0:00

Coming up on this episode of the doctor's pharmacy.

0:02

So what happens in the gut impacts the brain

0:04

and vice versa. There's a couple of pathways that

0:06

have been isolated. Caught down bottom up. Right. I

0:08

guess bottom up being more specific in this case

0:10

to the gut, the brain, but sure, both ways.

0:12

And again, I think we will learn

0:14

in the future that maybe this part is not in

0:16

as much control as we thought. Before

0:20

we get into today's episode, I'd like to take a

0:22

minute to remind you of some exciting news. My

0:25

new cookbook, the Young Forever Cookbook will

0:27

be released on Tuesday, June 4th nationwide

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in my new cookbook, the cooking companion

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over a hundred mouthwatering, anti-inflammatory recipes that

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4th. Preorder yours today. Hey

0:54

everyone. It's Dr. Mark. We all know

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2:54

Welcome to Doctors Pharmacy. I'm Dr. Mark

2:56

Hymaness, pharmacy with a place for conversation that

2:58

matters. And the truth

3:00

is this conversation relates to everyone

3:03

because we are having an epidemic

3:05

of brains on fire, something

3:07

called neuroinflammation, which is affecting so many things that

3:09

we're going to talk about in a minute. And

3:12

our guest today is a incredible physician,

3:15

Dr. Austin Promutter, who

3:17

is deep into this topic of neuroinflammation.

3:19

He's a board-certified internal medicine physician, a

3:22

New York Times bestselling author, and he

3:24

talks a lot about neuroinflammation in his

3:26

book called Brainwash. He's also

3:28

a published researcher and an international educator.

3:31

His mission is to help people improve their health

3:34

by targeting the biological basis of stuckness in

3:36

our brains and bodies. Who wouldn't want to

3:38

be free of stuckness? His

3:40

writing and presentations, podcasts, and online

3:42

educational programs explore how environmental factors

3:45

influence our cognitive and mental state, and they've

3:47

reached millions of people. He's been

3:50

featured on PBS, Rolling Stone, Newsweek, NPR, and

3:52

a wide range of other outlets. He's a

3:55

co-producer of Alzheimer's, the science and prevention series,

3:57

and the host of the Better Brain Blueprint

3:59

Society. Harrys. He currently serves as the

4:02

Managing director of Big Both Health Food

4:04

is Medicine Company Folks are helping keep

4:06

on rejuvenate health to better immune function

4:08

where he is running. First of it's

4:11

kind study for the effects of plant

4:13

nutrients on human aging to epigenetics. A

4:15

Why this conversation is so important is

4:18

that we're seeing an explosion, a brain

4:20

inflammation. Disorders. Everything from

4:22

mental health crisis with depression, anxiety,

4:25

bi polar, even psychosis, Schizophrenia all

4:27

connected to bring information not to

4:29

mention a D H D, Autism

4:31

and even memory issues like Alzheimer's

4:34

all connected to brain inflammation. And

4:36

what's more, Are we

4:38

talk about in his podcast is

4:40

how that brain inflammation is affecting

4:43

at Us as a society meeting

4:45

to increase divisiveness strife. Oppositional

4:47

behavior, aggression, violence, all of which

4:49

may be linked in small or

4:52

large part to nor information's we

4:54

talk about how to eat dinner,

4:56

finer information, what causes it, how

4:58

to resolve it, and what do

5:00

about it. In his fastening conversation

5:03

with Doctor Austin Perlmutter, let's dive

5:05

right in. I

5:08

asked the welcome to the Doctor Sauce a

5:10

podcast martin say to be here sorry for

5:12

the conversation so I just as background are.

5:14

It out. Ah your dad and I go

5:17

back a long time ago and I were

5:19

were been friends for long time. David promoter

5:21

of Rain Rain saw together you wrote Rain

5:23

Washed with him which is really going to

5:25

be a lot of the top or in

5:27

an argument that a we had you other

5:29

podcasts number years ago when that book out

5:32

which is that's an that. Your Dad really

5:34

was one of the pioneers in helping us

5:36

think about. Brain.

5:38

Inflammation know I knew you

5:40

are now heavily focused on

5:43

this whole topic of. Why?

5:46

Our brains are inflated. Which.

5:48

Leads to. So. Many

5:50

downstream problems and pretty much everything

5:53

that goes wrong when the brain.

5:55

from autism to Alzheimer's from anxiety

5:57

to depression. From a.

6:00

Elisa Schizophrenia to Parkinson's I'm you

6:02

name it anything. The Salon in

6:04

the Brain. That the brain's

6:06

not working. It. Doesn't

6:08

in a way of like saying out of

6:10

your joints in plane hits read and soren

6:12

and hurts when your brains inflamed. It

6:15

comes out of all these other manifestations and

6:17

season. so he are you few I'm been.

6:19

He'd been in the topic of this and

6:21

I I've been very impressed with your thinking

6:23

about it. I just really came from a

6:26

lecture that you game it the Israeli Health

6:28

Symposium here on your information. I learned a

6:30

lot actually. And. In,

6:32

it really seems to me that that we are.

6:35

In an era of masses inflammation

6:38

your daddy's satisfied with. like the

6:40

brain on fire now and I

6:42

think our brains on fire. Emotions

6:44

on fire. Society on fire, polarized

6:47

and disconnected is more aggression where

6:49

violence, my depression, We have

6:51

a mouse myth of crisis. Opioid

6:54

does this disease of despair and.

6:57

The really didn't seem to be are very coherent approach

6:59

to it. Other than know

7:01

suing the sack for family for oxycontin and

7:03

coaches are really a solution and it's very

7:06

don't seem to be a lot a coherent

7:08

thinking about it in in i really miss

7:10

him crazy studies where there are like we're

7:13

going to use. These. Drugs called

7:15

seen a powerful blockers to treat depression.

7:17

Because. No one of the brain. As

7:20

depressed as Flamer. And

7:22

I'm like wait a minute or get

7:25

using a fifty thousand. I drug been

7:27

prisoners of cancer and are only affection

7:29

death to treat depression have a figure

7:31

of the cause of the information. So

7:33

let's let's talk about. In,

7:35

I've narrowed summation as a concept.

7:38

What Is it? I'm you know?

7:40

What's causing it? And

7:42

and why we sing such an epidemic of

7:45

nor inflammation and by the way, some really

7:47

something April and about medical schools and you

7:49

got me read your medical school lot more

7:51

research and I did. I bet you didn't

7:53

learn a lot about I've so kind of

7:55

walk us through this whole. Time.

7:58

Conceptual framework of known for me. Then why

8:00

would you care about in what is

8:02

causing and what was happening and sister

8:05

raids habits i think. Marvelous there with

8:07

the basic here says the understanding that

8:09

as we look at how people are

8:11

doing today crossed the world's we have

8:14

to have a realistic moment of pause.

8:16

To ask whether people are doing well,

8:18

are people getting better? crossed the plan.

8:21

Something we've talked mouse and there's a

8:23

multiple choice question cause they're the answers.

8:25

Hell no power. None of the about

8:27

finding I me about. So as you

8:29

can look at all these different disease

8:31

but if you look at time is

8:33

underlying. ah the lowest common denominator for

8:35

many of these cases it is chronic

8:37

inflammation. We understand this in the body.

8:39

So seven on its hands of the

8:42

top cause of disease and death on

8:44

the planet say are these chronic diseases

8:46

of which. Many of these are driven by

8:48

chronic inflammation, and we'd come to terms with this

8:50

as it relates to what's happening in our body.

8:53

There. Has been this fundamental disconnect though with

8:55

this expectation that we don't need to look

8:57

at the brain and the same own. And

9:00

you looted to this with this. Strange.

9:02

Sense of if information seventy in the joint we

9:04

could point to it. We can say that there's

9:06

a problem in the stories and it is customary.

9:09

If. A person has painted their joint for

9:11

them to go to the store and

9:13

buy an anti Islam for medication like

9:15

our exactly alien and said this is.

9:17

City. Prototypical with this is the way that we

9:20

look at inflammation. We have kind of this loop

9:22

that we follow, but what does it was open.

9:24

Information occurs in the plane. And

9:26

you've reference under these diseases that what

9:28

we know is so of the three

9:31

hundred plus million people around the world

9:33

right now experiencing depression, a sizable proportion

9:35

of them have elevations in serum inflammatory

9:37

markers and so it's believed that was

9:39

which which are talking about. There are

9:41

things like the side of time we

9:43

heard of uncovered. That I kind

9:45

of the messenger most of the new system,

9:48

if you're saying is it a family give

9:50

up your depression, have high levels of these

9:52

in there. But right? So anyway, speaking that

9:54

people, people who have depression, have a higher

9:57

likelihood of having evidence of elevated information. You

9:59

can make. In a number of different

10:01

ways. this is so important though not

10:03

just and depression buffer conditions like Alzheimer's

10:05

because. By. And large as we

10:07

look at these brain diseases, the standard of

10:10

care sucks. It's miserable. So if you go

10:12

through devalue official was married with i guess

10:14

is miserable a bipartisan specify the coat of

10:17

it's the point being though, if you were

10:19

to look at what's a depression for example,

10:21

So again, three hundred plus million people around

10:23

the world who are experiencing depression right now.

10:26

If you look at the kind of hit

10:28

rate for conventional anti depressants with least fifty

10:30

percent of people will get a substantial improvement.

10:32

Roughly thirty three percent of people will get

10:35

a actual remission. And somewhere in

10:37

the neighborhood of twenty percent of the

10:39

American population is going to be diagnosed

10:41

with major depression. So thinking about what

10:43

that means in practice or conventional therapeutics

10:45

are not doing a good enough job.

10:48

Similarly, When we look at Alzheimer's disease,

10:50

so we look at conventional drugs for

10:52

Alzheimer's they just don't really work to

10:54

actually mitigate the some that are to

10:56

mitigate disease process in a meaningful way.

10:58

So. Pausing. There for a

11:00

second we say is that sufficient The

11:02

answer no we need to keep looking

11:04

And then we start to ask what

11:06

systems within the body can help us

11:08

to explain what is going wrong. And

11:10

recently as two years ago a paper

11:12

came out looking at serotonin and serotonin

11:14

hypothesis of depression basically debunking the idea

11:16

that serotonin was the principal driver of

11:18

why people experienced Russians to me the

11:20

most, her. That will solutions

11:23

on him but also changes in the

11:25

receptors, changes in how those pathways are

11:27

activated. The majority of our anti depressants

11:29

work in theory on serotonin pathways, but

11:31

it hasn't necessarily been proven. So it

11:33

leads us to this conversation about is

11:35

there another system at play and inflammation

11:37

as really risen to the talks as

11:40

it relates to potential ways to explain

11:42

what is going wrong, what's really important,

11:44

and what I think we're going to

11:46

get into here. It's not just

11:48

talking about diseases. And we've

11:50

got to get away from thinking that health

11:52

starts when you get a diagnosis on the

11:55

talked about sensibly So for everyone who's out

11:57

there listening and may be doesn't have a

11:59

diagnosed mental health condition, doesn't have a diagnosis

12:01

of dementia, this stuff still really matters to

12:04

you because as we can talk about inflammation

12:06

is driving every aspect of who we are,

12:08

how we feel, how we interact with the

12:10

world. and to that end it means that

12:13

modulating changing our inflammatory balance in the body

12:15

and in the brain is a way for

12:17

us to change how we show up in

12:19

the world. So not just as the extreme

12:22

ends when things have gone so catastrophic li

12:24

wrong that we say you have a diagnosis,

12:26

you need a therapeutic, but even in the

12:28

database you want to. Think that are

12:30

be better and your relationships have the

12:33

planet that is an inflammatory out means

12:35

you don't have a diagnosable disease. Any

12:38

level inflammation. It's so that out

12:40

of control nobody will consider to

12:42

this function with to be symptomatic,

12:44

his brain fog fatigue or it

12:46

is not sharp or. Lil

12:48

little The prize lucifer not meet

12:50

the criteria for a disease spreading

12:53

so. I have I caught Frc

12:55

syndrome. As and you feel like that. That

12:58

another official diagnostic? Absolutely. And

13:01

lot of you will have another you don't

13:03

tiger mask and I I i think it's

13:05

it's is important and start to realize we

13:07

need a different thinking. Framework

13:10

for how to assess this

13:12

is because our current assessment

13:15

of psychiatric disease, of of

13:17

neurodegenerative diseases of. Dog.

13:20

Neurological diseases. Is served

13:22

our taste. It's very descriptive. we're

13:24

going to describing things that labeling

13:26

things. But. The or is it is have

13:29

a job in neurology which is diagnosed not e

13:31

o two or three Mystery to me a physically

13:33

like him out of the door because his numbers

13:35

you can do for. And and the

13:37

truth is, there's a lot that can be done. Ah

13:40

and your dad is really pay analog the wasting your

13:42

leading the way now and I think that. Are

13:44

we we need to serve. Think about

13:46

new information as is common. Framework.

