Speaker 1: Hi, it's Katie. Welcome to Wellness. Check our series of
Speaker 1: some of our favorite Next Question episodes focused on women's
Speaker 1: health and wellness. Enjoy. Hi everyone, I'm Katie Couric and
Speaker 1: this is Next Question. You know. I've known and admired
Speaker 1: doctor Sanje Gupta for years. He's such a great guy.
Speaker 1: He's also a neuroscientist and the chief medical correspondent for CNN, which,
Speaker 1: as you can imagine, when COVID hit put him at
Speaker 1: the center of the pandemic storm.
Speaker 2: So this may be a new pathogen that circulates around
Speaker 2: the world. You're running into a situation where you just
Speaker 2: don't have beds. If those numbers don't budge, it's going
Speaker 2: to be very hard to get to hurt immunity. I
Speaker 2: think this has added a lot more urgency to an
Speaker 2: already very urgent situation.
Speaker 1: There has been so much to cover. In fact, Sanjay
Speaker 1: also launched a daily podcast on the subject.
Speaker 2: I'm doctor Sanje Gupta's chief medical correspondent, and this is
Speaker 2: coronavirus fact versus fiction.
Speaker 1: Throughout this very long year, Sanche has really acted as
Speaker 1: our guide, helping us understand this thorny virus and what
Speaker 1: it means for our health, our communities, and our country,
Speaker 1: and he admits it's been as all consuming as you
Speaker 1: might think.
Speaker 2: All I think about, Katie is been COVID, you know,
Speaker 2: I viral transmission, how people evaluate risk social behavior. But
Speaker 2: there is some joy in getting so head down in something.
Speaker 2: I feel like we live such distracted lives. You get
Speaker 2: a little bit about a lot of things, like I
Speaker 2: really know so much about this virus.
Speaker 1: I also wanted to talk to sanj because he's got
Speaker 1: a new book out. Yeah, believe it or not, he
Speaker 1: found time to write a book during this crazy year.
Speaker 1: It's called Keep Sharp, Building a Better Brain at any Age,
Speaker 1: and it's fascinating. It's also a practical guide for better
Speaker 1: brain health, something I'm extremely interested in. And don't worry,
Speaker 1: we do get into that, but since I had the
Speaker 1: COVID expert of experts, I couldn't help but start our
Speaker 1: conversation there. You must feel like you have a PhD
Speaker 1: in virology at this point, right, yeah.
Speaker 2: I mean totally and and and the the irony is, Katie,
Speaker 2: is that this is a novel virus, right, So I
Speaker 2: mean novel actually means something, which which that didn't really
Speaker 2: strike me until a few months into this either, like
Speaker 2: I think, because you said the PhD in virology, the
Speaker 2: irony is that that I think people who had a
Speaker 2: lot of knowledge about this in some ways it got
Speaker 2: in their way because it's very hard to think about
Speaker 2: something as novel. You immediately want to put it into
Speaker 2: a box. It's the box of sars, it's the box
Speaker 2: of H one, N one, whatever you come up with.
Speaker 2: But this was novel, which means that if you try
Speaker 2: to put it in a box, you probably got it wrong.
Speaker 1: So they had to cast aside their preconceived notions completely,
Speaker 1: and that's hard to do, right for a scientist.
Speaker 2: It's really hard to do, and it goes against sort
Speaker 2: of how you think about things. Let's get the best experts.
Speaker 2: And by the way, I think there's really really value,
Speaker 2: great value and expertise. Don't get me wrong, But what
Speaker 2: you would do is grab the coronavirus experts, grab the
Speaker 2: pandemic experts, and that was all important. But this virus
Speaker 2: was just behaving in a totally novel way. I mean.
Speaker 2: One of the best examples, as you well know, was
Speaker 2: everybody believe that respiratory viruses really only spread when you
Speaker 2: were sick, when you had symptoms that's when you spread.
Speaker 2: And you know, the guidance was well screen people at
Speaker 2: airports will tell people to stay home if they're sick,
Speaker 2: which people should do anyway, regardless of whether in a pandemic,
Speaker 2: and we should be able to quell this thing. No
Speaker 2: one really believed initially that this thing would spread most
Speaker 2: efficiently when people didn't have symptoms. Was that's never really
Speaker 2: happened before, as doctor Faucia said, never in the history
Speaker 2: of respiratory viruses has that happened before. That's novel. I mean,
Speaker 2: you know, you remember the story of typhoid Mary. She
Speaker 2: was a silent carrier of typhoid. It was so dramatic
Speaker 2: because she infected all these people in this single residence
Speaker 2: in this community and all that, and people couldn't figure
Speaker 2: it out. This is like millions of typhoid Mary's in
Speaker 2: a way of a brand new disease, COVID. So it
Speaker 2: was quite extraordinary to sort of see see how that
Speaker 2: all played out.
Speaker 1: Well, before we talk about your new book, keep Sharp,
Speaker 1: because I'm really interested, as someone who's sixty four, in
Speaker 1: maintaining my mental acuity as i age. I just want
Speaker 1: to ask you one last question about COVID and that is,
Speaker 1: are we seeing the light at the end of the tunnel?
Speaker 1: Every time I feel optimist, stick Sanjay, I then read
Speaker 1: something about variants or increase cases, and it's quite nerve racking.
Speaker 1: I think for the average person who doesn't have a
Speaker 1: medical degree or hasn't been deeply, deeply entrenched in the
Speaker 1: science of this, I mean, are we screwed? Are we
Speaker 1: at the tail end of this pandemic?
Speaker 2: I do feel the light on my face, in your face.
Speaker 2: I mean, I do think that the tunnel is the
Speaker 2: end of the tunnels in sight. I mean the can
Speaker 2: I just remind people, and I think this is such
Speaker 2: an important reminder that they were having rave parties in
Speaker 2: Wuhan at the end of last summer, and I bring
Speaker 2: that up only to say that we talk about the vaccines,
Speaker 2: we talk about the fact that science is now rescuing us,
Speaker 2: which is great, fantastic, but so much of this didn't
Speaker 2: need to happen. And I know that's not your question, Katie,
Speaker 2: but I just feel like I can never answer a
Speaker 2: question about about the sort of future or being optimistic
Speaker 2: about this pandemic because I'm so it's just so, it's so,
Speaker 2: I'm so angry in so many ways. I mean, you know,
Speaker 2: six hundred thousand people died and some of them are
Speaker 2: my friends. And I've seen families, I talked to families. Still,
Speaker 2: I just it just this may not have even been
Speaker 2: the Black Swan event, right, we think of this black
Speaker 2: Swan event, this really contagious virus, which this was, but
Speaker 2: something that has a two to three percent mortality that
Speaker 2: would be awful, That would be the Black Swan event.
Speaker 2: This wasn't even that. There were countries around the world
Speaker 2: that immediately quelled this and measure their debts in the
Speaker 2: hundreds instead of the hundreds of thousands. Having said that,
Speaker 2: we are a society. Because we are, we focus on
Speaker 2: touchdowns and home runs and knockouts. We don't care much
Speaker 2: for singles and doubles. Because we're that society. We waited
Speaker 2: for science to rescue us, and the vaccines will. I
Speaker 2: think they're really extraordinary and really effective. They seem to
Speaker 2: be pretty effective against the variant u B one one seven,
Speaker 2: the UK variant, because there's a lot of concern about
Speaker 2: that very but if you have been vaccinated, or if
Speaker 2: you had the infection in the past, the other you know,
Speaker 2: the circulating coronavirus that should also protect you. So it's
Speaker 2: really I think it's really good. And I think with
Speaker 2: the warmer, warmer weather in the summer, viral transmission rates
Speaker 2: will go down. That'll be great. I do think, you know,
Speaker 2: we'll probably get to herd immunity over the summer, but
Speaker 2: it's worth reminding that herd immunity isn't a sort of
Speaker 2: destination necessarily. You can pop in and out of herd immunity.
Speaker 2: So if not enough people get vaccinated over the next
Speaker 2: few months, then going into the colder weather again in
Speaker 2: the fall, we could see resurgences.
Speaker 1: It's quite disturbing when you hear about the people who
Speaker 1: are refusing to get vaccinated. Many of them are white
Speaker 1: men in this country. I think you see the impact
Speaker 1: of politics on that number, not only in terms of
Speaker 1: the response to the pandemic, but now to the response
Speaker 1: to the vaccines. That must be quite disturbing for you too,
Speaker 1: it is for me.
