Health Longevity Secrets

Why Your Brain Doesn’t Have to Age | Majid Fotuhi MD

• Robert Lufkin MD • Episode 246

Share episode

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 50:08

Think your brain has to slow down with age? We push back hard with science, stories, and a step-by-step plan that has helped patients regain clarity in weeks, not years. Our guest, Dr Majid Fotuhi, a Harvard- and Hopkins-trained neurologist who has treated thousands of patients, explains why common forgetfulness isn’t the same as cognitive decline and how simple daily choices can restore sharpness at any age.

We break brain health down to four core levers: increase blood flow, reduce inflammation, enhance the brain’s cleaning systems, and minimize plaques and tangles. Then we map those levers to five daily pillars you can actually do: exercise, sleep, nutrition, stress reduction, and learning. You’ll hear why exercise is the highest-yield habit for cognition, how BDNF acts like fertilizer for the hippocampus, and what happens when sugar spikes and insulin resistance quietly shrink your memory center. We also get practical about sustainable nutrition, from curbing glucose swings to deciding whether keto is worth it for your lifestyle.

Beyond biology, we dig into the mindsets that keep the brain young. Boredom—of the unplugged, daydreaming kind—can unlock creativity and problem solving. A clear sense of purpose measurably lowers dementia and stroke risk while making healthy choices easier to keep. We share the telltale red flags (like repeating questions) versus normal lapses (like misplacing keys), plus the personalized assessment approach that uncovered treatable factors in patients who feared Alzheimer’s. If you want a realistic timeline, expect noticeable gains in about 12 weeks when you dial in the five pillars.

Ready to build a resilient, younger brain? Follow the five pillars, personalize your plan, and start today with one small step—take a brisk walk, protect your sleep window, or learn something challenging you actually enjoy. If this conversation helped you, tap follow, share it with a friend who needs hope, and leave a quick review so more people can find it.

https://drfotuhi.com/

Continue this conversation on SubStack: https://robertlufkinmd.substack.com


Get 120 Biomarkers for $99 and CT Calcium scans anywhere in the US. https://www.vitalsvault.com/

Lies I Taught In Medical School : Free sample chapter- https://www.robertlufkinmd.com/lies/

Web: https://robertlufkinmd.com/
X: https://x.com/robertlufkinmd
Youtube: https://www.youtube.com/robertLufkinmd
Instagram: https://www.instagram.com/robertlufkinmd/
LinkedIn: https://www.linkedin.com/in/robertlufkinmd/
TikTok: https://www.tiktok.com/@robertlufkin
Threads: https://www.threads.net/@robertlufkinmd
Facebook: https://www.facebook.com/robertlufkinmd
Bluesky: ...

SPEAKER_01:

Hey Majig, welcome to the program.

SPEAKER_00:

Thank you very much for inviting me, Rob.

SPEAKER_01:

I'm so excited today to talk about one of my favorite topics, and you're an expert on it. Basically, age-proofing our brains. And we're going to talk about your new book that's coming out this week. But before we do, this since it's the first time you've been on the podcast, I want to, I want to have our listeners get to know you a little bit better. I mean, your career spans, Harvard, Johns Hopkins, uh cutting edge research and and clinical practice. So what what first lit the spark in you in neuroscience? And maybe tell us a little how that evolved into this lifelong quest to understand brain resilience.

SPEAKER_00:

Yes, the story began actually when I was a kid. I was a probably a 12-year-old boy when uh my father talked to me about the brain. He gave me the story of a young girl who was born without arms. And out of necessity, she had learned to use her toes to paint, to cook, to open doors. And she actually became a very successful artist. And he said, see, the brain has all these capacities for you to do things with your toes, which you're not usually using, but your brain can do it. Your brain has this hidden potential to do a lot of things that you're not just doing it with today's day-to-day activities. And really, in that really inspired me to realize, way, you know, we can do so many things with our brain. When I was 14, 15 years old, I wrote a book about how to become successful. I wrote uh about the lives of famous scientists, politicians, uh, physicians, I you know, John F. Kennedy, Thomas Edison, Mart McGandy, and how they became successful and what they did. When I started in college in Montreal, I took a course called uh physiological psychology, and I just fell in love with the brain. I just realized, oh my God, this is so cool at the biological level, at the science, at the cellular level. And I went on to obtain my PhD at Johns Hopkins, focusing on basic neuroscience research. I worked with a very famous uh neuroscientist, Dr. Sal Snyder, and I went on to obtain my medical degree from Harvard, went back to Hopkins to do my residency, and I became particularly interested in memory and Alzheimer disease. And since then, I've been reading and writing and doing research and seeing patients all related to brain.

