The Brain / Body Connection With Dr. Ryan Williamson

Adiel Gorel is joined by US Navy Veteran and Neurologist, Dr. Ryan Williamson in this all-important episode about the brain-body connection as it relates to our overall health and wellness. Join Adiel and Dr. Williamson as they explore critical lifestyle changes people in the western world should make…now! Sleep, diet, exercise and more all impact the health of our brain, which in turn impacts the health of all our organ systems and the body as a whole. Don’t miss this all-important conversation about how you can optimize your brain for overall regeneration of the body’s systems.

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The Brain / Body Connection With Dr. Ryan Williamson

Why Dr. Ryan Williamson Became A Neurologist

I’m excited because we have with us Dr. Ryan Williamson, a neurologist. We all care very much about our brains, so this is very timely. I can’t wait to learn more from you. Welcome, Ryan.

Thank you, Adiel. I’m very happy to be here. I appreciate you having me.

Why Dr. Ryan Williamson Became A Neurologist

At the risk of sounding like a very rote, typical interviewer, I will ask a rote question. Tell us the path that you took to get here.

I’m happy to share that. Like a lot of people who end up in medicine, I suffered some loss early. I lost some relatives and people I was close to, which fueled my drive to understand how the human body works. A very common story of people in healthcare. That led me into medical school eventually, which I found fascinating, how the body works on a mechanistic level, and what can go wrong. I ultimately fell in love with neurology and the brain. The brain is fascinating, and how we work and how we’re wired.

I always felt called to serve in the military. I took a Navy scholarship to pay for medical school. Once I was done with my service commitment, I stepped back into civilian medicine, where I was seeing older patients. I didn’t realize this at the time, but in my first few years of practice, I was seeing healthy people by definition. I suppose I realized that, but I didn’t appreciate how much I enjoyed that, and keeping people healthy and keeping Marines and sailors combat effective.

It wasn’t until I returned to seeing an older population that was showing up with recurrent strokes, heart attacks, dementia, brain death, all of these horrible things that I have to tell people, my resources to make a meaningful difference in people’s lives were very limited at that point. People had lived 20, 30, 40 years or more with these chronic conditions that led to this ultimate event that was life-changing, disabling, or life-ending.

I and a lot of other physicians that I’ve come across are very frustrated by that, and the limitations of Western medicine and healthcare, and the way we do things. I said, “There has to be a better way.” I had this idea to go write a book. We can get into this, but my book will be out in the fall of 2025, The Incredible Brain, and it’s designed to look at the evidence about how we can understand our brains and bodies, and what we can do to be healthier and live longer lives. Some data is pretty fun to go through.

The moment that I did that, I reached out to a mutual connection between Chad and me. Amber Vilhauer is a person who writes books, builds websites, and does all these fun things. The day after I emailed Amber, my lifelong best friend died unexpectedly. He was a healthy guy. It was an accident. This made me rethink what I am doing with my life. It reinforced the desire and the reflection to go help more people, and to do this at scale and not sit here effectively with my hands tied, or at least one hand tied behind my back to provide limited care to people.

This doesn’t come to me from just a theoretical or an armchair vantage point. It’s professional and it’s personal. I’m very motivated to get this message out to the world to help as many people as I can. Hence, we launched Transcend Health, my business, where I am trying to disseminate this message about how to help people live longer lives, take better care of themselves, and their brains. Here we are. That’s the quick story.

Circadian Biology: The Sun, Melatonin, and Our Internal Clock

I’m so sorry about the loss of your friend. There are so many things. I don’t even know where to begin. It seems to me that, of course, we’ll be talking about what we can do. There is nature, nurture, and lifestyle changes we can make. Where do we start? Do we start with the diet, with the sleep? It occurred to me that some things are the lowest-hanging fruit. If you have a drug addict, if we get that drug addict off of the addiction via some methods, that would be the layer of the onion, the external one that led that person to get into what comes next. Not the crazy, horrible stuff. That’s a very low-hanging fruit.

Another one is the classic that people say, smoking. It’s not such an issue now. It used to be a very big issue. Again, it’s easy and simple. You stop smoking, and it’ll help your body, it’ll help your brain. You’ll be good. I understand. Now, we come back to a lifestyle that most of us can make. Do we start with diet, with exercise, with sleep? With your permission, I want to start with sleep.

I have a question for you. In our show, we had some guests, and we will have another one who will talk about circadian biology. I can see you smile because it’s bubbling to the surface. Sleep has a lot to do with it. I am very taken with the two-step approach of apparently, we need sunlight in the daytime, ideally starting with sunrise. It gives signals to our central clock, and then all the other trillions of little clocks working in us.

Related directly to the brain, from what I understand, is the new infrared light, which we get all day long from the sun, and we can get from other sources in the home. It can go deep through the hair, through the skull, into the folds of the brain, and maybe generate the production of melatonin. You know so much more than me. That’s in the nighttime, and it needs a darkened environment for that.

It’s been found that we generate a lot of melatonin in the mitochondria throughout the day. The analogy that I heard that I liked was that the mitochondria are like an engine creating energy. It’s like a car engine that can overheat. The mitochondria do, too, by releasing reactive oxygen species. Melatonin is the coolant for the engine. It seems to me the two steps we can take are spending more time outside in the daytime, even in the shade, and trying to keep it dark at night as much as we can. We live in a different way. Let’s start there. What do you think of all of this?

That is a great summary. You are correct. This idea of our circadian biology, or circadian entrainment, is the idea that we have a natural pacemaker that lives in our brain. Our hypothalamus, which is a little structure right in the middle of the brain, is responsible for a lot of that. That internal clock is a little longer than 24 hours. It’s like 24 hours and 20 minutes or something like that. There were some fun experiments that were done a few decades ago where they left people underground in the dark, and they didn’t let them know if it was day or night. Naturally, as that clock advanced, after a matter of weeks, their day and night had flipped because of this. It’s very interesting.

To your point, the sun, for tens or hundreds of thousands of years, perhaps even millions of years, as long as some bipedal version of us has been around on the planet, we have woken up with the sun and we have gone to sleep when it has gotten dark because there was no artificial light, like my studio lights or our computer screens or the lights behind you that we’ve become so used to in our society. The convenience of modern electricity, thanks to Mr. Edison and all those great folks 100-plus years ago, we can now do things for longer, but the trade off is that it does screw up our biology.

The way that I like to think about this is if we go back to caveman physiology, what we were doing when there was no electricity, when we were under this mechanism for which we evolved, you’re correct. It would be waking up with the sun. Getting early morning sunlight does several things for our brains. It primes that circadian pacemaker to tell your body that it’s time to be alert, it’s time to be awake, and it’s time to be active. It’s time for us to be metabolically active. It’s time for us to be productive, focused, energetic, and ready for our day, which, no matter what you’re doing, that’s a healthy thing to do.

It helps keep you alert in the daytime, number one. Number two is equally important. It helps with melatonin secretion at night. Priming that hypothalamus in the morning allows us to get ready for bedtime when it’s dark. The trick is that light also inhibits the secretion of melatonin. It blocks the release of melatonin from the pineal gland. As an extreme example of this, you can buy melatonin over the counter. Please don’t do this, but you can drink a bottle of this stuff. It’s not necessarily harmful. It might make you a little drowsy or feel weird, but you could do that and go sit outside or leave the lights on. You will not fall asleep because light blocks the binding and the release of melatonin. It’s an interesting thing.

