Does Alcohol Shrink Your Brain? | Dean and Ayesha Sherzai on The Exam Room

It is Brain Health Awareness
Week here on the Exam Room podcast brought to you
by the Physicians Committee. And I can think of two people
who are absolutely perfect to raise our health
IQ in terms of our brain health. And they are the authors of
the 30 Day Alzheimer's Solution. They are our good friends,
Dean and Ayesha Sherzai. Thank you both
so very much for being here. It's always fun
to speak with you. Thank you for doing this.
Oh, yeah. You guys are pure personality. And I think that that's part
of what makes you so impactful with your message, is being able
to build that connection with your audience, whether they're reading your book or they're
hearing you on a podcast. Or watching you on YouTube
or Facebook, you just have this this ability that few people have to
really get in there and connect.

And so that is truly, really than another a joy for
me to have you guys here. And let's start with
with your social media, right? You have made some changes
there. You are now @thebraindocs
on Instagram, important handle update. And so when I'm getting ready
to do this interview, I'm going through and I'm doing some prep
and I come across this post and it has to do with alcohol
and shrinkage. Now, that's
a whole other episode. But in this case, we're talking
about brain shrinkage. And you talk about the consumption,
the heavy alcohol consumption actually shrinking the brain. So the first question is what
exactly do you mean by this? Yeah. So there's this misconception that alcohol
seems to be a health food, or that's the misconception
that we all get. We keep hearing that
wine is good for your brain. A certain amount of wine is good
for your brain.

And. And reality
is the amount of alcohol that's good for you, for
your brain is zero. And now that's a that's that's going to lose
a lot of audience members. And we've gotten quite a bit
of pushback because people like drinking a little wine here
and there. And we actually ourselves once
in a while, on rare occasions, we do drink wine that what we do is separate
from what the science is, right? I mean, we try to be very,
very healthy most of the time. And as it applies to alcohol,
same thing. But alcohol is actually a toxin.

I mean, any amount of alcohol
can be bad for your brain in itself. How it's relates
to your stress management, how it relates
to your social ability, how relates
to how your convivial nature of your personality.
That's a separate thing. People make those arguments because it lowers the stress
level in certain people. Maybe it's beneficial, but at the molecular
level, there is no benefit. And then more and more there's data that actually
even at the population level, when you look at the data in a clean way, when you control
for other factors you see that even small amounts of alcohol
is not good for your brain and actually shrinks the brain,
meaning that cells die, connections are severed and the brain shrinks
and although that happens regularly in a Western diet
or in Western lifestyle, it appears to be worse
when people who drink even small amounts but definitely
when they drink a lot.

Right. Absolutely. So what what amount
are we talking about here? What would be a heavy drinker
here? Because I think in this post
you referenced maybe even just one
drink a day. Is that accurate? Yeah. So the latest data,
this paper actually came out just a couple of days ago,
a few days ago, last week on the fourth,
I think. And, you know, more and more
studies are showing that there really is no such thing
as a little bit of alcohol or what, you know, our least
favorite word is "moderate" amount of alcohol.
What does that even mean? It's such a meaningless term. You know, with all the data
that is coming to us and with all the tools that we have, we can actually see
that alcohol causes damage to not only the cells,
brain cells, but also to the connections
of the brain cells.

So the best thing about science is,
you know, we we change our minds
as we get more and more better and better data. And now we have better data
telling us that there is no such thing
as, you know, little bit of wine
being helpful for the brain. Now now the next natural question is, can I drink
any alcohol and be fine? And that's
a very important question. I mean, that's that's a question
that should be asked because we do lots of things
that are not perfectly healthy. For example, sedentary behavior, you know, sitting around for 8 hours in a row watching
what's the show. We watched the whole series. The Ozarks, you know. And so it's
such a good show, though. I completely understand. We love I mean, you couldn't even get out,
so that's not healthy. But once in a while,
you do things like that and and you eat, you know,
some some plant based burger ones on rare occasions,
which are now a little more fat.

And that's not healthy. But we're not going to change
science because we do that. The scientists says
that it's bad. We're going to say it's bad and we've done a bad thing
and it's okay. Once in a while. How much can each of us
do, you know, partake of these negative things in our life and still be okay
is a complex question. It has to do
with our resilience, our what they call cognitive reserve
and a brain bank. Bank account,
meaning the connectivity that we have created
that can withstand any trauma. And we can do quite a bit to
create that kind of resilience and that resilience matters. If you have a lots
of resilience, if you have a huge bank account, you can do more and still not
be damaged as much. I mean, it doesn't mean that you're
not going to be damaged at all, but you're going to be damaged
less if you do.

