The Fastest Way To Alzheimer’s.... 6 Science-Backed Brain Fixes!

I think everybody needs to listen to this episode if they want to start 2026 properly.

If there's one thing I've learned that's really stayed with me this year, it's from speaking to some of the world's leading minds about our brain, which might just be the most powerful asset that we all have.

You know, if you listen to the Diary of a CEO, you're probably listening because you're trying to get something, whether it's information, inspiration, maybe entertainment, all of which because you're striving towards some kind of goal.

And it's dawned on me this year because I've interviewed so many incredible neuroscientists that this all starts with having a healthy brain because all of our thoughts, our feelings, our relationships, our memories, our chance of having a future start in the brain.

So, in this special Christmas episode, we're going to focus on the brain: how you can have the most fundamentally healthy brain so you can live the most fundamentally meaningful life.

I've been through all the episodes where we've talked about the brain, and I've looked at the moments that you shared and replayed the most, and the moments that added the most value to your life.

I've put all of them into this episode today.

Do you remember the first time you saw a human brain? I do. Did it change how you think about your own brain? It changed

my life because I was like, I want to study that. That is the coolest thing that I've ever seen in my whole life.
It was life-changing.

I say that because we, you know, at the start of this conversation, we said that most of us don't appreciate our brain. A lot of people don't even realize it's there.

But the minute i had a brain scan one day and that brain scan really changed my life because seeing my own brain for the first time

it was the push that i needed to start caring more about how my decisions and behaviors are impacting it so let's talk about how i can make that ball of tofu in my head super healthy yeah big fat and fluffy right you talked about exercise earlier on but we didn't really dig dig into exactly what you mean by exercise because exercise i think is multifaceted in its definition what kind of exercise should i be doing to make my ball of tofu in my head great?

Yeah. Optimal.

Well, all the research shows that the best kind of exercise that you can do is anything that gives you aerobic activity that is getting your heart rate up.

So that goes for, you know, power walking will get your heart rate up. Soccer, so many different things.
Name your activity. So many people want to say, oh, well, my favorite activity, will that work?

And I always just say, is it, is your heart rate up when you're doing it? If the answer is yes, then yeah, that works great.

We know that that level of aerobic activity is critical because that's going to release that growth factor maximally to get into your hippocampus that will grow those new brain cells. How much?

So

I have an answer to that. So we did two different experiments in my lab.
One in low-fit people, people that are really not exercising very much at all, less than 30 minutes

in the last three weeks you've moved your body. And we asked what, could we see any behavioral improvement in your memory function from your hippocampus or your ability to shift and focus attention?

If we asked you to move your body in an aerobic way for two to three times a week. And we collaborated with a spin class.
So clearly very aerobic.

And what we found was in those people that did successfully do two to three times a week a 45-minute aerobic activity, their mood got significantly better, their memory function got better, and their ability to shift and focus attention got significantly better.

So that gives a little bit of a guideline for low-fit people. Two to three times a week can start to give you some of those, some of those cognitive changes.
But you don't look low-fit.

So let me let me answer the question you're about to ask me with like, what about me?

I exercise pretty regularly and um how much how much do i need so to answer that question we went to another spin studio and we said look we're going to give you free classes you could exercise as much as you want in this in this um at this studio and uh um go up to seven times a week.

And the control was just stay the same. You know,

they were working out twice a week at the studio. Control was the other group that way you were testing them against.
Yes, exactly. And so what we found was

basically every drop of sweat counted. The more you exercise, the more change in your brain we noted, both your hippocampal function, prefrontal function, and mood.

If you were already getting benefit, you know, you're already going twice a week, but the more you did, the more brain changes you got. So

that doesn't give the formula that I would like, but we were heading in that direction, which is part of one of the questions that I want to answer.

But I love to leave people with the idea that every drop of sweat counts for building your brain into the big, fat, fluffy brain that you really want.

And then, in the real world, again, making it super

real for people. Yeah.

How does that change how I show up? Yeah.

If you allow it to, should have a beautiful effect on your mindset.

That your mindset around

how often should I take, wake up 30 minutes early and do that walk before I start my day or accept the invitation to go walk the dog with a neighbor. It's not an obligation.

It is something that you're doing for yourself. It is going to have direct benefits on that ball of tofu, as you call it, in your head.
It's going to make it work better.

And I mean, I think the most immediate thing that I benefit from every single day is the mood boost that you get from that serotonin, dopamine, or adrenaline that gets released every time you move your body.

I always think that because obviously I do a lot of podcasting and it's, I'm super reliant on my brain being attached to my mouth. And sometimes I notice that it's not.
You know what I mean?

Like sometimes I'm not articulate. I can't get my thoughts together, whatever.

And I always try and figure out the correlation between what I did that day when I have a good day versus a bad day.

And I've, from your, and also I speak on stage sometimes. So I've often asked myself, because I saw Tony Robbins the speaker one day on a trampoline before he goes up on stage.

I asked myself, okay, should I be doing a workout in my green room before I go up on stage for a big talk or presentation?

You think I should? Oh, yeah, absolutely. What's the basis of that in science and neuroscience? It's the basis is that immediate fact.

So there's three key effects that we know happen every time you move your body. First one is mood.
You're going to get your dopamine, your serotonin up.

Second is focus and attention.

So, a single workout isn't going to make more synapses in your prefrontal cortex, but the prefrontal cortex uses dopamine.

And so, it's clear that even a single workout can make your prefrontal cortex work better in terms of focus and attention. Also, very important anytime you're speaking.
And the third is reaction time.

