EPI 241: Clinically Proven Plan To AGE-PROOF YOUR BRAIN & Stay Sharp For Life. This LITERALLY Grows Your Brain! With Dr. Majid Fotuhi

Welcome back to another episode of the Peak Performance Life podcast. Today, we are honored to have a very special guest with us. His name is Dr. Majeed Fatouhi. He is a pioneering neurologist, neuroscientist, and professor with more than 35 years of experience in brain health, memory, neuroplasticity, and the prevention of Alzheimer's disease. His work bridges research, clinical innovation, and public education. He earned his PhD in neuroscience from John Hopkins, completed medical training at Harvard Medical Schools, and he currently serves as an adjunct professor at Johns Hopkins University. He has written several books, his upcoming book, that is going to be released right around the time that this episode, this podcast is released, is called The Invincible Brain, The Clinically Proven Plan to Age Proof Your Brain and Stay Sharp for Life. This is such an important topic. It's something that's very near and dear to my heart, as I have seen my father and other older people kind of get older and lose some of their brain function. So I am super excited. Thank you so much for joining us. It's my pleasure to be on your podcast. Thanks for inviting me. Of course, yes. It's our pleasure. Let's start, I guess, with a little bit of a background of kind of how you, I know you've been doing this work, working on the brain for many, many years, researching and studying. But maybe kind of give us a little bit of a brief history of maybe how your views have evolved and kind of what your thought process is now kind of compared to when you started. I became interested in memory and Alzheimer's disease when I was doing my residency at Johns Hopkins Hospital. I realized that at that time, many people were over-diagnosed with Alzheimer's disease. I knew that diabetes, high blood pressure, depression, obesity, it could affect the brain. And I saw many patients who had all these treatable components and were diagnosed with Alzheimer's disease. And they were just asked to just come every year to Hopkins for monitoring. We were not addressing their medical conditions because they were diagnosed with Alzheimer's disease and sort of put in that category. And they were just asked to live in a nursing home and just decline. This was incredible. This was outrageous to me. And this was Johns Hopkins. This was not just a local clinic in some remote village. So I wrote my first book in 2002 talking about how medical conditions can affect the brain. I also went on to write several articles in like Nature and several other major scientific journals about the heterogeneity of what causes what we call Alzheimer's disease. That Alzheimer's is a super problem. Some of it is just plaques and tangles which appear to happen out of nowhere. It's a kind of degenerative disease. But it has these other components, these medical conditions that reduce blood flow in the brain, increase inflammation in the brain, and reduce the natural cleaning that happens in the brain. So I started seeing patients and I started actually applying what I learned through a review of the literature to see if it works. Like if I have a 75-year-old patient who has significant memory loss and repeating himself, whether that person can actually get better. This was totally revolutionary at the time to think that you have a 75-year-old who was in early stages of Alzheimer's disease or has a condition called mild cognitive impairment, which is like a between normal and Alzheimer's, and expect that they would get better. But they did. They did. And I was surprised in how quickly it happened. I thought it would take nine months. I thought it would take nine months of working with someone to address their particular issues and help them increase blood flow and reduce inflammation through lifestyle things like exercise and diet and so forth. I provided this for more and more people and fine-tuned the program in something that took 12 weeks. In 2012, I started my own neurology practice so that we'll have ownership of what I was doing and had full freedom in everything that I wanted to do. And I started seeing patient after patient coming to me and they were getting better. I collected the results of about 130 patients and published it in the Journal of Prevention of Alzheimer's Disease. And I showed that these patients actually increased the volume of the hippocampus, the part of the brain that's important for memory. So the program increased the volume of the hippocampus in these elderly patients. And 84% of them, to be exact, improved their cognitive function. I was pleasantly surprised that three months seemed to be just enough. Six weeks was not enough. And three months was just a sweet spot. I continued to provide this program and I saw patient after patient getting better. I became very busy in 2002, years ago, three years ago. Our office was field to capacity. I had 25 brain coaches and our office was open from 8 AM to 8 PM. And every slot was full. Like people were there Friday night, Saturday night, Sunday night at 7 PM. They were like, it was so busy. People were coming from different states. We have people from Arizona, Nevada, Connecticut, Florida, even from Boston. Boston is a place with all these medical centers. And I had patients flying over from Boston to near Washington DC in my office to help them with these things. And I realized I'm into something. I realized that, hey, I've really stumbled on something in that I thought it would take a long time, but in 12 weeks before I get any better. And that's when I decided I really need to provide