually tend to sleep much better later during the day if they get exposed to the Sun first thing in the morning one of the best things we can do for our brain health is a brisk walk in the morning that way you get exposed to the Sun so the Sun activates the circadian rhythm you get melatonin secretion that will actually make you sleepy during the night and also you know starting your day with a great exercise structure circulation I think it's one of the best things that one can do to stay well diseases like Alzheimer's disease why our Alzheimer's rates increasing there are several reasons one is the ageing of the population the fastest growing population in America are those 85 bit above four times faster than 65 and above who are twice as fast as everybody else they're growing in fact right now we have 80,000 centenarians in the United States that number is expected to go to 600,000 by 2050 if we don't have any other cures and we know we will so there's gonna be much bigger so aging now does does that mean that if you age you're expected to have dementia at this point yes without the lifestyle interventions that we're not instituting yes at age 65 about ten percent of population is expected I have dementia and it doubles every 10 years thereafter and by eighty-five nearly 50% or expect to have dementia and they do and Alzheimer's being the main type now is that at a foregone conclusion absolutely not we know that if you Institute lifestyle factors that number can be significantly lower so it's not correlated directly with age because at this point we're not doing anything with aging so that aging component is a factor and our cumulative trauma as we get older is another factor as we get older we don't do anything about the blood pressure at least not the underlying factors we just keep taking medicine we don't do anything about cholesterol which actually becomes more and more we just take more medicine we don't do anything about diabetes or prediabetes but we just give it medicine so that's why there's cumulative damages as we get older so all those factors have to do with greater risk for all Somers as we get older and what can reverse all that earlier institution of lifestyle factors then it's not then that it doesn't have to be an age factor do we have any control over preventing Alzheimer's absolutely there's no doubt about it you know people get to hear the myth that Alzheimer's cannot be prevented Alzheimer's can't be treated that's that's for sure we don't have any treatment for Alzheimer's disease and you know billions of dollars have been spent over the last few decades on focusing on the wrong model of Alzheimer's disease we always tend to focus on the end products at the latest or the last stages amyloid proteins here for example is a protein that accumulates in in the brain during the later stages but that's a downstream product of everything that has happened earlier on in life Alzheimer's can be prevented we've actually seen it in population studies we've seen it in our own clinic in patients who come in with mild cognitive impairment which is the earlier stage of Alzheimer's disease and if lifestyle and a lifestyle intervention is instituted we see reversal of some of the damage and doesn't let them go down that route absolutely can be prevented I think the misunderstanding is because people always confuse treatment and prevention we we never have claimed that we can treat Alzheimer's disease at this stage now when that happens the brain has already gone through the stages of its damage and it can't be but reversal but but when it comes to prevention absolutely we see it all the time one of the most important things we can do to prevent Alzheimer's and what proof is there that they really prevent it I think the most important thing we can do because it's a personalized disease it's not a one path disease some people come to it from inflammation some people come to it from glucose dysregulation some people come to it from fats and lipid this regulation it's multiple directions it's personalizing it finding out what are your risk factors and affecting those that's why it's good to get the testing it's a common you know do you have insulin resistance or diabetes do you have cholesterol do you have high blood pressure you have risks for those things do you have you know have you had head trauma you know other kind of factors that I put you in that path and if so then do the things necessary to reverse those risks and ironically what are the things you can do to reverse those risks the attrition exercise stress management sleep and mental activity that's why our acronym is neuro and 'url nutrition exercise unwind for stress management or for restorative sleep not just sleep you can knock people out but they might not be getting restore sleep and oh it's for optimizing mental activity and if you do those things absolutely you'll reverse it and each person has to decide where they're picking their battle first if somebody has sleep apnea which means that they're not getting enough oxygen at night for them they could eat a truck full of kale it's not gonna do any good they should start their battle with sleep apnea for others who are not getting any mental activity and social activity it could be eating all the healthy food and exercising but no social and mental activity that's going to damage them for others they have the social activity been eating extremely poorly then that's what the battle they should think but everybody can take on this battle in their own way and it's not that hard and you don't have to buy anything from anybody because it's your personal lifestyle and the concept of brain health is similar for all the other organs in the body what we say is if you start taking care of your brain you've taken care of the rest of the body the same concepts of you know a whole food plant-based diet being good for the heart actually applies to the brain as