There's a much more recent study that
took again older adults and randomized
them across three different groups. One
was like a low-intensity group. Another
group basically did kind of zone 2 type
work on a treadmill three times a week.
And the third group did um a
high-intensity interval training
intervention which was the Norwegian 4x4
protocol. So 4 minutes at 85 to 95% of
maximum heart rate. They had a 3minut
rest in their protocol. They did that
four times over.
>> That was three times a week.
>> Three times a week for 6 months. That's
that's pretty intense. But what they
showed was that that highintensity
interval training group, they improved
their fitness just as well as the zone 2
group, interestingly, but they had much
better improvements in hypocample
function and maintenance of hypocample
structure and MRI scan. And they
maintained that benefit for 5 years
after the six-month intervention. So
they worked really hard for 6 months,
but that that benefit was maintained for
for a really long period of time.
Welcome to the Huberman Lab podcast
where we discuss science and
science-based [music] tools for everyday
life.
I'm Andrew Huberman and I'm a professor
of neurobiology and opthalmology at
Stanford School of Medicine. My guest
today is Dr. Tommy Wood. Dr. Tommy Wood
is a medical doctor and neuroscience
researcher at the University of
Washington in Seattle. He is also the
chief science officer of BetterBrain, a
company that provides free brain health
coaching. Tommy is an expert in
neuroplasticity and human performance
and how science-based protocols can be
used to improve your focus, ability to
learn, and skill expression. His work
applies to everyone from the novice to
the elite expert, and for all kinds of
skills, cognitive, language skills,
athletic, and creative endeavors. Today,
we discuss the brain states that favor
learning and importantly, how to get
yourself into those states. We also
discuss how to get the most from a
learning session. for instance, how long
that session should last, how many
sessions to do per day, and perhaps most
importantly, how to tune your mind and
body to get better at learning. That's
something we don't often hear in the
context of learning and neuroplasticity,
that our brain circuits for focusing and
learning are also capable of plasticity,
meaning you can literally get better at
getting better. Today, we discuss things
like flow states and something called a
clutch state, which is a seldom
mentioned but critical brain state to
accelerate learning and performance. In
fact, a clutch state is the state that
you want to seek to learn and perform at
your best. We also discuss how different
types of physical exercise from long
slow cardio to brief high-intensity
cardio and different forms of resistance
training each open the window for
distinct types of neuroplasticity and
learning. So, this goes way beyond the
general discussion about exercise
improving your brain. We get really
granular about exactly what types of
things to do to improve your brain in
specific ways. As a career
neuroscientist who has worked on and
taught neuroplasticity for decades now,
it's rare that I encounter someone with
as deep knowledge about the real science
and application of learning and
plasticity as Tommy has. He's also
extremely unique because he has a ton of
knowledge about new science-based
protocols for plasticity. And he's also
an athlete. We discuss that a little bit
at the end as well. So today you will
hear a lot of information that I am
confident you have not heard on this
podcast or anywhere else frankly about
exercise, mental training, nutrition and
supplementation and much more and how
you can leverage each alone and in
combination to learn new skills with
accelerated speed, precision and
durability over time. I should also
mention that Tommy recently released a
new book that he wrote entitled The
Stimulated Mind: Futureproof Your Brain
from Dementia and Stay Sharp at Any Age.
It's an excellent book if you're
interested in following up on today's
discussion and learning more about how
you can make your brain better at any
age. Before we begin, I'd like to
emphasize that this podcast is separate
from my teaching and research roles at
Stanford. It is however part of my
desire and effort to bring zero cost to
consumer information about science and
science related tools to the general
public. In keeping with that theme,
today's episode does include sponsors.
And now for my discussion with Dr. Tommy
Wood. Dr. Tommy Wood, welcome.
>> So amazing to be here. Thanks so much
for having me.
>> Man, this is my favorite topic in the
entire world. What is more interesting
than neuroplasticity, right? The brain
is so interesting, but its most
interesting feature in my opinion
anyway, is that it can change itself.
>> Essentially, that's its core most
important function. If it can't do that,
literally none of the other functions
matter. You could you could argue and
it's something that we have to be able
to do right until the end of our end of
our lives.
You have an eclectic research tapestry,
right? Today we're going to talk about
neuroplasticity, what it is, what it
isn't, how to access it for men, for
women, different ages, and you also are
a high performance coach. You're also a
competing natural strongman.
>> Uhhuh.
>> Yeah. Yeah.
>> Uh does that mean lifetime no gear?
>> Lifetime. Well, it's tested. I Yeah.
Lifetime no gear for me personally, but
it's a drug tested version of the
strongman sport. So yeah, if you uh if
you compete in natural strongman, then
you you get tested.
>> Great. So we'll we'll talk about that.
I'll resist the temptation to talk about
your two boxer [snorts] pups because I'm
a dog lover. That's a different episode.
Neuroplasticity. I know what it means to
me. How do you conceptualize it? How do
you think people should think about it
in terms of wanting to learn things and
not forget things?
I essentially just think of it as the
brain
responding to inputs in order for us to
then be able to better navigate and
survive our environment. And that's why
I think it's such a fundamental part of
what the brain does. And essentially
every time you learn something, interact
with something, remember something, the
principles of neuroplasticity are
engaged, right? you are making new
sinapses or strengthening sinapses,
weakening other synapses. A lot of
people don't realize that particularly
brain development, but then also the
refining of functions in the brain
through neuroplasticity includes the
pruning or removal of signapses. Often
we think about it's all about growth and
new connections, but actually it also
involves the refining or removal of of
other connections that aren't needed.
That's that's a massive part of of brain
development in the first place. And this
is a process that's essentially
continuously on ongoing and you can
think of it as it primary role is so
that you can navigate survive the world
around you and that's through learning
skills through remembering people and
things and facts. Um, and
where I one of the one of the things
that's most interesting to me about
neuroplasticity
and the way we think about our brains
over time is that I think people have uh
conflated
neurogenesis and neuroplasticity. Mhm.
[snorts]
>> So when we're thinking about brain
development, we're thinking about um
then also brain function over with with
with age and either cognitive decline or
maintaining cognitive function. We
thought that the adult brain was was
fixed, right? Um or or then it was fixed
and then it lost function. And this goes
all the way back to Kahal who said the
adult brain is immutable, right? He told
us that you got into adulthood, it
finished developing and then it was kind
of done. He then at other times also
said that changes in the connections
between neurons could explain learning.
And so there he's talking about
neuroplasticity. But we we kind of got
this idea that the brain was essentially
fixed as an adult and then you know
couldn't change anymore. But that can't
be true because you still learn and
remember things on a daily basis as as
an adult. One of the things that I think
we've gotten um confused about is the
fact that the adult brain does not make
new neurons in many places, right? maybe
in the alactory bulbs in the dentus of
the hippocampus, but tiny tiny number.
>> Yeah. But like compared to the rest of
the brain, they're not you're not really
making new cells. And so because of
that, we thought, well, we can't then
grow and adapt or change our brains as
adults. But just because we have a fixed
relatively fixed number of cells doesn't
mean that we can't change the
connections between those cells. And
that's happening all the time. And that
is, you know, the main principle of
neuroplasticity.
>> Yeah, I like your definition. Um, in
part [clears throat] because I agree
with it. in part because it encapsulates
a lot of uh things including u helping
to clear up this misconception that you
know we generate new neurons. I think
>> the attractiveness of the new neuron
idea is just uh it's so sticky.
>> Um and so we would all love to believe
that.
>> Yeah.
>> But maybe there's good reason why we
don't add new neurons. Maybe maybe it's
uh not adaptive, right? Adding new
elements to a circuit is
>> maybe not the best way to change a brain
circuit. I think people also like the
idea that, you know, every organ in our
body turns over its cells. That we're
not the same person literally that we
were. The brain is same cells you were
born with, minus a bunch of them that
die off, as you pointed out. And thank
you for mentioning pruning and the and
the removal of connections as a
fundamental uh aspect of plasticity in
terms of um motor skill learning. Um
let's say I decide I'm going to um
practice billiards.
>> Mhm. and I'm okay now. Hang in there.
But let's say I want to get really good
as I learn and get better and better.
Can we reliably say that uh most of my
improvement is the removal of
inappropriate action and therefore
synaptic connections.
>> I don't know whether it's the majority.
You might know whether it's the
majority, but I think that there
certainly you it requires both, right?
the either the development or
strengthening of new connections and
then the removal of other connections
that decrease accuracy say or that don't
allow you to do the exact motion that
you were intending to do. This, like I
said, kind of goes all the way back to
the development of motor skills, say in
childhood, right? The brain has kind of
finished developing new neurons sometime
around 2 or 3 years old, right? Beyond
that point, you're actually primarily
removing connections in order to refine
[snorts] uh functions based on the
exposures that you have, be they
language, motor, social skills, which is
what the brain is essentially developing
during that time period. So then that
continues throughout our entire lives.
And I think that uh something that
happens later in life, one of the
reasons why we may lose function is
because we stop giving the brain inputs
to maintain a given function. Therefore,
that pruning continues, right? I don't
need to learn know how to do this. So,
I'm going to refine that away. That's
kind of the developmental theory of
aging or part of the developmental
theory of aging. So in that you know
when you're learning a skill as an adult
or anytime a big part of refining that
motor patterns that you're developing
has to be the removal of connections
that are or you know the down
reggulation of connections that aren't
allowing you to to do the skill that you
want to do. If you were to tell people,
look, you want to keep your brain as
young as it can possibly be relative to
your chronological age,
>> you should what?
>> Like it it so this is a general brain
health question, but really I'm
specifically asking about plasticity
[clears throat]
>> and let's make it multiple choice and
then you can add things to it. Okay,
>> you should exercise. So it can be
multiple things and then we'll talk
about which types of exercise. you
should continue to do the things that
you already know how to do.
>> Yeah.
>> And then third option um not mutually
exclusive with the others of course is
uh you should try to do new things that
you can't already do.
>> I I still toil with this when I look at
the literature on neuroplasticity and
aging,
>> right? Like yes, use it or lose it is
true,
>> but we're also told that novelty and
trying things that we're not good at is
an essential component of building out
brain circuits, continuing to make them
function better as we get older. So, how
do you how do you think about all of
that? I'll partly answer your last
question and then maybe give a framework
for how I think about it. So when you
look at a combination of epidemiological
studies and intervention studies in
older adults, everything about
maintaining cognitive function later in
life, you definitely see that those who
continue to engage in hobbies and
activities that are cognitively engaging
or cognitively demanding and that can be
lectures, that can be um volunteering,
that can be you know reading crosswords,
that kind of stuff. those individuals
tend to either have slowed rates of
decline or better maintenance of
function over time and or lower rates of
dementia. That's of course
observational, right? But that's usually
people continuing to engage in the
things that you know they've already
been doing, right?
>> So they're holding on to what they've
got.
>> Holding on to what they've got by
continuing to do that.
>> Okay. Now, of course, it could partly be
reverse causation because if you're
maintaining function, then you will
you're more likely to continue to do the
things that that you enjoy doing, right?
So, there's probably it probably goes in
both both directions. However, there's
an increasing body of literature that
shows that by engaging older adults in
novel cognitive activities, you see
improvements in function. So that can be
language learning. Uh that can be uh
complex like coordinative movement or
exercise. You see the same things with
um like musical training like people
learning a new musical instrument or
learning um musical theory trying to
identify different patterns in music.
And you see in randomized control trials
improvements particularly in executive
function that seems to be most common
across those different interventions.
But you're seeing um improvements in
cognitive function with novel cognitive
stimuli. Uh there's a lot of uh recent
trials that have also used types of
brain training um things like the
pointer trial that was here in the US
maintain your brain which is a massive
online study done in Australia recently
and that's sort of broad cognitive
training with like an online cognitive
training platform. So again it's it's a
new uh or novel um intervention or
exposure that seems to provide a
stimulus that improves function. So, I
think both can be or do seem to be
important.
>> I'm excited to share with you that my
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It provides a deep dive into and clear
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>> Can I ask what um for an example of
maybe one or two of the things that were
in that large-scale trial from
Australia, like just at a at a very top
contour level, um older adults, meaning
65 and older, um are doing what? The
maintain your brain uh study was
actually it was um sort of midlife kind
of uh 50s and 50s and 60s mainly and
they actually had interventions across
four different domains based on risk
factors within that given individual. So
they had uh dietary a dietary
intervention, they had physical
activity, they had um cognitive
behavioral therapy for those who had um
you know some potentially some mental
health um concerns and then they had uh
online brain training. Uh there was
something similar done in the pointer
trial uh which was in older adults now
60s and 70s that was done here in the US
that was a replication of an older trial
called the finger trial that was done in
Finland but what those guys did was
something very similar. So it's uh diet,
exercise, uh monitoring and and treating
uh cardiovascular risk factors and then
brain training. So what the brain
training looks like um so the points
trial is a good example. They did um
they used a platform called Brain HQ
>> which is an HQ
>> Brain HQ um which was uh developed based
on the work of Mike Mzinich um who's you
know like one of the godfathers of
learning and neuroplasticity right um
and they
do various tasks primarily focused on
developing and maintaining processing
speed. Um, some of that evidence goes
all the way back to an older trial
called active that was done in the US in
the '90s. It was still the biggest ever
trial of like pure cognitive brain
training again in older adults. So 60s
and 70s. They had three different um
training groups. The uh and then a
control group. Uh the training groups
did memory training and kind of like you
know pneumonics, memory palaces, that
kind of stuff to help them remember.
There was reasoning training which is
kind of like looking looking for
patterns in numbers and letters. And
then there was processing speed training
where in this example it's visual
processing speed. So things flash up on
a screen in increasingly small uh
increments. So could be hundreds of
milliseconds. And as you get better at
doing it, that time gets shorter and you
have to remember what you saw and where
you saw it on a screen. They just
published a secondary analysis of the
active trial that showed that um those
who did processing speed training with
uh booster sessions at one and three
years had a significantly decreased risk
of dementia 20 years later. Um and
they've done some other studies showing
that that kind of training improves
co-allergic signaling in the forebrain
um which we know is susceptible to um
the processes of dementia. So in
particular, it's this training uh to be
able to improve either visual or
auditory processing speed, which is not
something that you know, as you get
older, you tend to not do activities
that require you to process information
quickly. Like driving is probably the
the main one, but you can do it in
sports and music and and other
scenarios, but if you're not doing those
things, processing speed tends to drop
off sometime around 60 years old. When
you say uh well I say processing, you
say processing [laughter]
uh processing speed. Um are you talking
about reaction time, improving reaction
time or pushing people to um stay at the
edge of of reaction time? And when I say
stay at the edge, I should clarify for
people some task where if you go too
fast, you make errors. If you go too
slow, there's also a penalty
>> in this scenario. And there are, you
know, studies that look at these
different functions over time. Probably
the biggest one looked at uh data that
came from the implicit association test
people might have heard of where you get
um show these pictures of different
things and depending on how quickly you
respond it tells you something about
like your implicit um you like your
implicit thought processes. Um they took
some of the data from that. Um this is
published in one of the nature journals
a few years ago. And what they showed
was that um you can separate out
reaction time versus processing speed
because reaction time is just is a is a
very um just the basic of response to a
visual stimulus whereas processing
requires you is is based on how quickly
you can process and remember the
information that you're seeing. You
actually think Yeah. So [snorts] what
they showed in this study was that
reaction time kind of slowly decreases
on average in a population of it was
about 1.2 million people slowly
decreases in sort of like from about our
30s and then and then maybe decreases
even more once we get past about 60.
>> Processing speed on average tended to be
more stable until about 60 years old and
then tends to drop off. So in what
you're doing in these um training
modalities is you're being shown
information
for a very short period of time and then
having to remember what it was you saw
and where you saw it. Um so requires you
to actually think and you know remember
process the information rather than just
like responding to a stimulus.