Speaker 2: Yeah. I mean there's been no not a single part
Speaker 2: of this entire pandemic that hasn't been politicized in some way.
Speaker 2: I mean, that's I guess now you say that in
Speaker 2: April of twenty twenty one and it's obvious, right, everyone
Speaker 2: knows that, but it starts starting off covering the story
Speaker 2: and now all the way now to the vaccines, even
Speaker 2: every single component has been politicized in some way. So
Speaker 2: it is disturbing the anti VAXX movement. And you may
Speaker 2: not even remember this, kiddie, but I actually did a
Speaker 2: segment on your show years ago about anti vaccination movement
Speaker 2: at that time, around h one and one. But it's
Speaker 2: been around for a long time, the anti vaccination movement,
Speaker 2: and it's sort of you know, Simmers, we saw measles
Speaker 2: outbreaks in Brooklyn and Disneyland and Minnesota.
Speaker 1: This seems bigger, though, Sancha. You know, that was a
Speaker 1: particular group and it really dealt primarily with childhood vaccinations,
Speaker 1: and now this has expanded to you know, these adults
Speaker 1: who I don't know for one reason or another. I
Speaker 1: think you can understand people of color and the terrible
Speaker 1: history of Tuskegee and some of the ways that people
Speaker 1: of color have been abused in scientific research in the past,
Speaker 1: and this kind of deeply ingrained mistrust of the medical community.
Speaker 1: So I think you can appreciate that. But this is,
Speaker 1: you know, this is a whole other ball of wax,
Speaker 1: isn't it.
Speaker 2: Yes, it really is. And you know we're seeing some
Speaker 2: of this for or really seeing it come to light,
Speaker 2: I should say, you know, in a pretty dramatic way. Now.
Speaker 2: I think I was reading the statistics this morning Katie
Speaker 2: Kaiser Family Foundation, forty to fifty percent of those in
Speaker 2: rural areas who say they absolutely will not take the vaccine.
Speaker 2: It's not a question of hey, I want more information,
Speaker 2: I want to see how this plays out. They're just
Speaker 2: saying out of the gate they absolutely not take it.
Speaker 1: And I said, what is the explanation.
Speaker 2: That's the curious thing, Like you said, with some people
Speaker 2: who are vaccine hesitance, it is concerns about safety or
Speaker 2: mistrust or you know, my grandfather was experimented on as
Speaker 2: part of Tueski, you know, things like that. With this,
Speaker 2: I think it's almost an extension of this pandemic. Isn't
Speaker 2: even real. It's not a hoax. Why would I take
Speaker 2: a vaccine for something that's a hoax. I'm not scared
Speaker 2: for safety of it. I just don't. I think the
Speaker 2: whole thing is sort of, you know, the scamdemic sort
Speaker 2: of thing. So I don't know if that's the case.
Speaker 2: For it's a huge percentage of people we're talking about here,
Speaker 2: So maybe there's some heterogeneity, you know, some variety of
Speaker 2: opinions there, but bottom line, if the numbers stay that high,
Speaker 2: we're not going to get to herd immunity based on
Speaker 2: vaccinating adults.
Speaker 1: Alone, which is really depressing.
Speaker 2: It's so I mean, gosh, we wait for science to
Speaker 2: rescue us. We don't do the basic public health practice,
Speaker 2: and then when this truly extraordinary scientific achievement occurs in
Speaker 2: the form of this vaccine, people don't take it. You know,
Speaker 2: if you are a Martian coming to planet Earth and saying, so,
Speaker 2: let me get this straight. So you didn't do anything
Speaker 2: about the virus, you weighted, created this amazing medicine, and
Speaker 2: then you don't take the medicine. It just it doesn't
Speaker 2: make any sense.
Speaker 1: It's a head scratcher for sure.
Speaker 2: Yeah.
Speaker 1: When do you think Sancha will be able to go
Speaker 1: about our daily lives without mass I.
Speaker 2: Think it'll be the summer, Katie, I really do. I mean,
Speaker 2: I know that there's people who are painting a more
Speaker 2: dire prediction around that, but you know, we for no
Speaker 2: other reason alone with the warmer weather, and then you're
Speaker 2: going to really see the blunting despite the vaccine hesitancy
Speaker 2: that we're talking about. You are going to see a
Speaker 2: significant blunting of people who are getting very sick, people
Speaker 2: who are dying. And we know that the virus the
Speaker 2: vaccine does seem to have good evidence that it stops
Speaker 2: or decreases transmission. So I think we're really going to
Speaker 2: get to a pretty good point. I think you'll still
Speaker 2: seeks around, you know, in Hong Kong after Hong Kong
Speaker 2: really wasn't a mask wearing country until after SARS, and
Speaker 2: then there was this huge psychological impact. That's why they
Speaker 2: went to mass so early in Hong Kong, but they
Speaker 2: became a mask wearing culture. I think you will see
Speaker 2: people who are just frightened still want to wear masks
Speaker 2: in public places. I think in flu season, you know,
Speaker 2: the colder months, I think you'll see more masks. I
Speaker 2: think that may become a larger part of our culture.
Speaker 2: Not a dominant, but I think a larger part of
Speaker 2: our culture.
Speaker 1: That's interesting because I remember being in Tokyo maybe gosh, gosh,
Speaker 1: maybe ten ten or twelve years ago and going on
Speaker 1: the train to Kyoto and seeing everyone wearing masks and
Speaker 1: thinking this is so weird. Why are they wearing masks?
Speaker 1: And now, of course I understand, and you're right. I
Speaker 1: think when people are on places like public transportation, if
Speaker 1: they're in a closed spaces with lots of strangers, it
Speaker 1: actually makes sense, doesn't it.
Speaker 2: I mean, you know, one thing we saw, as you
Speaker 2: may remember, is that the flu numbers were way down
Speaker 2: this is past season, and that you know that that
Speaker 2: wasn't because of any increase in vaccination or anything. That
Speaker 2: was because of just public health behavior. It's always worked,
Speaker 2: you know. I don't know there's a metaphor for this, Katie, right,
Speaker 2: I mean we I don't know. I guess it's true
Speaker 2: in our lives, like we'd rather just take a pill
Speaker 2: for weight loss rather than go exercise, and we always
Speaker 2: want the convenience. And and this is this is another
Speaker 2: example of that. We I was struck. And again, we
Speaker 2: can talk about COVID all day long, but the but
Speaker 2: the I'll never forget these these mask researchers from Harvard,
Speaker 2: a guy named Aarbara Kuran. He basically was doing all
Speaker 2: this modeling all along. We were talking to him. He
Speaker 2: told me that if for four weeks and this is back,
Speaker 2: you know, October November of last year. If for four
Speaker 2: weeks everybody just wore a high filtration mask when they
Speaker 2: went out in public, that's it. For four weeks. If
Speaker 2: everybody did that, it would have ended the pandemic.
Speaker 1: Are you kidding? That's incredible.
Speaker 2: The virus would have nowhere to go. It couldn't find
Speaker 2: a willing host. I mean, you know, sort of that
Speaker 2: sort of concept is something that's more than one hundred
Speaker 2: years old. I just don't quite you know, I don't know.
Speaker 2: Maybe I'm just being naive. But you hear that and
Speaker 2: you think it's amazing, right, I think it's amazing. And
Speaker 2: yet we also know both of us that in the
Speaker 2: United States that couldn't happen. It just wouldn't happen. I mean,
Speaker 2: a human being survived and thrived as a species because
Speaker 2: we're reciprocally altruistic. There's a reason that it feels good
Speaker 2: to do good. Why should it feel good when I
Speaker 2: do something nice for you? I mean, what purpose does
Speaker 2: that serve my evolutionary tree? I don't know, But the
Speaker 2: reality is that it does feel good to do good.
Speaker 2: We encoded that in some way in our DNA, and
Speaker 2: then people can't be bothered to wear a mask to
Speaker 2: save tens of thousands of lives. I just I'll that
Speaker 2: may be one of the greatest mysteries of all out
Speaker 2: of this whole thing.