this program for the world at large. What the things I do don't require any magic equipment or any particular programs, protocols. I mean, people do need to go through an evaluation process to determine the factors that affect their brain. And in my book, I have a list of 40 questions that people answer and that helps them identify the specific things that apply to them, which then they can personalize a 12 week program for themselves to see the best results. So now that's what I do. I have this book now that's coming out. And I look forward to going around, giving lectures. I just did some national TV interviews. I plan to travel abroad. My book has been translated to 14 languages already. So I plan to just go to different parts of the world and continue to promote the idea that Alzheimer's disease is not what people think it is. And that if you have memory loss, you shouldn't think about Alzheimer's disease first. You should think about so many conditions that can cause memory loss and have a positive attitude to attack those and improve them. Wow, that's amazing. And very interesting. And you're right when you say people will kind of just categorize everything as either Alzheimer's or dementia. They don't really know exactly what it is. They just know the brain isn't working as well. I've seen this myself with older family members as well. But that's a good distinction that it's not just, hey, this person has Alzheimer's and there's nothing you can do about it. I know that what you teach is something that can help improve the brain at any age. So really incredible. So what would you say? I guess I'll start with maybe a personal story. So if someone in my family, for example, is seeing their brain deteriorate and kind of seeing it every year deteriorate a little bit more and more, where would you start? Obviously they should contact you. But let's imagine they did contact you. Where would you kind of start? And how would you go about beginning that process to figure out what is the right approach to help them improve their brain? What I do in individuals like that is to determine which of the 40 different things applies to them. Common issues are depression, sleep apnea, insomnia, poor diet, sedentary lifestyle, isolation. These are the common factors. Especially isolation and sedentary lifestyle can profoundly accelerate the decline once people go through that process of decline. With aging, with what I call optimal aging, you stay sharp throughout your 50s, 60s, 70s, and maybe in the 80s you go down by 5%. It's not a drop. Just like people can stay physically active. These days we know that people at any age can go to the gym and after three months become physically stronger. We know that there's no limit on how strong a 70-year-old can get if they have co-chain and they have all the support they need. They can build up muscle. The muscles don't fall apart just because you're 70s or 40s or 50s and so forth. My approach would be to go through my checklist and see are they depressed? Are they isolated? Are they sitting home doing nothing all day? Are there styles a lot? And by going through those things, I'll figure out which of these factors applies to them. That's very, very good. And I will say in my personal case, isolation is a big thing. Unfortunately, I'm not there. I'm on the other side of the country from where my father is. And he was really intent on staying in his house and having someone just help him stay in his house. And I think not to get too off topic, but it's an interesting thing how many people think that going to a retirement community or a place like that is such a bad thing. How can you let someone in your family do that? But I actually think it may have been better for him if he was willing to do that because he would have been having people to talk to every day, keeping the brain stimulated, whereas now he doesn't have many people coming over the house. He's not talking to many people. He has started to lose a little bit of his mobility. So he's literally just sitting down in front of a TV pretty much the whole day for the most part. And I can see the deterioration. Now, we compare that with someone who I followed for years, like a Warren Buffett and a Charlie Munger who are not a Charlie passed away at 99 and Warren just retired at age 95. And they've been involved. They've been keeping their brain active and engaged and not the opposite of isolation. They have some of the smartest people in the world coming to talk to them every week and having conversations. So you can really see the difference and it makes a lot of sense what you're saying there. Absolutely. Your father is a typical patient for us. Typical, typical. And coming to our office was part of that social engagement because they would come to our office twice a week to work with our brain coaches, to work on the five pillars of brain health. And as we work with them, they were becoming more energetic week by week. They would come in tired, not interested to talk to people. And then they didn't wanna come. Like usually the daughters are the ones who bring parents more so than sons. So it's a good that you're involved in your father's care. And week by week, they would blossom, literally blossom. And in six weeks, they would come back with a smile. They would dress nicely and they were flirting with some of the staff and they were like coming back to life again. And I loved it. I loved seeing a transformation which took only 12 weeks. It didn't take three years. It didn't take six months. And so I definitely think that people in that category should be encouraged to receive more stimulation. And I agree with you, going to an assisted