Latest / NO FILTER / Accelerate Learning _ Increase Cognitive Capacity _ Dr. Tommy Wood

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Accelerate Learning _ Increase Cognitive Capacity _ Dr. Tommy Wood · NO FILTER

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  Speaker 1: There's a much more recent study that took again older
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  Speaker 1: adults and randomized them across three different groups. One was
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  Speaker 1: like a low intensity group, another group basically did kind
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  Speaker 1: of Zone two type work and a treadmill three times
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  Speaker 1: a week, and the third group did a high intensity
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  Speaker 1: interval training intervention, which is the Norwegian four x four protocol,
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  Speaker 1: so four minutes eighty five to ninety five percent of
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  Speaker 1: maximum heart rate. They had a three minute rest in
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  Speaker 1: their protocol. They did that four times.
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  Speaker 2: Overs, three times a week.
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  Speaker 1: Three times a week for six months. That's pretty intense.
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  Speaker 1: But what they showed was that that high intensity interval
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  Speaker 1: training group they improved their fitness just as well as
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  Speaker 1: the Zone two group, interestingly, but they had much better
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  Speaker 1: improvements in hippocampal function and maintenance of hippocampal structure on
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  Speaker 1: an MRI SCAM, and they maintained that benefit for five
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  Speaker 1: years after the six month intervention. So they worked really
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  Speaker 1: hard for six months, but that benefit was maintained for
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  Speaker 1: a really long period of time.
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  Speaker 2: Welcome to the Huberman Lab podcast, where we discussed science
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  Speaker 2: and science based tools for everyday life. I'm Andrew Huberman,
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  Speaker 2: and I'm a professor of neurobiology and ophthalmology at Stanford
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  Speaker 2: School of Medicine. My guest today is doctor Tommy Wood.
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  Speaker 2: Doctor Tommy Wood is a medical doctor and neuroscience researcher
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  Speaker 2: at the University of Washington in Seattle. He is also
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  Speaker 2: the chief Science Officer of Better Brain, a company that
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  Speaker 2: provides free brain health coaching. Tommy is an expert in
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  Speaker 2: neuroplasticity and human performance and how science based protocols can
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  Speaker 2: be used to improve your focus, ability to learn, and
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  Speaker 2: skill expression. His work applies to everyone from the novice
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  Speaker 2: to the elite expert, and for all kinds of skills cognitive,
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  Speaker 2: language skills, athletic and creative endeavors. Today we discuss the
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  Speaker 2: brain states that favor learning, and importantly, how to get
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  Speaker 2: yourself into those states. We also discuss how to get
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  Speaker 2: the most from a learning session, for instance, how long
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  Speaker 2: that session should last, how many sessions to do per day,
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  Speaker 2: and perhaps most importantly, how to tune your mind and
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  Speaker 2: body to get better at learning. That's something we don't
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  Speaker 2: often hear in the context of learning and neuroplasticity that
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  Speaker 2: our brain circuits for focusing and learning are also capable
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  Speaker 2: of plasticity, meaning you can literally get better at getting better.
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  Speaker 2: Today we discuss things like flow states and something called
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  Speaker 2: a clutch state, which is a seldom mentioned but critical
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  Speaker 2: brain state to accelerate learning and performance. In fact, a
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  Speaker 2: clutch state is the state that you want to seek
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  Speaker 2: to learn and perform at your best. We also discuss
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  Speaker 2: how different types of physical exercise, from long slow cardio
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  Speaker 2: to brief high intensity cardio and different forms of resistance
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  Speaker 2: training each open the window for distinct types of neuroplasticity
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  Speaker 2: and learning. So this goes way beyond the general discussion
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  Speaker 2: about exercise improving your brain. We get really granular about
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  Speaker 2: exactly what types of things to do to improve your
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  Speaker 2: brain in specific ways. As a career neuroscientist who has
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  Speaker 2: worked on in taught neuroplasticity for decades now, it's rare
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  Speaker 2: that I encounter someone with as deep knowledge about the
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  Speaker 2: real science and application of learning and plasticity as Tommy has.
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  Speaker 2: He's also extremely unique because he has a ton of
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  Speaker 2: knowledge about new science based protocols for plasticity, and he's
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  Speaker 2: also an athlete. We discussed that a little bit at
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  Speaker 2: the end as well, So today you will hear a
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  Speaker 2: lot of information that I am confident you have not
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  Speaker 2: heard on this podcast or anywhere else, frankly about exercise,
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  Speaker 2: mental training, nutrition and supplementation, and much more, and how
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  Speaker 2: you can leverage each alone and in combination to learn
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  Speaker 2: new skills with accelerated speed, precision, and durability over time.
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  Speaker 2: I should also mention that Tommy recently released a new
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  Speaker 2: book that he wrote entitled The Stimulated Mind Future Proof
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  Speaker 2: your Brain from Dementia and Stay Sharp at any Age.
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  Speaker 2: It's an excellent book if you're interested in following up
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  Speaker 2: on today's discussion and learning more about how you can
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  Speaker 2: make your brain better at any age. Before we begin,
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  Speaker 2: I'd like to emphasize that this podcast is separate from
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  Speaker 2: my teaching and research roles at Stanford. It is, however,
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  Speaker 2: part of my desire and effort to bring zero cost
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  Speaker 2: to consumer information about science and science related tools to
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  Speaker 2: the general public. In keeping with that theme, today's does
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  Speaker 2: include sponsors. And now for my discussion with doctor Tommy.
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  Speaker 2: Would Doctor Tommy would welcome.
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  Speaker 3: So amazing to be here, Thanks so much for Hamily Man.
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  Speaker 2: This is my favorite topic in the entire world. What
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  Speaker 2: is more interesting than neuroplasticity? Right? The brain is so interesting,
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  Speaker 2: but It's most interesting feature, in my opinion anyway, is
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  Speaker 2: that it can change itself.
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  Speaker 1: Essentially, that's its core, most important function. If it can't
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  Speaker 1: do that, that you none of the other functions matter,
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  Speaker 1: you could argue, and it's something that we have to
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  Speaker 1: be able to do right until the end of our
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  Speaker 1: end of our lives.
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  Speaker 2: You have an eclectic research tapestry. All right, Today we're
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  Speaker 2: going to talk about neuroplasticity, what it is, what it isn't,
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  Speaker 2: how to access it for men, for women, different ages.
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  Speaker 2: And you also are a high performance coach. You're also
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  Speaker 2: a competing natural strong man. Yeah yeah, so does that
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  Speaker 2: mean lifetime, no gear lifetime?
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  Speaker 1: Well it's tested, yeah time, no gear for me personally,
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  Speaker 1: but it's a drug tested version of the strongman sport.
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  Speaker 1: So yeah, if you compete a natural strong man, then
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  Speaker 1: you get tested.
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  Speaker 2: Great, So we'll talk about that. I'll resist the temptation
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  Speaker 2: to talk about your two boxer pups because I'm a
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  Speaker 2: dog lover. That's a different episode neuroplasticity. I know what
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  Speaker 2: it means to me. How do you conceptualize it? How
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  Speaker 2: do you think people should think about it in terms
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  Speaker 2: of wanting to learn things and not forget things.
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  Speaker 1: I essentially just think of it as the brain responding
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  Speaker 1: to inputs in order for us to then be able
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  Speaker 1: to better navigate and survive our environment. And that's why
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  Speaker 1: I think it's such a fundamental part of what the
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  Speaker 1: brain does. And essentially, every time you learn something, interact
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  Speaker 1: with something, remember something, the principles of neuroplasticity are engaged.
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  Speaker 1: Right you are making new synapses or strengthening synapses, weakening
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  Speaker 1: other synapses. A lot of people don't realize that, particularly
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  Speaker 1: brain development. But then also the refining of functions in
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  Speaker 1: the brain through neuroplasticity includes the pruning or removal of synapses.
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  Speaker 1: Often we think about it's all about growth and new connections,
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  Speaker 1: but actually it also involves the refining or removal of
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  Speaker 1: other connections aren't needed. That's a massive part of brain
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  Speaker 1: development in the first place. And this is a process
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  Speaker 1: that's essentially continuously ongoing, and you can think of its
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  Speaker 1: primary role is so that you can navigate survive the
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  Speaker 1: world around you, and that's through learning skills, through remembering
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  Speaker 1: people and things and facts, and where I one of
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  Speaker 1: the things that's most interesting to me about neuroplasticity and
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  Speaker 1: the way we think about our brains over time is
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  Speaker 1: that I think people have conflated neurogenesis and neuroplasticity. So
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  Speaker 1: when we're thinking about brain development, we're thinking about then
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  Speaker 1: also brain function over with age and either cognitive decline
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  Speaker 1: or maintaining cognitive function. We thought that the adult brain
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  Speaker 1: was was fixed, right, or then it was fixed in
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  Speaker 1: a lost function. And this goes all the way back
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  Speaker 1: to Kahal who said the adult brain is immutable, right.
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  Speaker 1: He told us that you got into adulthood, it finished developing,
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  Speaker 1: and then it.
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  Speaker 3: Was kind of done.
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  Speaker 1: He then at other times also said that changes in
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  Speaker 1: the connections between neurons could explain learning, and so there
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  Speaker 1: he's talking about neuroclassicity. But we kind of got this
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  Speaker 1: idea that the brain was essentially fixed as an adult
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  Speaker 1: and then you know, couldn't change anymore. But that can't
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  Speaker 1: be true because you still learn and remember things on
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  Speaker 1: a daily basis as an adult. One of the things
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  Speaker 1: that I think we've gotten confused about is the fact
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  Speaker 1: that the adult brain does not make new neurons in
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  Speaker 1: many places. Right, maybe in the factory bulbs, in the
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  Speaker 1: Dente jars, the HIPERC campus. Yeah, but like compared to
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  Speaker 1: the rest of the brain. You're not really making new cells.
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  Speaker 1: And so because because of that, we thought, well, we
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  Speaker 1: can't then grow and adapt, I will change our brains
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  Speaker 1: as adults. But just because we have a fixed number,
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  Speaker 1: relatively fixed number of cells, doesn't mean that we can't
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  Speaker 1: change the connections between those cells. And that's happening all
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  Speaker 1: the time, and that is, you know, the main principle
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  Speaker 1: of neuroplasticity.
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  Speaker 2: Yeah. I like your definition in part because I agree
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  Speaker 2: with it, in part because it encapsulates a lot of things,
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  Speaker 2: including helping to clear up this misconception that you know,
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  Speaker 2: we generate new neurons. I think the attractiveness of the
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  Speaker 2: new neuron idea is just it's so sticky, and so
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  Speaker 2: we would all love to believe that. But maybe there's
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  Speaker 2: good reason why we don't add new neurons. Maybe maybe
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  Speaker 2: it's not adaptive, right, Adding new elements to a circuit
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  Speaker 2: is maybe not the best way to change a brain circuit.
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  Speaker 2: I think people also like the idea that you know,
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  Speaker 2: every organ in our body turns over it cells, that
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  Speaker 2: we're not the same person literally that we were. The
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  Speaker 2: brain is same cells you're born with, minus a bunch
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  Speaker 2: of them. That die off, as you pointed out, and
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  Speaker 2: thank you for mentioning pruning and the removal of connections
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  Speaker 2: as a fundamental aspect of plasticity. In terms of motor
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  Speaker 2: skill learning, Let's say I decide I'm going to practice billiards,
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  Speaker 2: and I'm okay, now hang in there. But let's say
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  Speaker 2: I want to get really good as I learn and
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  Speaker 2: get better and better. Can we reliably say that most
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  Speaker 2: of my improvement is the removal of inappropriate action and
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  Speaker 2: therefore synaptic connections.
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  Speaker 1: I don't know whether it's the majority. You might know
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  Speaker 1: whether it's the majority, but I think that there's certainly
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  Speaker 1: it requires both, right, the either development or strengthening of
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  Speaker 1: new connections and then the removal of other connections that
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  Speaker 1: decrease accuracy, say, or that don't allow you to do
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  Speaker 1: the exact motion that you were intending to do. This,
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  Speaker 1: like I said, kind of goes all the way back
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  Speaker 1: to the the development of motor skills, say in childhood, Right,
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  Speaker 1: the brain is kind of finished developing new neurons sometime
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  Speaker 1: around two or three years old. Right beyond that point,
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  Speaker 1: you're actually primarily removing connections in order to refine functions
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  Speaker 1: based on the exposures that you have, be they language, motor,
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  Speaker 1: social skills, which is what the brain is essentially developing
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  Speaker 1: during that time period. So then that continues throughout our
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  Speaker 1: entire lives, and I think that something that happens later
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  Speaker 1: in life. One of the reasons why we may lose
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  Speaker 1: function is because we stop giving the brain inputs to
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  Speaker 1: maintain a given function. Therefore, that pruning continues, Right, I
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  Speaker 1: don't need to know how to do this, so I'm
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  Speaker 1: going to refine that away. That's kind of the developmental
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  Speaker 1: theory of aging, or part of the developmental theory of aging,
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  Speaker 1: so in that you know, when you're learning a skill
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  Speaker 1: as an adult or any time, a big part of
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  Speaker 1: finding that motor patterns that you're developing has to be
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  Speaker 1: the removal of connections that are or the downregulation of
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  Speaker 1: connections that aren't allowing you to do the skill that
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  Speaker 1: you want to do.
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  Speaker 2: If you were to tell people, look, you want to
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  Speaker 2: keep your brain as young as it can possibly be
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  Speaker 2: relative to your chronological age, you should what like. So
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  Speaker 2: this is a general brain health question, but really I'm
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  Speaker 2: specifically asking about plasticity. And let's make it multiple choice,
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  Speaker 2: and then you can add things to it you should exercise,
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  Speaker 2: so it can be multiple things, and then we'll talk
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  Speaker 2: about which types of exercise. You should continue to do
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  Speaker 2: the things that you already know how to do. And
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  Speaker 2: then third option, not mutually exclusive with the others, of course,
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  Speaker 2: is that you should try to do new things that
• 11:49
  Speaker 2: you can't already do. I still toil with this when
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  Speaker 2: I look at the literature on neuroplasticity and aging. Right, like, yes,
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  Speaker 2: user to lose it is true, we're also told that
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  Speaker 2: novelty and trying things that we're not good at is
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  Speaker 2: an essential component of building out brain circuits, continuing to
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  Speaker 2: make them function better as we get older. So how
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  Speaker 2: do you think about all of that?
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  Speaker 1: I'll partly answer your last question and then maybe give
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  Speaker 1: a framework for how I think about it. So, when
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  Speaker 1: you look at a combination of epidemiological studies and intervention
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  Speaker 1: studies in older adults, so everythink about maintaining cognitive function
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  Speaker 1: later in life, you definitely see that those who continue
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  Speaker 1: to engage in hobbies and activities that are cognitively engaging
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  Speaker 1: on cognitively demanding and that can be lectures, that can
• 12:42
  Speaker 1: be volunteering, that can be you know, reading crosswords, that
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  Speaker 1: kind of stuff. Those individuals tend to either have slowed
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  Speaker 1: rates of decline or better maintenance of function over time,
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  Speaker 1: and or lower rates of dementia. That's of course observational, right,
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  Speaker 1: but that's usually people continuing to engage in the things
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  Speaker 1: that you know they've already been doing.
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  Speaker 2: Right, They're holding on to what they've got.
• 13:05
  Speaker 1: Holding on to what they've got by continuing to do that. Okay, Now,
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  Speaker 1: of course it could partly be reverse causation, because if
• 13:12
  Speaker 1: you're maintaining function, then you will you're more likely to
• 13:15
  Speaker 1: continue to do the things that you enjoy doing, right,
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  Speaker 1: So there's probably it probably goes in both directions. However,
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  Speaker 1: there's an increasing body of literature that shows that by
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  Speaker 1: engaging older adults in novel cognitive activities you see improvements
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  Speaker 1: in function. So that can be language learning, that can
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  Speaker 1: be complex like coordinative movement or exercise. You see the
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  Speaker 1: same things with like musical training, like people learning a
• 13:42
  Speaker 1: new musical instrument or learning musical theory, trying to identify
• 13:45
  Speaker 1: different patterns in music. And you see in randomized control
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  Speaker 1: trials improvements particularly in executive function. That seems to be
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  Speaker 1: most common across those different interventions. But you're seeing improvements
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  Speaker 1: in cognitive function with novel coggnitive Steve. There's a lot
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  Speaker 1: of recent trials that have also used types of brain training,
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  Speaker 1: things like the point of trial that was here in
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  Speaker 1: the US Maintain your Brain, which is a massive online
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  Speaker 1: study done in Australia recently, and that's sort of broad
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  Speaker 1: cognitive training with like an online cogative training platform. So
• 14:18
  Speaker 1: again it's it's a new or novel intervention or exposure
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  Speaker 1: that seems to provide a stimulus that improves function. So
• 14:28
  Speaker 1: I think both can be or do seem to be important.
• 14:32
  Speaker 2: I'm excited to share with you that my book, Protocols
• 14:35
  Speaker 2: and Operating Manual for the Human Body is now available
• 14:38
  Speaker 2: for pre order and will be coming out in less
• 14:40
  Speaker 2: than two months. It's my first book and it's a
• 14:43
  Speaker 2: reflection of decades of research, hundreds of conversations with leading
• 14:46
  Speaker 2: scientists and medical doctors, and my own exploration of health,
• 14:50
  Speaker 2: fitness and performance. Protocols is a straightforward to use manual
• 14:54
  Speaker 2: for overcoming any number of different pain points you might
• 14:56
  Speaker 2: have in terms of mental health, physical health, and performance.
• 15:00
  Speaker 2: They're already doing well with mental health, physical health, and performance.
• 15:03
  Speaker 2: It can make you that much better at any and
• 15:05
  Speaker 2: all of those things. It's meant for anyone interested in
• 15:07
  Speaker 2: achieving better health and vitality. It provides a deep dive
• 15:11
  Speaker 2: into and clear explanation of tools to improve your sleep, nutrition, exercise, focus,
• 15:16
  Speaker 2: stress management, neuroplasticity and motivation, and much more. I'm truly
• 15:21
  Speaker 2: thrilled to share Protocols with all of you. The launch
• 15:23
  Speaker 2: date is September fifteenth. You can learn more about it
• 15:26
  Speaker 2: by going to Protocols book dot com. That's Protocols book
• 15:30
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• 16:50
  Speaker 2: what for an example of maybe one or two of
• 16:54
  Speaker 2: the things that were in that large scale trial from Australia,
• 16:56
  Speaker 2: like just at a very top contour level, older adults
• 17:00
  Speaker 2: meaning sixty five and older, are doing what.
• 17:03
  Speaker 1: The Maintain Your Brain Study was actually was sort of
• 17:08
  Speaker 1: midlife kind of fifties and fifties and sixties mainly, and
• 17:13
  Speaker 1: they actually had interventions across four different domains based on
• 17:16
  Speaker 1: risk factors within that given individual. So they had dietary intervention,
• 17:21
  Speaker 1: they had physical activity, they had pogitive behavioral therapy for
• 17:25
  Speaker 1: those who had some potentially some mental health concerns, and
• 17:32
  Speaker 1: then they had online brain training. There was something similar
• 17:35
  Speaker 1: done in the Point trial, which was in older adults
• 17:39
  Speaker 1: now sixties and seventies, that was done here in the US.
• 17:42
  Speaker 1: That was a replication of an older trial called the
• 17:44
  Speaker 1: Finger trial that was done in Finland. But what those
• 17:46
  Speaker 1: guys did was something very similar. So it's a diet, exercise,
• 17:50
  Speaker 1: monitoring and treating cardiovascular risk factors, and then brain training.
• 17:55
  Speaker 1: So what the brain training looks like, so that the
• 17:59
  Speaker 1: Points trial is good example they did. They used the
• 18:02
  Speaker 1: platform called brain HQ, which is brain HQ, which was
• 18:07
  Speaker 1: developed based on the work of Mike Merzinich, who was
• 18:10
  Speaker 1: you know, like one of the godfathers of learning and neuroplasticity.
• 18:14
  Speaker 3: Right, and they.
• 18:18
  Speaker 1: Do various tasks primarily focused on developing and maintaining processing speed.
• 18:25
  Speaker 1: Some of that evidence goes all the way back to
• 18:28
  Speaker 1: an older trial called Active that was done in the
• 18:31
  Speaker 1: US and the nineties. It was still the biggest ever
• 18:33
  Speaker 1: trial of like pure cogative brain training again in older
• 18:37
  Speaker 1: adults the sixties and seventies. They had three different training
• 18:42
  Speaker 1: groups and then a control group. The training groups did
• 18:47
  Speaker 1: memory training and kind of like you know, mnemonics, memory palaces,
• 18:51
  Speaker 1: that kind of stuff to help them remember. There was
• 18:53
  Speaker 1: reasoning training, which is kind of like looking looking for
• 18:55
  Speaker 1: patterns in numbers and letters. And then there was processing
• 18:58
  Speaker 1: speed training, where in this example is visual processing speed,
• 19:02
  Speaker 1: so things flash up on a screen in increasingly small increments,
• 19:07
  Speaker 1: so it could be hundreds of mileter seconds, and as
• 19:10
  Speaker 1: you get better at doing it, that time gets shorter
• 19:13
  Speaker 1: and you have to remember what you saw and where
• 19:14
  Speaker 1: you saw it on a screen. They just published a
• 19:17
  Speaker 1: secondary analysis of the Active trial that showed that those
• 19:21
  Speaker 1: who did processing speed training with booster sessions at one
• 19:24
  Speaker 1: and three years had a significantly decreased risk of dementia
• 19:27
  Speaker 1: twenty years later. And they've done some other studies showing
• 19:29
  Speaker 1: that that kind of training improves co allergic signaling in
• 19:32
  Speaker 1: the forebrain, which we know is susceptible to the processes
• 19:37
  Speaker 1: of dementia. So in particular, it's this training to be
• 19:43
  Speaker 1: able to improve either visual or auditory processing speed, which
• 19:47
  Speaker 1: is not something that as you get older, you tend
• 19:50
  Speaker 1: to not do activities that require you to process information quickly,
• 19:53
  Speaker 1: like driving is probably the main one, but you can
• 19:57
  Speaker 1: do it in sports and music and the scenarios. But
• 20:00
  Speaker 1: if you're not doing those things, processing speed tends to
• 20:03
  Speaker 1: drop off sometime around sixty years old.
• 20:06
  Speaker 2: When you say, well, I say processing, you say processing,
• 20:10
  Speaker 2: processing speed? Are you talking about reaction time? Improving reaction
• 20:14
  Speaker 2: time or pushing people to stay at the edge of
• 20:18
  Speaker 2: reaction time? And when I say stay at the edge,
• 20:19
  Speaker 2: it should clarify for people some task where if you
• 20:23
  Speaker 2: go too fast you make errors. If you go too slow,
• 20:25
  Speaker 2: there's also a penalty.
• 20:26
  Speaker 3: In this scenario.
• 20:27
  Speaker 1: And there were studies that look at these different functions
• 20:32
  Speaker 1: over time. The biggest one looked at data that came
• 20:35
  Speaker 1: from the implicit association test people might have heard of,
• 20:38
  Speaker 1: where you get show these pictures of different things, and
• 20:41
  Speaker 1: depending on how quickly you respond, it tells you something
• 20:43
  Speaker 1: about like you're implicit, so you're like your implicit thought
• 20:46
  Speaker 1: processes they took some.
• 20:48
  Speaker 3: Of the data from that.
• 20:50
  Speaker 1: This is published in one of the Nature journals a
• 20:52
  Speaker 1: few years ago, and what they showed was that you
• 20:55
  Speaker 1: can separate out reaction time versus processing speed because reaction
• 20:59
  Speaker 1: time is just is a very just the basic of
• 21:03
  Speaker 1: response to a visual stimulus, whereas processing requires you is
• 21:07
  Speaker 1: based on how quickly you can process and remember the information.
• 21:11
  Speaker 3: Actually you actually think. Yeah.
• 21:13
  Speaker 1: So what they showed in this study was that reaction
• 21:16
  Speaker 1: time kind of slowly decreases on average in a population
• 21:19
  Speaker 1: of it was about one point two million people slowly
• 21:22
  Speaker 1: decreases in sort of like from about our thirties and
• 21:26
  Speaker 1: then and then maybe decreases even more once we get
• 21:28
  Speaker 1: past about sixty. Processing speed on average tending to be
• 21:32
  Speaker 1: more stable until about sixty years old and then tends
• 21:35
  Speaker 1: to drop off. So in what you're doing in these
• 21:38
  Speaker 1: training modalities is you're being shown information for a very
• 21:44
  Speaker 1: short period of time and then having to remember what
• 21:47
  Speaker 1: it was you saw.
• 21:48
  Speaker 3: And where you saw it.
• 21:49
  Speaker 1: So it requires you to actually think and you know,
• 21:51
  Speaker 1: remember process the information rather than just like responding to
• 21:55
  Speaker 1: a stimulus.
• 21:56
  Speaker 2: So for people that want to jump to the okay
• 21:59
  Speaker 2: what do I do? YEH can we conclude, Okay, if
• 22:04
  Speaker 2: you like crossword puzzles, keep doing them, but do really
• 22:07
  Speaker 2: hard ones for you. If you like lifting weights, continue
• 22:11
  Speaker 2: to challenge yourself with those. If you like to run,
• 22:14
  Speaker 2: you know, push harder or should it be we shift domains.
• 22:18
  Speaker 2: You like to lift and run, great, start swimming again, Andrew,
• 22:22
  Speaker 2: I'm telling myself I used to you know, I just
• 22:24
  Speaker 2: notice over time it's such a cliche of aging, right
• 22:28
  Speaker 2: that you one does tend to become more narrow quote
• 22:32
  Speaker 2: unquote set in their ways. You like what you like,
• 22:34
  Speaker 2: you don't want, but like we don't know, you get busier,
• 22:36
  Speaker 2: probably don't actually get busier, but you convince yourself while
• 22:39
  Speaker 2: I'm doing these things, and I do plenty of them,
• 22:41
  Speaker 2: so but I'm not doing these other things. Or for
• 22:45
  Speaker 2: those of us, I think this is everybody if they
• 22:48
  Speaker 2: really ask themselves an answer. Honestly, you'd love to hold
• 22:52
  Speaker 2: onto your motor function and cognitive function as long as
• 22:54
  Speaker 2: you can maybe even improve it. Should we push ourselves
• 22:58
  Speaker 2: to do something that's really far outside the box or
• 23:00
  Speaker 2: maybe sort of current skill adjacent? So I think of
• 23:04
  Speaker 2: those three categories, what do the data say if you
• 23:08
  Speaker 2: want the greatest effect for the minimum amount of time.
• 23:10
  Speaker 2: Assuming you're still going to do all this stuff you
• 23:12
  Speaker 2: normally do, you're going to add something else. Should it
• 23:15
  Speaker 2: be something really different, slightly different, or just push harder
• 23:18
  Speaker 2: in the thing you do.
• 23:19
  Speaker 1: I think it's going to depend a little bit on
• 23:23
  Speaker 1: what it is the things that you currently do, right, So,
• 23:25
  Speaker 1: like crosswords are a good example, even if you're doing
• 23:28
  Speaker 1: hard ones. If you look at the work of people
• 23:31
  Speaker 1: like Gloria Mark that things like crossword and Sudoku, they're
• 23:35
  Speaker 1: less of like a true cogaitive challenge, right, It's almost
• 23:40
  Speaker 1: has more of like a meditation, meditative like effect, right,
• 23:43
  Speaker 1: which can be a good thing. Right, So you're focused
• 23:46
  Speaker 1: but not challenged really, whereas if we're trying to build capacity,
• 23:52
  Speaker 1: you need to spend some time doing something where you
• 23:54
  Speaker 1: are both focused and challenged cognitively, so that can come
• 24:00
  Speaker 1: from learning new skills, be the motor language, social, and
• 24:08
  Speaker 1: ideally as broad as possible, because you're going to get
• 24:14
  Speaker 1: better overall stimulus as well as kind of like the
• 24:18
  Speaker 1: broader potential for transfer into other areas of daily life.