Speaker 1: Well, I just want to say, on behalf of the
Speaker 1: American public, thank you for your coverage of this. I
Speaker 1: think you're so measured and so eloquent and honestly calming
Speaker 1: in a way. And I just really appreciate all the
Speaker 1: fantastic reporting you've done throughout this pandemic. So on, behalf
Speaker 1: of a grateful America, I would like to say, thank you,
Speaker 1: Sancha Gufta.
Speaker 2: Well, Katie, thank you, thank you, And that obviously means
Speaker 2: a great deal in particular coming from you, So I
Speaker 2: appreciate that. You know, you get it. You know, I
Speaker 2: mean you are the standard obviously by whom we all
Speaker 2: measure ourselves. But also you know, we're all in these
Speaker 2: black holes, right I mean, I don't know where you
Speaker 2: are right now. As I said, I'm in this tiny
Speaker 2: little closet. You don't get any feedback. Sometimes it's been
Speaker 2: really dispiriting because you think, Okay, I'm a medical reporter
Speaker 2: in the middle of a pandemic. That is my you know,
Speaker 2: that's a job, and at the same time, the country
Speaker 2: in which I'm reporting arguably did the worst in the world.
Speaker 2: I mean, I know I keep taking this in that direction,
Speaker 2: but it's just so dispiriting. Did anyone listen to me?
Speaker 2: I mean, if you're the medical reporter and presumably people
Speaker 2: are counting on you to provide knowledge hopefully that will
Speaker 2: inform how they behave, and then we do the worst
Speaker 2: in the world. That's you know, I'm going to need
Speaker 2: to reflect on that. I think, you know, in the
Speaker 2: years to come, Like what is the real impact here?
Speaker 2: One could argue that maybe it would have been worse,
Speaker 2: who knows, you know, but it's pretty bad.
Speaker 1: Well, don't get too dispirited, because I think a lot
Speaker 1: of people listened, relied on you, and actually acted. So
Speaker 1: even though the track record was bad, your information was
Speaker 1: good and important. So thank you.
Speaker 2: I appreciate that.
Speaker 1: Let's talk about sharp because moving forward, I think many
Speaker 1: people like me really are interested in how to keep
Speaker 1: our cognitive and mental health at the top. And I think,
Speaker 1: you know, certainly one big change in medicine is that
Speaker 1: we as patients are not passive. It turns out, Sanjay,
Speaker 1: that there is a lot of things that we can
Speaker 1: do to keep our brains in shape, just like we
Speaker 1: can do to keep our bodies and our organs and
Speaker 1: other things in shape. And that's why you broke keep sharp.
Speaker 1: But you have a very very personal connection to this,
Speaker 1: I guess well, obviously because of your specialty, but particularly
Speaker 1: about Alzheimer's dementia and our failing brain power that happens
Speaker 1: as we age. Tell me about that.
Speaker 2: Well, when I was twelve or thirteen years old, my grandfather,
Speaker 2: my mother's dad, who I was very close to, developed,
Speaker 2: you know, signs of dementia. He had had a stroke
Speaker 2: earlier in his life that had recovered and was now developing.
Speaker 2: You know, just these these periods of time where he
Speaker 2: really wasn't aware of what was going on. He would
Speaker 2: sometimes make a joke that no one else was in on,
Speaker 2: you know, and it was all these things that I
Speaker 2: remember really being struck by as a kid, because you
Speaker 2: look at adults and you're not used to seeing brain
Speaker 2: power start to diminish. And it was the first time
Speaker 2: I saw really specific things like he could he could
Speaker 2: still write, but he couldn't really read. It was it
Speaker 2: was all these things that became really fascinating in a
Speaker 2: way for me in terms of just how does the
Speaker 2: brain work like that? But also to see it in
Speaker 2: a loved one to wonder, is that, how genetic? Is that? That?
Speaker 2: Is my mom going to develop those symptoms? Will I
Speaker 2: one day all of that? And then you know, fast forward,
Speaker 2: you know, thirty forty years later, and we're still worrying
Speaker 2: about the exact same things and haven't really made a
Speaker 2: lot of progress in terms of being able to deal
Speaker 2: with that. So that was a large part of what
Speaker 2: I think inspired me to write the book What has
Speaker 2: Happened over the Last forty years, both from a, you know,
Speaker 2: a pharmaceutical standpoint, but also more importantly, I think from
Speaker 2: a lifestyle behavioral standpoint in terms of what we.
Speaker 1: Know and how does that influence you to go into neurology?
Speaker 2: No, you know, it's funny, it didn't. I Actually when
Speaker 2: I started medical school, I thought I was going to
Speaker 2: go into pediatrics, and then I did a neurosurgery rotation
Speaker 2: during my third year of med school and I just
Speaker 2: sort of fell in love. So I came to it
Speaker 2: quite late, but I was always interested in the brain
Speaker 2: because of my grandfather, and so it felt like a
Speaker 2: very natural fit.
Speaker 1: Let's talk about the numbers. Because forty seven million Americans
Speaker 1: have some of and so a pre clinical Alzheimer's disease,
Speaker 1: and by twenty sixty one new case of dementia will
Speaker 1: be diagnosed every four seconds. Sonjay, what the heck is
Speaker 1: going on here?
Speaker 2: Well, this will become the most dominant neurodegenerative disease of
Speaker 2: our time. I think that part, I think is pretty
Speaker 2: well established at this point. But there was two things
Speaker 2: about the statement that you just made that I thought
Speaker 2: were really important in terms of what we could potentially
Speaker 2: do about it. As you point out, there's probably about
Speaker 2: forty seven million people who if you were to look
Speaker 2: at their brains, they would have objective evidence of plaques
Speaker 2: and tangles and things like that, but also have no symptoms.
Speaker 2: That's the pre clinical time, right.
Speaker 1: So, Okay, you're breaking me out a little.
Speaker 2: Well, it's you know, but I think this is ultimately
Speaker 2: good news, and I'll tell you why. If you look
Speaker 2: at patients with Alzheimer's disease and able to retrospectively look
Speaker 2: at their lives and their skins in their brains, you
Speaker 2: find we now know that Alzheimer's starts in the brain
Speaker 2: decades before people develop symptoms decades so you're starting to
Speaker 2: see the kindling and then even plaques and tangles. But
Speaker 2: the fundamental point that neuroscientists really started to focus on
Speaker 2: was almost the the the analog of that meaning, Okay,
Speaker 2: so now you've established it, you can have a brain
Speaker 2: that has plaques and tangles but still functions normally. So
Speaker 2: why don't we focus on that side of things instead
Speaker 2: of saying, hey, look, let's get rid of the plaques
Speaker 2: and tangles. And we have spent billions of dollars testing
Speaker 2: drugs to do that that haven't really worked. What if
Speaker 2: we say, instead, we have established that a brain with
Speaker 2: plaques and tangles can function normally. Let's figure out why
Speaker 2: and see if we can basically make that an aspiration.
Speaker 2: Do you still have objective evidence of Alzheimer's in your brain? Yes?
Speaker 2: Is it consequential no? Because you know you are able
Speaker 2: to still have normal cognitive function, memory, judgment, all the
Speaker 2: things that you associate with a healthy functioning brain. The metaphor,
Speaker 2: in some ways, Katie would kind of be like a
Speaker 2: heart bypass surgery. You got a block blood vessel. Now
Speaker 2: you go in there and you bypass that area of
Speaker 2: the blockage with a new blood vessel, Do you still
Speaker 2: have heart disease? Yes? Is it causing you some dysfunction? No,
Speaker 2: because you're getting enough blood flow now to the heart.
Speaker 2: If you can think about that same metaphor for the brain, Yes,
Speaker 2: you have plaques, but there's so many ways to build
Speaker 2: all these new pathways in the brain to your destination
Speaker 2: that little blockages due to the plaques becoming consequential.
Speaker 1: So is there a tipping point? You know, you talk
Speaker 1: about these tangles and plaques in your brain. Is it
Speaker 1: just a slow growth of plaque or slow accumulation of
Speaker 1: plaque and increase kind of tangles that then lead you
Speaker 1: from being perfectly functional? You know, maybe some memory issues
Speaker 1: right that once in a while, you know, you're not
Speaker 1: quite as sharp as you were as you when you
Speaker 1: were younger. But where you kind of fall off or
Speaker 1: it's just gradual build up of this gunk in your brain.