If you have very little reserve, the smallest bit
can actually push you over. And as we are, we actually see
patients in the hospital and we see this all the time,
people who have low resilience, and we can define that
in a few minutes. What that means, even a small UTI
when they're in their sixties, urinary tract infection pushes them over
and they become, you know, delirious and and have confusion
and even dementia but others who've had an
incredible life of resilience, they, you know, face small strokes
and trauma and everything and they still able to maintain
their cognitive capacity. That's important. That speaks to how much wine
you can drink. That's speaks to I mean, it doesn't
it's not helpful, but you can withstand
more damage, speaks
to how many other bad things you can do
and still withstand it. So resilience
does matter in that picture. So when you're
talking about resilience, is there a way to build
that resilience up or are. Or is everybody born with
the same level of resilience? And then you just kind of make
withdrawals over time? It's just a matter
of how quickly you deplete those savings.

Mm hmm. So that's a great question. And our entire message of
why we're on social media, why we're outside of our clinic
and engaging with the community and with everyone is just that that we have tremendous
amount of control in building that resilience. So the resilience is
brain reserve. You know what? You're born with it
all, making sure that, you know, when babies are born,
that they're healthy, that they haven't
had any head traumas, that during their intrauterine life
their mothers were healthier, etc., etc..

And then the cognitive reserve
is everything else that we build from the day we're born,
you know, making sure that we're exposed to a loving,
comfortable environment with, you know, lack of toxins,
good food, sleep movement,
having a purpose driven life. All of that is
critically important. So even if, you know,
sometimes if the brain reserve is not perfect,
we have a lot of influence on how we can build our brain
and how we can expand it. Because, you know, as sensitive
as the brain sounds, you know, this this £3
little gelatinous origin, it has tremendous capacity
to continuously grow and continuously connect the cells if it's given
the right environment.

I mean, I can said it
beautifully. I mean, the connectedness,
the original size of the brain, as you know, grows rapidly
within the first five years. And that cellular
growth, in fact, what's amazing is at a certain age,
like 3 to 5, there's a process called
apoptosis programed cell death. There's actually a dying
back of cells. That dying back actually leaves infrastructure that ultimately is the
infrastructure of your brain, the cells, how they're organized
and all of that.

And then thereafter
there's the connectivity between these cells. I mean we have 87 billion
neurons, but each of the neurons
can make a couple of connections or as many
as 30,000 connections. Do the math. That's incredible plasticity. That's incredible resilience. 87 billion neurons
making thousands of connections each of them. Now those thousands of
connections are not programed. Those are not at determined
a priority.

And everybody
has the same. No. Well, as Ayesha said, by
getting rid of the bad things. Well, for example,
we know fetal tissue, fetal alcohol syndrome,
mothers of children, infants, that had drank alcohol
during pregnancy, they create significant damage
in the babies or drinking
in the first few years, or even if there's alcohol that children consume
accidentally or otherwise But beyond alcohol, we're
talking about other things, bad food, things that we don't
even talk about nowadays. The amount of sugar in our diet,
the amount of fat in our diet saturated, the amount of salt these things matter, or absence
of certain things like B-12 or omega three or not enough
antioxidant scientists, lavatories and greens and beans
and all of that stuff. Those things really create the infrastructure of that brain
to grow. It's ready to grow. You've given it all the fuel. Now all you have to
do is push it.

Where does the push come from? Movement, exercise. Exercise pushes
the blood vessels to connect. Where does
other movement come from? Mental activity. An organized, resilient,
positive mental growth. Not this stress induced
mental growth that a lot of children
go in school, but a personalized education system
where it's built around their child's strengths
and around their joys. Around their pleasures. Learning is gamified that actually grows
the connections between neurons exponentially. And we say that every child
has a potential to be a genius if we do the right things. Now, whenever
we say things like this or the fact
that Alzheimer's can be avoided, there's a sense of guilt. And we people say,
are you trying to say that we did something? Or No,
nobody's done anything wrong. We're saying that what we could do to do better
as a society, as communities, all of us together
matters instead of.

So that's
where the resilience happens in the first few years,
in the first 20 years of life. That's where you create
that connectivity and then afterwards,
the kind of jobs you have, how you entertain yourself,
how you push your brain around your purpose
makes those connections. And those are not nominal
things. They are literally
the protection for your brain. If you look at the nuns study,
the answer is amazing. It really is just incredible. And you in the study, they found that,
you know, nuns who had better vocabulary, who were connected
more with the community in spite of having pathology
of Alzheimer's disease in the brain, they actually never had
any symptoms. On the contrary, you know, the nuns
who were more withdrawn, they were sedate, they were kind of
you know, staying indoors and not really connecting
with everyone else and had lower vocabulary.

They didn't really expose
themselves too much to activity. They didn't have much
Alzheimer's pathology in their brains, but they actually manifested
the symptoms quite early, even with a relatively good
looking brain. So that gives us a great winter
window to understanding that, you know, brain resilience and cognitive resilience is a thing that you can continuously
work on in your life. So when you say pathology
in this particular study, I would I be correct in assuming that they had received
an Alzheimer's diagnosis. After the fact? They did, yeah. After they died, all of the nuns had agreed
to give their brains for autopsy and these nuns had Alzheimer's
diagnosis. They had microvascular disease,
their strokes.