• 24:22
  Speaker 1: In reality, the narrowness of the response or the breadth
• 24:25
  Speaker 1: of the response is proportional to the narrowness or the
• 24:28
  Speaker 1: breadth of the stimulus.
• 24:30
  Speaker 3: Right, So you.
• 24:31
  Speaker 1: Could get really good at one very specific thing, or
• 24:36
  Speaker 1: you could try and learn a new skill that requires
• 24:41
  Speaker 1: that involves a wide variety of tasks. So I'll give
• 24:44
  Speaker 1: an example, is learning a new ball sport, right, that
• 24:47
  Speaker 1: is going to require multiple assets of motor skills, social skills.
• 24:52
  Speaker 3: It's going to.
• 24:53
  Speaker 1: Include both visual and auditory processing. That's going to get
• 24:58
  Speaker 1: faster and faster and harder and harder the better you get.
• 25:00
  Speaker 1: So something like that creates a much broader stimulus than
• 25:06
  Speaker 1: you know, if you get very good at one very
• 25:09
  Speaker 1: specific brain training task on like one computer program.
• 25:13
  Speaker 3: Right.
• 25:13
  Speaker 1: This is one of the main arguments against online or
• 25:18
  Speaker 1: digital brain training is that you get very good at
• 25:21
  Speaker 1: doing that one specific thing, but it doesn't transfer over
• 25:23
  Speaker 1: to other areas of your life, whereas some of these broader,
• 25:25
  Speaker 1: more complex, ultimately more human skills probably give us much
• 25:31
  Speaker 1: broader transfer as well as you know, because of the
• 25:35
  Speaker 1: multiple pathways or networks that are being activated.
• 25:38
  Speaker 2: If my interpretation what you said is correct, pick something hard, Yeah,
• 25:42
  Speaker 2: Ideally pick something that's a bit outside or really outside
• 25:46
  Speaker 2: your current skill set that involves motor and cognitive aspects
• 25:52
  Speaker 2: like maybe, and that's kind of tricky to find, right.
• 25:56
  Speaker 2: I mean that with sports stuff it feels motor and
• 25:58
  Speaker 2: cognitive because you have to learn the rule of the game,
• 26:00
  Speaker 2: you have to in some cases interact with others. With
• 26:03
  Speaker 2: cognitive stuff, the motor skills involved in writing or turning
• 26:10
  Speaker 2: a page, they're not that significant, right, even with a
• 26:13
  Speaker 2: video game. I know video games can improve reaction time
• 26:16
  Speaker 2: and visual search and things like that, but basically, your
• 26:19
  Speaker 2: thumbs get real, real good. I actually went to a
• 26:21
  Speaker 2: video game competition. They have teams. A kid that used
• 26:26
  Speaker 2: to work for me. I was like, what do you
• 26:27
  Speaker 2: want for kind of end of your gift, and he's like,
• 26:30
  Speaker 2: I really want to go to this video game championship.
• 26:33
  Speaker 2: And the kids actually who compete warm up their hands.
• 26:36
  Speaker 2: The kids in the audience like have these styrofoam things
• 26:38
  Speaker 2: that they clap so they don't make noise, so they
• 26:41
  Speaker 2: it was a whole thing. So I don't want to
• 26:43
  Speaker 2: take anything away from the real sport. I discovered that
• 26:47
  Speaker 2: is playing video games, but mostly what was moving was
• 26:51
  Speaker 2: thumbs and fingers, not a lot of large scale motor activity.
• 26:56
  Speaker 2: So if you had to maybe throw out three or
• 26:58
  Speaker 2: four things that are party clearly potent plasticity inducers. What
• 27:04
  Speaker 2: would those be?
• 27:05
  Speaker 1: This definitely doesn't have to be super complicated. So like
• 27:07
  Speaker 1: the things that you mentioned earlier, So because you mentioned
• 27:10
  Speaker 1: exercise and then skills, right, and so you could do
• 27:13
  Speaker 1: those things separately, right, I would maybe we'll get into
• 27:16
  Speaker 1: why aerobic and strength training do different things to different
• 27:20
  Speaker 1: parts of the brain. Right, So ideally you do a
• 27:23
  Speaker 1: little bit of both. If you don't feel super compelled
• 27:26
  Speaker 1: to go and start a new sport, but you're getting
• 27:29
  Speaker 1: these inputs from elsewhere, and so you would rather say,
• 27:33
  Speaker 1: learn a new language, right, which we have some good
• 27:35
  Speaker 1: evidence for. Then that combination is great. But if you're
• 27:39
  Speaker 1: thinking about some of the things that we have very
• 27:42
  Speaker 1: good evidence for that kind of hit multiple networks at
• 27:47
  Speaker 1: the same time. Dancing is probably number one. Learning a
• 27:51
  Speaker 1: new dance, learning a new dance solo er.
• 27:54
  Speaker 2: With someone else. I'm sort of half joking, but some
• 27:55
  Speaker 2: people dance on their own, some people dance with someone else.
• 27:58
  Speaker 1: So like dancing on your own in your living room,
• 28:01
  Speaker 1: highly encouraged.
• 28:01
  Speaker 3: Right. It's a great form of physical activity. It's fun.
• 28:04
  Speaker 1: Of course, they're The best evidence is for ballroom and
• 28:09
  Speaker 1: line dancing, which generally requires and so the Reremeta analysis
• 28:12
  Speaker 1: of these interventions in odder adults showing that ballroom and
• 28:15
  Speaker 1: line dancing have the greatest effect on cogative function, and
• 28:18
  Speaker 1: so both of those require other people as well as learning,
• 28:22
  Speaker 1: you know, various sets of movements. So you have skill learning,
• 28:26
  Speaker 1: you have social interaction and the other physical activity component.
• 28:29
  Speaker 1: There's probably also the musical component, right, you have to
• 28:31
  Speaker 1: listen for the timing of the music and those kinds
• 28:33
  Speaker 1: of things. That is its own skill set. So dancing
• 28:37
  Speaker 1: has a large body evidence behind it. But then I
• 28:40
  Speaker 1: think you know, in the exercise realm, you've got all
• 28:43
  Speaker 1: the sort of ball sports, board sports, team sports. I
• 28:47
  Speaker 1: think skateboarding would be a great example, as long as
• 28:48
  Speaker 1: you are a helmet and don't hit your head too often.
• 28:51
  Speaker 1: Most martial arts again as long as sudbody is not
• 28:53
  Speaker 1: punching you in the face too much.
• 28:54
  Speaker 3: Somehow like Brazilian exactly.
• 28:56
  Speaker 1: So like your there's a physical component, there's a complex
• 29:00
  Speaker 1: motor skill component. Usually there's a social component. There's a
• 29:04
  Speaker 1: there's a lot of responding reacted into the environment or
• 29:07
  Speaker 1: your opponent. Right, So then talking about processing speed again,
• 29:11
  Speaker 1: but then beyond that there's some really interesting data on
• 29:15
  Speaker 1: some other creative arts that do seem to have some
• 29:17
  Speaker 1: effect on you know, network stability and function in the brain,
• 29:21
  Speaker 1: particularly the networks at the front of priorit or network
• 29:23
  Speaker 1: that we know is really important for like focus and attention,
• 29:26
  Speaker 1: and its function does tend to decrease with age. So
• 29:31
  Speaker 1: things like like creative or visual arts. Some maybe some
• 29:35
  Speaker 1: similar effects of learning language. Again, similar effects from learning
• 29:42
  Speaker 1: to play video games. Yes, of course there's no like
• 29:44
  Speaker 1: big motor patterns evolved, but you're having to do you know,
• 29:49
  Speaker 1: solve complex problems, you know, react quickly to a changing environment.
• 29:54
  Speaker 3: That that kind of stuff.
• 29:55
  Speaker 1: So that's you know, eight or nine different things that
• 29:58
  Speaker 1: that somebody could try and like just one of those,
• 30:01
  Speaker 1: I think it's going to be a new skill, a
• 30:03
  Speaker 1: new stimulus often happens in a social environment, a number
• 30:07
  Speaker 1: of different things happening at the same time.
• 30:09
  Speaker 2: Any particular instruments.
• 30:12
  Speaker 1: I don't think anybody's looked at instruments like the difference
• 30:16
  Speaker 1: in different instruments. So I would say, no, pick one
• 30:19
  Speaker 1: that you would that you feel motivated and interested to learn.
• 30:22
  Speaker 2: Dancing by oneself has a lower shame quotion.
• 30:25
  Speaker 1: Well, the shame quotion I think might be might be important. Right,
• 30:30
  Speaker 1: you know, there's the discomfort of making mistakes, and we
• 30:33
  Speaker 1: know how critical that is for learning, and so like
• 30:35
  Speaker 1: you're I think some of.
• 30:37
  Speaker 3: That can be important too.
• 30:38
  Speaker 1: But if you do it in a class, everybody else
• 30:41
  Speaker 1: is a beginner, You're all doing it together. Maybe that
• 30:43
  Speaker 1: adds a fun component because you can laugh at each
• 30:45
  Speaker 1: other when you don't get it right.
• 30:46
  Speaker 3: You know.
• 30:47
  Speaker 1: So a few years ago I wrote a paper with
• 30:51
  Speaker 1: my colleague Josh Turknit about this idea that potentially one
• 30:56
  Speaker 1: of the reasons why we lose cognitive function as we
• 30:59
  Speaker 1: get older is as we stop giving our brain novel
• 31:02
  Speaker 1: inputs or complex inputs that help maintain function drive neuroplasticity.
• 31:06
  Speaker 1: And I think one of the reasons that that happens
• 31:09
  Speaker 1: is because adults hate being bad at things. Right, you
• 31:13
  Speaker 1: just like this thought, like you, you just imagined it. Right,
• 31:16
  Speaker 1: I'm in a dance class, and I'm going to suck
• 31:19
  Speaker 1: at dancing. Right, I imagine that I'm going to take my
• 31:22
  Speaker 1: wife to a tango class. There's something I've always wanted
• 31:25
  Speaker 1: to do. But when I go in the first time,
• 31:27
  Speaker 1: I imagine I'm going to be like Arnold Schwarzenegger and Jamie
• 31:30
  Speaker 1: Lee Curtis in True Lies. Do you see that movie anyway?
• 31:34
  Speaker 1: So right at the beginning, they're like their spies and
• 31:36
  Speaker 1: they're doing the tango at this you know, like Gangster's
• 31:39
  Speaker 1: mansion or something, and it's like he leans over, she
• 31:42
  Speaker 1: grabs the rose from the table in her in her mouth,
• 31:45
  Speaker 1: like I'm going to try that, and I'm going to
• 31:47
  Speaker 1: drop my wife and she's gonna hit her. She's gonna
• 31:49
  Speaker 1: be mad at me, and lots of people are going
• 31:50
  Speaker 1: to see, and I'm going to feel stupid, right, And
• 31:52
  Speaker 1: so that's why we don't do those things. But it's
• 31:56
  Speaker 1: so critical to driving those processes of neuroplasticity. We make
• 32:00
  Speaker 1: those mistakes that we have to kind of let go
• 32:03
  Speaker 1: of some of that that we feel as adults, like
• 32:06
  Speaker 1: we think that everybody expects us to be good at everything
• 32:09
  Speaker 1: and the best at everything, and you know, we shouldn't fail,
• 32:11
  Speaker 1: we shouldn't make mistakes. But as you've covered many times,
• 32:15
  Speaker 1: it's so critical to do that. And so I think
• 32:20
  Speaker 1: acknowledging that shame component exists and leaning into it is
• 32:23
  Speaker 1: going to be a really important part of trying to
• 32:25
  Speaker 1: maintain this function over time.
• 32:27
  Speaker 2: A couple of quick anecdotes, and then some encouragement to
• 32:30
  Speaker 2: do the tango class. I'll start with tango. My grandparents
• 32:33
  Speaker 2: on my Argentine side did tango until they're into their eighties,
• 32:37
  Speaker 2: so it can be done, but they learned it rather young.
• 32:40
  Speaker 2: And Tim ferriss As I recall to talk about, yeah,
• 32:45
  Speaker 2: he learned tango, and and then gets to the other point,
• 32:49
  Speaker 2: which is, I want to talk about sex differences in
• 32:53
  Speaker 2: results of experiments on in plasticity. But when you dance
• 32:57
  Speaker 2: the sorts of dances that we're talking about, so salsa tango,
• 33:02
  Speaker 2: typically this is, you know, traditionally the male leads. Years ago,
• 33:08
  Speaker 2: I had a girlfriend who was really into salsa, so
• 33:10
  Speaker 2: I went salsa dancing with her in the Bay Area
• 33:13
  Speaker 2: one night. And it's a tricky thing if you're not
• 33:16
  Speaker 2: skilled salsa dancer, because basically you're taking your girlfriend to
• 33:18
  Speaker 2: go dance with a bunch of other men you know,
• 33:21
  Speaker 2: and then you until you learn. So it's there are
• 33:25
  Speaker 2: conditions that make it harder, social conditions that make it
• 33:28
  Speaker 2: harder for men to learn than women to learn particular
• 33:31
  Speaker 2: types of dance, unless, as Tim did, he got a
• 33:34
  Speaker 2: dance coach, a female dance coach to teach him how
• 33:37
  Speaker 2: to lead, and then he learned how to lead, and
• 33:39
  Speaker 2: then he was able to dance tango competitively. I think
• 33:41
  Speaker 2: I have that right, tim. They'll direpen you in the comments.
• 33:43
  Speaker 2: But as I recall, that's the story. So there's that.
• 33:47
  Speaker 2: Not that following is trivial. It requires some skill. But
• 33:51
  Speaker 2: if the person, and traditionally the male, can't lead the
• 33:56
  Speaker 2: whole thing, it doesn't work.
• 33:59
  Speaker 3: Right.
• 34:00
  Speaker 2: So I just made you more nervous about going to
• 34:02
  Speaker 2: this class, But you should do it because I had
• 34:05
  Speaker 2: a roommate when I was a postdoc, was a neurology
• 34:08
  Speaker 2: resident at UCSF, and she would go do tango late
• 34:10
  Speaker 2: at night and she would come back a different person.
• 34:13
  Speaker 2: And so this is like the other piece here is
• 34:15
  Speaker 2: you know, it seems that when we are trying something
• 34:18
  Speaker 2: truly new that involves interactions with other people, and we
• 34:21
  Speaker 2: go into that willingness to enter beginner's mind or whatever
• 34:26
  Speaker 2: it is, embrace the shame, and as we start to
• 34:29
  Speaker 2: get even just a little bit better at something, I mean,
• 34:32
  Speaker 2: it almost seems like there's this kind of halo around
• 34:35
  Speaker 2: the rest of our life. We go to work the
• 34:37
  Speaker 2: next day differently, we interact with people differently. Think our
• 34:40
  Speaker 2: nervous system is changed. What do you think that is?
• 34:44
  Speaker 2: I mean, we can make up stories about chemicals, and
• 34:45
  Speaker 2: maybe we should because they're likely to be true. What
• 34:48
  Speaker 2: do you think that is? That like general change in arousal,
• 34:51
  Speaker 2: Like you're sleeping better, you're you're more excited for the
• 34:54
  Speaker 2: other things in life. When you're trying to learn tango
• 34:57
  Speaker 2: and you get just a little bit better.
• 35:00
  Speaker 1: I don't think I would make up anything about about chemicals.
• 35:03
  Speaker 1: I think you could boil a lot of it down
• 35:05
  Speaker 1: to we like to be good at stuff and we
• 35:08
  Speaker 1: like to overcome things, right, this is like this this
• 35:11
  Speaker 1: like core need to be challenged and then to overcome
• 35:15
  Speaker 1: those challenges. And I think there's a lot of downstream
• 35:18
  Speaker 1: effects of not doing that, and they could be, you know,
• 35:22
  Speaker 1: related to mental health. They could also be related to
• 35:23
  Speaker 1: physical health, right because if you think about physical and
• 35:27
  Speaker 1: cognitive or you know, stress a psychological related challenges and
• 35:31
  Speaker 1: the process of overcoming them, because that's what really drives
• 35:35
  Speaker 1: you know, a lot of physical or mental psychological growth.
• 35:39
  Speaker 1: And I think that's something that you know, fundamentally is
• 35:42
  Speaker 1: part of what we need on a daily basis, And
• 35:45
  Speaker 1: so you did this thing that you were bad at
• 35:48
  Speaker 1: and you got better at it, and you prove to yourself, hey,
• 35:51
  Speaker 1: I'm capable. I'm able to overcome challenges. I'm able to
• 35:55
  Speaker 1: you know, engaged and do difficult things. And I think
• 35:59
  Speaker 1: the psychological benefits of that, you're just that process of
• 36:04
  Speaker 1: engaging with the challenge ofcoming it working hard to do that.
• 36:08
  Speaker 1: I think that's just you know, almost like a core
• 36:11
  Speaker 1: psychological need that we have, and then that transfers to
• 36:13
  Speaker 1: all these other things. Oh yeah, I can do these
• 36:15
  Speaker 1: hard things. I'm going to do that other thing. I'm
• 36:16
  Speaker 1: excited to try something else that's difficult. I'm excited to
• 36:20
  Speaker 1: challenge myself again.
• 36:21
  Speaker 3: And it needs to be.
• 36:22
  Speaker 1: Something that feels meaningful, feels difficult enough that you have
• 36:27
  Speaker 1: the ability to overcome with some dedicated practice or you know,
• 36:30
  Speaker 1: focus time working on it. If it's too hard, you
• 36:34
  Speaker 1: can have the opposite effects, right, Like making something so
• 36:37
  Speaker 1: difficult somebody can't do it and they just fail.
• 36:38
  Speaker 3: Again and again and again and again. Right, that can
• 36:40
  Speaker 3: obviously have the opposite effect.
• 36:41
  Speaker 1: But something that you know you can get better at,
• 36:44
  Speaker 1: you know you can work on, you can see progress.
• 36:47
  Speaker 1: I think all of that then has all these knock
• 36:49
  Speaker 1: on effects.
• 36:50
  Speaker 2: Maybe we could talk about flow for a second. You know,
• 36:52
  Speaker 2: one of the most bastardized terms in neuroscience, performance psychology,
• 36:57
  Speaker 2: and the rest. When Chiksim High talked about it initially,
• 37:01
  Speaker 2: when he really defined the term, it was about being
• 37:05
  Speaker 2: engaged in a process where you have a certain level
• 37:08
  Speaker 2: of skill, but the thing you're trying to do is
• 37:10
  Speaker 2: just beyond your skill level, so really striving a bit
• 37:13
  Speaker 2: and that kind of general sense of well being that
• 37:16
  Speaker 2: can come from that. Nowadays, I think people assume flow
• 37:19
  Speaker 2: is when you are able to do something in the
• 37:22
  Speaker 2: absence of kind of feeling of effort. It's like you
• 37:26
  Speaker 2: just you get the magic power kind of thing, which
• 37:29
  Speaker 2: is not what flow was originally intended to mean. I'd
• 37:33
  Speaker 2: like to know how you think of this concept of
• 37:35
  Speaker 2: flow and whether or not it's even a meaningful term.
• 37:37
  Speaker 2: And I you know, I tip my hat to Stephen
• 37:39
  Speaker 2: Kotler and others who have written about it and studied it,
• 37:43
  Speaker 2: and a great respect for Stephen and what he's done
• 37:47
  Speaker 2: with the concept, and and I think it's a meaningful concept,
• 37:52
  Speaker 2: but I don't think we really know how to define it.
• 37:56
  Speaker 2: And I think this is important in the context of plasticity,
• 37:59
  Speaker 2: because I think what we see in Harry Potter movies
• 38:02
  Speaker 2: and sci fi and you know, fight Club and everything
• 38:06
  Speaker 2: else is that suddenly we're just going to be endowed
• 38:08
  Speaker 2: with these powers just because we want them and need them,
• 38:11
  Speaker 2: and that is not how it works. Yeah, So is
• 38:14
  Speaker 2: flow an expression of skill or is it the striving
• 38:17
  Speaker 2: to attain a skill?
• 38:18
  Speaker 1: I think of flow as the maximal expression of a
• 38:22
  Speaker 1: complex learned skill. Like you said, you're like right at
• 38:25
  Speaker 1: the edge your capabilities, You're still managing to maintain, maintain function, whatever,
• 38:30
  Speaker 1: whatever skill it is you're performing at the thing that
• 38:34
  Speaker 1: really frustrates me is that because of that, or you know,
• 38:39
  Speaker 1: some version of their definition of flow, people like, well,
• 38:42
  Speaker 1: I've always got to search for flow, like everything happens
• 38:44
  Speaker 1: in flow, and like we need to be in flow
• 38:46
  Speaker 1: all the time, which doesn't make any sense to me whatsoever.
• 38:49
  Speaker 1: There's two different parts of this. So one is that
• 38:51
  Speaker 1: people assume that for optimal performance you need to be
• 38:55
  Speaker 1: in flow. That is not true. Flow is one of
• 39:00
  Speaker 1: you of being able to perform at the best of
• 39:03
  Speaker 1: your abilities. If we think about this in terms of
• 39:06
  Speaker 1: sports performance, they might be broadly two states associated with
• 39:12
  Speaker 1: top level performance. One is flow states, the other is
• 39:15
  Speaker 1: clutch states. And so a clutch state, you are still
• 39:20
  Speaker 1: at the optimal level of arousal, right if we think
• 39:22
  Speaker 1: about the arousal curve and performance, which we can come
• 39:24
  Speaker 1: back to, but so at the optimal level of arousal
• 39:27
  Speaker 1: which is required for you to perform the skill that
• 39:30
  Speaker 1: you're trying to perform. But when you're in a clutch state,
• 39:33
  Speaker 1: it still feels like hard work.
• 39:35
  Speaker 3: Right.
• 39:35
  Speaker 1: So, like you can talk to any athlete about a
• 39:38
  Speaker 1: time that they they performed well, they won. They you know,
• 39:43
  Speaker 1: they did the best of their abilities, but it was
• 39:45
  Speaker 1: hard cognitive work, it was hard physical work, it was
• 39:47
  Speaker 1: a slog, but they still managed to perform. Well, that's
• 39:51
  Speaker 1: a clutch state. And people can perform at the best
• 39:53
  Speaker 1: of their abilities in clutch states, and you know, even
• 39:57
  Speaker 1: though they're not in flow, it's not all coming to
• 39:59
  Speaker 1: them easily. It requires them to like really focus and
• 40:03
  Speaker 1: work hard to get the job done. And both of
• 40:05
  Speaker 1: those are perfectly reasonable states in which to perform, and
• 40:09
  Speaker 1: assuming that you have to be in flow to perform
• 40:11
  Speaker 1: just isn't true if you look at like how you
• 40:12
  Speaker 1: know athletes perform in the moment. The other side of
• 40:15
  Speaker 1: it is that some people have intimated that flow is
• 40:20
  Speaker 1: required for learning, or like optimal learning happens to flow,
• 40:23
  Speaker 1: which doesn't make any sense. Right If we talked about
• 40:26
  Speaker 1: making mistakes and errors and friction required for learning, that
• 40:30
  Speaker 1: is not conducive to flow, because it's it can be stressful,
• 40:34
  Speaker 1: it could be frustrating and sort of the other side
• 40:38
  Speaker 1: of that is, if you know flow is expressing your skill,
• 40:44
  Speaker 1: if you want to get better of that skill, you
• 40:46
  Speaker 1: have to work even further beyond your current capacities, which
• 40:49
  Speaker 1: it will move you out of flow, right because of
• 40:52
  Speaker 1: like the friction and the mistakes and the errors that
• 40:54
  Speaker 1: come from that. So I think, yeah, flow is super
• 40:57
  Speaker 1: interesting and I wouldn't pretend to be an expert in flow.
• 40:59
  Speaker 1: But well, all these other states where learning happens, where
• 41:03
  Speaker 1: performance happens, that aren't flow, and that's fine too, right,
• 41:07
  Speaker 1: But sometimes it's hard, and that's okay.
• 41:09
  Speaker 2: I'm so glad you're here. I've been looking for this
• 41:11
  Speaker 2: conversation for well since I started the podcast, because I
• 41:16
  Speaker 2: completely agree about flow and the misunderstanding of the concept
• 41:21
  Speaker 2: of flow. I've never heard of a clutch state. Is
• 41:26
  Speaker 2: that a term that you coined or something.
• 41:28
  Speaker 3: In the sports psychology. That's show that'll talk about it.
• 41:30
  Speaker 2: That's what happens.
• 41:30
  Speaker 3: Seen it.
• 41:31
  Speaker 2: Yeah, because I'm very familiar with the neuroplasticity literature, but
• 41:34
  Speaker 2: I've never heard of it. Maybe I'm just not up
• 41:36
  Speaker 2: to date on my reading. But thank you for introducing
• 41:39
  Speaker 2: clutch state, which is when one is performing well, but
• 41:42
  Speaker 2: it's it's evolving. And this is a term I did
• 41:45
  Speaker 2: make up, sort of some limbic friction, like you have
• 41:48
  Speaker 2: to push yourself, you're feeling constrained. It's that you're at
• 41:50
  Speaker 2: that edge where's there's real challenge. You're not You're definitely
• 41:53
  Speaker 2: not in flow. Fantastic clutch state. Everyone learn it, know it,
• 42:00
  Speaker 2: embrace it, live there for some period of time in
• 42:04
  Speaker 2: your life, across your lifespan, and you'll be better off.
• 42:08
  Speaker 2: I mean that maybe we could drill into this a
• 42:10
  Speaker 2: little bit more, because you know, several times on this
• 42:13
  Speaker 2: podcast or more, we've talked about the interimid singulate cortex,
• 42:16
  Speaker 2: the structure that you know maintains size and superagers who
• 42:19
  Speaker 2: take on hard things, and you know this area of
• 42:22
  Speaker 2: the brain that seems associated with tenacity, which when stimulated
• 42:26
  Speaker 2: people feel like an impending challenge. Is actually neurosurgery experiments
• 42:30
  Speaker 2: done by Joe Parvezi at Stanford. People feel like, oh,
• 42:32
  Speaker 2: there's an impending challenge. I'm going to lean into it.
• 42:35
  Speaker 2: This sounds more like the clutch state then certainly then
• 42:39
  Speaker 2: flow state. So maybe the thing we need to embrace
• 42:41
  Speaker 2: is the clutch state. It's pretty catchy. It's not quite
• 42:44
  Speaker 2: as catchy as flow, but I like it because it
• 42:50
  Speaker 2: has an element of like friction kind of written into it.
• 42:53
  Speaker 2: You heard it first from Tommy wood Folks, not me,
• 42:57
  Speaker 2: a good friend who comes from the special operation community.
• 43:01
  Speaker 2: We talked about performance years ago and he said, well,
• 43:05
  Speaker 2: there's unskilled, skilled, mastery and virtuosity. Okay, cool, And he
• 43:10
  Speaker 2: said virtuosity is when someone who has mastery pushes out
• 43:15
  Speaker 2: to an edge of effort where they're sort of inviting
• 43:20
  Speaker 2: in the unknown. They don't quite know what they're going
• 43:22
  Speaker 2: to do next. They have some semblance of an idea,
• 43:25
  Speaker 2: like they're not being haphazard, but there's an inviting in
• 43:29
  Speaker 2: of the unknown and they find themselves at a new level.