living is a good idea. These days, many assisted livings are like resorts. They have 20, 30 different activities daily. They have a shift to prepare food for them. It depends on how much you spend on such places. Some of them are very expensive. But if you can afford them, they have Bible studies. They have poker games. They have book clubs. They have outings as a group. They live in life. I tell you, they live in life. If you can afford it. And even the more modest ones, they have a lot of classes. They have a pool that people can play pool or they have an actual swimming pool that can swim and can get exercise classes, exercises in the pool. So the concept is our brain has a high degree of malleability. For better or for worse, if you don't take care of it, it declines really rapidly, especially when you get older. But if you take care of it, that malleability allows the brain to grow, literally grow. In our case, we looked at hippocampus, which is the size of your thumb. We have one on the right, one on the left. Hippocampus is ground zero for learning a memory. And we saw that half of our patients actually increase the volume of hippocampus. I mean, these are people in their 70s. And in some cases, the enlargement was so noticeable that we get the MRI. And we can see which one was after, which one was before, just looking at the MRI. I really recommend people to change their view about brain aging in general. The other thing is that in old days, a lot of people were not taking care of their teeth as well as we do these days. 50, 100 years ago, a lot of people would have cavities, and they would lose their teeth, and they would need dentures. It was not uncommon even 30 years ago to go somewhere and see that a third of people in assisted living would have dentures. It was such a common problem. Nowadays, you don't see that as often, because people have figured out if you take care of your teeth, as you go to your 40s, 50s, 60s, and 70s, you have a nice set of teeth in your 80s, and these are your own teeth. You have had some repairs, some cavities they fixed, but these are your own teeth. You don't need dentures. And your brain is the same way. And fortunately, we don't have a equivalent of a denture for the brain. We can't put an artificial brain to replace the whole teeth. But the best thing to do is to keep your brain healthy just the same way you keep your teeth healthy. So I'm sure people listening now are thinking, how do I do that? How do I keep my brain healthy as I get older? Having reviewed the literature in the past 30 years are on what are the most important things for brain health. I have developed what I call the five pillars of brain health. These are exercise, optimal sleep, healthy diet, mindset, and stress reduction, and brain training. Those are the five pillars of brain health. Amazing. Amazing. And I think people know we can go into exercise, and we can go into nutrition. But one of the ones that's unique is the brain training. So that one really caught my attention. Because I think many of us have heard, yes, you need to exercise. You need to eat healthy. Now, how many are actually doing it is a different story. But I think people may have heard that. But brain training, tell us a little bit more about what does brain training look like, and which types of brain training have you seen to be effective? Your brain is like a muscle. And the more you stimulate it, the stronger it gets. There's a part of brain called cortex, which is the outer layer of the brain, and there's a pair of hippocampus on either side of the brain. Cortex is responsible for your higher cognitive abilities, things like reading, writing, typing, doing your taxes, working. All these higher brain functions emanate from the functions of the cortex and hippocampus. Now, the cortex and hippocampus shrink with aging. And the more risk factors you have, the more these parts of the brain shrink. So diabetes, sleep apnea, insomnia, stress, center lifestyle, they all literally shrink the brain in a dose-dependent manner, which means the more of them you have, the more it shrinks. So the solution is to grow up the brain back. And the five pillars of the brain health help to regrow the brain. And brain training is an important element of how you can grow back the size of cortex and hippocampus. See, the cortex is like a mosaic of nodes and different nodes form networks. So you have a memory network. About 10 or 20 nodes work together to allow you to remember things and recall things. And there's a network for attention and so forth. And this memory network can then get stimulated with brain training. Now, if you do brain training for memory, the memory parts of the brain improve. If you do brain training for attention, the attention part of the brain improve. If you do brain training for executive function and planning and decision-making, that part of the brain improves. It's just like a muscle. You go to a gym, you work on your biceps, you work on your core, you work on legs. Whichever part of the body you work, those part of the body get stronger. I recommend to focus on brain games that improve memory. Since memory is such a common problem, I recommend that people learn how to improve their memory through what memory training. There are many, many programs and apps these days available. I have an app myself which has components of brain training, but there are hundreds of apps. And there's also brain games apps like Lomocity, BrainHQ, Elevate, Peek, all of these brain apps, brain game apps provide brain training for different things. So you can go to these apps and pick up the menu for memory. Many of them have a section for memory