Latest / Resiliency Radio with Dr. Jill Carnahan, MD / 337: Protecting Your Brain: The Latest Science on Cognitive Longevity with Dr. Majid Fotuhi

Transcript

337: Protecting Your Brain: The Latest Science on Cognitive Longevity with Dr. Majid Fotuhi · Resiliency Radio with Dr. Jill Carnahan, MD

• 0:01
  Dr. Jill Carnahan: Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine.
• 0:08
  Dr. Jill Carnahan: I'm your host, Dr. Jill, and with each episode we dive into the heart of healing and personal transformation.
• 0:14
  Dr. Jill Carnahan: Join me as I interview world leaders, medical innovators and thought leaders of all types, helping you on your journey to optimal health and healing and longevity.
• 0:24
  Dr. Jill Carnahan: One of the new favorite buzzwords.
• 0:27
  Dr. Jill Carnahan: If you have not yet stopped by the store, DrJill Health.com, you want to be sure and stop by.
• 0:31
  Dr. Jill Carnahan: You can get 15% off your first order and you can find all kinds of very curated products and services like the Epstein Barr Bundle, the tick prevention bite treatment protocol.
• 0:43
  Dr. Jill Carnahan: You can find things for mast cell activation and some of my favorites for brain health.
• 0:47
  Dr. Jill Carnahan: In our episode today, we're going to be talking about optimal brain health, the invincible brain with Dr. Fatoui.
• 0:53
  Dr. Jill Carnahan: Steven, stay tuned.
• 0:54
  Dr. Jill Carnahan: I'll introduce him in just a moment.
• 0:55
  Dr. Jill Carnahan: But in the meantime, if you want to get some important nutrients for the brain, you can grab my favorite duo, which is Cognicare and BDNF Essentials.
• 1:04
  Dr. Jill Carnahan: You can find them at drjillhealth.com I take them every day.
• 1:08
  Dr. Jill Carnahan: I find them incredibly helpful to support optimal cognition.
• 1:12
  Dr. Jill Carnahan: Finally, if you have not yet listened or seen the movie Doctor Patient, you can get that@drpatientmovie.com it's also streaming on Amazon Prime.
• 1:22
  Dr. Jill Carnahan: Check it out, leave a review, let me know what you think.
• 1:25
  Dr. Jill Carnahan: it's been a powerful change agent for those suffering from complex chronic illness.
• 1:30
  Dr. Jill Carnahan: it tells my own journey through illness and that of several of my patients.
• 1:35
  Dr. Jill Carnahan: And if you haven't yet watched it, check it out on Amazon prime again.
• 1:39
  Dr. Jill Carnahan: Doctor Patient movie.
• 1:41
  Dr. Jill Carnahan: Okay, let me introduce our guest, Dr. Fatoui.
• 1:43
  Dr. Jill Carnahan: Dr. Majid Fatoui is a world renowned neurologist, neuroscientist and adjunct professor at John Hopkins University.
• 1:50
  Dr. Jill Carnahan: he's recognized for his pioneering work in brain health, cognitive aging and dementia prevention.
• 1:55
  Dr. Jill Carnahan: He's going to prevent some of the research present today, some of the research he's done on his recent book the Invincible Brain and the programs that have been proven to reverse the brain aging.
• 2:07
  Dr. Jill Carnahan: Okay, let's get to it with Dr. Fatouy.
• 2:09
  Dr. Jill Carnahan: Here we go.
• 2:10
  Dr. Jill Carnahan: Dr. Fatouy, so glad to have you on Resiliency Radio.
• 2:14
  Dr. Jill Carnahan: Today I want to talk about your new book that's already a bestseller, the Invincible Brain.
• 2:19
  Dr. Jill Carnahan: Brain health is so critical, so many people are struggling and I don't know if there's a more common concern that patients come into My office with then, am I getting dementia?
• 2:29
  Dr. Jill Carnahan: Is my brain diminishing in function?
• 2:32
  Dr. Jill Carnahan: And all of these questions around our brain.
• 2:35
  Dr. Jill Carnahan: So I want to talk to you today about all of this and more.
• 2:39
  Dr. Jill Carnahan: Before we dive into your book, I want to know just a little bit about you and your story and your journey into medicine.
• 2:45
  Dr. Jill Carnahan: How did you get to studying the brain?
• 2:49
  Dr. Majid Fotuhi: First of all, thanks for inviting me to be on your show.
• 2:52
  Dr. Majid Fotuhi: I became interested about the brain when I was a kid.
• 2:56
  Dr. Majid Fotuhi: My father always talked to me about how our brain has no limit.
• 3:00
  Dr. Majid Fotuhi: How he wanted to encourage me to learn several languages, you know, be a famous author, doctor, and do something with my brain.
• 3:09
  Dr. Majid Fotuhi: So when I was 14, actually, I wrote a book about how our brain has incredible capacity.
• 3:15
  Dr. Majid Fotuhi: So when I started college and medical school, I became more and more interested in neurology.
• 3:22
  Dr. Majid Fotuhi: And during my residency, I became particularly interested about longevity prevention of Alzheimer's disease.
• 3:29
  Dr. Majid Fotuhi: I realized that many patients who were diagnosed with Alzheimer's disease had multiple medical conditions that were contributing to the cognitive decline, yet were just called as Alzheimer's patients.
• 3:44
  Dr. Majid Fotuhi: I wrote several articles about how we are over diagnosing Alzheimer's disease and we are not paying attention to these treatable components.
• 3:52
  Dr. Majid Fotuhi: And, you know, I wrote several books, and this is my fourth book on this topic.
• 3:58
  Dr. Jill Carnahan: Amazing.
• 3:58
  Dr. Jill Carnahan: And that you started at 14, that just tells us a lot about the kind of kid you were.
• 4:02
  Dr. Jill Carnahan: You were probably really curious and, you know, wanting to learn.
• 4:05
  Dr. Jill Carnahan: I always feel like lifelong learning and curiosity are those things that define some of my favorite people.
• 4:11
  Dr. Jill Carnahan: And clearly, at 14, you were thinking ahead.
• 4:14
  Dr. Jill Carnahan: And then you had a father who said, you know, anything's possible, which made it even more amazing.
• 4:20
  Dr. Jill Carnahan: I love the question because like you're saying, I want you to more frame that many people out there are diagnosed with dementia or Alzheimer's.
• 4:27
  Dr. Jill Carnahan: But the truth is, we have a lot more control than we think.
• 4:30
  Dr. Jill Carnahan: And you mentioned over diagnosis.
• 4:33
  Dr. Jill Carnahan: So maybe a better question would be, can we build a brain that's more resilient as we age?
• 4:40
  Dr. Majid Fotuhi: Yes.
• 4:40
  Dr. Majid Fotuhi: And that was my first book.
• 4:42
  Dr. Majid Fotuhi: I realized that throughout life, we have the opportunity to build a cognitive reserve.
• 4:50
  Dr. Majid Fotuhi: Cognitive reserve is like a retirement fund.
• 4:54
  Dr. Majid Fotuhi: When you learn new things, you create new synapses in your brain.