Yet they never manifested
outcomes of those. Why? Because they had more connected neurons and that protected them
in spite of pathology. That resilience is
what I'm talking about. And the reason that we bring up things
like alcohol and a fat, saturated fat and sugar
and things like that is because
we have to know what's bad. But we also have to know
that we have control both in avoiding those but even in spite of those creating resisting resilience
in so many different ways, we're talking about
the neuro concept that I can I always talk
about our neuro concept, which is nutrition whole food,
plant based exercise, significant exercise more
than people think they need to you as you
as unwind a stress management and a particular method of stress management
are as restorative sleep.

There's a reason
were knocked out for 8 hours. Those 8 hours are literally
the most important 8 hours of your day where the brain
recuperates, rejuvenates. It actually makes connections,
it cleanses itself, it organizes memories, and then always
optimizing mental activity. That's the vocabulary,
that's the cognitive challenge. Or what was the term
that you used? I said, I always say that if I if I ever had a rock band,
it would be called idea density. Idea density yeah.
Yeah. It's a pretty cool name.
It is a cool. That is dope. That is dope. You need to register
that one on Instagram and yes, put me in the front row, dude. I'm right there with you. Yes, yes, yes. Let's talk a second about sleep. This is an interesting one
that somebody asked on the show not too terribly long ago.

They said,
look, for the last five years, I've really struggled to be able
to sleep through the night. It's usually 6 hours
of interrupted sleep up to maybe three times
if they get back on track. Is there a way
to kind of unring the bell the damage that they had done
over those years where they were struggling
with their sleep? Or is it a case of a man? You better hope
that you got some good reserves because there's not much
that you can do yeah.

And I'll take a stab
at that, sir. I think those kind of questions are difficult to answer
because, you know, when you look at lifestyle
factors, they don't they don't have a linear effect
on the brain, right? Everything is mixed. So nutrition and exercise
and sleep and stress and cognitive activity,
they have a very multifaceted effect on the brain. Right. So for someone who has had
bad sleep, if they manage
every other factor, then, yeah, I don't think the damage
is going to be extensive. And if they fix, you know,
they're they're sleeping pattern,
they can actually thrive and get better. As a matter of fact,
there have been studies that show that people who have had sleep apnea,
which is a condition where people stop
breathing, right? They have sleep apnea, they started having damages
and they're at a higher risk of Alzheimer's disease. But if that's treated at that,
that gives the brain to start getting better
and healing itself.

And their risk for Alzheimer's
disease reduces significantly. So those kind of situations,
you just have to look at other factors as well. And how much or how much improvement
can you bring into your life in all of those areas? That's that's
that's exactly right. I mean, I said it perfectly, but and the main thing is
where the person is in their journey, right? If their journey is such
that they're eating healthy, they've had some
cognitive decline and a couple of the elements
are lacking and they improve it. Absolutely. They've seen it. People even have pre dementia
at stage. Right. We call them mild cognitive
impairment or MCI stage.

Even at that stage,
when people have instituted changes, they've
actually reversed. In fact, multiple studies
on exercise and nutrition that even at that stage
when they instituted change, the brain
actually started to grow again. Especially with the exercise
studies repeatedly. So there is
a lot of reserve now. There is a point of no return,
right? And we want to make sure
that we speak to that because a lot of charlatans out
there are making money off of people's
fears. Once that person already
has Alzheimer's forming in Alzheimer's,
where they have the diagnosis and it's pretty advanced, you can't reverse that
and you can give comfort. You can you know, you can
you can help the people. But there's we don't want to give false
hope, but anything short of that
is quite hopeful.

And I'm really glad
that you brought that up because it's quite unfortunate
to see, you know, groups of people and individuals
making a ton of money based on, you know, the fears
that people have. They they sell, you know, vitamin concoctions
and they prescribe like strange, unnecessary tests
that are not based on science. So there definitely
is a point of no return. And I'm I'm I'm I'm very happy
that, you know, we do have data
that supports that.

But at the same time,
there's a lot of hope to. A lot of. Those
those same factors, though, that we were talking about
in terms of preventing it, even though you do reach
that point of no return by implementing these changes
early in the diagnosis, more sleep better nutrition,
getting up, staying active, can that potentially then slow
the progression of the disease? Absolutely. Absolutely. Yes, there is there is a
very clear data that shows that, you know, once a healthy
lifestyle is instituted, the the decline is not as sharp. It actually slows down
the progression of the disease. And so we have data
that supports that concept.

I mean, anecdotally, I know this is just anecdotal data,
but we see our own patients and by the time have been diagnosed
with mild cognitive impairment and they were either able
to reverse their scores and get better like that,
the couple we always talk about or,
you know, even if they're
in their early stages of Alzheimer's disease,
by instituting these measures, they significantly
slow down the process and they feel better And it's all about quality of life
and having good memories and being able to make decisions
for themselves at this stage.

And what about happiness? And I'll bring this up
for a specific reason, because my mother in law
has Alzheimer's disease. She's in a nursing home really
just a half a mile from here. And since she's moved up
so close to my wife and I. And those two are just
I mean, thick as thieves, Thelma and Louise.
Kind of tight, right. We have seen
her mood really improve and even kind of
a slowing of that decline because she's being as she's able to interact
with my wife, Julie, on a daily basis
and just smiling and maybe it's bringing back
memories, too.