13:49

For understanding a lot of what's wrong with

13:51

our brains and all of things that go

13:53

wrong when it rains from all the mood

13:56

disorders, attention Disorders, autism disorders in various orders.

13:58

All these things that. will really

14:00

have great treatments for in traditional medicine are

14:02

actually very amenable to treatments

14:04

that address the root causes. And I'd say prevention.

14:07

And I think that's key to this conversation. So

14:09

I don't know what it was like back when

14:11

you were learning these strategies, but for the most

14:13

part, you screen for depression in the clinic. And

14:15

if a person meets criteria, then they get into

14:18

the algorithm. Person's feeling a little bit

14:20

low. You maybe make a note in the chart, but you're

14:22

not necessarily following up on that. We'd say that's part of

14:24

the spectrum of normal human experience. We

14:26

do a similar thing when it comes to

14:28

MCI or pre MCI, meaning mild cognitive impairment.

14:31

What we're talking about, exactly. So

14:34

if a person comes into the clinic and say, I'm

14:36

not really thinking clearly, you might start a workup. You

14:38

might check B12 and some other markers, but in a

14:40

traditional sense, you're not necessarily doing much until they've received

14:42

a diagnosis. So what about somebody in their 30s is

14:45

coming in saying, you know, I just don't feel like

14:47

I'm as sharp as I used to be. What can

14:49

I do? Conventional medicine would

14:51

say, well, exercise, get some good sleep and

14:53

we'll do some evaluations in the future unless

14:56

things get really bad. And so

14:58

that, and I'd say again, prevention is the key. It's

15:01

my belief, and I don't know if you share this,

15:03

that mental health is kind of the absolute final outcome

15:05

that we need to care about. It's

15:07

what makes life worth living. Everything else to

15:09

this surrogate marker for mental health.

15:11

Yeah. And if that is the

15:14

belief, then we should be having... It determines the

15:16

quality of our life, relationships, it determines our behaviors

15:18

because if we're not happy, we're going to do

15:20

something that might be self harming, like eat junk

15:22

food or not exercise, drink too much. Yeah.

15:24

I mean, if you push somebody hard enough and ask them, why

15:27

do you care about that? So maybe they say, I'm

15:29

really, I care about making a ton of money. Why? What

15:32

does it mean to you? Eventually you get to, it makes me feel

15:34

good. And that's kind of at the end of

15:36

the day, the thing that matters most. So if we

15:38

agree and hopefully we do that mental health matters more

15:40

than anything else, then if we work

15:42

backwards, we say, what are we actually doing

15:44

to optimize for mental health? And

15:46

for the most part, we do very

15:48

little until things get bad enough that

15:50

it necessitates a diagnosis, pharmaceuticals. And

15:53

that's just a problem because we take so

15:55

much time now to think about preventive cardiology,

15:57

right? You should be jogging each day. You

16:00

can decrease your risk of heart attack. What

16:02

are we doing each day to prevent

16:04

depression, to prevent anxiety, to prevent Alzheimer's

16:06

disease? I would argue that is

16:08

even more important. So yes, heart disease kills

16:10

more people than does dementia and Alzheimer's directly.

16:13

But if our goal is quality of life and mental health,

16:15

then that actually should come first. I

16:17

think that's just such a critical point you just made

16:20

because we think

16:22

about certain things like, oh, I can prevent diabetes

16:24

if I eat better, or I can prevent heart

16:26

disease if I exercise and eat better and reduce

16:28

stress. And there's sort

16:30

of an understanding within traditional medicine, even though

16:32

it's not applied, right? Just take your stuff,

16:34

right? Take your ozone pipe.

16:37

But there's not even a framework

16:40

for understanding how to improve

16:42

brain health or prevent brain

16:44

diseases or prevent depression. And

16:47

the truth is, there's so much we know about

16:50

this. This is in the evidence-based literature. It hasn't

16:52

been translated into clinical practice. And that's really one

16:54

of the fundamental problems in medicine. It's just such

16:56

a lag time. And even within traditional

16:59

approaches, there's a lag time. And forget about

17:01

things like systems biology and medicine, network medicine.

17:03

I mean, they've got microbiome, but they're a

17:05

huge role in mental health. But how many

17:08

psychiatrists are checking a poop test? Not

17:10

a lot. Not too many. I

17:13

think to go into that for a second here,

17:15

I mean, think about where we should be heading

17:17

as it relates to upstream

17:19

thinking for depression. Our

17:23

population is one, and

17:25

I'll try to say this as carefully as I

17:27

can, where at least in the United States, it

17:30

behooves most interests for us not to have solved

17:32

for mental health. And why is

17:34

that? It's because when

17:37

a person is feeling good about what's going

17:40

on immediately around them when their cup is

17:42

full, they're not as likely to buy all

17:44

the unnecessary stuff, to fall victim to all

17:46

of these unnecessary ploys for their money and

17:49

for their time. So this

17:51

is not to say necessarily that we've created

17:53

an evil society. It's simply the fact that

17:55

our incentive structure has very little to do

17:57

with better mental health. Exactly.

18:01

It is better for most large entities,

18:03

corporations, companies for us not to feel

18:05

good because if we feel good, we

18:07

don't need their X, Y, or Z.

18:10

Yeah. I don't know if you saw that, Austin,

18:14

but there was a recent article in

18:16

Fortune magazine about the CEO

18:18

of the company that makes Ozempic,

18:21

which by the way, I don't think they sell

18:23

in Denmark. It's the biggest

18:25

contributor to the GDP of Denmark

18:27

right now. And the

18:29

CEO kind

18:31

of called it out, but he was getting phone calls

18:33

from all the junk food makers concerned

18:35

that they were going to be

18:38

in trouble because of this drug cutting into their market

18:40

share or stomach share. And

18:42

I think, you know, you

18:44

saw the Super Bowl, but this year, in the

18:46

first half, there were 11 commercials for junk

18:48

food. The rest of the commercials, other

18:51

than the Christian commercials,

18:54

were for basically addictive things, gambling

18:56

and alcohol and junk food. So

18:58

when you think about what's

19:00

being told to us and

19:03

the things that are being shown to us and the pressures

19:05

on us to kind of consume and buy things

19:07

that are going to numb us, dumb

19:10

us down, make us sick, it's

19:12

kind of frightening. It's literally like,

19:14

wow, this is the most watched

19:17

show on television. And

19:19

the entire show

19:21

was punctuated by

19:24

pushing us to become more addicted

19:27

and more depressed and more obese and

19:29

more sick. And

19:32

it was sort of striking to me. And I was like,

19:34

wow. It's also

19:36

just a great representation of Snapshot in Time as

19:38

to which companies have enough might to be able

19:40

to afford those ads on TV. So their margins

19:43

are big enough that they can put up a

19:45

couple million dollar commercial for X, Y

19:47

or Z. And that is a direct reflection

19:49

of the fact there is that degree of

19:51

consumer buying. You're absolutely right, though. I mean,

19:53

it's always the irony of watching professional athletes

19:56

and then watching them in commercials, Advocating

19:58

for the things that would. Absolutely destroy.

20:00

Their careers are the I did. Where do

20:02

you know if they continue to consume? But

20:04

you're right. So whether it was the beer

20:06

or the food or the gambling, these are

20:08

the things that we defaults. You. And.

20:11

Again, I think there's there's an important points

20:13

we made here, which is it's easy to

20:15

go to the place to sang evil corporations.

20:17

I think it's just this is what corporations

20:19

are incentivized to do and. Humans.

20:21

Find places have minimal resistance or least

20:24

resistance is has been discovered by people

20:26

over the time at we've had our

20:28

marketing that when you make things appeal

20:30

to more primitive parts of our brain

20:33

when you take away psychological pain says

20:35

people are more likely to buy your

20:37

products or whether that's a sugary food

20:39

or a gambling ah it's app on

20:42

your phone, you are in essence taking

20:44

away short term psychological pain at the

20:46

expense of long term health and I

20:48

think that is the fundamental nature of

20:51

the problems. We have in essence outsource

20:53

decision making to corporations that are not

20:55

evil, but rather do not have our

20:57

best interest. I mean maybe know? I

20:59

mean like when you're putting little children

21:01

in functional Mri machines and showing images

21:03

of different junk food meeting which. Images

21:06

like their brains of the most to

21:08

though he likely to one it in

21:10

by or Wayne Klein screaming so they

21:12

get his yeah. I. I

21:14

don't have a term supporters on evil to

21:16

me I was as those are children other

21:18

the future of our country of early if

21:21

we're if we're actually did degree or how

21:23

to make our children addicted. To.

21:25

Sophisticated scientific investigations and

21:27

and and experiments. That.

21:30

Mess claiming to me so I'm I'm I'm by

21:32

the way I'm not making this up. this isn't

21:34

the New England Journal medicines his polish data for

21:37

on what's actually happening of a marketing and

21:39

children's centres I'm going to know about brought when

21:41

I want to come back to his as the

21:43

the new information because I think. It

21:45

is. It's funny how much of

21:48

a problem the zoos, but it's

21:50

also encouraging if there's a real

21:52

pathway in our understanding of science

21:54

about how modulator information to die

21:56

of lifestyle. nutraceuticals other

21:59

thera therapies that can actually help

22:01

to fix the brain, to repair

22:03

the brain, to improve the connectivity of the

22:05

brain, to reduce the amplitude of the

22:09

anxiety and depression and the aggression and

22:12

the violence and the behavioral

22:14

issues we're having in the societal

22:16

polarization, not to

22:18

mention all the neurodegenerative diseases and all that stuff.

22:21

We know how to do this. It's not like you

22:23

and I do this in clinical practice. This is something

22:25

we see in our patients and it works. But most

22:28

people don't have access to this. So why don't we

22:30

kind of back up and talk about what is neuroinflammation

22:32

and why does this happen? Right.

22:35

So neuroinflammation is a little bit variable as far as how

22:37

it's defined. I'm going to use some technical terms here and

22:39

then you could walk me back if we go too far.

22:42

But basically what we're talking about is an

22:44

activation of the immune system within the brain

22:46

with certain markers that tell us this

22:49

is inflammation. Inflammation is just

22:51

a state of activation of the immune system.

22:54

In the brain what we're talking about... No, no, inflammation is bad. You need

22:56

it. You got it cold. You

22:58

want inflammation to fight the virus. You've got COVID.

23:00

But if it's overactive and it's overactive for too

23:02

long a time and it's triggered by the wrong things... Exactly.

23:05

Exercise increases inflammation. But it's not bad

23:07

because it's a short burst

23:10

of inflammation that over time actually

23:12

suppresses inflammation. That's right. As

23:14

a caveat here, what we're trying to talk about is either

23:16

an incredibly high level, so something like what

23:18

might have been seen in the cytokine storm, or

23:21

a chronic low level, which is what we

23:23

really see in metabolic diseases. And that's the

23:25

one that's been more associated with conditions like

23:27

dementia and depression. So in

23:29

the brain what we're talking about is one, a

23:31

breakdown of the blood-brain barrier. That's the barrier that

23:34

surrounds the majority of the brain and is supposed

23:36

to help protect the brain from what is happening

23:38

in the bloodstream. The second

23:40

thing to consider is that the brain has immune cells

23:42

within it. And this will be news to people who

23:44

think about the brain as separate from the rest of

23:47

the body. Yeah, that was a big lie we were

23:49

talking about. It's called the blood-brain barrier. Nothing gets through.

23:51

Nothing gets through. Well, not really.

23:54

We have leaky brains, guys. We're

23:56

talking about that. Think about what's in your

23:58

brain right now. I Guess your brain marks.

24:01

you probably have somewhere the neighborhood is eighty

24:03

to one hundred billion neurons with long as

24:05

amazing as the plenty we do and great

24:07

but they're really interesting. Part of it is

24:09

that you have about the same number of

24:12

glial cells. These are the cells that in

24:14

essence do so much for how you think,

24:16

how you act and how you feel and

24:18

in some ways kind of tell your neurons

24:20

how to behave of that number. something like

24:23

twenty billion or so called a micro glial

24:25

cells and a my for we'll sell as

24:27

a bonafide immune cell that lives in the

24:29

brain. It's. Role is not just to

24:31

protect the brain against outside threats, but

24:34

it's actually an immune cell that modulator

24:36

how neurons fire, how they work And

24:38

this is really the cell type that

24:40

has been very carefully researched as it

24:42

relates to increasing our risk for brain

24:44

health conditions, mental health, cognitive health conditions

24:46

like the immune system of the brain.