• 43:35
  Speaker 2: I've probably mentioned this documentary four times in the last
• 43:38
  Speaker 2: four episodes, but when Andy Stumpf for Tier one Seal
• 43:44
  Speaker 2: Operator came on this podcast, former wingsuitor Red Bull High
• 43:47
  Speaker 2: Performance Team came on here. He suggested a podcast that
• 43:49
  Speaker 2: I'm now suggest He suggested, excuse me, a documentary that
• 43:53
  Speaker 2: I highly recommend, which is The Dark Wizard, which is
• 43:55
  Speaker 2: about Dean Potter, who is a free climber, a free
• 43:58
  Speaker 2: solo climber turned wing suitor, et cetera. And you see
• 44:01
  Speaker 2: in that documentary how somebody who's pushing to their edge
• 44:07
  Speaker 2: and a little bit beyond where the consequences, the death consequence,
• 44:12
  Speaker 2: is able to access levels of skill that are like
• 44:16
  Speaker 2: jaw dropping, I think, even to him, So does that
• 44:20
  Speaker 2: make sense? Like is that sort of how you think
• 44:22
  Speaker 2: about unskilled skilled mastery virtuosity? Do you think virtuosity is
• 44:26
  Speaker 2: like where someone's like, all right, I've mastered this thing.
• 44:29
  Speaker 2: Now put me in a situation or I'll put myself
• 44:31
  Speaker 2: in a situation where I don't know what's going to happen,
• 44:35
  Speaker 2: and maybe it'll all go wrong. But when it doesn't,
• 44:39
  Speaker 2: new levels or performance emerge.
• 44:41
  Speaker 1: As it's described that way, because people might talk about
• 44:46
  Speaker 1: virtuosos in a skill just because there's so much better
• 44:49
  Speaker 1: than everybody else, right, But like that that that definition
• 44:53
  Speaker 1: requires a specific scenario and moment of performance right. So
• 45:01
  Speaker 1: then that sounds a lot like how I would think
• 45:02
  Speaker 1: about flow, right, and so like when you when you
• 45:05
  Speaker 1: look at some of the classic descriptions from individuals who've
• 45:08
  Speaker 1: been in that kind of level. So like, there's there's
• 45:12
  Speaker 1: one from so I do a lot of work in
• 45:13
  Speaker 1: Formula one. There's one from Airton Center where he's from.
• 45:16
  Speaker 1: Who I'm sorry, airs and Center. The driver, the driver sener.
• 45:22
  Speaker 2: Excuse David the podcaster. He's the He's the virtuoso of
• 45:27
  Speaker 2: of of performance and business and finance podcasting.
• 45:30
  Speaker 1: Don't let any of your f one loving friends hear
• 45:34
  Speaker 1: that part of the podcasts and Center. Some people consider
• 45:39
  Speaker 1: him to be the best Formula one driver of all time.
• 45:42
  Speaker 1: He died tragically in a crash. But there's this famous
• 45:48
  Speaker 1: quote from him where he's driving in the Monaco Grand Prix,
• 45:53
  Speaker 1: and basically what he describes is that he's like going
• 45:57
  Speaker 1: faster and faster and faster. He's like, this is beyond
• 46:00
  Speaker 1: my capabilities, Like he doesn't feel like he's actually connected
• 46:03
  Speaker 1: to doing the thing.
• 46:03
  Speaker 3: It's just kind of like happening exactly.
• 46:05
  Speaker 1: It's exactly like he's going seconds fast around the lap
• 46:07
  Speaker 1: than anybody else and so like that's kind of what
• 46:10
  Speaker 1: like he is so good, right, he achieved mastery and
• 46:12
  Speaker 1: that in that moment he's displaying virtuosity in that kind
• 46:15
  Speaker 1: of in that under that kind of definition, and so
• 46:19
  Speaker 1: like that that feels like there's a lot of overlap there.
• 46:21
  Speaker 2: Yeah. Ever since seeing this Dark Wizard documentary, which I've
• 46:25
  Speaker 2: watched twice all the way through because it as a
• 46:27
  Speaker 2: mental health component. It's a it's a brilliant and beautifully
• 46:30
  Speaker 2: shot documentary recently released, I think about this virtuosity thing
• 46:36
  Speaker 2: like constantly. But I love this notion of the clutch
• 46:39
  Speaker 2: state because it sounds to me that that's the state
• 46:45
  Speaker 2: that we want to seek. And the assumption is that
• 46:48
  Speaker 2: high performers are in this relaxed, mellow state, but I'm
• 46:52
  Speaker 2: guessing they spend a significant amount of time there and
• 46:55
  Speaker 2: drilling the really boring stuff to make sure they can
• 46:57
  Speaker 2: get there.
• 46:58
  Speaker 3: Yeah.
• 46:59
  Speaker 2: Twyla Tharrapet, it's in her eighties, world class choreographer sat
• 47:04
  Speaker 2: in the chair that I'm in and described with the
• 47:06
  Speaker 2: daily routine of her world class dancers. They go through
• 47:10
  Speaker 2: the most basic drills every single day, but every iteration
• 47:16
  Speaker 2: for hours upon hours upon hours before they begin quote
• 47:19
  Speaker 2: unquote practice right before they try and embrace the new
• 47:25
  Speaker 2: performance piece, but over and over and over, often after
• 47:30
  Speaker 2: multiple hours of morning exercise. I think we don't see
• 47:34
  Speaker 2: all of that foundational work and that it needs to
• 47:36
  Speaker 2: be maintained, which raises a question, do we always need
• 47:39
  Speaker 2: to maintain practice the fundamentals?
• 47:42
  Speaker 1: Before I answer your question, I think there's another useful
• 47:45
  Speaker 1: thing just kind of to remember that relates to all
• 47:48
  Speaker 1: of this from you know, in you know, athletes and sports.
• 47:53
  Speaker 1: On the training side, there's this general idea of thirds. Right,
• 47:57
  Speaker 1: A third of your sessions training, learning, whatever it is,
• 48:03
  Speaker 1: are going to feel great. You're going to feel really good.
• 48:05
  Speaker 1: You're just going to get stuff you know immediately, it's
• 48:07
  Speaker 1: going to just come to you. A third will just
• 48:11
  Speaker 1: be average, right, and a third is just going to
• 48:13
  Speaker 1: suck and you just have to show up and get
• 48:15
  Speaker 1: it done.
• 48:16
  Speaker 2: But this is all on the same days, across the week,
• 48:20
  Speaker 2: across months, across the years where this stuff undulates.
• 48:22
  Speaker 1: And the main reason why I say that is because
• 48:27
  Speaker 1: related to this sort of glorification of flow is this
• 48:30
  Speaker 1: idea that these things you just like always come easily
• 48:33
  Speaker 1: to us. But that's completely antithetical to the idea that
• 48:36
  Speaker 1: we have to work hard and challenge ourselves in order
• 48:38
  Speaker 1: to build capacity drive neuroplasticity. So there's kind of this
• 48:42
  Speaker 1: weird tension between what people are seeking versus what is
• 48:45
  Speaker 1: actually just the part of the grind of getting better
• 48:49
  Speaker 1: and you know, over time, and sometimes it is a
• 48:51
  Speaker 1: grind and that's you know again, that's okay, doesn't mean
• 48:54
  Speaker 1: you're doing it wrong.
• 48:55
  Speaker 3: Maybe it means you're doing it right.
• 48:57
  Speaker 1: When you then think about maintaining the fundamentals, I think yes,
• 49:01
  Speaker 1: but probably it's going to depend on the scenario that
• 49:05
  Speaker 1: you're that you're thinking about, because sometimes the skill that
• 49:10
  Speaker 1: you're performing, the fundamentals are kind of baked into that
• 49:14
  Speaker 1: in some way. So it kind of depends on what
• 49:17
  Speaker 1: the fundamentals really are maybe, you know, if it's so
• 49:21
  Speaker 1: thinking about one specific study that was done in pianists,
• 49:27
  Speaker 1: so this is kind of it was kind of related
• 49:30
  Speaker 1: to the ericson studies in violinists, right, but this time
• 49:33
  Speaker 1: they were looking at a pianists, and so they had
• 49:36
  Speaker 1: they had four groups, older and younger. So the younger
• 49:39
  Speaker 1: was like twenties and thirties. Older were fifties and sixties,
• 49:41
  Speaker 1: expert and amateur pianists, and so the experts came from
• 49:45
  Speaker 1: German like music conservatories, and then they looked at sort
• 49:51
  Speaker 1: of basic skills related to you know, moving the fingers
• 49:56
  Speaker 1: and other things that you would do playing the piano,
• 49:59
  Speaker 1: and so they were like very task specific skills related
• 50:03
  Speaker 1: to piano playing. And what they found was that the
• 50:06
  Speaker 1: most important predictor of how well somebody performed at those
• 50:11
  Speaker 1: piano specific skills was not their age, it was how
• 50:14
  Speaker 1: much they practice. So it's just that getting those reps
• 50:18
  Speaker 1: in helps you maintain those sort of like basic functions.
• 50:21
  Speaker 1: And maybe right when you're playing very complex piano pieces,
• 50:25
  Speaker 1: you're encompassing all those fundamentals anyway, Right, you don't need
• 50:29
  Speaker 1: to you don't need to like do your you don't
• 50:31
  Speaker 1: need to do your scales every day because some of
• 50:33
  Speaker 1: that stuff is kind of built in. But you will
• 50:35
  Speaker 1: also see people as they warm up, say maybe they
• 50:39
  Speaker 1: will do scales and things because that's part of just
• 50:41
  Speaker 1: like you know, the warm up. Maybe part maybe that's routine, right,
• 50:46
  Speaker 1: this is me getting in the in the mode of
• 50:49
  Speaker 1: playing complex piece. But then maybe some of it is
• 50:51
  Speaker 1: just kind of helping to maintain those fundamental skills.
• 50:54
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• 52:15
  Speaker 2: kill the ten thousand hours. I know other people who
• 52:18
  Speaker 2: have attempted to. But what does that really boil down to.
• 52:21
  Speaker 2: Is it simply that about eight hours a day of
• 52:24
  Speaker 2: practice for a dedicated period of time is what leads
• 52:27
  Speaker 2: to rapid plasticity and that's what was measured, or is
• 52:30
  Speaker 2: there really some sort of rule about time under seeking
• 52:37
  Speaker 2: clutch state?
• 52:38
  Speaker 1: The simple answer is what the study showed was that
• 52:41
  Speaker 1: ten thousand hours was the average amount of time that
• 52:43
  Speaker 1: an expert violinist had spent practicing by the time they
• 52:46
  Speaker 1: reached twenty years old. That's what the study showed. They
• 52:48
  Speaker 1: weren't even experts by that point. That was how much
• 52:50
  Speaker 1: they'd practiced essentially in their youth. So that number of
• 52:55
  Speaker 1: hours doesn't even translate over to true expertise in violinists
• 52:58
  Speaker 1: in this one specific exige sample. So I don't think
• 53:02
  Speaker 1: there's some fixed number of hours required. It is interesting.
• 53:07
  Speaker 1: Other parts of that study kind of looked at the
• 53:11
  Speaker 1: practice routines of these expert violinists, and what they found
• 53:15
  Speaker 1: was that they tended to practice for about two sessions
• 53:18
  Speaker 1: of sixty to ninety minutes a day. And I think
• 53:23
  Speaker 1: that's a pretty good rule, right, if you're going to
• 53:27
  Speaker 1: do something hard, you're pushing beyond your current skill level.
• 53:31
  Speaker 1: Focusing for sixty to ninety minutes maybe with you know,
• 53:34
  Speaker 1: a couple of breaks in there, a couple of times
• 53:37
  Speaker 1: a day. That's probably about as much as most people
• 53:40
  Speaker 1: can do. And I think that also relates to how
• 53:42
  Speaker 1: we perform on a day to day basis in other
• 53:44
  Speaker 1: areas of life. Right, we kind of expect that we
• 53:46
  Speaker 1: can go to work and we can work really hard
• 53:48
  Speaker 1: for eight hours straight during the day, but like, the
• 53:50
  Speaker 1: brain doesn't really work like that. If we're doing hard
• 53:54
  Speaker 1: cognitive work, you're focused and highly challenged, as you might
• 53:59
  Speaker 1: be if you you know, a future virtuoso on the
• 54:04
  Speaker 1: violin and you're trying to really practice and push yourself,
• 54:07
  Speaker 1: you can only really do that for you know, chunks
• 54:10
  Speaker 1: of twenty to thirty minutes, maybe a couple of times
• 54:12
  Speaker 1: of the break, right.
• 54:12
  Speaker 3: So that's why Pomodoro.
• 54:13
  Speaker 1: Even though there's no like good studies on the Pomodoro technique,
• 54:16
  Speaker 1: like those time periods, you know, twenty five minutes or
• 54:19
  Speaker 1: the five minute break a few times, they do kind
• 54:21
  Speaker 1: of fit into that kind of rhythm that translates over
• 54:25
  Speaker 1: to multiple areas where we might want to use our brains.
• 54:28
  Speaker 3: And just remember that.
• 54:30
  Speaker 1: Hard cognitive work and that process of learning can only
• 54:34
  Speaker 1: really happen in those kinds of size of chunks if
• 54:36
  Speaker 1: you want to do them sustainably.
• 54:37
  Speaker 2: Yeah. Before I started writing my book, somebody who's published
• 54:41
  Speaker 2: several very well received books said you can only write
• 54:45
  Speaker 2: for about four solid hours per day, broken up into
• 54:49
  Speaker 2: a couple of sessions.
• 54:50
  Speaker 3: Yeah.
• 54:51
  Speaker 2: I was like, come on, I mean, like, I'm not
• 54:54
  Speaker 2: trying to books. But I used to go into the
• 54:55
  Speaker 2: lab and sit down and work on a grant for
• 54:58
  Speaker 2: six hours or something like that, and I started thinking,
• 55:00
  Speaker 2: was it really six hours? Go in there, see my
• 55:03
  Speaker 2: students and postoc, sit down. Okay, then there's lunch any
• 55:06
  Speaker 2: my dog, you know, and there were some late nights.
• 55:09
  Speaker 2: But then the next morning I'm kind of dragging because
• 55:11
  Speaker 2: I was in you know, in my office really late,
• 55:13
  Speaker 2: and you get real honest with yourself real quick, and
• 55:16
  Speaker 2: you go ooh okay. In the periods of time where
• 55:20
  Speaker 2: I definitely pushed to the six, eight, ten, twelve hours
• 55:23
  Speaker 2: of just NonStop work as a deadline approached, there was
• 55:26
  Speaker 2: a compensatory drop and output after you click send, And
• 55:31
  Speaker 2: so I think you're right, they're right somewhere between. Maybe
• 55:35
  Speaker 2: I mean you're saying sixty to ninety minutes and they're
• 55:37
  Speaker 2: saying four hours, but not a whole lot more than
• 55:40
  Speaker 2: that for real focused in clutch state work, so really
• 55:45
  Speaker 2: digging in and no distractions, no phone, no checking your
• 55:48
  Speaker 2: text messages, just you know, do you ever give yourself
• 55:52
  Speaker 2: forced constraints to get real work done?
• 55:55
  Speaker 1: Not to force it. I will say that one of
• 55:58
  Speaker 1: the best ways to like truly get deep focused work
• 56:03
  Speaker 1: done is to eliminate distractions, right, That's one of the
• 56:06
  Speaker 1: most important things that you can do.
• 56:08
  Speaker 3: So close the email.
• 56:09
  Speaker 1: I will like put my phone in a different room
• 56:11
  Speaker 1: or because like nowadays, your own you know, closed slack.
• 56:16
  Speaker 1: I have slack teams, my lab and I we interact
• 56:20
  Speaker 1: on you know, messing back and forth on WhatsApp, Like
• 56:22
  Speaker 1: there's email. I've got like five or six different ways
• 56:25
  Speaker 1: that people can like constantly try and get my attention right. So,
• 56:29
  Speaker 1: like eliminating distractions is really important. And again I returned
• 56:33
  Speaker 1: to Gloria Mark's works. You wrote an excellent book called
• 56:35
  Speaker 1: Attention Span. If anybody's like really interested in this. But
• 56:39
  Speaker 1: you get used to a pattern of distraction such that
• 56:42
  Speaker 1: when you're not actually being distracted, you will distract yourself, right,
• 56:49
  Speaker 1: But you can be trained out of that as well.
• 56:50
  Speaker 1: But so you know that thing where you're trying to
• 56:53
  Speaker 1: do work and you like reach for your phone for
• 56:55
  Speaker 1: no reason, it's because your brain is kind of used
• 56:57
  Speaker 1: to this pattern of you know, around about now, somebody
• 57:01
  Speaker 1: will text me or send me an email, and I'll
• 57:03
  Speaker 1: reach my phone, so you go looking for it even
• 57:06
  Speaker 1: if it hasn't happened. But again, you can train yourself
• 57:09
  Speaker 1: out of that if you if you have periods where
• 57:11
  Speaker 1: you're not getting constantly distracted, so I will eliminate notifications.
• 57:15
  Speaker 1: But at least for me, what I've found is that
• 57:18
  Speaker 1: if I, if I have a ton of friction in
• 57:21
  Speaker 1: terms of trying to get something done, I will usually
• 57:25
  Speaker 1: step away from it because there's something in there that
• 57:29
  Speaker 1: just like needs to click or come back before I
• 57:31
  Speaker 1: can like really engage in.
• 57:33
  Speaker 2: It, or if you're at a sticking point.
• 57:35
  Speaker 1: Yeah, So if I'm at a sticking point, or it's like,
• 57:38
  Speaker 1: if something feels like it's just not coming in the moment,
• 57:42
  Speaker 1: I'll usually switch over to something else, which is also
• 57:45
  Speaker 1: kind of a normal. It's one of a possible set
• 57:49
  Speaker 1: of patterns of work, which is that you have two
• 57:52
  Speaker 1: or three projects you're working on any given time. If
• 57:54
  Speaker 1: one just like isn't quite working, that you can switch
• 57:56
  Speaker 1: over to the other one and come back to it,
• 57:58
  Speaker 1: and then like the alternative is that when the deadline
• 58:01
  Speaker 1: is so close, and you know this often happens with
• 58:05
  Speaker 1: a grant deadline, or you know, when I was writing
• 58:07
  Speaker 1: my book, when there's a you know, a book deadline
• 58:09
  Speaker 1: and you've got to get this to my editor in
• 58:12
  Speaker 1: how many days or hours, I tend to just not
• 58:17
  Speaker 1: need to eliminate those things because I'll I'll just focus in,
• 58:22
  Speaker 1: like I don't feel that kind of draw to be
• 58:26
  Speaker 1: distracted by other things. But that usually only happens for
• 58:29
  Speaker 1: relatively short periods of time, Right, It's going to be
• 58:30
  Speaker 1: a day or two or hours during a day, rather
• 58:32
  Speaker 1: than you know, extended periods of time.
• 58:34
  Speaker 2: Are you familiar with this recent study about phone on
• 58:37
  Speaker 2: the table, phone in the bag. You would just remind
• 58:39
  Speaker 2: people that if your phone has to be out of
• 58:41
  Speaker 2: the room, even if it's in your bag beneath your
• 58:43
  Speaker 2: chair turned off, you can still focus. But there's a cost.
• 58:48
  Speaker 2: Your cognitive flexibility, et cetera, really suffer. So that means
• 58:52
  Speaker 2: that the brain is unconsciously expecting a call of waiting
• 58:55
  Speaker 2: for it. And the way you describe this attentional break
• 58:58
  Speaker 2: expectation thing that we get in trained to interruptions is
• 59:04
  Speaker 2: really interesting. Maybe this is why meditation is such a
• 59:08
  Speaker 2: useful tool for improving focus, is that it's just a
• 59:11
  Speaker 2: forced no breaks yeah thing. Although it's pretty easy to
• 59:15
  Speaker 2: drift in meditation if you are not used to doing
• 59:17
  Speaker 2: twenty minutes of meditation, you sit down to do that,
• 59:19
  Speaker 2: you set the time, or like your brain can end
• 59:21
  Speaker 2: up way off the trail.
• 59:24
  Speaker 1: There could be some benefit to that as well, right,
• 59:25
  Speaker 1: because there's you without kind of building that in And
• 59:30
  Speaker 1: I don't routinely meditate. But unless you have some parts
• 59:36
  Speaker 1: of your day where actually you're not either putting in
• 59:41
  Speaker 1: information distracting yourself thinking about a specific thing, right, you
• 59:46
  Speaker 1: don't necessarily get that time to integrate. You know, that's
• 59:50
  Speaker 1: kind of you know, the classic is you come up
• 59:51
  Speaker 1: with your best ideas in the shower, right because actually
• 59:54
  Speaker 1: the time when you don't have your phone on you
• 59:55
  Speaker 1: and you're not watching TV, and you're not doing all
• 59:57
  Speaker 1: those other things that you know the same time. So
• 1:00:01
  Speaker 1: maybe yes, that's not what meditation is formally for, but
• 1:00:05
  Speaker 1: it could potentially be beneficial if your mind's going to wonder,
• 1:00:10
  Speaker 1: you know, making new connections, you know, coming up with
• 1:00:13
  Speaker 1: new ideas, having that space and time to do it,
• 1:00:15
  Speaker 1: it could potentially be beneficial too.
• 1:00:17
  Speaker 2: In these studies, these large scale trials, what was the
• 1:00:21
  Speaker 2: diet intervention? Can we distill it down to some things
• 1:00:24
  Speaker 2: that everyone should do or ought to consider?
• 1:00:28
  Speaker 1: Most interventions in the sort of cognitive and psychological space
• 1:00:33
  Speaker 1: have focused on some version of the Mediterranean diet. There's
• 1:00:39
  Speaker 1: the Mind Diet Mediterranean Intervention to Prevent Your Degenerator Delay
• 1:00:44
  Speaker 1: that came out of the Rush Memory an aging project,
• 1:00:48
  Speaker 1: and it's basically just a version of the Mediterranean diet
• 1:00:52
  Speaker 1: kind of focused on dementia prevention, and the way they
• 1:00:55
  Speaker 1: initially created it was they looked at foods that people
• 1:00:59
  Speaker 1: ate more or less of and created a score, and
• 1:01:01
  Speaker 1: those who had a higher score tend to know had
• 1:01:03
  Speaker 1: a lower risk related dementia. It wasn't an intervention when
• 1:01:06
  Speaker 1: it was first developed, but that was kind of the version.
• 1:01:10
  Speaker 1: It was a kind of combination of the Mediterranean diet
• 1:01:12
  Speaker 1: and the DASH diet, which is like an anti hypertension
• 1:01:16
  Speaker 1: blood pressure treatment type diet. So it's you know, seafood, vegetables, berries,
• 1:01:22
  Speaker 1: whole grains, that kind of.
• 1:01:24
  Speaker 2: Stuff, not too much saturated fat or animal approach.
• 1:01:28
  Speaker 1: And so this is very similar to the diet that
• 1:01:30
  Speaker 1: used in the Smiles trial, which was the first randomized
• 1:01:32
  Speaker 1: control trial in depression that showed significant improvements in mood symptoms.
• 1:01:37
  Speaker 1: I think the principles are useful, but there's not necessarily
• 1:01:40
  Speaker 1: a huge amount of evidence to say that, like this
• 1:01:42
  Speaker 1: is the way that you you should or you have
• 1:01:45
  Speaker 1: to eat to maintain cognitive health. There was actually a
• 1:01:49
  Speaker 1: big trial of the Mind diet. It was published in
• 1:01:52
  Speaker 1: the New England Journal of Medicine a couple of years ago,
• 1:01:55
  Speaker 1: and they compared the Mind diet to standard chloric restriction
• 1:02:00
  Speaker 1: and actually there's all similar benefits in both groups.
• 1:02:03
  Speaker 3: There have been big.
• 1:02:04
  Speaker 1: Observational studies that have looked at how much their diet
• 1:02:07
  Speaker 1: looks like a Mediterranean diet, and those whose diets look
• 1:02:10
  Speaker 1: more like Mediterranean diets, yes, they have a lower risk
• 1:02:12
  Speaker 1: of dementia. Of course, right, this is observational data, right,
• 1:02:15
  Speaker 1: so it's not you can't say it's causal. But what's
• 1:02:18
  Speaker 1: interesting in some of these studies, So there's a big
• 1:02:20
  Speaker 1: one that came out of the UK Biobank was that
• 1:02:22
  Speaker 1: they took out individual foods or food components of the
• 1:02:28
  Speaker 1: Mediterranean diet to see if that changed the relationship between
• 1:02:31
  Speaker 1: the Mediterranean diet and dementia risk. And there was no
• 1:02:34
  Speaker 1: food or you know, olive oil or food group or
• 1:02:37
  Speaker 1: you're eating more or less meat, that changed the relationship
• 1:02:40
  Speaker 1: between the Mediterranean diet and dementia risk. So what that
• 1:02:43
  Speaker 1: tells me is it's much more about whole foods their
• 1:02:47
  Speaker 1: nutrient dense rather than avoiding any you have to eat
• 1:02:53
  Speaker 1: you have to consume lots of olive oil, right, or
• 1:02:55
  Speaker 1: you have to restrict meat because if those things are
• 1:02:59
  Speaker 1: eaten in the context of other stuff. It's really that
• 1:03:01
  Speaker 1: bigger context of diet quality and nutrient density that really matters.
• 1:03:06
  Speaker 3: So the parts of diet.
• 1:03:09
  Speaker 1: That I think about are there's three, so there's energy,
• 1:03:14
  Speaker 1: there's nutrients, and then there's overall diety pattern. So one
• 1:03:19
  Speaker 1: of the confounding things about that trial I told you
• 1:03:21
  Speaker 1: about the mind diaversus coloric restriction is you're like, well,
• 1:03:24
  Speaker 1: the mind diet should win, out right, how does caloric
• 1:03:26
  Speaker 1: restriction do just as well? And in the kind of
• 1:03:30
  Speaker 1: average population. We tend to have some issues with metabolic
• 1:03:36
  Speaker 1: health and have been in a state of chronic energy
• 1:03:39
  Speaker 1: excess for some period of time. There's been some very
• 1:03:42
  Speaker 1: nice studies that have looked at brain aging and brain
• 1:03:45
  Speaker 1: volume or brain reserve across different populations. There was one
• 1:03:51
  Speaker 1: group that looked at different tribes in Bolivia, the Blivian Chimanae,
• 1:03:55
  Speaker 1: who are unta gathered group, the Mussettan, who are kind
• 1:03:58
  Speaker 1: of an intermediate group between sort of the chimane and
• 1:04:01
  Speaker 1: like a standard kind of industrialized group, and then industrialized
• 1:04:05
  Speaker 1: humans in the US and Europe. And what they found
• 1:04:07
  Speaker 1: is the kind of this bell shaped curve between energy
• 1:04:10
  Speaker 1: availability and brain volume and in general brain volume, right,
• 1:04:15
  Speaker 1: the more the better, we think. And so if you're
• 1:04:18
  Speaker 1: chronically chlorically restricted, your brain is smaller because you just
• 1:04:22
  Speaker 1: don't have the resources to invest in the structure and
• 1:04:27
  Speaker 1: to maintain it. At the other end, you see the
• 1:04:29
  Speaker 1: same thing. So if you're chronically in a chronic state
• 1:04:32
  Speaker 1: of chloric excess, you also tend to have a smaller
• 1:04:34
  Speaker 1: brain on average, and this is related to metabolic disease,
• 1:04:38
  Speaker 1: you know, and you know potentially what comes with it,
• 1:04:42
  Speaker 1: higher levels of inflammation, high blood pressure, things like that
• 1:04:45
  Speaker 1: that we know can negatively impact the brain. So the
• 1:04:48
  Speaker 1: most important thing, and I think this is where some
• 1:04:50
  Speaker 1: of the benefits of chlorical.
• 1:04:50
  Speaker 3: Restriction happened in that in that trial compared.
• 1:04:53
  Speaker 1: To the mind diet, was that people's cognition improved just
• 1:04:57
  Speaker 1: because they decrease their energy intake to a point there
• 1:05:00
  Speaker 1: was more was essentially kind of what their brain kind
• 1:05:05
  Speaker 1: of needed, you know, kind of supported their overall physical health,
• 1:05:08
  Speaker 1: which then affects cognitive health and brain volume and brain function.