A dark environment during sleep is equally as important as a bright or a light environment during the daytime to maintain that rhythmicity. That’s the sleep end of it, but in terms of making sure that our metabolism is healthy, making sure that our resting heart rate stays low, making sure our blood pressure stays regulated, and making sure that our blood glucose stays steady. As you mentioned, the thousands or the trillions of clocks in our cells are all part of this process. They’re all regulated by our brain, and that circadian rhythm in some fashion. If that gets out of whack, we can see measurable changes and measurable issues with this.

There were a few interesting studies that were done around 2013 or 2014, if memory serves, but this was around daylight saving time. This group of researchers looked at data from the state of Michigan, and they looked at admissions for acute coronary syndrome, like chest pain in the setting of a heart attack or people at risk for a heart attack. The Monday after spring forward, this is the loss of an hour of sleep when we all wake up groggy and irritated. We all do this as a country. Very rarely do we get a population-level look at this because we’re in different parts of the country.

I’m down here in Atlanta, Georgia. I’m not sure where you are, Adiel, but Chad is probably up in Canada. We’re all over. It’s hard to track this data and what all our sleep cycles are. Interestingly, there was about a 25% increase in the rate of admission for chest pain and even a potential heart attack with one hour of loss of sleep. This is across a statewide population that looked at 40,000-something people. It’s that important that there’s that much of a risk if we don’t get this right. This is measurable.

Similarly, in the fall months, when we gain an hour and people are sleeping more, the numbers decrease. This is reproducible for stroke as well. It’s very important that we entrain this, number one. Number two, back to light and back to our mood, because our brain, light, and our bodies are all related. Light projects to a different area of the brain. The habenula is one of them, a tiny little spot behind the pineal gland. That helps regulate mood. Not only are you going to be more productive and active, but you’re going to feel better when you get some light in the morning. That’s an easy win-win to start. I can keep going, but I’ll pause there.

Is Sleep Non-Negotiable? The Glymphatic System & Alzheimer’s

This is why I started with this, because not only does sleep lie at the foundation, but if you didn’t sleep, now we can talk about diet, but if you are very tired all day long, you’re going to eat without even thinking. That’s screwed up. If you didn’t sleep well, you didn’t repair and regenerate. That’s why I started with that. Assuming we get this dialed in, so we do get the amount of natural light that we need, which I think is very doable by most people, regardless of where you live. You could live very far North, and you can still do some things.

The much more challenging thing to do is what happens after the sun goes down with our phones, with our laptops, and the television. People wear blue light blockers. Now we know that our skin, as well, gets the blue light. Assuming people get that under control, and if they do, before we talk about diet, exercise, and many other things, do you think we’ve done something very fundamentally good for our brain right there?

There is zero question. Sleep is non-negotiable. Back to caveman physiology. I think about this from the perspective, why the opportunity cost of something that takes 7 to 9 hours out of a 24-hour cycle for all of us to not be productive, to not be able to procreate, to not be able to take in energy or work or build something? Why would something that long still exist over this timeframe? The reason is that it’s that important.

Every higher-order animal sleeps in some form. Some sleep longer than others. Even humans have different requirements. That 7 or 9-hour window is a little different for all of us, biologically and genetically. You said it, Adiel. It’s the only time that we heal after exercise. It’s the only time that our immune system is regulated. It’s the only time that we consolidate memories in addition to all the other autonomic reasons that I mentioned with the blood pressure, heart rate regulation, lowered risk of heart attack, stroke, etc.

All of those are fundamentally important and a big one. This is a relatively new discovery within the last decade or so. We’ve known about this system for years, but its importance is newer in the last decade. That’s the glymphatic system. The glymphatic system is a fluid network or a flow of fluid that’s separate from actual blood vessels. Think about the lymph nodes that are in your neck that get swollen if you’re sick. It’s the same thing, but in the brain. This is a clearance mechanism for metabolic junk that accumulates throughout the day.

Our brains burn pretty hot. Our brain makes up about 2% of our body weight, but it takes up 20% of our total body’s energy supply. You think of all the processes that we have to run are pretty energy intensive, and there are some waste products as a result of that. This glymphatic system turns on when we sleep. It clears out a lot of that metabolic waste and junk. That’s a helpful recycling.

There’s one protein, in particular, that’s very important and has to be cleared that we form through the day. It’s a protein called beta amyloid. Beta amyloid is one of the two classic hallmarks when we look at cells under a microscope or slides of patients who have Alzheimer’s. This is one of the two harmful proteins that accumulate that we know is a hallmark of that particular type of dementia, which makes up 80% of all dementia cases.

If you imagine if you chronically under slept over a period of, maybe not months, but years or decades, and this smolders and flies under the radar and you accumulate more of this amyloid protein, this has a cascade of effects that imply increased neuroinflammation, accelerated aging of the brain, accelerated premature death of neurons or loss of brain cells. This can translate into Alzheimer’s if unchecked, among an array of other mechanisms that fit together. From any angle you look at it, sleep is something that has to be preserved at all costs and optimized in every way people can.

Age-Related Sleep Challenges & Biological Vs. Chronological Age

You reminded me of a B movie that I saw decades ago. It was about a rogue government that said exactly what you said. You said, “Why should we lose the productivity of one-third of the whole day?” Let’s build an army that doesn’t need to sleep. The movie is a science fiction/action movie about how they put a chip in people’s brains, and they never have to sleep. Of course, all the horrible stuff happened as a result, but that was the idea.

You talked about the older population that you encountered when you came back from the military. Regarding the notion of sleep, older people have more objective barriers to sleeping. Some people who might not have snored or had sleep apnea as young people might have it later in life. Men might wake up more times in the night to go to the bathroom. Women who have been through menopause report, at least from what I hear, that they wake up to go to the bathroom a little more.

It seems like it’s almost like a confluence exactly at the age where sleep would be the most important. People encounter all of those. There is a big thing about couples who used to sleep together in the same bed, how sweet it is. They say, “You know what, not only are we going to move to different beds, we’re going to move to different rooms because we want to sleep.” What do you make of all of this thing that sleep is under so much attack as people get older?

My suspicion is that when people cross that threshold into their older years or if women are postmenopausal, which has to do with the failure of estrogen production from the ovaries, which has a cascade of effects with increased risk of dementia and decreased bone mineral density, muscle loss, increased risk of stroke, heart attacks on so forth.

By the time we’ve crossed that threshold where we’re seeing clinical symptoms, based on my readings of the current literature, that is a result of slow changes that have happened over time. This is one of the things that bothers me the most about the way that we approach medicine nowadays, as reactive rather than proactive. There have been identified what are called the twelve hallmarks of aging, and these are all subcellular mechanisms that we know reflect deficits in mitochondrial energy production.

To your point, that is central to how all of this works. Damage to the DNA, misfolded proteins, and unhealthy gut microbiome, I won’t list them all out, but there are a handful of these that all interrelate with one another. We’re not built with a gauge, like a check engine light or a low fuel light, for DNA damage, or if my mitochondria aren’t producing 100% of the ATP that they should. We don’t perceive these. “Maybe it is okay that I feel a little disorganized today,” or “Maybe I didn’t sleep as well, so I’m fuzzy, but then that goes away.” These are imperceptible, undetectable changes.

