THINKWELL

AGEWELL

The Buckets Framework: The New Way to Understand Alzheimer’s Risk

00;00;00;00 – 00;00;28;04
Speaker 1
Welcome to this episode of the Think Well eight World podcast. I’m your host, doctor Heather Sanderson, and I’m delighted today to be introducing you to Doctor Rachel Kisner. She is a colleague and a friend and works closely with me at Salisbury. Seeing patients in collaboration with Pacific Neuroscience Institute doctor David Merrill, who you’ve met here on the podcast, Doctor Bredesen and others who support our collaborative efforts to get patients the dementia care that they deserve so that they can see true outcomes.

00;00;28;06 – 00;00;30;15
Speaker 1
So, Doctor Rachel, he’s very welcome.

00;00;30;17 – 00;00;33;13
Speaker 2
Thank you. Thank you for having me.

00;00;33;16 – 00;00;42;12
Speaker 1
I want to understand first your why. Why are you here? To help patients who are suffering with dementia and their families.

00;00;42;14 – 00;01;20;10
Speaker 2
So I grew up with three out of four of my grandparents ending up having dementia in their later years. And my. Yeah, my grandmother, she was pretty severe in her later years with Alzheimer’s and it was heartbreaking. It was really hard to see me lose my grandmother. I look back and I wasn’t able to ask her all the questions that I wanted to ask her, like how she came here from Spain, what her upbringing was like, and then to see the toll that it took on my family, especially my mother, when she was balancing kids and full time work.

00;01;20;12 – 00;01;44;22
Speaker 2
It was exhausting for her. So I saw how emotional it was and it just for the devastating components of of Alzheimer’s, the toll it takes on the on the person in the family. And I never wanted that. I don’t want that for my family. I don’t want that for my kids, for my parents. And then I tested myself.

00;01;44;22 – 00;02;02;22
Speaker 2
And I am April 8th, three, four. So I know that I also have that increased risk. So I show up every day to help reduce the statistics there and make this something that we can prevent, and that we can help make a change in that space.

00;02;02;24 – 00;02;07;12
Speaker 1
It’s exciting work. It’s very fulfilling. Do you have any patients that stand out to you?

00;02;07;14 – 00;02;39;11
Speaker 2
Oh, so many, So many. I am so blown away by my patients. I learn every day from them. It really is so special to work with this population. I have we did an in-person support group for a couple of weeks, and there was some fantastic shifts that happened within six weeks. Within six weeks, I saw this one woman go from having three words to more verbal fluency and being able to and by her grandkids.

00;02;39;11 – 00;02;44;05
Speaker 2
And I mean, her daughter would come in like, look, she doesn’t have smile and ankles.

00;02;44;08 – 00;02;44;21
Speaker 1
And she’s.

00;02;44;21 – 00;03;13;03
Speaker 2
Speaking fluently. And then there was another woman within that class who who reverse her diabetes from getting into ketosis and was able to hang with her girlfriends more and play games more. I think, you know, those are just two examples of within a short amount of time, what’s possible when people do the work. And it was so inspiring to see just how excited they were and how they lit up by the small changes.

00;03;13;05 – 00;03;19;06
Speaker 1
So tell us about that six week program. What was that designed? What does it do? How can people get involved or learn more about it?

00;03;19;14 – 00;03;57;23
Speaker 2
So it was in person support group for patients with cognitive decline. Or I should say people with cognitive decline and their care partner and the structure of it was based off of your book a bit to really help people with what they can implement at home, with exercise, with nutrition, with limiting toxins. But the purpose of it really was to, yes, educate and help that, but to get people together to tell their story and have that one on one, storytelling and care and support that everybody in that family unit needs.

00;03;57;28 – 00;04;00;16
Speaker 1
So many caregivers feel so alone.

00;04;00;22 – 00;04;01;01
Speaker 2
Yeah.

00;04;01;02 – 00;04;09;27
Speaker 1
And when you can get in a room, even just once a week with people who are in a similar situation, it can it can lift a little bit of that weight that burden of caregiving.

00;04;10;02 – 00;04;37;01
Speaker 2
Right. Of course, there were difficult conversations that were coming up and a lot of emotions, but also a lot of laughter and joy and hearing about how people got into ketosis, what was their favorite meals, what they made for their birthday cake. Maybe at a new gym that they found out about, or workout class and your activity to being able to share those resources and local.

