25 - Brain Health & Alzheimer's Prevention with Dr. Cynthia Libert

Introduction to Dr. Cynthia Libert and Cognitive Decline Prevention in Asheville

In this episode, host Travis Richardson sits down with Dr. Cynthia Libert, a board-certified family physician, functional medicine practitioner, and cognitive decline prevention specialist in Asheville, NC. Together, they explore how to protect your brain, prevent Alzheimer's disease, and age powerfully from the inside out.

Dr. Libert trained at Loyola University of Chicago, completed her residency in Asheville, and discovered Dr. Dale Bredesen's groundbreaking Alzheimer's prevention framework in 2016 — a moment that transformed her practice. Today, she helps people in their 40s, 50s, and 60s take proactive control of their brain health before symptoms appear.

Key Takeaways:

• Why Alzheimer's has five distinct root-cause subtypes — not one
• What "Type 3 Diabetes" means and how insulin resistance drives cognitive decline
• Why midlife (ages 40–45) is your most critical prevention window
• How hormones, muscle mass, and gut health protect your brain
• What epigenetics means and how daily choices switch genes on and off
• Why community, faith, and purpose are evidence-based brain health strategies

Timestamps:

• 00:00 | Welcome & Introduction
• 01:15 | Dr. Libert's origin story
• 04:30 | Lifestyle medicine in rural Georgia
• 08:00 | Discovering the Bredesen Protocol
• 11:00 | The five subtypes of Alzheimer's
• 14:45 | Functional testing & 2.5-hour consult
• 17:30 | Fasting mimicking diet & new research
• 20:00 | What is Type 3 Diabetes?
• 24:30 | Blood sugar management strategies
• 29:20 | The three pillars of Dr. Libert's practice
• 33:30 | Midlife window & the cognoscopy
• 38:25 | Hormones, menopause & brain health
• 42:50 | Strength training as a longevity tool
• 44:15 | Rethink Aging platform & membership
• 49:30 | Rapid-fire: foods, Sabbath & books
• 54:30 | Final words: there is always hope

Episode Links:

• Be Well Asheville
• Be Well Asheville Podcast Archive
• Dr Cynthia Libert (Main Website)
• Rethink Aging with Dr. Libert — YouTube
• The End of Alzheimer's by Dr. Dale Bredesen
• Breath by James Nestor
• The Longevity Nutrient by Dr. Stephanie Venn-Watson

This episode is brought to you by the 9th annual Love, Shine, Play Yoga Festival, happening July 23rd through 26th in Asheville, North Carolina.

Join world-class teachers, inspiring workshops, live music, and a heart-centered community in the beautiful Blue Ridge Mountains. Whether you’re deepening your practice or just starting, it’s the perfect summer experience to reconnect and recharge.

Get your tickets at loveshineplay.com

The Wellness in Asheville podcast is produced by Be Well Asheville, your local news source covering health + wellness news + events in Asheville. Get the latest at bewellasheville.com or follow @bewellasheville.

Transcript

Travis Richardson (00:00)
so today we have Dr. Leibert on the show. Welcome to the show,

Cynthia Libert (00:04)
Thank you, Travis. Great to be here.

Travis Richardson (00:06)
Yeah, so for the listeners here, just meeting you for the first time, can you give us like a 30 second version of kind of who you are and what you do?

Cynthia Libert (00:16)
Of course. Well, I'm a family physician by training here in Asheville, North Carolina, and I have a private practice where I help people with prevention of chronic disease and also ⁓ treating complex chronic illness. My focus is on cognitive decline prevention. That's my passion.

Travis Richardson (00:40)
Nice, yeah, I'm really excited. There's so many people who are interested in this topic and there's so much great science and there's so many great modalities that are out

to address some of the issues. And of course, you're the expert in all of that. But I want to ask you, so you're a functional medicine expert, but you're also a board certified family physician. So ⁓ that's kind of often a rare combination, just because often you're one or the other, but not both. So I'm curious how those two things kind of sit together for you in your practice, and how did those emerge?

Cynthia Libert (01:10)
Sure.