• 4:59
  Dr. Majid Fotuhi: When you exercise, you increase the number of blood vessels in the brain and provide better blood supply for the brain.
• 5:07
  Dr. Majid Fotuhi: When you challenge your brain in learning a new hobby, and you improve the networks of connections in your brain, and the more connections, the more synapses and the more blood flow you have, your brain, the more resilient your Brain becomes against the effects of pathological features of Alzheimer's disease.
• 5:28
  Dr. Majid Fotuhi: See, Alzheimer's technically is a condition in which these proteins clump up into little plaques or tangles.
• 5:38
  Dr. Majid Fotuhi: You can think of them like a piece of gum that's insoluble and just sits there in the brain where it doesn't belong.
• 5:45
  Dr. Majid Fotuhi: But those things by themselves cannot cause problems if the brain is healthy and strong.
• 5:53
  Dr. Majid Fotuhi: Otherwise, if somebody has a large cognitive reserve, they can have quite a number of these plaques and tangles in the brain and have no symptoms.
• 6:03
  Dr. Majid Fotuhi: This is what the non study showed.
• 6:05
  Dr. Majid Fotuhi: The nun study, which was an observational study of several hundred nuns for many years, showed that many of them who died were quite sharp at the time of their death.
• 6:17
  Dr. Majid Fotuhi: In the late 80s and 90s, you know, some of them were still teaching, crocheting, driving, doing community work.
• 6:25
  Dr. Majid Fotuhi: And their brains under microscope showed evidence of lots of Alzheimer's pathology, lots of plexitangus, but they were fine, they were functioning.
• 6:35
  Dr. Majid Fotuhi: And that's what resilient means.
• 6:38
  Dr. Majid Fotuhi: If you have a healthy brain through your lifestyle choices, by the time you get to your 80s and early 90s, you could stand some degrees of plaques and tangles and have those symptoms.
• 6:51
  Dr. Jill Carnahan: Now, that's promising because one of the most popular new tests is the P tau.
• 6:56
  Dr. Jill Carnahan: And some of the.
• 6:57
  Dr. Jill Carnahan: We can actually test this now at Quest and LabCorp in different labs for these markers of neurofibrillary tangles and platinum plaques.
• 7:05
  Dr. Jill Carnahan: But what you're saying is, even if those are positive or you have some form of that, it doesn't always equate with the fact that you're going to get dementia.
• 7:14
  Dr. Jill Carnahan: What would you tell someone who maybe has gotten that test or is ordering that test with how much weight?
• 7:19
  Dr. Jill Carnahan: Like, obviously there's something there, but it doesn't necessarily determine the outcome.
• 7:25
  Dr. Majid Fotuhi: I put them in perspective by comparing the P Tau to 17 to having high cholesterol levels.
• 7:33
  Dr. Majid Fotuhi: If you have high cholesterol levels, you are at risk of developing a heart attack.
• 7:38
  Dr. Majid Fotuhi: Clearly.
• 7:39
  Dr. Majid Fotuhi: But you know, having high cholesterol by itself does not guarantee that you will have heart attack.
• 7:46
  Dr. Majid Fotuhi: You have to have other risk factors such as smoking, sedentary lifestyle, obesity, diabetes, too much stress, sleep apnea.
• 7:57
  Dr. Majid Fotuhi: If you have those and you have high cholesterol, then your risk of developing cardiovascular disease is high.
• 8:06
  Dr. Majid Fotuhi: Similarly, having high levels of amyloid and tau in your brain is a risk factor.
• 8:12
  Dr. Majid Fotuhi: I wouldn't want to have high levels in my brain, but if I have a high cognitive reserve, then I can harbor some degrees of these plaques and tangles in my brain and have little to no symptoms.
• 8:27
  Dr. Majid Fotuhi: I think it's unfortunate that we don't have a complete profile for all the things that affect our brain.
• 8:34
  Dr. Majid Fotuhi: We have an incomplete picture of pathologies.
• 8:38
  Dr. Majid Fotuhi: Now you could, for example, get a carotid ultrasound and get a feel for your blood circulation.
• 8:46
  Dr. Majid Fotuhi: You can do all brain imaging to see the degree of atrophy in your brain and you could do other tests to get a more complete picture.
• 8:55
  Dr. Majid Fotuhi: So I see a lot of people who have had high P Tau to 17 and they're otherwise healthy and they're really panicking over the risk of Alzheimer's disease.
• 9:05
  Dr. Majid Fotuhi: And my message to them is, if you follow what I call the five pillars of brain health.
• 9:13
  Dr. Majid Fotuhi: Exercise, optimal sleep, a Mediterranean type diet, stress reduction and meditation, and brain training.
• 9:23
  Dr. Majid Fotuhi: If you do those five things and incorporate them in your daily activities, you will have a larger cognitive preserve and you will be able to remain functional despite having plexitangles in your brain.
• 9:38
  Dr. Jill Carnahan: Now, I loved with a list of five, none of them was one of the new meds for Alzheimer's because we know those are just targeting a target that we just talked about that is not really relevant and in some cases it makes people worse.
• 9:50
  Dr. Jill Carnahan: So I love that you're talking about these really lifestyle oriented types of things that do change and that people could start in their 20s or 30s or 40s, way before they ever have some cognitive symptoms.
• 10:02
  Dr. Jill Carnahan: Do you want to go through each of your categories and talk a little bit about some of the practical, like maybe the best types of exercise evidence based, what each of those start with number one, and let's go down the list and talk real specifics about maybe just a couple tips for each one for a patient out there.
• 10:19
  Dr. Majid Fotuhi: We now have solid scientific evidence for these recommendations.
• 10:23
  Dr. Majid Fotuhi: People have been talking about diet and exercise and sleep for decades.
• 10:28
  Dr. Majid Fotuhi: The difference between now and 30, 40 years ago is that we have randomized control trials and we have lots of observational studies that together provide basis for making specific combinations.
• 10:43
  Dr. Majid Fotuhi: When it comes to exercise, I think people need to make sure that they do not have a sedentary lifestyle.
• 10:49
  Dr. Majid Fotuhi: You know, if you have a desk job, you really need to make sure that you walk 3,000 to 5,000 steps a day.
• 10:56
  Dr. Majid Fotuhi: There's a lot of debate as to whether you should do aerobic exercise or resistance training.
• 11:01
  Dr. Majid Fotuhi: Ideally you should combine.
• 11:02
  Dr. Majid Fotuhi: That's what I do.
• 11:03
  Dr. Majid Fotuhi: I usually do like 45 minutes of my Peloton and I do like 45 minutes of some kind of weight training.
• 11:11
  Dr. Majid Fotuhi: So bottom line is that you need to increase your stamina.
• 11:15
  Dr. Majid Fotuhi: You need to be one notch stronger than you are now.
• 11:18
  Dr. Majid Fotuhi: And you don't have to become, you don't have to run a marathon.
• 11:21
  Dr. Majid Fotuhi: Many studies have shown that just walking by itself is very powerful.
• 11:25
  Dr. Majid Fotuhi: So if walking's all you do, and you walk 5,000, ideally 7,000 steps a day, you're fine.