Your reaction time is, you know, motor,

you're working your motor cortex when you move your body, and your response and reaction time is significantly shorter after a even a single workout compared to if you just don't work out and sit sit alone so

great great things to do a great thing to do before you you stand up and speak what about coffee

I'm trying to figure out if coffee is good for my brain yeah bad for my brain I've had a couple of mixed messages around the impact it might be having yeah

you know caffeine is a stimulant and uh

respond to that kind of stimulant in different ways. Overstimulation with caffeine is not good for

your ability to put words together. You know, this is where I turn to

a main theme in my book, Healthy Brain, Happy Life, which is self-experimentation.

For you,

how, what can you titrate your coffee to see what level of coffee is best for whatever, your podcast or you're giving a talk?

The other thing that can work similarly to coffee that I've started and that I do every morning is hot, cold contrast showers because that cold that you

shower on yourself after the heat stimulates adrenaline in you, a natural adrenaline.

It wakes you up. And okay, it was painful the first.
kind of few times I tried it, but then you get addicted to it.

And I have forgotten to do it and gotten back in the shower just to douse myself with cold water because I feel better when I do that for, you know, first thing in the morning.

So lots of different things that one can explore with. Okay, on the other side of the coin then, what are some of the central behaviors that people do that destroy their brain?

Well, sedentary behavior is one of them.

Not getting enough sleep is critical. We haven't talked about sleep yet.
Sleep is so important for normal functioning of the brain. I like to scare my students by saying that,

you know, in torture situations, if you deprive a person of sleep for too long, they literally die.

They die. You cannot function if you are deprived of sleep for too many hours in a row.
It's that critical. Yet

we happily, you know, watch too much Netflix at night

and get only five hours of sleep when we could have had eight. So, what's happening exactly? Why is it so important? Well,

there's so many different things.

I'm going to say two. One is that we know that in regular,

healthy sleep, there is activity in the hippocampus that helps you strengthen the memories that you have formed in that previous day. It's called consolidation, and it's so important.

If you shorten that, if you don't get enough, you are not consolidating your normal everyday memories.

And second, it is the time during sleep when all the metabolites, all that garbage that your brain is producing, because all biological cells produce garbage, it gets kind of cleaned up through the cerebral spinal fluid that is flowing through your brain.

And if you do not get enough sleep, you build up garbage metabolites in your brain. It's like you have a gunky brain.

And do you feel like I feel like I have gunk in my brain when I don't sleep enough? That That is exactly what is what is happening.

When you think about things that we consume, you know, like food and drink and alcohol and all these kinds of things,

is there anything that if I'm trying to have an optimal brain, I should be having or not having? Yeah. Well, so

I think the most evidence is around the benefit of the Mediterranean diet, which is basically all healthy,

kind of organic, not organic, but non-processed is the word I was trying to think of, things to eat that are very, very colorful.

There is so much evidence about how good that is generally for the brain, that that is my go-to. Like, what should I eat? Well, is it on the Mediterranean diet? If it is, then go ahead.

If it's too processed, only do it just a little bit.

Is it true that if we have less friends, if we have less strong relationships, if we're lonely, then our brain will shrink and is more prone to dementia and Alzheimer's and things like that.

Yes, we are social creatures. And

there are really powerful studies that have shown the correlation between the number of social connections that we have, including just saying hello to the barista at Starbucks.

It's not a close friendship that you develop over 30 years. It's just how many people you interact with and greet, and longevity.

The more people you are regularly interacting with, the longer you are living. Overall longevity.
But if you go into brain health, absolutely, it's also very, very healthy for you.

It also brings happiness. So a friend and colleague of mine, Robert Wallinger, studied what makes people happy.
The study started in the 20s, the 1920s in Harvard.

And after all of those many, many, many decades, the answer is what brings happiness is the strength of your social connections. So it makes you happier, it makes you live longer.
And

yes, loneliness on the flip side causes stress, long-term stress that damages the brain. And yeah, in the long term, can make it smaller and less healthy.
Here's the fifth most replayed moment.

When I asked you before this conversation started rolling, what you're really excited about at the moment, your response to me was, there was a few things, but one of them which lit up your face was creatine.

Yes. And it's funny because it lit up your face again.

Yeah, it's it's funny because creatine has been around for, I mean, ever, for decades. And it's always been, in my mind, it was like one of those gymbro things.
I'm like, I don't need to be swole.

Yeah, yeah, yeah. I don't need creatine to get get swole.
And, you know, this is, this was the thought for many, many years. And then over the last five years or so,

the effects of creatine on the brain starts to really get my interest. Anything that affects the brain, I really become interested in.

And so, that's kind of what did get me the most excited about creatine. But also, I started doing a lot of resistance training.
And so, I was like, okay, here I am now. I'm like one of those gym guys.

I'm doing, I'm doing the barbells. I'm doing the, you know, the squats and the deadlifts and all that.
And so, so, why not give myself some of the creatine? Well, what is creatine, right?

Why is it important? You talked about earlier, you know, why doesn't our body just make more of these things that are so beneficial? We do make creatine.

We make about, I don't know, our liver makes about one to three grams a day of creatine, and our brain also makes creatine. And those are the two organs that make it.
Creatine...

gets consumed by other tissues like the muscle is probably the one that's the greediest because creatine is stored as phosphocreatine but it's used to make energy, essentially.

So it can increase muscle mass, it can increase muscle strength in combination with resistance training because you're able to regenerate and make energy faster.

So for example, I became interested in it after reading studies where people that supplemented with creatine that were engaged in resistance training were able to gain more lean body mass.

They were able to gain more strength. It was increasing their training volume.
So you can do one to two more reps, right?

Whatever exercise you're doing. And it seems to decrease the recovery time between those sets as well.
So you're able to increase your training volume.

Well, anything that's going to increase your training volume is going to then have the downstream effect of, you know, increasing the adaptations, like increased muscle mass or increased muscle strength.

I started supplementing with creatine about a year ago, and I started supplementing with it for that reason, for my training.