I don't really know. But I know that in speaking with other experts
in terms of help, health, happiness is really something
that should be thought of as a premium. So I would imagine that mood
here is ultra important as well. Oh, I mean, if if we are
all about mood aren't we? I mean, what's the point of cognitive capacity
without the joy and love of art? Beauty, friendship, family? That's that's that's
why we're here.

I mean, that's that's what
we're hoping to do for others. Yeah, that that's central. That's critical. We know also know that people
who have had chronic depression or anxiety are also at increased
risk of dementia as one of the factors
that's never one thing. But also people who instituted
joy and happiness in their life at a particular time, slow down
the process, reduce the risk.

So that relationship is absolute
because we know that stress, chronic stress creates profound
inflammation, oxidation, all of these abnormalities through
this pathway we call the limbic hypothalamic pituitary pathway
and also the autonomic pathway. These two pathways are anxiety and stress pathways
that were created. You know, throughout our history
as as primates And what happens is they were there to as a reaction,
as a survival reaction, as a survival reaction.
They're fantastic. You're running away from a tiger
for that period of time. If you if you survive,
I don't know how you would survive
running away from Tiger. But let's say you survived.

Then it's gone. It's dead. You're fine. That little stress
actually turns out to be great for your long term. But if that kind of indolent
stress continues, which is what we are
living in, in modern life, with with the stressors
with anxieties, with sadness, with the cycle of time
and with depression, that actually creates
this protracted, sympathetic overdrive, this protracted abnormal
response in the pituitary, which is the hormone essential,
which affects every hormone in your body, including growth hormone,
sex hormones, thyroid hormone, even all the way indirectly
with your immune system.

So stress as manifest through depression, anxiety and others
over a long period of time. Completely alters
your entire system, let alone your,
you know, your immune system. So your entire system
is affected and directly and directly it really starts
degrading the brain. So let's go back
to happiness here for a second. I know that this was something, Dean, you and I, we're kind of like brothers
from another mother here in terms of things
that make us happy. Right. And one of those things
is just flat out being immature. And right
before we hit the record high, you said,
hey, bring up immaturity. I was like, no problem.
We're talking about shrinkage. It's going to be really easy
to work that in size. So when it comes to immaturity,
and Alzheimer's, like how did those two go
hand in hand here? Immaturity or comedy or humor or anything that gets you happy. So why does comedy
make you happy? Not to make it not make not to even kill comedy
with esoteric with the joy.

But comedy is stress relief. It's an anxiety
that's raised and relieved. It's actually the most the most
primordial form of stress. Relief. In fact, if you the first time
that a child laughs is actually an anxiety
that's relieved. This guy with a beard
comes to him as it could. You could.
You could. It's a stress but it's a stress
that there turns out to be, not a stress. It's a threat that turns out
to be not a threat. In fact, the first laughter is a form of cry
that becomes a laughter Look it up.

See how so? It is
the ultimate stress reliever. It's the primordial stress
reliever. It's the central stress
reliever. And the more immature,
the better because it goes to the simplest
aspects of humanity. In fact, you want to live in a parasympathetic state
in your body where it's growth and rejuvenation
and all of that stuff. It's a completely different
system. The rest. And digest. Rest and digest
and rest and restore state as opposed to the fight
or flight sympathetic state. One of the things that does that
the most is comedy, humor and and the simpler, the better the you know, the more immature,
the better. Don't don't hold yourself back. There's no ego to be lost. There's only connectivity
to be gained. There's only happiness
to be gained. There's only you're talking about medicine, the Fed that affects your limbic
hypothalamic pituitary axis. Look at that complexity. The strongest medicine
is humor by far because it affects it
at the most primordial level.

So get gets silly you know, it doesn't matter
if people don't laugh. You you are happy. You know, it's a shrinkage joke. Go for it. Somebody's actually
in our pocket and our posts this alcohol thing
really brought out everybody. And somebody was making a joke
that, you know, does everything shrink I said,
no, gravity has to do with it. There's something with it,
too. So not everything that's But, but but but, you know, comedy is, you know,
they say comedy medicine. Well,
I just gave you the pathway to it's a matter of medicine, medicinal power,
and it's real and it's profound. You have made me a happy man. You have made me a happy man.
I'm telling you. I'm telling you
I'm going to live forever. Now, let's put that back over
to nutrition because goodness gracious knows that the exam room is absolutely
love to talk about food. So we've been talking a lot
recently about low carb diets. And, boy, you know, that
just seems kind of risky.

pexels photo 4348404

So you're talking about low
carb, probably talking about low
fiber as well. What do we know about the association
between fiber, low carb diets and the
risk of cognitive decline? Right. So low carb diet is becoming, you know, very popular because because of this whole notion
that when you cut off an entire group,
you actually tend to do better. I mean, that whole notion of,
you know, getting rid of such an important
aspect of nutrition, which is carbohydrate, which is the fuel that the brain
actually needs, are brain runs on glucose,
period.