• 11:32
  Dr. Majid Fotuhi: You don't have to do extra.
• 11:33
  Dr. Majid Fotuhi: But if you want to do extra, do three hours of exercise a week and try to combine maybe half and half of aerobic and resistant training.
• 11:42
  Dr. Majid Fotuhi: And exercise is just incredible.
• 11:44
  Dr. Majid Fotuhi: It increases number of blood vessels in the brain, it increases neurogenesis.
• 11:49
  Dr. Majid Fotuhi: You have more new neurons in the memory part of the brain called hippocampus.
• 11:54
  Dr. Majid Fotuhi: It reduces inflammation, it increases the number of mitochondria, which generate more energy for the brain, and it increases the fiber bundles in the brain.
• 12:03
  Dr. Majid Fotuhi: So exercise from like 1 to 10 is 9 out of 10 in terms of how important it is.
• 12:10
  Dr. Majid Fotuhi: So when it comes to sleep, people need to appreciate that sleep is not a passive process.
• 12:19
  Dr. Majid Fotuhi: During sleep, there's a lot going on in your brain to make everything clean.
• 12:24
  Dr. Majid Fotuhi: There's a cleaning and cleansing operation that's hard at work during sleep and especially during deep sleep.
• 12:33
  Dr. Majid Fotuhi: So if you cut short the amount of sleep you get, you really are making your brain deprive that sense of waste management system.
• 12:44
  Dr. Majid Fotuhi: Imagine if you don't take the trash out of your house, or maybe take half of the trash from your house and see what would happen to your kitchen.
• 12:53
  Dr. Majid Fotuhi: After two months, literally the same thing happens.
• 12:56
  Dr. Majid Fotuhi: The brain.
• 12:56
  Dr. Majid Fotuhi: The trash gets out of the brain.
• 13:00
  Dr. Majid Fotuhi: And that trash is metabolic byproduct of chemical reactions.
• 13:04
  Dr. Majid Fotuhi: Just like a factory that has some byproducts that need to be taken out.
• 13:08
  Dr. Majid Fotuhi: There are a lot of activities in your brain.
• 13:11
  Dr. Majid Fotuhi: In fact, there are more chemical and electrical activities in your brain than anywhere else in your body, by far.
• 13:20
  Dr. Majid Fotuhi: So you can't really deprive your brain of that, you know, waste management operation.
• 13:25
  Dr. Majid Fotuhi: So you need to make the sleep a priority.
• 13:29
  Dr. Majid Fotuhi: In my experience, many people say, I just can't sleep, or I've tried everything.
• 13:35
  Dr. Majid Fotuhi: Nothing works.
• 13:36
  Dr. Majid Fotuhi: And that's not really true because most people's insomnia is treatable.
• 13:42
  Dr. Majid Fotuhi: Many times people have a lot of stress and anxiety that keeps them up at night.
• 13:46
  Dr. Majid Fotuhi: And many people don't do this basic sleep hygiene, like make sure you don't drink caffeinated beverages at night, make sure you don't eat spicy food before you go to bed.
• 13:56
  Dr. Majid Fotuhi: Make sure your bed is quiet and dark, don't break your Homework or your work related material and desk to your bed.
• 14:08
  Dr. Majid Fotuhi: A lot of basic sleep hygiene interventions can improve sleep.
• 14:13
  Dr. Majid Fotuhi: And if somebody still can't sleep, then there's this thing called cognitive behavior therapy which is very powerful.
• 14:20
  Dr. Majid Fotuhi: I think at least 90% of sleep issues can be treated with fairly simple interventions.
• 14:27
  Dr. Majid Fotuhi: There are people who have serious insomnia issues or sleep disorders, but they are the ones who will benefit from seeing a sleep specialist.
• 14:37
  Dr. Majid Fotuhi: So make sleep a priority.
• 14:39
  Dr. Majid Fotuhi: Get at least seven hours, ideally seven to eight hours.
• 14:43
  Dr. Majid Fotuhi: Now when it comes to diet, the guidelines are very simple.
• 14:48
  Dr. Majid Fotuhi: You should not eat junk food.
• 14:51
  Dr. Majid Fotuhi: If you avoid eating processed food and things that are high in trans fat, Whatever else you eat is good, you know, because you're left with fruits, vegetables, you know, proteins, fish, meat.
• 15:04
  Dr. Majid Fotuhi: You know, there's some debate whether to ketogenic diet or vegetarian diet.
• 15:09
  Dr. Majid Fotuhi: I think just stick to one of them and do it, you know, just make sure you don't eat too many french fries and chips and cookies and donuts and muffins.
• 15:20
  Dr. Majid Fotuhi: Or if you do eat them, be reasonable, just have a little spoon, a little bite.
• 15:25
  Dr. Jill Carnahan: Hey guys, Just a quick interruption to the show to remind you that you can get my book Unexpected Finding Resilience through Functional Medicine, Science and Faith anywhere books are sold.
• 15:35
  Dr. Jill Carnahan: If you haven't yet read the book or shared it with a friend, please do so.
• 15:39
  Dr. Jill Carnahan: You can also find it on my website, Dr. Jill health.
• 15:43
  Dr. Jill Carnahan: Com.
• 15:44
  Dr. Jill Carnahan: If you're wanting a signed copy for yourself or a friend or family member as a gift, you can order it directly from our clinic and I will send you a signed copy.
• 15:52
  Dr. Jill Carnahan: You can just put in the checkout cart what you want that signed to who you want to send it to.
• 15:57
  Dr. Jill Carnahan: And I will do that personally before we send it off.
• 15:59
  Dr. Jill Carnahan: Okay, let's get back to Dr. Fatou and our show.
• 16:02
  Dr. Jill Carnahan: I always loved like the Blue Zones data from Dan Buettner because it's all these five, six different places all over the world, Greece and Italy and Loma Linda and.
• 16:12
  Dr. Jill Carnahan: And each of them have different, like some eat soy and some don't and some eat tubers and some don't and some eat meat and some don't.
• 16:18
  Dr. Jill Carnahan: So but the commonality was real food, local food, non processed food, non chemicalized food, community with food.
• 16:25
  Dr. Jill Carnahan: And so it feels like what you're saying is very similar to like the Blue Zones diet, which is quite varied according to geography.
• 16:32
  Dr. Jill Carnahan: But the commonalities are highly processed food is out, sugar is out, you know, and these things that aren't real food are not part of the Diet.
• 16:41
  Dr. Majid Fotuhi: Exactly.
• 16:42
  Dr. Majid Fotuhi: You know, when you eat ice creams and you eat, you know, pizzas that are poorly prepared or hamburgers that are poorly prepared, or this food you get, like fried chicken that, you know, God knows what's in it.
• 16:55
  Dr. Majid Fotuhi: Those things are harmful for the brain.
• 16:57
  Dr. Majid Fotuhi: You know, just think of it.
• 16:58
  Dr. Majid Fotuhi: You can have the best factory, but if the material you bring to the factory are junk, you're not going to get good products.
• 17:05
  Dr. Majid Fotuhi: And what you eat are the nutrients that your brain is going to use.