And I was doing about five grams a day because that was really what was shown to be beneficial for muscle health in combination with resistance training.

And it's important for people to realize that supplementing with creatine by itself without any type of resistance training isn't going to grow your muscle. It's not going to make you stronger.

You have to put in the effort because what creatine is doing, it's helping you make the energy quicker, right?

And that, and then being able to make that energy quicker means that you're able to then do that exercise better,

harder, more of it, right? So it's sort of supercharging your exercise routine. I had already been aware of the effects on the brain.
I thought maybe the five grams a day would do that.

So what are the effects on the brain? Well, your brain also consumes a lot of energy, you know, needs a lot of energy. So it does make its own creatine.

But it turns out,

if you can give your brain more of that creatine, particularly under a period of anything that's causing stress.

So let's say lack of sleep, or let's say emotional, psychological stress, or in my case,

high cognitive load, where you're just every day learning concepts, complex things, you're trying to remember them, you're putting ideas together and coming up with new hypotheses.

And, you know, you're just, you're just, you're studying a lot and it's very cognitively demanding. And it's, it's a type of stress on your brain.
That's like my life, right?

Under this condition of stress, depression is another one. That's a stress on your brain, or neurodegenerative disease, that's a stress on your brain.

So any kind of stressful condition, that's where creatine shines in the brain. I would argue that

all of us, who has the perfect amount of sleep, never has stress? Nobody, right? There's always some sort of stress in the background.

So that's when I was like, okay, so if you're the perfect person, you have no stress, you get the perfect amount of sleep every night, your brain makes enough creatine to kind of do what it needs to do.

I know that I'm constantly under stress.

So I'm like, okay, well, I think I need a boost.

And this is where a lot of very interesting studies have come out of many different labs, some out of Germany that looked at the dose of creatine and how it increases creatine levels in the brain.

And this is why I now supplement with 10 grams a day.

So the study out of Germany found that five grams a day of creatine, if you're supplementing with five grams a day, your muscles are greedily consuming it, particularly if you're working out.

They want it. They want it.
After about five grams a day, especially over a few months, like you're saturating your muscle and that's enough, right?

Anything above that kind of spills over to the brain. And so they've, what this German study found was that 10 grams of creatine increased creatine levels in several different regions of the brain.

And that was probably the most exciting, you know, I would say, evidence that supplementing higher than five grams a day was actually doing something in terms of getting creatine into the brain.

There have now been a variety of studies that have looked at different outcomes, right?

So if you supplement with 10 grams of creatine or even go higher than that, like 20 grams of creatine, how does that affect cognitive function, right?

And so some of these studies have been done by Dr. Darren Kandau.
He's at the University of Regina in Canada. And

they've looked at things like sleep deprivation.

And it's been found that if you take someone and you sleep deprive them for 21 hours and give them about 25 to 30 grams of creatine, it completely negates the cognitive deficits of sleep deprivation.

Actually, not only does it negate the cognitive deficits of sleep deprivation, it makes people function better than if they were well rested. That's where I was like,

wait a minute, there's many times when I'm traveling, I'm jet lagged,

lots of times when I'm sleep deprived and I have to be doing a podcast or a presentation, whatever.

And in those situations, I go up from my 10 grams to more like 20 grams, like today, for example. I wasn't really sleep deprived, but you know, there's a lot of high cognitive demand.

This is a long podcast. There's all that stuff.
And so I went up to 20 grams today on my creatine.

And I, well, I will say, even at the 10 grams for me, we were talking about this with respect to being in ketosis.

I don't feel that mid-afternoon crash when I have the creatine. Not being on a ketogenic diet, not being in ketosis.
It's very clear for me. And I've done this where sometimes I only do five grams.

And then if I do that, I'll notice, I'm like, why am I tired right now? So there's something interesting. And maybe it's placebo.
I'm going to throw that out there, very possible.

But I don't know, maybe the creatine is again, it's able to regenerate that energy quicker. And so that's also beneficial for the brain.

And now I would say all these creatine researchers, a lot of them are shifting to the brain. It used to be all muscle focused.

And now people are super interested in what creatine is doing to the brain, especially if you're supplementing with more of it.

And, you know, this is important for people that are under a stressful situation, but also for vegans, because creatine is found in food, mostly in animal products like meat and poultry and fish, dairy.

A lot of vegans don't eat that. And I've had so many of my vegan friends,

I've got them on the creatine and it's changed their lives. I mean, they're like, this is like incredible.

You know, can you imagine someone who's not getting any creatine from their diet because they eat no meat?

And all of a sudden they start supplementing with five, 10 grams of creatine. And it's like they have energy.
Some people say they require less sleep, which is kind of interesting.

That's kind of a comment I've heard many, many times from people is that it's like their brain doesn't need as much sleep. They have more energy.
So

I've been a big fan of the creatine, not only for the muscle, especially because, you know, working out is something that's very important, but for the brain as well.

I always thought of creatine as something that you took and you kind of had to load up on. And then over a couple of weeks or months, the effects would kick in.

But you're telling me that if I had creatine in the morning that same day, I would experience potentially improved cognition if I have a big enough dose.

Yes. So

great question. A lot of studies that have been done that you're referring to have been done in the context of exercise and muscular performance.

And the reason why people have to load up on like they do a loading phase, let's say 20 grams.

and then they go down to this sort of maintenance phase of five grams is because it takes, I don't know, I I think it's about a month or so before you can saturate your muscular stores of creatine.

And then you're- What does that mean? It means that the creatine, which is actually stored in your muscle as phosphocreatine, is there and ready to be used to make energy.

So it takes,

again, it takes about a month or so to do that. unless you are really giving your muscles a high dose, right? So the five grams a day,

it can only do it for so many days.