SPEAKER_01:

That's great. But you know I'm gonna ask you to tip your your camera back a little bit. It looks like we're it's it's clipping off your chin there, getting better. Great, that's a great view there. Uh, you and I share the love of uh of the brain. I I I hearing you talk about it, I my I remember my own journey. I started out in physiological psychology also, and then um in medicine it drew me to neuroradiology, where I you know spent a lot of time. But I it's funny, we our our paths are very similar that way, and and the brain, the brain is is so so fascinating. One thing um about the brain, most people think about cognitive decline as being inevitable, and and um you know that we have a certain number of brain cells, we only lose them. There are all these things. So, at what point in your training or research did you realize that maybe maybe this was wrong and and why?

SPEAKER_00:

I had this aha moment when I was in residency and I saw many patients who were diagnosed with Alzheimer disease. And as I uh looked into their charts, I realized they had many treatable components that were not being addressed. Patients were diagnosed with Alzheimer's disease who also had diabetes, depression, back pain, I'll take many medications. And I thought, wait a minute, they are diagnosed with Alzheimer's disease, but they have so many treatable components. And why aren't we treating the treatable components? And as I read my, as I wrote my first book in 2002, The Memory Cure, I really appreciate that our day-to-day lifestyle choices make a difference whether our brain stays sharp or whether it declines. In other words, it's not inevitable that you become uh 60 years old that all of a sudden everything falls apart. People who reach their 60s have comorbidities that could include sleep apnea, you know, when people snore at night and feel sleepy during the day, it could be depression, it could be multiple medications, it could be obesity. There's so many things that affect the brain, and the brain is not this magical box. Brain is made up of cells. Cells have needs, they need ATP, they need oxygen, they need nutrients. If you have a metabolic condition that reduces blood flow to your brain, your brain is not gonna work. It's not anything magical, it's not like suddenly because you reach your 60s, things are gonna fall apart. You don't take care of your brain, it falls apart. You don't take care of your car, it falls apart. Now, brain needs maintenance, just like a car needs a maintenance. And that's when I realized I really can minimize the amount of decline that may happen with aging. Now it's not to say that you know a 72-year-old uh person would be as quick and sharp and uh as a 27-year-old. You know, there is some decline now over time. There are some wear and tear, but that wear and tear may be 5%, 2%, 3%, not 50%, not 80%. And I think what happens, the mistake people make, is they feel they're in their 60s, they must slow down. Then they slow down, they have less activity in the brain, and when there's less activity in the brain, the brain slows down further. It becomes a self-fulfilling prophecy. So wishes cycle. You feel you're getting worse, you get worse, then you say, Hey, I am getting worse. You do less, you get worse, which then confirm that you are getting worse. And if you stop that cycle, you can reverse things. And that's what I did in my neurology clinic. We had, you know, hundreds, maybe thousands of patients in their 70s and 80s who came to me with um belief that they had Alzheimer's disease. They were forgetting things, they were repeating themselves, uh, family was concerned, they were withdrawing from conversations. And then within weeks of us working with them, you know, we worked on five pillars of brain health: exercise, sleep, nutrition, stress management, and brain training. We personalized the program for individual patients and treated their treatable components and provide them with these five pillars of brain health uh lifestyle changes. And the thing that was exciting, the thing that was most exciting to me is how quickly they changed. When I first put together this program, which I call the brain fitness program, I gave myself nine months. I figured it would take nine months to help someone really see noticeable changes in their lives. And to my surprise, people were getting better faster. So I made it six months. And I realized, you know, people are getting faster. So I made it three months. Then I said, well, maybe six weeks. The six weeks wasn't enough. So I realized 12 weeks, three months is the amount of time that you can expect noticeable changes in your brain. It could be so different that people in your family and your work environment noticed that, hey, this guy is sharper or this lady is quicker than she used to be. And people loved it. And the thing that gave me joy was the excitement they had in their faces when they came to see me for follow-up. Like they couldn't wait to come and tell me how much better they were. And they couldn't believe it. They said, Doc, I thought I had Alzheimer's disease. I couldn't remember five things, I have memorized a hundred things. I'm impressing my grandchildren. And that self-esteem that they had developed was priceless. You can't put a price on giving someone their life back. If somebody thinks they have Alzheimer's disease and this is the end of their life, that's the most miserable ending to a person's life. Thinking that you're sinking in a swamp and there's nothing you could do. And as you go down, you can just feel it you're going down. Then to come out and start walking on the ground and running, which is what happened to them. Not only were they not declining, they were improving. They were going, like you are familiar with neurology and neuroscience testing. There's a test called MOCA, which is Montreal cognitive testing, and the score of you know 0 to 30. Most people are 27, 28, 24 is a cutoff or like things that are slipping. Uh, and of course, below 20 is bad. So 24 is called mild cognitive impairment, 24-26. And many of our patients were in that range, and they would go, they would leave the program with a mocha of 29 or 30. They would become almost normal. So I felt like this is really exciting, and I decided to uh provide all this circuits of little things that we did uh for the population throughout my book. You know, there's more to it than what I just told you. Like you need to personalize the program, you need to do a full assessment. I would ask people like 40 questions to figure out all the little things that may be affecting them. Things like, you know, you have numbness in your toes, you can have B12 deficiency, or you can have early stage of diabetes, you know. If you have sex problems, well, maybe you're a little depressed. You know, if you have obviously heart issues, you don't have enough blood flow to the brain. Um your body has multiple organs, and each organ communicates with the brain. And if your brain needs to be in tip-top shape, your lungs, your kidney, your heart, your skin, everything else needs to be in tip-top shape. You need to have good muscles, good bones, good blood vessels. Everything to me is serving the brain. I mean, and the brain serves the body, it's a two-way communication. And I find this all exciting, and so that's what I did. I decided to summarize all these 30 years of work into one book.