• 1:05:13
  Speaker 1: So the first thing to do is to make sure
• 1:05:15
  Speaker 1: that you're eating enough but not too much, right And
• 1:05:18
  Speaker 1: that's very simplistic, but like energy is really critical, energy availability,
• 1:05:22
  Speaker 1: not too low, not too high. Then the next thing
• 1:05:25
  Speaker 1: that you need is there is nutrients. We know there
• 1:05:28
  Speaker 1: are several critical nutrients related to cognitive function and risk
• 1:05:32
  Speaker 1: of dementia. The ones that we have the best evidence
• 1:05:35
  Speaker 1: for vitamin D, iron, omega three, fatty acids, the B
• 1:05:39
  Speaker 1: vitamins involved, and the B vitmins involved in methylation, so
• 1:05:42
  Speaker 1: particularly B twelve and folate, also potentially B six and
• 1:05:46
  Speaker 1: riber flavor, although that might depend a little bit more
• 1:05:48
  Speaker 1: on the individual. Then there are some other nutrients that
• 1:05:51
  Speaker 1: have some pretty good evidence for them. So many of
• 1:05:54
  Speaker 1: the antioxidant polyphenols, things that you get from berries, coffee, tea, chocolate,
• 1:05:59
  Speaker 1: the carotenoils that make things orange yellow and red, lutine
• 1:06:03
  Speaker 1: zas aanthin astxanthin if it comes from seafood, that's what
• 1:06:07
  Speaker 1: makes shrimp and salmon pink. And then you know some
• 1:06:10
  Speaker 1: other aspects like dietary fibers seems to have some.
• 1:06:13
  Speaker 3: Benefits as well.
• 1:06:14
  Speaker 1: Not magnesium, so magnesium is absolutely absolutely in there in
• 1:06:18
  Speaker 1: there two and in general, I think, and so magnesium zinc.
• 1:06:25
  Speaker 3: Then there's some of the.
• 1:06:26
  Speaker 1: Structural lipid components, things like choline and ethanolamine that you
• 1:06:30
  Speaker 1: might get from.
• 1:06:31
  Speaker 3: Nuts and seeds or eggs.
• 1:06:34
  Speaker 1: They have some slightly less like less evidence we're really
• 1:06:38
  Speaker 1: when you're looking at brain changes over time and dementia risk.
• 1:06:42
  Speaker 1: But those certainly do seem too related to coggnative functions.
• 1:06:45
  Speaker 1: So there are some studies that show that those who
• 1:06:47
  Speaker 1: have lower magnesium and takes tend on average to perform
• 1:06:51
  Speaker 1: less well on some some cognitive function tests. So all
• 1:06:54
  Speaker 1: of those do seem to be important.
• 1:06:56
  Speaker 2: I have two questions about nutrients and brain health short
• 1:07:00
  Speaker 2: and long term, and they have to do with interactions
• 1:07:03
  Speaker 2: between nutrients, which at least to my understanding, are rarely explored.
• 1:07:08
  Speaker 2: You know, you'll see studies of supplementing omega three or
• 1:07:10
  Speaker 2: having people eat some fatty fish or less and so on,
• 1:07:13
  Speaker 2: but rarely in the presence or absence of some other
• 1:07:17
  Speaker 2: vitamin that you know that can potentially impact the same pathway.
• 1:07:21
  Speaker 2: So there's synergy. There's also you know, necessity, so that
• 1:07:25
  Speaker 2: could impact results. The other piece is on what timescale
• 1:07:30
  Speaker 2: are these nutrients needed and on what time scale are
• 1:07:33
  Speaker 2: they metabolized. So maybe to just kind of drill into
• 1:07:36
  Speaker 2: the second question first. So you know, I'm not out
• 1:07:39
  Speaker 2: here as like the defender of supplements, but I've been
• 1:07:42
  Speaker 2: taking supplements in various forms and eating whole foods, and
• 1:07:45
  Speaker 2: eating is generally healthily you know less so when I
• 1:07:49
  Speaker 2: was younger, but still pretty healthy, and more so as
• 1:07:51
  Speaker 2: I get older. But here's where my brain goes. Wait,
• 1:07:56
  Speaker 2: whole food is great, but let's say dark leafy greens
• 1:08:01
  Speaker 2: have a bunch of things in them that are fundamentally
• 1:08:04
  Speaker 2: important for brain and bodily health. Great, and they have fiber,
• 1:08:07
  Speaker 2: et cetera. How many times a week am I eating
• 1:08:11
  Speaker 2: dark leafy greens. Let's say I do Monday, Tuesday, Wednesday,
• 1:08:13
  Speaker 2: I'm great, But then I'm traveling on Thursday Friday. Should
• 1:08:17
  Speaker 2: I be just supplementing Thursday Friday? Am I good until
• 1:08:19
  Speaker 2: the next week? I think one of the reasons why
• 1:08:23
  Speaker 2: eating really well, I think everyone knows what that means.
• 1:08:26
  Speaker 2: Not enough calories, not too many mostly whole foods, et cetera.
• 1:08:30
  Speaker 2: Enough vegetables, fruits, and high quality protein and quality fats.
• 1:08:37
  Speaker 2: I think the reason why supplements still become enticing to me,
• 1:08:41
  Speaker 2: maybe even necessary, is because you can take them every
• 1:08:43
  Speaker 2: day very easily, so you can make sure that you're
• 1:08:47
  Speaker 2: in range and maybe above range. So let's take one
• 1:08:52
  Speaker 2: of these things, okay, Omega three fatty acids. I believe
• 1:08:56
  Speaker 2: that the data are pretty compelling. They can be helpful
• 1:08:59
  Speaker 2: for health and rain health. Certainly, I believe that. But
• 1:09:03
  Speaker 2: let's say the early part of my week is Omega
• 1:09:06
  Speaker 2: three rich, and the later part of my week is
• 1:09:08
  Speaker 2: omega three poor, Am I good? Versus you know, spreading
• 1:09:13
  Speaker 2: it out across the week, it just becomes difficult to
• 1:09:15
  Speaker 2: eat in a truly healthy way. If if it's the
• 1:09:19
  Speaker 2: case that it has to be consistent in every twenty
• 1:09:22
  Speaker 2: four hours, so what do we know?
• 1:09:24
  Speaker 1: So again, I think we're often tempted to overcomplicate this
• 1:09:29
  Speaker 1: and try and think, oh, you know, I have to
• 1:09:32
  Speaker 1: hit all these things at this interval, and if I
• 1:09:35
  Speaker 1: can't do that, then I have to supplement. And in reality,
• 1:09:40
  Speaker 1: we probably have more buffer in the system than we realize.
• 1:09:43
  Speaker 1: So Omega three fats is a really good example. Your
• 1:09:48
  Speaker 1: adipose tissue, your fat tissue is a depot, you know,
• 1:09:52
  Speaker 1: it kind of stores excess and Mega three's Actually I
• 1:09:55
  Speaker 1: wrote a paper on this with a colleague of mine,
• 1:09:57
  Speaker 1: Rory Heath, a few years ago. The long chain of
• 1:10:00
  Speaker 1: Mega threes that we have in our fat stores may
• 1:10:04
  Speaker 1: help to explain why supplementation does or doesn't work in
• 1:10:08
  Speaker 1: some of these trials, because some people just have more
• 1:10:11
  Speaker 1: kind of hanging around and if you eat more than
• 1:10:13
  Speaker 1: you need on one day, especially in a state of
• 1:10:17
  Speaker 1: caloric excess, that's going to be stored in your fat tissue,
• 1:10:20
  Speaker 1: and then when you're sleeping or when you initiate like polysis,
• 1:10:25
  Speaker 1: the breakdown of fat, so particularly during periods like you're
• 1:10:28
  Speaker 1: doing exercise, those then get released and they know the
• 1:10:31
  Speaker 1: brain then has access to them. So there's some studies
• 1:10:33
  Speaker 1: that show that when you this relates to the form
• 1:10:37
  Speaker 1: of the Mega threes as well. So many people will
• 1:10:40
  Speaker 1: tell you that you have to take a Mega three
• 1:10:41
  Speaker 1: is in the phospholipid form, which is like a special
• 1:10:44
  Speaker 1: it's a special supplement. You can get it from Krill.
• 1:10:49
  Speaker 1: And the form is that the fat is attached to
• 1:10:53
  Speaker 1: like a phospholipid head group, just like it would be
• 1:10:55
  Speaker 1: if it was sitting in a cell membrane, and there's
• 1:10:57
  Speaker 1: a specific pathway for those to get into the brain.
• 1:11:01
  Speaker 2: It's only Kriller's fish oil, So.
• 1:11:03
  Speaker 1: Fish tends to be the triglyceride form, which is your glyceroole,
• 1:11:07
  Speaker 1: and then three fasciassas attached.
• 1:11:10
  Speaker 3: When you compare a.
• 1:11:11
  Speaker 1: Single dose of phospholipid versus triglyceride form, then more of
• 1:11:16
  Speaker 1: the phosphlipid form gets into the brain.
• 1:11:17
  Speaker 3: Some of this. Most of this comes from rodent studies.
• 1:11:20
  Speaker 3: But what's interesting.
• 1:11:22
  Speaker 1: Is that if you supplement over several days, it all
• 1:11:24
  Speaker 1: kind of comes out in the wash because the triglyceride
• 1:11:27
  Speaker 1: form cycles through the adipose tissue as a depot, and
• 1:11:31
  Speaker 1: then it gets released and the brain can then use it.
• 1:11:33
  Speaker 1: So if you're going to take just one day of
• 1:11:36
  Speaker 1: supplement and you want to get as much of that
• 1:11:38
  Speaker 1: omega three in your brain, yes you should take the
• 1:11:40
  Speaker 1: we think we should should take the phosphilipid form. But
• 1:11:43
  Speaker 1: the form that comes in seafood, which is primarily the
• 1:11:46
  Speaker 1: trigusride form, is regulated through the body's fat stores. So
• 1:11:50
  Speaker 1: this is a really long way of me telling you
• 1:11:52
  Speaker 1: if you eat some fish early in the week, you
• 1:11:54
  Speaker 1: don't then have to supplement later in the week, as
• 1:11:56
  Speaker 1: long as you got kind of enough, and especially if
• 1:11:59
  Speaker 1: you've can sistently eat and seafood across your entire life,
• 1:12:01
  Speaker 1: because you probably have a bit of a depot.
• 1:12:04
  Speaker 3: And so what you see in.
• 1:12:06
  Speaker 1: Several trials where they've given omega threes to decrease dementia
• 1:12:13
  Speaker 1: risk or improve cognitive function. So many studies like that
• 1:12:17
  Speaker 1: have been done, there was actually a very recent one
• 1:12:18
  Speaker 1: that just came out of USC where they gave mega
• 1:12:21
  Speaker 1: three's for a long period of time.
• 1:12:23
  Speaker 3: They measured a mega three.
• 1:12:24
  Speaker 1: Levels in the CSF right, the spinal flui of these people,
• 1:12:27
  Speaker 1: to show that this the omega threees were getting into
• 1:12:29
  Speaker 1: the brain. They didn't see any changes in terms of
• 1:12:32
  Speaker 1: cognitive function or brain structure or an MRI scan, So
• 1:12:35
  Speaker 1: that everybody's.
• 1:12:36
  Speaker 3: Like, well, a mega three is don't work.
• 1:12:38
  Speaker 1: But when you kind of squint at the data, and
• 1:12:40
  Speaker 1: they didn't quite give me the data that I wanted.
• 1:12:43
  Speaker 1: But when you look at it, those the people in
• 1:12:45
  Speaker 1: the chrial just didn't seem that a mega three deficient
• 1:12:48
  Speaker 1: in the first place.
• 1:12:48
  Speaker 3: So, right, if this isn't.
• 1:12:50
  Speaker 1: Something that you need more of to start with, giving
• 1:12:53
  Speaker 1: a load more of it isn't going to make that
• 1:12:55
  Speaker 1: much of a difference, right, And this is the case
• 1:12:58
  Speaker 1: for all of these different supplements. So the best advice,
• 1:13:02
  Speaker 1: if you have access to it, is to test your levels.
• 1:13:04
  Speaker 1: Test your vitamin D levels, test your hemoglobin and iron levels,
• 1:13:08
  Speaker 1: test your Mega three levels, test your homocystine levels, which
• 1:13:10
  Speaker 1: is as a marker of a B vitamin stasis, which
• 1:13:12
  Speaker 1: we know is a risk factor for cogitan declined dementia
• 1:13:16
  Speaker 1: as well. So if if you can test your levels
• 1:13:20
  Speaker 1: and it shows that you need more, and yes there
• 1:13:23
  Speaker 1: are the normal ranges that you have on a blood
• 1:13:26
  Speaker 1: tests are not necessarily the same as the risk ranges.
• 1:13:29
  Speaker 1: So homocystine is a good example a normal range for
• 1:13:33
  Speaker 1: homocysteine which goes up if you need some of these
• 1:13:36
  Speaker 1: methylation dependent B vitamins. The normal range might go up
• 1:13:40
  Speaker 1: to like fifteen or sixteen. But we know that risk
• 1:13:43
  Speaker 1: is definitely elevated above thirteen and is probably elevated above
• 1:13:46
  Speaker 1: sort of ten to eleven. So what your target range
• 1:13:51
  Speaker 1: really might be is probably lower than what the normal
• 1:13:53
  Speaker 1: range might be. But we have very good evidence that
• 1:13:57
  Speaker 1: if you then supplement when somebody is above that range
• 1:14:00
  Speaker 1: and you bring that down, you see significant improvements in
• 1:14:04
  Speaker 1: cognitive function or slowed cognitive declinent. That is particularly the
• 1:14:08
  Speaker 1: case for omega three's and B vitamins that lower homo systeine.
• 1:14:12
  Speaker 1: And so this is the interactions that you were talking
• 1:14:14
  Speaker 1: about earlier, and this is the best one that we
• 1:14:15
  Speaker 1: know of, although I'm sure there are many more. Like
• 1:14:18
  Speaker 1: I said, there are lots of trials that have given
• 1:14:21
  Speaker 1: omega three's or have given B vitamins to lower homo
• 1:14:24
  Speaker 1: systeine and just haven't seen much of an effect.
• 1:14:26
  Speaker 3: And everbodys ah, well they don't work.
• 1:14:28
  Speaker 1: But there are now at least three randomized controlled trials
• 1:14:31
  Speaker 1: that have shown that omega three status and BE vitamin
• 1:14:34
  Speaker 1: status interact and they're dependent on one another. So if
• 1:14:37
  Speaker 1: you give B vitamins to somebody who has elevated homo systeine,
• 1:14:41
  Speaker 1: you bring down their homo systeine, but they have poor
• 1:14:43
  Speaker 1: Omega three levels, you don't see any benefit. And that's
• 1:14:46
  Speaker 1: been shown in two trials. It was originally shown in
• 1:14:48
  Speaker 1: the VITACOG trial that was run out of the University
• 1:14:50
  Speaker 1: of Oxford. It was then replicated in the b proof trial.
• 1:14:55
  Speaker 1: Then the other side has also been shown. There was
• 1:14:57
  Speaker 1: a in the omega AD trial. They show that supplementing
• 1:15:01
  Speaker 1: with the mega threes didn't result in any benefit if
• 1:15:03
  Speaker 1: people had elevated term as system. So that's just one example,
• 1:15:08
  Speaker 1: and you could imagine, like you kind of said, there
• 1:15:09
  Speaker 1: are probably lots of these and if we're not going
• 1:15:12
  Speaker 1: into a study actually looking like, well, what nutrients does
• 1:15:16
  Speaker 1: this person need and then supplementing with them, you're.
• 1:15:21
  Speaker 3: Not going to find any effect.
• 1:15:22
  Speaker 1: Like you shouldn't be surprised when there's a when when
• 1:15:25
  Speaker 1: the study doesn't show anything potentially.
• 1:15:27
  Speaker 3: The one recent example of kind of.
• 1:15:36
  Speaker 1: Just giving a broad based, kind of set of nutrients,
• 1:15:39
  Speaker 1: so with a multi vitamin that seemed to work fairly
• 1:15:41
  Speaker 1: well was the Cosmos study people may have heard of.
• 1:15:44
  Speaker 1: It was thousands of people of older adults and they
• 1:15:48
  Speaker 1: were given either a multi vitamin or a flavoroid supplement,
• 1:15:51
  Speaker 1: like a centrum type vitamin.
• 1:15:52
  Speaker 2: It was.
• 1:15:52
  Speaker 1: It was centrum silver, like the most basic multi vitamin,
• 1:15:56
  Speaker 1: just one hundred percent of the recommended daily allowance, not
• 1:15:59
  Speaker 1: like no mold, no like massive doses of anything. And
• 1:16:02
  Speaker 1: in that study, those who got the multivitamin saw changes
• 1:16:06
  Speaker 1: in cognitive function that suggested some like some improvements. But
• 1:16:11
  Speaker 1: that was literally just covering the bases, right, no massive doses,
• 1:16:14
  Speaker 1: the most basic multivitamin. So in the kind of general population,
• 1:16:19
  Speaker 1: I think you could say that something like that is
• 1:16:21
  Speaker 1: probably a reasonable strategy. But what they also showed was
• 1:16:24
  Speaker 1: that supplementing with this antioxidant cocoa flavonol was only beneficial
• 1:16:29
  Speaker 1: in those who tended to have a poor quality diet
• 1:16:31
  Speaker 1: to start with, right, So they just weren't getting many
• 1:16:33
  Speaker 1: of these kind of compounds for their diet. If you're
• 1:16:35
  Speaker 1: drinking a lot of coffee and a lot of berries,
• 1:16:37
  Speaker 1: seeing a lot of fruits and vegetables, you probably don't
• 1:16:39
  Speaker 1: need it because you're already getting it.
• 1:16:41
  Speaker 2: I'd like to take a quick break and acknowledge our sponsor, Function.
• 1:16:45
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• 1:16:48
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• 1:16:54
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• 1:17:17
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• 1:17:24
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• 1:17:27
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• 1:17:33
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• 1:17:35
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• 1:17:37
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• 1:17:39
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• 1:17:41
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• 1:17:45
  Speaker 2: to spend thousands of dollars per year trying to get
• 1:17:47
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• 1:17:50
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• 1:18:01
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• 1:18:04
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  Speaker 2: that's functionhealth dot com slash Huberman. Thank you for that clarification.
• 1:18:21
  Speaker 2: I look forward to a day, hopefully not long from now,
• 1:18:23
  Speaker 2: where people get their blood work done, they are told
• 1:18:30
  Speaker 2: and they decide it's a collaboration after all, which supplements
• 1:18:35
  Speaker 2: to take. Ideally those supplements are tailored to them so
• 1:18:39
  Speaker 2: it's not gazillion tablets and capsules, and then they can
• 1:18:43
  Speaker 2: redo their blood work and see whether or not things
• 1:18:45
  Speaker 2: come into range. And of course that should be measured
• 1:18:47
  Speaker 2: against subjective experience of well being and sleep and all
• 1:18:52
  Speaker 2: of that. That's not hard to do in today's environment
• 1:18:55
  Speaker 2: of technology and trackers and blood testing. It's just that
• 1:18:59
  Speaker 2: we're a little bit in the still in the nineties.
• 1:19:03
  Speaker 2: Even just the way that most people talk about supplements.
• 1:19:06
  Speaker 2: Certainly not you, but I think when people hear supplements
• 1:19:08
  Speaker 2: and they go, oh, it's expensive urine. Okay, that's vitamin minerals.
• 1:19:11
  Speaker 2: Maybe some of that is just getting a urinated out.
• 1:19:13
  Speaker 2: But then there's food replacement supplementation, and then there's supplements
• 1:19:17
  Speaker 2: to get a specific desired effect like speed up the
• 1:19:20
  Speaker 2: transition time to sleep, get more slow wave sleep, more focus,
• 1:19:24
  Speaker 2: et cetera. So it's unfortunate that we don't have good
• 1:19:27
  Speaker 2: nomenclature like we do in science, where words are very
• 1:19:31
  Speaker 2: important so that people can communicate with accuracy. And I
• 1:19:35
  Speaker 2: also wonder whether, okay, if you know one gram of
• 1:19:40
  Speaker 2: omega three epa per day is good, but maybe three
• 1:19:46
  Speaker 2: is better. Even though I'm at you know, upper range,
• 1:19:50
  Speaker 2: upper reference range, and this is something that like nobody
• 1:19:53
  Speaker 2: really wants to address because then it sounds like quote
• 1:19:59
  Speaker 2: unquote biohacking. But ultimately, I think people want to feel good,
• 1:20:02
  Speaker 2: they want to live longer. No one wants to do
• 1:20:04
  Speaker 2: anything dangerous. I feel like we're really like in the
• 1:20:07
  Speaker 2: in like prehistoric times, with how we think, how most
• 1:20:10
  Speaker 2: people think about nutrition and supplementation. I feel like the
• 1:20:13
  Speaker 2: last forty years have been spent mostly focusing on what's
• 1:20:16
  Speaker 2: bad for us O get transfats bad, fried food's bad,
• 1:20:19
  Speaker 2: eating too much bad, right, energy over energy, toxicity bad,
• 1:20:25
  Speaker 2: too much alcohol bad. Zero is better than anybody. You
• 1:20:27
  Speaker 2: could probably drink a little bit and be fine. Okay,
• 1:20:29
  Speaker 2: if you're gonna take nicotine, don't smoke it or vapor
• 1:20:32
  Speaker 2: or different, Like we sort of figured it out, right,
• 1:20:34
  Speaker 2: don't hit your head. If you do, don't hit it twice,
• 1:20:38
  Speaker 2: you know, like we've sort of been spending so much
• 1:20:40
  Speaker 2: time on the don'ts. Then now I feel like we're
• 1:20:42
  Speaker 2: in this exciting time of what can you do for
• 1:20:45
  Speaker 2: one's health? And then there's this divide, right, to see
• 1:20:48
  Speaker 2: whole foods. You'll be fine, and you've actually convinced me
• 1:20:51
  Speaker 2: that will be fine. The question is could I be
• 1:20:53
  Speaker 2: that much better?
• 1:20:55
  Speaker 1: This is really interesting to me because there's there's two
• 1:20:58
  Speaker 1: different parts to it potentially, although you know they may
• 1:21:01
  Speaker 1: end up being the same thing. So one is if
• 1:21:04
  Speaker 1: we're thinking about if we're thinking broadly about improving brain health,
• 1:21:10
  Speaker 1: cognition at the population level, what's really important is kind
• 1:21:15
  Speaker 1: of raising the floor, like what is going to work
• 1:21:19
  Speaker 1: for everybody and get most of us most of the
• 1:21:21
  Speaker 1: way there. So like that really is improving food quality.
• 1:21:27
  Speaker 1: And then you know access to those foods as well, right,
• 1:21:29
  Speaker 1: because that's different. You know that can be very inequitable,
• 1:21:32
  Speaker 1: like can people afford it, do they know how to
• 1:21:34
  Speaker 1: cook it?
• 1:21:35
  Speaker 3: Can you know? Can they access it?
• 1:21:37
  Speaker 1: And then within that, I think we also know we
• 1:21:40
  Speaker 1: have very good evidence for cutoffs that predict risk. And
• 1:21:43
  Speaker 1: if you can't get those nutrients from food, I think
• 1:21:47
  Speaker 1: we should supplement. I think I like to call nutrients
• 1:21:50
  Speaker 1: like the great leveler of like there's no point in
• 1:21:53
  Speaker 1: arguing about different diets because your body requires these nutrients
• 1:21:57
  Speaker 1: and like I don't care where you get them from
• 1:21:58
  Speaker 1: as long as you get them, right, So if you
• 1:21:59
  Speaker 1: need to get them from supplements, I think that's fine.
• 1:22:01
  Speaker 3: That should be fine.
• 1:22:03
  Speaker 1: When you then get kind of to the next level,
• 1:22:06
  Speaker 1: like how much further can we push function? My answer
• 1:22:10
  Speaker 1: is I genuinely don't know. Like when you say, like,
• 1:22:13
  Speaker 1: you know, if I put so, if I test my
• 1:22:14
  Speaker 1: mega three and your mega three index, right, you said
• 1:22:17
  Speaker 1: it was the kind of the higher level. Maybe it's
• 1:22:19
  Speaker 1: seven or eight or something like that, all right, if
• 1:22:21
  Speaker 1: you push it to twelve, is that better?
• 1:22:23
  Speaker 3: I genuinely genuinely don't know.
• 1:22:26
  Speaker 1: Like some of these more complex AI systems data collection
• 1:22:31
  Speaker 1: kind of seeing how you then respond to individuals. As
• 1:22:34
  Speaker 1: long as you can perform your own sort of like
• 1:22:36
  Speaker 1: personal experiments, right, as much as you can hold one
• 1:22:39
  Speaker 1: variable constant have some meaningful output that you can kind
• 1:22:43
  Speaker 1: of track over time see whether it works or not.
• 1:22:46
  Speaker 1: Can we then aggregate those data to kind of better
• 1:22:48
  Speaker 1: understand this. I'm excited to see where that goes. I
• 1:22:51
  Speaker 1: will say that the best evidence we have just says,
• 1:22:55
  Speaker 1: in reality, don't be deficient. If you can reach that
• 1:22:57
  Speaker 1: threshold of not being deficient or insufficient, maybe that's enough.
• 1:23:01
  Speaker 1: I'm hopeful that that's the case. Right, because then more
• 1:23:04
  Speaker 1: people will get to that point more and more easily.
• 1:23:07
  Speaker 1: But you know, there's there's a lot that we have
• 1:23:09
  Speaker 1: to learn there.
• 1:23:10
  Speaker 2: There was a time in the nineties and two thousands
• 1:23:14
  Speaker 2: where people would take stuff and do stuff. I'm not
• 1:23:18
  Speaker 2: talking about anabolic steroids, although that was happening too, And
• 1:23:22
  Speaker 2: the whole idea was find things that work, perform really
• 1:23:27
  Speaker 2: well in one's job or in one's sport, assuming you're
• 1:23:31
  Speaker 2: not breaking any rules, right, but not tell anyone you
• 1:23:34
  Speaker 2: were doing. And what changed, I think we're two things.
• 1:23:38
  Speaker 2: One is there became a market value for telling people
• 1:23:42
  Speaker 2: what one does in order to make money, so people
• 1:23:45
  Speaker 2: started doing that, and I do believe sharing is good, right.
• 1:23:49
  Speaker 2: But also there's this problem that goes with that, is
• 1:23:52
  Speaker 2: that people who sit on the outside of kind of
• 1:23:55
  Speaker 2: brain and sports performance or just life just trying to
• 1:23:58
  Speaker 2: maintain memory and do well in school and be a
• 1:24:01
  Speaker 2: busy person and still get sleep and all of that,
• 1:24:04
  Speaker 2: feel like, oh, you know, we're being sold this one
• 1:24:07
  Speaker 2: thing that's supposed to make all the difference. And I
• 1:24:09
  Speaker 2: think the thing that really came in and changed all
• 1:24:11
  Speaker 2: of it are the glps. I've never taken a JLP,
• 1:24:15
  Speaker 2: but I'm just struck by, like Americans are now willing
• 1:24:17
  Speaker 2: to inject themselves. So now it opens up this whole
• 1:24:19
  Speaker 2: thing about peptides, which you know, the major consumers of
• 1:24:23
  Speaker 2: peptides are not the bro science guys like the Jim bros.