24:49

It. Is if you're going to remember the

24:51

immune cell of the rain, the answer is

24:53

micro glial cells. But I will say and

24:55

as I talked about earlier, turns out all

24:58

the cells in your brain participate An immunity

25:00

neurons are immune cells in that capacity. astrocytes,

25:02

oliver gender sites, They all kind of participate

25:04

in this immune conversation or for the purposes

25:06

of this. The one to now is the

25:09

microbial some because they seem to be the

25:11

master orchestrate years of your brains immune seat

25:13

and in doing so regulate whether your brain

25:15

is and flamed or is moving towards more

25:17

of a state of resolution and anti. Inflammatory

25:20

state and and so so.

25:22

How do you measure that? Like nine or

25:24

a on the doctor? I'm like I'm measure.

25:26

Bring information winning us. In. A little

25:29

or whole young. Girls.

25:31

noom frame bob see regular to don't do

25:33

that no yeah doctor that mcclain is not

25:35

a good idea it's it's a great question

25:37

and you are using most of your brain

25:39

right now as a my hopefully you don't

25:41

want to be taking out big pieces of

25:43

tissue to study under the microscope too unless

25:45

a person is hospitalized unless something's going pretty

25:47

seriously wrong when i'm going into the brain

25:49

to take a biopsy so in the our

25:51

aims you back or exactly organ section right

25:54

need to know whether to back sooner malignant

25:56

but in the absence of that certainly you

25:58

can look at csf again as israel spinal

26:00

fluid. Exactly. Not super convenient. So we

26:02

wind up looking at other tests. There's

26:04

a lot of imaging research that's been

26:07

done using MRI, using PET scan to

26:09

look at various kind of correlates of

26:11

inflammation. And this gets technical

26:13

again, but there's a certain type of protein

26:16

called TSPO that when activated, when we see

26:18

more of that on imaging, is

26:20

an indicator that there may be more activation

26:22

of microglial cells, inflammation in the brain. Again,

26:24

so now there's advanced imaging that looks at

26:26

the brain on fire, but it's not really

26:28

available for everybody. It's not something that we should be

26:31

routinely testing that. And

26:33

to that end, the important piece is

26:35

to look at the data that we have available. And

26:38

that can be everything from, you know, waist

26:40

to hip ratio. It can be looking at

26:42

a hemoglobin A1C. It can be looking at

26:45

potentially things like zonulin, insulin resistance. These are

26:47

surrogates for inflammation in the body and they

26:49

correlate with risk for neuro immune neuro inflammatory

26:51

diseases. Okay. So, so I'm going to unpack

26:53

that a little bit because it was a

26:56

big mouthful and it went fast, which is

26:58

essentially what you're saying is people

27:00

have biomarkers of poor metabolic health. And

27:02

by poor metabolic health, we mean somewhere

27:05

on the spectrum from slightly

27:08

imbalanced glucose and insulin regulation

27:10

to pre-diabetes, to full blown

27:12

type diabetes, which leads to

27:14

increased belly fat, which is very inflammatory.

27:16

And it

27:18

leads to other biomarkers in the blood like

27:21

C-reactive protein. You mentioned

27:23

zonulin, which is a marker of something

27:26

that gets triggered in the gut in relation to

27:28

gluten that can cause a leaky gut. And we'll

27:30

talk about the gut brain in a little more

27:32

detail, because I think that's a really important center

27:35

for the source of inflammation. And

27:39

so basically what you're saying is between kind

27:41

of the gut being messed up and our diet

27:45

and its consequences for our

27:47

metabolic health, that's driving

27:49

a lot of the brain inflammation that's

27:51

related to the ultra processed

27:54

food and starch and sugar and refined foods

27:56

that we're eating that are Generally

27:58

inflammatory. You

28:00

expanded a little bit. If. You

28:03

blazer right eat your You're correct that to

28:05

expand of little bit. Your. Brain is

28:07

a reflection of the inputs. You get what

28:09

you consume. And is think about

28:11

what you're consuming. Of course it's what you put

28:13

into your mouth which is all the food you

28:16

eat. It's also a you inhale so it's a

28:18

reflection of the quality, the air you breathe. and

28:20

then the piece that many people don't pay enough

28:22

attention to is what you consume your eyes and

28:24

through your ears. And so I'd say in that

28:26

sense it is an ultra process consumption. Of

28:29

data from number of sources that it is a

28:31

very easy one to get into because it's something

28:33

we have a choice around. I'm I'm as don't

28:35

have much choice around the other pieces but certainly

28:38

all of these things into the brain inflammation. The.

28:40

I'm Yasuo, you know? That. The

28:42

media that we now mostly consume, whether it's

28:44

news or social media, Is this like junk

28:46

food for the brain? Yeah. It's

28:48

have his that is. It's

28:50

I know deterrence, don't his

28:52

hands? Speyside is not of

28:54

leveling herself narrow. I realize

28:56

this is is the sink.

28:59

a cesspool of get off

29:01

that that activates anger and

29:03

activates you're from him. When

29:05

big brain and medulla years dope mean activation you

29:07

end up in this vicious cycle of of addiction.

29:09

Than that to me neither I nor is some

29:12

I saw my i want to says have been

29:14

rubber like the should be called news should be

29:16

called bad news and been so good news happening

29:18

or we never hear about. I think. We

29:21

really have to think carefully about what we

29:23

ingest. Bowman said to her mouth. And.

29:25

Through our eyes and ears and her

29:27

relationships as a big factor, it's all

29:29

that. Whatever the input as

29:31

the end result is the same and

29:33

it was thing and information as the

29:35

final com and pathway for business. I

29:37

saw his insults it sort of away

29:39

the body responds with activating. This

29:42

inflammatory process this fire in the body

29:44

which is also ends up in the

29:46

brain. If you're right and I think

29:48

taking a moment here to consider this

29:50

through kind of an evolutionary lions if

29:52

we may. Ah, One of

29:54

the experiences that many people may be familiar with

29:56

is how they feel when they get sick. Said

29:58

you got a cold if you got. Blue

30:00

If you came down the some illness

30:02

how you're thinking is and how you

30:04

interact with the world, this has been

30:06

deemed sickness behavior as the terminology for

30:09

it because humans by and large when

30:11

they get sick, act and feel in

30:13

certain ways. Was really interesting about this

30:15

is they feel depressed, they feel socially

30:17

withdrawn, and so it's been hypothesized that

30:19

this makes sense again evolutionarily because you

30:22

want to be somewhere safe, so you

30:24

want to kind of go back somewhere

30:26

that you can recover on your own

30:28

and you don't want to. Infect

30:30

other people with whatever not exist you're

30:32

experiencing. So that makes sense in

30:34

the context of an illness, see how it.

30:36

But. Think. Now about the fact that

30:39

really what it is is inflammation telling your

30:41

brain how to behave the and how to

30:43

withdraw from other people off and how to

30:45

have more kind of walls up against may

30:47

be hearing what other people are talking about

30:49

now appreciate that that same inflammatory pathway to.

30:52

Caught. Frankly activated fire interactions with the

30:54

modern world and you can start to

30:57

understand perhaps some of the behavioral changes

30:59

are seeing at scale across the planet

31:01

with polarization with people are in essence

31:04

having more trouble connecting with others. This

31:06

is really I think and impactful way

31:08

to look at the real power of

31:10

the immune system is changing human behavior

31:13

at scale. I mean this is a

31:15

really important topic. awesome because sought being

31:17

discussed much front of me. Oh, we're

31:20

unassuming of. Maybe bad food

31:22

causes depression? May be no a

31:24

metabolic syndrome and in some resistance

31:26

leads to. Alzheimer's disease and

31:28

that and there's is sort of

31:30

inflammatory process of happens is relates

31:32

to. Myself. But. Not.

31:35

Really in terms of our way of seeing

31:37

the world suing the world to acting as

31:39

and there's a really important. Thing

31:43

for people understand and me because tackle that

31:45

is this relationship between what I call the

31:47

adult in the room. And

31:50

and the lizard brain. And

31:53

and the lizard brain is a

31:55

baby. Wants. To do what it wants

31:57

to do when he wants to do it. is

32:00

it's focused on survival. So it's feeding, we

32:02

used to call it the forest in medical

32:04

school, feeding,

32:07

fighting, or fleeing,

32:09

or reproduction. And that and

32:11

that and that is also

32:14

going to be fawning

32:16

as another one of those. But there's these

32:18

behaviors that are just ancient behaviors

32:21

that are built into our brain that

32:24

if we listen to all those things, if we act

32:26

on all those thoughts and we all have those crazy

32:28

thoughts, whether it's I want to eat that entire pint

32:30

of ice cream or I want to go and make

32:32

out with that person that I saw on the subway

32:34

even though I don't know them. Like you know you

32:36

have these crazy thoughts but you don't do it because

32:39

you have an adult in the room and

32:41

says, no, that's probably not such a good

32:43

idea Marky, you probably don't want to do

32:45

that. And so what's happening and this is

32:47

what satisfies me with the science is increasing

32:50

amount of scientific literature that points

32:52

to inflammation as being an

32:55

interrupter of the communication

32:57

between the adult in the room who

32:59

makes coherent decisions that protect

33:02

themselves and community and society and

33:05

the kind of reptile dinosaur in the room

33:07

that wants to attack and eat everything. So

33:10

can you explain the science behind this and you

33:13

did a lot of work on this in your

33:15

book Brainwash. And

33:17

I think it's the only even more relevant as

33:19

we're seeing our society break down and as we're

33:21

seeing this, globally we're seeing

33:23

polarization, globally we're seeing increased

33:26

hatred, increased violence, increased polarization.

33:29

And it's really concerning to me and

33:31

I think there's a solution for it

33:33

but can you sort of explain the

33:35

science behind this disconnection for people. The

33:37

idea here is as you've alluded to

33:40

we have ways of looking at parts of

33:42

our brain. Everything of course is networked but

33:44

certain aspects of our brain when they communicate

33:47

in a positive way seem

33:49

to help regulate our decision making process. So

33:51

the area of the brain that we really

33:53

focus on is the prefrontal cortex as being

33:55

that adult. When the prefrontal cortex is active,

33:57

when it's kind of able to do

33:59

its It is able to

34:01

calm down and speak to the more

34:05

Perhaps primitive parts of our brain that are

34:07

very helpful very necessary, but shouldn't always be

34:09

the ones making decisions So if

34:11

you think about it the the primitive parts of

34:13

the brain are the ones that hear a bump

34:15

in the night and think there's A monster under

34:17

the bed. It doesn't probably make sense to most

34:19

adults, but it might pop up. Maybe it's a

34:21

snake Maybe it's something else and the adult the

34:23

prefrontal cortex says I know that's what you think,

34:25

but it's just windy Yeah, I was

34:27

I was you know I was trying to know the other

34:29

night because I had to leave the door open because my

34:32

right my wife basically Came late in that

34:34

with some friends and she forgot her keys So I

34:36

left the door open in the hotel room and

34:38

I'm trying to fall asleep and I'm thinking oh Maybe

34:40

somebody to come in attack. Yeah. Oh, I

34:43

can't fall asleep I had this whole

34:45

conversation in my head between my amygdala and

34:47

my friend alone I mentioned my

34:49

friend alone one I saw Steve Not

34:52

that easy well sometimes there is a real danger and

34:54

I think that's important too Right, like if you're walking

34:56

if you're walking through the forest and hear a rustling

34:58

in the underbrush that might be Mounted

35:01

line probably not yeah, but maybe it's just

35:03

the wind and the point is as it

35:05

relates to our day-to-day decisions We

35:07

need to have that adults present because the

35:10

impulsive choice the emotionally Bias

35:13

choice is most often the thing that's going

35:15

to detract from our ability to have high

35:17

quality of life if you think about why

35:19

a person Let's say chooses an unhealthy food.

35:22

It's not always that they think this tastes good. And

35:24

this is the decision I want to make It's often

35:26

an impulsive choice and one of the

35:29

things that's been very clear in this research around

35:31

the prefrontal cortex to kind of Amigdala connection and

35:33

the quality of it and we can unpack that

35:35

a little bit because really what you want is

35:37

the Bi-directional communication is that stress seems

35:39

to take the prefrontal cortex offline?