And then finally you get saturated when you do this loading phase you kind of just accelerate that whole process and so that's why when people are doing these experiments where they want to test the effects of creatine they want they want the participants to have really high levels of creatine in their muscles quick because they don't want to do a month-long experiment right they want the experiment to be like a couple of weeks or a week so that was kind of the whole concept behind this loading phase if you're not someone who's going to some kind of competition, you know, like you're a CrossFit games or something, you don't really need to do that loading phase if you've already been supplementing with five grams a day for like a month.

When it comes to the brain, what's happening if you get above that five grams, that's pretty much all consumed by the muscle, you're having some left over in circulation, and the brain takes it up and it takes it up, right?

What it really shines is under that stressful condition, which again, for me, I feel like every day

is like cognitively demanding for me because I'm constantly, you know, learning new material or learning learning new information or working on things. Right.

And so there's a lot of cognitive stress on my brain. And so I feel like I'm constantly under that stress.
And that's where getting the creatine in your brain helps you make that energy quicker.

And so that's why, like, I've done, I've had, you know, been jet lagged and have have to give a talk at, you know, like 5 a.m. in the morning, my, my biological time after not getting sleep.

And I've done like 25 grams of creatine and it, it's insane how much it helps me. Again, it could be placebo because I'm anticipating that effect, which is fine.
Placebo is a real thing. It's great.

I'm all about it. But there's some evidence also that this works, right? That the creatine is helping with under that sleep deprivation and that stressful condition.

I was reading about a study in 2025 where they

gave creatine to people that had depressive symptoms alongside CBT training.

And the people that had creatine and the cognitive behavioral therapy training experienced a greater improvement in their depression symptoms than those who just received the cognitive behavioral therapy,

which is

incredible. It's fascinating.
I mean, depression is a type of brain stress, right? I mean, we know inflammation plays a role in depression. We know oxidative stress plays a role in depression.

And there have now been some animal studies that have shown creatine is somehow having an anti-inflammatory effect. That hasn't all been worked out.

So I don't know if it's all just the energy component of it. It could also be this other sort of newly newly identified role that creatine is playing in sort of having an anti-inflammatory effect.

And I don't know enough about that. I don't know that there's enough even known about that, but I do know that it exists.

And it's fascinating because again, I think where creatine really shines in the brain, and it's been shown study after study, is under some kind of stressful condition, depression or sleep deprivation.

Or there's a new study that came out. It was published, I don't know, a month ago or so, showing that it was a very small pilot study.
And I want to caveat this: there was no placebo control,

but it did show that giving people with Alzheimer's disease creatine, I believe it was 20 grams a day, did improve their cognition.

And so, again, this is a whole new field where now we're looking at creatine in the brain, not just the gym bros and not just the muscular effects, but in the brain and how it's affecting the brain and being beneficial for cognition, for brain aging, for depression.

Here's the fourth most replayed moment. One of the most inspiring and I think liberating things that I've heard in your work is this idea of neuroplasticity, because

if the brain can physiologically change based on what I'm doing, then it means that who I am now, my identity,

that 19-year-old who's sleeping in the mummy thing with the ferret, isn't who I always have to be. I can literally change.

We've spoken a little bit around what causes the motivation to actually change, but knowing that there's a, my brain will actually change, those two things are really inspiring for me because it means that whatever rut I'm stuck in isn't necessarily a permanent one.

Now, you said that the motivation to change comes from fear.

Well, in my case, it took a fear circumstance, fear of becoming a permanent failure to motivate immense change. And

that was that circumstance.

I do believe, however, that the best work, our most creative and best work, comes from from a love of craft.

But sometimes, in order to find what you truly love, you have to be scared into setting off on a path to find it. So, neuroplasticity is absolutely real.
But if the question is, can

a person change? Can you learn new thing? Can you unlearn certain patterns? Can you overcome traumas at any age? The answer is absolutely, categorically, yes.

How? Well, it's very clear that as a child, until about age 25, more or less, just passive experience will shape the brain for better or worse.

After about age 25, and again, these are not strict cutoffs,

we can change our brain, but what's required is a marked shift in the neurochemical environment under which something happens.

So one of the reasons why any traumatic event will forever be remembered, although by the way, you can remove some of the emotional load of that. Trauma does not have to be traumatic forever,

is because when we see or experience something very intense of a fearful nature, there's the release of certain what we call neuromodulators, things like epinephrine, adrenaline, and other neuromodulators that cause a state shift in our body and brain.

And the nervous system recognizes this as unusual.

And as a consequence, in the subsequent days, there's reordering of the connections so that the brain can prepare for that event should it happen again.

This is why we have what's called one trial learning. You go to a certain location, something terrible happens there.
You will forever associate that location with something terrible.

But there are tools, therapy and other tools, that can allow the emotional load to be removed from that so that you could go to that location and feel calm, no fear whatsoever.

The good news is you can also learn anything you want to learn, provided there's a shift in this neurochemical environment.

This is why when we are very interested and focused on something, two of the main requirements for neuroplasticity, we have to be alert and we have to be focused. We can't learn passively as adults.

We can't just play,

you know, a lecture about AI and large language models or neuroscience in the room, and then it just, the knowledge doesn't just sink in by osmosis.

But if we pay attention and we're alert when we pay attention,

there's a shift in the neurochemicals associated with that attention, what we call the catecholamines, it's three molecules, dopamine, epinephrine, and norepinephrine, all which cause an increase in alertness, all which cause an increase in focus, a tightening of our visual field and our auditory field.

So, like cones of attention is one way to think about it.

And then it sets in motion a bunch of biological processes, such that if we get adequate sleep that night, maybe the next night as well, there's reordering of neural connections so that that knowledge, that new experience, is consolidated in your brain.

You You are forever changed as a consequence of that experience. So when we hear that the brain is constantly changing, everything that we encounter changes our brain, that's not true.