• 1:24:26
  Speaker 2: It's women who look, I have female family members right
• 1:24:31
  Speaker 2: who have and they'll tell you me. And there's a
• 1:24:36
  Speaker 2: long history of people doing and taking things and doing
• 1:24:38
  Speaker 2: things for their cosmetic appearance and not necessarily sharing it
• 1:24:41
  Speaker 2: with the world. So these are the performance enhancing substances
• 1:24:47
  Speaker 2: of a whole different kind, right, And so how is
• 1:24:51
  Speaker 2: it that this peptide industry is so intriguing so many
• 1:24:53
  Speaker 2: people that yeah, like jabbing yourself with something that is
• 1:24:56
  Speaker 2: not FDA approved, Like people are doing it like crazy,
• 1:24:59
  Speaker 2: even people who are kind of cautious about what they'll
• 1:25:02
  Speaker 2: do and put into their body. Because of this bridge
• 1:25:05
  Speaker 2: that the glps have made, it's so much easier now
• 1:25:07
  Speaker 2: to just people aren't as needlephobic. So I think we're
• 1:25:11
  Speaker 2: entering a time now where people are saying, Okay, you
• 1:25:13
  Speaker 2: know what the government, the food pyramid, whatever, the food quadrants, like, yeah,
• 1:25:20
  Speaker 2: that's just like if you don't want to die. But
• 1:25:22
  Speaker 2: I want to feel great, And there's actually this potential
• 1:25:25
  Speaker 2: that you and others are sort of offering, like you
• 1:25:27
  Speaker 2: can learn things into your older age, you can be
• 1:25:30
  Speaker 2: lean and have great posture into your sixties, seventies, eighties,
• 1:25:33
  Speaker 2: and nineties. We see examples of this. So I think
• 1:25:35
  Speaker 2: that there's this pull we're getting kind of pulled forward
• 1:25:37
  Speaker 2: towards this promise. And I don't think that promise is
• 1:25:40
  Speaker 2: all about avoiding the bad stuff. And people say, oh, yeah, well,
• 1:25:44
  Speaker 2: my grandfather lived to be one hundred and two and
• 1:25:46
  Speaker 2: he was smoking every great like awesome, But a lot
• 1:25:49
  Speaker 2: of people don't have those kinds of genetics in their family,
• 1:25:52
  Speaker 2: they really and genetics play a big role. So I'm
• 1:25:54
  Speaker 2: kind of editorializing here. I'd love your thoughts on how
• 1:25:57
  Speaker 2: you sort of sit back and you look at the
• 1:25:58
  Speaker 2: landscape of things, eat right, exercise, get good sleep, socialize
• 1:26:03
  Speaker 2: is awesome, but that is just that is difficult for people.
• 1:26:07
  Speaker 2: That puts people into a clutch state, just trying to
• 1:26:10
  Speaker 2: do that while managing family and profession and cost of life,
• 1:26:14
  Speaker 2: you know, the cost of living. That's a lot. So
• 1:26:17
  Speaker 2: I think people do want something that gives them more energy,
• 1:26:19
  Speaker 2: gives them better sleep, you know, picks up their mood,
• 1:26:22
  Speaker 2: you know. And I don't think there's anything wrong with
• 1:26:25
  Speaker 2: thinking about those things as long as it feeds back
• 1:26:27
  Speaker 2: to better behaviors.
• 1:26:28
  Speaker 1: Particularly when I think about this kind of this new
• 1:26:32
  Speaker 1: part of the of the supplement in the industry, And
• 1:26:35
  Speaker 1: like you said, the peptides are just the next then
• 1:26:40
  Speaker 1: the next iteration of the pills and potions, that they.
• 1:26:42
  Speaker 2: Are supplements more than drugs, because look, there's no putting
• 1:26:47
  Speaker 2: the genie back in the bottle. I don't care what
• 1:26:49
  Speaker 2: the FDA does, and they can mark my words. People
• 1:26:51
  Speaker 2: are going to find their way to get their peptides
• 1:26:53
  Speaker 2: because they love them. And most people are not playing
• 1:26:57
  Speaker 2: a drug tested sport. And there may be adverse events
• 1:27:01
  Speaker 2: out there, and this isn't a plug for peptides per se,
• 1:27:04
  Speaker 2: But where are all these adverse events that are not
• 1:27:06
  Speaker 2: from botched injections or from really bad black market sources.
• 1:27:10
  Speaker 2: Where are all the roid rages of peptides? Where are
• 1:27:14
  Speaker 2: all the like I think you can see way more
• 1:27:17
  Speaker 2: plastic surgery, like like whoa that looks bad kind of
• 1:27:21
  Speaker 2: things in it, Like okay, milanna tan is kind of
• 1:27:23
  Speaker 2: an issue because people can really mess themselves up there,
• 1:27:26
  Speaker 2: But where are all the adverse events Until people start
• 1:27:30
  Speaker 2: dropping dead from BPC injections. People are going to get
• 1:27:33
  Speaker 2: and they're going to take their BPC.
• 1:27:35
  Speaker 1: I'll admit I'm more conservative when you're trying a new
• 1:27:39
  Speaker 1: supplement or peptide. I'm going to include peptides into this,
• 1:27:44
  Speaker 1: but of course it could be a pill or whatever.
• 1:27:46
  Speaker 1: Some peptides come as pills. I would want some reasonably
• 1:27:49
  Speaker 1: good evidence of efficacy that this is going to work
• 1:27:53
  Speaker 1: in humans like me. That's probably not a bar that
• 1:27:58
  Speaker 1: most of these things are going to hit anytime soon.
• 1:28:01
  Speaker 2: People don't care. I mean, people who who have no
• 1:28:05
  Speaker 2: interest in walking into a gym are contacting me like crazy.
• 1:28:09
  Speaker 2: These are adults who have kids, they love, spouses, they love.
• 1:28:12
  Speaker 2: They are not medicine phobic like traditional medicine phobic, and
• 1:28:17
  Speaker 2: they're like, should I be taking low dos? Should I
• 1:28:19
  Speaker 2: be microdos incter, zeppetite or rditrue Tide. I'm like red
• 1:28:21
  Speaker 2: True Tie is not even released yet. They're like, where
• 1:28:23
  Speaker 2: can I get it? Like are you kidding me? You know,
• 1:28:25
  Speaker 2: but it's it's incredible what's happened in the last few years.
• 1:28:29
  Speaker 1: So we think about what might what you might think
• 1:28:33
  Speaker 1: about if you're going to start to consider one of these,
• 1:28:39
  Speaker 1: First of all, I would want to see evidence that
• 1:28:41
  Speaker 1: it works.
• 1:28:42
  Speaker 3: The majority of peptides.
• 1:28:43
  Speaker 1: Don't have good quality evidence in humans. Accept the gop
• 1:28:47
  Speaker 1: ones right, they're on the.
• 1:28:48
  Speaker 2: Market, and the growth hormone secretagogues, but for reasons other
• 1:28:51
  Speaker 2: than people are.
• 1:28:52
  Speaker 1: Taking yeah soccopenia, you know other and with the most
• 1:28:58
  Speaker 1: of those growth on screensgogs come with a risk of
• 1:29:01
  Speaker 1: instant resistance diabetes at high particularly higher dice es.
• 1:29:05
  Speaker 2: They're not the super popular ones. I think the super
• 1:29:06
  Speaker 2: popular ones are besides the glps and retitude tide is
• 1:29:10
  Speaker 2: a GLP and other things. But I would say microdosing
• 1:29:14
  Speaker 2: a retitude tide inter zeppatide one category for weight loss
• 1:29:18
  Speaker 2: fat loss, I would say BPC one five seven. People
• 1:29:21
  Speaker 2: are taking it without even knowing what the desired effect is.
• 1:29:25
  Speaker 2: Recovery is really broad. I think it's injury repair. That's
• 1:29:29
  Speaker 2: the thesis. No human evidence as far as no good
• 1:29:32
  Speaker 2: human evidence. And then there are these other kind of
• 1:29:34
  Speaker 2: dot dot dot ones. I would say g HK, copper
• 1:29:38
  Speaker 2: or skin appearance. Those are the three biggies that seem
• 1:29:45
  Speaker 2: and the last one in particular with women.
• 1:29:47
  Speaker 1: So I would want evidence that in humans it does
• 1:29:50
  Speaker 1: what I want it to do. Most of those, if
• 1:29:52
  Speaker 1: not all of them, except for the GP ones, don't
• 1:29:55
  Speaker 1: don't have that evidence or for the thing that you're
• 1:29:58
  Speaker 1: you're trying to get, right, But beyond that a question
• 1:30:03
  Speaker 1: that you have to ask. And I like this reframing
• 1:30:08
  Speaker 1: I heard it. I heard it recently from Jeffrey Bland,
• 1:30:11
  Speaker 1: which is that if you're going to consider injecting or
• 1:30:13
  Speaker 1: taking something, the first thing you should want to know
• 1:30:16
  Speaker 1: is is this safe?
• 1:30:17
  Speaker 3: Right?
• 1:30:18
  Speaker 1: If you have good safety data, then trying it is
• 1:30:21
  Speaker 1: low risk, right, even if it doesn't work, right, at
• 1:30:25
  Speaker 1: least you know it's not dangerous. But we don't even
• 1:30:28
  Speaker 1: have that for most of these No, we.
• 1:30:30
  Speaker 2: Just have the absence of documented adverse effects. Yeah, and
• 1:30:33
  Speaker 2: in the time course that they've been used, because we
• 1:30:35
  Speaker 2: don't know about long term use.
• 1:30:37
  Speaker 1: And so everybody has their own risk tolerance. Everybody is
• 1:30:41
  Speaker 1: welcome to do whatever whatever they want, of course, but
• 1:30:44
  Speaker 1: for me personally, first I would want documented evidence of safety.
• 1:30:49
  Speaker 1: And then you can say, well, I'm willing to try
• 1:30:53
  Speaker 1: it because you know it may or may not do
• 1:30:55
  Speaker 1: this thing, but you should also have a specific problem
• 1:30:57
  Speaker 1: that you're trying to solve, right, Otherwise why would you
• 1:30:59
  Speaker 1: bother taking it? But it's also the case for the
• 1:31:00
  Speaker 1: vast majority of supplements that are out there and have
• 1:31:02
  Speaker 1: been around for long periods of time. Is first of all,
• 1:31:04
  Speaker 1: we don't have good evidence of long term safety at
• 1:31:07
  Speaker 1: whatever dose that you're taking. And then second of all,
• 1:31:09
  Speaker 1: we don't know whether it works for.
• 1:31:11
  Speaker 2: Something we do like creatine. Oh ye, Mega three is magnesium.
• 1:31:15
  Speaker 1: And creatine is actually the best So like omega three is,
• 1:31:18
  Speaker 1: we know that there are critical nutrient. Creatine, I think
• 1:31:21
  Speaker 1: is the best example because we know it's very safe. Right,
• 1:31:24
  Speaker 1: So even though there's this idea of creatine responders and
• 1:31:27
  Speaker 1: non responders, you know, maybe it's going to be useful
• 1:31:31
  Speaker 1: to improve or support cognition for some people or not others,
• 1:31:35
  Speaker 1: may improve physical performance for some people or not others.
• 1:31:37
  Speaker 1: At least we know that you can give high doses
• 1:31:40
  Speaker 1: of creatine to frail, older individuals with essentially no side effects.
• 1:31:45
  Speaker 3: Right.
• 1:31:45
  Speaker 1: We know it's very safe, so then you can try
• 1:31:47
  Speaker 1: it and see if it benefits you. So creatine is
• 1:31:49
  Speaker 1: a great example, but there aren't that many others that
• 1:31:52
  Speaker 1: kind of fit into that category.
• 1:31:54
  Speaker 2: Interesting times, again, I go back to I love the
• 1:31:57
  Speaker 2: idea of blood testing tailor tailor supplementation to the needs
• 1:32:01
  Speaker 2: of the individual retesting, so people can be really objective
• 1:32:04
  Speaker 2: about whether their levels are moving in the right or
• 1:32:06
  Speaker 2: wrong direction subjective experience. The sleep supplementation thing is kind
• 1:32:11
  Speaker 2: of interesting because either people feel it improves their sleep
• 1:32:13
  Speaker 2: or it doesn't, even if it's a placebo effect, which
• 1:32:16
  Speaker 2: in some cases it could be. With sleep tracking, people
• 1:32:20
  Speaker 2: can see are they getting more rim or are they
• 1:32:21
  Speaker 2: getting more slow wave sleep? Such a fascinating area. I mean,
• 1:32:27
  Speaker 2: as you and I both know, there's no plasticity pill,
• 1:32:30
  Speaker 2: but arousal, alertness focus seems to be a prerequisite of plasticity,
• 1:32:38
  Speaker 2: which is why things like caffeine and stimulants and al
• 1:32:41
  Speaker 2: tyrascene in all these things that you can find some
• 1:32:43
  Speaker 2: evidence for them improving plasticity, but it's very likely to
• 1:32:48
  Speaker 2: be indirect, right. It's not that they make you learn,
• 1:32:52
  Speaker 2: they set the stage for learning. It seems to always
• 1:32:54
  Speaker 2: get back to arousal. So this is what I want
• 1:32:56
  Speaker 2: to get back to. Exercise as a tool for opening
• 1:32:59
  Speaker 2: the window for plasticity. Could it be that it's simply
• 1:33:04
  Speaker 2: a matter of moving your body to get enough adrenaline
• 1:33:09
  Speaker 2: in your body or epeneffrin in the brain, and maybe
• 1:33:11
  Speaker 2: some dopamine as well, so that the stage is set
• 1:33:13
  Speaker 2: for plasticity. And it doesn't matter whether you jump rope,
• 1:33:17
  Speaker 2: do jumping jacks, sprint, or do deadlifts. It's all about
• 1:33:22
  Speaker 2: getting your brain into an altered, admittedly endogenous, chemical altered
• 1:33:28
  Speaker 2: state of just more arousal and then boom you can
• 1:33:30
  Speaker 2: go learn. I mean, could it.
• 1:33:32
  Speaker 1: Just be that before we get into the x scise,
• 1:33:35
  Speaker 1: there's an interesting part with the supplements that increase arousal, Right,
• 1:33:39
  Speaker 1: so the stimulants in particular. And I am a big
• 1:33:44
  Speaker 1: proponent of thinking about all tracking how somebody feels, right,
• 1:33:50
  Speaker 1: I think that how you feel is this kind of
• 1:33:53
  Speaker 1: ultimate integration of all these inputs and outputs that the
• 1:33:55
  Speaker 1: brain is kind of bringing together, right, And we know
• 1:33:58
  Speaker 1: that how you feel, so how an athlete feels is
• 1:34:01
  Speaker 1: a much better predictor of their performance than their HRV
• 1:34:04
  Speaker 1: or any of their blood tests.
• 1:34:05
  Speaker 2: And you ask, and I'm like, how good do you
• 1:34:07
  Speaker 2: feel today?
• 1:34:08
  Speaker 3: Yeah?
• 1:34:08
  Speaker 2: On one to ten some some versions, and I feel
• 1:34:10
  Speaker 2: like I can conquer the world.
• 1:34:11
  Speaker 1: One I feel like exactly, you know, and you can
• 1:34:15
  Speaker 1: boil it down or I mean, you can spread it
• 1:34:18
  Speaker 1: out to many more questions. So there's there's a question
• 1:34:20
  Speaker 1: there called the rest cue, which is all about like
• 1:34:22
  Speaker 1: how you recovered, how recovered you feel, how motivated you
• 1:34:25
  Speaker 1: feel to train or perform that kind of stuff. But
• 1:34:27
  Speaker 1: essentially it boils down to how good you feel. If
• 1:34:30
  Speaker 1: you feel good, you're more like to perform well, and
• 1:34:33
  Speaker 1: that works better than the vast majority of data that
• 1:34:36
  Speaker 1: you biological physiological data you can collect. There are papers
• 1:34:39
  Speaker 1: that come out of this every year that essentially show
• 1:34:42
  Speaker 1: the same thing.
• 1:34:42
  Speaker 2: That's kind of cool, yeah, because mindset is my college
• 1:34:46
  Speaker 2: Galley Chrome has focused on so much like mindset can
• 1:34:49
  Speaker 2: be you can be honest with yourself and you can
• 1:34:53
  Speaker 2: lie to yourself and tell yourself like, Okay, you got
• 1:34:55
  Speaker 2: allows your sleep score, but like I feel good, yeah,
• 1:34:59
  Speaker 2: or you know, maybe sleep scores are like they mean something,
• 1:35:02
  Speaker 2: but today you know, right, I mean, and it can work, right,
• 1:35:07
  Speaker 2: I mean in terms of performance?
• 1:35:09
  Speaker 1: Yeah, and so absolutely right. Then that gets into the
• 1:35:12
  Speaker 1: like the nocebo effect of how we think about either
• 1:35:16
  Speaker 1: our sleep data or these other things, right, that can
• 1:35:18
  Speaker 1: negatively impact our performance. And we have good, good studies
• 1:35:21
  Speaker 1: that show that as well. So I think that like
• 1:35:24
  Speaker 1: tracking how you feel is really important, but when it
• 1:35:27
  Speaker 1: comes to stimulants in particular, they see they seem to
• 1:35:31
  Speaker 1: dissociate how we feel versus how we perform. Right, So,
• 1:35:35
  Speaker 1: there are studies that show that giving people caffeine makes
• 1:35:40
  Speaker 1: them feel like they're performing better, but they're actually performing
• 1:35:44
  Speaker 1: worse on certain cognitive tasks. So there's been studies done
• 1:35:46
  Speaker 1: with like the end back task, so like very complex
• 1:35:49
  Speaker 1: working memory tasks, particularly as you get like to like
• 1:35:52
  Speaker 1: end three, you're like trying to remember did I see
• 1:35:54
  Speaker 1: this letter three letters ago? Right, In those kinds of
• 1:35:58
  Speaker 1: complex cognitive tasks, people who take caffeine feel like they're
• 1:36:02
  Speaker 1: performing better, but they're actually performing worse. They're making more errors,
• 1:36:05
  Speaker 1: or they're kind of you know, they're reacting too quickly,
• 1:36:08
  Speaker 1: they're not really thinking about it. And there is similar
• 1:36:11
  Speaker 1: data from other similants too. So there was a paper
• 1:36:13
  Speaker 1: that came out in Science a couple of years ago
• 1:36:15
  Speaker 1: giving people methil fenade some of the other like ADHD
• 1:36:19
  Speaker 1: medications in people who don't have ADHD. These stimulant medications
• 1:36:23
  Speaker 1: again show this dissociation between so they feel great, not take.
• 1:36:26
  Speaker 2: The inverse of the cannabis thing where people think they've
• 1:36:29
  Speaker 2: got all these great and more creative and then the
• 1:36:31
  Speaker 2: next day even they are like, oh my goodness, this
• 1:36:33
  Speaker 2: is dreadful.
• 1:36:33
  Speaker 1: Yeah, And that's again been like formalized in studies where
• 1:36:37
  Speaker 1: you can do these tests where then other people objectively
• 1:36:40
  Speaker 1: see how creative were you? People taking cannabis felt like
• 1:36:43
  Speaker 1: they were more creative, but actually they weren't. And so
• 1:36:47
  Speaker 1: the reason why I say this is that when we're
• 1:36:50
  Speaker 1: talking about supplements, all these other things were like, well,
• 1:36:52
  Speaker 1: I feel much better, Therefore it must be must be
• 1:36:55
  Speaker 1: doing something good. We know that with many of these
• 1:36:58
  Speaker 1: supplements you can create this dissociation between how you feel
• 1:37:01
  Speaker 1: and how you perform, whereas some of these endogenous things
• 1:37:04
  Speaker 1: don't have that effect. So that's why that kind of
• 1:37:08
  Speaker 1: like endogenous increase in arousalor using things like exercise is
• 1:37:11
  Speaker 1: a much more reliable way to improve performance because you
• 1:37:15
  Speaker 1: don't kind of get this association between the two.
• 1:37:18
  Speaker 3: So with exercise in particular, we.
• 1:37:22
  Speaker 1: Know very well that some period of exercise can be
• 1:37:25
  Speaker 1: resistance training, aerobic exercise, very brief sprints, increase arousal, improve
• 1:37:30
  Speaker 1: cognitive function across multiple domains, improve learning, and retrieval. Right,
• 1:37:36
  Speaker 1: So you're definitely augmenting some of these process of neuroplastisty.
• 1:37:40
  Speaker 1: Some of that's going to be related to the catecholamines
• 1:37:42
  Speaker 1: and other things that get released as you as you
• 1:37:44
  Speaker 1: as arousal increases. But we also know that different types
• 1:37:50
  Speaker 1: of exercise have different effects on different parts of the brain.
• 1:37:53
  Speaker 1: So yes, I think some of just like the general
• 1:37:56
  Speaker 1: process of moving your body and exerting efforts, definitely increases arousal,
• 1:38:03
  Speaker 1: definitely improves cognitive function, improves learning, as long as it's
• 1:38:07
  Speaker 1: not truly exhaustive exercise like anybody who's done some terrible
• 1:38:12
  Speaker 1: CrossFit wad or you know, I used to be a rower.
• 1:38:14
  Speaker 1: I used to do a two K test on the
• 1:38:15
  Speaker 1: Rying machine. Right, you do a two K test on
• 1:38:18
  Speaker 1: a Ryan machine. Your brain does not work afterwards. It's
• 1:38:20
  Speaker 1: like a six minute flat out, like VO two max
• 1:38:24
  Speaker 1: kind of level of exertion.
• 1:38:26
  Speaker 2: Yeah. Thanks, So I'm going to interruptriefly thank you for
• 1:38:27
  Speaker 2: pointing that out, because I think that people assume they
• 1:38:30
  Speaker 2: have an infinite amount of energy and there's crossover and
• 1:38:34
  Speaker 2: I certainly have done you know, extra sets to failure
• 1:38:39
  Speaker 2: in a great morning workout and then in the afternoon,
• 1:38:42
  Speaker 2: I'm dragging. H If I hold back just a little
• 1:38:44
  Speaker 2: bit in terms of volume, I find I get a
• 1:38:47
  Speaker 2: real boost out of training that I do low low volume,
• 1:38:51
  Speaker 2: high intensity, or usually two sets per exercise, you know,
• 1:38:55
  Speaker 2: two or three exercise muscle like quadrceps being one muscle
• 1:39:00
  Speaker 2: or something like that. If I do three, it's a
• 1:39:03
  Speaker 2: small addition. Right the rest of the day, I'm kind
• 1:39:06
  Speaker 2: of dragging. So leaving something in the tank yeah, does
• 1:39:09
  Speaker 2: seem worthwhile. Not during the sets, but leaving something in
• 1:39:12
  Speaker 2: the tank in terms of volume really seems to.
• 1:39:14
  Speaker 1: Help, especially if you want your like to perform hard
• 1:39:17
  Speaker 1: cognitive work directly afterwards. Sometimes if you're trying to really
• 1:39:21
  Speaker 1: push sure performance or adaptation right, is worth digging into
• 1:39:25
  Speaker 1: that hole. But it really just depends on what you
• 1:39:27
  Speaker 1: want to be able to do directly afterwards.
• 1:39:29
  Speaker 2: I think student athletes, especially in D one schools, they
• 1:39:32
  Speaker 2: really come to appreciate this. I've had a few of
• 1:39:35
  Speaker 2: them in my courses over the years, and they really
• 1:39:39
  Speaker 2: understand when they're pushing very very being pushed very hard
• 1:39:43
  Speaker 2: in their sport, and they know that they have to
• 1:39:48
  Speaker 2: sit in the front of the classroom, sit up right,
• 1:39:51
  Speaker 2: take extra measures to make sure they're not dozing off.
• 1:39:54
  Speaker 2: Attention drifting, especially in the age of phones and iPads
• 1:39:58
  Speaker 2: and things like that, be very difficult. Yeah, thank you
• 1:40:02
  Speaker 2: for mentioning that, because they're just an extreme case of
• 1:40:05
  Speaker 2: the rest of us. You know, we're told we're all
• 1:40:06
  Speaker 2: very busy, like, oh, you need to exercise it, I'll
• 1:40:08
  Speaker 2: help your brain, and be like, well, I exercise and
• 1:40:10
  Speaker 2: I'm exhausted. You know that's not helping my brain. Let's
• 1:40:12
  Speaker 2: get practical here. So is there any way to It's
• 1:40:18
  Speaker 2: got to be really subjective and depend day to day.
• 1:40:21
  Speaker 2: Is there any way to kind of formalize that, like
• 1:40:23
  Speaker 2: should you train let's say, resistance training or running, you know,
• 1:40:29
  Speaker 2: should you cap it at an hour? Should you pull
• 1:40:32
  Speaker 2: back on the intensity if you have harder cognitive work
• 1:40:34
  Speaker 2: to do in the afternoon. We all want the maximum
• 1:40:36
  Speaker 2: effective exercise, but we don't want it to undercut our efforts.
• 1:40:39
  Speaker 3: Yeah.
• 1:40:40
  Speaker 1: I think that a lot of it's going to be
• 1:40:41
  Speaker 1: based on what your current capacity is, right as with everything.
• 1:40:45
  Speaker 1: So if you're you know, you want to do some
• 1:40:49
  Speaker 1: you've got some you know, learning to do, You've go
• 1:40:51
  Speaker 1: on exam, you want to do some hard cogrenitive work.
• 1:40:54
  Speaker 1: Whatever it is, writing presentation, unalysing data, reading papers, write
• 1:40:58
  Speaker 1: your book, then doing some kind of workout, there's probably
• 1:41:03
  Speaker 1: below your kind of typical or below.
• 1:41:07
  Speaker 3: What you would do when you're really sort of pushing
• 1:41:10
  Speaker 3: pushing the envelope.
• 1:41:11
  Speaker 1: I think that when you look at meta analysis of
• 1:41:15
  Speaker 1: exercise and then cognitive function immediately afterwards, the protocol that
• 1:41:21
  Speaker 1: has like the best evidence for it is like a
• 1:41:23
  Speaker 1: twenty to thirty minute jog, right, So like that's the
• 1:41:26
  Speaker 1: kind of level of activity that really seems to sort
• 1:41:30
  Speaker 1: of like support all those general processes of plasticity and learning.
• 1:41:34
  Speaker 2: What do you think is going on? Because it can't
• 1:41:35
  Speaker 2: be that much arous I mean, the amount of catechola
• 1:41:38
  Speaker 2: means released from Again, catechola means folks being the you know,
• 1:41:41
  Speaker 2: adrenaline and europe and ephron and dopamine generally increased levels arousal, alertness,
• 1:41:48
  Speaker 2: propensity to move you. Just that's that I feel better.
• 1:41:51
  Speaker 2: People often think about the runners high and endorphins. The
• 1:41:54
  Speaker 2: endorphins come from pretty long, intense duration effort. They're more
• 1:41:57
  Speaker 2: of a you're floating kind of like, you know. I
• 1:42:00
  Speaker 2: think the catecholamines are really the cocktail of like all right,
• 1:42:03
  Speaker 2: I got a great workout in this morning, showered, got dressed,
• 1:42:06
  Speaker 2: them off to work. Let's go. That's the so twenty
• 1:42:10
  Speaker 2: and thirty minute jog. I don't expect you get that
• 1:42:13
  Speaker 2: much catecholamine release.
• 1:42:14
  Speaker 1: I mean you'll definitely get some, right, And yeah, like
• 1:42:17
  Speaker 1: quartzol too, right, which obviously increases alertness and arousal and
• 1:42:20
  Speaker 1: can can in the short term make you feel good.
• 1:42:22
  Speaker 2: It's a good thing here.
• 1:42:23
  Speaker 1: You see similar effects of you know, short resistance training workouts.
• 1:42:28
  Speaker 3: I think of it.
• 1:42:29
  Speaker 1: It's probably a little bit of like an area under
• 1:42:31
  Speaker 1: the curve thing, because you see some similar effects of
• 1:42:34
  Speaker 1: like you go out and you do six second really
• 1:42:37
  Speaker 1: hard sprints, like max effort sprints. You do that a
• 1:42:40
  Speaker 1: few times with a long break in between, right, that
• 1:42:42
  Speaker 1: seems to have a similar effect. But you're only working
• 1:42:44
  Speaker 1: for very short periods with very long rest periods.
• 1:42:47
  Speaker 3: So it's something. It's something in that in that sphere,
• 1:42:51
  Speaker 3: and I think that's probably just it. It's just enough to.