Is crazy. And of course,
there are many reasons for it. There are multiple, you know, things
that have happened in the past that has brought on that concept
in the realm of health. You know, cutting out
carbohydrates reduces fasting, glucose and it actually
completely derails, you know, the way that our body
manufactures energy. So, you know, ketogenic diet
and ketosis on and so forth. When you look at the data,
there really isn't any clear answer of low carbohydrate diets
being beneficial in the long run. And the short run. And most of these studies
that have looked at low carbohydrates
and let's kind of stick to key to a ketogenic diet specifically
because that is a form of low carbohydrate diet that is high in fat and low
in carbohydrates, complex carbohydrates
and simple carbohydrates. They've only been done
for a couple of months, three months to maybe
add the most six months and there were only feasibility
studies, which means they wanted to find out whether
people stuck to it or not.

And most of the results
showed that first of all, it was difficult to stick
to, you know, and then secondly, the results were so bad
and they were so meaningless that when you look at a factor
of memory test scores it really didn't make a
difference of one or two scores to begin with. So overall. First of all,
we don't even have good evidence that low carbohydrate diet
is good for brain health. As far as weight loss,
as far as diabetes is concerned, in the short run,
it might seem beneficial because when you cut down on carbohydrates,
you lose a lot of water weight. And so people think that
this is actually a good thing. But in the long run,
our bodies are not made. We're not biologically made to you know, get rid
of carbohydrates from our diet.

We actually see the damage
not only in our vasculature, but in
our brain health as well. So there really isn't any good data
showing that low carbohydrate diet
is good for the brain. What about the types
of carbs, though? So you talk about refined carbs,
your donuts, your sweets and things like that versus
the natural carbs that you would find in, say, sweet potatoes or fruit
or something like that. That is the biggest problem,
isn't it? Everybody thinks that
carbs are bad. And, you know, you put a whole spectrum of foods
in that category. You know, an apple is very different
from an apple crumble dessert that you find on the shelves
in a grocery store. You know, a sweet
potato is different from donuts and apple,
you know, all kinds of fruits and vegetables are different
from the processed carbohydrates
that we see on the shelf.

So the data on the unprocessed
complex carbohydrates is there. It shows that when people eat
whole grains, fruits, vegetables, fruits, vegetables, the carbohydrates that come from different kinds
of grains and seeds and nuts, they're phenomenal. As a matter of fact,
adding all that fiber and the complex carbohydrates
allows for our muscles our brain and all of our organs to thrive because it produces
it gives off, you know, the simple forms of glucose
in a very quantified manner. In a time released fashion that
our body recognizes and uses. But obviously, you know,
eating donut or pure sugar that people add to their teas, to the coffees
and to all that you know, carbonated drinks are the
sweetened beverages that we see that can't be good for you, that our body is not made
to actually accept the the increased surge of sugar
in our circulation.

So it's important
for us to understand what carbs actually mean. You know, what is the simple carbon,
what is a complex carbohydrate? So to kind of you know,
summarize it, fruits, vegetables,
whole grains, nuts and seeds, complex carbohydrates
in its most natural, unprocessed forms,
are the healthiest things ever. And our body actually needs them
while processed carbohydrates, you know, white sugar, even, you know, regular pastas
that are fun, refined carbohydrates, bright white
bread, honey, or any kind of, you know, sugars
that have different names like coconut sugar or brown sugar
or natural cane sugar. They're all simple sugars
that could damage our brain and our body. A lot of people, though, they try to get away
from those sugars and they go for the zero
calorie sweeteners. So instead of drinking a regular can of Coke,
they'll reach for the Diet Coke. Have there been any studies on
what role those diet drinks might play in terms of overall
overall brain function? Yeah, so there are some studies
that show that, you know, there are certain artificial
sugars that may be harmful, but they were all done on
animals.

So, you know, aspartame is is considered as one of the
harmful artificial sweeteners because it was associated with inflammatory changes
and brain damage. But unfortunately, those studies
were done in animals. They haven't really done
good studies on human beings as of yet. And then there's
another category of sweeteners that are more natural
or I would say partially processed, are not as processed
as, say, aspartame. And sucralose
are things like monk fruit sweeteners or stevia
that is derived from a plant. There's no clear evidence
of those being harmful, obviously, in that, you know, normal
small amounts that we need.

They haven't been studies
showing that, you know, large amounts of stevia
could be harmful for people. So as far as its use is concerned,
we as two neurologists, we say if you want to sweeten
your beverages, go with stevia monk for sweeteners
are good to provide at all. Erythritol all can be good too. And these are for people
who may have say, for example, some issue with their blood
sugar levels or they want to cut down
on their calories. But, you know,
if someone is really healthy a little bit of pure maple sirup
wouldn't really help them hurt them at all. So you're talking
about sweetening beverages here. Let's talk about tea and coffee. Tea, of course,
in your NEURONI nine, which is a you laid out
so beautifully in your book. There it is, right over
my shoulder here.