Yeah, well, I knew I wanted to be a doctor when I was in first grade. So it was a calling early on and I just, you know, went straight through. Didn't veer off course. I went to ⁓ St. Louis University for my undergrad in ⁓ biology and I love to sell biology. just love the science. And then went to Loyola University of Chicago for medical school. And that was also a

Travis Richardson (01:21)
Hahaha

Cynthia Libert (01:46)
wonderful experience and then I always wanted to live in North Carolina. So I came to Asheville here in the mountains for my family medicine residency training in 2002, 02 to 05 and did my three year training in family medicine. And during that process, I had my first baby. My first daughter was born the third year in residency.

And of course, that was challenging. And then getting out into private practice, I spent the first two years at a community health center working with migrant farm workers and helping people with the basics of health. And I started to have this stirring in me for going deeper. ⁓ I read the wellness literature early on, and it really planted this seed.

that there was so much more than we do in conventional medicine, which if you think of the illness wellness spectrum, on the far end you've got ⁓ premature death and disability. On the other end is optimal health and flourishing. In the middle is the line of fine, where we try to get people from symptoms, disability,

we try to move them toward this center line, which is a noble and worthy cause. And we do that with pharmaceuticals, largely counseling surgical procedures. And I knew that my calling extended beyond that. I wanted to help take people through the awareness and growth and education process to help them to actually move beyond that line of just

absence of symptoms, which is a great place to be, but into more of a flourishing piece. And so it just, it evolved over time as I continued my medical education outside of medical school and residency. I went to the National Wellness Conference in 2005, so 20 years ago, and that was a life changer for me. It was, you know, a gathering of ⁓ not only doctors, but

nutritionist and fitness professionals and counselors and just this very holistic view of medicine and it was inspiring. So that got me on the path of evolving my career to where I am now.

Travis Richardson (04:28)
What year was that around? What time period is that?

Cynthia Libert (04:30)
That was 2005.

Travis Richardson (04:32)
Okay, yeah, because then

Cynthia Libert (04:33)
Yeah.

Travis Richardson (04:33)
I, we had talked earlier ⁓ prior to this call and I had made a note that you were doing lifestyle medicine in Georgia, rural Georgia around I think 2010 it was and that's curious about that experience and then something happened in 2016. I remember the date but I don't remember what you exactly said so you want to elaborate quickly on those two time periods?

Cynthia Libert (04:45)
Yes.

Mm-hmm.

Yeah, sure. So

I joined up my friend from residency. We founded a private practice in rural Georgia in 2007. And so I got to do the full scope of family medicine in terms of hospital work and nursing home and hospice care and working at both the office and the hospital. And so it was very

very full life. I had three young daughters and working a lot. And so I also ⁓ just felt called to incorporate more lifestyle medicine into my practice because, you know, over time you see people just declining with the pharmaceutical dominant approach and

Travis Richardson (05:47)
And can you, and just to interrupt you here, can you define lifestyle medicine for those that don't maybe haven't heard that term? What is that and how is that different from just normal medicine?

Cynthia Libert (05:55)
Sure, that's

the foundations of health through nutrition, physical fitness, stress management, sleep optimization, those things. And in terms of, we all probably know what to do, but it's the science of behavior change, of helping people start where they are and then walk through a process of changing daily thoughts. starts in our...

our mindset, changing your thoughts and then behavior shifting over time and maintaining those changes. So yeah, I got it so that it sticks. So I really put a lot of energy and effort into bringing that into rural Georgia. It was quite a process, but my patients loved it. I had amazing outcomes with people having like a hemoglobin A1C of

Travis Richardson (06:31)
Yeah, so that it sticks.

Cynthia Libert (06:53)
14. So that's like severe insulin dependent diabetes being able to actually come off of insulin, which I didn't think was possible, but we, you know, help people. It was amazing. And, you know, people with severe psoriasis, just their skin clearing up after shifting to a Mediterranean diet and adding some foundational supplements like probiotics, vitamin D, fish oil. So it was really

powerful and it led me down a path where I saw the limitations of the third party payer system. This was a passion project where one day a week I would work with patients with a health coach, a nutritionist, we would, instead of seeing 25 patients on that day, I would see maybe five or six. It's been an hour with

each of them and it was wonderful for the patient outcomes and the patients loved it and I loved it, but for the bottom line, it didn't compute. so that spurred me on to try to evolve my practice in a way that allowed me the freedom to spend time with people to do this deeper lifestyle medicine work.