for names. And when you go there and you do the brain games, offer memory, you improve your memory. The concept that I think is really important is this. Most people don't appreciate that they can improve their memory. They feel like once the memory fades, it's gone. And the learning ability is gone. So many of people I know, who are in their 60s or even 50s, they say, I'm too old for that. They don't even make the effort to learn. I can show people how to memorize a deck of cards and it's not that complicated. So when I offered to a lot of people I know, I said, let me show you. They don't want to try because they're convinced they can't do it. And of course I offered to my wife, she said, let's try it. And she learned it. It takes four or five hours of training, but it's doable. I mean, you can do it too. So I think we need to help people appreciate that they need to look at the brain as a vital, modifiable, malleable organ. And with brain training, along with this other four pillars of brain health, they can literally grow the parts of their brain that usually shrink with aging. And when those parts of the brain grow back, they're there. You don't get Alzheimer's disease. If your brain is large, you become resilient. The title of my book is the Invincible Brain, meaning that with doing these five pillars of brain health, your brain becomes more resilient. It becomes invincible against the effects of Alzheimer's disease. I really love the way this is a big reframe for me right now. I really like this. I'm thinking of the brain, like how I train a muscle in the gym, and it gets bigger. And now I can train my brain and get my brain better, especially as I age. I think this is a really important concept. You know, you kind of, at least me personally, I've heard of some of these brain games. I heard there are brain games. I never really tried one. I don't know. In my mind, I'm thinking, which one is legit and which one is not legit? You mentioned you have your own app. I would trust your app. What's the name of your app maybe so we can share that? And then maybe if you want to give one other of your favorite kind of brain training apps that you think is really legit. Yeah, my brain app is the Invincible Brain. And I think Lemosity has been around for a long time. The problem with brain training is that some people think that if they just do two weeks of brain training, suddenly everything returns and everything is fine. If you have sleep apnea, sedentary lifestyle, poor diet, never do anything for your brain. And all you do is to do 20 minutes of these brain games. Don't expect that in two weeks, suddenly you are 10 years younger. Because the brain training is the fifth of the five pillars of brain health. Number one is actually fitness and exercise. And number two is optimal sleep. And number three is optimal nutrition. Number four is reduce stress and doing things like meditation and slow breathing exercises. And number five is brain training. Brain training has had a bad rep because studies have shown that if you do cognitive stimulation, you don't, you still get Alzheimer's disease. Of course, you can't expect to do some brain training and not get Alzheimer's disease. The brain training is going to reduce your risk of Alzheimer's disease by 10%. Exercise can reduce it by 40%. Exercise and diet is going to bring it by 60%. And if you add food and breathing exercises, you bring it to 80%. And so you need to have an understanding of how this thing works. And unfortunately, if you hear on the news, oh, these brain trainings are useless because people still get Alzheimer's disease, you have to understand in the context that there are five pillars of brain health. And doing one by itself helps, but it's not enough to make a noticeable difference as long as you take care of the other pillars of brain health as well. That's a great point. That's a great point. I really love how you listed out sort of the order of importance there as well. Because yeah, if you're eating unhealthy food, you're drinking alcohol, you're not getting good sleep, you're not exercising. First of all, I don't even know. I guess it all goes together because I feel like if I was eating horrible, drinking, not getting good sleep, and not exercising, I wouldn't even have. I feel like I would be so lethargic. I wouldn't even want to do the brain training. I would have no motivation because I just don't have the energy that I need to actually live my life and do these things. So I think that's a great point. In terms of exercise, is there any one form of exercise that you have found to be more beneficial for the brain than another type? I think the aerobic exercise is particularly important. There is something called VO2max, which is a measure of your fitness. The more fit you are, the larger is your VO2max. VO2max is the maximum amount of oxygen that your body can use at your peak exercise. And it reflects that your lungs are working well, your heart is working well, your blood vessels are doing well, and your muscles are strong that they can absorb that oxygen. So VO2max is one test that captures your body's overall fitness. And in order to improve your VO2max, you need to do aerobic exercise. Now, muscle training and weight training is also very helpful because when you grow muscles, you increase the number of hormones that are released by the muscles called myokines. These myokines have neuroprotective properties. A well-known myokine is BDNF, brain, drive, neurotrophic factor. And the BDNF can increase the healing mechanisms in the brain. So when you do muscle training, you provide that BDNF, which helps with repair and rejuvenation of your brain. I