>> So for people that want to jump to the
okay what do I do? Um,
can we conclude? Okay, if you like
crossword puzzles, keep doing them, but
do really hard ones for you. If you like
lifting weights, continue to challenge
yourself with those. If you like to run,
you know, push harder. Or should it be
we shift domains? You like to lift and
run, great. Start swimming again,
Andrew. I'm telling myself, I used to I,
you know, I just noticed over time, it's
it's such a cliche of aging, right? um
that you one does tend to become more
narrow quote unquote set in their ways.
You like what you like, you don't want
like what you don't. You get busier.
Probably don't actually get busier, but
you convince yourself, well, do I'm
doing these things and I do plenty of
them, so but I'm not doing these other
things. Or for those of us, I think this
is everybody. If they really ask
themselves an answer honestly,
>> you'd love to hold on to your motor
function and cognitive function as long
as you can,
>> maybe even improve it. Should we push
ourselves to do something that's really
far outside the box or maybe sort of
current skill adjacent? So, I think of
those three categories. What What do the
data say? If you want the greatest
effect for the minimum amount of time,
assuming you're still going to do all
the stuff you normally do, you're going
to add something else.
>> Should it be something really different,
slightly different, or just push harder
in the thing you do?
>> I think it's going to depend a little
bit on what it what it is the things
that you currently do, right? So like
crosswords are a good a good example.
Even if you're doing hard ones, if you
look at the work of people like uh
Gloria Mark, the things like crossword
and sudoku, they're less of like a true
cognitive challenge, right? It's it's
almost has more of like a meditation
meditative like effect, right? Which can
be a good thing, right? So you're
focused but not challenged really. uh
whereas if we're trying to build
capacity, you need to spend some time
doing something where you are both
focused and challenged um cognitively.
So that can come from um learning new
skills be they motor, language, social
um and ideally as broad as possible
because you're going to get better like
overall stimulus as well as kind of like
broader potential for for transfer into
other areas of of daily life. In
reality, the narrowness of the response
or the breadth of the response is
proportional to the narrowness or the
breadth of the stimulus, right? So, you
could get really good at one very
specific thing or you could try and
learn a new skill that requires a that
involves a wide variety of tasks. So,
I'll give like like an example is
learning a new ball sport, right? that
is going to require multiple assets of
motor skills, social skills. Um, it's
going to include both visual and
auditory processing that's going to get
faster and faster and harder and harder
the better you get. So, something like
that uh creates a much broader stimulus
um than you know if you get very good at
one very specific brain training task on
like one computer program, right? This
is one of the main arguments against
online or you know digital brain
training is that you get very good at
doing that one specific thing but it
doesn't transfer over to other areas of
your life. Whereas some of these broader
more complex ultimately more human
skills probably give us much broader
transfer as well as you know you know
because of the the multiple pathways or
networks that are being activated.
>> If my interpretation of what you said is
correct, pick something hard.
>> Yeah. Ideally, pick something that's a
bit outside or really outside your
current skill set. Uh that involves
motor and cognitive aspects like maybe
um and that's kind of tricky to to find,
right? I mean, with sport stuff, it
feels motor and cognitive because you
have to learn the rules of the game. You
have to in some cases interact with
others. with cognitive stuff. Um the
motor skills involved in writing or
turning a page, they're not that
significant, right? Um even with a video
game, I know [clears throat] video games
can improve reaction time and visual
search and things like that, but
basically your thumbs get real real
good. I actually went to a video game
competition. They have teams. A kid that
used to work for me, I was like, "What
do you want for kind of end of year
gift?" and he's like, I really want to
go to this video game championship. And
the kids actually who compete warm up
their hands.
>> The kids in the audience like have these
styrofoam things so they clap so they
don't make noise. So they and it was a
whole thing.
>> Yeah.
>> So I don't want to take anything away
from the the real sport. I I discovered
that is playing video games, but
>> mostly what was moving was thumbs and
fingers, not a lot of large scale motor
activity. Yeah. So, if you had to maybe
[clears throat] throw out three or four
things that are particularly potent
plasticity inducers, what would those
be?
>> This definitely doesn't have to be super
complicated. So, like the things that
you mentioned earlier, so because you
mentioned exercise and then skills,
right? And so, you could do those things
separately, right? I would maybe we'll
get into why aerobic and strength
training do different things to
different parts of the brain, right? So,
ideally, you do a little bit of both. if
you don't feel super compelled to go and
start a new sport, but you're getting
these inputs from elsewhere. Um, and so
you you would rather say learn a new
language, right, which we have which we
have some good evidence for, then that
combination is great. But if you're
thinking about some of the things that
we have very good evidence for that kind
of hit multiple um networks at the same
time, dancing is probably number one.
Lots
>> learning a new dance.
>> Learning a new dance. solo or with
someone else? I'm sure we're half
joking, but some people dance on their
own. Some people dance with someone
else.
>> So, like dancing on your own in your
living room, highly encouraged, right?
It's a great form, physical activity.
It's fun. You of course the um the best
evidence is for ballroom and line
dancing, which generally requires and so
there are meta analyses of these
interventions in older adults showing
that ballroom and line dancing have the
greatest effect on cognitive function.
And so both of those require other
people as well as learning you know
various sets of of movements. So you
have a you have skill learning you have
social interaction and you have a
physical activity component. There's
probably also the musical component
right you have to listen for the timing
of the music and those kinds of things
that that is its own skill set. So
dancing has a a large body of evidence
behind it. But then I think you know in
the exercise realm you've got all the
sort of ball sports, board sports, team
sports. Um, I think skateboarding would
be a great example. As long as you wear
a helmet and don't hit your head uh too
often. You know, most martial arts,
again, as long as somebody's not
punching you in the face too much.
>> Something like Brazilian
>> jiu-jitsu. Exactly. So, like you're um
there's a physical component, there's a
complex motor skill component. Usually,
there's a social component, there's a
there's a lot of uh responding, reacting
to the environment or your opponent. Uh,
right. So then talking about processing
speed again but then beyond that there's
some really interesting data on some
other creative arts that do seem to have
some effect on um you know network
stability and function in the brain
particularly the networks like the front
of prioral network that we know is
really important for like focus and
attention and its function does tend to
decrease with age. Um so uh things like
like creative or or visual arts um some
maybe some similar effects of learning a
language um
again um uh similar effects from
learning to play video games. Yes of
course there's no like big motor
patterns involved but you're having to
do um you know solve complex problems
you know uh react quickly to to a
changing environment that that kind of
stuff. So that's, you know, eight or
nine different things that that somebody
could try. And like just one of those, I
think, is going to be a new skill, a new
stimulus, often happens in a social
environment. Um, a number of different
things happening at the same time.
>> Any particular uh instruments?
>> I don't think anybody's looked at
instruments like the difference in
different instruments. So I would say
no. Pick pick one that you would that
you feel motivated and interested to
learn.
>> Yeah. dancing by oneself has a lower
shame quotient.
>> Well, the shame quot I think might be
might be important, right? the um you
know there's the discomfort of making
mistakes and we know how critical that
is for learning and so like you're I
think some of that can be important too
but if you do it in a in a class
everybody else is a beginner you're all
doing it together maybe that adds a fun
component because you can laugh at each
other when you don't get it right you
know so a few uh years ago I wrote a
paper with my colleague Josh Tknet about
this idea that um potentially one of the
reasons why we lose lose cognitive
function as we get older is because we
stop giving our brain novel inputs or
complex inputs that help maintain
function, drive neuroplasticity. And I
think one of the reasons that that
happens is because adults hate being bad
at things, right? You just like this
thought like you you you just imagined
it, right? I'm in a dance class and I'm
going to suck at dancing, right? I
imagine that I'm going to take my wife
to to a tango class. It's something I've
always wanted to do.
When I go in the first time, I imagine
I'm going to be like Arnold
Schwarzenegger and Jam Lee Curtis in
True Lies. Do you ever see that movie?
But anyway, so right at the beginning,
they're like they're spies and they're
doing the tango at this, you know, like
gangsters mansion or something. And it's
like he leans her over, she grabs the
rose from the table in her in her mouth.
Like I'm going to try that. I'm going to
drop my wife and she's going to hit her.
She's going to be mad at me and lots of
people are going to see and I'm going to
feel stupid, right? And [snorts] so
that's why we don't do those things. But
it's so critical to driving those
processes of learn of neuroplasticity
that we make those mistakes that we have
to kind of let go of some of that that
we feel as adults like we we think that
everybody expects us to be good at
everything and the best at everything
and you know we shouldn't fail we
shouldn't make mistakes but as you have
covered many times um it's so critical
to to do that and so I think
acknowledging that shame component
exists and leaning into it is going to
be a really important important part of
trying to maintain this function over
time.
>> Couple of quick anecdotes and then some
encouragement to do the tango class. Um
I'll start with tango. My grandparents
on my Argentine side did tango until
they're into their 80s.
>> So it can be done but they learned it
rather young. Um
>> and Tim Ferrris as I recall talked about
this one of his books. Yeah, he learned
tango. And um and that gets to the other
point which is I want to talk about sex
differences in uh results of experiments
on in plasticity but when you dance the
sorts of dances that we're talking about
so salsa tango
>> typically this is you know traditionally
the male leads
>> um years ago I had a girlfriend who was
really into salsa so I went salsa
dancing with her in the Bay Area one
night and it's it's a tricky thing if
you're not skil salsa dancer because
basically you're taking your girlfriend
to go dance with a bunch of other men,
you know, and then you you until you
learn. So the the it's it's there are
conditions that make it harder, social
conditions that make it harder for men
to learn than women to learn particular
types of dance, unless as Tim did, he
got a dance coach, a female dance coach
to teach him how to lead and then he
learned how to lead and then he was able
to dance tango competitively. I think I
have that right, Tim. They'll correct me
in the comments, but as as I recall,
that's the story. So there's that. Um
not that following is is trivial. It
requires some skill. But there the if
the person again traditionally the male
can't lead the whole thing it it doesn't
work
>> right. So um I just made you more
nervous about going to this class but
you should do it because um I had a
roommate when I was a posttock who was a
neurology resident at UCSF and she would
go do tango late at night and she would
come back a different person. And so
this is like the other piece here is you
know it seems that when we are trying
something truly new that involves
interactions with other people and we go
into that willingness to
enter beginner's mind or whatever it is
embrace the shame and as we start to get
even just a little bit better at
something. I mean it almost seems like
there's this kind of halo around the
rest of our life. We go to work the next
day differently. We interact with people
differently. like our nervous system is
changed. What do you think that is? I
mean, we can make up stories about
chemicals and maybe we should because
they're likely to be true. What do you
think that is? That like general change
in arousal like you're sleeping better,
you're you're more excited for the other
things in life when you're trying to
learn tango and you get just a little
bit better. What is that?
>> I don't think I would make up anything
about about chemicals. I think you could
boil a lot of it down to we like to be
good at stuff and we like to overcome
things, right? There's just like this
this like core need to be challenged and
then to overcome those challenges. And I
think there's a lot of downstream
effects of of not doing that and they
could be um you know related to mental
health. It could also be related to
physical health, right? because we think
about physical and and um cognitive or
or um you know stressor psychological
related challenges and and the process
of overcoming them because that's what
really drives you know a lot of physical
or or mental psychological growth and I
think that's something that you know
fundamentally is part of what we need on
a daily basis and so you did this thing
that you were bad at and you got better
at it and you proved to yourself hey I'm
capable I'm able to overcome challenges
is I'm able to you know engage and and
and do difficult things and I think the
psychological benefits of that you just
that process of engaging with a
challenge overcoming it uh working hard
to do that um I think that's just you
know almost like a core psychological
need that we have and then that
transfers to all these other things oh
yeah I can do these hard things I'm
going to do that other thing I'm excited
to try something else that's difficult
I'm excited to challenge myself again
and it needs to be something that feels
feels uh meaningful, feels difficult
enough that you have the ability to
overcome with some dedicated practice or
you know focus time working on it. If
it's too hard, right, you can have the
opposite effect, right? Like making
something so difficult somebody can't do
it and they just fail again and again
and again and again, right? That that
can obviously have the opposite effect.
But something that you know you can get
better at, you know, you can work on,
you can see progress, right? I think all
of that then has all these knock-on
effects.
>> Maybe we could talk about flow for a
second. you know, one of the most
bastardized terms in uh neuroscience
performance psychology and the rest.
When Cheeks Mahai talked about it
initially, um when he really defined the
term, it was about um being engaged in a
process where you have a certain level
of skill, but the thing you're trying to
do is just beyond your skill level. So,
really striving a bit and that kind of
general sense of well-being that can
come from that. Nowadays, I think people
assume flow is when you are able to do
something in the absence of kind of
feeling of effort. It's like you just
you you get the magic power kind of
thing, which is not what flow was
originally intended to to mean. I'd like
to know how you think of this concept of
flow and whether or not it's even a
meaningful term. And I I you know I tip
my hat to Stephen Cutotler and others
who have written about it and and
studied it and
>> a great respect for Stephen and um what
he's done uh with the concept and and uh
and I think it's a meaningful concept
but I don't think we really know how to
define it. And I think this is important
in the context of plasticity because I
think what we see in Harry Potter movies
and sci-fi and um you know fight club
and everything else is that suddenly
we're just going to be endowed with
these powers just because we want them
and need them and that is not how it
works.
>> Yeah.
>> So is flow an expression of skill or is
it the striving to attain a skill?
>> I think of flow as the maximal
expression of a complex learned skill.
like you said, you're like right at the
edge of your capabilities, but you're
still managing to maintain um maintain
function whatever whatever skill it is
that you're you're performing at.
The thing that really frustrates me is
that
because of that or you know some version
of their definition of flow, people like
well I've always got to search for flow
like everything happens in flow and like
we need to be in flow all the time which
doesn't make any sense to me whatsoever.
There's two different parts of this. So
one is that people assume that for
optimal performance you need to be in
flow. That is not true. Um flow is one
version of your of your of of being able
to you know perform at the best of your
abilities. If you think about this in
terms of sports performance there might
be broadly two states associated with
top level performance. One is flow
states the other is clutch states. And
so a clutch state um you are still at
the optimal level of arousal right if we
think about the arousal curve and
performance which we can come back to
but so at the optimal level of arousal
which is required for you know you to
perform the skill that you're trying to
perform but when you're in a clutch
state it still feels like hard work
right so like there are you you could
talk to any athlete about a time that
they um they performed well they won
they you know they did at the best of
their abilities but it was hard
cognitive work it hard physical work. It
was a slog, but they still managed to
perform well. That's a that's a clutch
state. And people can perform at the
best of their abilities in clutch
states. Um, and you know, even though
they're not in flow, it's not all coming
to them easily, right? It requires them
to like really focus and work hard to
get get the job done. And both of those
are perfectly reasonable states in which
to perform. And assuming that you have
to be in flow to perform just isn't true
if you look at like how you know
athletes perform in the moment. The
other side of it is that some people
have intimated that flow is required for
learning or like optimal learning
happens in flow which doesn't make any
sense. Right? If we if we talked about
making mistakes and errors and friction
required for learning that is not
conducive to flow because it's uh it can
be stressful, it could be frustrating
and sort of the other side of that is if
you know flow is expressing your skill.
If you want to get better at that skill,
you have to work even further beyond
your current capacities which which will
move you out of flow, right? because of
like the friction, the mistakes and the
errors that come from that. So I think
yeah, flow is super interesting and I I
wouldn't pretend to be an expert in
flow, but there are all these other
states where learning happens, where
performance happens that aren't flow and
that's fine, too, right? But sometimes
it's hard and that's okay.
>> I'm so glad you're here. I I've been
looking for this conversation for well
since I started the podcast because I
completely agree about flow and the
misunderstanding of the concept of of
flow. I've never heard of a clutch
state. Um is that a term that you coined
or something?
>> No, no, it's in the sports psychology
literature. They'll talk about
>> that's why I haven't seen it. Yeah, cuz
I'm very familiar with the
neuroplasticity literature, but I've
I've never heard of it. Maybe I'm just
not up to date on my reading. But um
thank you for introducing clutch state
which is when one is performing well but
it's it is involving and this is a term
I did make up sort of some limbic
friction like you have to push yourself
you're feeling constrained it's that
you're at that edge where it's there's
real challenge you're not you're
definitely not in flow.