• 1:42:54
  Speaker 1: You just kind of boost catsculum is a little bit,
• 1:42:57
  Speaker 1: a little bit of quartsole that's enough to kind of
• 1:43:00
  Speaker 1: move you up the arousal curve to the point where
• 1:43:02
  Speaker 1: you're then able to focus and engage a little bit better,
• 1:43:04
  Speaker 1: And I think, yeah, you don't need a huge dump
• 1:43:07
  Speaker 1: of that in order to achieve that increase in arousal,
• 1:43:10
  Speaker 1: particularly as it pertains to like learning. And then you
• 1:43:13
  Speaker 1: know cognitive performance in like formal cognitive tests, which is
• 1:43:17
  Speaker 1: where this is usually done. If you're then thinking about
• 1:43:20
  Speaker 1: the type of exercise that changes cognitive function or brain structure,
• 1:43:24
  Speaker 1: long term effort and intensity do seem to matter a
• 1:43:29
  Speaker 1: lot more, But those studies have looked less of well
• 1:43:32
  Speaker 1: how did that? How do they feel directly afterwards? Right
• 1:43:35
  Speaker 1: now you're thinking about what's the kind of stimulus that
• 1:43:38
  Speaker 1: drives change over time, and then intensity matters a lot
• 1:43:42
  Speaker 1: as well. So that the best example is with aerobic
• 1:43:47
  Speaker 1: exercise on the kind of zone two up to kind
• 1:43:51
  Speaker 1: of zone four or five sprint spectrum. So most people
• 1:43:56
  Speaker 1: who listen to your show are probably familiar with the
• 1:43:58
  Speaker 1: study where older adults they had them do brisk walking
• 1:44:03
  Speaker 1: three times a week forty minutes. And when you kind
• 1:44:06
  Speaker 1: of read the study and the heart rate levels they
• 1:44:09
  Speaker 1: were trying to attain, it was basically zone two work
• 1:44:12
  Speaker 1: forty minutes brisk walking three times a week for a year,
• 1:44:15
  Speaker 1: and they saw significant increases in the volume of the hippocampus,
• 1:44:18
  Speaker 1: increases in VO two max fitness, increases in circulating BD
• 1:44:23
  Speaker 1: and F levels, though circulating BD and F doesn't actually
• 1:44:27
  Speaker 1: get into the brain, but it's kind of telling you
• 1:44:28
  Speaker 1: something about cro leaf BD and F that's being produced
• 1:44:31
  Speaker 1: in the brain, and improvements in memory. With all of that, however,
• 1:44:38
  Speaker 1: there's a much more recent study that took again older
• 1:44:42
  Speaker 1: adults and randomized them across three different groups. One was
• 1:44:45
  Speaker 1: like a low intensity group. Another group basically did kind
• 1:44:49
  Speaker 1: of zone two type work and a treadmill three times
• 1:44:51
  Speaker 1: a week, very similar similar to that previous study that
• 1:44:53
  Speaker 1: I mentioned. And the third group did a high intensity
• 1:44:56
  Speaker 1: interval training intervention, which was the Norwegian four by four protocol,
• 1:45:01
  Speaker 1: so four minutes eighty five to ninety five percent of
• 1:45:03
  Speaker 1: maximum heart rate. They had a three minute rest in
• 1:45:05
  Speaker 1: their protocol. They did that four times over.
• 1:45:08
  Speaker 3: That's really hard.
• 1:45:10
  Speaker 1: Anybody who's done the Norwegian four by four If you
• 1:45:13
  Speaker 1: then say, well, hey, do that three times a week
• 1:45:15
  Speaker 1: for six months, Like that's just three times a week,
• 1:45:17
  Speaker 1: three times a week for six months, that's that's pretty intense.
• 1:45:20
  Speaker 1: But what they showed was that that high intensity interfral
• 1:45:24
  Speaker 1: training group, they improved their fitness just as well as
• 1:45:27
  Speaker 1: the Zone two group, interestingly, but they had much better
• 1:45:30
  Speaker 1: improvements in hippocampal function and maintenance of hippocampal structure and
• 1:45:34
  Speaker 1: an MRI scam and they maintained that benefit for five
• 1:45:39
  Speaker 1: years after the six month intervention. So they worked really
• 1:45:44
  Speaker 1: hard for six months, but that benefit was maintained for
• 1:45:48
  Speaker 1: a really long period of time. And in several analyzes
• 1:45:51
  Speaker 1: within that study, they basically show that the harder people
• 1:45:54
  Speaker 1: worked and the more quarters they released, the better the benefit.
• 1:45:59
  Speaker 1: And so this is important because nowadays there's or you know,
• 1:46:02
  Speaker 1: there's several people out there saying, oh, don't do high
• 1:46:04
  Speaker 1: intense exercise. It releases quartersole. That's stressful. Your body can't
• 1:46:07
  Speaker 1: handle it. Right, This study directly shows that working really hard,
• 1:46:10
  Speaker 1: releasing a lot of cortsol in high intensity interfl training
• 1:46:13
  Speaker 1: actually improves zypercampal structure and function over time. So yes,
• 1:46:19
  Speaker 1: I imagine after they did their workouts, their brain wasn't
• 1:46:22
  Speaker 1: maybe working at its best because that's a hard workout,
• 1:46:24
  Speaker 1: but over time this was this really strong stimulus that
• 1:46:28
  Speaker 1: then resulted in significant improvements.
• 1:46:31
  Speaker 2: Forgive me if you said it, and I missed it.
• 1:46:34
  Speaker 2: What was the form of exercise, Was it rowing or
• 1:46:36
  Speaker 2: biking or it.
• 1:46:36
  Speaker 3: Was on treadmill?
• 1:46:37
  Speaker 2: Treadmill really interesting and you said it about eighty five
• 1:46:42
  Speaker 2: percent of max heart rate.
• 1:46:43
  Speaker 1: Yeah, so that's that's a typical Norwegian four by four protocol.
• 1:46:46
  Speaker 1: But I don't think that's the protocol you have to do.
• 1:46:49
  Speaker 1: I think it's just this process of high intensity exercise
• 1:46:54
  Speaker 1: that it releases a whole bunch of myer kinds and
• 1:46:56
  Speaker 1: lactate in particular, we know that lactate very easily gets
• 1:46:59
  Speaker 1: into the brain. Generate stimulates BD and F production as
• 1:47:03
  Speaker 1: kind of part of that support of neuroplasticity or augmenting
• 1:47:08
  Speaker 1: recent neuroplastic processes. I think there's something about that, just
• 1:47:11
  Speaker 1: that high intensity work that drives some of those factors
• 1:47:14
  Speaker 1: that then supports structure and function.
• 1:47:17
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• 1:48:32
  Speaker 2: interesting comparison between these studies and as somebody who incorporates
• 1:48:38
  Speaker 2: one day a week of four x four type exercise
• 1:48:41
  Speaker 2: in one day of longer, slower cardio. Maybe I should
• 1:48:43
  Speaker 2: try maybe doing a bit more of the high.
• 1:48:45
  Speaker 1: Intent I think if you want it to be sustainable
• 1:48:47
  Speaker 1: for long periods of time, like I would typically say,
• 1:48:49
  Speaker 1: one day of high intensity work is fine, right because
• 1:48:52
  Speaker 1: you probably you want to be doing some resistance training.
• 1:48:54
  Speaker 2: You doing that three days a week. I do one
• 1:48:56
  Speaker 2: long slow for me jog of about sixty minutes forty
• 1:49:00
  Speaker 2: five to sixty minutes, and then one kind of moderate
• 1:49:04
  Speaker 2: kind of maybe more like zone three four. So thank
• 1:49:08
  Speaker 2: you for putting in a strong word for cortisol, not
• 1:49:12
  Speaker 2: always being the bad guy. People are so afraid of cortisol.
• 1:49:16
  Speaker 2: You want your morning cortisol high. It's gonna make you
• 1:49:18
  Speaker 2: sleep better at night, more energy during the day. It's
• 1:49:21
  Speaker 2: it's interesting to me to dive into the literature on
• 1:49:24
  Speaker 2: cortisol and find that a moderate and a moderate intensity
• 1:49:29
  Speaker 2: resistance training session or cardio session, probably a little bit
• 1:49:33
  Speaker 2: easier than the four x four will triple one's baseline
• 1:49:39
  Speaker 2: levels of cortisol and like or quadruple it. It's transient.
• 1:49:43
  Speaker 2: But nobody's freaking out about these workouts, but they're afraid
• 1:49:46
  Speaker 2: to get in a cold shower, which doesn't have nearly
• 1:49:49
  Speaker 2: the same impact on cortisol. Or It's kind of wild.
• 1:49:52
  Speaker 2: How afraid of cortisol people are. People think they're gonna
• 1:49:55
  Speaker 2: get Cushing syndrome. It's been I don't know what the
• 1:49:57
  Speaker 2: syop on cortisol was all about, but you know you
• 1:49:59
  Speaker 2: can to get moon face, you won't be able to
• 1:50:01
  Speaker 2: lose abdominal fat I mean, there is a real condition
• 1:50:05
  Speaker 2: which is you and I know it's a Cushing syndrome
• 1:50:08
  Speaker 2: where cortisol is pathologically elevated. But come on, folks, Like
• 1:50:13
  Speaker 2: corsol goes up, corsol goes down. You have that twenty
• 1:50:16
  Speaker 2: thirtyfold from the morning until night in a healthy individual.
• 1:50:19
  Speaker 2: So what do you think it is that that people
• 1:50:21
  Speaker 2: will get, you know, like afraid of cortisol, afraid of
• 1:50:26
  Speaker 2: some stress, I mean like your hippo campus. Obviously, in
• 1:50:29
  Speaker 2: this case, their hippo campus got better. It's not dissolving
• 1:50:33
  Speaker 2: into a puddle of its own tears. What is this?
• 1:50:36
  Speaker 2: What did our predecessors do wrong? You know, let's blame
• 1:50:41
  Speaker 2: it on the parents because we weren't doing science communication.
• 1:50:44
  Speaker 2: Then what in the world was the incentive for like
• 1:50:47
  Speaker 2: demonizing molecules. It's so crazy.
• 1:50:49
  Speaker 1: So even though his frameworks are still potentially very helpful,
• 1:50:54
  Speaker 1: some of it we can blame on Hans Selling and
• 1:50:56
  Speaker 1: his like general adaptation response, like the original idea that
• 1:51:00
  Speaker 1: if you were chronically stressed, it would lead to like
• 1:51:03
  Speaker 1: true exhaustion of all your physiological systems, right, because that
• 1:51:05
  Speaker 1: was the final phase of his general adaptation response. People
• 1:51:08
  Speaker 1: have conflated acute stresses versus chronic stresses. And yes, we
• 1:51:12
  Speaker 1: know chronic stress be they psychological, physical increase, atastatic load increase,
• 1:51:19
  Speaker 1: metabolic disease, inflammation, bloody goodysregulation and sulm resistance significantly associated
• 1:51:24
  Speaker 1: with heart disease, dementia, all these kinds of things. Right,
• 1:51:26
  Speaker 1: so we know that these chronic stresses can be really
• 1:51:30
  Speaker 1: detrimental to our health, but we've kind of conflated that,
• 1:51:34
  Speaker 1: like any stress is bad, because chronic stress is bad.
• 1:51:37
  Speaker 1: But the way that I think about it, or I
• 1:51:39
  Speaker 1: try and talk about it, is that actually the stress response,
• 1:51:43
  Speaker 1: and this is as kind of cell Ye originally described
• 1:51:46
  Speaker 1: it is stress drives adaptation. He called it general adaptation
• 1:51:52
  Speaker 1: syndrome or the general adaptation response, because what stress is
• 1:51:57
  Speaker 1: is your body acknowledging that you need to respond to
• 1:52:02
  Speaker 1: some external stimulus, right, and so stress diverts resources so
• 1:52:07
  Speaker 1: that you can then adapt to that stimulus, be they physical, cognitive, neurological.
• 1:52:12
  Speaker 3: Right.
• 1:52:13
  Speaker 1: A stressor diverts glucose to the immune system right in
• 1:52:16
  Speaker 1: an infection, so that it functions better, you can eliminate
• 1:52:19
  Speaker 1: the infection. And so yeah, if you took somebody and
• 1:52:24
  Speaker 1: you look measure they course the levels after a workout,
• 1:52:27
  Speaker 1: it actually looks very similar to how it would look
• 1:52:29
  Speaker 1: if you just broken your arm or if you're like
• 1:52:31
  Speaker 1: really sick, right, But this is the body adapting to
• 1:52:34
  Speaker 1: a stimulus. And like everything we've talked about here, you know,
• 1:52:37
  Speaker 1: physical training driving neuroplasticity that requires adaptation, and so some
• 1:52:42
  Speaker 1: of that core stress response is involved in that. The
• 1:52:46
  Speaker 1: release of catacolum as you talked about in the brain, right,
• 1:52:48
  Speaker 1: those are stress related molecules that are driving adaptation so
• 1:52:52
  Speaker 1: that your body can deal with the stress are better
• 1:52:55
  Speaker 1: in the future. And we also know actually that there's
• 1:52:58
  Speaker 1: some where there's some evidence for the cross stress at adaptation,
• 1:53:02
  Speaker 1: particularly with exercise, right, So if you exercise regularly, you
• 1:53:05
  Speaker 1: are better at dealing with other stresses, like psychological stresses.
• 1:53:08
  Speaker 3: You won't. You're more robust to stresses.
• 1:53:11
  Speaker 1: Your mood or your cognitive function doesn't dip as much
• 1:53:14
  Speaker 1: when you're then psychologically stressed. So stress is actually really
• 1:53:18
  Speaker 1: important because it's the fundamental driver of adaptation. But because
• 1:53:22
  Speaker 1: we've kind of you know, we know that chronic stress
• 1:53:26
  Speaker 1: is bad if you never get a chance, and that's
• 1:53:27
  Speaker 1: because you never get a chance to adapt, you never
• 1:53:29
  Speaker 1: get a chance to down regulate, you never get a
• 1:53:31
  Speaker 1: chance to respond because it's just continuous. But right, intermittent
• 1:53:36
  Speaker 1: exposure to these stresses is really important. And Celia also
• 1:53:39
  Speaker 1: talks about the idea of hypo stress right, not having
• 1:53:41
  Speaker 1: enough stress, because then you can't you don't adapt, you
• 1:53:43
  Speaker 1: don't build function and response. So we just need to
• 1:53:45
  Speaker 1: think about them very differently because that those acute stresses
• 1:53:48
  Speaker 1: are incredibly important for driving adaptation.
• 1:53:52
  Speaker 2: Well, I think of it is pick your stressor you
• 1:53:54
  Speaker 2: can either be exercise or it can be psychological stress.
• 1:53:57
  Speaker 2: If you take it in the form of exercise, you
• 1:53:59
  Speaker 2: probably have less in the form of psychological stress. It's
• 1:54:02
  Speaker 2: obviously not completely true at a one for one, but
• 1:54:05
  Speaker 2: I think, as you pointed out, we d all organisms
• 1:54:09
  Speaker 2: thrive on some degree of stress. I think if people
• 1:54:12
  Speaker 2: are getting enough good sleep at night.
• 1:54:14
  Speaker 3: Yeah, sleep is that I want to say, there's a limit.
• 1:54:16
  Speaker 2: To the amount of stress they can absorb. But when
• 1:54:19
  Speaker 2: it starts to erode your sleep, that's perhaps when things
• 1:54:21
  Speaker 2: need to be you know adjusted. Yeah, resistance training. Is
• 1:54:26
  Speaker 2: there a particular protocol for resistance training that opens the
• 1:54:31
  Speaker 2: opportunity for plasticity better than others That is supported in
• 1:54:34
  Speaker 2: the literature.
• 1:54:35
  Speaker 1: Again, two different windows say of action. So there's that
• 1:54:41
  Speaker 1: that acute kind of arousal, and this would be you know,
• 1:54:46
  Speaker 1: you go in the gym, you do a couple of sets,
• 1:54:49
  Speaker 1: you're not maxing out, you know, it's it's probably going
• 1:54:53
  Speaker 1: to be your fairly typical a couple of sets of
• 1:54:57
  Speaker 1: eight to twelve reps kind of eighty percent of max
• 1:55:01
  Speaker 1: something like that.
• 1:55:02
  Speaker 2: You do.
• 1:55:03
  Speaker 3: So most studies use.
• 1:55:04
  Speaker 1: Machines, right, So maybe do a leg press and a
• 1:55:08
  Speaker 1: chest press and a lap.
• 1:55:09
  Speaker 3: Pull down.
• 1:55:11
  Speaker 1: Multi joint movements, usually with machines. And again, if that
• 1:55:15
  Speaker 1: takes twenty to thirty minutes, that kind of shows some
• 1:55:18
  Speaker 1: similar effects to that like twenty to thirty minute jog
• 1:55:20
  Speaker 1: that I talked about in terms of some acute bumps
• 1:55:22
  Speaker 1: in cognitive function. Probably through arousal. The mild activation of
• 1:55:27
  Speaker 1: those arousal pathways actually quite similarly, I mean, probably slightly
• 1:55:34
  Speaker 1: higher intensity will also be beneficial as long as you're
• 1:55:37
  Speaker 1: able to.
• 1:55:39
  Speaker 3: Recover over time like that.
• 1:55:41
  Speaker 1: Recovery is critical, just like I was just saying in
• 1:55:43
  Speaker 1: terms of any kind of adaptation. There are several studies
• 1:55:48
  Speaker 1: of resistance training looking at cognitive function and brain structure
• 1:55:52
  Speaker 1: over time. I say several, it's like three or four
• 1:55:55
  Speaker 1: in older adults, and they typically do two or three
• 1:55:58
  Speaker 1: times a week, five to six exercises, three sets of
• 1:56:02
  Speaker 1: eight to twelve reps.
• 1:56:04
  Speaker 3: You're very similar.
• 1:56:05
  Speaker 1: So those multi joint machines in the gym that anybody
• 1:56:09
  Speaker 1: can do, and that there were in any.
• 1:56:10
  Speaker 2: Gym presses, pull ups, rowing, pull downs, right leg press,
• 1:56:14
  Speaker 2: hamstring curl okay, yeah.
• 1:56:16
  Speaker 1: And what you tend to see is that if you
• 1:56:21
  Speaker 1: do that for at least six months, so the study's
• 1:56:23
  Speaker 1: gone for like six to twelve months, you see significant
• 1:56:29
  Speaker 1: changes in the structure of the white matter of the
• 1:56:31
  Speaker 1: brain and with that improvements in executive function.
• 1:56:34
  Speaker 2: Between to remind people what white matter is just for
• 1:56:37
  Speaker 2: the nit for the newbies.
• 1:56:39
  Speaker 1: Very broadly, you have why matter in gray matter in
• 1:56:42
  Speaker 1: your brain, and the human brain why matter makes up
• 1:56:44
  Speaker 1: approximately sixty percent more than most other species, any other species.
• 1:56:49
  Speaker 1: And so like the wrinkly outer part of your brain,
• 1:56:51
  Speaker 1: the cortex, that's gray matter, you also have more gray
• 1:56:54
  Speaker 1: matter deep inside the brain in between that is the
• 1:56:56
  Speaker 1: white matter, which is where you have the miolin sheaths
• 1:56:59
  Speaker 1: on axons. That's what allows those nerves to conduct information
• 1:57:03
  Speaker 1: really quickly. Whereas aerobic exercise on that kind of intensity
• 1:57:07
  Speaker 1: spectrum we just talked about seems to particularly benefit the
• 1:57:10
  Speaker 1: gray matter, which includes the hippocampus, resistance training seems to
• 1:57:15
  Speaker 1: particularly benefit the white matter. And so you see improvements
• 1:57:18
  Speaker 1: in a white matter structure, which and changed in why
• 1:57:21
  Speaker 1: matter structure with age are one of the best predictors
• 1:57:24
  Speaker 1: of congressive decline with age. Interestingly, like outside of other
• 1:57:28
  Speaker 1: things you see in terms of neuropathology, amaboid tau, et cetera,
• 1:57:30
  Speaker 1: that loss of white matter structure and function is closely
• 1:57:34
  Speaker 1: tied to congreitive decline over time. So you see improvements
• 1:57:37
  Speaker 1: in structure and function of the white matter, and there
• 1:57:39
  Speaker 1: are potentially improvements in something that we call white matter lesions,
• 1:57:43
  Speaker 1: which tend to happen around areas of poor blood flow
• 1:57:47
  Speaker 1: within the white matter of the brain and with that
• 1:57:50
  Speaker 1: improvements in executive function. So aerobic X size is gray
• 1:57:55
  Speaker 1: matter and memory, and resistance training is why matter, and
• 1:57:59
  Speaker 1: more so executive type decision making processing, speed type functions.
• 1:58:03
  Speaker 3: You know, we talked about lactate.
• 1:58:05
  Speaker 1: And some of these other things that might increase i
• 1:58:08
  Speaker 1: BDNF with the aerobic training. In resistance training, the I
• 1:58:13
  Speaker 1: think the primary mediator of that, or one of them
• 1:58:16
  Speaker 1: is IGF one, which is in particularly increased with resistance training.
• 1:58:20
  Speaker 1: We know that IGF one is really critical to the
• 1:58:22
  Speaker 1: development of white matter right you know, in the womb
• 1:58:26
  Speaker 1: and then as a baby, and it seems to be
• 1:58:28
  Speaker 1: also really important for white matter structure then throughout the lifespan.
• 1:58:33
  Speaker 1: So resistance training is a really great way to then
• 1:58:35
  Speaker 1: create these boosts of IGF one. So that's probably that's
• 1:58:38
  Speaker 1: probably part of why we see that difference, but that's
• 1:58:41
  Speaker 1: why you need to do both.
• 1:58:43
  Speaker 3: Though they may have similar kind of acute effects.
• 1:58:45
  Speaker 1: In terms of cogative function, they seem to be having
• 1:58:47
  Speaker 1: very different effects in terms of the structure and function
• 1:58:49
  Speaker 1: of the brain long term.
• 1:58:51
  Speaker 2: I so appreciate that you're basically telling us that different
• 1:58:54
  Speaker 2: forms of exercise impact different critical aspects of brain structure
• 1:58:58
  Speaker 2: and function, so resistance training, white matter, cardio, gray matter
• 1:59:02
  Speaker 2: broadly speaking, and many different molecules IGF one, BDNF, lactate,
• 1:59:07
  Speaker 2: and on and on. Just for how do you say
• 1:59:11
  Speaker 2: in Britain, it's not kicks. They use a different word
• 1:59:14
  Speaker 2: for kicking giggles. I'll just tell you. There's sort of
• 1:59:16
  Speaker 2: two running jokes in the field of neuroscience when I
• 1:59:19
  Speaker 2: was coming up, which was if you desperately need a thesis. Fortunately,
• 1:59:25
  Speaker 2: this was not the position I found myself in. If
• 1:59:28
  Speaker 2: you desperately need a thesis and like it's not going well,
• 1:59:31
  Speaker 2: study the effect of pretty much any compound on REM
• 1:59:34
  Speaker 2: sleep because it will reduce rem sleep. There are very
• 1:59:37
  Speaker 2: few things that increase remsleep, very very few except sleep
• 1:59:41
  Speaker 2: deprivation and then rem rebound. Likewise, there was a review
• 1:59:44
  Speaker 2: published by a guy named Jeff Flickman and Josh Sayins,
• 1:59:47
  Speaker 2: who were in a different field, so they did a
• 1:59:49
  Speaker 2: kind of cocky thing, but they back then they were like, like,
• 1:59:52
  Speaker 2: they're good guys. I know them both. But they published
• 1:59:56
  Speaker 2: this review about long term potentiation where they said they
• 2:00:00
  Speaker 2: did a review of the literature and they said, basically,
• 2:00:02
  Speaker 2: you can throw any molecule on a couple of neurons
• 2:00:05
  Speaker 2: and do the protocol for long term potentiation and you
• 2:00:07
  Speaker 2: get an enhancement of long term pertentiator. Now that wasn't
• 2:00:10
  Speaker 2: completely true. The reason I'm raising this is that there's
• 2:00:12
  Speaker 2: this theme right like it's there's certain processes, like processes
• 2:00:17
  Speaker 2: that are not that hard to disrupt, like rem sleep.
• 2:00:20
  Speaker 2: You just kind of tweet the system a little bit
• 2:00:22
  Speaker 2: you see a deficit, small or large deficit. And then
• 2:00:25
  Speaker 2: things like long term potentiation, which is thought to underlie
• 2:00:27
  Speaker 2: a lot of forms of learning and memory. In a
• 2:00:31
  Speaker 2: dish with some neurons or maybe even an animal, you
• 2:00:33
  Speaker 2: can knock something out or over express something in whoop,
• 2:00:36
  Speaker 2: you get more or less long term potentiat It's not
• 2:00:38
  Speaker 2: that hard to tilt the scale on it. But in reality,
• 2:00:41
  Speaker 2: the human body has tons of molecules that it deploys,
• 2:00:45
  Speaker 2: and it now to me makes perfect sense. Why plasticity,
• 2:00:50
  Speaker 2: which of course is the foundation of learning one and
• 2:00:54
  Speaker 2: the same in many ways, is brought about by resistance
• 2:00:59
  Speaker 2: training and by cardiovasco train because they're both motor. Just
• 2:01:04
  Speaker 2: like crossword puzzles, certain plasticity effect maybe less than you know, dance,
• 2:01:09
  Speaker 2: where there's a number of different things that social inputs,
• 2:01:12
  Speaker 2: balance inputs, and on and on. So whereas two three
• 2:01:16
  Speaker 2: years ago, I would have said, all right, are we
• 2:01:20
  Speaker 2: really talking about exercise opening plasticity. It's always seemed like
• 2:01:24
  Speaker 2: mice running on wheels and you get a few extra neurons,
• 2:01:26
  Speaker 2: you get a nature paper like I love that work,
• 2:01:28
  Speaker 2: don't get me wrong, but it turns out to not
• 2:01:30
  Speaker 2: be that meaningful in terms of new neuron production. Is
• 2:01:33
  Speaker 2: that doesn't seem to be that meaningful for human memory
• 2:01:37
  Speaker 2: and offsetting cognitive decline. So but now I have a
• 2:01:40
  Speaker 2: completely different view of exercise based on your work, based
• 2:01:43
  Speaker 2: on the studies that you're describing, because it's like, yeah,
• 2:01:46
  Speaker 2: these are the big guns in terms of deploying lots
• 2:01:51
  Speaker 2: of molecules that, without question are interacting with one another.
• 2:01:55
  Speaker 2: So I no longer think about exercise as like, okay,
• 2:01:58
  Speaker 2: well it's just in using vessel growth, you're getting more
• 2:02:01
  Speaker 2: metabolic helse, so then the brain gets better. I now
• 2:02:04
  Speaker 2: think about resistance training and cardio and their various forms
• 2:02:07
  Speaker 2: as you point out four by four et cetera, as
• 2:02:10
  Speaker 2: like the real plasticity triggers. So that was a long
• 2:02:16
  Speaker 2: witted way of saying thank you to you and your
• 2:02:18
  Speaker 2: colleagues who've been doing this and thinking about things like
• 2:02:21
  Speaker 2: clutch states and molecules that shift plasticity, because I love
• 2:02:26
  Speaker 2: reduction of single molecule manipulations. I think they're very important
• 2:02:29
  Speaker 2: in a certain context. But for a while, it was like, gosh,
• 2:02:32
  Speaker 2: everything opens plasticity and everything disrupts around a sleep, and like,
• 2:02:35
  Speaker 2: when are we going to get to this stuff anyway? Alzheimer's, Parkinson's.
• 2:02:40
  Speaker 2: Nobody wants these ner degenerative conditions. What is the current
• 2:02:45
  Speaker 2: thinking about the factors that make one susceptible to Alzheimer's.
• 2:02:52
  Speaker 2: I'm beginning to think that it's not just one. But
• 2:02:55
  Speaker 2: then there's a genetic predisposition issue that maybe you could
• 2:02:58
  Speaker 2: touch on. What can we do besides the things that
• 2:03:03
  Speaker 2: we're already talking about today to best reduce the chance
• 2:03:09
  Speaker 2: of accelerated cognitive declient or full blown Alzheimer's.