It’s not until we cross a clinical threshold of “My sleep is terrible. Now, I can’t remember the conversations that I could recall a year or six months ago, or I’m more fatigued.” Whatever the symptom is, that’s typically not an overnight process. That’s typically the result of these changes smoldering over time as aging has accelerated in the body. To that point, the science is continuing to improve there. I think the detection methods and the tests to identify this are improving.

One is a DNA methylation test. Maybe you have come across this or heard of this. There is something called your epigenome, which is all the proteins and all the cellular machinery that help read your DNA and translate that into protein. As part of that, they’re called methyl groups that flag your DNA for what should be read or what should not be read. There’s a pattern to this. A pattern typically corresponds more or less to an age group. Twenty-something-year-olds have a methylation pattern that looks like Pattern A, and 70-year-olds have a pattern that looks like Pattern B, roughly speaking.

You can do this simple test. It’s around $100, depending on the lab and the company, with a cheek swab or a deposit of some saliva onto a card that gets mailed off. It can assess your methylation pattern. If your chronological age is, let’s say, 50, and your methylation pattern looks more like somebody who is 40, for example, that would suggest that your cells are probably aging at a slower rate. Your lifestyle and your exposome, or the environment around you, are healthy or more optimal. Whereas if you’re 50 and your methylation pattern looks more like a 70-year-old, it probably means your cells have aged at an accelerated rate based on some of these metrics in these measurements.

That’s not quite 100% precise yet. I think those parameters are improving, but it proves an interesting concept and a point of this idea of our biological age, which keeps us as young as possible, helps increase our health span, which is how long we live well and can maintain our current level of function. Also, it probably increases our lifespan as well, or how long we live.

These are interesting concepts that are being explored. To tie that back to your point, I think that by the time people are needing to sleep in different rooms or that they’re experiencing poor sleep or these symptoms like joint pain as we age or all of these familiar rites of passage that we all deal with and see, is a result of years of change. It’s not something that just happened at that given point in time.

Can We Reverse Biological Aging?

In one way, we can look at it as the normal progression. For example, when you have a child, you know they’re going to lose their baby teeth. You expect it. When you have a child, they go through puberty, and you expect certain changes. One wonders if some of these changes are just as inevitable or if they can be mitigated. Let’s say you have a 50-year-old, and they show the methylation pattern of a 60-year-old. If they go through the layer of the onion the way we are going to discuss, can they reverse it?

In many ways, it would appear yes, based on our current technology and based on my read of the literature. That methylation pattern does appear to be modifiable with lifestyle intervention. That’s measurable on that objective test. You can do with the cheek swab, but it’s also objectively measurable on other physiological tests.

For example, it is never too late to start exercising. We lose about 1% to 2% of our muscle mass per year after about age of 30. Correspondingly, an increase in loss of strength, in particular, in what are called type two muscle fibers, which are the anaerobic fibers that are responsible for lifting things, rather than type one, which are more aerobic. They atrophy and they do die and they don’t come back, but those that are left can be rebuilt. This is not a forever thing.

I love this example. My paternal grandfather was a physician, and his medical partner, who is a few years younger, is still alive. I had the chance to go to dinner with him with my wife and his wife. He’s 88. He was telling me, “Ryan, over the past year or so, I got to a point where it was hard for me to get up out of a chair. I was losing my balance.” He had a couple of falls. Thankfully, he didn’t hurt himself, but he was like, “My strength was diminishing.” He was 87 at that point, for crying out loud. That’s old by conventional measures. He goes and starts lifting weights. He’s doing leg press, lunges, and dumbbell squats. He moves around like a 30-year-old, and he’s 88.

When I saw him at dinner, I was floored at how mobile this man is. He’s tack sharp. He reads biology textbooks for fun. He is a fascinating human being, but it proves the point that it’s never too late. That’s the point I’m trying to make. I don’t know that he’s done a DNA methylation test per se, but I would be willing to bet that if we were to do that, his biological age would appear much younger than 88.

There was a book that was written by somebody, and the title of the book is A Dud at 70…A Stud at 80! He explains the path similar to what your grandpa did. Also, it’s our attitude. I’ll give you an example. You can be with a couple of friends, everyone is 40 or younger, and somebody is, “What’s the word for that? It’s at the tip of my tongue,” they would jokingly say, “I’m having a senior moment.” They are only 40, a harmless joke. When this happens when they are 68, maybe the joke is not so harmless. Our perception might change things. Is that possible?

The Power Of Perception: Optimism And Gratitude For Longevity

Yes. I think language and perception, and the framework from which we operate, are paramount. I recorded an episode for an upcoming virtual series I have, which I’m very excited about, with another physician. We were talking about the idea of viewing this scared, scarcity, fearful mindset of, “I don’t want to get this disease, and everything I’m doing is about avoiding this potential negative consequence in my future, like memory loss,” versus the paradigm of, “I want to expand my cognitive ability, and I want to go do more, have this abundant view of the world, be more capable, live more largely, help more people, and travel,” or whatever the thing is.

I think that perspective matters tremendously in terms of how we view the world, not to mention there is data that optimists live longer, and people who practice gratitude live longer. That’s not anecdotal, and that’s not woo-woo or pseudoscience. When you break down those mechanisms of the restorative capacity that this has for our bodies, when you are happier and you are less stressed, and your body is, again, this brain-body connection where your neurotransmitters talk to your adrenal glands that release epinephrine and adrenaline, and then that releases more cortisol. That elevates your blood pressure, your heart rate, and your blood glucose.

Over time, that leads to chronic disease. Chronic disease is like pushing that accelerator pedal on the aging process and making that methylation pattern older, to tie that to that example, and therefore, aging the brain and the body and making it more likely to have a senior moment earlier versus maybe not being an occurrence or not at all. That’s one example.

There was a movie with Demi Moore. I think she got either an Academy Award or the Golden Globe. The content is an aging beauty. She can take the fact that she ages to the point that she goes to a company that does some shady dealing and all of that stuff. That seems to be a theme in society in general and in us that we all want to be younger and healthier. You know what? Just like a child loses their baby teeth, one can say, “One thing I know for sure is I was born. That is a fact, and I will die.” I think so far, that has been shown to be pretty much 100% that I’ll die.

Since we all know that, why not relax? It’s easier said than done, but why not relax into the process and say, “I’m 50, I’m 60, I’m 70, I’m 80, I’m 88. I accept the beauty of this stage of life. Every stage of life, if you think about it, has its own pros and cons in a way. You’re 25. You don’t have money. You don’t know what to do. You don’t have a job. Every stage of life has its own satisfaction and beauty. If people accepted that and embraced it, wouldn’t that go a long way?

Yes. In many ways, ironically, letting go of the stress related to trying to preserve and clinging to that youth, that is like the harder you squeeze, the more it slips through your fingers, or something like this. I think letting go of that stress, ironically, could help people live longer because they wouldn’t be so worried and wound up about it. The irony there, or at least one of the things that we’re potentially facing, and no one knows where this is headed, so this is very speculative, so I’m going to step out of my science brain here, my evidence-based brain and project or hypothesize for a moment, but the rate of technological change is such that the human brain is not wired to understand this very well.

Some people have done this much better than others, and they’ve been very successful in the technology space. You’re looking at products that are right for the market, so on and so forth. If you look at what’s the rate of development of AI, proteomics, genomics, and where that curve is headed, I truly cannot envision what the next five years are going to look like. The next decade is unfathomable. I don’t know how to wrap my mind around that based on the literature I’ve read and my understanding of that curve.