recommend that if you have only one hour to exercise in a day to do 45 minutes of aerobic, get on a bike or a rowing machine or something, and then do 15 minutes of weight training. If you have time, you can do more of each one. I personally aim for one hour of biking and a stationary bike and a 45 minutes of weight training three or four times a week. Excellent. Excellent. That's very good advice. The next one on your list, you mentioned sleep. And it's very interesting. We actually recently released an episode with someone who's kind of an expert in sleep apnea and sleep. And he mentioned how so many people have undiagnosed sleep apnea. And it's interesting. Last night, I was at dinner with a bunch of guys. And I actually, I don't remember how it came up exactly, but the topic of sleep apnea came up. And I actually asked a couple of these guys. I said, hey, do you snore? And a couple of them said, yes, we do snore. And one of the guys said, yeah, I have sleep apnea, but I couldn't wear that machine a long time ago. And this time, I'm going to try something else. But it was almost like, but actually, the topic came up because they were talking about how they always wake up in the middle of the night and can't go back to sleep. And they're only sleeping five hours. And it's affecting their life and things like that. So that's really important. Any advice for people, like for example, if someone's listening to this and they do snore at night, is that something that is just no big deal? Or should they look into that? Or should they look at getting a sleep apnea kind of test? Sleep apnea is a silent killer of the brain. It's horrible for the brain. It really, really affects the brain. Some studies have shown that if you go to a stroke unit and ask all the patients who have had a stroke and find out how many of them have had sleep apnea, 80% have sleep apnea, and many of them did not know they have it or they were not treating it well. Sleep apnea is a condition in which a person snores during the night. They wake up multiple times almost with their drop in the oxygen levels. During the day, they feel tired. They feel foggy. Many of them wonder if they have attention deficit disorder, not realizing the sleep apnea that's making them not be able to pay attention. So we have to also keep in mind that not everybody who snores has sleep apnea. If you have snoring but you don't have these other symptoms, you don't feel grumpy or tired during the day, chances are that you have benign snoring. But if you do snore, you definitely need to have a test. These days, they're in-home testing, they are very convenient and they're easy to complete. The testing is very easy to complete. Once you do have a doctor who has sleep apnea, you must treat it aggressively. Sleep apnea increases your scope of strokes and heart attacks and Alzheimer's disease. During patients have sleep apnea, it's not like they wake up because the oxygen levels have dropped. They also get increased levels of cortisol, which then increases blood pressure, which can affect the cardiovascular system. And it also increases the clotting of the blood. The blood becomes more quadruple. And because the blood becomes more quadruple, they can have blood clots formed in their heart or in their vessels, which then go and lodge it in their brain to cause a stroke. I really can't tell you how many patients I have seen. And as a part of my checkup, I sent them for a sleep study and they came back and they did have a sleep apnea. And once they treat it, they become more energetic. They become like a new person. They love it. It's true that the mask that is used for sleep apnea, for treatment of sleep apnea, is uncomfortable for most people. However, I tell patients that these are like shoes. You really can work with the sleep medicine specialists that you're working with to find a sleep apnea machine and a mask that's comfortable for you. Some of them have nasal sprays that pushes the air. Some of them are really packed your whole face. I know someone who I've gotten skiing with who's a sleep medicine doctor himself and he had his own sleep app. We were traveling, we were skiing and he loves his sleep app machine and everywhere he goes, he carries it because as a sleep medicine specialist himself, he knows how important it is to treat the sleep apnea. So if any of your friends have snoring, I really encourage them to get sleep apnea testing. And if there are diagnosed with sleep apnea, they must treat it one way or the other. There are five, six different treatment options. CPAP is one treatment options. There's also tonsillectomies that can help. There are also the little devices that are coordinated with your breathing and it pushes your tongue forward with every time you're breathing out, which helps with the passage of airflow. And there are many different other treatment options. So you should not ignore if you have a diagnosed with sleep apnea already. Yeah, that is great advice. And for anyone listening who has maybe, try to CPAP machine and said, oh, I don't like it, it's uncomfortable, someone knows, hey, I might have sleep apnea, but I don't wanna wear that machine and be next to my spouse with this machine. This is so much more important than that. Your quality of life will improve so much. You may add years to your life, healthy years with a good working brain. This is really good advice. And I like what you, the advice you gave as well is that you might try one CPAP and maybe you don't like it. Maybe you try another one. Maybe you try three or four of them until you find one that works or try a different device or a different option. But to ignore it is really the worst thing