35:42

Which is why if you are stressed you're more likely

35:44

to eat junk food similarly if you're

35:46

sleep-deprived this connection becomes a little bit more

35:48

Interesting, right so it becomes a little bit

35:50

less concrete and to that end It

35:53

helps to explain why people who are sleep-deprived have trouble

35:55

making healthy choices They tend to eat a lot more

35:57

food and they eat a lot more junk food. Oh,

35:59

yeah I don't see if I want sugar

36:01

and carbs, give me the cookies and ice cream. I've

36:04

written books all about why not to eat

36:06

that. I still want it. Absolutely. I think

36:08

in the long run, what we're looking at

36:10

is what are the effects of chronic inflammatory

36:12

stimuli on kind of dismantling the ability of

36:15

the prefrontal cortex to stay in control. And

36:17

that's where it gets really interesting because we're

36:20

thinking about these insults, the foods that we're

36:22

eating, the air that we're breathing, the things

36:24

that are functionally disabling the ability of our

36:26

prefrontal cortex to make good decisions. It

36:28

can help us to explain why we're seeing certain aspects

36:31

of the world not make as much sense, people

36:33

not doing the things that maybe we would think

36:35

they should be doing or that would be beneficial

36:37

to even the people if you were to ask

36:39

them. Yeah, it's interesting. You know, it sort of

36:41

reminds me of this

36:44

trial back in the 70s. There

36:48

was for the guy, this guy

36:50

Dan White who killed

36:52

the mayor of San Francisco, Jordan Moscone

36:54

and his supervisor, Harry Milk. And

36:58

the lawyers mounted what they called the

37:01

Twinkie Defense, which is a very famous

37:03

legal defense. And they argued that his

37:06

consumption of basically junk food

37:08

and Twinkies led to

37:10

his disordered behavior and they

37:12

were able to convince a jury to not convict

37:15

him of first degree murder but of

37:18

voluntary manslaughter, which is a reduced charge.

37:21

So that was really fascinating. And

37:23

then we kind of began to look at the data on

37:25

this and I know there's more and more research coming all

37:27

the time on this but there was a recent

37:30

study looking at the link between

37:32

junk food, sugar, sweetened beverages and psychological

37:34

distress. And

37:36

there was a study called the Caspian Force

37:38

Study that took a nationwide sample of 13,000

37:42

plus Iranian children, adolescents 16 to 18 and

37:44

they basically looked at how much junk food

37:46

they had and what their mental health was.

37:49

And it was just striking that there was

37:51

such a huge correlation, actually it's between depression,

37:53

anxiety and things you might

37:55

expect but violent behavior, you

37:57

know, violence. You

38:00

know, increasing junk food led

38:02

to a 39% increase risk

38:04

of the odds of physical fighting, 19%

38:06

increase odds of being a victim, and

38:09

55% increase odds of bullying other people.

38:11

Yeah. So, you know. Yeah,

38:13

let's dive into this just a little bit because

38:15

I think this is the message that very few

38:17

people are aware of, which is it's not just

38:20

that people maybe make worse choices as far as

38:22

I'm going to eat this junk food, I'm going

38:24

to skip sleep to watch another three seasons on

38:26

Netflix, I'm not going to call my mom. We're

38:29

talking about real world violence behavior.

38:31

So one of the biggest studies that was ever

38:34

done on air pollution looked at the link between

38:36

a certain air pollutant PM2.5 and risk for violence

38:38

behavior. And what they found is after awaiting 10

38:40

years to see if these correlations survived

38:43

is that PM2.5 exposure

38:45

correlated with not

38:47

just any crime, but violent

38:49

impulsive crime. And that's important.

38:52

This isn't premeditated stuff. What we're talking

38:54

about is that it changes people's brains,

38:56

their thinking such that they're more likely

38:58

to do things like hurt another person.

39:00

So there's actually work being done now

39:02

on questioning what should be done in

39:04

prison systems to help people with aggressive

39:07

behavior as far as what nutrients do

39:09

people need. Because the reality of it

39:11

is that we've just ignored this completely.

39:13

We have operated under this assumption that

39:15

why a person does what they do is

39:17

a reflection of a psychological construct like willpower.

39:20

Yeah, I think that's right. Awesome. And

39:23

that's something huge, which is that we misappropriate

39:25

the meaning of the behavior.

39:28

In other words, we say

39:30

it's because they're crazy or

39:32

because they're whatever. Not because

39:34

maybe their brains are inflamed and then

39:37

they're really acting in ways that are not willful

39:39

in a sense because they're controlled by this

39:42

underlying biology. The Twinkies. The

39:44

Twinkies, right. The Twinkies are bad. So,

39:46

I mean, I don't think people should

39:48

be absolved of responsibility for doing bad

39:50

things, but I think it sort of speaks

39:52

to the massive prevalence of things

39:55

that are driving information. I think we hit

39:58

on two big ones, which is ultimately... The

40:00

Process food and server starch. And.

40:02

Then environmental pollution or as

40:04

air pollution, heavy metals, And

40:07

I think you're these are things that we

40:09

don't really talk about. We were talking about

40:11

exists in size. Would I met a mental

40:13

health crisis? has such on the science of

40:15

get more mental health care less get more

40:17

drive was get more. I know with such

40:19

figure out why the braves breath working properly

40:22

as it there's There's not a lot of

40:24

upstream about this and I totally agree. We

40:26

need more emphasis on how to support people

40:28

who already have these issues That is absolutely

40:30

necessary. At the same time we need to

40:32

be thinking about why are prevalence rates for

40:34

these diseases continuing to go up despite the

40:36

fact that we had sulfur technological. Issue is

40:38

that we'd never thought we were and other

40:40

to bring in one other kind of line

40:42

of science here. So a lot of recent

40:44

work has focus on something called maternal immune

40:47

activation am I. The idea

40:49

here is that mom's exposure to

40:51

inflammation. While. The child is

40:53

in utero can influence outcomes in children

40:55

and so big study was published last

40:58

couple of days and it looked at

41:00

in essence mom's inflammatory status when pregnant

41:02

twenty four weeks and then it looked

41:04

at children's rate of developing a D

41:06

H D at each ten. So how

41:08

long time? Way to be a forty

41:10

percent increase right? Now why might

41:12

that be the case? And why does

41:14

research suggests that maternal immune activation correlates

41:16

with Tourette's Syndrome? With a D H

41:19

D With Autism With Schizophrenia, it is

41:21

very likely. That the immune saddest

41:23

of the mom the been state of the

41:25

mom inflammatory status is able to speak to.

41:27

The. Children by way of central transfer. Seems.

41:30

Like it may modify epigenetics. it seems

41:32

like it might speak to might have

41:34

a macro glial cells. Yeah so what

41:36

What we're talking about here is not

41:38

just the even ourselves, we're talking about

41:40

a generational effect of are pro inflammatory

41:43

lifestyle that may not be visible until

41:45

decades later. We're talking with the mommy's

41:47

as I heard diarrhea. And the

41:49

programming and happens to the baby's. Mpg.

41:51

No one or the term and knowing the

41:54

risk of obesity or cancer heart disease with

41:56

the risk of. Mood. Disorders their

41:58

behavior and six. And, you

42:02

know, when

42:04

you think the fact that 65% of our

42:07

diet is ultra-processed food, and

42:09

that Americans eat about 150 pounds of sugar and 130 pounds of flour a year

42:11

each, this is

42:15

like a national emergency. It is. I

42:17

mean, this is the stuff that matters most. It's how we

42:19

think, it's how we act, it's how we feel. I

42:22

think one of the challenges here is

42:24

when you look at things through the pharmaceutical lens,

42:26

the effects of a food, of a lifestyle modification

42:28

or not, may not be experienced the next day

42:30

or a few minutes later, right? So if you

42:33

push epi, you're going to see an effect on

42:35

the patient pretty quickly, you would hope. But

42:37

if you change a person's diet... That's epinephrine, that's the

42:40

drug we use in the hospital, allergies,

42:42

the heart attacks. Right, you

42:44

don't want to be doing that casually, but the

42:46

point being, you will see an effect. And if

42:48

you've changed somebody's diet, they may not think clear

42:50

immediately, they may. Honestly, I would

42:53

say if you are

42:55

effective enough by using a big

42:57

enough lever, in other words, dramatically changing

42:59

the diet enough, you'll see changes

43:02

in literally days. So I have seen

43:04

that. I guess the point I'm making though is

43:06

when we're looking at these global factors, this

43:08

is where it becomes challenging because we would

43:11

say, oh well, as an evidence-based intervention, if

43:13

we give somebody a bowl of kale as

43:15

opposed to a hamburger, we didn't necessarily see

43:17

their depression alleviate overnight. So let's just stick

43:19

with what we have. But if you look

43:22

at longer term data, for example, the Mediterranean

43:24

diet on rates of dementia, on rates of

43:26

depression, it's pretty profound. The

43:28

challenge is how do we get people to care

43:30

enough to implement it? How do we

43:32

decrease the barriers to making those the

43:35

norms in our diet? And I think

43:37

this is where our food industry has

43:39

us in a really bad spot. Because

43:41

what they would say is, well, everything in

43:44

moderation and give people the opportunity to choose

43:46

what they want. Now that's fine.

43:48

And one light of cocaine or one shot of heroin.

43:50

Right, everything in moderation. So you can have your hamburger.

43:52

Don't do that. So you

43:55

can have your hamburger, you can have your soda, but then you

43:57

have to make sure to exercise. And I like the, it's part

43:59

of a complete. breakfast, right? You've seen this for

44:01

the cereals where they have the cereal but

44:03

then they have the fresh fruit and they have

44:05

five pounds of fiber on the side. The

44:07

problem is that we believe in this idea,

44:09

this myth that it's great to promote freedom

44:11

and that you can do that through letting

44:13

people have freedom of choice. But the reality

44:15

is you don't. Well, you don't have choice

44:17

unless you understand, right? You can't make a choice

44:20

unless you have the knowledge to make the choice.

44:22

And you have access. Access

44:24

and knowledge even in terms of

44:27

the food labeling, food marketing, advertising,

44:29

it corrupts our understanding. Unless

44:31

you're a PhD in nutrition and even then it's

44:33

hard to understand a nutrition facts label or

44:35

an ingredient list for most people. And in other

44:37

countries they don't have this problem. They've eliminated all

44:40

the advertising for kids on junk

44:43

food. They've eliminated all the

44:45

cartoon characters in Chile on the rocket

44:47

flights with no more Tony the Tiger.

44:49

They've gotten rid of all junk food

44:51

in schools. They've put front of

44:53

package labeling on big stop signs that say don't eat

44:55

this. This is going to kill you. Essentially you can

44:57

eat it but it says this is really bad for

44:59

you. It actually changes behavior

45:01

and it changes what people choose

45:03

because they have the right information. We don't have

45:05

that. I'm actually working in Washington now on a

45:09

food labeling effort to change food labeling

45:11

so we can protect our children and

45:13

have a clear grading so that we know what's

45:15

in the food and people can actually understand it. That's

45:26

so important because what you're bringing up

45:28

is the significance of default. And this

45:30

is an aspect that requires policy. It

45:32

requires higher level intervention. We do

45:34

things that are easiest to do. And at

45:36

scale that plays out. So many researchers now

45:38

have been looking into how do you make the

45:40

healthy choice easier to make. At companies like

45:42

Google, so there's the stoplight system. This food is

45:45

green. This food is red. And this stuff

45:47

is really important because it's often the subtle

45:49

things that have the biggest effect. I would just

45:51

say going back to what you described as

45:53

far as the Cartoon

45:55

animals. We Won't name any of our friends,

45:57

but we know these animals on the boxes.

46:00

That sugary cereal see things have an impact. There's

46:02

a reason that there there and when you look

46:04

at an adult preference for serial decades later it

46:06

is consistent with what they were given as a

46:08

kid. Because of some of this. Fun! Association

46:10

they had Yes, this is one of only

46:13

two countries though that allows direct to consumer

46:15

pharmaceutical emphasize Gusto were hitting people on both

46:17

sides of the spectrum with the belief again.

46:20

Is people freedom of choice?

46:22

But. It's not actually freedom of choice

46:24

when the defaults are structured in such

46:26

a way that you're almost certain to

46:28

make the wrong decision. Scale of I'd

46:30

be fine of as I they had

46:33

no junk food as on television the

46:35

Zebra or whether the A just like

46:37

farm. As he said, if you use

46:39

this thing you will kill you and

46:41

cause diabetes and heart attacks. Early deaths

46:43

drove depression, dementia, Alzheimer's is like that

46:45

far as fast as a speck of

46:47

you will Joyce read is actually information

46:49

education classes of a theory about why

46:51

washing so screwed up. I've been many

46:54

times. washing walks in the sand, walk

46:56

to the house, been there, I have

46:58

some on once there and the cafeterias

47:00

is where the centers in the Congress

47:02

mean our staff eats and it essentially

47:04

it's a cesspool of junk food I

47:06

mean in a monster size. sugary drinks,

47:08

processed foods and also of fast food

47:10

outlets. are there zone know, Mcdonalds, Burger

47:12

King pizza. they're all their. And.

47:15

That's what they're eating and I'm like, well,

47:17

that's what people are trying to like. Make

47:19

Millionaires country better. Decisions in their brains and

47:21

bodies are off. Such as

47:23

Governor Has Cross and the Braves wrong flames.

47:25

No wonder their emotions or blames. I think

47:27

people forget the brain is fills out of

47:29

nutrients from food. It's not like weekends, you

47:32

know it's a carbon from the atmosphere sequester.

47:34

it's we have to create greens, thrust our

47:36

bodies well out of the modules, and our

47:38

food. See, if you're literally building your brain

47:40

out of junk food, that's going to have

47:42

an impact on how you make Sources said

47:44

using us is going to say here, which

47:46

I know you're incredibly familiar with. Yeah.