SPEAKER_01:

Yeah, I well, I want to I want to dive into the book and and and also dive into the brain uh physiology as well. But just the just the the point you bring up, I think is such a great one. We're you know, we're undergoing truly a revolution in longevity and anti-aging or whatever you whatever you call it. And what you described with with uh brain health, it it sort of reminds me of uh the ideas of people as they get older with sarcopenia or muscle loss, that they figure, well, they're just getting old, you know, their muscles are getting smaller, and that's that's okay, that's normal aging, when in fact it's not. It's it is sarcopenia and and it can be it can be overcome and this can be stopped and even reversed just by doing strength training, which I recommend everybody over 50 should be doing to preserve muscle mass and and not do that. But what you're saying is there's this is true also in the brain. And I guess the question I wonder you you say that a certain amount of um mental decline is acceptable. I guess then the question becomes what is it, what are acceptable levels? How do we know if, you know, I maybe I forget the keys or I can't remember somebody's name once in a while. What how do we know when is that just normal for normal aging, or when when does it cross the threshold, or is there a way to tell with that?

SPEAKER_00:

I think the threshold is when somebody repeats the same question multiple times. It's okay to forget your keys, it's okay to go to a garage and wonder where you parked your car. Those are common things that happen. What if you ask the same question three times and forget that somebody gave you the answer, that's a red flag. That doesn't mean you have Alzheimer's disease. It means that there's something is affecting your brain. I also want to make a comment about what you just said. There's a difference between what's common and what's normal. You know, in 1950s, 60s, 70s, it was common for people to be smoking in restaurants and cafeterias and you know, public places and even an airplane. But it's not normal. And so it's common for many people to slow down and develop muscle mass loss, sarcopenia, but it's not normal. So that's the the mistake that a lot of people make is to confuse what's common and what's normal. It's not normal for people to have cognitive decline. And I want to be reasonable. You know, I think that I take care of everything, I do exercise and I I do what I preach, you know. But when I play card games with my daughters in college, they really beat me. They don't beat me every time. You know, we play this family card game, which is very fast. Of every 10 times, uh, I may win twice. You know, and they win most of the time. So I need to be reasonable that you know a 22-year-old brain is faster than a 62-year-old brain, even if a 62-year-old don has everything right. Now, to be fair, if I were to just sit down and practice that card game that we play three hours a day for a month, then I will beat them because I will get better at it. You know, you could get better at anything with practice. My recommendation to people is don't think that your brain should decline because you're getting to the 60s or 70s or even 80s. You should always try to push your brain and learn new things every day. Do things that are difficult. You know, it's difficult to take a dance lesson. Take it. Do things you like. It has to be something you enjoy but you find challenging. If you dread, you know, doing crossword puzzles, don't do them. Don't don't torture yourself. Instead, you know, uh learn a new sport. Every time you're learning something new, you're challenging your brain, and that's good for you. I plan to reach the age of 90 and be sharp and independent. I plan to be what I call the brain superager. I believe that I should be able to do it. I, you know, everything I know based on the science tells me that my body is not gonna fall apart because I'm getting to my 80s, and my brain is not gonna fall apart because of my 80s. So much of it is attitude, especially in your 40s, 50s, and 60s, to maintain uh a lifestyle that keeps your muscles strong, keeps your bones strong, your heart strong, your lungs strong, your kidney, liver, skin, everything strong, and your brain strong. You have to have daily habits that support your body and your brain. Now, as long as you do that, there's only like a four or five percent chance that you have a gene out of nowhere will hit you. I think honestly, that a very small percentage of people are going to be affected by genes to either be super sharp even though they didn't do anything wrong, or become uh they lose their marbles even though they did everything right.