>> Yeah. Uh, fantastic clutch state
everyone. Um, learn it, know it, embrace
it, um, live there for some period of
time in your life across your lifespan.
Uh, and you'll be better off. I I I mean
that. Maybe we could drill into this a
little bit more because you know several
times on this podcast or more we've
talked about the anterior midsulate
cortex the structure that you know
maintains size and super aers who take
on hard things and
you know this area of the brain that
seems associated with tenacity which
when stimulated people feel like an
impending challenge there's actually
neurosurgery experiments done by Joe
Parvey at Stanford people feel like oh
there's an impending challenge I'm going
to lean into it this is sounds more like
the clutch state than certainly and flow
state. So maybe the thing we need to
embrace is the clutch state. It's pretty
catchy. It's not quite as catchy as
flow, but but I I like it because um
it has an element of like friction kind
of written into it. You heard it first
from Tommywood folks uh not me. A good
friend who uh comes from the special
operations community. Uh we talked about
>> performance uh years ago and he said,
"Well, there's unskilled, skilled,
mastery, and virtuosity." M okay cool
and he said virtuosity is when someone
who has mastery pushes out to an edge of
effort
where they're sort of inviting in the
unknown. They don't quite know what
they're going to do next. They they have
some semblance of an idea like they're
not being um haphazard
>> but there's an inviting in of the
unknown and they find themselves at a
new level.
I've probably mentioned this documentary
four times in the last four episodes,
but when Andy Stumpf, former uh tier one
SEAL operator, came on this podcast,
former wings sutor,
>> Red Bull High Performance team came on
here, he suggested a podcast that I'm
now suggest he suggested, excuse me, a
documentary that I highly recommend,
which is The Dark Wizard, which is about
Dean Potter, who was a free climber, a
free solo climber, turn wings, etc. And
you see in that documentary how somebody
who's pushing to their edge
and a little bit beyond where the
consequences the death consequence is
able to access levels of skill that are
like jaw-dropping I think even to him.
>> Mhm.
>> So does that make sense? Like is that
sort of how you think about unskilled
skilled mastery virtuosity? Do you think
virtuosity is like where someone's like,
"All right, I've mastered this thing.
Now put me in a situation or I'll put
myself in a situation where I don't know
what's going to happen and maybe it'll
all go wrong, but when it doesn't, new
levels of performance emerge
>> as it's described that way." Um, because
you people might talk about virtuosos in
a skill just because like they're so
much better than everybody else, right?
But like that that that
definition requires a specific scenario
and moment of performance, right?
>> So then that sounds a lot like how I
would think about flow,
>> right? And so like when you when you
look at some of the classic descriptions
from individuals who've been in that
kind of level. So like um there's
there's one from so I I do a lot of work
in Formula 1. So there's one from Aton
Center where he's
>> from who? I'm sorry. and Senna. Um,
>> the driver.
>> The driver.
>> Sra.
>> Yeah. Senna. Senna. Excuse me. Sra is
David Senna. The great podcaster. He's
the He's the virtuoso of of uh
performance and business and finance
podcasting.
>> Don't let any of your uh F1 loving
friends hear that part of the podcast.
>> No, no, I like Sen. [laughter]
Some people consider him to be the the
the best Formula 1 driver of all time.
He died tragically in a in a crash. Um
but there's this um famous quote from
him where he's driving in the Monaco
Grand Prix and basically what he
describes is that he's like going faster
and faster and faster. He's like this is
beyond my capabilities. Like he doesn't
feel like he's actually connected to
doing the thing. It's just kind of like
happening. It's exact it's exact like
he's going seconds faster around the lap
than anybody else. And so like that's
kind of what like he is so good, right?
he achieved mastery and in that in that
moment he's displaying virtuosity in
that kind of um in that under that kind
of definition and so like that that
feels like there's a lot of overlap
there.
>> Yeah. Ever since seeing this uh Dark
Wizard uh documentary which I've watched
twice all the way through because it has
a mental health component. It's a it's a
brilliant and beautifully shot
documentary recently released. I um I
think about this virtuosity thing like
constantly. Uh, but I I love this notion
of the clutch state because it sounds to
me that
that's the state that we want to seek.
And the assumption is that high
performers are in this relaxed, mellow
state, but I'm guessing they spend a
significant amount of time there and
drilling the really boring stuff to make
sure they can get there. Yeah.
>> Um, Twilight Tharp, who's in her 80s,
uh, worldass choreographer,
sat in the chair that I'm in and
described the daily routine of her
worldass dancers. They go through the
most basic drills
>> every single day, but every iteration
for hours upon hours upon hours before
they begin quote unquote practice,
right? Before before they try and
embrace the the new performance piece.
>> Mh. but over and over and over often
after multiple hours of morning exercise
I think we we don't see all of that
foundational work and that it needs to
be maintained which raises a question do
we always need to maintain uh practice
the fundamentals
>> before I answer your question I think
there's there's another useful thing
just kind of to remember that relates to
all of this from you know in um you know
athletes and sports particularly on the
training side there's this general idea
of thirds right? A third of your
sessions,
>> training, um, learning, whatever it is,
are going to feel great. You're going to
feel really good. You're just going to
get stuff, you know, immediately. It's
going to just come to you. Um, a third
will just be average, right? And a third
are just going to suck and you just have
to show up and get it done.
>> But this is all in the same day or this
week across across the week, across
months, across years, right? This stuff
undulates. And the the the main reason
why I say that is because
related to this sort of glorification of
flow is this idea that these things
should just like always come easily to
us. But that's completely antithetical
to the idea that we have to work hard
and challenge ourselves in order to
build capacity drive neuroplasticity. So
there's kind of this weird tension
between what people are seeking versus
what is actually just the part of the
the grind of getting better and you know
o over time and sometimes it is a grind
and that's you know again that's okay
doesn't mean you're doing it wrong you
maybe it means you're doing it right
when you then think about maintaining
the fundamentals I think yes but
probably it's going to depend on the
scenario that that you're that you're
thinking about um because sometimes the
skill that you're performing, the
fundamentals are kind of baked into that
in in some way. So, it kind kind of
depends on what the what the
fundamentals really are. Maybe, you
know, if it's um so I'm thinking about
one specific study that was done in in
pianists. Um so this is kind it was kind
of related to the Ericson studies in uh
in violinists, right? But this time they
were looking at uh pianists. And so they
had four they had four groups uh older
and younger. So the younger was like 20s
and 30s, older were 50s and 60s, expert
and amateur pianists. And so the experts
came from um German like music
conservatories. Um and then they they
looked at um sort of basic skills
related to um you know moving the
fingers and other things that that you
you would do playing the piano. And um
so they were like very task specific
skills related to piano playing. And
what they [snorts] found was that the
most important predictor of how well
somebody performed at those piano
specific skills was not their age, it
was how much they practice. So it's just
that getting those reps in helps you
maintain those sort of like basic
functions. And maybe right when you're
playing very complex piano pieces,
you're encompassing all those
fundamentals anyway, right? You don't
need to you don't need to like do your
you don't need to do your scales every
day because some of that stuff is kind
of built in. But you will also see
people as they warm up say you maybe
they will do scales and things cuz
that's part of just like you know the
the warm up maybe part maybe that's
routine right this is me getting in the
mo in in the mode of you know playing a
complex piece but then maybe some of it
is just kind of helping to maintain
those fundamental skills. I'd like to
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>> So, now's your opportunity to kill the
10,000 hours. I mean, I know other
people have attempted to, but what what
does that really boil down to? Is it
simply that about 8 hours a day of
practice for a dedicated period of time
is what leads to rapid plasticity and
that's what was measured or is there
really a a some sort of rule about time
under uh seeking clutch state? The
simple answer is what the study showed
was that 10,000 hours was the average
amount of time that an expert violinist
had spent practicing by the time they
reached 20 years old. That's what the
study showed. They weren't even experts
by that point. That was how much they'd
practiced, you know, essentially in
their youth. So that number of hours
doesn't even translate over to true
expertise in violinists in this one
specific example. So I don't think
there's some fixed number of hours uh
required. It is interesting. Other parts
of that study kind of looked at the the
the practice routines of these expert
violinists and what they found was that
they tended to practice for about two
sessions of 60 to 90 minutes a day. And
I think that's a pretty good rule,
right? If you're going to do something
hard, you're pushing beyond your current
skill level, focusing for 60 to 90
minutes, maybe with, you know, a couple
of breaks in there, um, a couple of
times a day, that's probably about as
much as most people can do. And I think
that also relates to how we perform on a
day-to-day basis in other areas of life,
right? We kind of expect that we can go
to work and we can work really hard for
eight hours straight during the day, but
like the brain doesn't really work like
that. If we're doing hard um, cognitive
work, right? you're being you're focused
and highly challenged as you might be if
you're a um you know a future virtuoso
on the violin. You're trying to you know
really practice and push yourself. You
can only really do that for you know
chunks of 20 to 30 minutes maybe a
couple of times of the break right? So
like that's why Pomodoro, even though
there's no like good studies on the
Pomodoro technique, like for those time
periods, you know, 25 minutes with a
5-minute break a few times, they do kind
of fit into that kind of rhythm that
translates over to multiple areas where
we might want to use our brains. Um, and
just remember that hard cognitive work
and that process of learning can only
really happen in those kinds of size of
of chunks if you want to do them
sustainably.
>> Yeah. Before I started writing my book,
somebody uh who's published several uh
very well-received books said, "You can
only write for about four solid hours
per day
>> uh broken up into a couple of sessions."
>> I was like, "Come on." I mean, like I'm
I'm not trying to boast, but I used to
go into the lab and sit down and work on
a grant for six hours or something like
that. And I started thinking like, was
it really six hours? Go in there, see my
students and postocs, sit down. Okay,
then there's lunch. I need to walk my
dog. Yeah. you know, and there were some
late nights, but then the next morning
I'm kind of dragging because I was in,
you know, in my office really late and
you you get real honest with yourself
real quick and you go, "Oh, okay." In
the periods of time where I definitely
pushed to the 6 8 10 12 hours of just
non-stop work as a deadline approached,
there was a compensatory drop in output
after after you clicked send. And so I I
think
>> you're right. They're right. It's
somewhere between maybe I mean you're
saying 60 to 90 minutes and they're
saying 4 hours, but not a whole lot more
than that for real focused in clutch
state work.
>> Yeah.
>> So really digging in and no
distractions, no phone, no checking your
text messages, just you know.
>> Yeah.
>> Do you ever give yourself uh forced
constraints to get real work done?
>> Not to force it. I will say that um one
of the best ways to like truly get
deep focused work done is to eliminate
distractions, right? That's one of the
most important things that you can do.
So close the email. I like put my phone
in a different room or something because
like nowadays your own, you know, close
Slack, I have Slack, Teams, my lab and I
uh we uh interact on, you know, we
message back and forth on WhatsApp. Like
there's email. I've got like five or six
different ways that people can like
constantly try and get my attention,
right? So, like eliminating distractions
is really important. And again, I return
to Gloria Mark's work. She wrote an an
excellent book called Attention Span if
anybody's like really interested in
this. Um, but you get used to a pattern
of distraction such that when you're um
not actually being distracted, you will
distract yourself,
>> right?
>> Um, and but you can be trained out of
that as well. But so you know that thing
where you're trying to do work and you
like reach for your phone for no reason.
It's because your brain is kind of used
to this pattern of you around about now
I'm somebody will text me or send me an
email and I'll and I'll reach my my
phone. So you you go looking for it
>> even if it hasn't happened. But again
you can train yourself out of that if
you if you have periods where you're not
getting constantly distracted. So I will
eliminate notifications. Um, but at
least for me, what I found is that if I
if I have a ton of friction in terms of
trying to get something done, I will
usually step away from it. Um, because
there's something in there that just
like needs to click or come back before
I can like really engage in it. Or
>> if you're at a sticking point.
>> Yeah. Mhm.
>> So if if I'm at a sticking point or it's
like if something feels like it's just
not coming in the moment, uh I will
usually switch over to to to something
else, which is also kind of a normal
it's a it's it's one of a a possible set
of patterns of work, which is that you
have two or three projects you're
working on on any given time. If one
just like isn't quite working, then you
can switch over to the other one and
come back to it. [snorts] And then like
the alternative is that when the
deadline is so close and uh you know
this often happens with a with a grant
deadline or you know when I was writing
my book and there's a you know a book
deadline and you I've got to get this to
my editor in um how however many days or
hours
I I tend to just not need to to
eliminate those things because I'll I'll
just I'll just focus in like I I I don't
feel that kind of draw to be distracted
by other things. But that usually only
happens for relatively short periods of
time, right? It's going to be a day or
two or hours during a day rather than,
you know, extended periods of time.
>> Are you familiar with this recent study
about phone on the table, phone in the
bag? We would just remind people that if
you're your phone has to be out of the
room, even if it's in your bag beneath
your chair turned off,
>> you can still focus, but there's a a
cost.
>> Your cognitive flexibility, etc. really
suffer. So that means that the brain is
unconsciously expecting a call. You're
sort of waiting for it. And and the way
you describe this attentional break
expectation thing um that we get
entrained to interruptions is uh really
interesting. Um maybe this is why
meditation is such a useful tool for
improving focus is that it's just a
forced no breaks
>> yeah thing. Although it's pretty easy to
drift in meditation if you are not used
to doing 20 minutes of meditation. You
sit down to do that you set the timer
like your brain can end up way off the
trail. there could be some benefit to
that as well, right? Because there's,
you know, without kind of building that
in and I and I don't routinely meditate,
but um unless you have some parts of
your day where actually you're not
either putting in information,
distracting yourself, thinking about a
specific thing, right? You don't
necessarily get that time to integrate.
Um, you know, that's kind of, you know,
the classic is you come up with your
best ideas in the shower, right? because
that's actually the time when you don't
have your phone on you and you're not
watching TV and you're not doing all
these other things, you know, at the at
the same time. So maybe yes, that's not
what meditation is formally for, but it
could potentially be beneficial if your
if your mind's going to wander, you
know, making new connections, um you
know, coming up with new ideas, having
that space and time to do it, you know,
could potentially be beneficial, too.
>> In these studies, these large scale uh
trials, what was the diet intervention?
Can we distill it down to some things
that um everyone should do or ought to
consider?
>> Most interventions in the sort of um
cognitive and psychological space are
focused on some version of the
Mediterranean diet. Um there's uh the
mind diet um Mediterranean intervention
to prevent neurogenerative delay. It
came out of the Rush U memory and aging
project and it's basically just a
version of the um Mediterranean diet
kind of focused on um dementia
prevention and and the way they
initially created it was they looked at
foods that people ate more or less of
and created a score and those who had a
higher score tends to you know had a
lower risk of later de dementia. It
wasn't an intervention when it was when
it was first um developed but that was
kind of the version. And it it's kind of
combination of the Mediterranean diet
and the DASH diet which is um like a a
anti-hypertension blood pressure
treatment type diet. So it's uh you know
seafood, vegetables, berries, whole
grains, that kind of stuff.
>> Not too much uh saturated fat or animal
protein.
>> And so this is very similar to the diet
they used in the Smiles trial which was
the first randomized control trial in
depression that showed significant
improvements in in mood symptoms. I
think the the principles are useful, but
there's not necessarily a huge amount of
evidence to say that like this is the
way that you you should or you have to
eat uh to maintain cognitive health.
There was actually um a big trial of the
of the mind diet. It was published in
the New England Journal of Medicine a
couple of years ago and they compared uh
the mind diet to standard caloric
restriction. Um and actually they saw
similar benefits in both in both groups.