• 17:10
  Dr. Majid Fotuhi: So if you want your brain to be happy, you need lots of vitamins, sufficient amount of protein, adequate amount of fiber, and that's the kind of diet that your brain likes.
• 17:21
  Dr. Majid Fotuhi: Not things that are sugary and spice, your sugar levels and result insulin resistance and things like that.
• 17:29
  Dr. Majid Fotuhi: Food is very important.
• 17:30
  Dr. Majid Fotuhi: But really the principle of what to eat, in my opinion, is very simple.
• 17:36
  Dr. Majid Fotuhi: Don't eat junk food.
• 17:37
  Dr. Majid Fotuhi: If you just do that, whatever else you eat, it's good for you.
• 17:42
  Dr. Majid Fotuhi: Especially if it's, you know, organic food and.
• 17:45
  Dr. Majid Fotuhi: And is healthy otherwise.
• 17:48
  Dr. Jill Carnahan: Exactly.
• 17:49
  Dr. Majid Fotuhi: Now, the fourth thing is stress.
• 17:52
  Dr. Majid Fotuhi: Chronic stress is bad for the brain.
• 17:56
  Dr. Majid Fotuhi: Occasional stressful events are part of life.
• 17:59
  Dr. Majid Fotuhi: And there's this thing called EU stress where a little stress is actually good for you.
• 18:05
  Dr. Majid Fotuhi: If you're preparing for a deadline, if you're like, when I was finishing my book, I had a deadline, or, you know, I have to prepare things, I think a little bit of stress sort of builds character and challenges you.
• 18:17
  Dr. Majid Fotuhi: It's a good thing.
• 18:18
  Dr. Majid Fotuhi: The stress that's bad is the kind that affects your daily life all the time.
• 18:23
  Dr. Majid Fotuhi: There are people who are stressed from the time they wake up in the morning.
• 18:26
  Dr. Majid Fotuhi: They're stressed out during the traffic, they're stressed out at work, they're stressed out with their family members, and really they need help.
• 18:34
  Dr. Majid Fotuhi: One of the things people don't appreciate is this.
• 18:38
  Dr. Majid Fotuhi: You have control over your thoughts.
• 18:40
  Dr. Majid Fotuhi: You can think of the thoughts you have, like the clothes you wear every day.
• 18:45
  Dr. Majid Fotuhi: You really need to choose how you start your day.
• 18:49
  Dr. Majid Fotuhi: I think the first 10 minutes of your day is the most important part of your day.
• 18:54
  Dr. Majid Fotuhi: You need to sort of think good things.
• 18:57
  Dr. Majid Fotuhi: You should say, today is going to be a good day, and I'm going to have a good time at work.
• 19:03
  Dr. Majid Fotuhi: I'm going to have good interaction with my family members.
• 19:06
  Dr. Majid Fotuhi: I'm lucky to have these five things and just name all the things that you're grateful about.
• 19:11
  Dr. Majid Fotuhi: And then get out of bed with a positive attitude, with a sense of happiness and joy.
• 19:19
  Dr. Majid Fotuhi: Now I understand, you know, many people have financial problems.
• 19:23
  Dr. Majid Fotuhi: There Are marital problems.
• 19:25
  Dr. Majid Fotuhi: There are, you know, health related issues.
• 19:28
  Dr. Majid Fotuhi: People have problems.
• 19:30
  Dr. Majid Fotuhi: And my point is everybody has some problems.
• 19:34
  Dr. Majid Fotuhi: You can't find anybody, regardless of financial status, that has no problems.
• 19:39
  Dr. Majid Fotuhi: Is how you view your problem is what matters.
• 19:44
  Dr. Majid Fotuhi: If you view your problem as gigantic, then it is a big deal.
• 19:48
  Dr. Majid Fotuhi: But the same problem to a different person is minor.
• 19:52
  Dr. Majid Fotuhi: So you need to decide what is really a major problem for your life and ask yourself, is it really a major problem?
• 20:00
  Dr. Majid Fotuhi: See as a neurologist, I see for example, parents who bring their teenage kids who are not studying and they're really devastated because they want the kid to get A's, go to medical school, be successful, and the kid is just not interested.
• 20:14
  Dr. Majid Fotuhi: And the whole life, their lives of the whole family is affected.
• 20:18
  Dr. Majid Fotuhi: And you know, I tell parents, they say, listen, you do your part.
• 20:22
  Dr. Majid Fotuhi: You try to be a good role model, you try to communicate, you try to set rewards.
• 20:27
  Dr. Majid Fotuhi: You do your part and if it's not working, you've done your part.
• 20:31
  Dr. Majid Fotuhi: And you take care of yourself and don't let that become the most stressful thing.
• 20:38
  Dr. Majid Fotuhi: And then the other thing that helps is a few minutes of meditation and deep breathing really do wonders.
• 20:47
  Dr. Majid Fotuhi: Slow breathing has huge benefits in that they increase the vagus nerve activity, they improve parasympathetic tone, they increase something called hrv, which is heart rate variability.
• 21:01
  Dr. Majid Fotuhi: And that heart rate variability training has great benefits for the brain.
• 21:06
  Dr. Majid Fotuhi: So make it a point to sit down somewhere quietly and just breathe deeply.
• 21:12
  Dr. Majid Fotuhi: Just breathe in for a count of six, hold for the count of three, and then breathe out for a count of three.
• 21:18
  Dr. Majid Fotuhi: And try to do it at least two minutes, ideally five minutes, and you will see, you really feel calm and relaxed even after two to five minutes of this slow breathing.
• 21:28
  Dr. Majid Fotuhi: If you can meditate while you do that, even better.
• 21:31
  Dr. Majid Fotuhi: But if you can't meditate, you just can't clear your mind.
• 21:35
  Dr. Majid Fotuhi: Just pay attention to the air going to your nostrils and breathe in, breathe out.
• 21:41
  Dr. Majid Fotuhi: Two to five minutes.
• 21:42
  Dr. Majid Fotuhi: Maybe in the morning, maybe in the middle of the day when things are hectic, or maybe going to bed.
• 21:48
  Dr. Majid Fotuhi: The last pillar of brain health after exercise, optimal sleep, meditating, diet and meditation is brain training.
• 21:58
  Dr. Majid Fotuhi: Your brain is like a muscle, and the more you challenge it, the stronger it gets.
• 22:03
  Dr. Majid Fotuhi: You really want to find opportunities to tease your brain.
• 22:08
  Dr. Majid Fotuhi: Maybe you can try to memorize names, maybe you can learn something new about your work, about what people tell you.
• 22:17
  Dr. Majid Fotuhi: Dig in deep in a topic, Maybe you know, start bird watching, take a new hobby, or try to improve your skills in baseball or tennis or anything.
• 22:28
  Dr. Majid Fotuhi: Else or pick a ball.
• 22:29
  Dr. Majid Fotuhi: Every time you learn, your brain is improving.
• 22:33
  Dr. Majid Fotuhi: But learning doesn't have to be like a boring thing sitting in front of a computer.
• 22:37
  Dr. Majid Fotuhi: Learning means acquiring new skills, and ideally, you should do something that's fun.
• 22:43
  Dr. Majid Fotuhi: For example, I love dancing, so my way of brain training is to learn new dance steps.