SPEAKER_01:

Yeah, yeah. Yeah, I want to come back to those those daily habits that uh that you're you that you're personally using to be a super agent, but before we do, just a couple couple general uh concepts. You've been interviewed by global outlets, uh, CNN, Washington Post, Wall Street Journal. Why why do you think the message of brain health is is resonating so widely right now in 2026?

SPEAKER_00:

I think people hear so much about Alzheimer's disease that they're concerned. Alzheimer's disease has often been overdiagnosed, and we talk about it more than we should. Too many people worry that the memory loss is the earliest stage of Alzheimer's disease. It's like somebody has nausea and think that the nausea must be the earliest stages of cancer. You know, if you're in your 40s and 50s or 60s and you're not as sharp as you used to be, there are reasons for it. You may have poor sleep, you may have poor diet, you may be taking too many medications, medical conditions that affect the body affect the brain. And instead of jumping to the worst-case scenario, you should be asking yourselves, what why do I have memory lapses? Unfortunately, there's so much talk about Alzheimer's disease that the average person worries that their memory lapses are the beginning of the end. You know, I give lectures around the world as well. And in many countries, when I have large audiences, I just ask, how many of you think your memory is not good? And like 90% of the population, 90% of the audience raises their hand. I mean, how could this be that there's a condition that affects 90% of the population? It just tells me that people have heard so much about Alzheimer's disease, they have um too much anxiety about their uh memory and what could be causing it. And when I talk with hosts, like I was talking to Kelly in Kelly and Mark uh uh show on ABC, and she was so worried about it. You know, before she introduced me, she said something like, This is gonna be the most important episode we've had. We're gonna talk about dementia and Alzheimer's disease. Of all the things she's talking about in her show, which she's done for more than 20 years, she said as an intro, this is the most important one. This tells me that she too worries about it, she too thinks about this like everybody else does. Many people have a family member who's been diagnosed with Alzheimer's disease, and they think, oh my God, this is the end for me as well.

unknown:

Okay.

SPEAKER_00:

Um late-life Alzheimer's disease has a very small genetic component. To put you put in perspective, if your parents develop Alzheimer's disease in their 80s, you have a 2% increased chance that you may develop it too. And if you're in your 70s, you may have a 2% chance as as a population level. So 2 more percent is 4%. So there's a 96% chance that even though your parents both had Alzheimer's disease in their 80s, there's only 4% chance that you would develop it in your 70s and maybe you know a little higher in your 80s. It's not like you're gonna get it. And most people feel like if they have it, if their grandparents had it, or their uncle has it, they're gonna get it. So I believe there's too much emphasis on Alzheimer's disease, and people instead need to be thinking about how to become a brain superager. They need to think positive instead of thinking like my muscles are uh thinning and I must be developing a muscle disease. They must be thinking, how am I gonna make this muscle stronger? We need to put positive spin on how we approach our daily habits.

SPEAKER_01:

Yeah, yeah, I I want to dive into that a little bit. And just just before we do, let's take a moment and and do some brain, kind of brain 101 to get get everybody up to speed, uh, so we're all on the all on the same page there. So Maybe start off, we'll break down the brain's uh infamous complexity. You know, when when you explain this to a non-scientist, what's the core idea they should absolutely understand about brain aging?