00;04;37;02 – 00;04;40;27
Speaker 2
So it’s nice to have that local support. It was so fun.

00;04;40;29 – 00;05;05;16
Speaker 1
Yeah, the support groups are a lot of fun and we have the online support group we are trying to hit that, think, well Agewell support group here, in Encinitas, going regularly so that we always have a handful of couples in their Covid care diets in there. And it is I think we do it. We both do this support group work because it is so fulfilling, so meaningful.

00;05;05;22 – 00;05;22;23
Speaker 1
When we have especially those foundations in place, right? The diet, the exercise, the lifestyle. And I want to talk more about those, but I really want to dive into the medical care that we provide. And so give me a roadmap for what it looks like to become a new patient with you.

00;05;22;26 – 00;05;50;10
Speaker 2
So you’ll come establish care. And typically we sit down for about 75 to 90 minutes and talk through your history. I mean, even starting from, you know, did you hit your head as a kid? Did you play any contact sports as a kid? And what were your medical history? And we’ll go through current symptoms and really get an idea of what what do we need to investigate here and then set you up for labs.

00;05;50;12 – 00;06;21;11
Speaker 2
And before we get those labs done, we’re talking through a foundational plan because there’s this is the perfect time for us to start the things that you can start it, that you can start on your own, that don’t require a lot of resource. So just changing diet alone, I mean, yes, I would love to get everybody into ketosis and eating more plants and having healthy fats, but even just trying to eat all, all organic whole foods, limiting sugar, no sugar, limiting carbohydrates.

00;06;21;14 – 00;06;25;03
Speaker 1
Maybe wearing a continuous glucose monitor to really understand that.

00;06;25;04 – 00;07;03;07
Speaker 2
Yeah, maybe taking ketones to help just drive more ketones to the brain. Optimizing exercise or getting people moving in. There’s some people that come in that that’s a great first place to start is just walking to the mailbox or going for a short walk every day, get that blood moving. And activities. So what they can do to help stimulate their brain, you know, we see people after they stop working that that scent that tends to fall off, just stimulating the brain in general, learning new things or maybe even having a hobby.

00;07;03;09 – 00;07;14;02
Speaker 2
So finding what is sustainable for them and what they can commit to is it’s really fun. You’re meeting the patient where they’re at, but also making it a sustainable plan for them.

00;07;14;04 – 00;07;30;09
Speaker 1
Yeah, and giving them permission to engage in things that they enjoy that are fun. Yeah. It’s sustain that they would look forward to having more friends and spending more time with your friends playing cards. I think a lot of us have that narrative in our mind that if we’re not being productive, it’s not time well spent.

00;07;30;12 – 00;07;30;20
Speaker 2
Right?

00;07;30;20 – 00;07;52;29
Speaker 1
And yet it can be supremely productive for our brain health to be engaged with peer group, with, with something that a hobby like you mentioned, something that challenges us, but also really engages us where we’re present and really in the moment. So when we talk about that first visit, yeah, there’s the labs that go with it.

00;07;52;29 – 00;07;58;00
Speaker 1
And then when are you following up with them to review the lab? Stick with it. What’s the timeline?

00;07;58;02 – 00;08;21;09
Speaker 2
So we’ll try to get those labs in as soon as possible, because they do take some time to get back about 4 to 6 weeks. So we’ll get you started on the foundational plan, a great time for you to start implementing these changes. And we’ll also start some supplements that could be beneficial for everybody with brain outlook, with any cognitive decline, or for brain health in general.

00;08;21;11 – 00;08;48;22
Speaker 2
And then in about 4 to 6 weeks, we get those labs back and go through them in detail. I find that when people understand why I’m recommending something and saying this is important, it just is. It’s more, motivation for them to stick to it. So if I can under go through the labs and have them understand exactly what it’s showing me about their health, about their biochemistry, they’re more likely to be involved in their own plan.

00;08;48;29 – 00;09;12;07
Speaker 1
And it’s a very personalized, precision based plan, because not everybody with an Alzheimer’s diagnosis has the same reasons for why they’ve got they’re likely. So, so we have a baseline visit with labs, hopefully within a day or two after the visit and then 4 to 6 weeks later, we’re following up. And then what happens after that? Take me through like a year or two.