• 22:50
  Dr. Majid Fotuhi: And it's fun and I'm learning it and it's, you know, social interactions, so it's a great thing.
• 22:59
  Dr. Majid Fotuhi: So my recommendation to people, especially those in midlife who worry about their memory sleeping, is try to incorporate these five pillars of brain health in your daily activities.
• 23:11
  Dr. Majid Fotuhi: When you wake up in the morning, have a plan of how much activity you can get.
• 23:17
  Dr. Majid Fotuhi: Maybe you can plan to go for a walk during lunch hour.
• 23:21
  Dr. Majid Fotuhi: Maybe you can go for a walk with your spouse in the evening.
• 23:24
  Dr. Majid Fotuhi: Maybe you can go for a pickup ball and then decide what you're going to eat.
• 23:30
  Dr. Majid Fotuhi: Have some idea that were not going to eat the french fries and hamburger today, and instead you're going to get a salad or, you know, prepare something yourself.
• 23:38
  Dr. Majid Fotuhi: Maybe you can have egg and omelette or maybe, you know, some chicken, something that's, you know, preferably healthy and, you know, high protein, high fiber.
• 23:49
  Dr. Majid Fotuhi: And then set a goal of when you're going to do two to five minutes of breathing and make it a point to maybe listen to a podcast or learn something new.
• 23:58
  Dr. Majid Fotuhi: It's not really that complicated.
• 24:00
  Dr. Majid Fotuhi: Incorporating these five pillars of brain health in your daily activities is quite simple and feasible.
• 24:06
  Dr. Majid Fotuhi: It doesn't have to be new.
• 24:08
  Dr. Majid Fotuhi: It does not need to be a new source of stress for people that I'm not taking care of my brain.
• 24:14
  Dr. Jill Carnahan: Such great practical advice.
• 24:17
  Dr. Jill Carnahan: And if you guys want to hear more or learn more, you can get the invisible brain.
• 24:20
  Dr. Jill Carnahan: Because I'm sure that everything is in the book with lots of details.
• 24:23
  Dr. Jill Carnahan: But thanks for running through that.
• 24:25
  Dr. Jill Carnahan: My thought.
• 24:26
  Dr. Jill Carnahan: Interestingly, I just listened to a podcast the other day which talked about literacy rates in the US and how they're really dramatically dropping because so few people are reading anymore.
• 24:34
  Dr. Jill Carnahan: They're listening to their books and audio is great.
• 24:37
  Dr. Jill Carnahan: I love podcasts.
• 24:37
  Dr. Jill Carnahan: I love audiobooks.
• 24:39
  Dr. Jill Carnahan: But I was just challenged personally, and I want to challenge you listeners out there to actually pick up a book.
• 24:44
  Dr. Jill Carnahan: And I used to years ago read like two books a week.
• 24:47
  Dr. Jill Carnahan: I don't do that pace anymore.
• 24:49
  Dr. Jill Carnahan: But there's a cognitive dissonance that happens with reading, especially reading out loud.
• 24:54
  Dr. Jill Carnahan: So I just was encouraged the other day of like, oh, I need to get back to making sure I have a of couple books by my nightstand and maybe before bed do 15 to 20, 30 minutes of reading and even reading out loud.
• 25:05
  Dr. Jill Carnahan: I thought those were really good tips because there is a skill there that a lot of us are losing the literacy rate.
• 25:11
  Dr. Jill Carnahan: Most recently, I think it was at 16% of adults actually read a book in the last year.
• 25:16
  Dr. Jill Carnahan: That's crazy.
• 25:17
  Dr. Jill Carnahan: That's really crazy.
• 25:19
  Dr. Jill Carnahan: So let's talk about one thing.
• 25:21
  Dr. Jill Carnahan: I love this question.
• 25:22
  Dr. Jill Carnahan: What do you think is the biggest misconception that physicians have about cognitive aging?
• 25:26
  Dr. Jill Carnahan: Like, what might your doctor be getting wrong?
• 25:30
  Dr. Majid Fotuhi: Unfortunately, many doctors, especially those who are busy, think dichotomously about dementia versus normal aging.
• 25:42
  Dr. Majid Fotuhi: They talk to a patient and they say, you're fine, you're driving, you're cooking, you're working.
• 25:47
  Dr. Majid Fotuhi: What are you talking about?
• 25:49
  Dr. Majid Fotuhi: Or worse is if somebody has some memory lapses, which could be, for example, due to menopause, it could be due to poor sleep, it could be due too much work.
• 26:02
  Dr. Majid Fotuhi: And the person says, well, you know, my grandfather had Alzheimer's disease and I'm forgetting names.
• 26:08
  Dr. Majid Fotuhi: And they jump on the other side of this glycotomy spectrum and say, oh, it looks like you may have Alzheimer's disease.
• 26:15
  Dr. Majid Fotuhi: Let's check some biomarkers.
• 26:17
  Dr. Majid Fotuhi: And of course the biomarker may be positive.
• 26:20
  Dr. Majid Fotuhi: And all of a sudden you forget that you have many treatable issues for your memory lapses.
• 26:28
  Dr. Majid Fotuhi: And instead of working on those, you're worried about Alzheimer's disease and now you're struggling with the fact that you're going to be demented, what's going to happen to your finances?
• 26:40
  Dr. Majid Fotuhi: Who's going to take care of you?
• 26:42
  Dr. Majid Fotuhi: Which is really not necessarily.
• 26:45
  Dr. Majid Fotuhi: I think it would be great if more and more doctors appreciated that cognitive decline is on the spectrum, let's say from 1 to 100.
• 26:53
  Dr. Majid Fotuhi: And even if somebody has what we call mild cognitive impairment, a condition in which people repeat the same question multiple times, but they still function, even those patients improve greatly with lifestyle interventions.
• 27:08
  Dr. Majid Fotuhi: I develop a 12 week brain fitness program for people with cognitive decline.
• 27:15
  Dr. Majid Fotuhi: I initially provided this program for patients who were in their 70s and early 80s.
• 27:20
  Dr. Majid Fotuhi: These patients had mild cognitive impairment, which is considered to be a stage between normal and Alzheimer's disease.
• 27:26
  Dr. Majid Fotuhi: These are the people who repeat themselves often.
• 27:28
  Dr. Majid Fotuhi: If you look at their brain, they do have footprints of Alzheimer's disease in their brain.
• 27:34
  Dr. Majid Fotuhi: During this program, I would do a head toe evaluation to determine all the causes for their cognitive decline, which included, you know, hormonal changes, poor diet, maybe respiratory issues, smoking, poor cardiovascular functions, low stamina, maybe they have Some liver or kidney problems, maybe they had, you know, joint pain that limited their ability to move and lack of movement were contributing.
• 28:02
  Dr. Majid Fotuhi: So I would do a full evaluation of all the medical problems.
• 28:08
  Dr. Majid Fotuhi: I checked 40 things, and then every person would have four or five or six things.
• 28:13
  Dr. Majid Fotuhi: Hearing loss, poor vision, alcohol, a whole lot of things.