There have been big observational
studies that have looked at how much
their diet looks like a Mediterranean
diet. And those whose diets look more
like Mediterranean diets, yes, they have
a lower risk of dementia. Of course,
right, this is observational data,
right? So, it's not you can't say it's
causal. But what's interesting in some
of these studies, so a big one that came
out of the UK bio bank was that they um
took out individual uh foods or food
components of the Mediterranean diet to
see if that changed the relationship
between the Mediterranean diet and
dementia risk. And there was no food or
you know olive oil or food group or you
eating more or less meat that changed
the relationship between the
Mediterranean diet and dementia risk. So
what that tells me is it's much more
about whole foods. they're nutrientdense
rather than avoiding any you have to eat
you have to consume lots of olive oil
right or you have to restrict meat
because if those things are eaten in the
context of all this other stuff it's
really that bigger context of diet
quality and nutrient density that really
matters so the the parts of diet that I
think about are the you know there's
three so there's energy there's
nutrients and then there's overall
dietary pattern. So, one of the
confounding things about that trial I
told you about the mind diet versus
caloric restriction is you're like,
well, the mind diet should win out,
right? How does caloric restriction do
just as well? And [snorts] in the kind
of average population,
we tend to have some issues with
metabolic health and have been in a
state of chronic energy excess for some
period of time. There's been some very
nice studies that have looked at brain
aging and brain volume or brain reserve
um across different populations. There
was um there was uh one group that
looked at different um tribes in
Bolivia, the Bolivian Chiman who are
hunter gatherer group, the Metan who are
kind of an intermediate group between
sort of the Chiman and like a standard
kind of industrialized group and then
industrialized humans in the US and
Europe. And what they found is there's
kind of this um bell-shaped curve
between energy availability and brain
volume. And in general, brain volume,
right, the more the better, right, we
think. And so if you're chronically
calorically restricted, your brain is
smaller um because you just don't have
the resources to invest in, you know,
the structure um and to maintain it. At
the other end, you see the same thing.
So if you're chronically in a chronic
state of chloric excess, you also tend
to have a smaller brain on average. And
this is related to metabolic disease um
you know and you know potentially and
what comes with it um higher levels of
inflammation high blood pressure things
like that that we know can negatively
impact the brain. So the most important
thing and I think this is where some of
the benefits of caloric restriction
happened in that in that trial compared
to the mind diet was that you know
people's cognition improved just because
they decreased their energy intake to a
point that was you know more you know
was essentially kind of what their brain
kind of needed or you know kind of
supported their overall physical health
which then affects you know cognitive
health and and brain volume and and
brain function. So the first thing to do
is to make sure that you're eating
enough but not too much right and that's
very simplistic but like energy is
really critical energy availability not
too low not too high then the next thing
that you need is there is is nutrients
we know there are several critical
nutrients for uh related to cognitive
function and risk of dementia. Um the
ones that we have the best evidence for
are vitamin D, iron, omega-3 fatty
acids, uh the B vitamins uh involved and
the B vitamins involved in methylation.
So particularly B12 and folate also
potentially B6 and riboflavin although
that might depend a little bit more on
on the individual. Then there are some
other nutrients that you know have some
pretty good evidence for them. So many
of the antioxidant uh polyphenols things
that you get from berries, coffee, tea,
chocolate, the carotenoids that make
things orange, yellow and red. Um
lutein, zeazanthin, aazanthin if it
comes from seafood that's that's what
makes shrimp and salmon pink. Um and
then you know some other aspects like
dietary fiber seems to have you know
some some benefits as well.
>> Not magnesium.
>> So magnesium is absolutely absolutely in
there in there too. Um and in general I
think um and the so magnesium uh zinc um
then there's some of the structural
lipid components things like choline and
ethanolamine that you might get from um
nuts and seeds or eggs. They have some
slightly less you like less evidence.
you really when you're looking at um
brain changes over time and dementia
risk, but they certainly do seem to be
related to to cognitive function. So,
there are some studies that show that
those who have lower magnesium intakes
tend on average to perform less well on
some some cognitive function tests. So,
all of those do seem to be important. I
have two questions about nutrients and
brain health in the short and
[clears throat] long term. And they have
to do with interactions between
nutrients,
>> which at least to my understanding are
rarely explored. You know, you'll see
studies of supplementing omega-3 or
having people eat some fatty fish or or
less and so on, but rarely in the
presence or absence of some other
vitamin that, you know, that can
potentially impact the same pathways. So
there's synergy. There's also, you know,
necessity. So that could impact results.
The other piece is on what time scale
are these nutrients needed and on what
time scale are they metabolized? So
maybe to just kind of drill into the
second question first. So you know I'm
not out here as like the defender of
supplements, but I've been taking
supplements in various forms and eating
whole foods and eating as generally
healthily. You know, less so when I was
younger, but still pretty healthy and
more so as I get older. But here's where
my brain goes. Wait, whole food is
great, but let's say dark leafy greens
have a bunch of things in them that are
fundamentally important for brain and
bodily health. Great. And they have
fiber, etc.
How many times a week am I eating dark
leafy greens? Let's say I do Monday,
Tuesday, Wednesday. I'm great. But then
I'm traveling on, you know, Thursday,
Friday. Should I be just supplementing
Thursday, Friday? Am I good until the
next week? I think one of the reasons
why eating really well, I think everyone
knows what that means, not enough
calories, not too many, mostly whole
foods, etc., enough vegetables, fruits,
and high quality protein and quality
fats.
I think the reason why supplements still
become enticing to me, maybe even
necessary, is because you can take them
every day very easily. So you can make
sure that you're in range and maybe
above range. So let's take one of these
things. Okay, omega-3 fatty acids. I I
believe that the data are pretty
compelling. They can be helpful for
health, maybe even brain health.
Certainly, I believe that. But let's say
the early part of my week is omega-3
rich and the later part of my week is
omega-3 poor.
Am I good? Versus, you know, spreading
it out across the week. it just becomes
difficult to eat in a truly healthy way
if uh if it's the case that it has to be
consistent every 24 hours. So what do we
know?
>> So again, I think we're often tempted to
over complicate this and try and think,
oh, you know, I have to hit all these
things at this interval and if I can't
do that, then I have to supplement. And
in reality, we probably have more buffer
in the system than than we realize. So,
um, omega-3 fats is a really good
example. Your adapose tissue, your fat
tissue is a depo. You know, it kind of
stores excess omega-3s. I actually wrote
a paper on this with a colleague of
mine, Rory Heath, a few years ago. The
longchain omega-3s that we have in our
in our fat stores um may help to explain
why supplementation does or doesn't work
in some of these trials because
>> some people just have more kind of
hanging around. And if you eat more than
you need on one day,
um especially in a state of caloric
excess, um that's going to be stored in
your fat tissue. And then when uh you're
sleeping or when you uh initiate uh
lipolysis, the breakdown of fat. So
particularly during periods like you're
doing exercise, those then get released
and they you know the the brain then has
access to them. So there's some studies
that um show that when you this relates
to the form of the omega-3s as well. So
many people will tell you that you have
to take omega-3s in the phosphoipid form
uh which is like a a special it's a
special supplement. Um you can get it
from krill. Um and the the form is where
the the fat is attached to like a a
phosphoipid head group just like it
would be if it was sitting in in a cell
membrane. And there's a specific pathway
for those to get into the brain.
>> It's only krill or it's fish oil also.
>> Uh no. So fish tends to be the
triglyceride form uh which is you know
glycerol and then three fatty acids
attached.
>> When you compare a single dose of
phosphoipid versus triglyceride form
then more of the phosphoipid form gets
into the brain. Some of this, you know,
most of this comes from rodent studies,
but what's interesting is that if you
supplement over several days, it all
kind of comes out in the wash because
the triglyceride form um cycles through
the adapose tissue as a depo and then it
gets released and the brain can then use
it. So, if you're going to take just one
day of supplement and you want to get as
much of that omega-3 in your brain, yes,
you should take the we think we should
you should take the phosphoipid form.
But the form that comes in seafood,
which is primarily the trig triglyceride
form, is regulated through the body's
fat stores. So, this is a really long
way of me telling you if you eat some
fish early in the week, you don't then
have to supplement later in the week as
long as you got kind of enough. And
especially if you've consistently eaten
seafood across your entire life because
you probably have a bit of a depo. And
so what you see in several
trials where they've given omega-3s to
decrease dementia risk or improve
cognitive function. So many studies of
like that have been done. There was
actually a very recent one that just
came out of of USC where they gave
omega-3s for a long period of time. They
measured omega-3 levels in the in the
CSF, right, in the spinal fluid of these
people to show that this the omega-3s
were getting into the brain. they didn't
see any changes in terms of cognitive
function or um brain structure on an MRI
scan. So, everybody's like, well,
omega-3s don't work. But when you kind
of squint at the data and and they
didn't quite give me the data that I
wanted, but when you look at it, those
the people in the trial just didn't seem
that omega-3 deficient in the first
place. So, right, if this isn't
something that you need more of to start
with, giving a load more of it isn't
going to make that much of a difference,
right? And this is the case for all of
these different supplements. So the best
advice if you have access to it is to
test your levels. Test your vitamin D
levels. Test your hemoglobin and iron
levels. Test your omega-3 levels. Test
your homocyine levels which is as a
marker of B vitamin status which we know
is a a risk factor for cognitive decline
dementia as well. So if um if you can
test your levels and it shows that you
need more and yes there are the the
normal ranges that you have on a blood
test are not necessarily the same as the
risk ranges. So um homoyine is a good
example. A normal range for homocyine
which goes up if you need uh some of
these methylation dependent B vitamins
the normal range might go up to like 15
or 16. But we know that risk is
definitely elevated above 13 and is
probably elevated above sort of 10 to
11. So what your target range really
might be is is probably lower than what
the normal range might be. But we have
very good evidence that if you then
supplement when somebody is above that
range and you bring that down, you see
significant improvements in in cognitive
function or slowed cognitive decline.
That is particularly the case for
omega-3s and B vitamins that lower
homocyine. And so this is the
interactions that you were talking about
earlier and this is the best one that we
know of although I'm sure there are many
more. Like I said, there are lots of
trials that have given omega-3s or have
given u B vitamins to lower homocyine
and just haven't seen much of an effect.
And everybody goes, "Oh, well, they
don't work." But there are now at least
three randomized control trials that
have shown that omega-3 status and B
vitamin status interact and they're
dependent on one another. So, if you
give uh B vitamins to somebody who has
elevated homocyine, you bring down their
homocyine, but they have poor omega-3
levels, you don't see any benefit. And
that's been shown in two trials. It was
originally shown in the vittog trial
that was run out of the University of
Oxford. Um it was then uh replicated in
the B proof uh trial. Then the other
side has also been shown there was a in
the omega AD trial they showed that
supplements with omega-3s didn't result
in any benefit if people had elevated
homocyine. [snorts] So this that's just
one example and you can imagine like you
kind of said there are probably lots of
these and if we're not you know going
into a study actually looking like well
what nutrients does this person need and
then supplementing with them um you you
you're not going to find any effect like
you shouldn't be surprised when there's
a when when the study doesn't show
anything. potentially the one
recent um example of kind of
just giving a broadbased kind of set of
nutrients with a multivitamin that
seemed to work fairly well was the
Cosmos study people may have heard of.
It was thousands of people of older
adults um and they were given either a
multivitamin or a a flavonoid
supplement.
>> It's like a sententrum type vitamin.
Yeah, it was it was Centrum silver,
right? The most basic multivitamin, just
100% of the recommended daily allowance,
not like no mult no like massive doses
of anything.
>> And in that study, those who got the mil
got the multivitamin saw, you know,
changes in cognitive function that
suggested some like some some
improvements. And but that was literally
just covering the bases, right? No
massive doses. The most basic
multivitamin. So in the kind of general
population, I think you could say that
something like that is probably a
reasonable strategy. But what they also
showed was that um supplementing with
this antioxidant cocoa flavonol was only
beneficial in those who tended to have a
poor quality diet to start with. Right?
So they just weren't getting many of
these kind of compounds from their diet.
If you're drinking a lot of coffee,
eating a lot of berries, seeing a lot of
fruits and vegetables, you probably
don't need it because you're already
getting it.
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Thank you for that clarification. I I
look forward to a day hopefully not long
from now where people get their blood
work done.
They are told and they decide, it's a
collaboration after all, which
supplements to take.
Ideally, those supplements are tailored
to them. So, it's not gazillion tablets
and capsules and then they can redo
their blood work and see whether or not
things come into range. And of course,
that should be measured against
subjective
>> experience of well-being and sleep and
all of that. That that's not hard to do
in today's environment of technology and
trackers and blood testing. It's just
that uh we're a little bit in the um
still in the '9s. uh even just the way
that most people talk about supplements,
certainly not you, but I think when
people hear supplements, they go, "Oh,
it's expensive urine." Okay, that's
vitamin minerals. Maybe some of that is
just getting urinated out, but then
there's food replacement
supplementation. And then there's
supplements to get a specific desired
effect like speed up the transition time
to sleep, get more slowwave sleep, um
more focus, etc. So it's unfortunate
that we don't have good nomenclature
like we do in science where where where
words are very important so that people
can communicate with accuracy.
>> And I also wonder whether okay if you
know one gram of of uh omega-3 uh EPA
per day is good um but maybe three is
better even though I'm at you know upper
range upper reference range. And this is
something that like nobody really wants
to
address because then it sounds like
quoteunquote biohacking, but ultimately
I think people want to feel good. They
want to live longer. No one wants to do
anything dangerous. I feel like we're
really like in the in like prehistoric
times with with how we think how most
people think about nutrition and
supplementation. I feel like the last 40
years have been spent mostly focusing on
what's bad for us. get trans fats, bad,
fried foods, bad, eating too much, bad,
right? Um, energy over energy toxicity,
bad. Um, too much alcohol, bad. Zero is
better than any, but you could probably
drink a little bit and be fine. Okay, if
you're going to take nicotine, don't
smoke it or vapor dip it or like we sort
of figured it out, right? Don't hit your
head. If you do, don't hit it twice, you
know? Like, like we've sort of been
spending so much time on the don'ts that
now I feel like we're in this exciting
time of what can you do for one's
health? And then there's this divide,
right? Just eat whole foods, you'll be
fine. And you've actually convinced me
that we'll be fine. The question is,
could I be that much better?
>> This is really interesting to me because
there's there's there's two different
parts to it potentially, although, you
know, they may end up being the same
thing. So one is if we're thinking about
if we're thinking broadly about
improving brain health, cognition at the
population level,
what's really important is kind of
raising the floor. Like what is going to
work for everybody and get most of us
most of the way there. So like that
really is improving food quality. Um and
then you know access to those foods as
well, right? because that's diff you
know that can be very inequitable like
can people afford it do they know how to
cook it can you know can they access it
and then within that I think we also
know we have very good evidence for cut
offs that predict risk and if you can't
get those um nutrients from food I think
we should supplement I think I I like to
call nutrients like the great leveler of
like there's no point in arguing about
different diets because your body
requires these nutrients and like I
don't care where you get them from as
long as you get them, right? So, if you
need to get them from supplements, I
think that's fine. That that that should
be fine. When you then get kind of to
the next level, like how much further
can we push function? My answer is I
genuinely don't know. Like when you say
like, you know, if I put so if I if I
test my omega-3
index, right, you said it was the kind
of the higher level, maybe it's seven or
eight or something like that. All right.
If you push it to 12, is that better? I
genuinely I genuinely don't know. like
some of these more complex um AI
systems, data collection, kind of seeing
how you then respond individually as
long as you can perform your own sort of
like personal experiments, right? As
much as you can hold one variable
constant, have some meaningful output
that you can kind of track over time,
see whether it works or not. Can we then
aggregate those data to kind of better
understand this? I'm excited to see
where that goes. I will say that the
best evidence we have just says in
reality don't be deficient. If you can
reach that threshold of not being
deficient or insufficient, maybe that's
enough. I'm hopeful that that's the
case, right? Because then more people
will get to that point more more easily,
but you know, there's there's a lot that
we have to learn there.