Travis Richardson (08:18)
Yeah, so we're in season two right now and the topic is longevity. And so I chose you specifically because I wanted to talk a lot about brain health and longevity as it relates to.

disease processes that we're all too familiar with, like Alzheimer's and such. So we're gonna get into that. That's the rest of the conversation will be about that. But I'm curious how you sort of found yourself in that domain and why you have a strong focus there today in your practice.

Cynthia Libert (08:51)
Yeah.

Well, I've always been drawn to brain health, mental health, I think in part because I'm a female and I'm a good listener and people tend to just open up to me and tell me their challenges. And so ⁓ as a family doctor, I did a lot of mental health care, but I never thought about cognitive decline prevention as even ⁓ something to aspire to because

what we're taught in medical school that Alzheimer's disease is this mysterious disease, neurodegenerative process that sort of, there's no cure, no way to prevent it. so I was pretty deep into integrative and functional and lifestyle medicine. By the time I learned of Dr. Bredesen's work in 2016, I had closed my private practice in Georgia and moved to

back to Asheville area, my mom had cancer at the time and so wanted to be near her and that gave me the opportunity to do a deep dive into Dr. Bredesen's work in 2016. And that just blew my mind that he had all these case studies of people who had a mild cognitive impairment or early stage Alzheimer's disease.

who actually halted the disease process and in many cases actually reversed. And I got to see the case studies, hear the testimonials of people, meet his research team and just hear the whole approach. And so it was like a light bulb went off for me that this systems biology approach that I've been doing for years for...

everything else that I could actually apply this to something so terrible as Alzheimer's disease. And so that shifted the trajectory of my career.

Travis Richardson (10:57)
Hmm.

Dr. Dale Bredesen has a framework. ⁓ In my research, thought the most interesting thing is that there's all these subtypes and there's like ⁓ many different ways Alzheimer's may develop in terms of like the components or what goes into it. ⁓ And we'll talk about type three diabetes here in a bit as to what that means for the listeners who will go into that. But he also has other things like

Cynthia Libert (11:21)
Mm-hmm.

Travis Richardson (11:28)
inflammation, infection, there's of course ⁓ the sugar component that we'll talk about with type 3 diabetes and what that means, but vascular, traumatic, and there's all these different subtypes. That was really interesting to me to find that, but it makes sense though, right? Because Alzheimer's, like so many other things, even heart disease and such, they are an accumulation of insults to the body that have lots of times many different ⁓ sources. so I felt

like that was a really like a relief because it seems like we're always looking for like this silver bullet or the real real ⁓ singular cause of a thing and what we're finding is there isn't a singular cause often right it's a it's a mix of of lifestyle ingredients that create the disease is that how you see it or is it you see it differently

Cynthia Libert (12:17)
Yeah, that's

exactly right, Travis, that well articulated that Dr. Bredesen opened my eyes that Alzheimer's disease is not really a single disease process. It has so many different root causes. And so he actually introduced this subtyping process where we go through and look at type one, the inflammatory infectious drivers of cognitive decline and then type.

So 1A and then 1B because it's so closely related is the glycotoxic piece from blood sugar and insulin resistance. Then you've got the deficiencies, the atrophic subtype, and that happens more as we age, as hormones decline, the different growth factors for the brain, thyroid hormones, hormones, estrogen, testosterone, that sort of thing.

vitamin D, B12, magnesium, CoQ10. So you've got the atrophic or deficiency of growth factor subtype, and then toxicity, which is a huge topic. So many different ⁓ risk factors fall under that, whether it's mold, mycotoxins from mold in the home or office, environmental toxins, environmental pollutants.

pollutants, things in the air and water and pesticides, herbicides, that sort of thing. And then we have vascular subtype, which is also very important, not just for Alzheimer's disease, but also vascular dementia. And there's often overlap there, a mixed picture. And then the toxic subtype, I'm sorry, in the traumatic subtype is the last one.