00;09;12;10 – 00;09;34;19
Speaker 2
Okay. So we’re following up. We’re doing the lab review. We’re going through all of that data and making this more precision based plan. And then from there we want to check in about every 12 weeks, you know, retest some things, toxins or nutrient values that we would like to see improving and following up, making sure we’re staying in the plan, fine tuning that plan.

00;09;34;24 – 00;09;49;11
Speaker 2
There’s always the fine tuning. And that is the part where, it can it it’s better to stay on track if you can make the fine tuning and stay up with the plan. There’s more there’s more success from that.

00;09;49;11 – 00;09;49;25
Speaker 1
Yeah.

00;09;49;27 – 00;10;01;29
Speaker 2
So about every 12 weeks and then once people get to a more maintenance mode, about every six months is when we can follow up and check in. And again, just fine tune. Health is not linear.

00;10;02;02 – 00;10;03;04
Speaker 1
Things happen, things.

00;10;03;04 – 00;10;14;23
Speaker 2
Happen, and things will always come up in life. That feels like a step back. But I like to say it’s just it’s just a little speed bump, right? Like there’s some there’s always something that will happen that we can address on the way.

00;10;14;25 – 00;10;18;23
Speaker 1
Yeah. And then we can it can motivate us or inspire us to get back on track.

00;10;18;23 – 00;10;22;19
Speaker 2
Exactly. And then discover something else that we need to figure out.

00;10;22;24 – 00;10;30;16
Speaker 1
Absolutely. Another piece of our process is health coaching. So can you talk about how the health coach supports this process?

00;10;30;19 – 00;10;51;20
Speaker 2
Oh my goodness. I think this is maybe the best part is having that one on one support. So meeting with the doctor is great. You get the medical knowledge and you get the treatment, but then no one is going to be there. I can’t be there in the kitchen showing you how to cook keto. So having the health coach appointments, we set one up.

00;10;51;20 – 00;11;15;25
Speaker 2
So after the initial you have one to go through the initial plan, go through what it looks like to get into ketosis. What foods should you be eating? How do you measure your ketones? What is a great exercise routine going through all of that and I like to tell patients, go through your daily schedule. Make a daily schedule with our health coach, so that way you can eliminate any roadblocks as they come up.

00;11;15;27 – 00;11;33;17
Speaker 2
And then we have another check in after the lab review, because now we’re really putting a lot into the plan based on that data. So it’s another great time to optimize a daily routine go through, especially what lifestyle things are in the way.

00;11;33;19 – 00;11;55;25
Speaker 1
So I want to go back to our framework. We talk about buckets and we talk about I know even people listening might feel overwhelmed. They’re like, well, what labs? Or wait, what are we talking about? Is this simple? It sounds complicated. So one of the ways I like to wrap my brain around it is to is really just to create a framework that we can kind of hang everything on.

00;11;55;27 – 00;12;00;17
Speaker 1
And so talk me through, like how you view that framework, how you think about it.

00;12;00;20 – 00;12;33;02
Speaker 2
So I like the idea of the buckets because it you can kind of organize, you know, why we’re looking into certain things and how it can affect brain health. One would be infections. So we are looking at an overall infectious burden on the body. You know, what is this regulating the immune system that can take away resource from brain power, or cause any kind of neuro inflammation in the brain that might look like testing for HSV, herpes simplex virus.

00;12;33;04 – 00;12;54;03
Speaker 2
We know that when people have been exposed to herpes simplex and when they have an outbreak, it can cause neuro inflammation, it can cause, more amyloid and tau pathology. So we test for it. Test? Don’t guess. That’s kind of our motto. I want to know exactly what I should be chasing. So for infections we’ll look at HSV.

00;12;54;03 – 00;13;20;24
Speaker 2
You know we’ll talk about oral health. If there’s any infections in the mouth that we can look into and test. We’ll look at an overall infectious panel. So we look at the side panel, look at immune response to all these different pathogens, viruses, bacteria, parasites, etc. and then toxins is another bucket. This is another big one, especially with this toxic soup that we’re all living in.