• 2:03:14
  Speaker 1: First of all, we talk about dementia, which is essentially
• 2:03:19
  Speaker 1: the end stage of cognitive decline. There's some trajectory of
• 2:03:22
  Speaker 1: decline that happens from your peak to that point where
• 2:03:25
  Speaker 1: ideally we'd intervene much sooner. But right now, you know,
• 2:03:30
  Speaker 1: we don't really do much until dementia is diagnosed. But
• 2:03:33
  Speaker 1: it's very similar with like we don't do very much
• 2:03:35
  Speaker 1: until diabetes is diagnosed. You know, ideally we can act
• 2:03:38
  Speaker 1: much earlier in that trajectory, and that's increasingly being accepted
• 2:03:42
  Speaker 1: in the neuroscience and neurology communities that actually we could
• 2:03:45
  Speaker 1: potentially change that.
• 2:03:47
  Speaker 3: Trajectory or at least decrease risk.
• 2:03:50
  Speaker 1: And so within dementia there as an umbrella term which
• 2:03:54
  Speaker 1: is essentially the loss of cognitive function such that you
• 2:03:57
  Speaker 1: can't look after yourself on a day to day basis.
• 2:03:59
  Speaker 1: You can't do the date, you know, sort of the
• 2:04:00
  Speaker 1: basic activities a day living. Alzheimer's disease is the most common.
• 2:04:06
  Speaker 1: It makes up about sixty to eighty percent of cases
• 2:04:09
  Speaker 1: of dementia. The next most common is vascular dementia, although
• 2:04:13
  Speaker 1: vascular dementia and alzheimer'ssease overlapp a ton like. The vast
• 2:04:17
  Speaker 1: majority of people who have alzheimer'ssease also have some element
• 2:04:20
  Speaker 1: of pathology or changes in the blood vessels in their brain,
• 2:04:23
  Speaker 1: which is what you get with vascular dementia. And then
• 2:04:25
  Speaker 1: there's also dementia with Louis bodies, front of temporal dementia,
• 2:04:29
  Speaker 1: and then demension related to Parkater's potentially, although that overlaps
• 2:04:33
  Speaker 1: a lot with Louis body dementia and demension Parkinsons may
• 2:04:37
  Speaker 1: be may actually mostly be Louis body dementia. But we've
• 2:04:42
  Speaker 1: gotten to a point now where it's generally accepted that
• 2:04:45
  Speaker 1: potentially half of cases of dementia are preventable, and I
• 2:04:49
  Speaker 1: think the majority of that falls into those first two buckets,
• 2:04:52
  Speaker 1: Alzheimer's and vascular dementia, although metabolic disease and other risk
• 2:04:57
  Speaker 1: factors for alzheimer'ssease also increase the risk of Parkinson's and
• 2:05:00
  Speaker 1: those other dimensions as well. When you then think about
• 2:05:03
  Speaker 1: Alzheimer's disease specifically, there's one small slice of Alzheimer's, which
• 2:05:07
  Speaker 1: is like monogenic dominant mutations that you have in either
• 2:05:12
  Speaker 1: most of them happen either in the presnilline genes precentin
• 2:05:15
  Speaker 1: in one and two, or the amyloid precursor protein gene.
• 2:05:18
  Speaker 1: They make up at this point less than five percent,
• 2:05:20
  Speaker 1: maybe as little as one percent of Alzheimer's disease, so
• 2:05:23
  Speaker 1: it kind of we set those to the side.
• 2:05:25
  Speaker 3: A little bit.
• 2:05:25
  Speaker 1: The vast majority of Alzheimer's disease is what we would
• 2:05:28
  Speaker 1: call late on set Alzheimer's disease, although it's happening actually
• 2:05:31
  Speaker 1: earlier and earlier in some populations. Yes, there's a genetic component.
• 2:05:35
  Speaker 1: Your apoe gene is you're probably your most common risk gene.
• 2:05:41
  Speaker 1: It's also associated. There's also polygenic risks, so thousands of
• 2:05:45
  Speaker 1: genes can give you a little bit more, a little
• 2:05:47
  Speaker 1: bit less risk of Alzheimer's disease. But it's much more
• 2:05:51
  Speaker 1: related to lifestyle and the environment than say that they're
• 2:05:55
  Speaker 1: kind of early onset monogenic Alzheimer's disease and the kind
• 2:06:02
  Speaker 1: of the best accepted review of all of this is
• 2:06:07
  Speaker 1: run by the Lancer Commential Commission on Dementia Prevention, overseen
• 2:06:11
  Speaker 1: by Professor Jill Livingstone, and their most the most recent
• 2:06:14
  Speaker 1: version of this suggested that there were fourteen risk factors
• 2:06:18
  Speaker 1: who between them accounted for about forty five percent of
• 2:06:22
  Speaker 1: dementia risk or dementia cases, and that are modifiable so
• 2:06:27
  Speaker 1: life education, high blood pressure, diabetes, hearing loss, vision loss,
• 2:06:31
  Speaker 1: brain trauma, high high cholesterol. They recently recently added high
• 2:06:36
  Speaker 1: LDL high LDL cholesterol, low fitsical activity. So this is
• 2:06:40
  Speaker 1: all related to the things we've already talked about, right,
• 2:06:42
  Speaker 1: maintaining good physical health, maintaining maintaining inputs, getting inputs in
• 2:06:46
  Speaker 1: the first place where education is critical.
• 2:06:49
  Speaker 2: And hearing loss, as I recall, was an important one
• 2:06:52
  Speaker 2: written in reference to inputs like you don't want sensory
• 2:06:55
  Speaker 2: input degraded.
• 2:06:56
  Speaker 3: Absolutely so hearing lost, vision loss, social isolation. They didn't.
• 2:07:02
  Speaker 3: It was quite so.
• 2:07:03
  Speaker 1: Two things they didn't include that were fairly controversial and
• 2:07:07
  Speaker 1: was sort of debated. Letters were written to the editor
• 2:07:09
  Speaker 1: and all that kind of stuff as happens in academia
• 2:07:12
  Speaker 1: related to So they didn't include sleep loss or sleep
• 2:07:15
  Speaker 1: deprivation as a respective for dementia, even though the evidence,
• 2:07:18
  Speaker 1: particularly if.
• 2:07:18
  Speaker 2: You can look at it or didn't include it.
• 2:07:20
  Speaker 3: They didn't include it.
• 2:07:21
  Speaker 1: So like they talked about it, but they felt that
• 2:07:23
  Speaker 1: the level of evidence wasn't high enough, though it was
• 2:07:25
  Speaker 1: probably as high as some of the other things that
• 2:07:27
  Speaker 1: they included.
• 2:07:28
  Speaker 2: It's a tricky one. I don't want to take us
• 2:07:29
  Speaker 2: on too much of a tangent, but having looked at
• 2:07:31
  Speaker 2: these data a lot, I do think that people need
• 2:07:33
  Speaker 2: to get enough sleep, but some people like myself do
• 2:07:35
  Speaker 2: fine on six and a half or seven hours, and
• 2:07:38
  Speaker 2: other people can do fine on only seven or eight
• 2:07:40
  Speaker 2: or nine. Very few people are AOKA all the time
• 2:07:44
  Speaker 2: on just four to five hours for prolonged periods of time.
• 2:07:47
  Speaker 2: But when we say not AOKA, what tends to happen
• 2:07:50
  Speaker 2: with shift work or people that are chronically sleep deprived
• 2:07:52
  Speaker 2: is most of the other things you're talking about get worse. Oh,
• 2:07:56
  Speaker 2: the ad goes up striving he's got So it's it's
• 2:08:00
  Speaker 2: it's like, I can understand why they might not have
• 2:08:03
  Speaker 2: included it, but it seems so foundational to me that
• 2:08:05
  Speaker 2: it does seem kind of a shame.
• 2:08:06
  Speaker 1: Part of it is related to how they analyze the data,
• 2:08:10
  Speaker 1: so we can get to that. But I mean, in reality,
• 2:08:13
  Speaker 1: when you look at the data on sleep loss and
• 2:08:15
  Speaker 1: dementia risk, the cutoff is really around six hours. So
• 2:08:18
  Speaker 1: if you're consistently sleeping fewer than six hours, that's where
• 2:08:21
  Speaker 1: risk starts to increase.
• 2:08:23
  Speaker 3: So that that kind of about right.
• 2:08:24
  Speaker 2: Yeah, Yeah, that sounds about right, because it's I think
• 2:08:26
  Speaker 2: it's it's the lack of those last two cycles where
• 2:08:30
  Speaker 2: that are rem enriched. Yeah, you know, because in the
• 2:08:32
  Speaker 2: beginning of the night you get your growth home on surge,
• 2:08:34
  Speaker 2: you get a lot of deep sleep, assuming you're you know,
• 2:08:36
  Speaker 2: doing things right during the day, and then it's those last,
• 2:08:40
  Speaker 2: you know, two ninety minute ish cycles that you glean
• 2:08:43
  Speaker 2: most of your rem Yeah, and if you're not getting
• 2:08:46
  Speaker 2: those night in and night out and night in night out,
• 2:08:48
  Speaker 2: like sooner or later, you're gonna have issues.
• 2:08:51
  Speaker 3: Yeah.
• 2:08:52
  Speaker 1: So sleep was one. Then the other one was nutrient status.
• 2:08:55
  Speaker 1: So they didn't talk about Omega three's beavis Men's, which
• 2:08:57
  Speaker 1: we do actually have some some quite high quality interventional
• 2:09:00
  Speaker 1: and observational kind of epidemiological data for so there was
• 2:09:04
  Speaker 1: kind of some discussion as whether those things should have
• 2:09:05
  Speaker 1: been included. Other analyzes that looked at those suggested that
• 2:09:09
  Speaker 1: they potentially contribute a significant of the amount of the
• 2:09:12
  Speaker 1: population the tributal risk of dementia. So all that to
• 2:09:15
  Speaker 1: say that their forty five percent estimate could be quite
• 2:09:20
  Speaker 1: conservative if we consider some of the other things. There
• 2:09:23
  Speaker 1: are some other studies that suggest that there maybe as
• 2:09:27
  Speaker 1: many is or as much as seventy percent of dementias
• 2:09:29
  Speaker 1: may be preventable. But then you have to start including
• 2:09:31
  Speaker 1: things related to socio economic status and deprivation, and of
• 2:09:36
  Speaker 1: the societal factors that we know have a massive impact
• 2:09:38
  Speaker 1: as well, So that's less modifiable, like on the individual level,
• 2:09:42
  Speaker 1: it really would require changes at the societal level, which
• 2:09:46
  Speaker 1: is kind of harder to do.
• 2:09:47
  Speaker 2: Can I ask you a question? It's going to be
• 2:09:48
  Speaker 2: a very controversial one. But there are people arguing, there
• 2:09:55
  Speaker 2: are very smart people, i should say, arguing that the
• 2:09:58
  Speaker 2: shingles vaccine is lowering rates of dementia significantly. I haven't
• 2:10:03
  Speaker 2: looked at those data closely yet I plan to, but
• 2:10:06
  Speaker 2: it certainly is intriguing given the data that herpes viruses
• 2:10:10
  Speaker 2: of various sorts have been correlated with Alzheimer's.
• 2:10:14
  Speaker 1: This comes off the back of three or four very
• 2:10:18
  Speaker 1: large natural experiments that have been done in various countries,
• 2:10:22
  Speaker 1: and really how you interpret these data is going to
• 2:10:25
  Speaker 1: depend a little bit on your kind of risk tolerance
• 2:10:28
  Speaker 1: and like how what you think should be done in
• 2:10:32
  Speaker 1: terms of the level of evidence required to intervene. So
• 2:10:35
  Speaker 1: I'll describe the studies in the second, but some people
• 2:10:37
  Speaker 1: are definitely saying, you know, if you want, if you
• 2:10:39
  Speaker 1: want to say that the shingles vaccine decreases dementia risk,
• 2:10:43
  Speaker 1: you have to have a clinical trial that's adequately powered
• 2:10:46
  Speaker 1: to show that and there is a trial like that
• 2:10:49
  Speaker 1: being planned currently. So the studies that have happened so far,
• 2:10:55
  Speaker 1: there was one in the UK, in Wales, one in Australia,
• 2:11:00
  Speaker 1: one in Canada, and in each of those countries what
• 2:11:05
  Speaker 1: happened was that on a single date, a huge tranche
• 2:11:09
  Speaker 1: of people became eligible to get the shingles vaccine, whereas
• 2:11:14
  Speaker 1: if they were born one day earlier, they weren't eligible.
• 2:11:18
  Speaker 1: So you get what you call like a natural experiment
• 2:11:21
  Speaker 1: where from one day to the next, those people shouldn't
• 2:11:24
  Speaker 1: be that different otherwise, And they showed that rates of
• 2:11:27
  Speaker 1: other diseases weren't that different, rates of uptake of other
• 2:11:31
  Speaker 1: healthcare and other vaccines wasn't that difference, But they're different,
• 2:11:34
  Speaker 1: But there was a big shift in the uptake of
• 2:11:36
  Speaker 1: the shingles vaccine. And so what they essentially consistently showed
• 2:11:40
  Speaker 1: across all those different populations was that those who got
• 2:11:42
  Speaker 1: the shingles vaccine or were eligible to have the shingles vaccine,
• 2:11:46
  Speaker 1: depending on whether they had access to the data on
• 2:11:48
  Speaker 1: whether people got it or not, had a decreased risk
• 2:11:51
  Speaker 1: of dementia. And that was consistently seen across those three groups.
• 2:11:55
  Speaker 1: All those three trials used an older version of the
• 2:11:58
  Speaker 1: shingles vaccine called zostapha zoster vax, which was a live
• 2:12:01
  Speaker 1: attenuated vaccine. There's now a newer version called Shingrix, which
• 2:12:06
  Speaker 1: is a recombinant vaccine. And there was a study done
• 2:12:10
  Speaker 1: in the US that compared people who switched from but
• 2:12:14
  Speaker 1: you know, there was a similar switch from zostero vaxa
• 2:12:17
  Speaker 1: shingricks and saw that shingricks was associated with a lower
• 2:12:20
  Speaker 1: risk of dementia compared to zoster vax, although both were
• 2:12:23
  Speaker 1: associated with a lower risk than none. When you look
• 2:12:26
  Speaker 1: at some of these trials or studies because they're not trials,
• 2:12:31
  Speaker 1: people have made a very fair comment which is that
• 2:12:33
  Speaker 1: when you look at the trajectory of dementia over time,
• 2:12:36
  Speaker 1: you look at something called a Kaplan Meier curve. So
• 2:12:38
  Speaker 1: it's like a survival curve. So like every time somebody
• 2:12:41
  Speaker 1: gets a case of dementia, like the line goes up,
• 2:12:44
  Speaker 1: and you look at the trajectory of the two lines
• 2:12:46
  Speaker 1: those who got you know, got the vaccine or not,
• 2:12:49
  Speaker 1: they diverge very early, which kind of says that, oh,
• 2:12:53
  Speaker 1: it only takes a couple of months to kind of
• 2:12:55
  Speaker 1: see this difference in dementia risk, which you wouldn't really
• 2:12:57
  Speaker 1: expect based on like the natural core of dementia takes
• 2:13:00
  Speaker 1: years to happen. So this is very common in these
• 2:13:05
  Speaker 1: kinds of studies, and it's it's due to residual confounding.
• 2:13:10
  Speaker 1: So there's like something inherently different about the populations that
• 2:13:13
  Speaker 1: may be driving some of this different Right, they were
• 2:13:15
  Speaker 1: going to get less dementia anyway, and so maybe the
• 2:13:18
  Speaker 1: shingles vaccine isn't having that big of an effect.
• 2:13:20
  Speaker 3: But I would say that having.
• 2:13:23
  Speaker 1: Looked at all those trials and all those data, I'm fairly,
• 2:13:26
  Speaker 1: you know, I'm convinced enough that there's a signal there.
• 2:13:31
  Speaker 1: There should be a randomized control trial that's that's happening.
• 2:13:35
  Speaker 1: But there is a number of reasons why this might
• 2:13:37
  Speaker 1: be the case. One, obviously, we know it reduces cases
• 2:13:41
  Speaker 1: of shingles. Shingles can be very painful. It can you know,
• 2:13:46
  Speaker 1: can change how people interact with the world. You stay
• 2:13:49
  Speaker 1: at home, you don't feel good, You're a lot of painful.
• 2:13:51
  Speaker 1: Long period of time that can be that can go
• 2:13:53
  Speaker 1: for many months. It's rare for it to last many months,
• 2:13:56
  Speaker 1: but it can last long time. Then you know they've
• 2:14:00
  Speaker 1: hypothesized in some of those papers that the magnitude of
• 2:14:06
  Speaker 1: the reduction of dementia risk didn't map perfectly onto the
• 2:14:09
  Speaker 1: reduction in cases of shingles, right, there had to be
• 2:14:13
  Speaker 1: something else going on as well. They've suggested that it
• 2:14:16
  Speaker 1: may be due to an immunomodulatory effect. It may be
• 2:14:20
  Speaker 1: because you're also suppressing other viruses like purpose implex virus
• 2:14:24
  Speaker 1: that we know may also be associated with certain cases
• 2:14:28
  Speaker 1: of dementia Alzheimer's. And the reason one of the arguments
• 2:14:33
  Speaker 1: for the immunomodulatory effect is because not in all the studies,
• 2:14:37
  Speaker 1: but in most of the studies is a slightly bigger
• 2:14:40
  Speaker 1: signal in women than there is in men.
• 2:14:42
  Speaker 3: And it may be that.
• 2:14:43
  Speaker 2: That sort of meaning it's more effectively.
• 2:14:46
  Speaker 3: More effective in women than it was in men.
• 2:14:47
  Speaker 2: And we should mention that the shingles virus lives on neurons. Yes, yeah,
• 2:14:54
  Speaker 2: Herpes viruses tend to live on neurons and they hang
• 2:14:57
  Speaker 2: out on neurons, which is why people who you know
• 2:15:00
  Speaker 2: get herbe'es one infections will get a cold sort a
• 2:15:02
  Speaker 2: particular location that will come back because it's living on
• 2:15:05
  Speaker 2: the trigeminal nerve. That's just you know, I think people
• 2:15:08
  Speaker 2: don't often understand that viruses can you know, harbor in
• 2:15:12
  Speaker 2: particular cell types. Yeah, and so the logical link between
• 2:15:17
  Speaker 2: herpes viruses and dementia risk is you know, it's not
• 2:15:22
  Speaker 2: I mean that alone is not a causal relationship, but
• 2:15:25
  Speaker 2: it makes sense mechanistically.
• 2:15:27
  Speaker 3: Yeah.
• 2:15:28
  Speaker 2: And a fundamental feature of herpes viruses is they generally
• 2:15:31
  Speaker 2: don't kill the nern they can, but that's why they
• 2:15:34
  Speaker 2: stay alive. These viruses are very smart. They know how
• 2:15:37
  Speaker 2: to get infect their host, but not kill their host,
• 2:15:39
  Speaker 2: which is what really smart viruses do. So what age
• 2:15:43
  Speaker 2: are people getting the shingles vaccine?
• 2:15:44
  Speaker 1: These studies actually quite late. It's like people in their
• 2:15:48
  Speaker 1: seventies and eighties.
• 2:15:49
  Speaker 2: Oh wow, yeah, okay, So.
• 2:15:51
  Speaker 1: Again it would be very fair to argue that getting
• 2:15:56
  Speaker 1: it much earlier, we don't have any evidence for because
• 2:16:00
  Speaker 1: reality in these particularly in these the studies like the UK,
• 2:16:04
  Speaker 1: this is done in the national healthcare system. It was
• 2:16:06
  Speaker 1: for the highest risk older adults. And so getting it
• 2:16:10
  Speaker 1: in your like fifties or mid fifties, which is sort
• 2:16:14
  Speaker 1: of the guidelines in the US that yes, to reduce
• 2:16:18
  Speaker 1: shingles absolutely, but it doesn't map onto the dementia risk
• 2:16:21
  Speaker 1: age that was seen in these studies. A final piece
• 2:16:25
  Speaker 1: of this that I think is important and kind of
• 2:16:28
  Speaker 1: goes beyond just the shingles vaccine.
• 2:16:31
  Speaker 3: Is that.
• 2:16:33
  Speaker 1: If you want to maintain function over long periods of time,
• 2:16:37
  Speaker 1: one of the best things you can do is minimize
• 2:16:39
  Speaker 1: your chances of getting really sick. There have been several studies.
• 2:16:44
  Speaker 1: One was the Adult Changes and Thought Studies down at
• 2:16:45
  Speaker 1: the University Washington and Seattle. Primarily a similar thing was
• 2:16:49
  Speaker 1: shown in the Rush Memory and Aging project. But basically,
• 2:16:52
  Speaker 1: when you when you look at the same individual over
• 2:16:54
  Speaker 1: time and you measure their cognitive function every few years,
• 2:16:57
  Speaker 1: which these studies did, cognitive function doesn't just decline sort
• 2:17:03
  Speaker 1: of linearly or steadily with age. It goes down, you know,
• 2:17:07
  Speaker 1: a little bit on average, But the biggest decreases sort
• 2:17:10
  Speaker 1: of happens step wise after periods of significant illness. And
• 2:17:14
  Speaker 1: so like in Adult Change the Thought study, those who'd
• 2:17:16
  Speaker 1: been you know, sick in between you know, had a
• 2:17:20
  Speaker 1: major illness in between having their cognition retested, they had
• 2:17:24
  Speaker 1: a step change down, and those who were hospitalized that
• 2:17:26
  Speaker 1: that step change down was even bigger. So you could
• 2:17:31
  Speaker 1: talk about, you know, how people maybe could have changed
• 2:17:34
  Speaker 1: things in order to recover some of that function afterwards.
• 2:17:36
  Speaker 1: I think that would have been possible if you'd thought
• 2:17:39
  Speaker 1: about how you might intervene. But a major I think
• 2:17:44
  Speaker 1: it's a it's a reason to say if I can
• 2:17:46
  Speaker 1: do as much as I can to minimize the chance
• 2:17:49
  Speaker 1: that I get really sick, because what happens then is
• 2:17:51
  Speaker 1: I'm at home, I'm not receiving any stimuli, any inputs,
• 2:17:55
  Speaker 1: I'm not moving, I'm not eating well. Obviously there's the
• 2:17:58
  Speaker 1: all the downsides of the infection itself. Then you know,
• 2:18:03
  Speaker 1: if I can avoid that as much as possible, then
• 2:18:06
  Speaker 1: over time that that that could be to know greater benefits. Right,
• 2:18:11
  Speaker 1: change trains change the overall trajectory. So I think that's
• 2:18:14
  Speaker 1: one reason why some of these vaccinations could be beneficial
• 2:18:17
  Speaker 1: is just you're minimizing the time you spend really sick
• 2:18:21
  Speaker 1: as you're older, which we've seen is results in these
• 2:18:24
  Speaker 1: sort of like step changes down in CogAT function.
• 2:18:27
  Speaker 2: Fascinating. I realized that we could and probably should, do
• 2:18:32
  Speaker 2: an entire podcast about traumatic brain injury and concussion. But
• 2:18:37
  Speaker 2: as a teaser for that, are there anythings that people
• 2:18:44
  Speaker 2: should do and or take in the immediate aftermath of
• 2:18:48
  Speaker 2: a head hit. Now I'm not talking about uh, hopefully
• 2:18:51
  Speaker 2: people are getting checked out for brain bleeds and things
• 2:18:54
  Speaker 2: like that. So I'm talking about moderate concussion. Someone got
• 2:18:57
  Speaker 2: their quote unquote bell rung. Uh, they slipped and fell,
• 2:19:01
  Speaker 2: they got clipped in soccer practice, their kids a little dizzy. Now,
• 2:19:06
  Speaker 2: of course, somebody young or old is vomiting or you know,
• 2:19:10
  Speaker 2: not able to sleep, or real issues. I mean, everyone
• 2:19:13
  Speaker 2: should probably be checked out in the first case. But
• 2:19:15
  Speaker 2: I get asked this question all the time. Is there
• 2:19:17
  Speaker 2: anything that people can take to kind of get over
• 2:19:19
  Speaker 2: mild concussion or moderate concussion?
• 2:19:22
  Speaker 1: The evidence based on this is a little shaky, but
• 2:19:26
  Speaker 1: I think for most things it kind of fits into
• 2:19:30
  Speaker 1: this idea of positive asymmetry, right, low risk, high potential
• 2:19:34
  Speaker 1: for benefit. And there have been lots of you know,
• 2:19:36
  Speaker 1: there have been randomized control trials to kind of look
• 2:19:38
  Speaker 1: at some of these things.
• 2:19:38
  Speaker 3: So we a couple of.
• 2:19:39
  Speaker 1: Years ago we published a paper looking at different nutritional
• 2:19:42
  Speaker 1: supplements after concussion.
• 2:19:45
  Speaker 3: That you know, we have some reasonably good evidence for.
• 2:19:47
  Speaker 1: So, yes, you should be seen by a doctor, you
• 2:19:51
  Speaker 1: should get whatever scans, and you know, immediate medical care
• 2:19:54
  Speaker 1: that you need. Absolutely right, that's we're assuming all of
• 2:19:57
  Speaker 1: that is done or done yeah immediately. There are a
• 2:20:01
  Speaker 1: couple of things that I think we know from sort
• 2:20:05
  Speaker 1: of animal studies that translate fairly well onto humans, but
• 2:20:10
  Speaker 1: also some maybe some observational studies in humans.
• 2:20:12
  Speaker 3: But a couple of things are important.
• 2:20:14
  Speaker 1: So one is temperature management, temperature regulation. There have been
• 2:20:18
  Speaker 1: this is what my PhD was actually in hypothermia after
• 2:20:21
  Speaker 1: a cute brain injury.
• 2:20:22
  Speaker 3: Hyper hypo thermia, so cooling down.
• 2:20:26
  Speaker 1: Although I did do some studies where we heated up
• 2:20:28
  Speaker 1: and that makes things worse.
• 2:20:30
  Speaker 3: So this kind of potains I.
• 2:20:31
  Speaker 2: Can imaginein doesn't like to get too hot.
• 2:20:33
  Speaker 3: That's essentially what I'm about to say.
• 2:20:35
  Speaker 1: So there have been lots of studies where they've done
• 2:20:37
  Speaker 1: cooling hypo thermia in people after traumatic brain injuries and
• 2:20:41
  Speaker 1: concussions hasn't really shown much.
• 2:20:43
  Speaker 3: Of an effect.
• 2:20:44
  Speaker 1: What seems to be important is preventing hyper thermia. So
• 2:20:50
  Speaker 1: one of their effects of cooling somebody down is that
• 2:20:53
  Speaker 1: they don't get hot. So that's probably something that's really important.
• 2:20:57
  Speaker 1: So often concussions happen in a heat stress environ.
• 2:21:00
  Speaker 3: You're on a football pitch.
• 2:21:01
  Speaker 1: It's August in Alabama, it's forty degrees right, get inside,
• 2:21:06
  Speaker 1: get cool as quickly as you can, because there are
• 2:21:08
  Speaker 1: studies that and that doesn't mean you have to get
• 2:21:10
  Speaker 1: an ice bath. Just don't be really hot. If you
• 2:21:12
  Speaker 1: get a fever, which you might might do after a
• 2:21:15
  Speaker 1: more significant injury, you know, thilanol or something like that
• 2:21:18
  Speaker 1: to help maintain thermoregulation will be really important. The next
• 2:21:22
  Speaker 1: is blood sugar regulation. So we know that after a
• 2:21:26
  Speaker 1: significant brain injury you have increases in blood sugar that's
• 2:21:29
  Speaker 1: associated with worse outcome. Some of it's like what's caused,
• 2:21:32
  Speaker 1: what's consequence is the injury driving the blood sugar? Is
• 2:21:34
  Speaker 1: the blood sugar driving the injury? I think an easy
• 2:21:37
  Speaker 1: thing to just say is I would avoid any super
• 2:21:40
  Speaker 1: sugary refined carbohydrates that might just sort of, you know,
• 2:21:45
  Speaker 1: kind of pile on for one of a better word, right,
• 2:21:47
  Speaker 1: So alcohol, So alcohol I would avoid as well, mainly
• 2:21:52
  Speaker 1: because it impairs sleep, and we know that sleep is
• 2:21:54
  Speaker 1: going to be critical to recovery. Some people would say
• 2:21:56
  Speaker 1: something similar about caffeine acutely after injury, because it's it's
• 2:21:59
  Speaker 1: a stimulant. One thing that the reason why hyper therm
• 2:22:03
  Speaker 1: you're getting too hot makes the injury worse.