And that can be either physical trauma, concussions, head trauma, or emotional, psychological trauma abuse, which is unfortunately very common. And so that's what I do for all my patients, whether they're 14 or 74. When I meet with a patient, I'm always keeping track of their risk factors in these different subtypes. And it helps me to...

know how to personalize their care and help with prevention.

Travis Richardson (14:42)
Do you do functional medicine tests to identify these kinds of things so that you understand like a baseline for folks or does that come in later like after you start working with them? ⁓

Cynthia Libert (14:52)
Yeah, so we do the whole

spectrum. We do a lot of extensive intake questionnaires just so we know background on someone and all the symptoms they're dealing with, all the different life events, toxic exposures and traumas. And then I get the privilege of sitting down with people for two plus hours for new patient consultation. So we go from preconception, what they know about their...

Mom's pregnancy all the way up to present day looking for antecedents.

Travis Richardson (15:25)
Nice. I want to stop you right there. I got to stop you right there because I want the listeners to

hear that again. Did you say 2.5 hour initial consult? That is remarkable. I think most people get seven minutes max. That's amazing.

Cynthia Libert (15:35)
Mm-hmm. Yes. Yeah. Yeah. Well, I find

even just the act of sitting there and listening, people feel heard. That's healing for them to have someone hear their story and to listen and to care. And that's a privilege. And I really enjoy it.

Travis Richardson (15:59)
Mm-hmm. Well, it's part of healing too. I mean, that's a healing ⁓ modality and to itself is to sit and listen to someone. Well, here on the, so of those subtypes that you mentioned, all those different subtypes, I guess what do you see is the most common one showing up in Western North Carolina?

Cynthia Libert (16:01)
Yeah.

It is.

I see pretty much everyone having multiple risk factors. It's rare that I'll put unknown next to one of my subtypes. And even if I can't find something initially, eventually we do find something in all the subtypes, unfortunately.

Travis Richardson (16:35)
Are you aware of Dr. Walter Longo's work? I was just reading up, because, yeah, FMD. if the listeners are not aware, Dr. Walter Longo's, I'm a fan of his. He's done lots of great research, think, out of, was it University of Berkeley, is it? Somewhere in California, I forget where he is, UCLA maybe. Anyways, a lot of people have heard of the fasting mimicking diet. ⁓

Cynthia Libert (16:38)
I am, yes, the fasting mimicking diet.

Mm-hmm.

Travis Richardson (17:03)
But he also, as well as the other fellow that you mentioned, I forgot his name already, ⁓ who does the research, Dr. Dale, yeah, Dr. Dale, sorry. ⁓ He also has shown that you can... ⁓

Cynthia Libert (17:12)
Dr. Dale Bredesen.

Travis Richardson (17:20)
potentially halt or reverse Alzheimer's through his fasting mimicking diet. So we see that there's a lot of research now around this. so are there others that are coming out? Is there more research? I'm not up to date on the very latest, but that's one of the things I remember reading about recently is that he's ⁓ shown pretty decent, ⁓ decent case study on the research showing it can be reversed.

Cynthia Libert (17:25)
Mm-hmm.

Yeah, there is so much on the horizon, so many exciting developments. Actually, Dr. Bredesen and colleagues all around the country have just completed a randomized controlled trial on precision medicine showing amazing results. It's not yet published in peer-reviewed literature, but that is on the horizon. I'm so excited for that.

Travis Richardson (17:48)
Yeah.

Ooh, sneak peek.

Yeah, that's

awesome. Well, that's that is super exciting. I'm also can't I can't wait because because these are the kinds of things that we've been waiting for in the holistic sort of health world that that we have oftentimes not to never trying to bash drug companies, but they are they're typically the ones that have all the money to be able to fund studies. And even if they're good studies, they're nobody's looking at some of these alternative ways of

of ⁓ reversing disease. So it's kind of, I'm really excited about this one. ⁓

Cynthia Libert (18:47)
And it's much simpler to study one drug and a placebo pill than it is

to study a polyprogrammatic lifestyle medicine approach where you're fine tuning hormones and micronutrients and everybody's treatment plan is different. It's really our method of studying needs to evolve to be able to show the power of functional medicine.