00;13;20;26 – 00;13;58;23
Speaker 2
And we break it down into molds, environmental toxins or chemical toxins, and heavy metals. So looking at, urinary excretion of micro toxins. So toxins produced from mold within the body from exposure to mold. We’re looking at heavy metal analysis. We’re looking at chemicals like phthalates and parabens from personal care products, VOCs or benzene and different chemicals that we are exposed to in air pollution and, and dirty water.

00;13;58;25 – 00;14;29;13
Speaker 2
So testing, excretion and levels of those we’re looking at signaling pathways. So infections, toxins, signaling, signaling I think of hormones, hormone signaling to the brain to grow in your muscles, telling your brain to grow. So hormones, we’re looking at and vitamin D amount, you know, vitamin D can be considered a hormone. And then stressors.

00;14;29;15 – 00;14;58;03
Speaker 2
So cortisol, chronic cortisol stimulation or stress hormone stimulation we know can be toxic to the brain can cause, atrophy of the hippocampus. So we’ll look at the amounts of cortisol throughout the day. We’re also thinking about if the person’s in chronic pain and taking into account any amount of, pain that they might be exhibiting or levels of inflammation from that.

00;14;58;05 – 00;15;26;28
Speaker 2
So I want to make sure I got them all. Toxins, infections, signaling, stress structure. Well, that’s why we ask a lot about traumatic brain injury. We might test certain markers like NFL for, markers of brain injury and then, sleep apnea. So sleep apnea, we know, is cutting off oxygen to the brain while someone is sleeping and supposed to be restoring their brain and getting into deep sleep.

00;15;27;01 – 00;16;00;02
Speaker 2
But if they don’t have that oxygen at night, then that can be causing direct injury to the brain. So that can be maybe from a structural defect. So we’ll test that. We’ll send people for sleep studies at home. Sleep studies. And you know, vasculature is a part of that as well. If, someone has, vascular disease or anything with a heart, you know, we want to test cholesterol and their levels of cardiac inflammation or SDL oxidase, LDL.

00;16;00;02 – 00;16;27;10
Speaker 2
You know, all these fancy words to look at how cholesterol is being used in the body and if they’re at risk for cardiovascular disease, and then AP so we know that genetics you know, it’s part of our structure if that increases one’s risk of dementia. And we want to make this thing there toxins, infection signaling stress structure nutrients nutrients nutrients.

00;16;27;17 – 00;16;28;29
Speaker 1
Thank you.

00;16;29;01 – 00;16;47;22
Speaker 2
Yes. I mean, we know, like omegas, that’s a huge one. And I see everybody is low in omegas. We know the link with vitamin D as well. So we’re looking at these key nutrients. We use micronutrient analyzes to look at the levels and optimize them through diet through supplementation.

00;16;47;25 – 00;16;55;01
Speaker 1
Amazing. And then I think as we go through that list, it really becomes apparent that not every person is going to have the same imbalances.

00;16;55;01 – 00;16;55;15
Speaker 2
Oh, no.

00;16;55;22 – 00;17;15;16
Speaker 1
We’re looking for at a high level is an imbalance that there’s too much too little in the wrong place at the wrong time of all of these different things, have all of these different categories or buckets like you are describing. And what we want to do is optimize it through creating balance. So giving providing more if there’s too little and and getting it out if there’s too much.

00;17;15;18 – 00;17;42;26
Speaker 1
And in in that scenario when we can support balance in a complex system we get better function, right? Right. The neuronal level. Exactly. Which is fun to see. Right? It’s so fun to see when we get to see someone like get the benefits of that. I’m curious as well, you know, this foundational plan, are there supplements that you’ve seen particular success with that you are sending people home with for the most part, right.

00;17;42;26 – 00;17;51;14
Speaker 1
Like, of course, talk to your doctor. Make sure that these are safe for you. But generally speaking, are there relatively safe supplements that people can just get started with?

00;17;51;16 – 00;18;18;26
Speaker 2
Yes, Omegas and vitamin D, pretty much everyone is on the low level there, so we’re starting everybody off on good levels of, a third party tested fish oil to get their omega threes and a vitamin D supplement creatine. There’s so much great research now about creatine for the brain and increasing energetics of the brain. I tell my patients all the time, think of your brain like a battery.