>> There was a time in the '9s and 2000s um
where people would take stuff and do
stuff. I'm not talking about anabolic
steroids, although that was happening
too. Um, and the whole idea was find
things that work, perform really well in
one's job or in one's sport, assuming
you're not breaking any rules, right?
But not tell anyone you were doing them.
And then what changed, I think, were two
things. One is there became a a market
value for telling people what one does
in order to make money. So people
started doing that. And I do believe
sharing is good, right? But also there's
this problem that goes with that is that
people who sit on the outside of kind of
brain and and sports performance or just
life just trying to maintain memory and
do well in school and be be a busy
person and still get sleep and all of
that feel like, oh, you know, it's it
we're being sold this one thing that's
supposed to make all the difference.
>> And I think the thing that really came
to came in and changed all of it are the
GLPs. I've never taken a JLP, but I'm
just struck by like Americans are now
willing to inject themselves. So now it
opens up this whole thing about
peptides, which you know the major
consumers of peptides are not the bro
science guys like the gym bros, it's
women
>> who look I have female family members,
right? Um who have and they'll tell you
me and and
there's a long history of people doing
and taking things and doing things for
their cosmetic appearance and not
necessarily sharing it with the world.
So, these are the performance-enhancing
uh um substances of of a whole different
kind, right? And so, how is it that this
peptide industry is so intriguing to so
many people that Yeah. like jabbing
yourself with something that is not FDA
approved? Like people are doing it like
crazy, even people who are kind of
cautious about what they'll do and put
into their body
>> because of this bridge that the JLPs
have made. It's so much easier now to
just people aren't as needlehobic. So I
think we're entering a time now where
people are saying okay you know what the
government uh the the the food pyramid
the whatever the food quadrants like
yeah that's just like if you don't want
to die but I want to feel great and
there's actually this potential that you
and others are sort of offering like you
can learn things into your older age you
can be uh lean and have great posture
into your 60s7s 80s 90s we see examples
of this so I think that there's this
pull we're getting kind of pulled
forward towards this promise
>> and I don't I think that promise is all
about avoiding the the bad stuff. And
people say, "Oh yeah, well my
grandfather lived to be 102 and he was
smoking every great like awesome." But a
lot of people don't have those kinds of
genetics in their family.
>> They really and genetics play a big
role. So I'm kind of editorializing
here. I'd love your thoughts on how you
sort of sit back and you look at the
landscape of things. Um eat right,
exercise, get good sleep, socialize is
awesome,
>> but that is just that is difficult
>> for people that puts people into a
clutch state. just trying to do that
while managing family and profession and
cost of life it you know cost of living
that's a lot so I think people do want
something that gives them more energy
gives them better sleep you know picks
up their mood you know and I don't think
there's anything wrong with thinking
about those things as long as it feeds
back to to better behaviors
>> particularly when I think about this
kind of this new part of the of the
supplement industry and like you said
the the you know peptides are just the
next they're the next iteration of the
pills and potions and things
>> to supplements more than drugs because
look there's no putting the genie back
in the bottle. I don't care what the FDA
does and they can mark my words people
are going to find their way to get their
peptides cuz they love them.
>> Mhm. [clears throat]
>> And most people are not playing a drug
tested sport.
>> Yeah. And there may be adverse events
out there, and this isn't a plug for
peptides, per se, but where are all
these adverse events that are not from
botched injections or from really bad
black market sources. Where are all the
roid rages of peptides? Where are all
the like I think you can see way more
plastic surgery like like whoa, that
looks bad kind of things in it like
okay, melanitan's kind of an issue
because people can really mess
themselves up um there. But where are
all the adverse events? Until people
start dropping dead from BPC injections,
people are going to get and they're
going to take their BPC.
>> I'll admit I'm more conservative when
you're trying a new supplement or you
peptide um I'm going to include peptides
in into this, but of course you could it
could be a pill or or whatever, right?
Some peptides come as pills. I [snorts]
would want some reasonably good evidence
of efficacy that this is going to work
in humans like me. Um,
that's probably not a bar that most of
these things are going to hit anytime
soon.
>> No, people don't care. I mean, people
who who have no interest in walking into
a gym are contacting me like crazy.
These are adults who have kids they
love, spouses they love. They are not
medicine phobic like traditional
medicine phobic. And they're like,
"Should I be taking low dose? Should I
be micro doing or reatite?" I'm like,
"Edite's not even released yet." They're
like, "Where can I get it?" like, are
you kidding me? You know, but it's like
it's incredible what's happened in the
last few years.
>> So, we think about what might what you
might think about if if you're going to
start to consider one of these.
First of all, I would want to see
evidence that that it works. The
majority of peptides don't have good
quality evidence in humans except the
GLP ones, right? They're on the market
>> and the growth hormone secrets, but for
reasons other than people are taking
them.
>> Yeah. Yeah. psychopenia um you know
other and and with with the most of
those growth hormones secret dogs come
with a risk of insulin resistance
diabetes at high you particularly at
higher doses
>> yeah they're not the super popular ones
I think the super popular ones are
besides the GLPS and reat is a GLP and
other things but are I would say micro
doing of reat and trespatide one
category for weight loss um fat loss I
would say BPC57 people are taking it
without even knowing what the desired
effect is
>> recovery is really broad I think it's
>> injury repair that's the thesis no human
evidence as far as no good human
evidence and then there are these other
kind of dot dot dot ones I would say um
GHK copper for skin
>> um appearance those are the three
biggies
>> um that seem and the last one in
particular with women
>> so I would want evidence that in humans
it does what I want it to do most of
those if not all of them except for the
GOP ones don't don't have that evidence
or for the thing or for the thing that
you're you're you're trying to get right
um but beyond that a question that that
you have to ask and and I I like I like
this reframing I heard it recently heard
it recently from um Jeffrey Bland um
which is that if you're going to
consider injecting or taking something
the first thing you should want to know
is is this safe right if you have good
safety data then trying it is low risk,
right? Even if it doesn't work, right?
At least, you know, it's not dangerous.
And but we don't even have that for most
of these.
>> No, we just have the absence of
documented adverse effects.
>> Yeah. And
>> in the time course that they've been
used because we don't know about
long-term use.
>> And so, everybody has their own risk
tolerance. Everybody's welcome to do
whatever whatever they want, of course.
But for me personally, first I would
want documented evidence of safety and
then you can say, well, I'm willing to
try it because, you know, it may or may
not do this thing. But you should also
have a specific problem that you're
trying to solve, right? Otherwise, why
why would you bother taking it? But it's
also the case for the vast majority of
supplements that are out there and have
been around for long periods of time is
first of all, we don't have good
evidence of long-term safety at whatever
dose that you're taking. And then second
of all, we don't know whether it works.
For some we do like creatine, omega-3s,
magnesium.
>> Yeah. And creatine is actually the best.
So like omega-3s, we know that they're,
you know, critical nutrient, creatine, I
think, is the best example because we
know it's very safe, right? So even
though this this idea of creatine
responders and non-responders, um, you
know, maybe it's going to be useful uh
to improve or support cognition for some
people, not others, may improve physical
performance for some people, not others.
At least we know that you can give high
doses of creatine to frail old older
individuals with essentially no side
effects, right? We know it's very safe.
So then you can try it and see if it
benefits you. So creatine is a great
example, but there aren't that many
others that kind of fit into that
category.
>> Interesting times.
>> Mhm. Again, I go back to I love the idea
of blood testing, tailor tailoring
supplementation to the needs of the
individual, retesting so people can be
really objective about whether their
levels are moving in the right or wrong
direction. Subjective experience. Um the
sleep supplementation thing is kind of
interesting because either pe people
feel it improves their sleep or it
doesn't. Even if it's a placebo effect,
which in some cases it could be. Um with
sleep tracking people can see are they
getting more REM, are they getting more
slowwave sleep? um such a such a
fascinating um area. [clears throat] I
mean, as you and I both know, there's no
plasticity pill,
>> but arousal,
alertness, focus seems to be a
prerequisite of plasticity,
>> which is why things like caffeine and
stimulants and elyroine and all these
things that you can find some evidence
for them improving plasticity, but it
it's very likely to be indirect, right?
It's not that they like make you learn.
They set the stage for learning. It
seems to always get back to arousal. So,
this is what I I want to get back to
exercise as as a tool for opening the
window for plasticity.
>> Could it be that it's simply a matter of
moving your body to get enough
adrenaline in your body, norepinephrine
in the brain, and maybe some dopamine as
well, so that the stage is set for
plasticity? And it doesn't matter
whether you jump rope, do jumping jacks,
sprint, or do deadlifts. It's all about
getting your brain into an altered
admittedly indogenous chemical altered
state of just more arousal and then boom
you can go learn is it I mean could it
just be that before we get into the
exercise there's a an interesting part
with the supplements that increase
arousal right so the stimulants in
particular and
I am a big proponent of thinking about
or um tracking how somebody feels right
I think that how you feel is this kind
of ultimate integration of all these
inputs and outputs that the brain is
kind of bring bringing together, right?
And we know that how you feel, so how an
athlete feels is a much better predictor
of their performance than their HRV or
any of their blood test.
>> What are you asking them? Like you how
good do you feel today on one to 10
>> some some version
>> I feel like I can conquer the world one
I feel like
>> exactly on you know and you you can boil
it down or I mean you can um spread it
out to many more questions. So there's
there's a question there called the rest
cue which is all about like how you
recovered how recovered you feel, how
motivated you feel to train or perform
that kind of stuff. But essentially it
boils down to how feel how good you
feel. If you feel good, you're more
likely to perform well. And that works
better than the vast majority of data
that you like biological physiological
data you can collect. There are papers
that come out on this every year that
essentially show the same thing.
>> That's kind of cool. Yeah,
>> because mindset as my colleague Ali
Crumb has focused on so much like
mindset can be you can be honest with
yourself and you can lie to yourself and
tell yourself like okay you got a lousy
sleep score but like I feel good.
>> Yeah.
>> Or I'm you know maybe sleep scores are
like they mean something but today
you know right I mean and it can work
right I mean in terms of performance.
Yeah. And so absolutely right then that
gets into like the noibo effect of of
how we think about either our sleep data
or these other things, right? That that
can negatively impact our performance.
And we have good good studies um that
that show that as well. So so I I think
that like tracking how you feel is
really important. [snorts] But when it
comes to stimulants in particular, they
they seem to dissociate how we feel
versus how we perform. Right? So there
there are studies that show that um uh
giving people caffeine makes them
[snorts] feel like they're performing
better, but they're actually performing
worse on certain cognitive tasks. So
there's been studies done with like the
the endback task. So like very complex
uh you know working memory task
particularly as you get like to like N3
you're like trying to remember did I see
this letter three letters ago, right? In
those kinds of complex cognitive tasks,
people who take caffeine feel like
they're performing better but they're
actually performing worse. they're
making more errors or they're kind of um
you know they're reacting too quickly,
they're not really thinking about it.
>> And [snorts] there are there's similar
data from other stimulants too. So there
was a paper that came out in science a
couple of years ago with uh giving
people um methylenadate some of the or
some of the other like ADHD medications
in people who don't have ADHD. These
stimulant medications again show this
dissociation between so they feel great.
>> It's like the the inverse of the
cannabis thing where people think
they've got all these great ideas and
then the next day even they are like oh
my goodness this is dreadful. Yeah. And
that's again been like formalized in
studies where where you can do these
tests where then other people
objectively see how creative were you
people taking cannabis felt like they
were more creative but actually they
weren't. And so the reason why um I say
this is that when we're talking about
supplements all these other things we're
like well I feel much better therefore
it must be must be doing something good.
We know that with many of these
supplements you can create this
dissociation between how you how you
feel and how you perform. whereas some
of these endogenous things don't have
that effect. So that's why that kind of
like endogenous increase in arousal
using things like exercise is a much
more reliable way to improve performance
because you don't kind of get this
association between the two. So with
exercise in particular, we we you know
know very well that some period of
exercise it can be resistance training,
aerobic exercise, very brief sprints,
increase arousal, improve cognitive
function across multiple domains um
improve learning um and retrieval,
right? So so you're definitely
augmenting some of these processes of
neuroplasticity. Some of that's going to
be related to the catakolamines and
other things that get released as you
know as you as arousal increases.
>> [snorts]
>> But we also know that different types of
exercise have different effects on
different parts of the brain. So yes, I
think some of just like the general
process of moving your body um and
exerting effort definitely increases
arousal. Um definitely improves
cognitive function, improves learning as
long as it's not truly exhaustive
exercise. Like anybody who's done some
terrible CrossFit wad or, you know, I
used to be a rower. We used to do a 2K
test on the rowing machine, right? You
do a 2K test on a rowing machine, your
brain does not work afterwards. It's
like a six-minute flat out like V2 max
kind of level of exertion.
>> Yeah. Thanks. I'm going to interrupt
briefly. Thank you for pointing that out
because I think that people assume they
have an infinite amount of energy and
there's crossover and um I certainly
have done, you know, extra sets to
failure in a great morning workout and
then the in the afternoon I'm dragging.
If I hold back just a little bit in
terms of volume,
>> I find I get a real boost out of
training. But I do low low volume high
intensity, you know, usually two sets
per exercise to, you know, two or three
exercises per per muscle, like
quadriceps being one muscle or something
like that. If I do three,
it's a small addition, right? The rest
of the day I'm kind of dragging. So
leaving something in the tank,
>> yeah,
>> does seem worthwhile. not during the
sets, but leaving something in the tank
in terms of volume really seems to help.
>> Especially if you want your like to
perform hard cognitive work directly
afterwards. Sometimes if you're trying
to really push
>> sure
>> performance or adaptation, right, is
worth digging into that hole. But it
really just depends on what you want to
be able to do directly afterwards.
>> I think student athletes, especially in
D1 schools, they really um come to
appreciate this. I've had a few of them
in my courses over the years and um they
really understand when they're pushing
very very being pushed very hard in
their sport and um they know that they
have to sit in the front of the
classroom, sit upright, do ex take extra
measures to make sure they're not
>> dozing off, attention drifting,
especially in the age of phones and
iPads and and things like that. It's
very very difficult. Um, yeah, thank you
for for mentioning that because they're
just an extreme case of the rest of us.
You know, we're told, we're all very
busy like, "Oh, you need to exercise.
It'll help your brain." And people like,
"Well, I exercise and I'm exhausted."
You know, that's not helping my brain.
Let's get practical here.
>> So, is there any way uh to
it's got to be really subjective and uh
depend dayto day. Is is there any way to
kind of formalize that? like should you
train let's say resistance training or
running you know should you cap it at an
hour should you pull back on the
intensity if you have harder cognitive
work to do in the afternoon we all want
the maximum effect of exercise but we
don't want it to undercut our efforts
>> yeah I think that a lot of it's going to
be based on what your current capacity
is right as as with everything so if
you're you you want to do some you got
some you know learning to do you got an
exam you want to do some hard cognitive
work at, you know, whatever it is,
writing a presentation, analyzing data,
you uh reading you reading papers,
writing your book, then doing some kind
of workout that's that's probably below
your kind of typical or below what what
you would do when you're really sort of
pushing pushing the envelope. We I think
that when you look at meta analyses of
exercise and then cognitive function
immediately afterwards, the the protocol
that has like the best evidence for it
is like a 20 to 30 minute jog, right? So
like that's the kind of um level of
activity that that really seem to sort
of like support all those general
processes of plasticity and learning.
>> What do you think is going on? Because
it can't be that much arousal. I mean
that the amount of catakolamines
released from again catakolamines folks
being the you know adrenaline,
norepinephrine and uh dopamine um
generally increased levels of arousal,
alertness, uh propensity to move. You
just that's that I feel better. People
often think about the runner's high and
endorphins. The endorphins come from
pretty long intense duration effort.
They're more of a you're floating kind
of like uh you know I think the
catakolamines are really the the
cocktail of like all right I got a great
workout in this morning showered got
dressed I'm off to work let's go that's
the so 20 or 30 minute jog I don't
expect you'd get that much catakolamine
release
>> I mean you'll definitely get some right
and like cortisol too right which
obviously increases alertness and
arousal and can can in the short term
make you feel good
>> it's a good thing
>> um you you see similar effects of you
know short resistance training workouts.