Travis Richardson (19:09)
Hmm

Well, that's a really interesting and actually really helpful observation, I think. Again, controlling variables is the main thing, the main problem in science. And when you have a person, you then have infinite variables to try to control with what they do in their life, right? So ⁓ yeah. OK, well, let's get on to type 3 diabetes. What is type 3 diabetes? Lots of folks maybe never have heard that term.

Cynthia Libert (19:24)
Mm-hmm.

That's right. ⁓

Yeah, well, that is ⁓

a term that's been coined to describe Alzheimer's disease because of the fact that the brain becomes insulin resistant. The brain has trouble utilizing glucose for fuel as it goes through this disease process. so it kind of opens up our understanding of how to prevent Alzheimer's disease through addressing

insulin resistance, focusing on body composition, helping people become aware of the importance of muscle mass as we age and keeping our body fat down, which is very challenging in our standard American living. so yeah, type three diabetes ⁓ is Alzheimer's disease.

Travis Richardson (20:32)
Yeah. So like we have metabolic diseases of the heart. We then have metabolic diseases of the brain, which is, think is the unique offering here is to term that that way. So we can start to think about our metabolic health as a thing that affects not just only the heart, but like outside of that as well. We, but it makes sense because you've got arteries and those can get clogged in the, in the hearts and other places and you've, well, they could probably get clogged in the brain as well. And

Cynthia Libert (20:57)
Thank

Travis Richardson (21:02)
the, ⁓ it's inflammatory, right? So I think that the biggest thing we find is that a lot of the research right now is pointing to ⁓ cardiovascular events happening as a result of runaway inflammation. So it's not only just deposits of things happening in the arteries, but it's the breaking off of them that can happen through inflammation. And I think they're even saying like stroke and other kinds

of events ⁓ in the brain are happening as well due to inflammation. like the circular, there's a lot of variables that go into it, I guess, is what I'm saying there.

Cynthia Libert (21:43)
Yeah, well, the health of the body really determines brain health. And that's such a paradigm shift, even in medicine. You know, we think about, I was trained to think about Alzheimer's as this mysterious thing where the amyloid plaques and tau tangles just show up and we need to figure out how to address those. But it turns out that, you amyloid is like a protective mechanism trying to deal with

⁓ insults to the brain, whether it's blood sugar challenges or toxicity or infections. And so addressing our risk factors really involves getting the body healthier and addressing the whole entire system.

Travis Richardson (22:31)
It's interesting how we like to find the scapegoat, right? We find the thing that we need to demonize and all get on board with. And it used to be in the 80s. I always remember my mom coming home with fat-free ice cream because fat was the problem. And so I grew up just with the basic understanding of health is that fat's a problem. It doesn't matter where it comes from. It's the issue. ⁓

Cynthia Libert (22:35)
Mm-hmm.

Yeah.

Travis Richardson (22:55)
Yeah, so you know, now it's sugar and I think we maybe we're on to something. Maybe we're on to something when we say that sugar is a problem. I was listening to a podcast episode recently and this guy was saying that he thinks he likes to consider sugar a toxin itself, like not, ⁓ he doesn't want to even give it just even a little bit of like, it's good for you. He's like, no, it's a toxic ⁓ substance just as if you were to ingest anything else that would you consider toxic.

Cynthia Libert (22:59)
Mm-hmm.

Mm-hmm.

Yeah, it's a metabolic poison, especially in liquid form.

Travis Richardson (23:26)
And I think, yeah, poison, yes.

And when we think of it that way, you think, okay, well, I mean, what goes through a parent's mind when they're about to serve their child breakfast? mean, not to try to make anybody feel bad, but if you put Froot Loops on the table or something like that, you just should know that that's, ⁓ well, if you agree with this guy, it's a form of poison.