00;18;18;28 – 00;18;38;19
Speaker 2
We want to increase all of that voltage that we possibly can. It’s so often that when we were doing EEGs at the office and testing, we could test people’s voltage of their brain. They’d come in and everybody was low, and then they’d get into ketosis, or they would be on creatine and increase their fish oil, and that voltage would go up.

00;18;38;22 – 00;19;08;07
Speaker 2
So anything that can increase the energetics and take away the stress and the information on the brain is the direction we want to go. So fish oil, vitamin D, creatine, lithium. Now lithium is has also great research, even in small doses of helping stabilize mood and increase brain optimization. I like a nootropic blend. I think like quality of mind to help with just being an overall like multivitamin for the brain.

00;19;08;09 – 00;19;23;29
Speaker 2
I mean, I personally take that and I find great success with that. And then, you know, magnesium in those things, especially if somebody is not sleeping well or having difficulty with bowel movements. And ketones. Yeah.

00;19;23;29 – 00;19;40;04
Speaker 1
Yeah, yeah. It’s super helpful. Yeah. I think we’ve both seen these transformations in patients. Is there one thing that stands out as the most important?

00;19;40;06 – 00;20;00;21
Speaker 2
I think keto. Yeah. It well, so every like we said, everyone has a different set of labs that will come back. And I like how you say it’s a smoking gun. Right. There could be a smoking gun that comes back. And it’s usually a combination of different things for people, but especially in the beginning when we’re waiting for that data.

00;20;00;23 – 00;20;26;16
Speaker 2
I have seen such incredible, significant changes with people just getting into ketosis. It is without a doubt the first thing I say. We have to try this. We have to. It would I would feel like a bad doctor if I didn’t say, let’s work on your diet first to try to get some movement because it’s food as medicine, you’re ingesting it every day and there are people that it makes a world of a difference.

00;20;26;16 – 00;20;33;27
Speaker 2
By getting into ketosis safely with your doctor, checking your ketones, etc.. But that would probably be the one thing.

00;20;33;29 – 00;20;48;07
Speaker 1
Yeah. And at first the men who maybe like, can’t get into ketosis or who’s worried about it, like, what are they? I guess maybe the better question is what are the challenges that you see people face, and then what helps them to overcome them?

00;20;48;10 – 00;21;12;17
Speaker 2
They’re the structure of the diet. It’s you really are trying to lower carbohydrates very minimally and increase that healthy fat. So you’re switching the biochemistry of the body to burn the fat as fuel and not carbs. So that alone can be hard for people to, especially when they eat a standard American diet that is very high in carbohydrates, to go into that lower side of carbs and higher fat.

00;21;12;17 – 00;21;49;28
Speaker 2
When we’ve been told for since the 90s, I think, to not eat high fat, that’s higher, that’s difficulty. Just making that mind shift. And also, for some people, they’re on the frailer side. We don’t want them losing weight and they might start to lose weight if they are decreasing carbs. So we do have to be mindful about weight loss, and get them on lots of high fat, checking weight frequently, maybe, putting them on ketones to start, if we find that keto is inappropriate for them at the beginning.

00;21;50;00 – 00;22;27;10
Speaker 2
Making the shift if weight is a challenge, blood sugar. People that are already high in blood sugar might have a difficulty with making that switch, but often once they do, those numbers plummet. It’s amazing they can reverse their diabetes right away. And then, you know, it takes a lot of resource. So being able to have good quality food that you can cook at home and that you can meal prep, that’s that’s how you will be more successful with getting into ketosis and not relying on food from a restaurant.

00;22;27;13 – 00;22;29;23
Speaker 2
But it takes effort and time.

00;22;29;25 – 00;22;31;25
Speaker 1
Resources, support and support.

00;22;31;25 – 00;22;33;28
Speaker 2
Absolutely. Yeah.

00;22;34;00 – 00;22;52;17
Speaker 1
I think generally speaking, do you feel like ketosis is what people struggle with the most, or are there other components of the program that, you know? It’s so funny because as we’re having this conversation, I think some of my favorite patients are the ones who come in with Doctor Patterson’s book or my book, and they’re like, I’ve already gotten better with what you guys wrote.