In theory, that opens up some possibilities where human life might be extended longer than what the paradigm that we are accustomed to suggests. Again, it’s highly speculative. I don’t know that we can operate with a degree of 100% certainty. I was chuckling in my head when you were talking about accepting the beauty of life and ending in this timeframe, because I think of Bryan Johnson not accepting that at all.

If your readers haven’t heard of Bryan Johnson, he’s a former tech CEO. His whole mission is not to die. It’s literally don’t die, but he also has some metaphors behind it in terms of the greater good of humanity. I think he’s got a very beautiful mission behind it. It’s a bold assertion to state that we are going to be the first generation of people who may not perish. That has never occurred. To your point, that’s a 100% success rate in the history of humans. Again, you look barely 100 years ago, and the average human life expectancy was 30.

Yeah, but that’s not a good measure because of the deaths from violent occurrences or childbirth. If you take those out, maybe it’s not as big of a gap. Life expectancy slid down because of what happened with COVID and all the controversies around that, which we’re not going to get into. If we talk about Bryan Johnson, there’s one thing we know about Bryan Johnson that is an absolute fact. He is 47 years old. Before you go into, “Show me what it has done for you,” and I know they measure everything, how about you get to be 77, and then we talk? We don’t know. It could be an empire of beautiful products, and it could be a whole movement, so to speak, and now he’s 57, 67, 77, 87. Let’s see what’s going on there.

AI, Humanoids, And The Future Of Human Connection

Yes, I couldn’t agree more. Time will tell. The last chapter in my book is on technology. I go into a little bit of this almost mind-bending thought experiment of what the future might look like. I don’t know that I’m fully on board with this, but I can’t ignore the possibility that we don’t know what the future holds. For sure, we don’t know what the future holds, but we don’t know where we might end up as far as what the technology looks like. You were mentioning earlier about the dystopian movie with the chip and humans that don’t need to sleep.

If the projections are correct and we see 6 million to 10 million humanoid robots on the planet in the next few years, they won’t need to sleep. They walk around with a rechargeable battery pack that they switch out for however many hours they’ll do on their own. Now, they’ve replaced labor, and you don’t need robots to replace doctors, attorneys, and accountants. AI has already done better than we have on almost every measure. It’s almost better than every individual expert, and soon will be better collectively than all the experts on the planet.

Chad and I talked earlier about this existential crisis that we’re in for humanity, which is adding to the stress, and embracing and identifying what it means to be human. Adiel, it speaks to your concept of embracing this beauty in the moment for what it is. That’s a very healthy thing to do with the positive outlook that the future should be bright and will be bright if we steer it in that direction.

I’ve observed this in medicine, at least in American culture, but we have this unspoken fear of death. We have an unhealthy obsession with clinging to life at all possible cost, rather than accepting the end for what it is and having a beautiful death surrounded by loved ones, family, friends, perhaps in the home. One of the least favorite parts of my job, I get called when people are suspected of having a devastating neurologic injury. This is someone who’s maybe had a heart attack and had a prolonged time with decreased blood flow to the brain.

The brain can only go about 8 or 10 minutes without blood flow without serious permanent damage. If somebody has CPR done for 30 minutes, for example, the outcomes aren’t typically good. I have to go explain that to people and do a bunch of tests that either confirm or refute that. When I have conversations with families, a lot of people get it, but inevitably, there are a few family members who can’t accept that. They want everything done when there’s minimal to no chance that their loved one is going to wake up and return to the life that they enjoyed, as the person that they knew them as. That’s a hard thing to explain to people based on our cultural expectations.

It’s a very understandable human desire. “Grandpa is dying. We want grandpa to stay. Do this. Do whatever you can. We’ll pay whatever.” If they can pay, they will pay. Here, we also diverge into belief. Many people on this planet are of a certain religion or belief. It seems like when it comes to this, those people who see us, there are two types.

One type is the tech bros who say, “No, a brain is a computer. We are going to download our brains. The body is going to go. We’ll get an exoskeleton. An amazing body with the strength of a robot will download your brain. Now here you are living in an invincible body. It’s your brain. You’re cool.” Those people would refute or ignore the existence of what somebody might call a soul.

Those eight grams or whatever it is, no soul, just a computer that can be uploaded to the cloud. There’s another very large group of people on the planet who believe that we do have a soul. Our body is just a vessel for the soul. When the body goes away, the soul remains, and then it might come back, reincarnation style, in another body.

If people have this mindset, then the notion of death becomes, “I have a decrepit old vehicle. It barely moves. I’m going to trade it in for a shiny new model. My soul is still the same.” It’s almost the same notion of the tech bros, but a little bit more inclusive of the notion of a soul. I don’t want to get into those discussions, but those beliefs have a huge effect on how you view death.

I was a philosophy major in college. I have some background thinking about these issues that don’t ever solve any problems, but allow us to arrive at a deeper level of confusion, as one of my professors put it once. The philosophy is like a badly laid piece of carpet. You smooth one area out, and then another bubble pops up. You can’t ever fix it like that.

I think it was the ship of Thaddeus or Perseus, one of those two, but this idea of if you build a brand new ship, as a metaphor for the body, and over time the ship goes to sea and planks and boards are rotting, they’re being replaced, the sail gets worn down, the ropes are replaced, the crew changes, eventually, you have a whole new ship, yet it’s still the same vessel, the HMS Lady or whatever.

Our bodies, strangely, are similar. Molecule for molecule, every seven-ish years, plus or minus, we are made up of an entirely new set of atoms. That’s the long version. That’s to replace all the calcium in the bones and the stuff that sticks around for a long time. Whereas your epithelial lining in your mouth turns over every day. You eat hot soup, you burn your mouth, you wake up the next morning, you’re fine. Your cells turn over fast.

We’re a new person biochemically every few years, for all intents and purposes, yet we are still us. You have the Law of Energy, the Law of Conservation of Matter, and Thermodynamics. Matter and energy cannot be created nor destroyed. It’s just altered in a chemical reaction. I think there’s some scientific evidence to say that energy exists in the universe in different forms. That’s to say that if someone believes in a soul or not, or someone wants to be uploaded, there are arguments both ways, certainly.

I agree with what you say about it. Many of the technologies are moving exponentially, but the curve of the exponential is getting steeper because I talked to one of the best AI minds in the world. Luckily, he’s a friend. He says to me that even as of now, and it’s totally in its infancy, AI is already a better programmer than pretty much all the programmers on the planet who are human. Maybe save 1 or 2. The AI is going to write the software better, and another AI will write it even better, so it’s the exponential curve of the speed.

We can even take your notion one step further. There already exist what they call nanorobots. Nanorobots, in the future, which could be very near, could be so small that you spray a few billion of them into someone’s mouth. They find their way into every cell. They repair the cell, the mitochondria, whatever it is. They’re on that scale. Now, maybe they made the old car become a new car. I don’t know, and the brain, too, by the way. We don’t know about that.

I referenced nanobots and nanotechnology in that chapter that I was mentioning. That’s one of these paradigm-shifting technologies that we don’t have the framework for as far as what that might mean for the human lifespan and our abilities. That’s a possibility that would change the world.