It's always on the bookshelf
behind me. I don't know
if you guys knew that, but what about coffee? I didn't see coffee
on the Neurontin list. So how did the two compare
their. So anti so far
to the best of our knowledge seems to be beneficial,
especially certain types of tea, green teas
and and others are seem to be beneficial. They're antioxidants
that they're anti inflammatory factors. Coffee is a complex beverage. I mean we all know this definitely people that have
anxiety disorders, people who have heart conditions,
people who have, you know, all kinds of other
maladies that might be worsened by a coffee should avoid coffee
or. Acid reflux. Or acid reflux So there's a lot of diseases
that that should avoid, including thyroid
and others should avoid coffee. But and then if you are drinking
coffee, definitely not with, you know, with dairy and sugar,
which is actually something that's usually consumed
with try to avoid that. Now, how much coffee
seems to be beneficial? The data is kind of all over the place,
but it appears that drinking some coffee seems to be benefit or there seems to be
a positive correlation with drinking some coffee.

And some lack absence
of degenerative diseases like Parkinson's
disease and Alzheimer's. Again, the data is not great,
but it's pretty strong enough to actually is to for us to say not an excess. And that's
difficult to determine as far as different populations. But for drinks a day or so,
it seems to be correlated positively when it comes
to Parkinson's and Alzheimer's. But all those other factors
have to be taken into consideration
because of its complexity. We didn't put it in the book because there are too many
factors that that negate it. Yeah, we say, you know,
if you don't drink coffee, you don't have to start it,
correct? Yeah.

You can eat some greens
or blueberries or whatever, maybe add some spices to your diet and you're going to get a lot of
anti-inflammatory foods. But if you are drinking it and if you're drinking, say,
for example, a cup of tea and you don't necessarily
have to stop it because you know there is evidence that
it might be good for the brain. Now I see a couple of mugs
in front of you. Personality questions. So what are
what are we sipping on.

Oh, I'm
drinking some jasmine green tea. And yeah, and mine is is always meant mint. It's always meant. Yeah. Mm. More into a peach.
You like. The bean? I like mint more. Yeah. Yeah. I'm not. So good
every. Season. Yeah, it's more mint. I for some reason,
I absolutely love mint. It's a good tea I usually get. Those are like those herbal tea
samplers. Mint is is usually one of them. Not bad. That's typically a PMB kind of
a tea for me as we tape this. It is evening time, so.

Hey, man, right on. So listen,
you mentioned heart health there just a minute ago,
and that brings me to one of my final questions. We have about 10 minutes
left here. Thank you all for being
so generous with your time. Viagra originally developed as I understand
it, as a heart medication. It turns out, you know, it's good for both your top
and your bottom parts. And you talk about this
study here showing that people who take Viagra have a significantly lower
risk of Alzheimer's disease. Then what's going on here,
buddy? Yeah, I don't know why you point
that me, but that's okay. Okay. Come on. Okay. I'm going to. Stop. No, no, no. So the data was pretty strong. I mean, it stood out. I was, but it still stood up. But it's still what you said. Be silly.
Somebody love you, man. Yeah, you are the best. So but the data is quite robust, and but again, it's one study
we always say, even if it's a powerful study,
even if it's a robust and even if it's a well powered study, one study
does not science make one study? That's not a conclusion.

Me. We have to see this repeatedly. We have to see that others,
other types of studies actually do produce this and then practice studies that
where people actually give it and not give it and
and see how people do as well. So at this point,
we're kind of optimistic that this incredible, you know,
easy drug that could benefit. Well, both your brain and your
your sexuality can be out there and where
the studies have started. And we're hoping
that this might actually open up a pathway mechanistically,
although we don't always make conclusions mechanistically,
but mechanistically. It kind of makes sense. You know, nitric oxide,
this is the the the drug that
actually affects nitric oxide. Nitric oxide actually
these are dilates the most vascular organ in your body
is not what you think it is.

It's your brain by far. Trillions, billions
of no connection arteries. If you ever look at this vascular picture of the brain,
it's all vessels. So those vessels become tenuous
as we get older. Those vessels become tenuous as we move more
and more as as we move less. That's
where movement is so important. And and maybe this is
how it actually works. The vessel dilates
those vessels, especially over long term and gives blood to the cells
that would be otherwise lost. Exciting. So hard turn here. I want to make sure
that I get this question in because I thought that
it was absolutely fascinating. I was speaking recently
with TI Colin Campbell, and I asked him,
I was like, well, look, man, you know, the way that you're
kind of framing this, I think that you're suggesting
that all animal proteins, whether they be from chicken
or fish, whatever, should be viewed in the same light as red and processed meat
in terms of cancer.

He thought, yeah,
they probably should. How do you feel about those
other animal proteins in terms of the risk
of Alzheimer's disease? Um, yeah. So as far as animal protein
and brain health is concerned, we don't have good evidence
that fish specifically fish and marine
animals are bad for the brain. And that's one thing
that we keep on. You know,
for the sake of integrity and being true to science,
we try to understand it better and we're hoping
that we understand it clearly. There's really no good evidence
that fish is bad. And I think it's not the fish,
it's the omega three fatty acid content and the fish
and fish being the major source of omega
three fatty acids for most population
is the issue. Now, if people were able
to get omega three fatty acids from, say, flaxseeds and chia seeds or ala
coming from plant foods, or if they supplemented with
algae I think that would not be an issue at all. But from the data that we have,
it seems like omega three fatty acids is the most important
fat for the brain.