Um, I think of it, it's it's probably a
little bit of like an area under the
curve thing because you see some similar
effects of like you go out and you do
>> sixsecond really hard sprints like max
effort sprints. You do that a few times
with a long break in between, right?
That seems to have a similar effect, but
you're only working for very short
periods with very long rest periods.
>> So, it's some it's something in that in
that sphere. And I think it's that's
probably just it. It's just enough to
you just kind of boost catakonamines a
little bit, a little bit of cortisol.
That's enough to kind of move you up the
arousal curve to the point where you're
then able to focus and engage a little
bit better. And I think yeah, you don't
need a huge dump of that um in order to
achieve that increase in arousal
particularly as it pertains to like
learning and then you know cognitive
performance in like formal cognitive
tests when which is where this is
usually done. If you're then thinking
about the type of exercise that changes
cognitive function or brain structure
long term,
effort uh and intensity do seem to
matter a lot more. But those studies
have looked less of well how did that
how do they feel directly afterwards?
Right now you're thinking about what's
the kind of stimulus that drives change
over time and then intensity matters a
lot as well. So um the the best example
um is with aerobic exercise on the kind
of uh zone 2 up to kind of zone four
five sprint spectrum. So most people who
listen to your show are probably
familiar with a study where in older
adults they had them do uh brisk walking
three times a week 40 minutes. Um and
when you kind of read the study and and
the heart rate uh levels they were
trying to attain, it was basically zone
2 work, 40 minutes brisk walking three
times a week for a year. And they saw
significant increases in the volume of
the hippocampus uh increases in V2 max
fitness, increases in circulating BDNF
levels, though circulating BDNF doesn't
actually get into the brain, but it's
kind of telling you something about
probably BDNF that's being produced in
the brain. um and improvements in
memory. With all of that, [sighs]
however, there's a much more recent
study that took again older adults and
randomized them across three different
groups. One was like a low inensity
group. Another group basically did kind
of zone 2 type work on a treadmill three
times a week, very sim similar to that
previous study that I mentioned. And the
third group did um a highintensity
interval training intervention, which is
the Norwegian 4x4 protocol. So 4 minutes
85 to 95% of maximum heart rate. They
had a threeminute rest in their
protocol. They did that four times over.
>> That's really hard. Anybody who's done
the Norwegian 4x4, if I then say, well,
hey, do that three times a week for 6
months. Like that's
>> that was three times a week.
>> Three times a week for 6 months. That's
that's pretty intense. But what they
showed was that that high-intensity
interval training group, they improved
their fitness just as well as the zone 2
group, interestingly, but they had much
better improvements in hippocample
function and maintenance of hypocample
structure on an MRI scan. And they
maintained that benefit for 5 years
after the six-month intervention. So
they worked really hard um for 6 months,
but that that benefit was maintained for
for a really long period of time. And in
several analyses within that study, they
basically show that the harder people
worked um and the more cortisol they
released, the better the benefit. And so
this is important because nowadays
there's or you know there's several
people out there saying, "Oh, don't do
high intensity exercise. It releases
cortisol. That's stressful. Your body
can't handle it." Right? This study
directly shows that working really hard,
releasing a lot of cortisol in
high-intensity interval training
actually improves hippocample structure
and function um over over time. So yes,
I imagine after they did their workouts,
their brain wasn't maybe working at its
best cuz that's a hard workout. But over
time, this was this really strong
stimulus that then resulted in
significant improvements.
>> Forgive me if you said it and I missed
it. Uh what was the form of exercise?
Was it rowing or biking or
>> It was on a treadmill.
>> Treadmill.
>> Yeah.
>> Uh really interesting. Um and you said
it about 85% of max heart rate.
>> Yeah. So that's that's a typical
Norwegian 4x4 protocol, but I don't
think that's the protocol you have to
do. I think it's just this process of
highintensity exercise that it releases
a whole bunch of myioines and lactate in
particular. We know that lactate very
easily gets into the brain, generate,
you know, stimulates BDNF production as
as kind of part of that support of
neuroplasticity or augmenting recent
neuroplastic processes. I think there's
something about that just that
highintensity work that drives some of
those factors that then support
structure and function.
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>> Yeah. Uh, two things. Super interesting,
um, comparison between these studies.
Um, and as somebody who incorporates one
day a week of 4x4 type
>> exercise and one day of longer, slower
cardio, maybe I should try maybe doing a
bit more of the high intensity.
>> I think if you want it to be sustainable
for long periods of time, like I would
typically say one day of highintensity
work is fine, right? Cuz you probably
you want to be doing some resistance
training. You
>> I'm doing that three days a week. I do
one long slow for me jog of about 60
minutes
>> uh 45 to 60 minutes and then one kind of
in moderate kind of maybe more like zone
3 4.
>> So thank you for putting in a a strong
um word for cortisol not always being
the bad guy.
>> Um people are so afraid of cortisol. You
want your morning cortisol high. It's
going to make you sleep better at night.
You'll have more energy during the day.
It's a It was interesting to me to dive
into the literature on cortisol and find
that a moderate and int a moderate
intensity
resistance training session or cardio
session probably a little bit easier
than the uh 4x4 will triple one's
baseline levels of cortisol and like or
quadruple it. It's transient, but
nobody's freaking out about these
workouts, but they're afraid to get in a
cold shower, which doesn't have nearly
the same impact on cortisol or um it's
kind of wild how afraid of cortisol
people are. People think they're going
to get Cushing syndrome. It's been I
don't know what the SCOP on cortisol was
all about, but you know, you're going to
get moon phase, you won't be able to
lose abdominal fat. I mean there is a a
real condition which is you and I know
it's a Cushing syndrome where cortisol
is is pathologically elevated but come
on folks like cortisol goes up cortisol
goes down you that but 20 30fold from
the morning until night in a healthy
individual. So what do you think it is
that that people get you know like
afraid of cortisol afraid of uh some
stress? I mean like your hippocampus
obviously in this case their hippocampus
got better. It's not dissolving into a
puddle of its own tears. [laughter]
What What is this? What did What did our
predecessors do wrong?
>> You know, let's blame it on the parents.
What? Because [clears throat] we weren't
doing science communication then. What
What What in the world was the incentive
for like demonizing molecules? It's so
crazy. So even though his uh frameworks
are still potentially very helpful, some
of it we can blame on Hans and his like
general adaptation response like the the
the original idea that if you were
chronically stressed it would lead to
like true exhaustion of all your
physiological systems, right? Because
that was the final phase of his general
adaptation response.
>> People have conflated acute stresses
versus chronic stresses. And yes, we
know chronic stress be they
psychological, physical, increase
allatic load, increase metabolic
disease, inflammation, blood sugar
dysregulation, insulin resistance
significantly associated with heart
disease, dementia, all these kinds of
things, right? So we so we know that
these chronic stresses are can be really
detrimental to our health. But we've
kind of conflated that like any stress
is bad because chronic stress is bad.
But the way that I think about it or I
try and talk about it is that actually
the stress response and this is as kind
of Sier originally described it is
stress drives adaptation. He called it
general adaptation syndrome or the
general adaptation response because what
stress is is your body acknowledging
that you need to respond to some
external stimulus, right? And so stress
diverts resources so that you can then
adapt to that stimulus. Be they
physical, cognitive, neurological,
right? A stressor diverts glucose to the
immune system, right, in in an infection
so that it functions better. You can
eliminate the infection. And so yeah, if
you took somebody and you like look you
measure their cortile levels after a
workout, it actually looks very similar
to how it would look if you just broken
your arm or if you were like really
sick, right? This is the body adapting
to a stimulus and like everything we've
talked about here you know physical
training driving neuroplasticity that
requires adaptation and so some of that
core stress response is involved in that
the release of cacodium as you talked
about in the brain right those are
stress related molecules that are
driving adaptation so that your body can
deal with the stressor better in the
future and we also know actually that
there's some where there's some evidence
for the uh cross stressor adaptation
particularly with exercise, right? So,
if you exercise regularly, you are
better at dealing with other stresses
like psychological stresses. You won't
you're more robust to stresses. Your
your mood or your cognitive function
doesn't dip as much when you're when
you're then psychologically stressed.
So, stress is actually really important
because it's the fundamental driver of
adaptation. But because we've kind of,
you know, we know that chronic stress is
bad if if you never get a chance and
that's because you never get a chance to
adapt. You never get a chance to
downregulate. you never get a chance to
respond because it's just continuous.
But right intermittent exposure to these
stressors is really important. And Selia
also talked about the idea of hypo
stress, right? Not having enough stress
because then you can't you don't adapt,
you don't build function and response.
So we just need to think about them very
differently because that those acute
stresses are incredibly important for
driving adaptation.
>> Way I think of it is pick your stressor.
You can either be exercise or it can be
psychological stress. If you take it in
the form of exercise, you probably have
less in the form of psychological
stress. It's obvious not not completely
true at a one for one, but I think uh as
you pointed out, we and all organisms
thrive on some degree of stress. I think
if people are getting enough good sleep
at night,
>> yeah, sleep is the
>> I don't want to say there's no limit to
the amount of stress they can absorb,
but when it starts to erode your sleep,
that's perhaps when things need to be,
you know, adjusted.
>> Resistance training. Um, is there a
particular protocol for resistance
training that opens the opportunity for
plasticity better than others that is
supported in the literature?
>> Again, two different windows say of of
action. So, there's that that acute kind
of arousal and this would be um, you
know, you you go in the gym, you do a
couple of sets, you're not maxing out.
Um, you know, it's it's probably going
to be your fairly typical couple of sets
of uh 8 to 12 reps, kind of 80% of of
max, something like that. You do
>> compound movements. So, most studies use
machines, right?
>> Um, so maybe do a leg press and a chest
press and a lat pull down, shoulder
press, multi- joint movements, usually
with machines.
>> [snorts]
>> And again, if that takes 20 to 30
minutes, that kind of shows some similar
effects to that like 20 to 30 minute jog
that I talked about in terms of some
some acute bumps in in in cognitive
function probably through through
arousal the mild activation of those
arousal pathways
actually quite similarly though I mean
probably um slightly higher intensity
will also be beneficial as long as
you're able to uh recover over time like
that that that recovery is is critical
just like I was just saying in terms of
any kind of adaptation. Um there are
several studies of resistance training
looking at cognitive function and uh
brain structure over time. I say
several, it's like three or four in
older adults and they typically do two
or three times a week, five to six
exercises, three sets of 8 to 12 reps.
Very very similar. Um, so those multi-
joint machines in in the gym that
anybody can do and they're in any gym.
>> Presses, pull-ups, rowing, pull downs,
leg press, leg press,
>> hamstring curls. Exactly. Okay.
>> Yeah.
>> And what you tend to see is that if you
do that for at least 6 months, so the
studies go on for like 6 to 12 months,
you see significant um
changes in the structure of the white
matter of the brain and with that
improvements in executive function. You
want to remind people what white matter
is just for for the for the newbies.
>> Very broadly, you have white matter and
gray matter in your brain. In the human
brain, white matter makes up
approximately 60% um more than um most
other species, any other species. And so
like the wrinkly outer part of your
brain, the cortex, that's gray matter.
You also have more gray matter deep
inside the brain. In between that is the
white matter, which is where you have uh
the myelin sheaths on your axons. That's
what allows those uh nerves to conduct
information really quickly. Whereas
aerobic exercise on that kind of
intensity spectrum we just talked about
seems to particularly benefit the gray
matter which includes the hippocampus.
Resistance training seems to
particularly benefit the white matter.
Um and so you see improvements in a
white matter structure which and and
changes in white matter structure with
age are one of the best predictors of
cognitive decline with age.
Interestingly, like outside of other
things you see in terms of
neuropathology, amaloid tow etc. That
loss of white matter structure and
function is you know closely tied to
cognitive decline over time. So you see
improvements in structure and function
of the white matter and potentially
improvements in something that we call Y
matter lesions which tend to happen um
around areas of poor blood flow uh
within the Y matter of the brain. Um and
with that improvements in executive
function. So um uh aerobic exercise is
gray matter and memory and resistance
training is um white matter and more
sort of executive type decision-m
processing speed type functions. You
know we talked about uh lactate and some
of these other things that might
increase uh um uh BDNF with the aerobic
training in resistance training. The I I
think the primary mediator of that or
one of them is IGF-1 which is in
particularly increased with resistance
training. We know that IGF-1 is really
critical to the development of white
matter uh you know right you know in the
womb and then as a baby and it seems to
be also really important for for white
matter structure then throughout um the
lifespan. So resistance training is a
really great way to then create these
boosts of of IGF-1. So that's probably
that's that's probably part of of of why
we see that difference. But that that's
why you need to do both though they may
have similar kind of acute effects in
terms of cognitive function. they seem
to be having very different effects in
terms of the structure and function of
the brain long term.
>> I so appreciate that you're basically
telling us that different forms of
exercise impact different critical
aspects of brain structure and function.
So, resistance training, white matter,
cardio, gray matter, broadly speaking,
and many different molecules, IGF-1,
BDNF, lactate, and on and on. Just for
uh
>> uh what how do you say in in Britain?
Well, it's not kicks, they use a
different word, but for kicks and
giggles, I'll just tell you there were
sort of two running jokes in the field
of neuroscience when I was coming up,
which was if you desperately need a
thesis, fortunately, this was not the
position I found myself in. uh if you
desperately need a thesis and like it's
not going well,
study the effect of pretty much any
compound on REM sleep because it will
reduce REM sleep. There are very few
things that increase REM sleep. Very,
very few except sleep deprivation and
then REM rebound.
>> Likewise, there was a review published
by a guy named Jeff Lickman and Josh
Sains who were in a different field. So,
they did a kind of cocky thing, but they
back then they were like like they're
good guys. Um I know them both. Um but
they published this review about
long-term potentiation
>> where they said they did a review of the
literature and they said basically you
can throw any molecule on a couple of
neurons and do the protocol for
long-term potentiation and you get an
enhancement of long-term potentiation.
Now that wasn't completely true. The
reason I'm raising this is that there's
this theme right like it's um there are
certain processes like processes that
are not that hard to disrupt like REM
sleep. you just kind of tweak the system
a little bit, you see a deficit, small
or large deficit. And then things like
long-term potentiation, which is thought
to underly a lot of forms of learning
and memory
in a dish with some neurons or maybe
even an animal, you can knock something
out or overexpress something and whoop,
you get more or less long-term
potentiation. It's not that hard to tilt
the scale on it. But in reality, the
human body has tons of molecules that it
deploys. And it now to me makes perfect
sense why plasticity which of course is
the the foundation of learning sort of
one in the same uh in many ways is
brought about by resistance training and
by cardiovascular training because
they're both motor.
>> Yeah.
>> Just like crossword puzzles certain
plasticity effect
>> maybe less than you know dance where
there's a number of different things
social inputs balance inputs and on and
on. So whereas 2 3 years ago I would
have said all right are we really
talking about exercise opening
plasticity that's always seemed like
mice running on wheels and you get a few
extra neurons you get a nature paper
like I love that work don't get me wrong
but it turns out to not be that
meaningful
>> in terms of new neuron production isn't
that doesn't seem to be that meaningful
for human uh memory and and offsetting
cognitive decline. So, but now I have a
completely different view of exercise
based on your work, based on the studies
that you're describing because it's
like, yeah, these are the big guns in
terms of deploying lots of molecules
that
>> without question are interacting with
one another.
>> So, I no longer think about exercise as
like okay well like it's just increasing
vessel growth, you're getting more
metabolic health, so then the brain gets
better. Um I now think about resistance
training and cardio and their various
forms as you point out 4x4 etc as like
the real
plasticity
uh triggers.