Speaker 2: Well, it does seem to be a pretty gradual build up,
Speaker 2: and you can tolerate a significant amount of build up
Speaker 2: before you I guess, as you say fall off, you know,
Speaker 2: so what exactly then pushes people over? It's not all
Speaker 2: of a sudden you have an exponentially more plaque, and
Speaker 2: that leads to the problem. Maybe for different people it's
Speaker 2: a different inflection point. But the brain is actually quite resilient.
Speaker 2: I mean, that's the thing that came out of this.
Speaker 2: Even with a lot of plaque and tangle, you could
Speaker 2: actually be doing fairly well. I mean, the occasional memory lapse,
Speaker 2: like you say, which is probably due more to inattention
Speaker 2: than even anything organic in the brain, but other than that,
Speaker 2: doing pretty well. And you see societies around the world
Speaker 2: where arguably brain function not only is it good, it
Speaker 2: may be improving as you get older.
Speaker 1: Which is so incredible, and that I think is one
Speaker 1: of the hopeful things about this book, that our brains
Speaker 1: can get sharper and better as we age, and dementia
Speaker 1: is not necessarily an inevitable consequence of old age. So
Speaker 1: you know, I remember reading Sanjay, how your brain like
Speaker 1: by the time you're twenty three or twenty four, and
Speaker 1: then your pre frontal lobe and all this thing that
Speaker 1: has to stuff that has to do with judgment, Like,
Speaker 1: after that, your brain really stops absorbing and growing and changing.
Speaker 1: I mean that was sort of what I always thought,
Speaker 1: And then it was downhill from there. But this book
Speaker 1: is really cause for celebration in some ways, right.
Speaker 2: Right, absolutely, you know I was told the same thing. Right,
Speaker 2: You've got a certain number of neurons in your brain,
Speaker 2: and then you're going to drain the cash as you
Speaker 2: go through life. Certain things like drinking alcohol and things
Speaker 2: like that are gonna kill more brain cells. You're never
Speaker 2: going to get them back.
Speaker 1: I think that's what our parents told us to keep
Speaker 1: us from shrink king.
Speaker 2: It works well to some extent, but the uh, you
Speaker 2: know it, but that that part of it is not true,
Speaker 2: and that may be one of the most fundamental new
Speaker 2: things that we learned. And by the way, you'll appreciate this, Katie,
Speaker 2: I'm in some ways this book. I'm acting as translator.
Speaker 2: I go to these neuroscience meetings because that you know,
Speaker 2: I live this bifurcated life between medicine and media. But
Speaker 2: I'm still going to these neuroscience meetings and they're talking
Speaker 2: about these fascinating developments, and yet that hasn't really gotten
Speaker 2: to the lay public yet. So it's about a ten
Speaker 2: year gap. In some ways, keep sharpest to just accelerate
Speaker 2: that that knowledge tree. But one of the things that
Speaker 2: they've been talking about is exactly what you mentioned, which
Speaker 2: is neurogenesis. Everyone's heard of neuroplasticity, which basically means you
Speaker 2: can recruit neurons brain cells from other areas of the
Speaker 2: brain to do new functions. This is actually growing new
Speaker 2: brain cells, and we were told throughout our lives that
Speaker 2: it basically happened twice. You know, when you were a
Speaker 2: baby and your brain was still forming, and maybe after
Speaker 2: an injury like a stroke or a traumatic brain injury,
Speaker 2: there may be a process of neurogenesis that occurs. But
Speaker 2: what these neuroscientists have really been writing about and focused
Speaker 2: on for some time is that at any age, a
Speaker 2: healthy brain can continue to grow new brain cells. You
Speaker 2: really can't say that about any other organ in the body.
Speaker 2: So it's quite incredible. The stem cell surges, the various
Speaker 2: growth factors, all these things that converge to allow you
Speaker 2: to grow new brain cells at any age. That to
Speaker 2: me was deeply inspiring.
Speaker 1: It's super exciting. But let me just backtrack for one moment,
Speaker 1: just so I understand the difference between neuroplasticity and neurogenesis.
Speaker 1: Explain it like I'm a fifth grader, So.
Speaker 2: You know, when you think of neuroplasticity, it's more like
Speaker 2: your brain is like plastic it's it's can be molded.
Speaker 2: So let's say there's been an area of your brain
Speaker 2: where someone had an injury or a stroke or something.
Speaker 2: You could sort of mold another part of the brain
Speaker 2: to fill the game compensate, compensate, yeah, exactly, you know.
Speaker 2: Take so if it was motor strength, for example, on
Speaker 2: the right side of your body that was affected, cells
Speaker 2: brain cells that normally don't do motor function, they're not
Speaker 2: responsible for motor function, could be recruited to do that
Speaker 2: sort of work. Or a sense. You know, even if
Speaker 2: you lose a sense, other senses can start to become
Speaker 2: heightened or even create.
Speaker 3: Right.
Speaker 1: You hear that with blind people, you know, in terms
Speaker 1: of a heightened sense of I guess all kinds of senses, right,
Speaker 1: that compensate for the fact that you can't.
Speaker 2: See exactly, and that and that is a that is
Speaker 2: a It's an amazing concept. It's what sort of gives
Speaker 2: real birth to physical therapy, to cognitive therapy. We're using
Speaker 2: these therapies to basically recruit neurons from other parts of
Speaker 2: your brain to do something.
Speaker 1: Body is so amazing isn't it.
Speaker 2: It continues to wonder and delight me every day. And
Speaker 2: I've been thinking about this for forty years, you know,
Speaker 2: I love it. Neurogenesis is the growth of new brain cells.
Speaker 2: So this, this, this lies in the face of what
Speaker 2: we were all told when we were young, that you
Speaker 2: only have a certain number of brain cells and that's it.
Speaker 2: This is basically saying you can create new brain cells
Speaker 2: at any age. The metaphor I think that may make
Speaker 2: it more more accessible is right now, our COVID life
Speaker 2: is kind of like how our brain operates. And what
Speaker 2: I mean is that you probably are at home. You
Speaker 2: may drive to the grocery store, maybe you drive to
Speaker 2: a couple of different places and you but you're not
Speaker 2: You're mostly in just a small, small square sort of
Speaker 2: area of place. You know how to get to all
Speaker 2: those places really well. You could drive there with your
Speaker 2: eyes closed, no problem. But you you're not traveling around
Speaker 2: the rest of the world. You're not even traveling around
Speaker 2: the to the state. Right now, that's kind of how
Speaker 2: our brains are. We use our whole brain, but ninety
Speaker 2: percent of the time we're using ten percent of our brains.
Speaker 2: That's the thing. If you start to actually do things
Speaker 2: to inspire neurogenesis in your brain. It's kind of like
Speaker 2: building new cities and visiting those new cities in your brain.
Speaker 2: It's a little bit of a simplistic metaphor, but it
Speaker 2: makes me really happy to think about, because visiting other
Speaker 2: places in your brain is an incredibly joyous thing. You
Speaker 2: start to see patterns that you would have otherwise missed.
Speaker 2: You connect dots, you're thinking is clearer, and that's the
Speaker 2: whole concept of what neurogenesis can do for you.
Speaker 1: When we come back Sanch's advice on how to keep
Speaker 1: our brains strong, especially as we age, well, take me
Speaker 1: on a trip, okay, and how can I visit these
Speaker 1: new places in my brain? Because this is really exciting
Speaker 1: And I know your book has a lot of recommendations
Speaker 1: for ways that we can encourage neurochemphasists.
Speaker 3: So what do I do, Sanjay?
Speaker 2: Yeah, well, so you know, the way I'll tell you
Speaker 2: the way that I wrote the book was I took
Speaker 2: all these these neuroscience concepts and try to make them
Speaker 2: accessible and also help you set up a substrate for
Speaker 2: your brain in terms of you know, how you nourish yourself,
Speaker 2: how you rest your brain things like that. So the
Speaker 2: basics are there, but your question is more about taking
Speaker 2: the trip and building the new brain cells. So after
Speaker 2: you sort of, you know, make sure and it's not
Speaker 2: challenging to get to the right sort of place in
Speaker 2: terms of your diet, you know, and and the amount
Speaker 2: of rest that you need. That's important. But the biggest
Speaker 2: I think difference with growing new brain cells versus how
Speaker 2: we typically think about strengthening our brain is that you
Speaker 2: don't necessarily want to just keep doing the same things
Speaker 2: over and over again. The whole practice makes perfect sort
Speaker 2: of teaching, the kill and drill sort of teaching that
Speaker 2: a lot of schools focus on. It's important to understand
Speaker 2: and be able to learn concepts. But that's kind of
Speaker 2: like those roads I was talking about that you travel
Speaker 2: so well, that's like getting even better at traveling those
Speaker 2: same roads. Now you can really do it with your
Speaker 2: eyes closed. Now you know, it's totally second nature to you.