SPEAKER_00:

They must understand that a brain is not a mysterious box, it's a it's an organ. Your heart is an organ, your kidney, your liver, your lungs are made up of cells. And the cells in your brain share some common features with the cells everywhere else in your body. They have basic needs. They need ATP, they need nutrogen, uh, oxygen, they're nutrients. And when you take care of your brain cells, then they function better. And if you abuse them, if you don't give them enough nutrients, if you do things that reduce oxygen, if the environment they work in is not clean, they don't function well. So it's not rocket science. At some point, it's very simple. You have these individual cells, think of those workers. You know, if you have people working for you, you need to give them salary, you need to give them a work environment, and they will perform. If you have a poor environment, you don't pay them, they don't eat well, they're not gonna perform well. It's very simple. So then instead of thinking, oh, what am I gonna do? Am I gonna get an Alzheimer disease? You need to ask yourself, how are we going to take care of the cells in our brain? And the things that help in the brain are things that increase blood flow, reduce inflammation, improve brain's natural cleaning and rinsing mechanisms, and reduce these plaques and tangles that can happen with aging and an Alzheimer's disease. There's four features: blood flow, inflammation, improving rinsing and cleaning, and reducing these plaques and tangles. So these are the four things that need to be done. So the next question becomes well, how are we going to achieve those goals? And there comes my five pillars of brain health. The five pillars of brain health individually contribute to different components of those four things I told you about. And those are exercising, sleeping well, eating well, reducing stress, and learning something new. So if you do those five things, then you're gonna make your cell brain cells happy. Those five things are gonna increase blood flow, reduce inflammation, improve clean cleaning and rinsing, and reduce amyloid. So I was brain in a nutshell.

SPEAKER_01:

Yeah, no, I love it. So uh so so these brain cells are like other cells in our body, of course, and they depend on their environment and they're influenced by many things. Now, there's one thing some some people say, oh, wait a minute, brain cells are different in that we only have a certain number of cells when we're brain cells and then they die off. Now, how does that that statement uh reconcile with the sort of modern concepts of neuroplasticity uh that we're we're doing? Is that is that's is that belief still true?

SPEAKER_00:

No, that is wrong. Neuroscience research has provided compelling evidence that our brain, and especially the memory part of the brain called the hippocampus, has a capacity to generate new neurons. Hippocampus, which is the size of your thumb, is one on the right, one on the left, is ground zero for learning a memory. This part of the brain is responsible for your ability to learn new things. And what's fascinating about uh hippocampus is that it has a high degree of malleability, it can change for the better or for worse every day. And hippocampus has the capacity to generate new neurons. One of the best ways you can generate new neurons is actually exercise. Physical exercise for some reason increases neurons in hippocampus. Like, why would that be a good thing? Why would like whoever designed it? What were they thinking? Like what who whoever was planning these things? Like, why is it that if you exercise and you run, for example, you have more cells in your hippocampus? I think the idea is that when you are fit, when you're strong, you provide more nutrients and more blood flow to all brain areas, including your hippocampus. Hippocampus is the area that has the highest malleability, and when its environment is optimal, when there's plenty of oxygen and nutrients and this clean environment, they blossom. Uh, and then blossom by generating new neurons because they have the capacity to do so. And other parts of the brain blossom as well. When they blossom, they have more blood vessels, they have more branches, they have more dendrites, and there are more fiber bundles that connect them. So other parts of the brain blossom as well, and hippocampus blossoms in all those ways, plus generation of new neurons. When I explain these things to lay audiences, I say, you know, think of your brain like a garden. You know, if you abandon a garden, you know, weeds grow, the nice plants, you know, start withering and falling apart, the soil will be dry. It's not a pretty environment. Whereas if you take care of it, if you take the weeds out and make sure you water it and put some fertilizer here and there and trim them once in a while, you will have a beautiful garden. And your brain is the same in many ways. If you just let it be, you know, there are uh metabolic byproducts that accumulate over time, and there are these things called plaques and tangles that accumulate over time. It just, you know, accumulate over time, the byproducts of metabolic activities accumulate, and there's a rinsing mechanism. And if things are not optimized, well, you know, things start falling apart. You know, everything needs maintenance. Your teeth needs maintenance. If you don't take care of your teeth and you just live life, eventually you will have cavities and you will lose your teeth. And that's not normal. It used to be common, it's not common anymore. But you know, 60 years ago, 70 years ago, people used to get dentures all the time because so many people lost their teeth. But these days we know there are things you could do to take care of your teeth, and when you get older, you'll have a beautiful set of teeth. And you know, whether it's your teeth or the garden or your brain, maintenance ensures high performance. And so it's it's it's it's not that complicated.

SPEAKER_01:

Yeah, it's a great, great concept. We we've talked on the program about BDNF as brain derived brain-derived neurotrophic factor, is one of the you know strongest signals for brain growth. And and so what you're saying is that exercise and those those bodybuilders are not just building muscle, but they're actually building brain, right? With uh as one of the strongest signals for BDNF, right? Is exercise.