Going back to the AI, the new future, the nanobots, and the robots, we are already at a stage where, technically, you could build a humanoid, including the density of the skin. That would be pretty realistic, let alone in 5 years or 10 years. We know already that AI is used for companionship. Companionship in the sense of people talking to it. When you put that in the form of a very realistic humanoid, now we may be gaining something, but we may be losing something. One of the things that I was going to ask you about the health of our brain, and everybody talks about it, is the human connection.

You talk to all these older people, and they all say, “I have a support system. I have friends, I have family. I have love in my life.” If you start replacing this with humanoids who are self-learning all the time and adjusting to be perfect for you, the probability, and it already can be seen around us, that it will diminish your social interactions gets higher and higher. It’s not too long into the future that people are going to have romantic partners that are robots.

There are already people falling in love with their AI, but I’m talking maybe 7 years or 12 years. That’s like infinity. We know that the best-selling first application is sex. Now you have romantic partners that are completely realistic. They never need anything. They only give. It’s very intoxicating, but it’s going to take away actual social human interaction. I think we are built as social animals. When you talk about people in jail, one of the worst punishments is to go into isolation. That can do a number on you. How do you view that in terms of what that’s going to look like in a decade?

There are a lot of directions to go with this. This is one of these paradigm-shifting moments because we don’t have a reference point in today’s world. I’ll go with a hopefully more positive or optimistic view. If somebody is socially isolated and, for whatever reason, they’ve lost their human partner, maybe they’ve outlived their children, they’re not close to other humans.

If that person had a humanoid robot companion that could provide them with social support, that could stimulate them, provide encouragement, play chess with them, or help them go to the restaurant or something like this, biologically, as long as there was satisfaction and connection with an AI or an agent that could provide that type of connection, that type of stimulation, the neural circuits in a human brain and the hormonal changes, i.e., being able to release oxytocin, which is the trust and the bonding hormone that we get when we have communal dining, friendships and healthy relationships, albeit attachments, lowering of cortisol and all the stress hormones.

Biologically, that could be a very helpful application in that particular instance. Do I think that having a romantic relationship with a robot is healthy? Probably not. We’ve discussed previously the importance of maintaining what it means to be human. If we are now blurring that line between human-to-human connection and a human-to-nonhuman connection, that’s simulating what our brains are used to. At the end of the day, these are very complex neural circuits, and our brain is a very sophisticated supercomputer that processes inputs and generates outputs.

If a large language model or an AI-based non-human organism, we can’t even call it an organism, but an entity, is providing that input that our brain generates the output with, I think it could simulate. I don’t know that your brain would know the difference at a high enough level. Perhaps at a rudimentary level, or it’s hard for us to conceptualize chatting with Claude, GPT, Gemini, or pick your favorite AI of today.

In short order, it’s theoretically possible that we could have that connection and potentially even be manipulated by such an entity that has the collective super intelligence of all of humanity. That’s built into every robot that would know that it would be able to anticipate and go, “This person who is aging or their brain is failing is feeling sad. They need more of this or this connection,” hopefully, a more utopian or positive view. I don’t know if that answered it or if that makes sense at all.

It does. It raises the question of imperfection. I was going to ask you later, but I’ll bypass and I’ll jump there now. I was going to ask about the role of creativity. We know that learning another language, learning how to play a musical instrument, writing a book, getting into all kinds of activities, rather than saying, “I’m already at this age, I shouldn’t be doing this. I should watch TV.” Creativity. For example, I play guitar and write songs. I got back from a few days in Los Angeles, where I got to play on stage my music, sing it, and play the guitar with a live pro band. You hear the band, you talk with the band, and everything.

There’s a real difference between a recorded performance and a live performance. We talked about it. A recorded performance is perfect in the sense that you have a computer, you did a few takes, you take the best part, you don’t like that sentence, you redo it until it’s perfect. However, the live performance is never perfect because they are humans. The guitarist, even the most accomplished one of all, is going to stumble.

That’s part of the beauty of a live performance. You also get some energy from the live performance. Now the robot companions, by definition, are perfect, or if they’re not perfect, they become perfect very quickly. Probably in the future, in a matter of minutes or seconds. Now they’re perfect. They project to you the ideal of perfection. That’s very different than sitting with your buddies over dinner. This guy doesn’t feel so good, and he’s a little grumpy, and this girl is a little bit giggly. Nothing is perfect. That’s what makes us human. I think navigating that might be a little challenge.

To push that boundary one step further, I would suspect that if AI gets to that level of super intelligence where it can detect those subtleties, it may be able to self-correct and even add the imperfections to be able to manipulate or trick. I think there will be a level of perfection that seems artificial. A good example of this is that there have been some unbelievable images and videos generated by AI. I forget which program this is on now because there are so many of them.

Will Smith eating spaghetti is one. Have you seen this Will Smith eating spaghetti thing? This started a couple of years ago. Somebody asked AI to show Will Smith eating spaghetti. It looks terrible. It doesn’t even look real. You’re like, “This is insane.” However, every year it has gotten better, to the point that it looks quite realistic, but there’s something still in your mind where you go, “I can tell this is AI.” It’s the way the light reflects in certain ways, the way the facial muscles move. We have this amazing ability to detect pattern recognition in everything that we do.

I sometimes scroll Instagram, X, or Twitter, whatever it’s called, and I see something that I think looks intriguing or strange. I look at it and I go, “This is artificially generated.” Sure enough, I’ll figure out that it was an AI-generated image. It’s not there yet. To your point, it looks too perfect or too good. Our brains have the ability to perceive this.

Where did I read this? I’m going to butcher the source and even the example, but an example that a neuroscientist gave in a book I read, I’m so sorry, I’m not remembering the source on this, but he gave the point of people who detect patterns in human history. One of them is somebody who sorts chickens, like baby chicks that are male or female. I know nothing about this, but I remember the example was that it’s hard to tell the difference between a male and a female chicken if they’re baby chickens. Apparently, after enough time, you can sort them. It’s not just looking at the genitalia and going, “This is male, this is female.” Apparently, it’s harder than that. Over time and enough repetition, the human brain can figure this out.

Another example was in World War II, there were British scouts that could see whether Royal Air Force or German lift off of planes were flying by to call in, “Is this going to be a bomb raid or are our guys returning home?” It was very hard to do, even with the binoculars or the scopes they had, because it was more rudimentary, and they’re moving at high speed. Over time, the scouts got it right. It was this inherent pattern recognition that’s subconscious that we don’t have an explanation for. We see it and go, “Yeah, that’s this thing or that thing.”

Even on a subconscious level, our reflexes and visual cues that we get that don’t reach the level of conscious perception are fascinating. I don’t know if this ever happened to you, but let’s say you’re walking on a trail and maybe a rock moves or something, and you jump or you look and you don’t think, is that a snake or a bear or a whatever? You just react to it. Your brain is that quick at recognizing the pattern. You have these circuits in place. It’s the same idea, but I still think the AI can get to the point where even they could overcome or manufacture those subtleties.

The Impact Of Hearing Loss On Brain Health And Dementia Risk

I agree with you. The AI is going to know that an imperfection is necessary and is going to manufacture that too. Now, I’m going to bring you back from the last chapter of your book, back to the first few chapters. Before we move into what we eat and how we move, I want to talk about the senses. From what I understand, as people age, some of their senses lose some of the acuity that they have, like vision. You talked about reading glasses, which is a rite of passage for absolutely 99% of people. That is once again like the toddler losing their teeth. You are 47. You already have those. I wonder if Bryan Johnson does, but let’s see what happens in 5 years or 10.