well prevention more maybe even more absolutely because it's a very very vascular organ we actually have more arteries in our brain than any other organ in the body so how can it not be affected by lifestyle and as far as data is concerned and research is concerned you know I don't think there's any controversy we've known for decades and decades of what works for the brain and for the body it's about getting rid of processed foods it's about getting rid of saturated fats from meats and poultry and dairy products it's about increasing a whole food plant-based diet as far as nutrition is concerned and then the same thing for exercise for stress management for sleep let me tell you about sleep sleep apnea which is an epidemic increases your chances of Alzheimer's disease by 70% 70% so like Dean said it's a personalized approach if you have sleep apnea and you refuse to wear your seatback machine because it's very uncomfortable no matter how much you exercise no matter how much you eat healthy foods if you don't take care of that that's not gonna be helpful for your brain at all so it has to be through an personalized approach are there any scientific studies showing anything that clearly prevents Alzheimer's and dementia there are many studies that have shown that lifestyle effects prevalence and and proclivity for Alzheimer's there are no drug studies none that have shown that they've actually even slowed down the disease none as far as data for nutrition is concerned there's plenty of data to show that you know a diet that is predominantly plant-based reduces the risk of Alzheimer's disease significantly one of the studies that came out a couple of years ago from Rush University showed that adherence to a mine diet a Mayan diet is a hybrid of Mediterranean diet and a diet low in sodium the DASH diet when you look at the scoring system it's high in vegetables fruits whole grains nuts and seeds and low in animal products and among animal saturated fats and processed foods of obviously by adhering to that diet people were able to reduce their risk for Alzheimer's disease by 53 percent 53 percent what medication does that we don't have any and even moderate adherence to that diet actually reduced the risk of Alzheimer's disease by 35 percent that was just diet alone not even including exercise or mental stimulation or anything of that nature and and you know the data goes on back in 1993 dr. Paul Guillen from Loma Linda University was interested to see the incidence and prevalence of Alzheimer's disease in the Adventist community now Adventists are gonna have vegetarian half non-vegetarian so he wanted to see what was the effect of diet on the development of all services and he found out that people who were non-vegetarian so we're omnivores actually had twice the risk of developing Alzheimer's disease and these were individual week consumed meats and poultry including fish as well well vegetarians had lower incidence and the same thing in Kaiser Permanente Northern California study about you know 10,000 individuals followed for many years they found that when people have high cholesterol during their midlife there are chances of Alzheimer's disease increased by 57% and even if they had moderately high cholesterol levels during midlife their chances increased by 23% and the same thing goes in Columbia University they found out that in the northern Manhattan study people who consumed a plant-based diet significantly reduced their chances of memory decline so you see these studies for nutrition let's take exercise for example there was a study a meta-analysis study which looks at data from multiple studies put together thousands of individuals you know fall over many many years they found out that moderate to strenuous activity you know something that makes you break a sweat and have a difficult time finishing a sentence reduce the risk of Alzheimer's disease by 38% now these numbers are incredible I mean for diet look at that you know 53% for exercise 38% you put those together and you do that in life the obvious the numbers don't add up it's not it doesn't being more than 100 percent but that statistics it doesn't work that way but these are incredibly strong evidence that shows us that if you live a certain lifestyle you're bound to reduce the risk of Alzheimer's disease we also know a lot about stress and how stress affects the brain there have been multiple studies done on what actually happens when people are stressed out and when we talk about stress it's the daily worries that little worries that kind of just eat at you and that causes the release of chemicals and hormones in their bodies like cortisol and adrenaline that literally shrink the brain and it doesn't allow you to consolidate memory it doesn't allow the brain to grow and thrive it actually stops from the formation of long term memory from all the information that you get on a daily basis same thing in optimization of cognitive activity Dean and his colleagues actually published a paper and they looked at brain games and cognitive activity and how it reduces the risk of cognitive impairment and they found out that when people focus on their weaknesses say for example not being able to focus on something or not being able to remember short-term items you know their recall is affected if they practice towards making those better you actually reverse that damage in your brain and you get a better brain so there's no shortage of data there's a lot of data that we can prevent Alzheimer's disease what do you think of the likelihood of a drug becoming available that could stop or reverse the progression of Alzheimer's or dementia we don't think that there will be a drug that will actually reverse the disease reverse means that the damage that's been done is actually then corrected there might be a drug that slows down the progression and there might be a combination of drugs that actually stop the progression altogether