SPEAKER_00:

Actually, it's brain-drive neurotrophic factor, but most of the BDNF originates from muscle. Is a BDNF is an example of a myocine, chemicals that are released from muscles when they're challenged. And so, and you can think of a BDNF as a fertilizer in that garden we're talking about. So you can think of a BDNF as a fertilizer. And so when you exercise, you provide more fertilizers. Now, it's important to point out that exercise by itself is not going to do everything for the brain. You really need to take care of multiple aspects of the brain. Like if you just water the water a garden and put fertilizers, then you will still have a lot of weeds, and those needs need to be taken care of. And it's better than if you abandon them. But there are there's a protocol on how to care of a garden, and there's a protocol on how to take care of your brain. And I feel humbly that the contribution I've made is that I made a protocol, a manual for people on how to take care of their brain based on published scientific data, like how much sleep you need, how much exercise you need. And there's, you know, people have a thousand questions. Which supplements should I take? What dose of supplements should I take? Should I drink one cup of coffee or two cups of coffee, one glass of wine, or two glasses of wine? And I think that based on the current recommendations, there are guidelines. They're they're highly there, you know, they're recommendations based on science. And I think if you do those things, there's a good chance that you get to your 80s and your brain will be nice and sharp.

SPEAKER_01:

Yeah, I love that about your book, the fact that it lays down these recommendations with a specific guideline. So it makes it simple. You just follow these things and uh it's really going there. So speaking about exercise, how do you differentiate or how do you think about the difference on the brain effects of physical exercise versus mental exercise? Are is is one or the other the same, or do we need to do both? And how do you how do you look look at those in this in this application?

SPEAKER_00:

I think you need both. If you had only one hour and you had to choose between the two, I would go with exercise. Exercise has multiple uh benefits for the brain. Brain exercise increases brain activity, it increases the number of synapses, it helps to grow the parts of the brain that have been challenged. Exercise increases blood flow, reduces inflammation, improves the cleaning system in the brain, and reduces plaques and tangles. So from one to ten, I would say exercise is ten and brain training is four. Now, this is not to say never challenge your brain. I do it all the time. However, if you were to compare the benefits, exercise also has benefits from your heart, for your kidney, for your lungs, for your skin, for your bones, for muscles. Um, so exercise is really the fountain of youth, and I would put that way up there in priorities.

SPEAKER_01:

As far as um healthy brain aging, what do you how how does um glucose metabolism and insulin resistance fit into that? Is where where do you see that in the in the picture there?

SPEAKER_00:

Yes, it's a it's not a pretty picture. It's not a pretty picture. Uh if you feed animals a high sugar diet only for four weeks, the neurons lose all their branches and they become almost half as uh elaborate as they were before the study began. High sugar uh is really toxic to the brain. And um, you know, I can talk about that an hour about all the things that sugar does. So many research studies have shown that when people gain weight and become obese, they the size of hippocampus shrinks. The the larger the belly size, the smaller size of hippocampus on average. On average. Also, if you have hemoglobin A1C that rises, uh the brain size decreases. So the higher hemoglobin A1C, which is a measure of glycemic control in diabetes, uh, the lower is the size of the hippocampus, the memory part of the brain. Uh so the sugar and the sugar spikes play an important role on brain health. And the best thing to do is to eat food that don't spike your sugar. Uh, you don't want to develop insulin resistance. When you have a sugary food like a donut, it spikes your insulin levels, and your insulin stays a little higher in your blood than the time that you finished eating the donut. Now, the high insulin in your level in your in your blood makes you hungry, and you also you develop hypoglycemic. Your sugar levels actually go down. And and then so you eat. Now you're generally your you know your sugar level is 50. And you eat more, and then of course you spike again, and then you know the cycle continues. Over time, the cells in the brain and in the body lose their responsiveness to insulin. The insulin comes to help put the sugar in, but those insulin receptors are worn out, and so insulin can't do its job, and the sugar stays in the blood, it doesn't go inside the cells where it belongs. And so as it travels through the blood and goes to your toes, it can damage the ends of the nerves and cause neuropathy. When it goes to uh your retina, it can cause retinopathy. It goes to your kidney, it causes nephropathy. So those high sugar levels randomly glycate, bind to different proteins, and by binding them, they cripple them, and then different body organs fall apart, including the brain. So sugar spikes are bad. You know, it's okay to eat an apple or a pear or an oranges or things that increase your sugar levels slowly and avoid things that spike your sugar levels, like a cookie or ice cream or things that are sugary, sugary sodas. You know, one sugary soda is like having 26 sugar cubes in one uh class. Yeah, don't sign me on that for hours. Yeah, bottom line is think of sugar as poison, sugar sugar, and avoid it as much as possible. Maintain a diet that avoids sugar spikes.