Anyway, from what I understand, and please correct me if I’m wrong, when people start hearing worse, so maybe it’s from being to too many concerts or being too close to the big speakers, or at the airports, noise, or who knows what, they start losing a certain portion of the hearing spectrum. Is it true that if they let it be versus using a hearing aid to complete the spectrum, that has a significant effect on dementia?

It does. There have been some studies that have looked at this. There are two components of hearing. There’s conductive hearing, and then there’s sensorineural hearing. Conductive hearing is when sound waves enter the external auditory canal and then cause the tympanic membrane or the eardrum to vibrate. That is conducted through a series of very tiny bones that then stimulate some cells that are then connected to a cranial nerve that sends a signal into our brainstem, and then up into our temporal lobes, which is where we process hearing. The temporal lobes are behind the ear, in that lobe of the brain.

Interestingly, the temporal lobes are connected to a little structure called the hippocampus, which is Greek for seahorse because this looks like a little seahorse on each side of the brain. The hippocampus is where we store our short-term memories before they’re converted to long-term memories. The reason I’m walking through all of this is that in Alzheimer’s, in particular, but classically, dementia, short-term memory is the first hallmark symptom because of the shrinkage or atrophy of the hippocampus. The short-term memories can no longer be stored and therefore converted to long-term memory. That’s a common symptom of someone asking repetitive questions or not remembering the names of acquaintances, and things like this.

There seems to be a relationship between that pattern of conductive hearing loss that’s acquired through time, that no longer stimulates part of the temporal lobe that’s in close proximity to this hearing apparatus, which seems to make a difference. The best way I can explain this, or at least hypothesize this, because I’m not sure that it’s fully worked out yet, other than that corrected hearing loss seems to lower the risk for dementia, whereas uncorrected hearing loss increases the risk.

We have this term called use it or lose it in neuroscience, meaning that if your brain is being actively stimulated, whether it’s through being creative, playing guitar, challenging yourself, doing new things, stimulating different areas of your mind, that engages the process of neuroplasticity and maintains brain health and neuron health. If that area or areas are not being stimulated, the connections wither and go away because your brain is efficient. It says, “We don’t need this real estate anymore.” In the setting of hearing loss, there seems to be a relationship that increases the risk of dementia, among many others.

Fascinating. From explaining so nicely about our hearing processes, what do you think of the in-ear earphones? Are they neutral? Are they positive or are they maybe slightly negative?

Do you mean like earbuds and things like that?

Yeah.

I worry that prolonged exposure to increased volume is problematic or could accelerate the process of conductive hearing loss. I think that’s a big concern with those for me, even in my younger years as an avid gym goer. I listen to some of my favorite rock bands at a higher volume than I should. So far, my hearing tests seem okay, but I don’t know. That remains to be seen. Conductive hearing loss is a concern. Back to my days in the military, where people were exposed to all kinds of gunfire and artillery, jets taking off, we saw all kinds of hearing loss prematurely in that crowd. We know that high decibels, over time, create serious problems.

There has been some limited, and in my opinion, mixed data on some of the electromagnetic frequencies and radio waves that have elevated the concern of cancer, like brain cancer, and things like this. In my interpretation, I don’t see any credible, meaningful increase in cancer in today’s literature. That may change if we have broader, bigger, more reliable data sets. There’s nothing that I’ve seen that concerns me for that being an issue for people who have the earbuds or the cell phone or anything like that.

Not from a cancer standpoint and not from a volume standpoint. Having a device that is on route to your brain through this canal, which generates all kinds of electromagnetic fields, could that have an effect of sorts?

It could. The question I would have is, is the power and the waveform strong enough to penetrate the skull, which is fairly thick, to make a meaningful difference? Take another example. There’s something called TMS or transcranial magnetic stimulation. These are fairly large machines that generate a strong or a condensed electromagnetic field that can be targeted at different areas of the brain, the frontal lobes, for example, to help treat things like PTSD or depression. Long COVID is another application.

There’s some data that this is effective in doing this, but that’s a fairly large, powerful machine that takes a series of dedicated treatments over a period of weeks to make that change. Is a smaller dose of a device of that size, over enough time, does that make a meaningful difference? Maybe, but I don’t know that there’s any credible data to support that, which doesn’t mean that that’s not a factor. My take is that I don’t think so.

Blue Zones & Lifestyle: Lessons From Longevity Hotspots

Going back to the requisite exercise and diet, because we want to bring it down to earth and have people think, “What can I do next?” Before we go there, though, I’d like to talk about something that occurred to me related to this circadian discussion we had at the very beginning. There is a guy who wrote a book about the Blue Zones, and many scientists love to go to the Blue Zones.

They talk to the people, and it’s basically what they do. What do they eat? How do they socialize? How do they move? It occurred to me related to the circadian, so far, I don’t think I have seen, I don’t know if you have, many of those people pretty much spend most of their day outdoors in nature, maybe working in the yard, in the fields, at night. They don’t seem to be big cell phone users or internet users. They go to bed. I wonder what part that plays in their longevity.

Yes. Recently, for what this is worth, there were some criticisms or whether people had falsified birth records or something. That’s been a matter of debate that I’ve read. To what degree is that credible? I don’t know. For example, my wife and I love Italy. We did our honeymoon in Ravello, Italy, which is on the Amalfi Coast, which is gorgeous. It’s on the side of the cliffs. You’re looking at the Mediterranean. The first time we stayed there, we stayed on a lemon farm.

You wake up every day to everybody speaking Italian. They’re picking lemons. They’re social. They’re outside, as you said. Beautiful culture. Nobody is overweight. I’m intentional about staying in shape so I can get around okay. These people are zipping up and down the side of a mountain with buckets of lemons without breaking a sweat. I’m going twenty steps, and I’m going, “This is steep.” They’re so in shape. It’s the whole lifestyle. I don’t know that it’s one thing that it’s necessarily being just outside or the community, or the lack of processed ingredients and the fresh food that they eat, or pick your thing. They do the right stuff. They’re active, they’re social, they’re happy, and they’re not stressing about making a ton of money. What does that all look like?

They’re positive. They make a nice living, but at the end of the day, they get together, they enjoy a meal, and they sleep well because they’ve earned it. Exercise helps deep sleep, too. I guess we skipped over that one. Morning exercise in particular helps you achieve deep sleep, which helps with the amyloid clearance and all the other things, all the mechanisms. I think that lifestyle happens to be the right ingredients for what our bodies require to function optimally. Certain groups of people have gotten it right. It’s so neat that we’ve been able to identify that in people.

You mention Italy as an example, let’s not talk about one of the lemon farmers because they might have a big difficulty moving to the US. It’s too different, unless they move to a lemon farm in the US. Let’s take somebody from Rome. That person has Italian as their native language. Now they move to the United States. They have to learn English.

Now they have good English because they live here. Their brain contains two languages. Isn’t that very helpful? How does that affect the multilingual aspect? Many Americans were born with their native language, the most important language in the world. They don’t have much of an incentive to learn Italian, so they may not have that benefit. What do you think about that?