And that we need it
on a regular basis. There have been actually some changes that have come in
different studies. So for example, for many years the Mediterranean diet
was touted as the best diet for brain health
and they looked at Alzheimer's disease and stroke
and Parkinson's disease and people
who ate a Mediterranean diet, they actually had lower
risk of that disease. And in that diet
people actually consumed fish several times a week. But then another dietary pattern
that was a more pure or a cleaner
and more specific version of the Mediterranean diet
called the Mind Diet, which is Mediterranean and dash diet for neurodegenerative
delay intervention for a neurodegenerative
delayed mind diet. It showed that people don't
necessarily have to consume fish on a regular basis. Maybe even consuming it
once a week would be enough to reduce
the risk of Alzheimer's disease.

And that shows
that if we have a planned plant based diet, meaning
if we pay attention to our omega three fatty acid consumption, we
don't have to eat fish at all. With all respect to Collin,
which is amazing, amazing human being, I think all meats
are not the same beef jerky. There's processed meat with
lots of salt is not the same as everything else.
We ourselves, we say that avoiding meat
altogether is great.

Even fish. We say that although there's no data
that is bad, in fact, some data that it might be good
for the brain. But we think it's the omega
three. We, we don't push from fish
because we think of the fact that maybe the thing
that's not accounted for long term is that the toxins
not just in mercury but lots of other toxins
that bio accumulate in fish. So we worry about that. And as well as the fact
that I mean, as a public health person, if you're not taking the bigger
picture into consideration, then you're not a public health
person you're
talking at on social media, you have to take
the animal component where how we are
devastating the oceans and we have to take
the environmental component where how
we devastating the environment.

If all of that does not take
into consideration, we are just trying to find followers. And that's wrong. Absolutely. We strongly believe that's
the omega three component. We just put in two papers that were accepted, one omega three in the developing brain
and one on omega three in the aging brain. The only fat that
the brain needs is omega three. You can get it from food,
but if you're worried, take some supplements. We take supplements
for transparency sake. Yeah, we don't sell anything. We don't push
any particular brand, but we take algae
based omega three because it's that important.
Our children do. They done very well
as plant based children. Throughout their life
and they've taken Omega three. So that's important to know. Give some gradation
to these things, but also speak to why we don't eat these
these these animals. So that brings me to actually
I wasn't planning on going this direction at all,
but this is an important one.

And we do also hear from a
certain segment of the audience. A lot of times they'll message me privately
and let's say, well, look, you know, like I take a supplement, but based off of some of the things that I've read, some of the things that are being said,
whether it's in the comments or by some of the other guests
on the show, you know, they feel guilty
about taking a supplement. If it's anything other than B12, they feel like they should be getting 1,000%
of everything that they need strictly by eating a whole food
plant based diet. But, you know, what would your message be to
somebody who's really struggling to or struggling
with those types of emotions? You know what I mean? It's like we have this idea
of what perfection is and you try to hit it,
but when you don't man, it's like that
just really hurts.

Yeah. First of all, I think we must be careful
not to make people feel guilty. We should inform people
we should give them guidance. We should even give them
difficult, difficult information. Like, for example,
this this poster we just put in, which is said basically
no amount of alcohol is good this is literally, you know,
touching the third, you know, the thing that you're not supposed
to touch and social media, you don't tell people
that alcohol is bad or that you shouldn't
drink at all. That's that's something
that's not to be done. We did it. But at the same time,
we said, if you choose to drink, don't feel guilty.

You know, you should know how much you
should know that it's not good. But at the same time,
you worry about resilience. Do other things
that that that make you healthy, sleep well, eat well,
all of that stuff. But we can't change the science for four, four, four
for the situation. But the same thing here. I mean, we our knowledge
of vitamin intake versus getting food your vitamins
from food is not 100%. And we do know that vitamin B12
is incredibly important. And if you think that you're
getting it all by from food, fine, check your levels. And we do check our levels as well as metabolomic acid,
which is how your body is using it. If you're you're sure
that you're getting all the other nutrients
and that's fine. Omega three, same thing. We don't have a good way
of measuring truly measuring. There are not of course
there are tests that check omega three but really don't
have a good way of measuring it.

And it is so critical
that you should be aware of it. You should have
you should take more food. We should take more ala, you know chia flaxseed at the same time
avoid omega six pathways, avoid alcohol because that will affect
the liver enzymes that would transfer ALA to EPA, to DHEA. So be extra aware of it
because that's how important Omega three is. But if you if you're not sure
if you're doing all that, take a supplement. Not always.