47:48

it's it's miserable that at the highest levels the

47:50

people who are in charge of our decision making

47:52

are powering their bodies would jump but this happens

47:54

in the hospital at an even nord stream love

47:56

only so i know we don't have to get

47:58

into this but i I remember being on my

48:01

residency interviews and being at some very prestigious centers

48:03

that were actually very close to where we are

48:05

now and going into the cafeteria and seeing that

48:07

the quality of that food was worse than what

48:09

you get at kind of a gas station restaurant.

48:12

And it just seems like... This is where the

48:14

doctors and the nurses and the staff are all eating. And

48:16

the reason is because we assume that it

48:18

doesn't matter that much, right? It's just, we'll

48:20

wait and when things get bad enough, we have

48:22

drugs, let's not focus on things that maybe are

48:24

not worthy of our time and money. And

48:27

it's so backwards. Not bad for what you

48:29

feed people in the hospital. No, it's terrible.

48:31

I actually, two of my anecdotes,

48:33

one, I used to work in the emergency room and I would take

48:36

this night shift on time and I would work from like, you

48:39

know, on an 11 in the morning, 11 at night to 7

48:41

in the morning. And I

48:43

kind of missed the cafeteria hours because they were only

48:45

like 8 to 9 in the morning, 12

48:48

to 1 lunch and then 6 to 7 at night. The

48:51

only thing that was open from like, I

48:53

think it was 6 in the morning till 2 in the morning

48:56

was McDonald's. Of course. And

48:59

you know, at Cleveland Clinic when I started

49:01

working there, Toby Cosgrove essentially tried to get

49:03

McDonald's out of there, couldn't do it because

49:05

it was a long-term contract. But literally the

49:07

day the contract expired, I was there and

49:10

the McDonald's was there one day and

49:12

we walked in the next morning and it was gone.

49:14

Like you literally had a board of officers completely shut

49:16

down. But that should be illegal.

49:18

I mean, I think it should be a law. Like you can't

49:20

smoke in a hospital. Or just be honest, it's not about health.

49:22

But you can't smoke in a hospital. Right. You

49:25

can't be serving food that actually kills people in a hospital.

49:28

What you're saying makes sense. I think if you were to

49:30

actually take a blanket statement and say, this is the place

49:32

where we're going to optimize for healing, then that is true.

49:35

But as we know, that is not necessarily

49:37

the case in all institutions in that for

49:39

a number of reasons.

49:41

There are wanting to give

49:43

people access to freedom of choice. And that I think

49:45

is part of the illusion that's been created, which is

49:47

we're not doing anything wrong because it's you that has

49:49

to pull the trigger. We're just creating the food. We're

49:52

just creating the scenario. And you have to be the

49:54

person to come eat it. Now, if your brain is

49:56

dysregulated, it's hard to make the right way. Which by

49:58

definition, if you're in the hospital. So, I

50:01

mean, we could talk about this a little bit. One

50:03

of the best instances that I saw early on of

50:05

how inflammation impacts the brain was in the ICU, for

50:08

up to 70% of people are experiencing delirium,

50:10

right? Delirium is a very common thing in

50:12

the hospital. Why is that happening?

50:14

Well, it actually correlates with levels of

50:17

inflammation in the bloodstream. So as you

50:19

increase inflammation in the context, often of

50:21

these kind of severe infections and metabolic

50:23

dysregulation, your thinking gets

50:25

messed up. We

50:27

see this in the hospital. We have the

50:29

connection with inflammation and people's cognition getting worse.

50:32

And then we think about what are the

50:34

lifestyle variables that map on to inflammation. So

50:36

we should be advocating for a Mediterranean diet,

50:38

healthy menu in the hospital. There are some

50:40

breakthroughs that I've seen happening around the country,

50:42

but by and large, it is-

50:44

And that doesn't mean pizza and pasta. Right. Because

50:47

that's a challenge. That could be Mediterranean. You mean

50:49

whole foods, lots of vegetables, nuts and seeds. Foods

50:51

your grandparents would recognize, however you want to describe

50:53

it. Exactly right. Yeah.

50:55

And I don't think you're the universal

50:57

definition of Mediterranean diet, so it's really-

50:59

Real food. Yeah, real food. And I

51:02

think, speaking of real

51:04

food and how important that is, we've talked

51:06

about how our ultra-processed diet,

51:08

sugar, starch, all

51:10

that drive inflammation in the brain. We're

51:13

going to get to how the gut plays a role. We've

51:16

learned about how environmental toxins, whether

51:18

it's air pollution or plastics or

51:20

petrochemicals or heavy

51:23

metals, all can interrupt the

51:25

brain's function and drive inflammation. Right. I

51:28

mean, we know this. The

51:30

felt maker, hat makers back

51:32

in London in the

51:34

1900s, 1800s, were all crazy because they

51:39

used mercury to make

51:41

the felt hat stiff. And

51:43

so that's where the Mad Hatter came from

51:45

in the house in Wonderland. Heavy

51:49

metals for sure. But

51:52

there's a flip side to it, which is there's an

51:54

antidote. And this one study really

51:56

compressed me with a study of young adolescent

51:58

girls. who ate

52:00

more sugar and starch and junk food. And

52:03

the more they ate, there was a 1,400% increase in

52:09

aggressive behavior. Now, for those listening,

52:11

if in medicine you see a

52:13

20 or 30% delta

52:16

change in something, that's

52:18

like a blockbuster. So statins reduce

52:20

the risk of heart disease by

52:22

30%. Wow!

52:26

Blockbuster drug. We're talking about 1,400%

52:28

increase. It's

52:30

not something that's unlikely to be correlated.

52:33

And what was then more interesting was

52:35

when they looked at the case control

52:37

study, if there was more fiber in

52:39

the diet, more omega-3s, more

52:41

vitamin K, there was a

52:43

lower association with aggressive behavior. And

52:46

this tracks against other studies that I've talked about

52:48

that I wrote about in my book, Food Fix,

52:50

or in prisons, for example, where they took prisoners

52:52

who were violent in prisons

52:55

and they gave them healthy food. There was a

52:57

56% reduction in violent crime. If they added a

52:59

multivitamin, it was an 80% reduction in

53:02

prisons. They did this at juvenile detention centers where

53:05

they took kids who were eating junk food, they

53:07

gave them whole food, and they saw that a

53:09

97% reduction in

53:11

bad behavior, a 75% reduction in

53:13

restraints, and

53:16

a 100% reduction in suicides, which is the

53:18

third leading cause of death in teenage boys.

53:20

So that's massive data. And

53:23

yet, to me, this should be things

53:25

that's shouted from the rooftops

53:27

that all academic medical centers should be implementing,

53:29

that policymakers should be paying attention to, that

53:32

we should be really getting to

53:34

the root of this mental health crisis. It's

53:37

not just that it creates more

53:39

polarization and disruption in society, but the depression,

53:41

the anxiety, the things that go along with

53:43

it are huge impacts on our

53:45

economy. When you look at, there

53:47

was a macroeconomic study looking at the cost of

53:49

chronic disease. It was estimated it was gonna cost

53:51

$95 trillion, which

53:55

is a lot of money. I

53:57

Think our GDP is like 20 trillion

53:59

or so. And.

54:02

And. It was ninety five trillion

54:04

dollars or thirty five years. and the

54:06

number one contributor Because they measured direct

54:09

and indirect costs, I suspect health

54:11

care costs was loss of productivity and

54:13

disability and dysfunction from depression. Yeah,

54:15

thats what. I don't think that it's

54:17

universal, but. What? You references or

54:20

as behavior is a reflection of. This.

54:23

Outdated ideology which is that behavior is

54:25

reflection of who a person is. And.

54:28

The best ways to change behavior are going

54:30

to be reward and punishment and that's it

54:32

Raises his you are you are if you

54:34

do something wrong or once you put you

54:36

in your room. right? Reminds: You allow

54:38

you to have time to reflect on the see.

54:40

Don't do it again And. Historically this

54:42

doesn't really work well in certain cases. For

54:44

example, drug recidivism after people are punished for

54:46

using a drug is pretty high because it

54:49

turns out the reason people were using the

54:51

drive was to feel better and that when

54:53

you made them feel bad in jail and

54:55

you didn't necessarily give them any of the

54:57

things that were necessary to improve their quality

54:59

life, they will go back to using these

55:02

molecules again. So it's this idea that behavior

55:04

is a six reflection of who a person

55:06

is. What? We're talking about

55:08

with this narrow information. Can.

55:11

Be controversial because or saying here is

55:13

your dynamically changing moment to moment. So

55:15

in your body, your immune cells turnover

55:17

as reflection of total number every couple

55:19

of months In your brain, you are

55:21

growing new neurons all the time. and

55:23

you're more importantly changing the strength of

55:26

the connections between those neurons all the

55:28

time. Since your thoughts, your feelings are

55:30

a reflection of your neuronal state and

55:32

of your brain. See that means that

55:34

you as a person, as an identity

55:36

as a belief system are changing moment

55:38

to moment when you appreciate what immunity.

55:41

Means to that because immunity is a master

55:43

system that modulator the strength and number of

55:45

the connections between your neurons. Yeah, changes how

55:47

you think, changes how you you realize you

55:49

have operating on the core operating system. But

55:51

what the I use and that can be

55:54

a scary thing. I think it's opportunity. Yeah,

55:56

because we don't have to sit and blame

55:58

people for the way that they. are,

56:00

we can be curious about what

56:02

is happening with you right now. There's

56:04

some low-hanging fruit that you can change,

56:06

that every person can change as it

56:08

relates to optimizing their overall immune health

56:10

and improving their brain's immune balance. And

56:13

if you do those things and you feel

56:15

less aggressive and you feel less impulsive and

56:17

you feel happier and you think clear, I

56:20

mean that's kind of all of the things that we

56:22

would define as who you are. Your interest change, there's

56:26

a really interesting study. You're nice with

56:28

your neighbors. You don't have road rage.

56:30

Right. So an interesting study

56:33

looked at microglial cells and it

56:35

found that it might predict people's

56:37

personality traits, meaning the state

56:39

of microglial cells. This is really fascinating

56:41

stuff because we're talking about one

56:44

of the areas in which you kind of change who you are.

56:46

So not to go too much on

56:49

this tangent, but psychedelics seem to increase

56:51

trait openness, right? So open-mindedness. These are

56:53

things that can happen and really in

56:55

some ways should be happening, not saying

56:57

that specific to psychedelics, but changing who

56:59

we are and updating our prior assumptions

57:01

is key to what makes humanity unique,

57:03

right? And when we get more and

57:05

more locked into patterns of thinking, which

57:07

I believe neuroinflammation does, we lose our

57:10

best chance at actually participating in this

57:12

life for all it's worth. And kind

57:14

of the cost of that, the fringe

57:16

cost is that we're more likely to

57:18

allow this world to fall into chaos and

57:21

to allow the climate to be destroyed.

57:23

These are things that are- Where's the grownup in the

57:25

room in the world, right? That's

57:27

it. We've got to be thinking about what

57:29

are the things at scale that will

57:31

promote more adult level thinking. And one

57:33

of the things we can do is

57:35

optimize our brain immune state neuroinflammation. It's

57:38

so important what you're saying, Austin. I want to

57:40

get into the details of how do we regulate

57:43

neuroinflammation. But before we do, I want to hit

57:45

on one more key point that you've kind of

57:47

touched on a little bit, which is the

57:49

gut brain connection and

57:51

the microbiome. Now I

57:53

want to start out by a little anecdote or

57:56

anecdote or end of one trial, which

57:58

was a little girl- I saw years

58:00

ago who came to me because

58:02

her mother didn't know what to do with her. And

58:05

she was, I had written

58:07

my book, Ultra Mind Solution, which is about how

58:09

to fix your brain by fixing your body first,

58:11

essentially dealing with the inflammation by taking your diet

58:13

and lifestyle. I wrote this book 15 plus years

58:16

ago. It was way ahead

58:18

of its time. It's still, you know, I was talking about

58:20

the gut and the brain and all this stuff way back

58:22

then and no one really talking about it. And

58:25

this girl, you know, I just, I

58:27

don't know what's going on. She's this beautiful little girl, but

58:30

she was so violent. She was

58:32

attacking her sister all the time. She was nine years

58:34

old. She was a violent in class. She was kicked

58:36

out of class multiple times a day on

58:38

the bus home. She'd be kicked out the bus. They had

58:40

to stop the bus, you know, a dozen times on the

58:42

way home. She would be ripping

58:44

pictures of her family, like ripping her sister

58:46

out and just like really crazy behavior. And

58:50

you know, they talk to the therapist. They do this and they do

58:52

that. Nothing helped. And I was like,

58:54

I don't know what's going on, but let's just have a

58:56

look. And so I just screamed her for her gut health

58:58

and put the urinary, organic acids

59:00

and look at the

59:03

microbiome and turn out she had

59:05

severe elevations of biomarkers for bacterial

59:07

overgrowth and the gut for yeast

59:09

overgrowth. So I literally gave her

59:11

an antibiotic and an antifungal.