• 28:19
  Dr. Majid Fotuhi: And then every person would have four or five issues which were potential culprits.
• 28:24
  Dr. Majid Fotuhi: And they were not the same four or five issue for every person.
• 28:27
  Dr. Majid Fotuhi: Every person had different issues.
• 28:29
  Dr. Majid Fotuhi: And then I started to work on their medical issues, including diabetes, depression, polypharmacy, taking too many medications.
• 28:37
  Dr. Majid Fotuhi: And as I did that, I would put them also in a program to work with my brain coaches.
• 28:44
  Dr. Majid Fotuhi: My brain coaches would meet with the patients twice a week for 90 minutes at each visit.
• 28:50
  Dr. Majid Fotuhi: And during each of those 90 visits, half of that time was devoted to going over their lifestyle issues, going over those five pillars of brain health.
• 29:00
  Dr. Majid Fotuhi: And then the other half was for brain training and biofeedback, HIV biofeedback and neurofeedback.
• 29:06
  Dr. Majid Fotuhi: And so, for example, a person was not walking much.
• 29:09
  Dr. Majid Fotuhi: I was sedentary, would talk to my brain coaches, and they say, okay, Mr. Smith, please walk 10 minutes.
• 29:17
  Dr. Majid Fotuhi: And they say, oh, I have, you know, joint pain, this and that.
• 29:20
  Dr. Majid Fotuhi: Okay, well, let's talk to your doctor, figure out how we can manage your pain, because we have to walk.
• 29:25
  Dr. Majid Fotuhi: If you can't walk, maybe you can do rowing, maybe you can do yoga, maybe you can do a stationary bike.
• 29:32
  Dr. Majid Fotuhi: You know, something we can swimming.
• 29:34
  Dr. Majid Fotuhi: You know, my brain coaches would work with them to find a way to exercise.
• 29:38
  Dr. Majid Fotuhi: And then they would talk with the patient about the food they were eating.
• 29:42
  Dr. Majid Fotuhi: And so wait a minute.
• 29:43
  Dr. Majid Fotuhi: You know, you're having just, you're having a lot of bread and cheese, and you don't have enough protein in your diet, or, you know, you're this eating this food that's highly processed, or this and that.
• 29:55
  Dr. Majid Fotuhi: And the same thing with sleep and brain training.
• 29:57
  Dr. Majid Fotuhi: So half the time was really sitting down with a patient, listening as much as talking, because you need to hear the excuses the patients have for not exercising, for example.
• 30:10
  Dr. Majid Fotuhi: And it's important to listen and not just lecture them.
• 30:13
  Dr. Majid Fotuhi: And then we started at where the patients were, like, if somebody was walking already 3,000 steps a day, then we would work with them to increase the stamina by running or do some circuit training and so forth.
• 30:29
  Dr. Majid Fotuhi: So while my brain coaches met with our patients twice a week and did half of time on five pillars of brain health and half time on brain training and biofeedback, I Took care of the medical issues.
• 30:41
  Dr. Majid Fotuhi: I ordered a sleep study and treated someone's sleep apnea.
• 30:45
  Dr. Majid Fotuhi: I managed hearing.
• 30:46
  Dr. Majid Fotuhi: I got them the hearing aid.
• 30:49
  Dr. Majid Fotuhi: So in parallel, we will work with the patients.
• 30:52
  Dr. Majid Fotuhi: So after six weeks, we would repeat the testing.
• 30:54
  Dr. Majid Fotuhi: The baseline cognitive testing would be repeated at six weeks, and then they would come to meet with me.
• 31:00
  Dr. Majid Fotuhi: Some things improved, some things didn't.
• 31:02
  Dr. Majid Fotuhi: And then six more weeks, and then they graduate with doing another set of cognitive evaluations.
• 31:08
  Dr. Majid Fotuhi: So what we found was 84% of our elderly patients who were one step away from getting Alzheimer's disease improved their cognitive function.
• 31:19
  Dr. Majid Fotuhi: It wasn't that they were less, worse, they improved.
• 31:23
  Dr. Majid Fotuhi: And in half, these patients agreed to have MRIs.
• 31:27
  Dr. Majid Fotuhi: An MRI showed that the hippocampus, which is the size of your thumb, as a part of brain for learning and memory, increased in volume by 1 to 3%.
• 31:37
  Dr. Majid Fotuhi: These are elderly patients.
• 31:38
  Dr. Majid Fotuhi: These are not teenage kids.
• 31:40
  Dr. Majid Fotuhi: These are elderly.
• 31:41
  Dr. Majid Fotuhi: We published those results in a Journal of Prevention of Alzheimer's disease in 2016.
• 31:47
  Dr. Majid Fotuhi: I kept providing the program for other groups of patients, those with concussions, those with brain fog, those with ADHD.
• 31:56
  Dr. Majid Fotuhi: And we saw similar results.
• 31:57
  Dr. Majid Fotuhi: More than 80% improved.
• 31:59
  Dr. Majid Fotuhi: And I published those in the Journal of Alzheimer's Disease reports.
• 32:04
  Dr. Majid Fotuhi: And that's the basis of my book, how we came up with this program.
• 32:09
  Dr. Majid Fotuhi: And what are the evaluation steps that need to be done and what are the interventions?
• 32:15
  Dr. Majid Fotuhi: All the details of the things we did are the basis of my amazing.
• 32:22
  Dr. Jill Carnahan: What incredible results.
• 32:23
  Dr. Jill Carnahan: And again, I like that our first question was, what do physicians need to know?
• 32:27
  Dr. Jill Carnahan: Because you're right, many of our colleagues kind of stop and just assume that either the drugs are going to do something, which we have very little evidence that the drugs are actually working versus these lifestyle.
• 32:37
  Dr. Jill Carnahan: And many physicians are taught, oh, patients won't exercise or do it.
• 32:41
  Dr. Jill Carnahan: But you've got this program that kind of walks them through with coaches, which I think is also part of the compliance, because they have someone to kind of check in and help them.
• 32:49
  Dr. Jill Carnahan: And I'm assuming now with AI and with virtual assistants and agents, I think we're going to have a lot more ability as physicians to give our patients tools to actually help them follow through with things like this program, which makes so much sense.
• 33:05
  Dr. Majid Fotuhi: Let me just add two little things quickly.
• 33:08
  Dr. Majid Fotuhi: One thing is that I just did what you mentioned.
• 33:11
  Dr. Majid Fotuhi: I set up an AI based on my book.
• 33:16
  Dr. Majid Fotuhi: I have developed an app, the Invincible Brain, a free app.
• 33:19
  Dr. Majid Fotuhi: And in this app, we have the same questionnaires that we provided for our patients.
• 33:25
  Dr. Majid Fotuhi: And we have used AI to Go over the questions and then use the information in my book to create a report and answer the questions that users have.
• 33:39
  Dr. Majid Fotuhi: The second thing I wanted to tell you, so it's the Invincible Brain app is available for iPhone androids.
• 33:46
  Dr. Majid Fotuhi: And the other thing is that I gave a lecture at the American Academy of Neurology this April to 5,000 neurologists who are there from 120 countries.