Speaker 2: But if you were to do different things, totally different things,
Speaker 2: things that get you out of your comfort zone a
Speaker 2: little bit and a totally different sort of hobby, that's
Speaker 2: when you're starting to actually build some of these new
Speaker 2: brain cells, create some of these new cities create some
Speaker 2: of the new roads, whatever metaphor you want to apply
Speaker 2: to it. That's a much better way to sort of
Speaker 2: do that versus the practice makes perfect. So if practice
Speaker 2: makes perfect, change is what's going to build the neurogenesis.
Speaker 2: It's going to be the resilience and redundancy in your brain.
Speaker 1: So I played the piano. Should I not focus as
Speaker 1: much on the piano? Because I thought about taking lessons
Speaker 1: even though I took for ten years and I played
Speaker 1: by ear.
Speaker 3: But I enjoyed the piano.
Speaker 1: And we actually have a beautiful piano that Jay and
Speaker 1: I bought each other for.
Speaker 3: Our birthdays back in the day.
Speaker 1: Yeah, but should I learn how to play the guitar
Speaker 1: or the viol of the violin sounds just horrible if
Speaker 1: you're not good at it. But what I mean, should
Speaker 1: I try a new instrument?
Speaker 2: Yeah? You know. So I asked a lot of neuroscientists
Speaker 2: about this, because one thing about writing a book like
Speaker 2: this is that it affects everybody. Right, So even the
Speaker 2: guys and gals who are doing all this research, they're
Speaker 2: thinking about what to incorporate into their own lives. And
Speaker 2: there are a couple of things that sort of jumped
Speaker 2: out at me. One is that something new is I
Speaker 2: think really important. That is a key, but something that
Speaker 2: you can also use your hands with that you're actually
Speaker 2: activating your motor cortex as you're doing, seems to be
Speaker 2: even more benefit. So an instrument is great painting, Try
Speaker 2: a new one because a new one, yes, I mean
Speaker 2: I mean the piano again. I want to be careful here.
Speaker 2: I did this Bill Clinton. I was talking to him
Speaker 2: about brain health the other day and he got on
Speaker 2: my case because he said he loves crossword puzzles. And
Speaker 2: he's like, so you tell me crossword puzzles are not
Speaker 2: good for No. No, I'm not saying don't do those things,
Speaker 2: but understand what you're accomplishing. You are you are. You're
Speaker 2: paving those roads really really well in your brain, and
Speaker 2: that is great. There's great value in that. But if
Speaker 2: it is true that you can build all these new roads,
Speaker 2: and the question you're asking me is how to do that,
Speaker 2: then it would be it would mean doing something different.
Speaker 2: So I'm not saying stop playing the piano, keep driving
Speaker 2: those roads, but if you want to start going on
Speaker 2: these trips around your brain, doing something different and preferably
Speaker 2: doing it in a way that may be even a
Speaker 2: little uncomfortable. So if you're painting, and I just bring
Speaker 2: up painting, because this is the one that came up
Speaker 2: several times among these neuroscientists. Learn how to paint. I'm
Speaker 2: a terrible artist. Learn how to paint. Do whatever you can,
Speaker 2: and do it with your non dominant hand. Do it
Speaker 2: with your yes. This was another. In fact, they went
Speaker 2: so far as to say that tonight at dinner, when
Speaker 2: you're eating your dinner, try eating your meal with your
Speaker 2: non dominant hand and just see what happens. And it's
Speaker 2: really interesting, Katie, because we think of building the brain
Speaker 2: means reading books and gaining new knowledge, and that's true,
Speaker 2: but in terms of actually creating neurogenesis, it's more like
Speaker 2: you think about a physical workout. I'm going to do
Speaker 2: something different, and I'm going to actually now focus the
Speaker 2: left side of my brain, which normally isn't doing motor
Speaker 2: function that's delicate or fine. On actually doing that sort
Speaker 2: of stuff. It has real relevance because again, you're you're
Speaker 2: actually building these roads in these cities in your brain,
Speaker 2: and that's fun. Try it. It's fun, but on a
Speaker 2: more practical level. To your original question, Let's say one
Speaker 2: day the road that you drive so well becomes blocked
Speaker 2: by one of these amyloid plaques that we're talking about,
Speaker 2: some of these tangles. Right now, you know that road
Speaker 2: really well, but you know what, you don't really have
Speaker 2: other roads to get from point A to point B.
Speaker 2: If you've been building all these roads by painting with
Speaker 2: your left hand and spilling your food, by eating with
Speaker 2: your non dominant hand, whatever it might be, you're actually
Speaker 2: building roads. This gets back to the bypass analogy. Do
Speaker 2: you still have clacks entangles in your brain? Yes?
Speaker 1: So are these the cognitive reserves that you're talking about, Yes.
Speaker 2: The cognitive reserves, the cognitive resiliency, which is often they
Speaker 2: often use these terms interchangeably, but that's exactly it. We
Speaker 2: have the capacity to have significant cognitive reserve. We're barely
Speaker 2: tapping into that. If you look at societies around the
Speaker 2: world where people are living into their nineties and hundreds
Speaker 2: and have hardly any dementia, the presumption now is that
Speaker 2: if you were to image their brains, they might have
Speaker 2: plaques and tangles. If you were doing autopsy, they may
Speaker 2: be diagnosed with Alzheimer's because that's how Alzheimer's was diagnosed
Speaker 2: was that autopsy. But the truth of the matter is
Speaker 2: that during their lives they had perfectly normal cognitive function.
Speaker 1: Before we talk about your twelve week program, I'm just
Speaker 1: curious in terms of diagnostic advances and therapeutic advances. I mean,
Speaker 1: will we get to a point where someone can have
Speaker 1: a brain scan and say, Okay, here's the status of
Speaker 1: your tangles and plaques, and.
Speaker 3: Here's what you need to do.
Speaker 1: Because brain imagery, you know, I always found it so interesting,
Speaker 1: even when you talk about like antidepressants and you know,
Speaker 1: serotonin reuptake inhibitors or whatever they're called ss rise. Yeah,
Speaker 1: that you know, there was never a way until recently
Speaker 1: to kind of measure how the brain was reacting. They
Speaker 1: would just kind of it would be very anecdotal, you
Speaker 1: kind of throw it against the wall to see what sticks.
Speaker 1: And now we have so much better brain imagery. So
Speaker 1: will that translate into dimension Alzheimer's and preventative strategies that
Speaker 1: we could follow.
Speaker 2: I think so. I mean, we're making a lot of
Speaker 2: progress on brain imaging, and you're absolutely right. I mean,
Speaker 2: the brain has long been sort of considered this black box,
Speaker 2: only measured by its inputs and its outputs. You really
Speaker 2: couldn't get a good idea of its internal machinery, but
Speaker 2: now we can. I mean, I don't know that we're
Speaker 2: at the point yet where we can determine degree of
Speaker 2: severity of dementia based on a scan. And as I say,
Speaker 2: I think we will.
Speaker 3: You think we'll get to that point though.
Speaker 2: I think we'll get to the point where we can
Speaker 2: very quantifiably measure the burden of plaques and tangles and
Speaker 2: other things in the brain. But again, what I think
Speaker 2: is so extraordinary, Katie, is that you could have two
Speaker 2: people with the exact same scan essentially and very different
Speaker 2: clinical pictures. One person may be completely debilitated, obviously having dementia,
Speaker 2: and the other person maybe functionally cognitively normal. Right, And again,
Speaker 2: I look, do I I don't want to I don't
Speaker 2: want to have blackx entangles in my brain, But mostly
Speaker 2: what I don't want to have is the cognitive dysfunction
Speaker 2: that comes with that. It's a different way of thinking.