but reversing implies that at the same time that it stopped that it helped regrow the brain that's not going to happen because by the time that Alzheimer's has manifested significant damage will have been done we're talking about amyloid accumulation vascular disease neuronal loss so let's say that you find the drug that stops that well they're also at the same time help regrowth no but that in itself is actually profound if and when they do this where they in a combination drug and I don't think it's gonna be one drug they're able to stop the disease from progressing that's profound in itself because then you can give lifestyle the chance to regrow the brain or at least the connections of the brain so I think there's hope it's not in the near horizon but there will be definitely something in the near future in the future and in the meantime what we have to do is Institute lifestyle changes because even when there's stoppage of the disease let's say in five to ten years you still need lifestyle to regrow so why not Institute it now I think it's important for people to understand that Alzheimer's is not one disease there are multiple pathways to Alzheimer's disease and unfortunately at NIH and other you know research institutes the focus has been on a particular protein or a particular molecule and that's not what happens it's a very complex disease and the way to approach its prevention also has to be multifaceted and complex and right now prevention is the only treatment what do you think of the likelihood that we'll discover a natural remedy or a lifestyle choice being able to stop or reverse the progression of Alzheimer's or dementia I would say a hundred percent and I would say we have it now and that's lifestyle intervention through a whole food plant-based diet exercise stress management good sleep hygiene and mental activity 100% we have it now we just have to accept it at a population level why is this not being promulgated in a spread because there's no money to be made nothing to be sold nothing to be bought and start a controversy it's not a conspiracy it's just that even us as patients as consumers we love that one pill one vitamin one protocol one plan here's the plan go home buy more vegetables less meat and sugar go home and exercise in your living room get a recumbent bike and connect it to your TV so the TV is not working unless the bike is moving go home and identify on a whiteboard what your good stresses are learning a new musical instrument what your good stresses are learning to lead a charitable organization and that kind of stress actually grows the brain and identify the bad stresses the job repetitive that you're doing and work reduce it and make it more more more and more varied sleep sleep better you know identify your bedroom as a place of as a sanctuary make it a spa sleep hygiene and then get socially and mentally involved in the community learn a musical instrument go get a group and play cards with them by the way eating healthy food snack you know start you know chatter and you know ripping on each other and you know all kinds of stuff because that takes mental activity that's the kind of stuff that will actually reverse prevent brain diseases brain is a living machine the kinds of which we will not see in a while we keep hearing about AI this and AI that the brain is 87 billion neurons 1 quadrillion connections 1 times 10 to the 50th power and we're using it and 1 percent efficiency you know when they say that we only use 10% of the brain no we're using 100% of the brain but at 1 percent efficiency we're repeated cycles repeat habits even our thoughts our habit loops we keep rerunning the same habit lewis or thought we think we're thinking we're running the same loop why because it's high energy to go in the cortex and the higher brain thinking and brain doesn't want to spend that much energy well evolutionarily but it actually grows the brain when you go outside of the habit loop and that is that not in a fancy spa in Arizona it's done in your living room and your kitchen ironically even with that passion even with that data we said this to the people and I know that they're incredulous because we've been raised in a pill society if it doesn't come in a pill it can't be working it's not science and they will accept pseudoscience with these vitamins and blue jellyfish things that all this stuff instead of real real life science which is lifestyle science as long as it's in a pill we have to change that mentality we have to change that mentality because the consequence is dire this tsunami of Alzheimer's or dementia in general is going to take the healthcare system right now it's the costliest disease of them all two hundred fifty nine billion dollars direct cost two hundred forty billion dollars in direct cost five hundred billion all together more than let's put that in comparison the second costliest diseases heart disease at 120 billion third Carsley says all cancers at 70 billion 500 billion 70 billion and that number is going to go to three trillion dollars by 2050 2040 actually if we don't do something about it and it's not going to be in a pill it's gonna be in our communities please tell us about the paper you published on insulin resistance so it's a long resistance is a condition where your body does not recognize the amount of glucose circulating and it does not use glucose as a fuel for cells because of excess now saturated fats have a lot to do with that saturated if I'd actually jams the doors to the cells to take in glucose and it completely messes up the mechanism of insulin allowing glucose to go into the cells we wanted to find out whether insulin resistance increase the chances of cognitive impairment a large population and we studied that in an Haynes which is a large database and we found out that when people have insulin regardless of diagnosis of diabetes had an increased chance of having bad memories and