You shouldn't take supplements
for everything. We know that
that can be harmful. But for these kind of things
like, you know, of B12
and Omega three, they are essential, critical and if you're not sure
of your levels, getting a supplement is not bad
and don't feel guilty about it. And don't
let anybody make you feel guilty because we're giving you
a science in perspective. Science
is perfecting perspective. That's important. Yeah. And I can't speak
for anybody else at the organization,
but I will speak for me personally and I will say
I want to isolate that clip and play it back on loop.

So thank you very much
for bringing that truth forward. Man, that is a critically
important message. We have one minute left
and so really quickly Aisha, a thumbs up, thumbs down. When it comes to
olive oil and brain health. It depends. I wish
it was just that clear. Right. So you ask very difficult
questions now. Thank you. Is olive
oil is concern. So oil,
you know, it's a processed food. It's highly it's very dense
as far as calories. In one minute. Oh, okay.
I'll I'll make it short. But, you know. Look, we're not live, you know, take all the time
that you need. But, you know, as far as and, you know, I want to be respectful
for people who are on, you know, a no oil diet. And that's absolutely fine. It's not an extremely important
element of our diet.

But if people add a little bit of extra virgin
olive oil to their diet that makes their food palatable,
then there is really no harm. Again,
just like I mentioned with fish, there really isn't any data
that shows that we're going to harm our body
or our brain by having a little bit of extra
virgin olive oil. But yes, if you eat a lot of it,
that would add more calories that would just, you know, cause a lot of other problems
as far as weight management and inflammation
in the body is concerned. So I don't know
if that was helpful. That was definitely help
your family. Definitely. And who knew that there were so many layers
to olive oil, right? It's not just opening a bottle
and sprinkling a little bit on this
or that or whatever.

Like that is complex. Is coffee, man. So I know we have no time, but
I'll tell this story to end it. So I told this to all
of my patients, that of oils. If you want to take any oil,
extra virgin olive oil. And a month later,
he came back with a bottle saying, here it is. I said,
why did you bring the bottle? He said, I have three glasses
of this a day. I was like, oh, my goodness. What I was talking about
was spritzers, you know, spray the olive oil on your food, on small amounts,
not three glasses.

So you got to be careful
when you when you give information
like that, context matters, complexity matters. And binary always hurts. But at the same time, yeah,
imagine drinking three cups of olive oil for a month,
then, goodness, I stopped that because that was
that was damaging I guess. You're just thinking about like. Like cups. Yes, my. Cups. Absolutely. Well, I just went to Costco
and got like those Costco sized. Olive oil yes. Gallon of course. Know his insides for all kinds. The lubed up that. Goodness
gracious. Yeah. Oh, my God. I was very careful from then
on to just say spritzer. Oh. Wow. Okay. That's some boy
that deserves an award. I just I don't even know what to
say about that. Oh, my gosh. But speaking of
awards, you guys just got a cool one from the National Academy
of Medicine, right? For the research that you're
doing in the community. Congratulations. What what are you able to
share with us? What do you guys have cookin? Well, our our joy, our purpose,
our very existence is about promulgating
information about health and prevention
in the community, especially disparities,
communities, communities that don't have information.

Remember, real estate is location
location, location, public health is access,
access, access. And the very communities
that need more access to information, more access
to resources have less so. And certain populations,
be it African-American, Hispanic and even women in general,
that information is lacking. And that's why the rate of stroke
is three times as much dementia as two or three times as much and all these vascular diseases
significantly higher. And it has nothing to do
with genetics. It has more to do with access
to information. And our entire work is to spread that information to communities
in the way that they can, you know, take it in. We don't just go in and say
hopeful plant based or nothing or you're out, we are out. That's that's insensitive,
arrogant, top down methodology, which is very common
in many circles. We say this is the optimal
of a plant based, but how can we change your diet
10%, which is your diet, the way you're eating and the way you love it, the way
your family will love it, but it will change it 10%.

Because once you make 10% change
and they see it in their lives and they see it in their health and the taste is still there,
the 20% will come. And then the 30%, that's
how it's approached. That's the way we do
it. Beautiful. I love that so much. I love I just love the way
y'all are built. Y'all are complex, immature, fun, doing
just extraordinary work. I mean, we're loving you. Oh, no,
you guys are the greatest. And listen again, there it is
right there on Instagram.

Notice the updated
handled the brain docs, right? So pull it up right now
on your mobile devices. Give them a follow. And yeah, there you are, Dean talking about alcohol once again
so that you've got. A good grip that we're.
Getting ready for the. Become. Comebacks. You guys are awesome. You are. So welcome back.
Anytime. I mean, my goodness gracious. When I go on vacation, I'm just going to have you guys
guest host just the best dehydration.

Chuck, thank you so much
for having as like I said earlier, you're amazing. Thank you for creating
this wonderful platform. We hear so many people actually
saying amazing things about the podcast so
thank you for what you're doing. If your health IQ was a couple of points higher
than it was a few minutes ago, go ahead and like this video or subscribe
to the YouTube channel and to take it even higher, head
over to Apple Podcasts or wherever
you get your favorite shows. Look for the exam room
by the Physicians Committee.

Hit the subscribe button there as well and help to make
your world a healthier place..

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