you can do. So this has been great advice. And hopefully anyone listening who does snore will go get a sleep test. Do you have a preferred sleep test that if someone listening now snores, they should, they could take? No, there are wrist bands. And it looks like a watch that people put around their wrist and they go to sleep. It's so easy, you just wear it. Even the aura ring, I think, helps people with determining if they're likely or unlikely to have sleep apnea. So there are many easy tools for diagnosis. And one of the treatment options for sleep apnea is oral appliances. There are things that it can put you in your mouth that puts your, pushes your job forward and opens the airways. And so you need to work with a sleep specialist. Who knows the different treatment options and work with that person until you find a treatment. You can't give up. There are, like I said, five, six different approaches to a treatment of sleep apnea. And when people say I don't have time for it, it was inconvenient, I just say, it's also inconvenient if you have a stroke and you can't talk anymore. When people come to the hospital and have a stroke, they all look surprised. It's like, why did I get it? It's like, you have risk factors. Obesity, sleep apnea, center lifestyle, too much stress, poor diet, high blood pressure, high cholesterol are risk factors for stroke. Who gets a stroke? People have risk factors. And it's interesting to me that people always think other people develop stroke. Like, I don't, I'm not the person who has a stroke or heart attack, other people develop it. And when they come to the hospital and they've lost the control of half their body or they can't walk, can't talk, and they're frustrated, it's like, this is not a surprise. You know, some statistics are very alarming. 80% of strokes can be prevented. 80% of strokes can be prevented. And yet a stroke is the number one cause of disability in the United States. It's the second leading cause of death in the world. And 80% of it can be prevented. To me, it's a tragedy. It's a tragedy that we don't have more public health announcements, that we don't have more emphasis on treatment of risk factors for stroke and sleep apnea being a main risk factor for it. Because sleep apnea happens in people who have obesity. You know, sometimes there are people who are thin and they still develop it as sleep apnea. But the majority of cases, people have obesity or early diabetes. And they also have high blood pressure and high cholesterol. It's like a package deal that happens. Rarely does somebody have sleep apnea and nothing else. So this is something that, when I see my friends, I really get under case. I really get under the case. As soon as this is over, I'm gonna text this guy who was sitting next to me yesterday who said he tried the CPAP machine. And by the way, he is overweight. He does snore. He knows he has sleep apnea. Said he tried the CPAP machine. And he's also working hard, working 10, 12 hours a day. Busy guy, successful guy, but kind of neglecting his health. And so I'm gonna text him right after this and I'm gonna say, hey, you have no option. You have to give back on, try another CPAP, try something else, work with a sleep doctor, try something. This is great advice. I think people really got that point now and I think it's such an important point. Moving on to nutrition. Is there anything that you have seen with regards to nutrition for brain health specifically? Yes. Eating a Mediterranean diet is very effective in reducing inflammation associated with aging. Foods such as donuts, cookies, poorly prepared sandwiches, pizza, the junk food that is so readily available around us really increase the amount of inflammation in the brain. Many studies have shown that people with a standard American diet, you know, SAD, sad diet have smaller brains. Higher levels of trans fats are associated with smaller cortex and hippocampus. And so the first thing that people need to do is to stop eating junk food. It's difficult, I give them that, because we're surrounded by junk food. Everywhere we go, you go to a ball game, you go to a shopping mall, everywhere you go, most of the food you see is poorly prepared, salty, high trans fat, highly processed food, and it's unfortunate, it's really unfortunate. So if you wanna have a healthy brain, you have to realize inflammation is your enemy. Yes. And one of the ways you can increase inflammation is to eat junk food. The junk food is junk, and our body reacts to it by increasing inflammation. And it's not inflammation in the brain only, it's inflammation in your gut system, in your heart, in your liver, in your kidney. So when you eat junk food, you're harming all your body organs. To me, junk food is like smoking. And you used to say, well, I can't stop smoking, and everybody else smokes, and we know that smoking was so harmful, and now so many people have stopped smoking. I think we need more awareness for the general public to appreciate that junk food is really not food. It's chemicals that are packaged together and have some spices added to them so they taste good. So some of these fried food that you see on television adds that tastes good. They do taste good. I mean, I don't wanna name any particular company, but I've had it in the past, and I must say they taste good. But they taste good because of all the spices, not because of the food. You can get any amount of things and pack it together and then add the spice and now it tastes good. It's not the food that's tasting good. It's the spices that are added that taste good. So we see that when people get older, they have cognitive decline. It's because of the things they're