>> So that that was a long-winded way of
saying thank you to you and your
colleagues who've been doing this and
thinking about things like clutch states
and and molecules that shift plasticity
because I love reductionist single
molecule manipulations. I think they're
very important in a certain context, but
uh for a while it was like gosh,
everything opens plasticity and
everything disrupts REM sleep and like
when are we going to get to this stuff?
>> Anyway, Alzheimer's, Parkinson's, nobody
wants these neurodeenerative conditions.
What is the current thinking about
the factors that make one susceptible to
Alzheimer's? I'm beginning to think that
it's not just one, but that there's a p
genetic predisposition issue that maybe
you could touch on. And what can we do
besides the things that we're already
talking about today um to
best reduce the chance of um accelerated
cognitive decline or full-blown
Alzheimer's?
>> First, we talk about dementia
um which is essentially the end stage of
cognitive decline. there's some
trajectory of decline that happens from
your peak to that point um where ideally
we'd intervene much sooner but right now
you know we don't really do much until
dementia is diagnosed. It's but it's
it's very similar like we don't do very
much until diabetes is diagnosed. you
know, ideally we can we can act much
earlier in that trajectory and that's
increasingly being accepted in the
neuroscience and neurology communities
that actually we could potentially
change that trajectory or at least
decrease risk. And so within dementia
there are as an umbrella term which is
essentially the loss of cognitive
function such that you can't look after
yourself on a day-to-day basis. You
can't do the day you sort of the the
basic activities of daily living.
Alzheimer's disease is the most common.
It makes up about 60 to 80% of cases of
dementia. Um the next most common is
vascular dementia. Although vascular
dementia and Alzheimer's disease overlap
a ton like the vast majority of people
who have Alzheimer's disease also have
some element of pathology or changes in
the blood vessels in the brain which is
what you get with vascular dementia. And
then there's also dementia with Louis
bodies um uh front to temporal dementia
and then uh dementia related to
Parkinson's potentially although that
overlaps a lot with um Louisibody
dementia and and dementia and
Parkinson's may just be may actually
mostly be Louis body dementia but
[gasps] we've gotten to a point now
where it's generally accepted that
potentially half of cases of dementia
are preventable and I think the majority
of that falls into those first two
buckets Alzheimer's and vascular
dementia although
metabolic disease and other risk factors
for Alzheimer's disease also increase
the risk of Parkinson's disease and and
those other dementias as well. When you
then think about Alzheimer's disease
specifically, there's there's one small
slice of Alzheimer's which is like
monogenic dominant mutations that you
have in either most of them happen
either in the precinylan genes pin one
and two or the amaloid precursor protein
gene. They make up at this point less
than 5% maybe as little as 1% of
Alzheimer's disease. So, we're kind of
we set those to the side a little bit.
The vast majority of Alzheimer's disease
is what we would call late onset
Alzheimer's disease, although it's
happening actually earlier and earlier
in in some populations. Yes, there's a
genetic component. Um, your APOE gene is
your probably your most common uh risk
gene. It's also associated there's also
polygenic risk. So thousands of genes
can give you a little bit more a little
bit less risk of of of Alzheimer's
disease, [gasps] but it's much more
related to lifestyle and the environment
than say that that kind of early onset
monogenic Alzheimer's disease. And
the the kind of the best accepted
um review of all of this um is is run by
the Lancet Comm Commission on Dementia
Prevention uh overseen by professor Jill
Livingston and their most the most
recent version of this suggested there
were 14 risk factors who between them
accounted for about 45% of uh de
dementia risk or dementia cases and that
that are modifiable. So early life
education, high blood pressure,
diabetes, hearing loss, vision loss,
brain trauma, um high uh high
cholesterol, they recently recently
added
>> high LDL,
>> high LDL cholesterol, low physical
activity. So this is all related to the
things we've already talked about,
right? Maintaining good physical health,
maintaining uh maintaining inputs,
getting inputs in the first place,
right? Education is is uh is critical.
Um
>> and hearing loss, as I recall, was an
important one, right? in reference to to
inputs like you don't want sensory input
degraded.
>> Absolutely. So hearing loss, vision
loss, um social isolation. Um they
didn't uh it was quite so two things
they didn't include um that were fairly
controversial and were sort of debated.
Letters were written to the editor and
all that kind of stuff as happens in in
academia uh related to so they didn't
include sleep loss or sleep deprivation
as a risk factor for dementia even
though the evidence particularly if
you're
>> didn't look at it or didn't include it.
>> They didn't include it. So, like they
talked about it, but they felt that the
level of evidence wasn't high enough,
though it was probably as high as some
of the other things that they included.
>> It's a tricky one. I I don't want to
take us on too much of a tangent, but
having looked at these data a lot, I do
think that people need to get enough
sleep, but some people, like myself, do
fine on 6 and 1 half or 7 hours, and
other people can do fine on only seven
or eight or nine.
>> Very few people are a-okay all the time
on just four to five hours for prolonged
periods of time. But what but when we
say not a-ok okay what tends to happen
with shift work or people that are
chronically sleepd deprived is most of
the other things you're talking about
get worse LDL goes up stress levels goes
up diabetes go so it's
>> it's like uh I can understand why they
might not have included it but it seems
so foundational to me that it does seem
kind of a shame
>> part of it is related to how they
analyze the data so we can we can we can
get to that but I mean in reality when
you look at the data on sleep loss and
dementia risk The cut off is really
around 6 hours. So if you're
consistently sleeping fewer than 6
hours, that's where risk starts to
increase. So that that kind of sounds
Yeah, that sounds about right. Cuz it's
the I think it's the LA it's the lack of
those last two cycles where that are REM
enriched.
>> Yeah.
>> You know, cuz in the beginning of the
night, you get your growth hormone
surge, you get a lot of deep sleep,
assuming you're, you know, doing things
right during the day and and then it's
those last, you know, 290 minuteish
cycles that you glean most of your REM.
>> Yeah. And if you're not getting those
night in and night out and night in
night out, like sooner or later, you're
going to have issues.
>> Yeah. So, so sleep was one. Then the
other one was was nutrient status. So,
they didn't talk about omega-3s, B
vitamins, which we do actually have some
some quite high quality interventional
and observational kind of
epidemiological data for. So, there was
kind of some discussion as whether those
things should have been included. Other
analyses that looked at those suggested
that they potentially contribute a
significant of the amount of the
population attributable risk of
dementia. So all that to say that their
their 45% estimate could be quite
conservative if we consider some of the
other things there there are some other
studies that suggest that the maybe as
many as or as much as 70% of dementias
may be preventable but then you have to
start including things related to
socioeconomic status and deprivation and
other societal factors that we know have
a massive impact as well. So that's less
modifiable like on the individual level,
right? It really would require mod like
changes at the societal level which is
kind of harder to do.
>> Could I ask you a question? It's going
to be a very controversial one, but
>> um
>> there are people arguing
there are very smart people I should say
arguing that the shingles vaccine is
lowering rates of dementia
significantly. I haven't looked at those
data closely yet. I plan to, but it
certainly is intriguing given the data
that herpes viruses of various sorts
have been correlated with uh
Alzheimer's. This comes off the back of
three or four very large natural
experiments that have been done in in
various countries. And really how you
interpret these data is going to depend
a little bit on your kind of risk
tolerance and like how you what you
think should be done in terms of the le
level of evidence required to to
intervene. So, I'll describe the studies
in a second, but some people are
definitely saying, you know, if you want
if you want to say that um the shingles
vaccine decreases dementia risk, you
have have to have a clinical trial
that's adequately powered to show that.
And there is a trial like that being
planned currently.
>> So, the the studies that have happened
so far, uh there was one in the UK, in
in Wales, uh one in Australia, uh and
one in Canada. And in each of those
countries, what happened was that on a
single date, a huge trunch of people
became eligible to get the shingles
vaccine. Whereas if they were born one
day earlier, they weren't eligible. So
you get what you call like a natural
experiment where from one day to the
next, those people shouldn't be that
different otherwise. and and they showed
that, you know, rates of other diseases
weren't that different. Rates of uptake
of other, you know, health care and
other vaccines weren't wasn't that
different, but there different there was
a big shift in the uptake of of the
shingles vaccine. And so what they
essentially consistently showed across
all those different populations was that
those who got the shingles vaccine um or
were eligible to have the shingles
vaccine, depending on whether they had
access to the data on whether people got
it or not, had a had decreased risk of
dementia. And that was consistently seen
across those three groups. All those
three trials used an older version of
the shingles vaccine called zostifax
zostifax which was a live attenuated
vaccine. There's now a newer version uh
called Shingri which is a recombinant
vaccine and there was a study done in
the US that um compared people who
switched from you know there was a
similar switch from Zustvax to Shingri
and and saw that Shingrix was associated
with with a lower risk of dementia
compared to Zustvax although both were
associated with a lower risk than none.
When you look at some of these trials
um or studies because they're not
trials, people have made the a very fair
comment which is that when you look at
the trajectory of dementia over time,
you look at something called a Kaplan
Meyer curve. So it's like a survival
curve. So like um every time somebody
gets a case of dementia like the line
goes up and you look at the trajectory
of the two lines those who got you know
got the uh vaccine or not they diverge
very early which kind of says that oh it
only takes a couple of months to kind of
see this difference in dementia risk
which you which you wouldn't really
expect based on like the natural course
of dementia takes years to happen. So um
this is very common in these kinds of
studies. Um and it it's it's due to
residual confounding. So there's like
something inherently different about the
populations that may be driving some of
this different. Right? They they were
going to get less dementia anyway. And
so maybe the shingles vaccine isn't
having that big of an effect. But I
would say that having looked at all
those trials and all those data, I'm
fairly, you know, I'm convinced enough
that um there's there's a signal there.
there should be a randomized control
trial. That's that's happening. But
there's a number of reasons why this
might be the case. One, uh it obviously
we know reduces cases of shingles.
Shingles can be very painful. It can,
you know, can uh change how people
interact with the world. You stay at
home. You don't feel good. You're in a
lot of pain for a long period of time.
That can be that can go for you many
months. It's rare for it to last many
months, but it can can last a long time.
Um then you know there's they've
hypothesized
in some of those papers that the
magnitude of the reduction of dementia
risk didn't map perfectly onto the
reduction in uh in cases of shingles.
Right? There had to be something else
going on as well. They've suggested that
it may be um due to like an imunom
modulatory effect. It may be because
you're also suppressing other viruses
like herpes simplex virus that we know
uh may also be associated with certain
cases of dementia Alzheimer's. Um and
the reason you one of the arguments for
the imunom modulatory effect is because
not in all the studies but in most of
the studies there's a slightly bigger
signal in women than there is in men. Um
and it may be that that sort of um
>> meaning it's more effective in
>> more effective in women than it was in
men. And we should mention that the
shingles virus lives on neurons.
>> Yes.
>> Yeah. The herpes viruses tend to live on
neurons that and they hang out on
neurons which is why people who you know
get herpes [clears throat] one
infections will get a cold sore at a
particular location that will come back
because it's living on the trigeminal
nerve. This just you know uh I think
people don't often understand that
viruses can you know harbor in in
particular cell types.
>> Yeah. And uh so the logical link between
herpes viruses and and uh dementia risk
is you know it's not
>> I mean that that alone is not a causal
relationship but it but it makes sense
mechanistically.
>> Yeah.
>> And a fundamental feature of herpes
viruses is they generally don't kill the
neuron. They can
>> but that's why they stay alive. These
viruses are very smart.
>> They know how to get infect their host
but not kill their host which is what
really smart viruses do.
>> Yeah. So what age are people getting the
shingles vaccine?
>> The study is actually quite late. It's
like people in their 807s and 80s.
>> Oh wow.
>> Yeah.
>> Okay.
>> So again, um it would be very fair to
argue that getting it much earlier we
don't have any evidence for because you
know in reality in these particularly in
these the studies um like the UK this is
done in the national healthcare system.
it was you know for the the highest risk
older you know older adults and so
getting it in your like 50s or you know
mid-50s which is u sort of the
guidelines in the US that yes to reduce
shingles absolutely but it doesn't map
onto the dementia risk um age that was
seen in seen in these studies a final
piece of this that I think is important
and kind of goes beyond just the
shingles vaccine is that
if you want to maintain function over
long periods of time, one of the best
things you can do is minimize your
chances of getting really sick. There
have been sever several studies, one was
the adult changes in thought study done
at the univers University of Washington
in Seattle primarily. Um this a similar
thing was shown in the Rush memory and
aging project. But basically, when you
when you look at the same individual
over time and you measure their
cognitive function every few years,
which these studies did,
cognitive function doesn't just decline
sort of linearly or steadily with age.
It goes down, you know, a little bit on
average, but the biggest decreases sort
of happen stepwise after periods of
significant illness. Um and so like in
the adult changes in the thought study,
those who'd been um you know sick in
between, you know, had a major illness
in between uh have be having their
cognition retested, they had a step
change down and those who were
hospitalized that that step change down
was even bigger. So
you could talk about, you know, how
people maybe could have changed things
in order to recover some of that
function afterwards. I think that would
have been possible if you'd, you know,
thought thought about how you might
intervene. But a major I think it it's a
it's a reason to say if I can do as much
as I can to minimize the chance that I
get really sick because what happens
then is I'm I'm at home. I'm not
receiving any stimuli any inputs. I'm
not moving. I'm not eating well.
Obviously there's the all the downsides
of the infection itself. um then you
know if I can avoid that as much as
possible then over time that that that
could lead to you know greater benefits
right change change change the overall
trajectory so I think that's one reason
why some of these vaccinations could be
beneficial is just you're minimizing the
time you spend really sick as you're
older which we've seen is results in
these sort of like step changes down in
cognitive function
>> fascinating
I realized that we could and probably
should do an entire podcast about
traumatic brain brain injury and
concussion.
>> But as a [clears throat] teaser for
that, um,
>> are there anything
that people should do and or take in the
immediate aftermath of a head hit? Now,
I'm not talking about uh hopefully
people are getting checked out for brain
bleeds and things like that. So, I'm I'm
talking about moderate concussion.
Someone got their quote unquote bell
rung. uh they slipped and fell. Uh they
got clipped in soccer practice. Um their
kids a little dizzy. Not of course
somebody young or old is vomiting or you
know not able to sleep or real issues. I
mean everyone should probably be checked
out in in the first case but I get asked
this question all the time. Is there
anything that people can take to kind of
get over mild concussion or moderate
concussion? The evidence base on this is
a little shaky, but I think for most
things
it kind of fits into this idea of
positive asymmetry, right? Low risk,
high potential for benefit. And there
have been lots of you there have been
randomized control trials to kind of
look at some of these things. So we a
couple years ago we published a paper
looking at different nutritional
supplements after concussion that you
know we have some reasonably good
evidence for. So, um, yes, you should be
seen by a doctor. You should get
whatever scans and, you know, immediate
medical care that you need. Absolutely.
Right. That's we're assuming all of that
is done or will be done.
>> Yeah.
>> Immediately, there are a couple of
things that I think we know um from sort
of um animal studies that translate
fairly well onto onto humans, but also
some you maybe some observational
studies in humans. But, a couple of
things are important. So one is temp
temperature management temperature
regulation. There have been this is what
my PhD was actually in hypothermia after
acute brain injury
>> hyperothermia.
>> Hypothermia. Yeah. So cooling down.
>> Although I did do some studies where we
you know heat it up and that makes
things worse. So this kind of pertains
to imagine brain doesn't like to get too
hot.
>> That's essentially what I'm about to
say. So there have been lots of studies
where they've done cooling hypothermia
in people after traumatic brain injuries
and concussions hasn't really shown much
of an effect. What seems to be important
is preventing hyperothermia.
So um one of the effects of cooling
somebody down is that they don't get
hot. So that's probably something that's
really important. So often concussions
happen in a heat stressed environment.