00;22;52;17 – 00;23;16;29
Speaker 1
You know, I want to take it to the next level. I that is such a luxury because those foundations are in place, right? There’s always some fine tuning to do, but they’ve really taken the initiative. They’ve committed to the process. They’ve already gotten maybe some of that benefit and they want to just level up. And so I guess I’m curious from your perspective, like what is the difference between the patients who are successful and those who are not?

00;23;17;02 – 00;23;41;12
Speaker 2
Well, that’s a part of it, right? If you already come in with that motivation high and the ball rolling, you’re in ketosis. There’s more room for success there. But also the support. Yeah, I think that’s the biggest thing when people have a family unit around them, a football team around them. Right? A team of support. Those are the more successful patients.

00;23;41;14 – 00;24;01;14
Speaker 2
It’s a lot to keep track of supplements and medications and doctor’s appointments and exercise routines and meal prepping. So having more people and more resources to help with that supporting care team is ultimately how people can be more successful.

00;24;01;18 – 00;24;19;01
Speaker 1
Yeah, when both a patient and the care provider, like the primary person who’s they’re day to day when they’re on the same page with them both want to be engaged in this program. That is the ultimate success. Now, that being said, I’ve had patients who have been so impressive they don’t have any support right. And they make it happen somehow.

00;24;19;01 – 00;24;45;09
Speaker 1
It’s incredible. And and there’s always, you know, caregiving can be a burden. And so there’s a recommitment, there’s we fall off track. We, you know, where things go sideways, something comes up, we get tired of it, and we give up for a bit. But how how do you see people get back to it? Like, is there, or is there something that makes it more sustainable.

00;24;45;12 – 00;24;46;18
Speaker 2
That care partner.

00;24;46;20 – 00;24;49;24
Speaker 1
For all the, the whole thing?

00;24;49;26 – 00;25;16;29
Speaker 2
I mean, more support, more support. Yeah, yeah. And having, you know, having that time for themselves where they can like rebalancing around and get back to what makes them feel joy and happiness. I think the biggest motivator for people too, is when they have a little win. And so if they can get into ketosis or if they can get a good night’s sleep, or if they can do something that makes them feel a little bit better, they’re more motivated to go in the direction of feeling better.

00;25;17;01 – 00;25;26;13
Speaker 1
Absolutely. So with you, you have eight, you’re eight, three, four. So what are your big takeaways like what do you do personally to protect your own brain?

00;25;26;16 – 00;26;01;17
Speaker 2
Oh, I love this question because it’s my life and I’m so passionate about it. I do so much because I have seen what happens. You know, with my, with my grandparents. But also I get motivated by how I feel in the moment. I feel so much better mentally when I’m sticking to my exercise, when I’m sticking to the diet, when I’m doing things that bring me joy, and I’m taking my supplements and I can tell when I stray from that, I come from a, the reason why I went into naturopathic medicine.

00;26;01;19 – 00;26;27;19
Speaker 2
I dealt with a lot of depression going, I come from that like mental health history. And it took me changing my life holistically and working on nutrition and working on all of that to feel better. I was on many different medications and unfortunately they didn’t work for me. I know they work for some people, but it was the holistic medicine that worked for me, and that’s what ultimately brought me to not try to take medicine.

00;26;27;22 – 00;26;58;03
Speaker 2
But now when I think about brain health, I do it. I do my exercises, I strength train, I run, I have a mix of cardio. I go to Pilates a couple times a week. I try to eat healthy because it makes me feel good, eat whole foods and get lots of good, healthy fat. And you know, I eat paleo or cycling to keto because in the moment I feel mentally so good and in the future I know it’s preventing cognitive decline.

00;26;58;05 – 00;27;22;20
Speaker 2
So I can break it down a little bit more. But, physically I was an athlete, so I really lean into that. It’s easy for me to do. I understand that’s not easy for everybody, but that’s why I really pull the lever, workout every day or go for a walk. I move my body some type of way every day and with diet, I have to, you know, eat my whole foods and eat my healthy fats.

00;27;22;20 – 00;27;53;26
Speaker 2
Lots of avocado, lots of eggs, lots of good protein. And, I do a lot of, like, meditation and breath work to limit my stress. Be in the moment. I go to yoga, I go to places, I take my omegas and my magnesium, my supplements, and find what brings me joy because I can tell if I’m staying away from hobbies and things outside of work that don’t bring me joy, then I can’t show up my best self.