Why would the brain change unless it needed to?

As a child, the brain is basically a template for change. It's trying to understand the environment and make predictions.
And so that's true. Neuroplasticity is...

a cardinal feature of childhood and adolescence and the teen years. Just think about the music you listen to when you were a teen.
No other music will ever have as much significance.

And that's because as a teen, your body is flooded with hormones and neuromodulators that the amount of meaning that comes from now seemingly trivial events when you're a teenager or adolescent is immense.

That song meant so much, and it's because of the neurochemical milieu it creates in you. But as an adult, it takes a stronger stimulus, as we say.
The nervous system is very

efficient in that way. It doesn't change unless it has to.
And it always changes if it needs to in order to keep you safe.

This is why there's an asymmetric influence of fear as opposed to just interest in terms of what will shift our brain. But

it's nice to know that love and excitement and appreciation are very strong stimuli for changing the brain. From everything we know about neuroscience, it's clear that...

It doesn't matter if you're 90 years old, 70 years old, 50 years old. If you want to learn, you can learn.

And that learning occurs through neuroplasticity, which is the reordering of neural connections, strengthening of certain connections, weakening of others, and in some rare cases, the addition of new neurons.

But you absolutely can change your brain, but you have to pay attention to the thing you want to incorporate into your brain.

You have to be alert while you do that, and then you absolutely have to go get some rest because it's during sleep and during meditative states and during rest that the actual rewiring of the brain occurs.

You know, every once in a while you come across a product that has such a huge impact on your life that you'd probably describe it as a game changer.

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But the reason I became a co-owner of this company and the reason why they now are a sponsor of this podcast is because one day when I came to work, there was a box of this stuff sat on my desk.

I had no idea what it was. Lily in my team says that this company have been in touch.
So I went upstairs, tried it, and quite frankly, the rest is history.

In terms of my focus, my energy levels, how I feel, how I work, how productive I am, game changer. So if you want to give it a try, visit ketone.com/slash steven for 30% off.

You'll also get a free gift with your second shipment. And now you can find Ketone IQ at target stores across the United States where your first shot is completely free of charge.

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Here is the third most replayed moment.

for those people who have just clicked to listen to this conversation can you tell them the mission you're on and why it's so important yeah well thanks so much for having this conversation with me i think that illustrates the problem right someone as informed as you don't know anything or never heard of nitric oxide so it's important for us to just make a distinction between um

like nitric gas that people you know inhale and that you if you played like uh some of those racing car games you press a button and the car goes really fast if nitrous.

These are two separate things.

Yeah, very good point. So this is not nitrous oxide.
Nitrous oxide is,

I mean, a medicine, it's a dental anesthetic, right? It's a gas. It's called laughing gas.
That's N2O. It's the chemical formula.

What we're talking about is nitric oxide, or NO, one nitrogen, one oxygen. This molecule is foundational for human health and longevity.
So nitric oxide is a gas. It's a naturally produced molecule.

It's a signaling molecule in the human body.

And so it regulates things like blood flow and oxygen delivery, and it mobilizes our own stem cells to help us recover and repair and replace dysfunctional cells.

It improves energy production inside the cell, and it regulates blood flow. So nitric oxide is a gas.
It's produced in the endothelium.

So the endothelium is the single layer of cells that line every blood vessel throughout the body.

So the function of these endothelial cells is to regulate vascular tone and to regulate, you know, solute exchange and extravasation or transport of molecules across that endothelial layer.

And so, when your endothelial cells can no longer make nitric oxide gas, they no longer dilate. So, the blood vessels become constricted.

You start to get inflammation, you get stiff arteries, plaque deposition, and that's what starts cardiovascular disease or atherosclerosis. So, let me get this straight.

I'll repeat back to you what I think I understand about nitric oxide, and you tell me if it's accurate.

So, this nitric oxide is a chemical that is in all the blood cells of my body, and it allows my blood cells to basically expand, open up, so blood can flow through there.

So, if I dilate, it dilates the smooth muscle.

It's not affecting the cells per se, but it's dilating the smooth muscle that surrounds the blood vessels, which is that leads to relaxation and dilation. Fine.
So, my blood cells would then expand

and more blood would go through there. But if I'm deficient, that mechanism doesn't work, and my blood cells wouldn't expand, ultimately expand through the relaxation of the muscles.
That's right.

And therefore, I would have higher blood pressure, which can lead to a series of downstream diseases and consequences.

And so, when we look at the graph that I showed a second ago, where we're seeing, for anyone that can't see this graph because you're listening on audio, we're seeing

nitric oxide levels in young people up to the age of roughly around 20 are optimal. And then from about 30 to 70, there's this tremendous sort of 80, 90% drop.

In terms of chronic disease, that is downstream from me losing nitric oxide level. Can you give me a bit of a menu of chronic disease that is associated with this nitric oxide deficiency? Yep.

We've touched on them. So erectile dysfunction.
So in erections in both men and women are dependent upon dilation of the blood vessels. to get engorgement, to get increase in blood flow.

And that's what an erection is.

And we call that the canary in the coal mine because for years people thought it was a lifestyle disorder right well erectile dysfunction yeah but now it's recognized that it's a symptom of loss of nitric oxide and really an accelerated form of cardiovascular disease high blood pressure metabolic disease and diabetes and then the other one is uh obviously alzheimer's because alzheimer's is a vascular disease And nitric oxide corrects every single thing we know about Alzheimer's.

It improves blood flow to the brain. It improves glucose uptake.
So it overcomes the metabolic aspect of Alzheimer's. It reduces inflammation.

In fact, a number of my patents are on a method of reducing inflammation. It inhibits the oxidative stress we see in Alzheimer's and neurological disease.
And it prevents the immune dysfunction.