cognitive decline and it makes sense if you constantly have dysregulation of glucose in your body and if you constantly are you know consuming a lot of saturated fat which contributes to insulin resistance obviously your brain is going to get shocked and it will not be able to function normally so it's very very important for people to understand that insulin resistance contributes to cognitive decline do you think it's accurate to call Alzheimer's type 3 diabetes well for the last few years we keep getting different names type 3 diabetes garbage-disposal disease different names reality is it's because we're not understanding that Alzheimer's is not one disease people come to Alzheimer's from insulin resistance side which would be a diabetic component from lipid this regulation which has to do with cholesterol and a plea for and all of that or from inflammation you know people who have repeat traumatic brain injury have a much higher risk of dementia so the definition depends on which pathway you've taken there so I think that calling it type 3 diabetes is is is not right because it's taking just a small category of the patients it's a combination of those and a lot of times it's all of those things combined inflammation seems to be a common pathway though even if you come from glucose regulation or fad this regulation inflammation seems to be the pathway that ultimately moves the process forward so it's better to look at it as a as I said a more multifaceted disease and and more complex disease than one pathway disease how does the prevalence of Alzheimer's compare today to say 50 years ago and how's it trending Alzheimer's is increasing significantly now for several reasons one is we're surviving more I mean right before Fleming and you know penicillin and all these that people wouldn't live to 65 people have no idea that from 1940s till now the world has changed significantly before that time there weren't that many people that would live to 70 80 90 we would die from infections whatever we give a talk we actually say how many people in this room had a dental procedure in their life I mean all have used the antibiotic how many people have had a surgery almost everybody ends up raising their hand but I'm saying most of you would be dead before the 1940s and so that revolution hasn't helped people live longer and given that Alzheimer's is not so much a disease of aging as it is a disease of a cumulative trauma throughout life so if you live longer or if you allow trauma to accumulate throughout your life meaning glucose and lipid and all that then your chances go higher that's what's happening people are living longer and therefore they're facing diseases that actually push this forward as physicians and health care providers we've become really good at managing disease and you hear that word a lot in the hospitals you manage diabetes you manage blood pressure you manage cholesterol nobody ever talks about treating it you know why because the medication that we have they don't really affect the disease process they just manage the symptoms on the surface it's like you know you clean off the dirt and the dust from your carpet and you just kind of swipe it underneath it but the dirt and the dust is already it's there you know you haven't gotten rid of it and so it's the accumulation of all these pathologies and this damage that's continuously going on in our bodies that result in brain damage and that's why people who have long term diabetes on multiple medications on blood pressure medication on cholesterol medication they feel fine they function but the pathology continues going on and then they get Alzheimer's disease and dementia and that's why we actually see more and more of it now compared to 15 years ago what were the main conclusions of your book and research the main conclusions of the book is about hope that the most important organ that we have in fact that what makes us who we are is the brain we can do a lot about not just preventing disease but actually having growing powerful brains well into our 80's 90's and beyond that's our control now whenever we say this people say oh are you are you actually blaming people who develop dementia and stroke for what they did no it's like saying somebody who had heart attack it's their fault no we identify what things actually put people at risk how we should learn from that how we should change for future I mean I lost two grandparents to this disease and I should lost two grandparents to the disease we're not blaming anybody but we're also identifying for the fact that lifestyle that that they led contributed to some extent and there are things that any one of us can do not to just avoid Alzheimer's that's that's just the icing on the cake but to have vibrant growing brains well into your you know later life because the opposite direction is also true after if you don't do the right things exercise mental activity and good food your pathology starts in your 20s and 30s we've seen the decline in your 20s and 30s you reach a peak in your 20s and then if you don't do the right things there's a continual decline in your memory and processing executive function everything but people actually who Institute the right lifestyles they start growing the brain at any age that's hope hope based on science there's nothing more valuable than that so we're empowering people and I think it's a book about empowerment and as a health care providers I think we have the privilege of being that that bridge between the world of science and public health I think Dean and I have completely dedicated ourselves to presenting the real data and I in our book we wanted people to know that there really isn't any confusion about brain health yes there's a lot of noise there's a lot of clutter out there but we've had the data for such a long time about prevention of brain diseases like Alzheimer's disease and stroke and it all has to do with lifestyle