doing to themselves, such as poor diet, you know, we just talk about sleep apnea or isolation. These are the things that bring the brain down, and they're clearly established things that bring your brain up, and you have the choice. Most of these things, as you said, are not secrets. Everybody knows that exercise, diet, sleep is good for you. Everybody knows that. What people don't know is how powerful they are. They're simple interventions, but powerful, especially when they're combined. And that's what I hope to help with people to appreciate that the combination of these lifestyle interventions can have profound effect, even if somebody is in early stages of Alzheimer's disease. I used to think that once somebody gets to the point where they don't know what year it is, it's gone gone. But some recent studies have shown that people with mild Alzheimer's disease can improve their brain functions and the levels of those plaques and tangles, the markers of Alzheimer's disease, drop by a lifestyle that combines those five pillars of brain health. It's very powerful that you can have a lifestyle program that reduces the very markers of Alzheimer's disease. Remember I told you Alzheimer's has two components, the plaques and tangles, and it's reversible components. So far, we were talking about how SIP apnea is one of those reversible components that you treat it, you get better. A poor diet is a part of that reversible package. You improve your diet, you get better. So what you learn is that with lifestyle changes, you're working on these reversible, treatable components. What's new and exciting and revolutionary is that these interventions, especially the diet and the exercise, reduce the markers of the very things we call pure Alzheimer's disease. And that's amazing. I mean, it makes sense that these things work on their treatable components, reversible components. We sort of expected that, we knew that. But these things are also reducing amyloid in the brain. Like if you eat a Mediterranean diet, you have less amyloid plaques in your brain. In fact, one study showed that people who eat a Mediterranean diet on a regular basis, and after they pass away, if they have donated their brain to science and researchers look on their brain, they see that people who on average ate a Mediterranean diet have plaques and tangles that are equivalent to someone 18 years younger. 18 years younger. Now, it's true that somebody who ate a Mediterranean diet was probably also exercising. People who eat well usually also take care of the other things. So it's probably not just pure diet. However, 18 years younger, in terms of plaques and tangles, sounds like a good deal to me. Yes, absolutely. And we know the Mediterranean diet, they're eating lots of fish, which maybe I've heard Omega 3 that you find in a lot of fish is good for brain health. I don't know what your thoughts are on that. Also, olive oil, which is a very healthy fat. And I remember years ago, I read another book about Alzheimer's. And the author was talking about really lowering the carbohydrate intake and using more healthy fats and showing that things like coconut oil or good types of MCT coconut oils can help with reversing Alzheimer's in some cases and things like that. What are your thoughts on kind of like, not saying people need to go full on ketogenic diet here, but replacing some of the carbs with healthy fats and proteins? I totally agree. Several studies have shown that replacing carbs with healthy fats is beneficial. I recommend in general to avoid things that spike your sugar levels. It's not just carbs, it's simple carbs, simple sugars. Things you eat in a donut or a cookie or a muffin, or sugar sodas that spike your sugar levels. If you eat an apple or a banana that complex carbohydrates, which do not spike your sugar levels, and they seem to be healthy, I think you should enjoy what you eat. I mean, after all, you want to enjoy the most fun thing you can do in a day by eating tasty food that you like. As such, I don't recommend people to go out of the way to avoid all sorts of carbs and not eat fruits and vegetables. Fruits have carbs, complex carbohydrates. So I think it's not really fair to eat a diet you hate just because you want to live two or three years more. I think you want to have quality years. So enjoy eating what you like, realizing that simple carbs are not good, and things like extra virgin olive oil, omega-3 fatty acids are really good for you. And a mid-train diet is a great diet. Like you said, fruits, vegetables, fish, extra virgin olive oil, hydration, one glass of wine. And the researchers have been trying to figure out what component of this overall diet seems to be more important. Is it the fish? Is it the fruits and vegetables? It turns out that the extra virgin olive oil is actually particularly important, followed by omega-3 fatty acids that you find in fish. Of course, the fruits and vegetables, leafy green vegetables, are particularly important. Spinach, kale are really good for your brain. And lentils are also very good. Legumes are very good. In general, I have a very simple approach to eating. I don't make it into a big, complex thing. I eat food I enjoy. If it's something that looks like a junk food, I don't eat it. And I also don't eat too much. My body has come to get used to having some oatmeal for breakfast. Maybe I add some blueberries to it. And then I eat just a bowl of yogurt for lunch. I don't sit down and eat a full meal for lunch. I don't feel it's necessary. And my body is used to it. And for dinner, I usually eat something that's a mixture of some meat and some vegetables. For example, it could be some salmon with