SPEAKER_01:

So, yeah, so clearly avoid the sugar spikes, uh, get rid of that. And I wonder, is there any advantage beyond uh just avoiding the sugar spikes of being in ketosis periodically to switch our brain fuel to ketones, either through fasting or or even ketogenic diet? What's your thinking on that?

SPEAKER_00:

There's a lot of research to recommend kiddos uh keto diet in terms of brain health. I'm not a fan personally because I want to enjoy my life. I want to eat my blueberries, I want to have my watermelon. And you know, you know, when we talk about longevity, we need to keep in mind we just don't want to live longer, we want to have good quality years. You know, I think it was Kennedy uh who said just don't add, we don't just want to add years to your life, you want to add life to your years. I want to enjoy life. If you enjoy keto diet, please go ahead. There's plenty of evidence to support that a keto diet is beneficial for the brain. And many health conditions improve when you reduce sugar. Sugar is not a good thing in general, however, it is a question of um quality of life. I mean, being a vegan is the best diet, I think, in terms of healthy, you know, your heart will function really well if you have um uh almost no animal fat, and you know, you just eat a vegetarian diet. I do want to eggs, and you know, I think that's good too. So that kind of vegetarian diet would be a very healthy diet. But again, I like to have a steak once in a while. You know, I don't want to deprive myself of the joy of eating.

SPEAKER_01:

Yeah, yeah, no, good, great, great concept. Uh one thing I liked in your book, you talk about why boredom is actually essential for creativity and problem solving. So that how does that work? You think, oh, I just stay busy all the time. I'm gonna like work really hard, but actually there's value in not working hard, right? Or can you talk to that a little bit?

SPEAKER_00:

I believe that it's good to challenge your brain and it's it's good to you know keep learning new things. However, I can tell you personally, I find that new ideas come to me when I'm not doing other things. For example, when I do a one hour of Peloton, or when I sometimes go biking for long distances, like 100 miles, I don't listen to anything because I want to be just let it, I want to let my mind wander. And I think it's in that wonder is that creativity comes. The creativity comes when your mind is freed from doing something right in front of you. As long as you're doing a structured thing, your brain is doing that. Your brain is not allowed to think outside the box. I believe that when you're bored, new ideas come in. You are able to think outside the box. Now, being bored on social media is not boredom that's like you know, ruining your brain. Boredom means you're sitting uh outside and just looking at the trees or you're going hiking and you're just letting your mind wander.

SPEAKER_01:

One other concept you have is uh how how having a sense of purpose in life actually makes your brain younger. Can you talk to that?

SPEAKER_00:

So many research studies have shown that people who have a sense of purpose they live longer, they're less likely to get Alzheimer's disease, they sleep better, they stress less, they have 50% lower risk of developing strokes, a 19% drop in risk of heart attacks, and on average they live much longer than people who don't have a sense of purpose. There's something magical about knowing what it is you enjoy in life. It's something magical about dreaming about something and going toward that dream. For example, some people love their grandchildren and they want to do everything for them. They want to be able to go, they will they want to be able to dance at the grandchildren's wedding, for example. Other people have the purpose in life of uh being a good Christian or Jewish or Muslim person. They believe in God and they their life is in service of God and they enjoy that. That's the meaning in their life. There are people who want to be rich, they just love money and they love the challenge of accumulating wealth. Uh, many people like to, you know, have longevity. Like I personally would love to reach the age of 90 and be chapter independent. Whatever it is, like my purpose in life is to teach about brain and educate the public about how to prevent Alzheimer's disease. And when I give lectures, I'm in my zone. I'm doing the things that give purpose to my life. So the science of why having a sense of purpose is such a powerful tool is not fully understood. But people who have a sense of purpose in life are into something, you know. And the good thing about having a sense of purpose in life is that you don't have to do anything. You know, like a sense of purpose reduces the risk of Alzheimer's, the risk of uh strokes by 50%. It's a major difference. And you don't have to exercise, you don't have to eat the Differently, it's like a hack. You change your mindset, you define what it is that gives you meaning in life. And if you don't have it, you know, in my book, I put like seven questions you can ask yourself to figure out what your sense of purpose is, redefine it because everybody has something. So one question you can ask is what would you want people to say in your memorial services after you pass away? How do you want to be reminded and recognized in front of other people when you're not there? What's your legacy? What do you want to what do you want to be known for? Another question is if somebody didn't pay you for any activities, what kind of job, how would you spend your days? And it can't just say sex or you know, seriously, how would you enjoy your days if nobody paid you anything for what you did? And the thing that you do when nobody's watching, oh that's the other thing, what would you do if somebody's watching? The things that you do this is not watching or not paid for are the things that are genuinely from the inside of you, and that's how you can help define and find your um your sense of purpose.