Speaker 2: It really is, like I think, again, we focus so
Speaker 2: much on making someone's images look better or whatever, and
Speaker 2: what the person really wants is them to be better,
Speaker 2: and there are ways to do that you know, with
Speaker 2: lifestyle changes. I mean, I'm a neurosurgeon saying this. By
Speaker 2: the way, just remember that because I'm a specialist. That's
Speaker 2: that's what I was trained to do. And yet I'm
Speaker 2: now becoming increasingly convinced that these types of changes that
Speaker 2: we talk about in this book really can can prevent
Speaker 2: you from developing the symptoms of dimasasion.
Speaker 1: I was going to say, so you're saying that brain
Speaker 1: scans are just part of the story. It's sort of
Speaker 1: like it's half of the story because even with them,
Speaker 1: you could have these cognitive reserves developed and be very asymptomatic. Well,
Speaker 1: let's talk about this twelve week program. Sharp take us
Speaker 1: through the steps, because I'm all ears.
Speaker 2: It's it's twelve weeks where I basically based on how
Speaker 2: I think your brain is going to change and react
Speaker 2: to things that you're now doing that are different or new.
Speaker 2: It all sort of builds on itself. I start off
Speaker 2: by really making sure you get the basics right, and
Speaker 2: I'll tell you it's not that complicated. There are a
Speaker 2: few big messages in terms of the overall getting it
Speaker 2: the substrate right, and as you might guess, diet nourishment
Speaker 2: is one of them. But the big takeaway here is
Speaker 2: I think generally people know what a healthy diet is,
Speaker 2: and for those who don't, there's some information in there
Speaker 2: about what's specifically healthy for the brain. There are some
Speaker 2: distinctions between the brain and the body in this regard.
Speaker 2: One is sugar. You know, we talk a lot about sugar,
Speaker 2: and people know that they shouldn't need too much sugar.
Speaker 2: We used to get sugar, you know, twice a year
Speaker 2: when fruit fell from the trees. Even honey was protected
Speaker 2: by the bees. And now we're eating one hundred and
Speaker 2: thirty a year on average of sugar. But what was
Speaker 2: a learning point for me was that the brain is
Speaker 2: exquisitely sensitive to sugar. So typically you eat a lot
Speaker 2: of sugar and you think, well, that's being absorbed in
Speaker 2: the cells. I have a lot of energy, whatever it
Speaker 2: might be. These these are a lot of calories that
Speaker 2: are now providing me energy the brain. As soon as
Speaker 2: sugar levels get beyond a certain point, and it's a
Speaker 2: pretty narrow range, the receptors basically shut down. So you
Speaker 2: could run into a situation where you're taking in a
Speaker 2: lot of calories, a lot of energy and starving your
Speaker 2: brain at the same time, and that is a situation
Speaker 2: that leads to a whole cascade of events that you
Speaker 2: can pretty easily avoid. So that's, you know, as much
Speaker 2: as I talk about in the first few weeks of
Speaker 2: what to do, there are several things that you're told
Speaker 2: not to do just to avoid, and that's that's more
Speaker 2: than half the battle, and they're not that hard to do.
Speaker 2: I also try to make the case for things like sleep,
Speaker 2: which you've read a lot about I've read a lot about,
Speaker 2: but reminding people just how metabolically active the brain is
Speaker 2: during sleep, and this wonderful conversation that I'm having with
Speaker 2: you right now will be encoded into my hippocampus if
Speaker 2: I get good sleep tonight, so that twenty years from
Speaker 2: now I can recall this and remember it. A lot
Speaker 2: of times people say that they can't remember something. It's
Speaker 2: not that they can't remember that, it's not that they
Speaker 2: forgot it, it's that they never actually stored it in
Speaker 2: their memory centers in the first place. So these are
Speaker 2: strategies to help that. But then, you know, sort of
Speaker 2: the midpoint of the book is really about the evidence
Speaker 2: based things that we know improve brain health. Starts off
Speaker 2: by asking you to define what you think a healthy
Speaker 2: brain is? What is a healthy brain? We know what
Speaker 2: a healthy heart is. It pumps a certain amount of
Speaker 2: blood out with each beat. What is a healthy brain?
Speaker 2: You know? And I spend a little bit of time
Speaker 2: talking through talking to the reader through how they define that,
Speaker 2: because it is different for different people. Robert Sapolski, who
Speaker 2: is this evolutionary biologist, I was interviewing him, and he
Speaker 2: and her forget. He said to me that a healthy
Speaker 2: brain is a is A is a brain that has
Speaker 2: a bigger circle of you is what he said, which
Speaker 2: basically means you let more people into your circle. Now
Speaker 2: why is that relevant? Well, it's relevant and you know
Speaker 2: ancient times because you are more likely to be protected
Speaker 2: by the group. But now it's this idea of what
Speaker 2: true connection does for protection of the brain. And and
Speaker 2: and now to your earlier point, measurable. You know, a
Speaker 2: lot of what we talk about is based on objective
Speaker 2: data that we couldn't collect some time ago. But I
Speaker 2: will tell you something fascinating because I find this topic
Speaker 2: really interesting. But there's this loneliness researcher named Stephanie Cacciopa.
Speaker 2: She's an Oregon.
Speaker 1: I know, I know, she's in Chicago. Her husband was
Speaker 1: one of the preeminent scientists about memory, and then he died.
Speaker 2: I died, I know. And now she's an organ and
Speaker 2: I talked to her from time to time. It's been tough,
Speaker 2: as you might imagine. And she's by herself an organ
Speaker 2: which you know, as a loneliness researcher through this pandemic
Speaker 2: has been such a significant thing for her. But she
Speaker 2: said this thing to me that I'll never forget, and
Speaker 2: and I talk a little bit about it in the book,
Speaker 2: which is we talk about connection, Like right now you
Speaker 2: and I get to zoom and have this call about
Speaker 2: you know, this this conversation that's very interesting to me.
Speaker 2: Most connections that we have with friends, maybe even family
Speaker 2: to some extent, are pretty cursory. How you doing, I'm
Speaker 2: doing fine, How you doing, I'm doing fine? You know,
Speaker 2: it's how do you get to a level of more
Speaker 2: profound connection, because it wasn't. As you've well heard, it's
Speaker 2: not about the number of connections you have. It's about
Speaker 2: the quality. But what does that mean quality? And one
Speaker 2: thing Stephanie said to me was a sort of shortcut
Speaker 2: to building the quality and the high intensity connection is
Speaker 2: to be vulnerable to ask for help, to share your problems,
Speaker 2: which is totally counterintuitive to how I think about things.
Speaker 2: I would rather not burden somebody with things. But I
Speaker 2: took it to heart, and I was talking to my parents,
Speaker 2: who are in their late seventies in Florida through this pandemic,
Speaker 2: and we were having those conversations how you do and
Speaker 2: how the girls? That was the conversation for months, and
Speaker 2: I said to them, I asked them a question about
Speaker 2: a problem I was having one of my cars, that
Speaker 2: my wife's car had some smoke coming from the hood.
Speaker 2: They're both engineers, and for days, Katie, we started to
Speaker 2: have these really interesting conversations about cars, about their history
Speaker 2: of being interested in engineering and all this stuff. Figure
Speaker 2: out the way to build the meaningful connection that is
Speaker 2: that is probably one of the most critical points, and
Speaker 2: there are pretty easy ways to do it.
Speaker 1: I think the point is connection, deep connection is good
Speaker 1: for your brain, yes, and good for you, and I
Speaker 1: think you know it's good for you in general.
Speaker 2: So the last part of the twelve week program, I'll
Speaker 2: just tell you quickly, is more about what we started
Speaker 2: talking about initially, which is, then, how do you create
Speaker 2: Now that I've primed your brain for neurogenesis, giving you
Speaker 2: all right amounts of the right hormones, not too much epinephrine,
Speaker 2: but enough oxytocin, and all that sort of is happening
Speaker 2: by going through the first few weeks of the program. Now,
Speaker 2: how do you build the new brain cells? And that
Speaker 2: gets to a lot of what we were talking about
Speaker 2: in terms of that cognitive reserve, you know, actually doing
Speaker 2: these different types of activities, doing similar activities in a
Speaker 2: totally different way, doing things with different people, doing them
Speaker 2: in at different times, eliminating certain things completely from your
Speaker 2: regimen for a while, adding in something totally unrelated. It
Speaker 2: was fascinating to me. I tried it. I based this
Speaker 2: entire thing on my conversations with these neuroscientists who all
Speaker 2: tried it and written about it and published it in journals.