And when you do that, when you restore blood flow and you get nutrients and oxygen in, and you take out the metabolic waste products, there's no misfolding of protein.

So you don't get the amyloid plaque, you don't get the tau tangles. So this simple molecule, nitric oxide gas,

I'm absolutely convinced will eradicate and cure Alzheimer's. Really? Because it addresses every physiological root cause of Alzheimer's.

If you can get it administered therapeutically to patients early enough?

No, I think that's a very key because

the success or failure of any clinical trial, any drug in any clinical trial, is dependent upon the design of the clinical trial.

and what patients, at what stage of disease that you enroll these patients. So what are the inclusion criteria and what are the exclusion criteria?

And there's a stage in every disease, whether it's heart disease, kidney disease, Alzheimer's, where you've reached a point of no return.

There's really no medical therapy that's going to reverse that disease because it's progressed to a state that's irreversible. So, I think what we try to do is take

patients early in the process, what we call vascular dementia, mild cognitive impairment, early Alzheimer's. Because what I want to be able to demonstrate is two things.

Number one, can we stop the progression of disease? Once it's started, can we stop the progression? And then number two is we want to enroll patients far enough along to where we can show regression.

So

can you move the needle back? And so that's a very kind of a specific and finite patient population. When you design a clinical study, number one,

at the absolute worst, we want to stop progression. At the absolute best, we want to show that we can regress disease.

And that's the goal of therapy: you understand the mechanism of disease to the extent that you can treat it, you can prevent it, you can reverse it, and you can cure it.

When I think about the role that food plays in my nitric oxide production, what should I be eating to increase my nitric oxide levels or to keep them at a healthy level?

I think the same answer is for that too. It's not so much what we should be eating, it's what we should not be eating.
Okay. so we'll cover those step by step.

Number one, you have to avoid sugar and high glycemic index foods

because sugar is a toxin, it's a poison. And let's think about what sugar is.

So, when we eat sugar or drink sugar beverages, right, whether it's sucrose, whether it's fructose, whether it's high fructose cornstriff,

the end result inside the human is we see an increase in glucose. So, elevation in blood sugar or blood glucose is diabetes, right?

And now there's continuous glucose monitors that you can get anywhere. And everybody does this.

So if you eat something and it causes an increase in your blood sugar, blood glucose, then you should avoid that. Because glucose, as the name applies, is glue, right? It's sticky.

And if you have a soda and you spill it on your countertop, you come back the next day, it's sticky, right? Well, that's what happens inside the body. That sugar sticks to everything.

It sticks to proteins. It sticks to enzymes.
And it lowers nitric oxide production. Absolutely.
That's why diabetics have a 10 times higher incidence of heart attack, stroke, all-cause

mortality. That's why they develop neurological or peripheral neuropathy.
That's why they have non-healing wounds. There's no nitric oxide.

That's why they're developing diabetic retinopathy, macrodegeneration, pancreatitis. I mean, all of that can be...

traced back to a lack of nitric oxide production because the sugar is stuck to the enzyme.

The sugar destroys the oral microbiome and completely changes the ecology of the bacteria and completely shuts down nitric oxide production. Right.

But I think to answer your question, what should we be eating? I think you've got to eat a balanced diet in moderation. You know, Americans are overfed.

All you got to do is walk around and see the epidemic of obesity. Good, high-quality protein, good quality fats, and little or no carbs.
And it's really that simple.

Here's the second most replayed moment.

When you you think about behaviors and habits that are popular and trendy at the moment, are there any that stand out to you as being particularly good for the brain or particularly bad for the brain?

Because I had a couple come to mind that I wanted to throw at you. I mean, one of them that's exploding in the UK at the moment is paddle, which is kind of, I think you call it pickleball here.

Good for my brain, bad for my brain. It's so good for your brain because

it's working your cerebellum. And I told you that because yours was sleepy,

and as you activate this and you do that with coordination exercises, it then activates your frontal lobes. Does that mean that people that are uncoordinated have a cerebellum issue? Yes.
Oh, really?

Okay. And the more you do it, the better coordination you develop.

And that's why coordination exercises for kids, so we talked about kids, is

you want to do that with them early.

Play sports, but not sports where they're going to get a head injury, right? I mean, we have to be smarter than we are.

But when I was young, my mother, who's now 93,

was the ping-pong champion. in the neighborhood.
And she was really good. And she never let us beat her until we could.

But she was always encouraging.

I've got,

I was looking then as you were speaking about different trends at the moment that are either good or bad for the brain. And one big trend at the moment is neuroplasticity training.

Lots of people are doing games and using other things to like there's apps you can get that are neuroplasticity training apps. Does any of that stuff work? Some of it.
Some of it works.

And if you're so, for example, if you're doing memorization games, do them while you're on the bike.

Now, not in the street, but if you're on a stationary bike

and

you're doing those games, it's been found that exercise increases blood flow to the hippocampus, meaning you're more likely to remember it and you're strengthening your brain in the process.

So exercise with new learning,

stunning.

So if I want to learn something, I should do it while walking or moving in motion. Right.
So if you're listening to a language app, for example, do it while you're walking.

Mindfulness and meditation, good or bad for the brain. Great.

I published three studies on a Kundalini yoga form of meditation called Kirtan Kriya. It's a 12-minute meditation.
I always say it's the perfect ADD meditation because it's only 12 minutes.

And for 12 minutes, you do this. Sa ta na ma.
Sa ta na ma. Sa ta na ma.
It's two minutes out loud, two minutes whispering, four minutes silently to yourself,

two minutes whispering, two minutes out loud, you're done. Sa ta na ma.
Birth, life, death, reborn, birth, life, death, reborn. But the one we studied is sa ta na ma.

And so if they look it up, kirtan crea

activates your cerebellum, activates your frontal lobes, calms down your emotional brain.