  1. THANKS for listening when I asked for you to add voice overs or narration of onscreen questions!!

  2. Hm,… I think it is stress, childhood wounds & unhappy lives, & toxins in our lives, mineral deficiencies, low quality food & sugar in places where it shouldn't be,etc,…

  3. I love your work and your message, but I do have a question. If Alzheimer's is diagnosed when it's too l late how do we know that it can be prevented or reversed if caught early enough? I'm just assuming that it's because eating a WFPB diet is so good at preventing or treating so many health issues that it's natural to assume that it would this as well. I'm trying to convince my meat-loving family to go plant-based.

  4. Amazing work and message. Wonderful and I praise these Doctors.

  5. Very good book!

  6. Keto diet has been said to promise protection to brain diseases and also better dental health and becoz of that maybe reduced risk of Alzhimer. Suggest Dean needs to look at his diet… He looks a little overweght…

  7. There has been numerous reports lately that P. gingivalis bacteria could be the cause of Alzhemer's disease.

  8. “We’re not selling vitamin concoctions…” Rare in a profit driven world where the vegan/plant based/supplement industries are worth billions in USA alone. I’m going to buy on Kindle and hardcopy to donate to library. We’re facing similar challenge here in Canada and I suspect other developed countries. Keep spreading facts based on science not trends and profit. 🙏👏🌱

  9. Excellent, so very well done. I've been very worried about Alzheimer's for a long time; my mother–doing almost everything right–had Alzheimer's that developed over two decades. (She was under tremendous stress taking care of my father.) So although I've been reading and knew most of this, your putting it all together in this video inspires me to stick to all my resolutions re: exercise and diet. At 72, there's still so much I want to do; you've given me hope that it's not necessarily downhill from here! I thank you from the bottom of my heart and mind for your dedication to noble goals.

  10. One thing that has helped me control my blood pressure in addition to a whole plant based diet including 3 cups of beans or lentils is intermittent fasting. By fasting 16 hours a day I have been able to drop my blood pressure medication and maintain a pressure of 110/65. Not bad for someone 71.

  11. So appreciated. Thank you for this. My why for a WFPB diet just got a booster shot. You two are amazing. Seriously, informative. Wow!

  12. Awesome information, Thank you!

  13. Whole food plant based diet is the answer..!!!!!

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