Back to the idea of stimulating and challenging the brain, as with your guitar example, creativity, learning a language, is perhaps one of the greatest challenges that we can do to learn a new character set to form new connections and associate different words with concepts. An interesting fact about language, up until we’re about 5 or 6, an infinite number of languages all map to the same region of the brain as we’re developing. We have almost infinite learning potential, and we’re like a sponge. Technically, if you grew up in a household where you had parents who were quintilingual or spoke five languages or whatever, every character you learned would be as if it were in the same language, minus learning all the rules in the structures and whatever.

It’s easy for a kid that age to learn, but much harder as an adult, for any of us who have tried. After their brain has fully formed into adulthood, it’s a very healthy thing to learn a new language to stimulate that neuroplasticity. Back to use it or lose it, you are making use of your language centers and mapping new concepts.

Interestingly, as Western culture has spread to certain Blue Zones or certain Blue Zone residents have moved into areas such as the United States, or say, Rome, where there’s more westernized food stress, etc., they die sooner. The language is very likely protective, but all of the other facets of stress and processed food and sedentary behavior, pick your poison, literally, that seems to have a deleterious effect.

Fueling Your Brain: Optimal Diet For Cognitive Function

Let’s talk about diet and exercise. Let’s start with the way we eat and what we can do to optimize our brain function.

When we look at all the literature, first off, diet or nutrition is a very nuanced subject, meaning that there are more dietary camps than there are actual evidence-based groups of people that follow this. It’s tough. Everybody has different preferences, genetic preferences. They have personal food preferences, so on and so forth.

Blanket statement here, without factoring all that in, a plant-based diet and a Mediterranean diet, which is basically a plant-based diet that allows for some healthy fats like fish, olive oil, stuff like that, those two appear to have the lowest all-cause mortality, so the risk of dying of anything. Those two Mediterranean diets are probably more neuroprotective because of the healthy fat allowance, as a general rule, if people can tolerate it.

I get very heartened when I hear you talk about the healthy fat. Those people in Sardinia or in the lemon farm where you were probably get a significant amount of olive oil. Never mind some of the fat from the fish, never mind butter. There used to be a lot of beef tallow around. Now it’s making a comeback. I do feel heartened to hear you talk about full fat as necessary. It makes a lot of sense. When people vilify cholesterol, I’m asking you, isn’t the brain made of a very large amount of cholesterol?

Every cell in your entire body has cholesterol in it. It is an integral part of what’s called the phospholipid bilayer, which is the dual layer that every cell is made of. It’s essential for cell function. That’s the end. There’s no good or bad cholesterol. You just have it. There are different risk factors of different types that we measure, and so on and so forth. The brain itself is about 60% fat. Back to that whole philosophership analogy from earlier, if you are not replacing the building blocks, you’re having problems. You’re having to scrap material from elsewhere, and it’s not optimal.

There was a study, I believe it’s JAMA or one of our neurology journals. Don’t quote me on this, but I do remember the number, though. Seven grams of olive oil a day, that’s about a tablespoon, conferred about a 28% reduction in dementia. Just a tablespoon. You’re replacing the building blocks. Olive oil, extra virgin olive oil, or fresh olive oil, this is the trick here, has polyphenols, which are good little hormetic stressors that stress your cells in a positive way. It has oleic acid, which is an antioxidant, and then has the actual substrate to help rebuild the brain. I’m very intentional about the olive oil that I put on a salad, which is typically my first meal of the day, for that reason.

Do you think that the 50 years of vilifying fats came because of a study that has now been shown to be iffy at best, but found its way to medical schools? There are still doctors who went to school at a certain time who believe that fat is the enemy, which has taken a toll on the health and the brain health, in particular, of the American people.

Yes, unfortunately. Luckily for me, I went through training at a time when it had mostly been debunked. To me, the bigger problem is that doctors do not have nutrition as a required course in medical school. We get very poor nutritional education, and we get biochemistry. We understand the cellular mechanisms. We get cell biology. We get immunology. We understand how disease operates and how these enzymes work. On a more macro view level, we don’t have the tools. I was told that’s the nutritionist’s job, or the dietitian. I’m not kidding. Not only do doctors have a poor understanding of nutrition, but if there is improper data and they’re fed improper data, that’s going to lead to poor outcomes.

The perk of being in academics is that you typically tend to be on more of the cutting edge of what is current. I don’t recall that being a paradigm when I was being taught, but I’ve worked with plenty of older physicians who still believe that and operate from that vantage point. Now, of the fats, everything in moderation. If you had an all-fat diet, that would be problematic for a handful of reasons. You wouldn’t have enough fiber, which your gut needs. You probably wouldn’t be getting enough protein, which your muscles and your brain need.

The rest of your body needs are mostly made of protein. Saturated fat, in particular, is probably the bigger culprit. No more than about 10% of total calories in a day is my general understanding of saturated fat, about 30%, maybe 40% of total calories from fat of any kind. Most of that should be unsaturated fat, which is the olive oils, the fish, the Omega 3s, that kind of thing. Too much saturated fat, too much total fat, problematic, yes. Imbalance and necessary, and most people probably don’t have that right ratio; that is certainly a problem.

The Dangers Of Polypharmacy And The Need For Nutritional Education

Talking about general health and brain health, I haven’t been through medical school, but you have. Do you find the propensity of medical education in medical schools to become a human Excel spreadsheet that looks at condition, here’s the medication for it, here is a prescription, is helping and harming all at the same time?

Yes. Part of my dissatisfaction with the Western model, and part of why I have chosen to take this path, is that I found I was not being effective. I was an effective provider for people. That has some to do with the algorithmic approach of this person comes in with high blood pressure, prescribed medication. Blood pressure is still not controlled, add medication B, that whole approach. It presupposes that we need a pharmacologic answer to everything. That is very much the allopathic of the Western model, which I trained under. I don’t think that’s the right answer, because it keeps people sick.

They let the pharma companies put ads on television. We usually skip the ads, but sometimes we don’t because we’re busy with something else. Sometimes out of the corner of my eye, I see an ad for a drug saying, “If you are taking drugs so and so, and are suffering from these side effects, our drug will take care of those side effects. By the way, if that gives you side effects, we have another drug for that.” There’s a whole chain.

Yes. There’s no question. There’s this term, polypharmacy, that comes up a lot, especially in older patients. Doctors are very siloed. We all go through the same basic level of medical education in medical school, but then we break off and go on to become surgeons, cardiologists, neurologists, and so forth. Patient A gets referred to me because they have a brain problem. I never hear about anybody unless there’s already something wrong, which is already backwards, number one.

I say, “I think you might benefit from an aspirin,” or whatever, and you’ve had a stroke. I send them off to the cardiologist, and they go, “Your cholesterol is out of control. Here’s a statin.” They go around these multi-specialty groups, and before you know it, somebody is on 10, 15, 20 medications, all of which, on some level, interact. These people come into the hospital, and they’re confused and they’ve got all this laundry list of medications and problems. If somebody had the time to sit down and educate people on how to better take care of themselves and avoid some of those hallmarks of aging and adopt a healthy, integrated lifestyle, we could get rid of a lot of medications, and a lot of people could do away with a lot of problems.

Movement As Medicine: Practical Exercise Tips For Brain Health

You talked about the diet. You made it pretty clear and simple. How about movement and exercise? Especially when people get a little bit older, what’s an amount that could be beneficial? We know we are made to move, also from a logical standpoint. Your blood flows through your body, and everything opens up. It’s clear. What kind of movement and how much?