People who did that for 12 minutes for eight weeks, their resting frontal lobe function was stronger.

So simple. What the hell is going on there?

I think it's the focused attention, plus you're doing a coordination meditation. Sa ta na.
Thank you. Sa ta.

Loving your job. Good or bad for the brain?

Absolutely great for your brain. If

you're learning new things, people who are in a job that does not require new learning have a higher incidence of Alzheimer's disease.

So if you're stagnant in your work, you have a higher risk of Alzheimer's. And like, if I just read brain scans all day, well, I know how to do it.
I'm not learning anything new.

So I do that,

but I also

am writing about something I don't know about

or I'm learning something new. What if you're working with arseholes?

I'm sorry? I love the job, but I'm working with arseholes. Bad for your brain.
Chronic stress

increases cortisol. And I think everybody should sort of know their baseline cortisol level.

And cortisol shrinks the hippocampus

and puts fat on your belly. So that's two very bad things for your brain.
Breath work, that's a big trap. Excellent.
Excellent. You want to break a panic attack?

The 15-second breath. Four seconds in, hold it for a second and a half.
Eight seconds out, hold it for a second and a half.

You just do that four or five times, your whole nervous system will calm down. And the research shows take twice as long to breathe out as you breathe in.

That's why four seconds in, eight seconds out. It shifts your nervous system, doesn't it? Yes.
It increases something called vagal tone. Okay, some bad things then.

Social media usage, chronic social media usage, good for the brain, bad for the brain.

Because you're constantly comparing yourself to people who aren't real.

What about workaholism and hustle culture?

So

I love my work.

Am I addicted to it? I don't know. But I love it.

When they say people are workaholics and it's bad for the brain, it's they're working with assholes

or doing something they don't like or doing it for the money but without

other purpose.

Microplastics. That's a big treatment.
Awful for the brain. One of the major causes of hormone disruption and cancer.

And other environmental toxicities. Thank you for not giving me a plastic water bottle.
Yeah, it's okay.

Imagine if we we did that and we spend a lot of time these days talking about the microplastics and other environmental toxins that I think people are becoming more aware of now, which is good.

Noise pollution.

Bad for the brain.

And if it hurts your hearing, hearing loss is actually one of the risk factors for Alzheimer's. Why is that?

I did a because you're not getting input. Right.
And if you're not getting appropriate input,

your brain starts to atrophy.

And

if you don't hear what other people are saying and you have a lot of ants, you have a high negativity bias, is you can actually begin to get a bit paranoid and fill in the empty spaces with negativity.

I just bought some new Apple AirPods. And when I connected them to my phone, it said, you want to do a hearing test? So I did the hearing test.

And then I asked my girlfriend, I said, you should do this hearing test as well because I needed something to compare it to. And I was a little bit shocked.

It said I hadn't lost any hearing yet, but my hearing was significantly not as good as hers. And I remember thinking, gosh,

you know, this is, but I didn't have any idea that it was linked to Alzheimer's at all.

So now I've turned down the volume for the first time in my life, because I think your hearing declines regardless, really, of what you do with age anyway.

But as you said earlier, like starting from a better baseline when you're talking about the brain reserves is really the game, I think, with aging.

My last point is a

my last question is a bit of a

seems to be uncorrelated, but the world is heading towards a world that's driven by artificial intelligence.

It's like all the, all the rage at the moment, if you log on on the internet, people talking about they're going to lose their jobs, all of these new tools that allow us to optimize our lives in a variety of different ways.

When you think about the world of AI that we're heading into, there's so many ways that I imagine it's going to make your job easier as as someone who's doing scans of brains and so on.

But do you think artificial intelligence is going to be good or bad for our brains?

I think in the short run, it's going to be bad because

your brain is going to do less, and that's bad for the brain.

I think it's fascinating to watch what's going to happen. And ultimately, in the words of my friend Byron Katie, argue with reality, welcome to hell.

We need to figure out how to use it to enhance our lives rather than to steal brain development.

Here's the first most replayed moment. There was a study done in 2007 that showed

can't even say it. Curcumin.

That shows curcumin upregulates anti-oxidant defenses and down-regulates oxidative stress.

And there was a study done in 2016, which is a meta-analysis of random control trials, found curcuminum comparable to ibuprofen in terms of pain relief.

Yeah, there's a lot of work on

curcumin and turmeric. As I said, a lot of people get confused because they think it only works if you absorb it into the blood.
And I'm saying that actually you don't.

What you do is you work with the microbiome to make it useful.

And there's early pre-clinical studies taking place around the impact it can have with cancers, and there's promising but early studies showing the impact that curcumin that comes from turmeric can have on brain health.

Yes, well that's the focus is switching on to the blood supply to the brain, what we call the vascular effects on the brain.

And there's something that we used to call the blood-brain barrier, which you've probably heard of, which is seen to be the place where the barrier that stops a lot of stuff entering the brain and potentially upsetting it.

We now know this blood-brain barrier is a very dynamic, interesting interface between the brain's tissue and the rest of us. It's now called the neurovascular unit, NVU,

and it is so exciting. And the more we look at it so far, the more we find that the things that help the neurovascular unit, the blood-brain barrier, are plants.

And we have green tea. And, you know, we can,

if you really want to help

our brain health, regular drinking of green tea, you know,

it's been shown to be really useful. Not that rather than the supplement, by the way, it's the drink that you have.

Oh, I put it in here.

Right, so we can make it.

So, as you make that, can you explain to me why green tea is a good idea?

Because it contains a number of, again, polyphenols

are these colours. These colours, yeah.
In this case, it's green, obviously. And green tea is just the smoked, unprocessed part of the tea leaf.
So it's a plant called camellia senensis.