00;27;53;28 – 00;28;18;15
Speaker 1
Yeah, yeah. So that’s really inspiring to patients. I think. Right. You’re working full time. It’s not like life is empty for you and this is your full time job to take care of your brain. It’s really you’re adding these things and incorporating these things into a very already very full life. And if there’s something that helps you to do that, to recommit to that, if you, you know, like you mentioned, I can tell that I don’t feel as well if I fall off.

00;28;18;15 – 00;28;27;04
Speaker 1
So like if you go on a trip or you know, people are here from out of town, whatever it is that makes you fall off the wagon, how do you get back to it?

00;28;27;07 – 00;28;28;21
Speaker 2
I have like my buffers in.

00;28;28;21 – 00;28;29;13
Speaker 1
Place.

00;28;29;16 – 00;28;36;00
Speaker 2
That I’ve learned over the years, and so I have a trainer that I’ll commit to go back to.

00;28;36;00 – 00;28;36;28
Speaker 1
Scalability.

00;28;36;28 – 00;28;55;08
Speaker 2
Yeah, it’s all about for me, it’s accountability. Mel Robbins, I’m sure you’re familiar with Mel Robbins. She talks a lot about the five second rule and how you have to count down really quickly to yourself. Five, four, three, two, one to get out of bed. Because our brains are wired to do it’s easy and do it feels good.

00;28;55;08 – 00;29;00;08
Speaker 2
And, you know, try to tell us any excuse to not get out of bed. That is me.

00;29;00;08 – 00;29;02;26
Speaker 1
With everything.

00;29;02;29 – 00;29;17;15
Speaker 2
So I like to have my accountability in place, my buffers in place. So when I get back from a trip and I don’t want to get back into working out, I’ll schedule something with my trainer. Or I’ll schedule a workout class with my best friend, something that kind of re motivate me.

00;29;17;17 – 00;29;18;25
Speaker 1
With food.

00;29;18;28 – 00;29;43;20
Speaker 2
You know, I’ll wear a continuous glucose monitor. That’s really motivating because I can see the data in real time. I will, set alarms on my phone. I really like reminding myself to do things. So. Like when to get ready for bed. I have a gratitude alarm every night at 8 p.m., and that’s a really great way to draw me back into my gratitude practice.

00;29;43;20 – 00;29;51;20
Speaker 2
And, you know, looking back on, my self-care, you know, am I checking in with that? Yeah. So it’s the accountability.

00;29;51;22 – 00;30;12;19
Speaker 1
Yeah. You and I both were offerings. And we have one continuous glucose monitors. And I think this idea of measuring it can go both ways. And people have a lot of anxiety around it. Right. Like it might I don’t am I doing it wrong. What is it going to say. I’m being measured. And my experience of it has been that when I’m being measured I make better decisions.

00;30;12;19 – 00;30;30;15
Speaker 1
I think it changes my behavior for the better. I eat better when I have a CGM on, because I don’t want that blood sugar level to go up. When I’m wearing the oil ring, I make sure I get my steps and I get my activity in, and I’m going to bed earlier and I’m drinking less frequently because I know it’s going to affect my HIV rate.

00;30;30;17 – 00;30;39;14
Speaker 1
And it’s kind of a way to gamify it. As long as you hold it loosely. Right? It’s not perfect. They’re not perfect tools, but they are really useful tools.

00;30;39;16 – 00;30;56;06
Speaker 2
I agree, I think all of the data is knowledge and or it’s power. Yeah, all of that is power. Like me knowing my ability. Three, four. That’s power to me to take accountability and take control of my health because I know that I can prevent cognitive decline and dementia.

00;30;56;13 – 00;30;58;12
Speaker 1
Yeah. Because we’re seeing reversal all the time.

00;30;58;13 – 00;30;59;07
Speaker 2
Exactly.

00;30;59;07 – 00;31;12;08
Speaker 1
We can reverse this and we can certainly prevent it. Yeah. Weird sort of like takeaways. Do you want to leave our listeners with like, if there is one thing that they should know about optimizing their brain health?

00;31;12;10 – 00;31;17;02
Speaker 2
Oh, wow. One thing.