• 2:22:06
  Speaker 3: Is because it.
• 2:22:08
  Speaker 1: Simply speaking increases the gap between energy requirements and energy production. So,
• 2:22:14
  Speaker 1: like one of the hallmarks of these acute brain injuries
• 2:22:17
  Speaker 1: is a deficit and energy production with mitochondrial failure or
• 2:22:20
  Speaker 1: mitochondrial dysfunction. And so if you get too hot or
• 2:22:24
  Speaker 1: you stimulate the brain, you're asking for more energy when
• 2:22:28
  Speaker 1: your neurons can't produce it, and that is a trigger.
• 2:22:32
  Speaker 1: That kind of deficit and energy production is a trigger
• 2:22:34
  Speaker 1: for cell death and neuroinflammation and some of these other
• 2:22:37
  Speaker 1: processes that then may happen. So avoid alcohol, avoid caffeine,
• 2:22:41
  Speaker 1: both of those potentially related to improving sleep. Then things
• 2:22:45
  Speaker 1: that we have some reasonable evidence for immediately after concussion,
• 2:22:49
  Speaker 1: creatine and what dosage.
• 2:22:52
  Speaker 3: The best trial was actually.
• 2:22:53
  Speaker 1: Done in a pediatric group, although very broad. It was
• 2:22:57
  Speaker 1: like one year old to eighteen years old. But they
• 2:23:00
  Speaker 1: gave zero point four grams per kilo per day, So
• 2:23:04
  Speaker 1: whoa yeah, so it's a pretty it's like double a
• 2:23:07
  Speaker 1: traditional loading dose if you're a one hundred kilo person,
• 2:23:10
  Speaker 1: but like if you're sevent if you're seventy kilos, you know,
• 2:23:13
  Speaker 1: one hundred and fifty five pounds or something like that.
• 2:23:15
  Speaker 1: Then that's twenty eight grams of creatine, so it's a lot.
• 2:23:19
  Speaker 3: But your trips in.
• 2:23:20
  Speaker 2: The bathroom could be expected, but you may just spread
• 2:23:22
  Speaker 2: it out across the day.
• 2:23:23
  Speaker 1: Yes, so well, one thing I'll say about that is
• 2:23:27
  Speaker 1: the most recent meta analyzes show that you actually don't
• 2:23:31
  Speaker 1: get is actually quite rare to get more geo side
• 2:23:34
  Speaker 1: effects with creating compared to placebo. Some of it is
• 2:23:37
  Speaker 1: probably related to the quality of the supplement, So poor
• 2:23:40
  Speaker 1: quality creating supplements have more adulterants that make all some
• 2:23:42
  Speaker 1: of those geo side effects. Some of it can be
• 2:23:45
  Speaker 1: due to high you can saturate the creatine transporters, it
• 2:23:50
  Speaker 1: doesn't get absorbed, water gets drawn into the gut that
• 2:23:53
  Speaker 1: can that can then go right cause diarrhea or something.
• 2:23:58
  Speaker 1: But some of the gi shoes that people experience are
• 2:24:01
  Speaker 1: probably due to poor quality products that they're taking.
• 2:24:04
  Speaker 2: For the non head injured individual, is there any reason
• 2:24:09
  Speaker 2: to go back to the old loading protocols of taking
• 2:24:11
  Speaker 2: twenty grams per day, putting it in a little bit
• 2:24:13
  Speaker 2: of grape juice or something else to spike blood sugar
• 2:24:16
  Speaker 2: for this very reason that it could augment the passage
• 2:24:20
  Speaker 2: of creatine into your cells as opposed to drawing water
• 2:24:23
  Speaker 2: into the gut. In the nineties, we would take five
• 2:24:26
  Speaker 2: grams of creatine four times a day in an ounce
• 2:24:30
  Speaker 2: or two of pure grape juice, and you draw a
• 2:24:34
  Speaker 2: lot of water into your muscle cells you put on.
• 2:24:38
  Speaker 2: You know, it varies, but for me, anywhere from five
• 2:24:40
  Speaker 2: to eight pounds of its water weight. But it's mostly
• 2:24:43
  Speaker 2: in the muscles. It's not insignificant translates to big strength increases.
• 2:24:48
  Speaker 2: I don't take nearly that much now, just do the
• 2:24:49
  Speaker 2: ten grams per day. But is there any reason to
• 2:24:52
  Speaker 2: go back to those traditional loading So.
• 2:24:54
  Speaker 1: If you're just like long term creating supplementation, probably not
• 2:25:00
  Speaker 1: in this kind of setting. I think, you know, the
• 2:25:03
  Speaker 1: evidence is for a loading style protocol, right, so for
• 2:25:07
  Speaker 1: most people it might be twenty to thirty grams of
• 2:25:10
  Speaker 1: creating spread spread across the day. You know, if anybody's
• 2:25:13
  Speaker 1: just like taking creatine for other reasons, you know this
• 2:25:17
  Speaker 1: is a standard dosing protocol.
• 2:25:19
  Speaker 3: I think it's fine.
• 2:25:20
  Speaker 2: I thought you're going to tell me I could get
• 2:25:21
  Speaker 2: it to work that way. Yeah.
• 2:25:22
  Speaker 1: So, like some of the studies that use traditional like
• 2:25:25
  Speaker 1: creating mode hydrate and look at creating levels in the brain,
• 2:25:28
  Speaker 1: they did use a loading protocol for a week, and
• 2:25:30
  Speaker 1: then you see significant increases in brain creatine, but creating
• 2:25:34
  Speaker 1: having other effects on the brain, you know, potentially improving mood,
• 2:25:37
  Speaker 1: improving memory, and in older adults. Some of those benefits
• 2:25:42
  Speaker 1: happen at just like a traditional creatine doses, so you
• 2:25:44
  Speaker 1: don't take massive dose, you know, think load loading doses.
• 2:25:47
  Speaker 1: You can actually see some benefits of like five to
• 2:25:48
  Speaker 1: ten grams, so that's creatine. So magnesium, so four hundred
• 2:25:52
  Speaker 1: mitigrams once or twice a day. There've been some trials
• 2:25:55
  Speaker 1: shouldn't form. Those studies actually use magnesium oxide surprisingly, but
• 2:26:00
  Speaker 1: I would probably use magnesium glyconate there it's very by available.
• 2:26:07
  Speaker 1: Athletes usually need a bit more glycine anyway, but any
• 2:26:11
  Speaker 1: bio available form will be fine.
• 2:26:14
  Speaker 3: Then I may get through fatty acids.
• 2:26:17
  Speaker 1: The evidence is a little bit better for like, there
• 2:26:20
  Speaker 1: are now several studies in like collegiate American football players
• 2:26:24
  Speaker 1: where they take a couple of grams of a mega
• 2:26:27
  Speaker 1: three's every day and across a season, you see less
• 2:26:31
  Speaker 1: accumulation of biomarkers of injury, like a neurofilament light that
• 2:26:35
  Speaker 1: are circulating in the blood. So that's something that I
• 2:26:37
  Speaker 1: would just take long like long itunely, if you're somebody
• 2:26:40
  Speaker 1: who's at risk of a concussion because of your sport
• 2:26:44
  Speaker 1: or your job, I would just take a reasonable Mega
• 2:26:47
  Speaker 1: three supplement, just long term, because we have some reasonable
• 2:26:49
  Speaker 1: evidence for that. Then other things might become a little
• 2:26:54
  Speaker 1: bit specific to.
• 2:26:57
  Speaker 3: The symptoms that you're experiencing.
• 2:26:58
  Speaker 1: So if you have sleep issues, then the studies that
• 2:27:01
  Speaker 1: have used a melatonin and that's that shown improvements branch
• 2:27:04
  Speaker 1: chain amino acids at high doses for sleep. And that's
• 2:27:08
  Speaker 1: interesting because outside of TBI, high doses of branchain and
• 2:27:12
  Speaker 1: menuo acids may actually impair sleep because they compete for
• 2:27:15
  Speaker 1: tripped fan up take into the brain, decreasing potentially decreasing
• 2:27:18
  Speaker 1: serotonin melatonin production. But in TBI, there are two studies
• 2:27:22
  Speaker 1: that suggest improvements in sleep with high doses of branchain
• 2:27:25
  Speaker 1: aminu acids.
• 2:27:26
  Speaker 2: If somebody is going to take branch chain and miniuo acids,
• 2:27:29
  Speaker 2: presumably they're going to look at how much leucine is
• 2:27:31
  Speaker 2: there variety of reasons, So do you recall how much
• 2:27:35
  Speaker 2: leucine to get this effect post TBI?
• 2:27:38
  Speaker 1: So I don't think they, at least I don't remember
• 2:27:40
  Speaker 1: the loucine dose, but they were taking up to sixty
• 2:27:44
  Speaker 1: grams of branchaming acids.
• 2:27:46
  Speaker 2: Six zero six zero, Okay, because typical kind of suggested
• 2:27:52
  Speaker 2: supplement bottled gym dose would be three to five grams.
• 2:27:55
  Speaker 2: That's usually about six capsules, okay.
• 2:27:58
  Speaker 1: So like one study they did in veterans, they had
• 2:28:02
  Speaker 1: I think it was three doses of twenty grams spread
• 2:28:07
  Speaker 1: across the day.
• 2:28:08
  Speaker 2: Are you curious about these? I begain studies that are
• 2:28:12
  Speaker 2: looking at you know, TBI and brain recovery. I mean,
• 2:28:16
  Speaker 2: abigain is a it's a whole other thing because it's
• 2:28:20
  Speaker 2: the most powerful, long lasting psychedelic at least that I'm
• 2:28:23
  Speaker 2: aware of. But it seems like there's some interesting data coming.
• 2:28:26
  Speaker 1: Out absolutely and then you know, in people with a
• 2:28:31
  Speaker 1: history of brain trauma and PTSD, and I think some
• 2:28:34
  Speaker 1: of these other psychedelics are going to be very interesting
• 2:28:38
  Speaker 1: there as well, potentially due to their neuroplastic effects that
• 2:28:43
  Speaker 1: tend to particularly happen in like macro doses, right in
• 2:28:47
  Speaker 1: the psychedelic doses. I think that there's a lot more
• 2:28:50
  Speaker 1: to come there, but certainly the trials that have been
• 2:28:52
  Speaker 1: done so far are quite compelling. But that's obviously in
• 2:28:54
  Speaker 1: a very controlled kind of clinical yeah.
• 2:28:58
  Speaker 2: Monitor Yeah. I again, it's not legal in the United States,
• 2:29:00
  Speaker 2: although things that things are shifting.
• 2:29:02
  Speaker 1: But coline is another thing, particularly our city cooline. So
• 2:29:06
  Speaker 1: best evidence is for one to two grams a day
• 2:29:10
  Speaker 1: of colin of coline in the form of CDP coding
• 2:29:13
  Speaker 1: or city coolin, which is the same thing. Those are
• 2:29:17
  Speaker 1: the main ones. Then there's some other like niche supplements
• 2:29:20
  Speaker 1: that do have some evidence. The one that's probably has
• 2:29:22
  Speaker 1: the most evidence for it is Boswellia Boswellia yeah, which
• 2:29:25
  Speaker 1: is frank Indian frankinsense. But there's an extract to Boswelia
• 2:29:29
  Speaker 1: that's been tested in i think three different clinical trials
• 2:29:31
  Speaker 1: after TBI showed some benefit. Enzogenol, which I think is
• 2:29:34
  Speaker 1: a pine extract, slightly less evidence than Boswellia.
• 2:29:38
  Speaker 3: I typically would.
• 2:29:39
  Speaker 1: Recommend people stick to the first group of kind of
• 2:29:41
  Speaker 1: nutritional type supplements, but in very specific use cases based
• 2:29:46
  Speaker 1: on specific symptoms, some of those other things might be beneficial.
• 2:29:49
  Speaker 1: Then beyond that, we know that physical returns physical activity
• 2:29:52
  Speaker 1: as soon as possible is really important after getting another
• 2:29:55
  Speaker 1: head in without getting another head injury, and so this
• 2:29:58
  Speaker 1: really changed over the line last few years. You know,
• 2:30:01
  Speaker 1: maybe five ten years ago, people like you know, rest
• 2:30:03
  Speaker 1: is what you need to do, go lie in a
• 2:30:05
  Speaker 1: dark room. If you've got a concussion. In sports, you
• 2:30:09
  Speaker 1: would expect the team to have a rigorous return to play.
• 2:30:13
  Speaker 1: Pros called that included low level aerobic activity as soon
• 2:30:17
  Speaker 1: as you're able to tolerate it two or few times
• 2:30:20
  Speaker 1: a week at a level just below what might make
• 2:30:23
  Speaker 1: your symptoms worse. And then first you do sort of
• 2:30:27
  Speaker 1: like nonspecific aerobic ex scize, and then you start to
• 2:30:29
  Speaker 1: bring back skill specific exercises, sports exercises, then go back
• 2:30:32
  Speaker 1: into full training, and then go back into playing kind
• 2:30:36
  Speaker 1: of it in that order, and that should be quite
• 2:30:38
  Speaker 1: systematized now, So I would expect sports teams to kind
• 2:30:41
  Speaker 1: of have that in place. So, like, the standard of
• 2:30:43
  Speaker 1: care is generally physical therapy if you have any ongoing
• 2:30:47
  Speaker 1: cognitive or physical symptoms sort of a month plus after
• 2:30:51
  Speaker 1: any kind of dramatic brain injury. There's some evidence that
• 2:30:56
  Speaker 1: like virtual reality or augmented reality physical activity might improve
• 2:31:02
  Speaker 1: cognitive symptoms, vestibular therapy for balance and dizziness issues, and
• 2:31:08
  Speaker 1: then increasingly, you know, there's a focus on sort of
• 2:31:13
  Speaker 1: oculo motor training for like convergence or other I who
• 2:31:17
  Speaker 1: like eye issues that are very common after concussions but
• 2:31:22
  Speaker 1: aren't picked up as often as people might like. But
• 2:31:25
  Speaker 1: increasingly kind of eye tracking and these kinds of things
• 2:31:29
  Speaker 1: are done, particularly in professional sports or other arenas after
• 2:31:33
  Speaker 1: brain injuries to kind of idea you'd have a baseline,
• 2:31:35
  Speaker 1: you figure out what's changed, and then you would track
• 2:31:37
  Speaker 1: that over time and you can you can train that
• 2:31:38
  Speaker 1: depending on the deficit.
• 2:31:40
  Speaker 2: Those recommendations are going to be extremely helpful for people
• 2:31:43
  Speaker 2: athletes at all levels. I mean, I think for people
• 2:31:46
  Speaker 2: that don't have access to the you know, all the
• 2:31:48
  Speaker 2: latest and greatest you know technology and coaches and nurses
• 2:31:53
  Speaker 2: and doctors that you know, there's a lot of head
• 2:31:56
  Speaker 2: hits out there that aren't necessari you know, fortunately aren't
• 2:32:00
  Speaker 2: full blown brain bleeds and brain damage, but the low
• 2:32:05
  Speaker 2: level trauma to the brain is obviously a consideration, especially
• 2:32:09
  Speaker 2: kids like just falling off the monkey bars. Like parents
• 2:32:12
  Speaker 2: want to know what they can do. So thank you
• 2:32:14
  Speaker 2: very much for those recommendations. You're doing a strong man competition,
• 2:32:17
  Speaker 2: Uh huh, all natural, this is not the enhanced games.
• 2:32:22
  Speaker 2: Just tell us what the format of that is.
• 2:32:24
  Speaker 3: Well, first of all, how old are you forty one?
• 2:32:26
  Speaker 2: Cool? Have you done one of these before?
• 2:32:28
  Speaker 3: Yeah?
• 2:32:28
  Speaker 1: I six or seven competitions at this point. I started
• 2:32:31
  Speaker 1: during COVID. I've done like a competition or two every
• 2:32:33
  Speaker 1: year since then.
• 2:32:34
  Speaker 2: You're a tall guy, you're like six two, you weigh.
• 2:32:37
  Speaker 3: Like two ten to fifteen usually.
• 2:32:38
  Speaker 2: And is it so it's heightened weight class or just
• 2:32:41
  Speaker 2: weight class.
• 2:32:41
  Speaker 1: So it's it's weight class. And so now that I'm
• 2:32:45
  Speaker 1: older than forty, I compete in the masters category. So
• 2:32:48
  Speaker 1: there's a It's one of my favorite things about strong
• 2:32:50
  Speaker 1: man is that if you weigh less than two hundred pounds,
• 2:32:52
  Speaker 1: you're a lightweight, So I mean the lightweight master's category.
• 2:32:56
  Speaker 3: It means that I usually.
• 2:32:57
  Speaker 1: Have to like do a water cut, like for a
• 2:33:01
  Speaker 1: way in because I don't normally I'm not I'm normally
• 2:33:03
  Speaker 1: above two hundred pounds.
• 2:33:06
  Speaker 3: But yeah, they so they have they have weight they
• 2:33:08
  Speaker 3: have weight classes and age classes.
• 2:33:10
  Speaker 2: Can you eat your way and hydrate your way back
• 2:33:12
  Speaker 2: up to.
• 2:33:13
  Speaker 1: After Oh yeah, like the usually weigh in twenty hours
• 2:33:17
  Speaker 1: twenty four hours before I'm I'm definitely back to my
• 2:33:20
  Speaker 1: usual weight by the next.
• 2:33:22
  Speaker 2: Day, gotcha. Yeah, we don't want you trying to lift
• 2:33:24
  Speaker 2: heavy things. Dehydrated. What are the big events? So you're
• 2:33:27
  Speaker 2: carrying stuff overhead, you're carrying stuff at your sides, You're
• 2:33:30
  Speaker 2: what are you doing?
• 2:33:31
  Speaker 1: A standard kind of local regional competition is five is
• 2:33:33
  Speaker 1: five events. I qualified for the Natural World Strongest Man,
• 2:33:38
  Speaker 1: which is going to be seven events. But there's usually
• 2:33:41
  Speaker 1: some kind of deadlift, some kind of overhead pressing event,
• 2:33:45
  Speaker 1: some kind of medley where you're like carrying something, lifting stones,
• 2:33:51
  Speaker 1: farmers walks, so in a truck pull.
• 2:33:56
  Speaker 3: Something like that.
• 2:33:56
  Speaker 1: So like more dynamics, So there's like usually like a
• 2:33:58
  Speaker 1: static max strength thing, but then also like more dynamic teeth.
• 2:34:02
  Speaker 3: Yeah, you do the teeth pool no teeth, no teeth
• 2:34:06
  Speaker 3: putting that.
• 2:34:08
  Speaker 1: We didn't talk about oral health and coggative function, but
• 2:34:10
  Speaker 1: that's really important too. The events in the competition that
• 2:34:13
  Speaker 1: I've got coming up, the World's Strongest there's going to
• 2:34:15
  Speaker 1: be a farmer's walk, So that's where you just like
• 2:34:17
  Speaker 1: pick things up at the side and kind of.
• 2:34:18
  Speaker 2: So for a guy, let's say you you hydrate back
• 2:34:21
  Speaker 2: to like two or five to ten or something like that.
• 2:34:24
  Speaker 2: What what's a good distance and weight to carry?
• 2:34:27
  Speaker 1: I know the weight in the competition, it's one hundred
• 2:34:29
  Speaker 1: and twenty kilos per hand, So it's two hundred and
• 2:34:31
  Speaker 1: sixty four pounds per hand and as far as you
• 2:34:34
  Speaker 1: can as far as you can carry it.
• 2:34:37
  Speaker 2: That's a big human in each hand.
• 2:34:39
  Speaker 1: Yeah, So typically you know, if you if you can
• 2:34:44
  Speaker 1: get to where you've got like your body weight in
• 2:34:45
  Speaker 1: each hand and you're able to pick it up and
• 2:34:47
  Speaker 1: move with it even if it's not very far.
• 2:34:48
  Speaker 3: I think that's pretty good.
• 2:34:50
  Speaker 1: But you know, some people might say half your body
• 2:34:52
  Speaker 1: weight in reality, if you pick something up heavy you
• 2:34:55
  Speaker 1: move with it, that's great, like and then get better over.
• 2:34:59
  Speaker 2: This is your time, your shun, my friend. People can
• 2:35:01
  Speaker 2: work their way up. I watch Tom Havilan's uh yeah Instagram.
• 2:35:06
  Speaker 2: We'll put a link to it everyone to see that.
• 2:35:08
  Speaker 2: His wife and his kid also walk into the workout.
• 2:35:11
  Speaker 2: So he's got a man, he's strong. But yeah, carrying heavyweight. No, No,
• 2:35:14
  Speaker 2: this is not your time to tell people how to
• 2:35:16
  Speaker 2: tiptoe under. That's a different podcast. So you're carrying two
• 2:35:19
  Speaker 2: hundred and twenty pounds in each hand.
• 2:35:21
  Speaker 1: To sixty four pounds per ham and walking how far
• 2:35:23
  Speaker 1: it's maximum distance in I can't remember if it's sixty
• 2:35:29
  Speaker 1: or ninety.
• 2:35:30
  Speaker 2: Set it down you.
• 2:35:31
  Speaker 3: Can set it.
• 2:35:32
  Speaker 1: You can set it down so as far as you
• 2:35:34
  Speaker 1: can get in that period of time and then be
• 2:35:35
  Speaker 1: similar with it with a yolk walk. So there's a
• 2:35:37
  Speaker 1: yoke where you know, like put it on your back.
• 2:35:39
  Speaker 1: It's seven hundred pounds. How far can you how far
• 2:35:42
  Speaker 1: can you walk in that period of time?
• 2:35:43
  Speaker 2: Oh, there's so primitive love. If you're a hyperthlamic event, yeah.
• 2:35:47
  Speaker 1: So in that event in the in the yolk walk,
• 2:35:48
  Speaker 1: if you get to the end, I think it's thirty
• 2:35:50
  Speaker 1: I think it's thirty meters ninety ish feet. If you
• 2:35:53
  Speaker 1: can carry that and that far in the time cap.
• 2:35:55
  Speaker 1: Then you do reps on a circus dumbbell, So like
• 2:35:57
  Speaker 1: this big massive dumbbell.
• 2:35:59
  Speaker 3: That like shot shoulders overhead.
• 2:36:01
  Speaker 1: There's one at one hundred and ten pounds and the
• 2:36:03
  Speaker 1: next is one hundred and thirty five pounds. Then there's
• 2:36:06
  Speaker 1: gonna be a loading medley, so sandbags and kegs like
• 2:36:10
  Speaker 1: over a platform that's like I think two hundred to
• 2:36:14
  Speaker 1: three hundred pound implements. They kind of increase over time.
• 2:36:18
  Speaker 1: There's a maximum squat and you have a choice of
• 2:36:20
  Speaker 1: two different weights, and so like if you choose the
• 2:36:25
  Speaker 1: bigger weight and you get reps on the bigger weight
• 2:36:27
  Speaker 1: that you get a better score than somebody. Back squat,
• 2:36:30
  Speaker 1: it's a standardbacks is with an axle bars like a
• 2:36:33
  Speaker 1: thick bar. And then in strong man, when you have squatting,
• 2:36:36
  Speaker 1: you usually have pads that you squat down to, so
• 2:36:39
  Speaker 1: it's a specific height you squat down to. So like
• 2:36:42
  Speaker 1: that could give you an advantage of your shorter right
• 2:36:45
  Speaker 1: because you have to go less distance to get the
• 2:36:47
  Speaker 1: weight on the pads.
• 2:36:47
  Speaker 2: But like there's no geeking it and calling less than
• 2:36:50
  Speaker 2: a one right now, Yeah, people have done that. It
• 2:36:52
  Speaker 2: doesn't look good.
• 2:36:53
  Speaker 1: Yeah, no, no, like it just has to hit the pads
• 2:36:55
  Speaker 1: and come back up. And the weights are one hundred
• 2:36:56
  Speaker 1: and seventy kilos and two hundred kilos, so that's what
• 2:37:00
  Speaker 1: nearly four hundred pounds and four hundred and forty pounds log.
• 2:37:03
  Speaker 3: Press for reps.
• 2:37:06
  Speaker 1: And again it's a similar style, and I think it's
• 2:37:08
  Speaker 1: one hundred kilos to two hundred and twenty pounds and
• 2:37:10
  Speaker 1: then one hundred and twenty so two sixty four. And
• 2:37:13
  Speaker 1: then there's a sled like you I think you push
• 2:37:16
  Speaker 1: a sled and then you load it with a two
• 2:37:18
  Speaker 1: hundred and seventy five pounds, samag and then you drag
• 2:37:21
  Speaker 1: it in a time cap.
• 2:37:25
  Speaker 3: I think I think that's all the events.
• 2:37:27
  Speaker 2: Awesome. You'll let us know when it is.
• 2:37:30
  Speaker 3: Yes, it's at the end of August.
• 2:37:32
  Speaker 2: Cool. Will it be online?
• 2:37:34
  Speaker 3: I won't be online, but I'm sure there'll be some
• 2:37:36
  Speaker 3: stuff on Instagram.
• 2:37:37
  Speaker 2: Cool. I love that you do this. Clearly, you got
• 2:37:40
  Speaker 2: a lot of brains in that skull, hears, and you're
• 2:37:43
  Speaker 2: also super strong. Love hearing it. That's great. And you
• 2:37:47
  Speaker 2: have no excuse not to carry the groceries. Yeah home, right,
• 2:37:50
  Speaker 2: So you lost that that right, but there's no doubt
• 2:37:53
  Speaker 2: you would anyway. That's awesome. I'm very impressed by the
• 2:37:57
  Speaker 2: by people who continue to take on at challenges in
• 2:38:02
  Speaker 2: their adult life, which is very appropriate to context today.
• 2:38:05
  Speaker 2: So doctor Tommy Wood, thanks for coming out today. I
• 2:38:09
  Speaker 2: learned a ton from you. And you know, going into this,
• 2:38:11
  Speaker 2: I like to think I know a thing or two
• 2:38:13
  Speaker 2: about plasticity, having spent so much time in it and
• 2:38:16
  Speaker 2: studying it over the years. But I learned a lot
• 2:38:18
  Speaker 2: from you today, and I know everyone else did as well.
• 2:38:20
  Speaker 2: You're an exceptionally clear communicator, and you're working on not
• 2:38:24
  Speaker 2: just an important issue. You're working on the issue this
• 2:38:28
  Speaker 2: neuroplasticity thing, and a whole lot more. So let's definitely
• 2:38:31
  Speaker 2: get you back to talk about recovery from brain injury
• 2:38:33
  Speaker 2: and stroke and things of that sort, because there's a
• 2:38:35
  Speaker 2: lot of additional things I think we could dig into.
• 2:38:38
  Speaker 2: But meanwhile, you've given us a lot of actionable tools,
• 2:38:42
  Speaker 2: and yeah, I love that you're doing this strong man
• 2:38:47
  Speaker 2: competition and come back again. We appreciate you well, thank you,
• 2:38:51
  Speaker 2: thank you, Thank you for joining me for today's discussion
• 2:38:53
  Speaker 2: with doctor Tommy Wood. To learn more about his work
• 2:38:56
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