You're on a football pitch. It's August
in Alabama. It's 40°, right? Get inside,
get cool as quickly as you can because
there are there are studies that and
that doesn't mean you have to get an ice
bath. Just don't be really hot. If you
get a fever, which you might might do
after a more significant injury, you
know, Tylenol or something like that to
help maintain thermmorreulation will be
really important. The next is uh blood
sugar regulation. So, we know that after
a significant brain injury, you have
increases in in blood sugar that's
associated with worse outcomes. Some of
it's like what's caused, what's
consequence, is the injury driving the
blood sugar, is the blood sugar driving
the injury. I think an easy thing to
just say is I would avoid any super
sugary refined carbohydrates that might
just sort of you know uh kind of pile on
for one of a better word, right? What
about alcohol?
>> So alcohol um I would avoid as well
mainly because it impairs sleep and we
know that sleep is going to be critical
to recovery. Some people would say
something similar about caffeine acutely
after injury because it's a it's a
stimulant. Um, one thing that the reason
why hyperothermia or getting too hot
makes the injury worse is because it um,
you know, simply speaking increases the
gap between energy requirements and
energy production. So like one of the
hallmarks of these acute brain injuries
is a deficit in energy production with
you know mitochondrial failure or
mitochondrial dysfunction. And so if you
get too hot or you stimulate the brain,
you're asking for more energy when the
when the when your neurons can't produce
it and that is a trigger that kind of
deficit in energy production is a
trigger for cell death and
neuroinflammation and some of these
other processes that then may happen. So
avoid alcohol, avoid caffeine. Both of
those potentially related to improving
sleep. Then uh things that we have some
you know reasonable evidence for um
immediately after concussion are
creatine.
>> At what dosage? The best trial was
actually done um in a p like pediatric
group although very broad. It was like
one year old to 18 years old. Um but
they gave point4 gram per kilo per day.
So
>> wa.
>> Yeah. So it's it's a pretty it's it's
like double a traditional loading dose
if you're a 100 kilo person. But like if
you're 7 if you're 70 kilos um you know
155 lbs or something like that then
that's 28 g of creatine. So like it's a
lot but not
>> trips to the bathroom could be expected
but you just spread it out across the
day right.
>> Yes. So well one thing I'll say about
that is um the most recent meta analyses
show that you actually don't get is
actually quite rare to get more GI side
effects uh with creatine compared to
placebo. Some of it is probably related
to the quality of the supplement. So
poor quality creatine supplements have
more adulterance that may cause some of
those GI side effects. Some of it is can
be due to high um um you can saturate
the creatine transporters. It doesn't
get absorbed. Water gets drawn into the
gut that can that can then write cause
diarrhea or something. Um but some of
the GI issues that people experience are
probably due to poor quality products
that they're taking. For the non uh head
injured individual, is there any reason
to go back to the old loading protocols
of taking 20 grams per day, putting it
in a little bit of grape juice or
something else to spike blood sugar for
this very reason that it could um
augment the the passage of creatine into
your cells as opposed to drawing water
into the gut? In the '9s, we would take
five grams of creatine four times a day
in an ounce or two of pure grape juice.
Yeah. Um, and you draw a lot of water
into your muscle cells. You put on, you
know, it varies, but for me, anywhere
from 5 to 8 pounds of, it's water
weight, but it's mostly in the muscles.
It's not insignificant. Translates to
big strength increases. I don't take
nearly that much now. I just do the 10
grams per day. But is there any reason
to go back to those traditional loading?
>> So, if you're just like long like
long-term creatine supplementation, pro
probably not. um in this kind of setting
I think a a you know the the evidence is
for a loading style protocol right so
for most people it might be 20 to 30
grams of of creatine spread spread
across the day you know for if anybody's
just like taking creatine
for other reasons you know this is a
standard dosing protocol I think is fine
>> I thought you were going to tell me I
could get it to work that way
>> so so like the the some of the studies
that use traditional like creatine
monohydrate and look at creatine levels
in the brain they did use is a loading
protocol for for a week and then you see
significant increases in brain creatine.
But you creatine having other effects on
the brain, you know, potentially
improving mood, improving uh memory and
in older adults. Um some of those
benefits happen at just like a
traditional creatine doses. So you don't
need to take massive doses, you know,
take load loading doses. You can
actually see some benefits of like 5 to
10 grams. So that's a creatine. So
magnesium, so 400 milligrams once or
twice a day. There've been some trials
that shown um
>> what form
>> those studies actually use magnesium
oxide. surprisingly. Um, but I would
probably use magnesium glycinate. Um,
the it's very bioavailable. Um, athletes
usually need a bit more glycine anyway,
but any bioavailable form will will be
fine than omega-3 fatty acids. Um the
evidence is is is a little bit better
for like um there are now several
studies in like America in like
collegiate American football players
where they take a couple of grams of
omega-3s every day and across a season
you see um less accumulation of uh
biomarkers of of injury like
neuropilament light that are circulating
in the blood. So that's something that I
would just take long like
longitudinally. you're somebody who's at
risk of a concussion uh because of your
sport or your job, I would just, you
know, take a reasonable omega-3
supplement just long term because we
have some reasonable evidence for that.
Then uh other things might become a
little bit specific to uh the symptoms
that you're experiencing. So if you have
sleep issues, then uh there's studies
that have used melatonin and that's
that's shown improvements branch chain
amino acids at high doses uh for sleep.
And that's interesting because outside
of TBI, high doses of branch chain amino
acids may actually impair sleep because
they compete for tryptophan uptake into
the brain, decreasing potentially
decreasing serotonin, melatonin uh
production. But in TBI, there are two
studies that suggest improvements in
sleep with high doses of branch chain
amino acids.
>> If somebody's going to take branch chain
amino acids, presumably they're going to
look at how much leucine is there for a
variety of reasons. Um, so do you recall
how much leucine to get this effect post
TBI?
>> So I I don't think they at least I don't
remember the leucine dose, but they were
taking up to 60 g of branches.
>> 6. Okay. Cuz a typical kind of
suggested supplement bottle gym dose
would be 3 to five grams. That's usually
about six capsules. Yeah.
>> So Okay. So like one study they did in
uh veterans they had um I think it was
three
doses of 20 grams AC spread across the
day.
>> Are you curious about um these uh Ibeane
studies that are looking at uh you know
TBI and brain recovery? I mean Ibeane is
a it's a a whole other thing because
it's a the the most powerful
long-lasting psychedelic at least that
I'm aware of. But it seems like there's
some interesting data coming out.
Absolutely. Um and then you know in
people with a history of brain trauma
and PTSD and I think some of these other
psychedelics are going to be um very
interesting um there as well potentially
due to their neuroplastic um effects
that tend to particularly happen in like
macro doses right in in [clears throat]
um in the psychedelic doses. I think
that there's a lot more to come there,
but certainly the trials that have been
done so far are quite compelling, but
that's obviously in in a very controlled
kind of clinical setting, heart rate
monitor. Again, it's not legal in the
United States, although things are
shifting. But
>> choline is another thing, particularly
acetyloline. So um uh best evidence is
for 1 to two grams a day um
>> of choline
>> of choline, you know, in the form of CDP
choline or citicoline, which is the
which is the same thing. Um those are
the main ones. Then there's some other
like Nisha supplements that do have some
evidence. The one that's probably has
the most evidence for it is Boswellia.
>> Boswellia.
>> Yeah. Uh which is a frank Indian
frankincense. But there's an extract of
Boswellia that's been tested in I think
three different clinical trials after
TBI showed some benefit. Enzogenol which
I think is a pine extract. Slightly less
evidence than Boswellia. I typically
would recommend people stick to the
first group of kind of nutritional type
supplements. um but in very specific um
use cases based on specific symptoms
some of those other things might be
beneficial. Then beyond that we know
that phys return to physical activity as
soon as possible is really important
after
>> without getting another head injury
>> without getting another head injury. And
you know so so this really changed over
the last few years. You know maybe 5 10
years ago people like you know rest is
what you need to do. Go lie in a dark
room. If you got a concussion in sports,
you you would expect the team to have a
rigorous return to play protocol that
included lowle aerobic activity as soon
as you're able to tolerate it u two or
three times a week at a level just below
what might make your symptoms worse. And
then first you do sort of like
non-specific aerobic exercise and then
you start to bring back skill specific
exercises, sports exercises, then go
back into full training and then um go
back into into playing kind of in that
order and that should be quite
systematized now. So I would expect
sports teams to kind of have have that
in place. So like the standard of care
is generally phys physical therapy. if
you have any ongoing cognitive or
physical symptoms sort of a month plus
after uh any kind of traumatic brain
injury. Um there's some evidence that
like virtual reality or augmented
reality uh physical uh activity uh might
improve cognitive symptoms uh vestibular
therapy for balance and dizziness
issues. And then increasingly uh you
know there's um a focus on sort of
ocular motor training for like
convergence or other eye like um eye
issues that are very common after
concussions but aren't picked up as
often as as people might like. But
increasingly kind of eye tracking and
these kinds of things are done
particularly in professional sports or
other arenas after brain injuries to
kind of ideally you'd have a baseline
you figure out what's changed and then
you would track that over time and you
can you can train that depending on the
deficit.
>> Those recommendations are going to be
extremely helpful for people athletes at
all levels. I mean, I think for people
that don't have access to the, you know,
all the latest and greatest, uh, you
know, technology and coaches and, uh,
nurses and doctors that, um, you know,
there's a lot of head hits out there
that aren't nec,
>> you know, fortunately aren't um
full-blown brain bleeds and brain
damage, but the the low-level
trauma to the brain is obviously a
consideration, especially kids like just
falling off the monkey bars. Like
parents want to know what they can do.
So, thank you very much for those
recommendations.
>> You're doing a strongman competition.
>> Uh-huh.
>> All natural. This is not the enhanced
games. No.
>> Um, just tell us what the format of that
is. Well, first of all, how old are you?
>> 41.
>> Cool. Have you done one of these before?
>> Yeah, six or seven competitions at this
point. I started during CO. I've done
like a competition or two every year
since then.
>> Mhm. You're a tall guy. You're like 6'2.
You weigh
>> like 210 215 usually.
>> And is it So, it's height and weight
class or just weight class? So, it's
it's weight class. Um, I now so now that
I'm older than 40, I compete uh in the
mast's category. So, there's a
>> this one of my favorite things about
strongman is that if you weigh less than
200 lb, you're a lightweight. So, I'm uh
I'm in the lightweight masters category.
It means that I usually have to like do
a a water cut to like for a weighin cuz
I don't normally I'm not I'm normally
above 200 lb. Um but yeah, they so they
have they have weight they have weight
classes and age classes. Can you eat
your way and hydrate your way back up to
after?
>> Yeah. Like the usually you weigh in 20
hours 24 hours before. I'm I'm
definitely back to my usual weight by by
the next day.
>> Gotcha. Yeah. We don't want you trying
to lift heavy things dehydrated. What
are the big events? So, you're carrying
stuff overhead. You're carrying stuff at
your sides. You're What are you doing?
>> A standard kind of local regional
competition is five is five events. Um I
qualified for the natural like world's
strongest man uh which is going to be
seven events. But there's usually um
some kind of deadlift, some kind of
overhead pressing event, uh some kind of
um medley where you're like carrying
something, lifting stones, farmers
walks. So in um truck pull, something
like that. So like more dynamic. So
there's like usually like a static max
strength thing, but then also like more
dynamic.
>> The teeth you do the teeth pull the
>> Oh, no. No teeth. Uh no, no teeth
pulling. Um the we didn't talk about
oral health and cognitive function, but
that's really important too. The events
in the competition that I've got coming
up, the the world's strongest, there's
going to be a farmer's walk. So that's
where you just like pick things up at
the side and kind of
>> So for a guy, let's say you you hydrate
back to like 2 205 210 or something like
that. What what what's a good distance
and weight to carry?
>> I know the weight in the competition.
It's 120 kilos per hand. So that's 264
pounds per hand. Um and as far as you
can as far as you can carry it. Um I
can't remember if
>> that's a big human in in each hand.
>> Yeah. Um so typically,
you know, if you if you can get to where
you've got like your body weight in each
hand and you're able to pick it up and
move with it, even if it's not very far,
I think that's pretty good. Um but like,
you know, some people might say half
your body weight. In reality,
>> if you pick something up heavy and move
with it, that's great. Like, and then
get better.
>> We're not talking about recommendations.
This is your time to shine, my friend.
People can work their way up. I I I
watch uh Tom Havlin's um uh Instagram.
We'll put a link to it. Everyone should
see that. His wife and his kid also work
into the workouts. He's got a But man,
he's strong. But yeah, carrying heavy
weight. No, no, this is not your time to
tell people how to tiptoe into it.
That's a different podcast. So, you're
carrying 220 lbs in each hand.
>> 264 lbs per hand
>> and walking how far?
>> It's maximum distance
um in I can't remember if it's 60 or 90
seconds.
>> You can set it down. You can set it. You
can set it down. So, it's as far as you
can get in that period of time. And
it'll be similar with a with a yoke
walk. So, there's a a yoke where you
know sort of like put it on your back.
It's 700 lb. How far can you how far can
you walk in that period of time?
>> Love this. So primitive. Love it. Pure
hypothalamic event. Yeah.
>> So, in that event in the in the yoke
walk, if you get to the end, I think
it's 30 I think it's 30 m 90ish feet. If
you can carry that in that far in the
time cap, then you do reps on a circus
dumbbell. So like this this big massive
dumbbell that you have to like shoulder
to overhead. There's one at 110 lb and
the next is at 135 lb. Then there's
going to be a loading medley. So
sandbags and kegs uh like over over a
platform that's like I think 200 to 300
lb implements. They kind of increase
over time. Um there's a maximum squat
and you have a choice of two different
um weights. Um, and so like if you
choose the bigger weight and you get
reps on the bigger weight that you get a
better score than somebody
>> standard back squat.
>> It's a standard back squat is with an
axle bar. So like a thick bar.
>> Um, and then in strongman when you have
squatting you usually have pads that you
squat down to. So there's a specific
height you squat down to.
>> Um, so like that could give you an
advantage if you're shorter, right?
Because you have to go less distance to
get the weight on the pads. But like
>> but there's no geeking it and calling
less than a one rep. Yeah, people have
done that. It doesn't look good.
>> Yeah. No, no. Like it just has to hit
the pads and come back up. And the
weights are 170 kilos and 200 kilos. So
that's
>> what uh nearly 400 lb and 440 lb uh log
press um for reps. And again, it's a
similar style. And I I think it's 100
kilos. So 220 lb and then 120. So 264.
And then there's a sled like you uh I
think you push a sled and then you load
it with a 275 lb sandbag and then you
drag it um in a in a time cap. I think
that I think that's all the events.
>> Awesome. Uh you'll let us know when it
is.
>> Yes. Uh it's at the end of August.
>> Cool. Will it be online?
>> Uh it won't be online, but I'm sure
there'll be some stuff on Instagram.
>> Cool. I I love that you do this. Uh
clearly um you got a lot of brains in
that. uh skull of yours and you you're
also super strong. Love hearing it.
That's that's great. And and uh you have
no excuse not to carry the groceries at
home, right? So you you lost that that
ride. But there's no doubt you would.
Anyway, that's awesome. I I I'm very
impressed by the by people who continue
to take on athletic challenges in their
uh in their adult life as which is very
appropriate to context today. So Dr.
Tommy Wood, thanks for coming out today.
I learned a ton from you and you know
going into this I like I like to think I
know a thing or two about plasticity
having spent so much time in it and
studying it over the years but I learned
a lot from you today and I know everyone
else did as well. You're an
exceptionally clear communicator and um
you're working on not just an important
issue you're working on the issue uh
this neuroplasticity thing and a whole
lot more. So, let's definitely get you
back to talk about recovery from brain
injury and stroke and things of that
sort because there's a lot of uh
additional things I think we could dig
into,
>> but uh meanwhile, you've given us a lot
of uh actionable tools and um
>> yeah, I I love that uh you're doing the
strongman competition and uh come back
again. We appreciate you.
>> I will. Thank you so much.
>> Thank you. Thank you for joining me for
today's discussion with Dr. Tommy Wood.
To learn more about his work and his
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