• 33:56
  Dr. Majid Fotuhi: This is the American academic, and I was honored to give the plenary speech.
• 34:03
  Dr. Majid Fotuhi: And my speech was about how lifestyle interventions are far more effective than these new medications.
• 34:10
  Dr. Majid Fotuhi: These new medications slow the rate of decline.
• 34:13
  Dr. Majid Fotuhi: And then lifestyle interventions based on randomized control trials improve cognitive function.
• 34:21
  Dr. Jill Carnahan: Yes.
• 34:22
  Dr. Majid Fotuhi: One reduces the decline, the other one improves cognitive function.
• 34:27
  Dr. Jill Carnahan: Yes.
• 34:28
  Dr. Majid Fotuhi: And so it's a very exciting time for us because we now have solid scientific evidence that the combination of lifestyle interventions are very powerful.
• 34:39
  Dr. Jill Carnahan: I love that.
• 34:39
  Dr. Jill Carnahan: And like you said, we've been very disappointed by the drugs because the drugs, again, they might prevent worsening, which is a very different outcome than actually improving the hippocampus volume.
• 34:50
  Dr. Jill Carnahan: That's very impressive data that you're presenting before we kind of wrap up and tell people where they can find the book.
• 34:56
  Dr. Jill Carnahan: One thing that I love to talk about is inflammation and environmental toxicity and some of these other things that obviously affect our bodies and brains.
• 35:04
  Dr. Jill Carnahan: What role do you see for inflammation caused by either infections or toxins in the brain health?
• 35:13
  Dr. Majid Fotuhi: I think inflammation is the fire that causes so many problems in the brain.
• 35:20
  Dr. Jill Carnahan: Yes.
• 35:21
  Dr. Majid Fotuhi: See, remember we started by saying that you have some plaques and tangles in the brain, that little pieces of gum sitting there.
• 35:28
  Dr. Majid Fotuhi: If those blacks and tangles just sit there without any inflammation, a person would not have so much problems.
• 35:35
  Dr. Majid Fotuhi: It's the body's inflammatory response that creates the problem.
• 35:41
  Dr. Majid Fotuhi: It's like you call the ambulances and then too many ambulances arrive and they just flood the house.
• 35:47
  Dr. Jill Carnahan: Yes.
• 35:48
  Dr. Majid Fotuhi: So the intention of inflammatory response is a good thing, unfortunately, because there are so many problems, there's an over response.
• 35:57
  Dr. Majid Fotuhi: And then the cells in the brain that are usually intended to help with reducing inflammation, called microglia, they become a part of the problem because they get overwhelmed, then they create more inflammation.
• 36:13
  Dr. Majid Fotuhi: So I think the ultimate cure for Alzheimer's disease would be ultimately to find a drug that will calm this inflammatory fire in the brain.
• 36:23
  Dr. Majid Fotuhi: Now, you know the inflammation in the brain is not just because of plaques and tangles.
• 36:28
  Dr. Majid Fotuhi: When you eat a poor diet, when you eat things that are high in trans fats and highly processed food increase inflammation in the brain.
• 36:36
  Dr. Majid Fotuhi: When you have gut problems and you have what's called a leaky gut that causes inflammation brain.
• 36:42
  Dr. Majid Fotuhi: If you're stressed, if you're stressed, if the environment is stressful, that increases inflammation in the brain.
• 36:50
  Dr. Majid Fotuhi: Is it fascinating that somebody giving you a hard time or you have an argument with someone somehow that converts into inflammation in the brain?
• 37:00
  Dr. Majid Fotuhi: It's fascinating.
• 37:01
  Dr. Majid Fotuhi: How does it work?
• 37:02
  Dr. Majid Fotuhi: I mean, what does.
• 37:03
  Dr. Majid Fotuhi: What do these inflammatory markers have to do with this?
• 37:06
  Dr. Majid Fotuhi: But then things like air pollution is a risk factor for inflammation in the brain and of course, you know, other toxins in the environment.
• 37:15
  Dr. Majid Fotuhi: Now it can play a role lead toxicity.
• 37:18
  Dr. Majid Fotuhi: And to me, the most important environmental factors that increase inflammation are the food, the highly processed food that people eat and stress in the environment that people have.
• 37:35
  Dr. Majid Fotuhi: And when you have a sedentary lifestyle and things are stagnant, your brain thrives with blood flow, with activity.
• 37:43
  Dr. Majid Fotuhi: When somebody has obesity and stagnation, that too inflam increase inflammation.
• 37:50
  Dr. Majid Fotuhi: So, you know, you have to change environment where you move more.
• 37:55
  Dr. Majid Fotuhi: You try not to be exposed to air pollution as much as possible, and you choose carefully what you eat.
• 38:01
  Dr. Majid Fotuhi: Of course, there are people who have Lyme disease.
• 38:04
  Dr. Majid Fotuhi: I treated many patients with mold and Lyme disease, and those were my patients who did not get better with my first round of treatments.
• 38:13
  Dr. Majid Fotuhi: You put people in the program, like I said, 84% improved, which means 16% they improved.
• 38:22
  Dr. Majid Fotuhi: Not like day and night difference, but.
• 38:24
  Dr. Majid Fotuhi: And that those 16% were people who had these other issues such as Lyme mold, environmental issues and toxins and other things.
• 38:34
  Dr. Jill Carnahan: Oh, yes.
• 38:35
  Dr. Jill Carnahan: So now you're speaking my language because those are the ones that come see me and they are the.
• 38:39
  Dr. Jill Carnahan: They're.
• 38:39
  Dr. Jill Carnahan: Come again.
• 38:39
  Dr. Jill Carnahan: I love.
• 38:40
  Dr. Jill Carnahan: That's who I treat.
• 38:40
  Dr. Jill Carnahan: I love treating those patients.
• 38:41
  Dr. Jill Carnahan: But they're very complex.
• 38:43
  Dr. Jill Carnahan: And this combination of infection and toxin is absolutely at the root of some of the hard cases.
• 38:48
  Dr. Jill Carnahan: So that's really awesome too, because you can do your program and if they're not getting well, they might seek out an infectious specialist, an eyelads doctor, someone that can go to that next level as well.
• 38:59
  Dr. Majid Fotuhi: I had many patients myself who, for example, came to me.
• 39:03
  Dr. Majid Fotuhi: I never forget.
• 39:04
  Dr. Majid Fotuhi: I had a patient with a CIA agent.
• 39:05
  Dr. Majid Fotuhi: Actually, she disclosed that I live here very close to CIA headquarters.
• 39:10
  Dr. Jill Carnahan: Yeah.
• 39:10
  Dr. Majid Fotuhi: And she said, I can't think clearly like I can.
• 39:14
  Dr. Majid Fotuhi: And she was in her 40s and we did the program and she said, Dr. Patui.
• 39:20
  Dr. Majid Fotuhi: And then I asked more questions and she said, oh, by the way, you know, we had some mold and I'm, you know, in the kitchen, we discovered.
• 39:30
  Dr. Majid Fotuhi: And then we had to.
• 39:32
  Dr. Majid Fotuhi: Do you think that has to do with anything?
• 39:33
  Dr. Majid Fotuhi: I said, wait a minute.