59:13

I mean, like, boom, overnight,

59:15

she was a different person. Yeah. Like

59:18

a perfectly behaved, sweet little nine year

59:20

old girl. And

59:22

that was when the light bulb went off in my head

59:24

of like, holy cow. Like, what else is going on here?

59:27

And so it's really, it's really been this

59:31

incredible treasure chest. We've been able to open

59:33

up understanding the link between the gut health

59:35

and everything in the body. But

59:37

we're going to focus on particularly the brain

59:40

right now and their inflammation. So can

59:42

you unpack for us how our gut

59:44

and our microbiome and gut inflammation and leaky

59:46

gut and leaky brain are all connected

59:48

and kind of unpack that story for

59:50

us? I think it's really important because there's

59:52

so much we can do to optimize our

59:54

microbiome. I think it's

59:56

a really incredible area of research. And there's

59:59

so much we can do to help. There are certain domains that

1:00:01

have overlapped between conventional medicine and kind of

1:00:03

the wellness domain and gut health is one

1:00:05

of them because it's interesting to my friends

1:00:08

who are practicing conventional gastroenterology and it's interesting

1:00:10

to my friends who are non-medical but think

1:00:12

maybe this is a way to get healthier.

1:00:15

What I first saw as a release

1:00:17

list and I think you've spoken about this

1:00:19

on previous podcasts is hepatic encephalopathy, right? This

1:00:22

is an instance in which people for one

1:00:24

reason or another develop liver failure, they build

1:00:26

up these nitrogenous compounds and

1:00:28

basically they get altered, they get loopy, they

1:00:30

kind of lose themselves in this haze

1:00:33

of… They have hallucinations, they get delirious,

1:00:35

they're brain fogged, they're not… They're

1:00:38

getting out of bed, they don't remember who

1:00:40

they are and the reason for it is

1:00:42

basically the absorption of these nitrogenous compounds

1:00:44

as a reflection of what is happening in

1:00:46

the gut and the conventional therapy for this…

1:00:49

The toxic metabolites of gut bacteria that are

1:00:51

getting absorbed and poisoning the brain causing the

1:00:53

brain to be crazy. So

1:00:56

this is a direct connection between the gut

1:00:58

and the brain because the interventions for this are

1:01:00

flush out the gut or give antibiotics to kind

1:01:02

of re-regulate the gut. Those are the conventional therapeutic.

1:01:04

Yeah, you get… Yeah, Neomycin to clear out all

1:01:07

the… It's like a nuclear bomb for all the

1:01:09

gut bacteria and then you give basically

1:01:11

a plunger called Laxolos which flushes the gut

1:01:13

out. It's like a super laxative and all

1:01:15

of a sudden they wake up, it's like

1:01:18

boom, right? And you track improvement by how

1:01:20

many bowel movements they've had. How many bowel

1:01:22

movements does this person have because the goal

1:01:24

is to flush out all of those toxin

1:01:27

producing bacteria so that they don't absorb all

1:01:29

of these nitrogenous compounds. So they

1:01:31

have shit for brain is basically what

1:01:33

you're saying. Again official diagnostic code there.

1:01:37

The point is there is a direct connection between the gut

1:01:39

and the brain in that sense. There's research as you know

1:01:41

going back nearly a hundred years looking at what had

1:01:43

happened as far as when you removed parts of the

1:01:45

gut that was being done for a variety of different

1:01:48

reasons. So the point here

1:01:50

is we've known for a long time that there's

1:01:52

something connecting the gut with the brain but we've

1:01:54

only more recently started to get specific as to

1:01:56

how that happens and what we can do to

1:01:58

modulate. of the statistics for

1:02:01

a few years for a close. By the way, what you're saying

1:02:03

about hepaticus, hep every

1:02:07

traditional doctor knows this and

1:02:09

yet it doesn't translate into the

1:02:11

rest of their medical practice that the gut could

1:02:14

affect the brain. Right. I think that's accurate. I

1:02:16

think this is the instance of knowing that there

1:02:18

is this connection. We have a specific protocol in

1:02:20

place, but by and large, you don't think about

1:02:23

it generalized. No, right. Exactly.

1:02:25

To what we now know, I think

1:02:27

it is fair to say that the

1:02:30

gut brain connection or really just gut health in

1:02:32

general is revolutionizing the way that we look at

1:02:34

our own health. We know that

1:02:36

the gut has, I think the most recent

1:02:38

update is 39 trillion microbes. The majority of

1:02:40

them clustered in the large intestine, which is

1:02:43

important because from a bacterial perspective of the

1:02:45

majority of those are bacteria. That's

1:02:47

about the same number of cells as we have in

1:02:49

our bodies and microbes have 10 times the DNA. As

1:02:52

a relative ratio, we're more bacteria than

1:02:54

we are human, which is kind of

1:02:57

a crazy thing. We're just

1:02:59

basically a walking carrier for all the

1:03:01

bacteria in our guts. I think that's true.

1:03:03

There was a recent study that I was

1:03:05

discussing with our friend Jeff Plune that suggests

1:03:07

that social transmission of microbes is a big

1:03:09

explanatory reason for why we think and act

1:03:11

the way we do. Wait

1:03:13

a few years and you'll find out that it's not about

1:03:15

us. It's about the microbes living on it and us that

1:03:18

are actually defining our interactions. To go back to

1:03:20

this, what we now understand is

1:03:22

that the gut and the brain are in

1:03:24

constant bi-directional communication. What happens in the gut

1:03:26

impacts the brain and vice versa. There's a

1:03:28

couple of pathways that have been isolated. The

1:03:30

top down and bottom up. Right.

1:03:34

I guess bottom up being more specific in this case to the gut

1:03:36

and the brain, but sure, both ways. Again,

1:03:38

I think we will learn in the future that maybe

1:03:40

this part is not in as much control as we

1:03:42

thought. The gut

1:03:45

can interact with the brain through the bloodstream,

1:03:47

through molecules that are created in the gut,

1:03:49

that get into the bloodstream, go up into

1:03:51

and either bind to receptors on the blood-brain

1:03:53

barrier or go through the blood-brain barrier. Then

1:03:56

we have this whole bypass system, the vagus nerve. You

1:04:00

just basically said that molecules from

1:04:02

poop, from your bacteria in your gut,

1:04:05

get absorbed and then

1:04:07

go up into our brain and

1:04:09

get absorbed into our brain and our cataclysmic with

1:04:12

our brain and regulating our brain and causing inflammation

1:04:14

in our brain. Or helping to suppress

1:04:16

it, as in the case of short chain fatty acids,

1:04:18

but you're correct. The idea is that on the pro

1:04:20

and on the con side, so the

1:04:22

bad ones, we would think about

1:04:24

lipopolysaccharide being the best example. This

1:04:26

is a component of a bacterium

1:04:29

that when absorbed is a potent

1:04:31

regulator, increases inflammation. It

1:04:34

is a toxin, it's believed to mess

1:04:36

with basically everything in our bodies, but

1:04:38

it seems to specifically activate microglial cells.

1:04:41

It binds to a receptor called the

1:04:43

tolag receptor 4, which maybe is just

1:04:45

interesting trivia, except where you realize the

1:04:47

microglial cells are listening for what is

1:04:49

happening in your gut to be able

1:04:51

to make decisions. And I'll just

1:04:53

say one more thing. Looking at animal

1:04:55

models, we know that microglial and neuronal

1:04:57

development is in part contingent on what

1:04:59

happens in the gut, which means that

1:05:02

our gut helps to teach our brains

1:05:04

how to kind of grow and establish

1:05:06

themselves. Really, really interesting stuff.

1:05:08

So what happens in the gut absolutely

1:05:10

influences the brain one way through the

1:05:12

bloodstream and the other way is

1:05:14

through the vagus nerve, because the vagus nerve runs

1:05:16

all the way from the brain down to the

1:05:18

gut, down to the majority of the gut, I

1:05:20

should say, and is mostly

1:05:23

fibers that carry messages from the gut to the

1:05:25

brain as opposed to the other way around. So

1:05:28

these are two of the most important pathways. And

1:05:31

the other thing I'll just lay in here, which I think

1:05:33

is really key to this conversation. The

1:05:35

gut is where we have a reservoir of the

1:05:37

majority of our immune cells. And

1:05:40

the reason for this is because our immune

1:05:42

system is not just a defense system, when

1:05:44

it is designed to learn from what is

1:05:46

happening in the outside world and transmit those

1:05:48

signals through the rest of our body, including

1:05:50

our brain. So your immune

1:05:53

cells live just below your gut

1:05:55

lining, and they actually send up

1:05:57

little arms to grab pieces of

1:05:59

food. to interact with bacteria

1:06:01

and they take that message down, they

1:06:04

change the way that they function and they

1:06:06

can actually send those signals through the rest

1:06:08

of the immune system and in doing so

1:06:10

influence the brain. So this is a constant

1:06:12

bi-directional communication. And this is just straight up

1:06:14

regular medicine science. We're not talking- nature

1:06:17

kind of high level paper. This is well understood

1:06:19

now everybody. It's not, it's not kind of some

1:06:21

quack side hustle we're

1:06:23

going to hear about poop in the brain.

1:06:25

It actually is really deep science. Right, this

1:06:28

is established. It's not being used in clinical

1:06:30

medicine at all really. It's just sort of

1:06:32

like, okay, well we get it now, now

1:06:34

what? Now, because most doctors have no

1:06:36

idea how to normalize the gut bacteria. Because like you

1:06:38

said, there's not, they're not

1:06:40

all bad bacteria are good. They do so

1:06:42

many good things. We have the right collection

1:06:45

of bacteria, but if we have noxious

1:06:47

bacteria, they produce more of these toxic

1:06:49

compounds. They produce more lipopolysaccharides. They're then

1:06:51

absorbed and it creates this cascade and

1:06:54

it doesn't just affect the brain. So

1:06:56

lipopolysaccharides also will cause you to be

1:06:58

more insulin resistant and diabetic, even if

1:07:00

you don't change your diet. So

1:07:03

literally, and these experiments just

1:07:05

blew me away. I don't know if you've

1:07:07

read those in like an animal model where

1:07:09

they would literally take the poop

1:07:11

of a fat mouse and

1:07:14

put it in a mouse that had sterilized gut.

1:07:16

There's a skinny mouse and then the

1:07:18

skinny mouse would have those bacteria. And

1:07:20

eating the same amount would gain like 57% more weight.

1:07:24

Right, they're similar to for depressed

1:07:26

humans into mice. It's absolutely fascinating.

1:07:28

I think just to back up your point. Maybe we're gonna treat depression

1:07:30

with a poop transplant. It's not

1:07:33

out of the range of possibilities. Or treat

1:07:35

obesity with a poop transplant. They've

1:07:37

done that with that. These are things that are happening. These

1:07:39

are things that are being considered. Just to take

1:07:41

this one step back, the idea which is

1:07:43

a very basic idea that most people probably

1:07:45

at this point in the conversation would agree

1:07:47

with is that what we eat influences our

1:07:49

brain function. If we believe

1:07:51

that, which I hope we do, then we can ask,

1:07:54

well, what should we eat to positively influence our brain

1:07:56

function, our brain immune balance? When I

1:07:58

did medical training, not all that long. There

1:08:00

were really only two domains in which we

1:08:02

connected diet with brain health. One is deficiency.

1:08:05

So if you are eating the tea and toast

1:08:07

diet, you get a B1 deficiency, you get a

1:08:09

B12 deficiency. And these are

1:08:11

conditions that we learned how to treat. So if an

1:08:13

alcoholic came in, we give them thymine. These are things

1:08:15

we knew. It's called wernickeese and simple alcohol, which is

1:08:17

that kind of insanity you get from

1:08:20

actually being vitamin deficient from being an

1:08:22

alcoholic. Exactly. Exactly. The

1:08:25

other piece of this was the metabolic component. So

1:08:27

we knew that if somebody's blood sugar dropped below

1:08:29

50, for example, they may go into a coma.