So this is a nice Japanese teapot. That's the sort of thing you'd have green tea in.
And these are the mugs, but we've filled these off already with ginger and cinnamon. So

let's leave it for a moment, but we can, while it's sitting there for a while, there are a number of these polyphenols in green tea that seem to be particularly

effective in modulating that barrier that we talked about, the neurovascular unit between the brain and the rest of us. And

there's all sorts of reasons why regular consumption of green tea seems to be linked to less of this sort of trouble.

What sort of trouble? The dementia-type problems, the culture decline as you get older. Do they find that in cultures where they drink a lot of green tea, they have less dementia?

Yeah, but that doesn't mean there's a cause and effect, so you need a few other things to establish that. What we're finding is that other plants have very likely powerful effects in this area.

And I mentioned the rosemary. Now, all you need to do to appreciate rosemary is to press it and sniff.

Oh, it it smells so good.

Really nice. That's not just nice because what you're doing there is you're inhaling volatile oils, the things that give the smell.
And when you're inhaling,

they're literally going into your brain because part of the brain actually reaches the outside world. It's called the olfactory lobe.
And when you inhale something, it literally moves into the brain

and from there into the limbic system. Remember, there's a line in a Shakespeare play called Hamlet, Ophelia,

the young lady says, Rosemary, that's for remembrance,

because everyone knew that this improved cognitive functions.

And when I was working on our campus in Maryland, we actually did a clinical trial with rosemary in people with struggling with their crosswords, you know, as they get older, and found that although it wasn't a conclusive study, there were pointers to it improving cognitive or performance in those people.

And there's been other studies since that

reinforce that.

I would say that rosemary is one of the ones to watch in terms of long-term brain health.

There's another remedy called Ginkgo that a lot of people know about, which is used as a prescription medicine in Europe for cardiovascular problems.

And that's been shown to be likely useful and using the same sort of mechanisms as we've seen here. And with the green tea, I'll check check it here.
Yeah, that looks alright.

You see it's more yellow than green.

And this is flavoured with a little bit of mint to make it a little more agreeable. Sometimes people find green tea is not their favourite taste.

Green tea is rich in polyphenols,

which are linked to benefits ranging from heart and brain health to fat loss and cancer prevention.

it's got a nice minty flavour, yeah, you can live with that, couldn't you? Yeah, yeah, my girlfriend, again, she's all over this stuff, she's always bloody right.

Well, you know that, or learned that lesson a long time ago, I know, right?

Like, I say it all the time on this podcast, but she's always like two, three years ahead of what then someone really, really smart comes and tells me. And I spend those two or three years in denial.

I'm like, what the fuck is she like?

Don't get me started on cacao if you start talking to me about cacao.

No, no, no, no, no, she's been telling me.

I'm gonna going to nail this because there's a lot of people listening who will want to hear this.

Cocoa,

chocolate, dark chocolate, is a medicine. End of

one of the best medicines around is 50 grams to 100 grams of 75% or more dark chocolate. Do you know what? I've just realized my girlfriend, she's going to live till she's 150 because

she eats 90% or something, 80%

dark chocolate. She drinks green tea all day.
She has

the ginger and cinnamon drinks all day.

She eats the full rainbow. She should be stepping in for you.
I know, I know, exactly.

No, cocoa,

seriously,

brain health as well, cardiovascular health.

I mean, they do studies where they've put cocoa into volunteers, it means students usually, you know, so young kids, and they were able to show changes in the blood flow within minutes, certainly within an hour of eating cocoa.

Beneficial changes in your blood flow. They call it the heart medicine.
Yeah,

heart circulation, brain.

So she's, my girlfriend's very spiritual. She runs a business called Bali Breath Work.

Hashtag Ada, if I have to say that.

But in her business, one of the things she does at the very start of the session with women all over the world that come to her retreats is she makes cacao for them and

you notice instantly how people change when they've had a hot cup of cacao it's almost and she says it like almost brings out their heart and i guess that's because of the circulation reasons it's it is but it also of course we know it contains a few other beneficial stimulate stimulating effects and sort of similar to the effects with coffee, which incidentally, as I've already said, is a medicine as well.

But cocoa and and chocolate does have an uplifting effect, which is why we love it so. And we have to be clear here.

We're not talking about hot chocolate that comes from a packet or something necessarily. We would like it to be as dark as possible.
Okay.

The less sugar, the less fat.

So we talk about 75% cocoa solids, you know, so it's dark chocolate. And it tastes a bit more medicinal, doesn't it? It's not as sweet.

But I'm saying to many of my patients, take 50 grams a day. It's a medicine.

Damn.

She's right. My fridge is full of dark chocolate.
I tend to avoid it, but the drawer of my fridge has all of her dark chocolate in, and

she likes it 90%. If she can get it 90%, she'll take it.
Yeah, 90% is quite good now. Yeah.

Having a look at the green tea.

There was a study done in 2008, which supports how it improved cognitive function, memory attention, accuracy, and long-term consumption is associated with lower risk of cognitive decline and Alzheimer's disease, according to the Journal of Nutritional Biochemistry in 2011.

It's nice to have somebody else just say what you said. Yeah, but it's exactly.

I didn't realize that. I had no idea.

I had no idea.

All those times I turned it down when she offered it to me.

You can't say sorry.

I have literally, literally, I've got a wow, heart health, brain function, fat burning and metabolism, cancer prevention, early evidence, blood, sugar, and insulin sensitivity, gut and oral health.

If there's anything we need, it is connection, especially in the world we're living in today.

And that is exactly why we created these conversation cards, because on this show, when I sit here with my guests and have those deep, intimate conversations, this remarkable thing happens time and time again.

We feel deeply connected to other. At the end of every episode, the guest I'm interviewing leaves a question for the next guest, and we've turned them into these conversation cards.

And we've added these twist cards to make your conversations even more interesting. And there are so many more twists along the way with the conversation cards.

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