• 39:34
  Dr. Majid Fotuhi: This is an important factor.
• 39:36
  Dr. Majid Fotuhi: Of course.
• 39:37
  Dr. Majid Fotuhi: Mold can affect your brain.
• 39:38
  Dr. Jill Carnahan: Yeah.
• 39:39
  Dr. Majid Fotuhi: And she.
• 39:40
  Dr. Majid Fotuhi: And I told her, like, you need to.
• 39:41
  Dr. Majid Fotuhi: You just need to move.
• 39:43
  Dr. Majid Fotuhi: So she moved to live with her boyfriend and then they redid the kitchen.
• 39:48
  Dr. Majid Fotuhi: And while I was working with her on brain health issues, just the fact that she was removed from exposure to mold contributed to her getting better.
• 40:00
  Dr. Majid Fotuhi: She became her usual self.
• 40:02
  Dr. Majid Fotuhi: And she actually wrote a very long complimentary review for me on Google Reviews.
• 40:07
  Dr. Majid Fotuhi: And don't forget her.
• 40:09
  Dr. Majid Fotuhi: But patients do respond to treatment of mold and especially Lyme.
• 40:15
  Dr. Majid Fotuhi: I've had many patients with Lyme who improved after treatment with Lyme.
• 40:20
  Dr. Jill Carnahan: I'm glad you said that because again, those complex people and a lot of people who listen to our podcast do have some of those kinds of things or know people who do.
• 40:26
  Dr. Jill Carnahan: And it's not the thing you would first think about brain health, but I always say clean air, clean water, clean food, which is exactly some of the things you're talking about.
• 40:35
  Dr. Jill Carnahan: And air is huge, which is your environmental exposures that you're mentioning, because 80% of our toxic load from nanoparticulate and mold and all these things that we breathe in our nose is so close to the cribiform plate and that blood brain barrier that we often get effects from the inhalation of noxious substances to our brain in particular.
• 40:54
  Dr. Jill Carnahan: So.
• 40:54
  Dr. Jill Carnahan: Well, I'm just so excited for people to get a copy of your book and learn more.
• 40:58
  Dr. Jill Carnahan: I think the last question I want to ask about is something we didn't specifically talk about.
• 41:02
  Dr. Jill Carnahan: And I have a feeling you'll have a word or two to say.
• 41:04
  Dr. Jill Carnahan: Community and connection seem to be the thing that people are missing more and more as we have this virtual world and people, we're all in our homes and we're ordering off Amazon and we're interacting less.
• 41:14
  Dr. Jill Carnahan: What role does community, connection, friendships, relationships have in brain health?
• 41:20
  Dr. Majid Fotuhi: They're huge.
• 41:22
  Dr. Majid Fotuhi: To me, that falls under the category of stress reduction and enjoyment of life.
• 41:27
  Dr. Majid Fotuhi: You really need to connect with people on real life situations and not through social media.
• 41:34
  Dr. Majid Fotuhi: Many, many studies have shown that isolation is a major risk factor for Alzheimer's disease.
• 41:41
  Dr. Majid Fotuhi: And it's not isolation.
• 41:42
  Dr. Majid Fotuhi: Like you live in a house in the middle of nowhere.
• 41:46
  Dr. Majid Fotuhi: You could be in the middle of New York and be lonely.
• 41:49
  Dr. Majid Fotuhi: Because it's not just the people, it's the communication you have with people and the real holding hand with a friend, going for a walk with a friend, or Having dinner with a group of friends, I really make that a priority.
• 42:04
  Dr. Majid Fotuhi: And I also notice how happy I am when I am with a group of family friends just at a picnic.
• 42:12
  Dr. Majid Fotuhi: And I really think that people need to make an effort to see their friends for real and cut back on, you know, social media and really work on real social life.
• 42:27
  Dr. Jill Carnahan: I couldn't agree more.
• 42:28
  Dr. Jill Carnahan: I've just been really making an effort to like on Saturdays call a friend to hike or walk or have coffee or go to the market.
• 42:34
  Dr. Jill Carnahan: And what I'll try to do is just every Saturday a different person.
• 42:36
  Dr. Jill Carnahan: I'll text a few and just see who's available.
• 42:39
  Dr. Jill Carnahan: And it's been some of the highlights of my week is that physical connection.
• 42:42
  Dr. Jill Carnahan: And what I love is I'm doing one of your brain steps which is we always do some activity walking or hiking or moving.
• 42:49
  Dr. Jill Carnahan: And a lot of people love pickleball.
• 42:50
  Dr. Jill Carnahan: I'm not a pickleball player but so you can do these things and do an activity with them as well.
• 42:56
  Dr. Jill Carnahan: Dr. Fatou, it has been a pleasure to talk to you and learn more about your work and your book.
• 43:01
  Dr. Jill Carnahan: If people want to find out more about you, where can they find your book and your research?
• 43:06
  Dr. Majid Fotuhi: Yes, there's a lot of information about me on my website, Dr.fatouhi.com that's D R F as in Frank O R T U H I.com Dr. Fatou.com I'm also on Instagram Dr. Fatuhi and on LinkedIn and on YouTube and I think it'll be great for people to try my free app which is the Invincible Brain in the app store and the app also includes free a set of videos.
• 43:42
  Dr. Majid Fotuhi: I have 18 modules about all the things we talked about.
• 43:46
  Dr. Jill Carnahan: Amazing.
• 43:47
  Dr. Jill Carnahan: We will be sure and link up if you're driving or walking or not near a computer we will link that in the show notes.
• 43:52
  Dr. Jill Carnahan: You can find that you know wherever you are listening to the podcast.
• 43:55
  Dr. Jill Carnahan: Dr. Fatou, thank you again for coming on the show.
• 43:58
  Dr. Majid Fotuhi: It's my pleasure.
• 43:59
  Dr. Majid Fotuhi: Thank you very much for inviting me.
• 44:00
  Dr. Jill Carnahan: Hey guys, hope you enjoyed that great episode on the Brain, the invincible brain with Dr. Fatou.
• 44:05
  Dr. Jill Carnahan: It's always fun to learn new evidence based protocols and things that we can do practically to help keep sharp into our 80s and 90s and beyond.
• 44:15
  Dr. Jill Carnahan: Recently I played Roomie Cube with my 94 year old grandmother and it was so fun to see her cognition.
• 44:22
  Dr. Jill Carnahan: She is sharp as ever.
• 44:24
  Dr. Jill Carnahan: Lucky me for those genetics.
• 44:26
  Dr. Jill Carnahan: And I just thought what a great thing that she's still playing games and doing that in her 90s and beating us all at the game.
• 44:33
  Dr. Jill Carnahan: So go grab a friend, go on a hike, try some new activities, play with neuroplasticity, and do whatever you can to optimize your brain health.
• 44:42
  Dr. Jill Carnahan: And as you know, we have a new episode coming out every single week on Resiliency Radio.
• 44:47
  Dr. Jill Carnahan: If you have not yet liked or subscribed or left a review anywhere you're listening to this podcast, it would be a great favor if you do that for me right now, and I'll see you again next week for another episode of Resiliency Radio.