00;31;17;04 – 00;31;23;24
Speaker 2

00;31;23;26 – 00;31;28;28
Speaker 2
I think, one thing.

00;31;29;00 – 00;31;34;24
Speaker 2
Oh, gosh. I want to say so many things. I do. And I think.

00;31;34;26 – 00;31;39;05
Speaker 1
We can also go in a different here. Why don’t we do it? What brings you joy?

00;31;39;08 – 00;31;45;14
Speaker 2
Being with my dog and being on the beach, running on the beach with my dog.

00;31;45;16 – 00;32;04;12
Speaker 1
And that’s. That’s all the things, right? That’s that’s a lot of brain health protection, right? You’re exercising. You’re connecting with nature. You’re connecting with your dog. You’re getting like the mirror neurons of seeing your dog happy, and you get to be happy. And I’m sure there’s community. You run into the same people in your neighborhood who are at the beach.

00;32;04;14 – 00;32;19;23
Speaker 1
And so I think that that there’s the genius in that is like, okay, how do I think the way I think of it as like, check a lot of boxes at the same time, how do I incorporate a lot of my goals into one activity? Because, yes, for for all of us.

00;32;19;23 – 00;32;20;28
Speaker 2
Right? I agree.

00;32;21;00 – 00;32;40;14
Speaker 1
And so when you can be in community, be outside, be physically active, connecting with with people. And then also like the purpose and meaning that comes from caring for an animal or a child or a loved one, at any age. But that also is so helpful for the the neurochemistry of our brain.

00;32;40;16 – 00;32;49;17
Speaker 2
And that is if I could leave one thing about brain health that I wish everybody knew it would be how important joy and purpose is for your brain.

00;32;49;20 – 00;32;50;11
Speaker 1
Yeah.

00;32;50;13 – 00;33;03;11
Speaker 2
It’s if you lean into that, you ultimately will end up taking better care of yourself and addressing the diet and the exercise and those things that come with it. If you can lean into what brings you happiness and joy.

00;33;03;14 – 00;33;29;01
Speaker 1
And that, I mean, that’s a life well-lived, right? And it’s a reason to to enjoy, like to live longer. We see there was a recent study. I know you’re familiar with it, but for our listeners, there was a recent study out of Northwestern in Chicago, and they showed that super agers, which they defined as people who were 85, who had the brains of someone 55, or, you know, if they were 87, the brain of someone 30 years younger, right, regardless of their age.

00;33;29;03 – 00;33;50;18
Speaker 1
And what they found was that the the single thing that set them apart, it wasn’t a supplement, wasn’t an exercise, it wasn’t a diet. It wasn’t any of the things that like, we’ve kind of been talking about. The common denominator for super eaters was that they were connected to a peer group. They had connections. They had social connections that they were regularly engaging in.

00;33;50;21 – 00;34;13;08
Speaker 1
Right. And I think, you know, like, well, we’re like, oh, we’re connected electronically but disconnected in real life. And I do think that this is something especially for the generations who are coming behind. Right. The people in their 70s, 80s, they’ve had a lifetime of real in real life connections. But people in their 30s, 40s, 50s even there a lot of their connections are online.

00;34;13;08 – 00;34;18;15
Speaker 1
And and this is not the same. And that is not going to get you super aging status.

00;34;18;17 – 00;34;19;29
Speaker 2
No, it’s going to increase your.

00;34;19;29 – 00;34;44;15
Speaker 1
Stress and your risk. Yeah, yeah. So good reminders to yes. Thank you for joining us to listen to this podcast. And hopefully you can enjoy it with someone and maybe chat about it. Play some cards, do something to go for a run on the beach with a dog. Go do something that you so find joy from. Any other final thoughts I share with our listeners?

00;34;44;17 – 00;35;03;11
Speaker 2
I’m just so grateful. I’m so grateful for the people in our community, the people that we get, and we’re lucky enough to come into our office. The people that believe in this and that are willing to have the courage to do this. It’s not easy, but it can change lives.

00;35;03;13 – 00;35;04;29
Speaker 1
Sam, thank you for sharing that.

00;35;04;29 – 00;35;07;06
Speaker 2
Thank you. Thank you for having me. It’s a pleasure.