1:08:32

That's not a good thing. That is a

1:08:34

real problem. If they came in with

1:08:37

diabetic ketoacidosis or any state of really

1:08:39

high blood glucose, they would, patients

1:08:42

might have a higher chance of being altered, mentally

1:08:45

unstable in the sense

1:08:47

of delirium and otherwise unsafe. So we

1:08:49

knew that blood sugar had

1:08:51

a direct correlation with brain state at

1:08:53

the extremes. On

1:08:56

that though, there was nothing else. What

1:08:58

is the diet a person should be

1:09:00

eating? And more specifically, are there customized

1:09:02

nutrients, patterns of eating that we should

1:09:04

be using to program our brain for

1:09:06

better health? So we were so many

1:09:08

steps away from the gastrointestinal tract. Unless

1:09:10

somebody had a functionally disabled

1:09:12

GI tract, we had to think about putting in a

1:09:14

tube or doing an IV feeding, but that was literally

1:09:16

it. So we're saying is the science

1:09:18

has gone so far and there's so much that we

1:09:20

can glean from these microbiome and gut studies

1:09:22

that really should be implemented today

1:09:25

for brain health based on the

1:09:27

research being published and literally the top

1:09:29

journals on earth. Yeah,

1:09:31

well there's now a whole field of

1:09:33

what we call psychobiotics, which are probiotics

1:09:37

that have an effect on mood

1:09:39

and depression, anxiety,

1:09:41

sleep. I'm trying one now,

1:09:43

which is basically a sleep probiotic. Suppose they increase deep

1:09:45

sleep. I don't know if this works. I'll tell you

1:09:48

later. But it's interesting that there's

1:09:50

these compounds starting to be like customized

1:09:52

probiotics to actually regulate these

1:09:54

various mood and mental health states. Again,

1:09:57

this all makes sense when you understand the pathways.

1:10:00

involved. There's a quote that many people bring up

1:10:02

which is the majority of your serotonin is produced

1:10:04

in the gut. Now that's nice, however, serotonin in

1:10:06

the gut doesn't cross the blood brain barrier, but

1:10:09

it can interact with the vagus nerve and vagus

1:10:11

nerve signaling can change the brain. And also there

1:10:13

are other metabolites like tryptophan which is the precursor

1:10:16

that can be produced in the gut and then

1:10:18

can get into the brain. So there is absolutely

1:10:20

a correlation between what happens in our gut and

1:10:22

our brain state both in terms of cognition and

1:10:25

in terms of things like sleep. One thing I'd just like to

1:10:27

say on that front is if we think

1:10:29

about what actually induces sleep. There are a

1:10:31

number of variables. We think about adenosine and

1:10:34

other things happening in the brain, but inflammation

1:10:37

was actually one of the first

1:10:39

variables that was studied as what

1:10:41

drives sleep, a hypnotoxin. Basically, they

1:10:43

looked at animal studies and they

1:10:45

derived kind of an immune marker

1:10:47

that predicted sleepiness. And it means…

1:10:49

Even if they're more inflamed, they're more likely to just want

1:10:51

to sleep? So that's part of it and it can help

1:10:53

explain why people who are sick tend to be very tired.

1:10:56

If you ever wonder why that is, it's

1:10:58

interesting when a person is incredibly

1:11:00

inflamed in the context of something like sepsis,

1:11:03

their immune system might actually be eating up 40, 50% of

1:11:06

their energy reserves in their body. So this

1:11:08

isn't kind of rocket science. If you don't

1:11:10

have energy, ATP going around, you're probably going

1:11:12

to be a little bit more fatigued. But

1:11:14

it does seem like the immune system and

1:11:16

sleep are really closely bi-directionally interacting. So if

1:11:19

the gut influences the immune system, the immune

1:11:21

system influences sleep, then the gut microbes seem

1:11:23

to be key to this process. Yeah. So

1:11:25

important. So let me just summarize a little bit and then we'll

1:11:28

get into like what the heck do we do about neuroinflammation? So

1:11:31

clearly, we're in an epidemic of

1:11:33

inflamed brains and

1:11:35

the drivers of it are diet,

1:11:38

lack of protective foods,

1:11:41

which we'll talk about in a minute, too

1:11:43

much ultra-processed food, particularly sugar and

1:11:46

starch, and

1:11:49

environmental toxins, which are ubiquitous.

1:11:52

All the petrochemical toxins,

1:11:55

heavy metals that are

1:11:57

everywhere, air pollution. Mm-hmm.

1:12:00

gut and our gut microbiome

1:12:03

and the disturbances in that because of our lifestyle

1:12:05

and diet. I mentioned a few of

1:12:07

the things that drive neuroinflammation like lack of

1:12:09

sleep, stress, lack

1:12:12

of exercise. So these are all things

1:12:14

that we actually have a fair bit of control over. We can't

1:12:16

control air pollution particularly and maybe we can get an air filter

1:12:18

in our house, but a lot of

1:12:20

these other things we can control. So

1:12:23

those are the things that seem

1:12:25

to be driving the neuroinflammation that's

1:12:27

leading to this sort of epidemic

1:12:30

of mood and behavior disorders and

1:12:32

neuropsychiatric and neuro-generative disorders, even

1:12:35

neurodevelopmental disorders. What

1:12:38

is the sort of right approach to take care of

1:12:40

your brain? You mentioned there's no preventive neurology,

1:12:43

right? Not really. There is

1:12:45

preventive cardiology. There's no preventive

1:12:47

psychiatry, but there

1:12:49

should be. So what does that look like and how

1:12:52

do people start

1:12:54

to prioritize those things? Do we know that our things

1:12:57

we should be avoiding or things we should be adding

1:12:59

in to optimize our brain

1:13:01

health? I'd start

1:13:03

with kind of a psychological construct here, which

1:13:06

is you and I have talked about lifestyle

1:13:08

modification for health for many years and many

1:13:10

people listening, watching will have heard about these

1:13:12

things before. I've been talking about more years

1:13:14

than you've been alive on. This is probably

1:13:16

accurate. It's probably accurate.

1:13:18

The crust of the matter is something that we've

1:13:20

discussed, which is people change when there is psychological

1:13:22

pain. I think that's the

1:13:25

key to it and it's to find an energy

1:13:27

within yourself that's going to fuel this because the

1:13:29

reality is any of us could do a diet

1:13:31

for a few weeks. Any of us could join

1:13:33

a gym for a few weeks. The core constituent

1:13:36

elements of lifestyle modification are well known to most

1:13:38

people. I think, at least for me,

1:13:41

it's that I've had two grandparents

1:13:43

die of Alzheimer's disease. I

1:13:45

have seen so many patients and people

1:13:47

I know suffer from mental health conditions

1:13:49

and neurodegenerative diseases and I refuse to

1:13:51

accept that that's the best we can

1:13:53

do. And I think if

1:13:55

we have that within ourselves, which is the understanding

1:13:58

that if you do not make changes... you

1:14:00

will, by the law of statistics here,

1:14:03

law of probability, wind up with

1:14:05

at least one chronic disease on at least

1:14:07

one medication at an incredibly high risk of

1:14:09

developing Alzheimer's disease and a mood disorder. Now,

1:14:11

I'm not trying to say we can prevent

1:14:14

all of it, but I'm saying that for

1:14:16

me, I am unwilling to accept the status

1:14:18

quo. So if that is for

1:14:20

you, if you're somebody who's saying, no, that's not me,

1:14:22

I want to do better than average, then

1:14:25

you start to gain some actual energy behind

1:14:27

making some of these changes. And I think

1:14:29

that's the really important kind of driver of

1:14:31

the thing. Really, people don't even know that

1:14:33

they can make a difference or that those

1:14:35

things are connected. And that's the next piece

1:14:37

of it, which is to know that by

1:14:39

simple lifestyle modifications, you can dramatically decrease your

1:14:42

risk for brain inflammatory conditions like dementia, like

1:14:44

depression, and a host of these other ones

1:14:46

that we've discussed. So let's go through some

1:14:48

of these things. I think diet

1:14:50

is probably the one that most people are interested in

1:14:52

hearing about and for good reason, because we actually have

1:14:54

a lot of choice over what we eat. So we

1:14:56

may not be able to modulate the air quality each

1:14:58

day. We may not be able to get as much

1:15:01

exercise as we want, but we have to eat and

1:15:03

therefore we can change the quality of the food that

1:15:05

we eat. By and large, based

1:15:08

on the research that I've reviewed, the

1:15:10

best diet for preventing neuroinflammation and promoting

1:15:12

brain health is some variant of the

1:15:14

Mediterranean pattern diet. So the Mediterranean or

1:15:17

its close cousin, the Mind diet, these

1:15:20

are not complicated things and I want to

1:15:22

stress that. These are not highly restrictive diets.

1:15:24

They're not bad diets. These are diets

1:15:26

that incorporate a wide range of primarily

1:15:28

plant-based foods. There's fish, there's some poultry,

1:15:30

but it's really getting a wide range

1:15:33

of plants. And these are things that

1:15:35

are rich in polyphenols, these molecules of

1:15:37

which there are thousands found in a

1:15:39

variety of plants across the planet that

1:15:42

seem to be correlated with better cognitive

1:15:44

outcomes and especially correlated with better immune

1:15:46

outcomes. So we're talking colorful fruits, vegetables.

1:15:48

We're talking things like spices. So herbs

1:15:50

and spices are actually some of the

1:15:53

most concentrated sources of polyphenols. These are

1:15:55

natural anti-inflammatory. Exactly. And we also know

1:15:57

coffee, which is one of my personal

1:15:59

favorites. For reasons beyond the

1:16:01

polyphenols, but the polyphenols help. Wine

1:16:04

has some. We could talk about that. I had

1:16:06

too much of that last night with you, Oscar. I

1:16:09

didn't sleep as good as I liked it. There you go.

1:16:11

It's a really good wine. Wow. I

1:16:13

only have one when it's really good and I don't usually have

1:16:15

it that often. When I do it, I like it. It was

1:16:17

a good wine. It was a good wine. So

1:16:20

again, it's just eating real foods most of the

1:16:22

time. I think there's a lot that can be

1:16:24

said for substitutions. And obviously, you know, we're doing

1:16:26

this work with the Simile and Tartary Buckwheat because

1:16:29

it is a better version of what most kind

1:16:31

of conventional grains are. It happens to be a

1:16:33

lot higher in polyphenols than almost any flour

1:16:35

on the market. So it's

1:16:37

really kind of concentrating a diet that

1:16:39

is rich in real foods. And I

1:16:43

know and I've listened to guests on your podcast

1:16:45

and other podcasts, everyone has their plant on the

1:16:47

ideal diet. I think what you talk about

1:16:49

with the Peking diet, what you talk about with eating

1:16:51

real foods, this is the key to it.

1:16:54

The benefit here is that this is the

1:16:56

diet that is most strongly associated with lower

1:16:59

levels of inflammation. There was actually a study just came out,

1:17:01

166,000 people, they followed them for multiple years

1:17:06

and what they looked at was basically rates

1:17:08

of people developing dementia. So they looked at

1:17:10

how anti-inflammatory was their diet, was it a

1:17:12

Mediterranean diet or was it a more conventional

1:17:15

diet? What they found is

1:17:17

that people who ate the anti-inflammatory diet,

1:17:19

the Mediterranean diet, lower risk for dementia

1:17:21

and that bigger hippocampus, which is the

1:17:23

memory center of the brain. So

1:17:25

it doesn't have to be super complicated stuff.

1:17:27

It doesn't even have to be super expensive

1:17:29

stuff. It's basically eating real food most of

1:17:31

the time. So that's my kind of dietary

1:17:33

plan. Fiber too for the microbiome, prebiotics, foods

1:17:36

and probiotic foods. I think the fiber comes

1:17:38

along with the prioritizing real minimally processed plant-based

1:17:41

food. I do think that we're learning more

1:17:43

and more. I mean, a study just came

1:17:45

out showing that fiber consumption inversely associated with

1:17:47

all-cause mortality, it's good stuff,

1:17:49

it's real stuff. We can talk about mechanisms. But

1:17:52

yeah, fiber prioritization comes alongside with eating foods

1:17:54

that people have messed with in a lean,

1:17:57

specifically plant-based food. Yeah. Don't

1:18:00

eat food that's been messed with. Unless

1:18:04

it's by an amazing chef. Right. It's

1:18:06

like a tomato from the plant. Okay, right?

1:18:08

If it's an egg from the farm, okay.

1:18:10

Can you name it? Right. My

1:18:13

joke, I used to speak at churches

1:18:15

and I was doing this work with

1:18:17

faith-based wellness. The rules

1:18:19

for eating are really simple. If

1:18:22

man made it, leave it. If God

1:18:24

made it, eat it. You know, did God make

1:18:26

it twinkie? No. Leave it. Did

1:18:28

God make an avocado? Yes, eat it. It's

1:18:30

pretty simple. Anybody can understand that. Yeah.

1:18:33

Yeah. Food made by plants, not in plants.