Speaker 2: It's fun. It's a fun ride.
Speaker 1: I was going to say, So give me some ideas
Speaker 1: real quickly before we go about things I could do.
Speaker 1: Should I take a pottery class, Should I learn Italian?
Speaker 3: Should I pick up the guitar? What should I do?
Speaker 2: I think that you know, I think the two big
Speaker 2: and greens. It's got to be something you really haven't done. Before.
Speaker 2: This isn't about trying to again build a two lane
Speaker 2: highway where you're used to driving one. This is about
Speaker 2: getting to Italy instead of staying in New York or
Speaker 2: going somewhere even different, Argentina, you know, totally different. If
Speaker 2: you can do something that involves your hands, like pottery
Speaker 2: or painting, even better, that was something that came up
Speaker 2: over and over again. And then the second ingredient I guess,
Speaker 2: and this is a little bit more vague, is that
Speaker 2: it's good if it makes you a little uncomfortable. And
Speaker 2: I know that sounds almost euphemistic or too easy or
Speaker 2: too simple, but the whole point is that when you
Speaker 2: start to release certain hormones in the body, like some
Speaker 2: stress hormone, stress can be good. It really helps that
Speaker 2: process of neurogenesis. So a little bit of discomfort with
Speaker 2: something totally new, preferably using your hands, that's a pretty
Speaker 2: good prescription.
Speaker 1: Before we go, can you tell me about foods that
Speaker 1: are healthy brain foods. I know that you hear about fish,
Speaker 1: you hear about nuts, you hear about extra virgin olive oil.
Speaker 3: Are all those things sort of good brain food?
Speaker 1: And what else should I be eating other than staying
Speaker 1: away from the cupcakes.
Speaker 2: Yeah, no, right, yes, definitely do the sugar thing I
Speaker 2: mentioned already, So, I mean that's just a I think
Speaker 2: you could accomplish seventy percent of all the other things
Speaker 2: by basically just eliminating added sugar from your diet. But
Speaker 2: I think the adage what is good for the heart
Speaker 2: is good for the brain remains true. But I think
Speaker 2: with the brain there are a few few distinctions. One is,
Speaker 2: if an apple a day keeps a doctor away, then
Speaker 2: berries are what's good for the brain. Berries really good
Speaker 2: data around berries. Really start to add berries into your diet.
Speaker 2: I think that's one of the big ones. And while
Speaker 2: most of the neuroscientists did not advocate a caloric restriction diet,
Speaker 2: necessarily a calorie reduced diet overall to the extent that
Speaker 2: you can do it. We create a lot of metabolic
Speaker 2: byproducts from overeating, and a lot of those metabolic by
Speaker 2: products get accumulated in the brain. So if you can
Speaker 2: cut down on the amount of energy that has to
Speaker 2: be metabolized in that way, you can make a lot
Speaker 2: of progress.
Speaker 1: Even though berries may be good for your brain, you
Speaker 1: don't believe in this whole idea of supplements or superfoods.
Speaker 3: Do you no?
Speaker 2: I you know, I think superfood first of all, is
Speaker 2: a really vaguely defined term. As part of this book,
Speaker 2: I asked a lot of people and I even talked
Speaker 2: to your friend Mark Hyman about this as well. It
Speaker 2: doesn't have a really objective meaning. There are some foods
Speaker 2: that are maybe better than others. But I think the
Speaker 2: thing about supplements that struck me was the idea that
Speaker 2: for certain people who have deficiencies, then supplementing that part
Speaker 2: of their diet's important. But you know, Katie, in this country,
Speaker 2: and I'm not advocating this, but in this country, even
Speaker 2: the standard American diet, like if you go to a
Speaker 2: MacDonald even the food is largely fortified, you know, with
Speaker 2: all these different vitamins and micronutrients and things like that.
Speaker 2: That is a decision that our USDA made decades ago
Speaker 2: to fortify food so that people wouldn't develop basic nutritional deficiencies.
Speaker 2: So oftentimes we're supplementing something that doesn't need to be supplemented.
Speaker 2: A lot of a lot of the approach is more
Speaker 2: in terms of what you're not eating versus what you
Speaker 2: are eating, and that you know that holds up to
Speaker 2: be true, So berries I single out because they are
Speaker 2: one of these foods whose active ingredients are particularly good
Speaker 2: at crossing the blood brain barrier, particularly good at creating
Speaker 2: these scaffoldings, you know, for the neurogenesis that we talked
Speaker 2: about earlier. So I put that high on the list.
Speaker 1: But what about you know, I see this stuff in
Speaker 1: the drug store and I'm like, Oh, should I be
Speaker 1: taking like prevagen or should I be taking what is
Speaker 1: it like? Almost isn't it like jellyfish derivatives and stuff?
Speaker 3: And I'm like, should I be doing that?
Speaker 2: Well? You know, the privilege in one is interesting because
Speaker 2: you know, Eric Candell is very involved with this, and
Speaker 2: he's a very prominent neuroscientist. Did a lot of the
Speaker 2: original jellyfish research, basically trying to figure out where the
Speaker 2: memory stores were in jellyfish, how jellyfish remembered, and isolating
Speaker 2: those stores and basically creating a supplement. It's a fascinating idea.
Speaker 2: I don't know that it really works. I mean, it's
Speaker 2: very hard to study this sort of thing. You know,
Speaker 2: it takes decades long studies to prove that something like
Speaker 2: that's improving memory. What we do have is decades long
Speaker 2: data on societies around the world where dementia is essentially
Speaker 2: so rare that it's reportable. You know, if somebody developed dementia,
Speaker 2: you'd report that in the medical journal. But my point
Speaker 2: is though, that with these we don't need to have
Speaker 2: the supplements. We know it's possible to be done because
Speaker 2: we see it having already transpired real time and large
Speaker 2: societies across the world. And in those societies, you know,
Speaker 2: I took the neuroscientific data that we had and tried
Speaker 2: to see, are they in some ways applying that unwittingly?
Speaker 2: I mean, they didn't read these papers obviously, but were
Speaker 2: they sort of just by default essentially following that right diet,
Speaker 2: following that right amount of movement, following the right amount
Speaker 2: of rest. So movement, for example, I'll just tell you
Speaker 2: this was an interesting one. If you look at movement,
Speaker 2: it's probably the only thing that has has the longest
Speaker 2: amount of evidence behind it in terms of actually creating neurogenesis.
Speaker 2: All of this is new research, but that's sort of
Speaker 2: the oldest new research. But what was fascinating to me
Speaker 2: was that what does movement mean to people? Right? I
Speaker 2: use the word movement instead of exercise, because what they
Speaker 2: found was that moderate movement, brisk walking, that tended to
Speaker 2: be a lot better for neurogenesis than intense exercise. Now
Speaker 2: why would that be Well, it turns out that when
Speaker 2: you briskly exercise, you're releasing a lot of what is
Speaker 2: known is brain derived neurotrophic factor. That's kind of like
Speaker 2: the miracle grow for your brain. As was described, if
Speaker 2: you are intensely exercising, you also tend to release a
Speaker 2: lot of epinephrine. And epinephrine is actually a blocker, It's
Speaker 2: a cascade blocker of what BDNF, this neurotrophic factor does.
Speaker 2: I know, I'm throwing a lot of language at you,
Speaker 2: but that's okay.
Speaker 3: I'm following.
Speaker 2: Intense exercise may be great for your heart and you know,
Speaker 2: maybe even weight loss, whatever your goals may be. But
Speaker 2: for your brain, intense exercise actually is not good. And
Speaker 2: you find that can actually be a little bit destructive
Speaker 2: by releasing these stress hormones that block the beneficial effects
Speaker 2: that exercise should have on your brain. I never knew that,
Speaker 2: and it so like I think, I go for a
Speaker 2: walk as often as I can with Rebecca. Now that
Speaker 2: wasn't something I did. I was out there thinking I
Speaker 2: got forty minutes, I'm going to go hard. That was
Speaker 2: my sort of approach, and sometimes I still feel the
Speaker 2: need to do that. But walking is great, brisk here's
Speaker 2: the best way to do it. If you want to
Speaker 2: just make it for your brain. Take a brisk walk
Speaker 2: with a close friend or family member and talk about
Speaker 2: your problems, and that sort of brings all these things
Speaker 2: together in some ways that we've been talking about. Take
Speaker 2: your you're very smoothie with you and you've pretty much
Speaker 2: nailed it.