mixed vegetables, or it could be some chicken with some vegetables, or sometimes I have a lentil soup. And throughout the day, I may have three or four pieces of vegetables, a piece of fruits, or maybe a small bowl of pistachios. And that's it. It's not that complicated. Occasionally, I go to a party and there's a lot of rice that I love. And so I indulge and have some white rice once a week. And sometimes I have red meat. I don't think it's as alarming as people worry about it. I don't eat red meat every day, once or twice a week. So I have a balanced diet. I eat what's in front of me. I don't have to really go out of my way to have a particular diet. I know the principle is simple. Don't eat junk food and you're like 70% of the way there. If you don't eat junk food, what's left? Natural food. And as long as we eat natural food, you're good. I think blueberries are particularly good because they're high in antioxidant vitamins. So I like blueberries. I think that beets are delicious and I like them. And they can increase nitric oxide, which dilates blood vessels and is good for the brain. I like pomegranate. So I try to add these things to my daily intake of fruits and vegetables. But I eat what's in that kitchen. I think it's important that when you go shopping, is to avoid buying things that comes in boxes and cans as much as possible. I do eat black beans and they come in cans. OK, I'll do that. But in general, I try to avoid things that comes in boxes and packages as much as possible. So if you don't bring junk food to the house, then you're one step ahead. You don't have to fight and resist the fact that you have cookies in the house. That's right. Yeah, yeah, great advice. Keep it out of the house and eat real whole foods. And all the advice you gave is really, really great. I know we're coming to the end here. Any final kind of pieces of advice as a whole, of course, people should go out and buy your book. The invincible brain should be just released right now by the time you're hearing this. What else? Any kind of final parting wisdom for everyone here? I think people need to change their attitude toward aging. I would like your listeners to set a goal of becoming a brain super-ager, someone who is 90 years old and is sharp and independent. This is what I plan to do. And I think it's a reasonable goal. Only small percentage of people have genes that may either keep them sharp despite everything bad they've done or make them develop cognitive decline despite everything that they've done right. Maybe 5%. 95% of people who follow these five pillars of brain health will be able to reach their 80s and be sharp and independent. Amazing, amazing. Dr. Fatuhi, this has been amazing. You are a wealth of knowledge. Where can they buy your book, I assume, everywhere that books are sold? Yes, the books are available everywhere books are sold. All major bookstores and Amazon and Barnes & Noble's all major booksellers. I also have social media platforms and I'm on Instagram, LinkedIn. I also have an app which helps people with the five pillars of brain health and some of the testing that can do. I do things called brain fitness calculator that helps people appreciate where they are in the big scheme of things. Are they more in the green zone or in the red zone? And that can provide them with the strategies and how to improve. Obviously, if someone is in the red zone, they have more work to do than somebody in the green zone. So my app, inside the app is an online course with all the information in the book. It's the book, the social media and my website, Dr. Fatuhi.com. That's D-R-F-O-T-U-H-I.com. And I'll be happy to communicate with people through my social media platforms. Amazing. And do you still work with a lot of clients? If people are maybe nearby your area or can fly in to see you? No. I retired from clinical practice three years ago because I think everything I do is a full-time job. I can't have a full-time clinic and spend 30, 40 hours on preparing things for social media, working on an app, giving lectures. That's a full-time job in and of itself. Yes. I think you can reach much more people this way as well. And we're so honored to have you on here. The work you're doing is incredible. Those of us who have gone through aging parents or people we love, who we've seen their brain deteriorate, we know how close this is to our heart and how important it is. And it's funny because right now everyone's talking about, yeah, we want to live forever and we're going to live for hundreds of years. But no one talks about, do you want to live hundreds of years with a brain that doesn't work and just sitting in front of a TV all day? Or do you want to live a long life where you're active and you're engaged and your brain is working as good as it did 30, 40, 50 years earlier? So thank you so much. I highly recommend people go buy the book. And I hope we can do this again sometime. Yes, Tellar. I really appreciate you inviting me on podcasts. I enjoy talking with you. Thank you. Thank you for listening. If you enjoyed this episode, it would really mean a lot to me. If you would forward this episode along to any friends, family members, anyone that you think that would get value out of it and learn something important, the mission at Peak Performance is to help people prioritize and transform their health. And so if you think someone will get value, please, please, please do forward this episode along to them. Also, if you could please rate and review and subscribe on whatever podcast player you are listening to this on, we would greatly appreciate that as well. It means a lot. 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