SPEAKER_01:

Yeah, I I love that. Any other questions I that you you want I'd like you want me to ask you uh before we wrap up here?

SPEAKER_00:

I think people need to appreciate that taking care of the brain is not that complicated. They should not make it into like a huge task. You should think yourself, there are five things I need to do every day. Or like this five buckets of things that need to be taken care of. Exercise. You want to keep your body moving every day. Now, if you have time to go for a jog or play pickleball or go for a run, do it. If you don't have time for any of those, do some walking. Research has shown that even five minutes of walking helps you know, statistically difference uh of this not walking. Five minutes. So do something. Do something. Walking 3,000 to 5,000 steps a day reduces this tau protein, which is a marker of Alzheimer's disease in the brain. So do some activity. Next is sleep. You know, prioritize your sleep. Don't just say that other people have sleep problems. I have sleep problems. Figure out what's affecting your sleep. And these days, there are many ways you can determine what is preventing you from falling asleep or what's waking you up in the middle of the night. I have a whole chapter on it, but the resources are everywhere. Nutrition, that's a big one. Don't eat junk food. Like think of junk food like smoking. Don't eat donuts and cookies and whole bags of chips. Try to eat natural sources. Now, we are surrounded by junk food everywhere we go. The food in most restaurants are horrible. I give you that. Fair enough. However, don't eat the whole bag of french fries. Don't eat these hamburgers that God knows what's inside them. As much as you can, try to eat healthy food as much as you can, realizing, especially if you travel, you don't have access to it. You know, when I travel, I try to go to a supermarket and get some fresh foods and something, and then go and try to cook something, even when I'm traveling. I try to avoid restaurants as much as possible. Or go to a restaurant I know serve good food. Then is stress. So much of stress is self-induced. We give our stress to ourselves by our thinking. We expect certain things, we don't get it, we stress out. You get angry at people for not doing their job. If other people are doing things that make you angry, it's your fault. You decided they should be different. And who are you to decide what other people should do? You need to have some humility, you need to accept that you only can work on yourself, and you can really not expect people to do other things. You really need to focus on yourself, and you need to realize what's stressing you out and just let it go. Let it go. And there's a whole lot of I mean, stress reduction, meditation, breathing exercises all over the place. Do one of those and then challenge your brain. I mean, read something, read a book, do some sudoku, you know, talk with a friend about something you learned. So in day-to-day life, there are habits and choices that you need to make. Just be mindful of their role in your brain and choose wisely. You don't have to do anything at an extreme level. I mean, preferably, you never touch any junk food. Preferably. Preferably, you stress only once a day over something reasonable, like you're missing a flight, and you really need to run to catch the flight. You can't say, just relax. You know, you need to run. And our body, our physiology, is set to do just that. We have a sympathetic nervous system to kick in in case of emergency. Don't be in a state of emergency two and a half hours a day. And so these are simple things. Don't don't make it into a project. And and and more important than everything else is forget Alzheimer's. Very small percentage of people are going to lose their marbles if they follow the five uh pillars of brain health and do everything according to books. Very few people, very few people develop Alzheimer's disease out of nowhere. Uh, and if you have parents who have late onset dementia, that's okay. You can do much better than they did.

SPEAKER_01:

We're gonna put your contact information in the show notes, and maybe you could just tell people uh what's the best way for them to find out more? Obviously, the book is The Invincible Brain, Clinically Proven Plan to Age-proof your brain and stay sharp for life. It's gonna be out this week on Amazon, Barnes and Noble, your local independent bookstore. Uh, but maybe tell us uh tell our listeners uh where they can reach you on your website as well.

SPEAKER_00:

Yes, my website is drfutuhi.com, is dr frankot i dot com, drfihi.com. I'm also on Instagram, dr underscore fatouhi, and on LinkedIn.

SPEAKER_01:

Great. Well, thank you so much, Majit, for spending time with us. This has been a wonderful conversation and thanks for all the work you're doing with the the new book, The Invincible Brain. I can't wait to have it come out and let people get access to it.

SPEAKER_00:

My pleasure. Thank you, Rob.