1:18:35

That's right. Yeah. That's

1:18:37

right. So food is such a critical

1:18:40

aspect of this and a critical aspect

1:18:42

of immunomodulation, immuno-rejuvenation. And now, you know,

1:18:44

one of your day jobs is the

1:18:47

managing director of Big Mold Health, which

1:18:49

is an extraordinary company that I am

1:18:51

an advisor to, an investor in, that's

1:18:53

been founded by my mentor, Jeffrey Bland,

1:18:55

who's the father of functional medicine. It's

1:19:00

a long story. We talked about it on

1:19:02

the podcast before, but this particular plant, Himalayan

1:19:05

tardary buckwheat, has particularly

1:19:07

immuno-rejuvenating anti-inflammatory properties. And it

1:19:09

comes from a plant that's

1:19:12

grown in extremely difficult circumstances. It's

1:19:14

high in the Himalayas, in

1:19:17

terrible soil, at high altitude, in

1:19:19

cold weather, and

1:19:21

it forces it to be really robust.

1:19:23

And the way plants become robust is

1:19:26

they build defenses. And the defenses that

1:19:28

plants have are these phytochemicals. So

1:19:30

these phytochemicals are found in extraordinary

1:19:33

numbers and levels in this particular

1:19:35

plant. Now, you can make pancakes out of

1:19:37

it, which is great, but there's a new,

1:19:39

and you can take it as

1:19:42

a concentrated supplement, which I do, and I recommend

1:19:44

it. It's got quercetin, bioplatmoids, many other things. But

1:19:47

there's a new product that's come out of this,

1:19:49

and it's all through regenerative agriculture. This plant has

1:19:52

grown in America now. Is

1:19:55

Himalayan tardary buckwheat sprouted powder,

1:19:57

right? Yeah, sprout powder. You

1:20:01

go to bigbolthealth.com and check it out. It's

1:20:05

really an amped up version of

1:20:07

the Himalayan I

1:20:30

think that the core idea here is the

1:20:33

idea of food as medicine, which is the idea

1:20:35

that food can help people to heal. And if

1:20:37

you believe that, then certain foods are better than

1:20:39

others. Certain foods are the

1:20:41

opposite. Certain foods are poison. They're taking away from

1:20:43

the quality of your life, the quality of every

1:20:46

aspect of what it means to enjoy our

1:20:49

existence. And certain foods are able to enhance

1:20:51

it. So I training

1:20:53

as a conventional medical doctor, I learn

1:20:55

things about diet. I learn things about

1:20:57

how to make recommendations mostly through the

1:20:59

Institute for Functional Medicine and other similar

1:21:02

programs. Hearing you speak actually a long

1:21:04

time ago. Within

1:21:07

this field, I learned

1:21:09

that in order to scale out nutrition based

1:21:11

solutions for people, you have to actually pay

1:21:14

attention to how that food is grown, who

1:21:16

is growing that food and how you get

1:21:18

food to people. So as much as I

1:21:20

would like to say, yeah, absolutely. Well,

1:21:22

that's a big piece of it. So as much as

1:21:24

I like to say, here's my top five foods at

1:21:27

Costco, I don't have a whole lot to say about

1:21:29

the quality of the Costco organic olive oil, which I

1:21:31

think is actually pretty high quality. But point being, I'm

1:21:33

not necessarily involved in that supply chain. So

1:21:36

at Big Bold Health, Jeff has decided

1:21:38

that he wants to really take a

1:21:40

more solid role in participating in that

1:21:42

entire process. So we have these farms

1:21:44

in upstate New York. We're

1:21:46

inoculating this plant with kind of fungi

1:21:48

and bacteria in order to promote a

1:21:51

healthier soil microbiome, which is something I've

1:21:53

been learning about more recently. It's kind

1:21:55

of an interesting thing. The soil itself has

1:21:57

a microbiome, speaks to the plant and

1:21:59

actually by way of. that bidirectional interaction

1:22:01

with kind of the plant brain and

1:22:03

the soil brain and the microbes changes

1:22:05

the amount of the plant's immune chemicals, these

1:22:07

polyphenols. So we grow it in New

1:22:09

York where it's colder, where we have

1:22:11

higher levels of these polyphenols to start

1:22:13

with, and we inoculate it to further

1:22:15

increase it. Then we grew this plant

1:22:17

and we've been kind of putting this tardary buckwheat, this

1:22:20

Himalayan tardary buckwheat into the market for a couple of

1:22:22

years. And one of the things we've heard is that

1:22:24

people wanted a more convenient version of it. So we

1:22:26

said, how can we make it more potent and how

1:22:28

can we make it more convenient? So

1:22:30

we found this incredible research, this literature

1:22:33

showing that when you sprout foods, it

1:22:35

actually can increase levels of a number

1:22:37

of different minerals, vitamins, and also certain

1:22:39

polyphenols while decreasing some of the trouble

1:22:42

that people have with digestion when they

1:22:44

might be eating a non-sprouted food. Yeah.

1:22:47

And I messed around with sprouted foods as

1:22:49

younger. By the way, buckwheat is neither wheat

1:22:51

nor grain. It's a fruit seed actually, of

1:22:53

all things, which again, very confusing name. It's

1:22:55

not a wheat, it's not a grain. So

1:22:58

we partnered with this group and we started sprouting

1:23:01

it and we measured the levels of these polyphenols,

1:23:03

things like root and quercetin. We found that they

1:23:05

were on average around four

1:23:07

times higher in the sprouted powder, which is super

1:23:09

convenient because actually I've used your pancake recipe several

1:23:12

times and it's great, but it's kind of more

1:23:14

of a weekend, Sunday morning type shit. You're not

1:23:16

just going to whip it up on your way

1:23:18

to the office. So what makes the sprout powder

1:23:20

unique is that it's, first of all, just

1:23:23

a little bit less bitter because of the way that

1:23:25

it's sprouted and it's just super convenient. You can travel

1:23:27

with it, you can put it in your smoothie, you

1:23:29

can put it in your coffee because it's kind of

1:23:31

like a sprout matcha latte kind of thing. Kind of,

1:23:33

yeah. But it's been fun. It's great. Yeah,

1:23:35

it's amazing. And the reason I brought it up is

1:23:37

because it's one of those compounds

1:23:40

in our food supply that can be

1:23:43

used to modulate our immune system or regulate our

1:23:45

inflammation. And there's obviously many others, but I just

1:23:47

sort of wanted to highlight that. And

1:23:49

then of course, there's other things we're going to have to

1:23:51

do for our brain, right? No, you're done.

1:23:53

You got it. That's it? That's it? No, we

1:23:55

have to sleep. We have to deal with stress.

1:23:57

We have to exercise. Yeah. All that's given. And

1:24:00

we can fix our microbiome. And part of

1:24:02

the sprout period is it contains a lot

1:24:05

of fiber that helps with the

1:24:07

microbiome, right? That's

1:24:09

right. And what makes the whole tartary buckwheat story

1:24:11

interesting, and my work with Jeff interesting, is that

1:24:13

we're trying to actually study this in a more

1:24:15

systematized fashion. So there's a study that I know

1:24:17

you're aware of where we're actually looking at what

1:24:19

happens when you give people the polyphenols in Himalayan

1:24:22

tartary buckwheat and you measure their immune system. And

1:24:24

specifically, you measure the epigenetics of the immune system. It's

1:24:27

complicated stuff. But it is

1:24:29

some of the first research looking at if we

1:24:32

believe in this idea of food as medicine, how

1:24:35

does food actually heal? We have for

1:24:37

years operated under this antioxidant paradigm where

1:24:40

certain foods have more antioxidants than others.

1:24:42

It hasn't necessarily panned out. So what we

1:24:44

do know is that certain diets correlate with certain

1:24:47

immune states. What we didn't know is why. And

1:24:50

I think the mechanism that we're looking

1:24:52

at here is through epigenetics, by changing

1:24:55

the way the DNA is being used.

1:24:57

And that's what we're looking at in this study. And

1:24:59

at least in the data we have so far, it

1:25:01

looks like when people's immune systems are aging faster, so

1:25:03

in the group of people who are kind of getting

1:25:07

older in their immune system more than

1:25:09

others, that it actually slows the rate

1:25:11

of aging when people are taking these

1:25:13

polyphenols that are found in Himalayan tartary

1:25:15

buckwheat. So this is early stuff. Early

1:25:18

research is basically reverses biological aging and

1:25:20

epigenetic aging. In the right population. And

1:25:22

again, early stuff. But the crazy thing

1:25:24

for me, at least, about this is

1:25:26

we are starting to get to this

1:25:28

core mechanism of food is medicine, okay, but

1:25:30

how and why? And if we're literally changing

1:25:33

the way our DNA is being used through

1:25:35

the food that we eat, think about the

1:25:37

possibilities. This has been looked at

1:25:39

in certain cancer therapeutics, and we're starting to

1:25:41

look at it as it relates to just

1:25:43

general health. Meaning when people eat certain foods,

1:25:46

you are changing the way your DNA is

1:25:48

being used. And in doing so, are going

1:25:50

to modulate a person's risk for a host

1:25:52

of issues and potentially use it to upregulate

1:25:54

pathways linked to better health, which is what

1:25:56

I'm excited about. Let's not be all about disease. Let's talk

1:25:58

about how to get people to eat better. Right, it's the

1:26:01

whole concept of not just anti-inflammatory

1:26:03

but immunorejuvenate. Right. Which

1:26:05

is how do you rejuvenate? Because that's what I care about. I

1:26:07

don't have any diseases but I want to optimize, I want to

1:26:09

rejuvenate, I want to feel better. I'm not

1:26:11

in a disease state but I want to get into

1:26:14

a better optimized state. That's

1:26:16

a whole other conversation. I think, you know, I

1:26:18

just want to sort of close by sort of

1:26:20

pointing out that, you know, this

1:26:22

research is backed

1:26:25

up by a lot of

1:26:27

evidence, this whole concept we're talking

1:26:29

about. And there's randomized human clinical

1:26:31

trials, for example, the SMILES trial.

1:26:33

They looked at basically diet and

1:26:35

antidepressants and it was basically

1:26:38

as effective if not better than antidepressants if

1:26:40

you need a whole foods diet. The

1:26:43

finger trial looking at Alzheimer's and

1:26:45

it's a multi-modal intervention using lifestyle

1:26:47

interventions, dietary interventions, optimizing

1:26:49

biomarkers, actually reverse cognitive decline. An Alzheimer's

1:26:52

patient says something that doesn't actually happen

1:26:54

and doesn't, there's no drug that does

1:26:56

that. Right. And so,

1:26:58

basically looking at these interventions which maybe seem

1:27:00

like soft or not real medicine, they actually

1:27:02

are the most effective medicine. I'd

1:27:04

also say this is your best chance at living a healthy,

1:27:07

happy life. This is what we've got

1:27:09

right now. It's not like there's some drug that

1:27:11

is going to come and save you. Drugs

1:27:13

are really great when things go wrong enough

1:27:15

to justify drug use but by and large,

1:27:17

the way that conventional pharmaceuticals work is they

1:27:19

slow the rate of decline. You're already on

1:27:21

the slope. You're already on the slippery slope.

1:27:23

You may not slide as quickly. What we're

1:27:25

talking about here is preventing yourself from getting

1:27:27

on that slope in the first place and

1:27:29

that is such a powerful message because so

1:27:32

much of my work, I seem to interact with

1:27:34

people who are a little bit older in further

1:27:36

years and there's so much that they can do

1:27:38

to improve their quality of life but I really

1:27:40

want to reach out to younger generations.

1:27:43

I see so many people my age and

1:27:45

younger who haven't yet started to prioritize their

1:27:48

brain health and inevitably, they all follow the

1:27:50

same kind of continuum. They ignore

1:27:52

it until it gets so painful that they have

1:27:54

to do something about it and I don't want

1:27:56

people listening to be the person brought into the

1:27:59

ER or brought in. into the clinic by

1:28:01

their partner when they're 70 years old

1:28:03

and everything's already gone wrong, this is

1:28:05

your best chance to ease health today.

1:28:08

So I just hope that more young people take that

1:28:10

to heart. Yeah, thanks so much Austin. Such a great

1:28:12

conversation, I could talk to you for hours. But

1:28:15

I just to sum up, I think, you

1:28:17

know, what we touched on is this

1:28:19

really important concept of brain inflammation driving

1:28:21

a lot of the stuff

1:28:23

that's wrong with our society, mental

1:28:25

health, the polarization, neurodendrodesis, kids

1:28:28

issues, ADD, autism, we didn't

1:28:30

really touch on that, but it's all linked to this

1:28:32

neuroinflammation. And the good news is we

1:28:34

know why and we know how to fix it. We're

1:28:36

still learning, there's still more to know, but I

1:28:38

think at this point we still have enough tools to

1:28:40

actually make a difference. And so I encourage people to

1:28:43

check out your book, Brainwash, with your dad, David Promutter,

1:28:46

check out Big Both Health. Anything else you

1:28:48

want them to know about? If you're interested

1:28:50

in brain science, free newsletter, austinpromutter.com.

1:28:52

austinpromutter.com, check it out. Thanks so

1:28:54

much, Austin. Thanks

1:28:58

for listening today. If you love this podcast,

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