This ties into nutrition on a handful of levels. A quick point too is it’s not just what you eat, but when you eat and how much. Timing and quantity also matter. This gets into the whole idea of energy balance in our body. Most Americans are in an excess state, and we have metabolic dysregulation, mitochondrial dysfunction, chronic inflammation, and all these problems because it’s easy to overconsume an American diet, very carbohydrate-heavy, very fat-heavy, lots of processed stuff, calorically dense, nutrient-poor, and easy to overconsume.

Movement helps buffer that. Getting nutrition in check is probably the easiest way. You have to burn a lot of calories to offset over-consuming, or it’s easier to overeat than it is to over-exercise. We all know that. Even the most minimal amount of movement moves the needle. What I mean by that is there have been studies on what are called exercise snacks. This is six minutes a day. That’s it.

In particular, broken up into two-minute segments. If you do anything that gets your heart rate up for two minutes at a time, so this could be jumping jacks, high knees, air squats, running up and down stairs. Pick your thing. If you do that, especially around meals, that has about a 40% decrease in all-cause mortality for people who have done this over time. Studies have looked at this. People who don’t have six minutes in their day need to reassess what they’re doing, because everybody has six minutes. That’s number one.

Number two, standing more. I’m in my home office. I do not have a chair in my office. I have a standing desk that I can move up and down, depending on whether I want to type or do a Zoom call. I intentionally stand for several reasons. Standing burns more calories per hour than sitting. It improves spinal alignment and our posture, which is quite helpful for back pain and other issues. That’s an easy pickup for people in the workplace. Humans designed chairs and desks. We designed cars to get us to and from more efficiently, so we can maybe make more money or get to work faster and be more productive as employees.

We sit on our way to work. We sit at work, we sit on our way home from work, we come back, we come home, we sit at dinner, and then we sit on the couch watching Netflix before we go to bed and sleep. We’re flat all night. We don’t move enough. We’re not like the lemon farmers going up and down with the buckets of lemons. That’s not good for our health. Those are the baseline levels.

If you want to take it up a step further from there, 10,000 steps a day, there’s a baseline metric there because there have been big studies that have looked at people who move this much. That’s about another 8% from memory reduction in all-cause mortality. Big pickup there for walking a couple of miles a day. I don’t have it turned on, but I have an under-desk treadmill that I use as well when I’m working here.

I get a 2-for-1. I stand and I walk a little bit, and we’re not talking about running marathon pace. I turn it on 2 miles an hour, enough so that I move my legs, and I’m not distracted from doing work. Plus, there’s probably a visual spatial element to this. Quick detour, there have been some studies that have looked at people who play racket sports, so tennis, pickleball, and racquetball. They tend to live longer than people who don’t for a handful of reasons. They’re moving, they’re active, they’re social, and they’re stronger. They get some cardio respiratory fitness, but there’s also a spatial and balance component to this. As silly as it sounds, as I’m walking and typing, this is like chewing gum and talking on the phone or whatever, that whole thing.

It does take a minute to get used to it, and it distracted me the first time I did it, or the first few times anyway. After you get used to it, you can work and you don’t think about it, but there’s some motor circuit neural processing that happens too, like your guitar and like learning a new language that seems to help. Again, 10,000 steps a day, easy pickup, whether that’s at your desk or outside, probably outside would be preferable to your point.

You’ve got dedicated strength training, cardiovascular training, and high-intensity interval training, and all of those have their benefits. Grip strength is heavily correlated with mortality, with lower all-cause mortality. A stronger grip equals a lower chance of dying from anything. It’s not that people need to go buy one of those little hand squeezers. It’s more reflection of what you have done to get strong. Same thing with VO2 max cardio respiratory fitness. We could spend four hours on those rabbit holes alone.

Rebounding, Grip Strength, And Neuroplasticity

What do you think of the rebounder or the mini trampoline? Something that is not expensive, relatively. People can have it in their homes. I’m not saying they should do it while they watch Netflix, but they could. It does generate some G-force. You can run on it. What do you think of that?

Is a rebounder the same thing as a mini trampoline? I don’t know what that is.

It’s the same thing. There’s also the balance, so you don’t fall off the thing, so you need to keep your balance.

Anything that gets people moving, whatever that thing is. Let’s put it this way. The best exercise is the one that you’ll do. Whatever that is, it does not matter. If that’s body weight, a trampoline, or you love to power lift, as long as that’s safe, whatever your thing is, it’s the thing that you’re going to stick to. A mini trampoline, that’s like racket sports. There’s balance involved there. You’re getting some strength. It’s load-bearing. This is interesting, but your muscles and your bones both independently send signaling molecules to your brain.

They’re called myokines, and I believe osteokines. I may have that second one backwards, but osteocalcin is a hormone or a signaling molecule from the bones that when they undergo stress or load so like box jumps is something I do, for example, where I jump on a box and try to see how high I can jump and load my femurs and my quads. That stress on the bones signals to the brain neuroplastic changes to help with motor circuits and with different neurotransmitters, like BDNF, which is brain-derived neurotrophic factor, nerve growth factor, which is like fertilizer for that neuroplasticity process. Trampoline, to some degree, probably activates some of that.

This could easily turn into a six-hour episode, but I want to thank you for your time. I know you’re busy. How can people reach you? How can people find your upcoming book? How can people benefit from your wisdom and experience?

Thank you, Adiel. This has been a pleasure. Thank you for having me. One of the best places to go would be our website, which is TranscendHealthGroup.com. From there, that links to our Instagram, which links to the book. We have a group in private coaching that I do. We have a group wellness membership where I do Zoom calls twice a month and help support people that way. It’s an open discussion where we do this and make sure people are supported through their health journey.

For people who need the one-on-one touch and a higher approach, I do one-on-one sessions with people as well, and have integrated biofeedback and neurofeedback devices. Currently, an Oura Ring and a Muse EEG device are both part of that for neurofeedback, which has been fun. That’s more focused on high performers. The book will be out in September 2025, The Incredible Brain. People can sign up for a newsletter and follow along on the website.

That’s great. As an aside, we didn’t talk about meditation, but I know that meditation would be good for all the stuff we’re talking about.

Yes. Some of the neurofeedback apps, with the Muse EEG, you can learn to control your brainwaves with these apps, which is super interesting. It helps with long-term resilience, with maintaining composure in the setting of stress and lowering some of those stress hormones we talked about.

Dr. Ryan Williamson, thank you so much for your time. It was fun. We learned a lot. I hope to see you again soon.

Welcome. Any time, Adiel. Thank you so much. It’s my pleasure.

Take care.

You too.

Important Links

• Dr. Ryan Williamson
• Dr. Ryan Williamson on LinkedIn
• Transcend Health
• The Incredible Brain
• Transcend Health Group on Instagram
• A Dud at 70…A Stud at 80!

About Dr. Ryan Williamson

Dr. Ryan Williamson is a board-certified neurologist, U.S. Navy veteran, and advocate for human longevity. As the owner and founder of Transcend Health, he uses his expertise to help individuals optimize their health, extend their lifespans, and create more meaningful legacies.

Ryan is deeply interested in improving the lives of others. Throughout his career, this has largely been accomplished through the practice of clinical medicine—but now, he is looking to affect change on a larger level, so more people can feel better and perform at their best.

Today, Ryan accomplishes his vision by educating people on evidence-based principles and proactive methods to improve brain health and expand longevity.