Speaker 1: I'm curious about social media and the way we live
Speaker 1: our lives. You know, we're constantly distracted, we have constant
Speaker 1: incoming information, Our attention spans have shortened. I read a
Speaker 1: fascinating study a while ago that said the part of
Speaker 1: your brain I think it's a hipocampus, you can correct
Speaker 1: me if i'm wrong, responsible for creativity. It only fires
Speaker 1: up when you're bored, and that's why you have so
Speaker 1: many great ideas when you're in this shower, when you're
Speaker 1: not distracted, or when you're taking a long walk and
Speaker 1: you don't have your phone with you.
Speaker 3: And I'm curious the.
Speaker 1: Impact of all this mental stimulus or stimulus lie has
Speaker 1: on neurogenesis and keeping our brains healthy.
Speaker 2: Yeah, okay, it's a great topic, and I approach it
Speaker 2: as a person who wrote this book frankly, also as
Speaker 2: a dad of three teenage girls, because and this is
Speaker 2: conversation topic number one on our household all the time.
Speaker 2: And and I'll tell you two things that actually came
Speaker 2: out of a dinner time conversation I recently had. And
Speaker 2: I try not to be too preachy with my girls,
Speaker 2: although sometimes I can say I don't use this line often,
Speaker 2: but I can say I did write a book about that.
Speaker 2: The girls hate it when I do that, but it's true,
Speaker 2: and I can use that as a wild card to
Speaker 2: actually get them to listen to what I'm saying about
Speaker 2: the fact that when you are distracted like that and
Speaker 2: you think maybe even you are multitasking, the brain is
Speaker 2: actually not that good at multitasking. It actually requires a
Speaker 2: lot of energy to shift back and forth between things,
Speaker 2: between scrolling through your social media feed, trying to have
Speaker 2: a conversation, trying to look your dad in the eye
Speaker 2: when he's talking to you, whatever it might be. It's
Speaker 2: hard to transition back and forth between all these things.
Speaker 2: We think we're being efficient and we're not because the
Speaker 2: amount of energy it takes to actually make the switch
Speaker 2: is a lot higher than we realized. That's kind of
Speaker 2: novel thinking, because you know, it's always been about multitasking.
Speaker 2: How many things can I do at the same time.
Speaker 2: But the second thing, which I think is, you know
Speaker 2: I worry about the most, and I think is what
Speaker 2: you're saying as well. Is that leaving aside just the
Speaker 2: content on social media for a second, and just the
Speaker 2: fact that it's so incessant, like you're saying, when we
Speaker 2: talk about stress and on the brain and on the body,
Speaker 2: stress in and of itself is not the enemy. I mean,
Speaker 2: in fact, we need stress. I was a little nervous
Speaker 2: to do this podcast with you today because I have
Speaker 2: so much respect for you. But it makes me a
Speaker 2: little stressed because I have that nervousness. But it's good.
Speaker 2: I need that because I prepared for this. But the
Speaker 2: problem is that we can't get a break from the
Speaker 2: stress social media screens, the incessant nature of it make
Speaker 2: it very differentficult for us to ever turn the stress off.
Speaker 2: We don't want to turn it off completely or never
Speaker 2: have it. That would not be a worthy or possible goal.
Speaker 2: But we don't get breaks from it. And that's what
Speaker 2: I worry about the most with my girls myself to
Speaker 2: some extent, although I'm much more aware of it, But
Speaker 2: that's what I worry about, Katie.
Speaker 1: So you're saying that it's really important to put the
Speaker 1: phones down, put them away, even studies that show if
Speaker 1: it's on a table it's distracting by its very presence,
Speaker 1: because you can't have a deep, focused conversation with that
Speaker 1: thing in your line of sight.
Speaker 2: Right. The distraction, just the presence of it, whatever it
Speaker 2: may be, it takes you away from being in the moment.
Speaker 2: And again, I know some of this sounds so euphemistic
Speaker 2: and maybe you've heard it all before, but now the
Speaker 2: data is there. I mean, I mean smartphone has only
Speaker 2: really been around since two thousand and five, Katie. I mean,
Speaker 2: think about that teen years, and it's not that long,
Speaker 2: and we've had some of the biggest behavioral shifts ever
Speaker 2: recorded in human history during that time.
Speaker 1: You talk about kind of constant stress and you need
Speaker 1: stress in them recovery. I guess that's because your brain
Speaker 1: is producing too much cortisolve, right, I mean, the stress hormone,
Speaker 1: or is it doing a lot of other stuff.
Speaker 2: Physiologically, I think I think the thing that that is
Speaker 2: becoming clearer is that the absolute amount may not be
Speaker 2: as important as how long your cells are are sort
Speaker 2: of exposed to the to the stress hormone, you can
Speaker 2: have these amazingly high spikes. And they saw this in
Speaker 2: people fighter pilots, people who are in these incredible situations
Speaker 2: for periods of time, really high spike, so high in fact,
Speaker 2: that the blood vessels in the back of their eyes
Speaker 2: would change. They would have to account for blurriness of
Speaker 2: vision because they're they're they're epinephrin spike so high. But
Speaker 2: the when they weren't, and that's a situation they had
Speaker 2: incredibly low levels of stress, really high heart rate variability.
Speaker 2: Heart rate variability is a really interesting measure of this
Speaker 2: because if you have high heart rate variability, that's good.
Speaker 2: That means that means your your bloodvessels aren't clamped down
Speaker 2: by all the stress hormones. They're the kind of loose
Speaker 2: and the variability is good. And so it wasn't the
Speaker 2: spikes in cortisol, epinephron other stress hormones as much as
Speaker 2: it was them staying plateauing at an at an unreasonably
Speaker 2: high level.
Speaker 1: Interesting when it comes to stress and closing because I've
Speaker 1: kept you far too long, sign Jay, but I could
Speaker 1: talk to you all day. Is what is the impact
Speaker 1: of this year plus of really for many people, this
Speaker 1: constant stress, and how is that going to, in your view,
Speaker 1: affect us in terms of collective trauma?
Speaker 2: You know, we we have pretty pretty good data on
Speaker 2: what these stress hormones in prolonged periods of time due
Speaker 2: to the brain we've you know, that's been documented now
Speaker 2: in all sorts of different studies. Nothing quite like this, obviously,
Speaker 2: because this is so unique, And that's why I still
Speaker 2: preface by saying I don't know for sure. With great humility,
Speaker 2: I try and answer some of these questions, but I
Speaker 2: think there will be an impact. But I think that
Speaker 2: we've also learned that we can grow new brain cells,
Speaker 2: though we can recover from that. We can create situations
Speaker 2: where it doesn't become such a incessant memory that it
Speaker 2: basically leads to post traumatic stress, which is a real
Speaker 2: concern as well. There will be people that have significant
Speaker 2: amounts of post traumatic stress, but our ability to treat that,
Speaker 2: to recognize it is better than before, and our ability
Speaker 2: to build new brain cells to help compensate is better
Speaker 2: than before, so impact significant, but solutions you know emerging
Speaker 2: as well.
Speaker 1: So it is possible to heal. I hear you say.
Speaker 2: It is possible to heal. And we've seen it before,
Speaker 2: you know, with other even other pandemics.
Speaker 1: A huge thank you to my friend doctor Sanche Gupta,
Speaker 1: who you can watch on CNN or listen to on
Speaker 1: his daily podcast Coronavirus Fact or Fiction. His new book,
Speaker 1: by the way, is called Keep Sharp, How to Build
Speaker 1: a Better Brain at Any Age. And I want you
Speaker 1: all to know I just ate breakfast using my left hand.
Speaker 1: Next Question with Katie Kirk is a production of iHeartMedia
Speaker 1: and Katie Kirk Media. The executive producers are Me, Katie Kirk,
Speaker 1: and Courtney Ltz. The supervising producer is Lauren Hanson. Associate
Speaker 1: producers Derek Clements, Hriana Fassio, and Emily Pinto. The show
Speaker 1: is edited and mixed by Derek Clements. For more information
Speaker 1: about today's episode, or to sign up for my morning newsletter, Wakeupcall,
Speaker 1: go to Katiecuric dot com. You can also find me
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