Cynthia Libert (23:47)
Mm-hmm.

Travis Richardson (23:56)
maybe rethink ⁓ options that way. ⁓ Yeah, so, all right, so managing blood sugar then becomes, with regard to type 3 diabetes obviously, is ⁓ the most, one of the most important things you can do for your health, your wellness, your prevention, and of course, longevity.

Cynthia Libert (24:01)
I agree.

Travis Richardson (24:19)
What strategies do you help your patients with in terms of how do they go about starting to change their lifestyle? ⁓ And are there any supplements? Like what do you do to address blood sugar?

Cynthia Libert (24:33)
Yeah, so the first thing is data. Every patient that walks through our doors gets an in-body body composition to look at the body fat percentage, the muscle mass, and then we address that, trying to aim for optimal muscle mass. then losing body fat usually is the case. Occasionally, someone is underweight, but most of the time, it's we're over.

overfed and undernourished and we have too much body fat and not enough muscle. And so just counseling people around that in terms of, you know, the physical fitness strategies, cardio, ⁓ respiratory fitness piece, the strength training piece. And then it really is holistic, you know, because if you're not sleeping well, your, your willpower and your desire for comfort foods goes up and

stress hormones go up and so it's managing stress is also a big part of the picture. A stress, you know, chronic, unremitting stress that's not managed, you can have dysfunction in the HPA axis that raises cortisol levels and that can contribute to visceral fat and so helping people to be creative in managing the stress that all of us face.

Addressing the gut microbiome is really key. Our gut's like a garden. And when you have a dysbiosis, an imbalance in the bacteria in the microbiome, that can actually set you up for insulin resistance and blood sugar issues. So feeding the gut healthy foods and maybe some probiotics or different herbals to soothe the lining and help with inflammation in the gut, that can help.

with the type 3 diabetes. yeah, the foundations of health are always key, but of course we have, that's one thing about being an integrative medicine is that we don't throw out the conventional pharmaceutical approach when it's indicated. And so I do use a fair amount of metformin medication that can help improve insulin resistance and

help modestly with weight loss. And the newer GLP-1 agonist ⁓ medications have been very, very helpful for people with pre-diabetes, insulin resistance, obesity, and can have some positive side benefits for inflammation in the body and cognitive health, autoimmunity. So there's a lot of tools that we have.

Travis Richardson (27:26)
Yeah, metformin has been in longevity news quite a bit. know one of the studies talked about it being, ⁓ for, let me try to get this right, diabetics ⁓ who took metformin showed increased ⁓ chance for life, ⁓ reduced chance for all-cause mortality, and I believe enhanced

lifespan potential. I'm being pretty vague there, but I remember there being something about above and beyond just ⁓ somebody who wasn't taking metformin, I guess. And I'd have to go in and clear clarify this up. And maybe I can put it in the show notes. it was showcasing that metformin was so powerful ⁓ in the overall longevity of people that they were saying that if you have diabetes, I was like, talk to my

for instance. So my mom is pre-diabetic and she was considering getting on metformin whether or not she should. And of course I'm not a doctor, I can't tell her one way or another, but I can say that there's been some beneficial outcomes for those that needed it and went on it. And I said because of that, if it were me, ⁓ and I were sort of in the same scenario as her, dealing with blood sugar that was really hard to control through other means,

I, based on the data that I had read, would have no problem ⁓ taking metformin if it were appropriate. My doctor, you know, said yes, but I thought that there was some really, but it just outlines how powerful it is to control your blood sugar, how important it is because you're getting these other beneficial things showing up in the research when you do that, so.

Cynthia Libert (29:18)
Yeah, in the properly

selected patient, it can be really powerful in terms of it being a geroprotective molecule for someone without pre-diabetes or diabetes. That's definitely hotly debated, and I think the verdict is still out on that. But certainly, if someone has a condition that would benefit, I do use it as a tool. Unfortunately, it can have some side effects, ⁓ GI side effects.

especially, you know, diarrhea and flatulence and heartburn, those sort of things, but we start low and go slow and a lot of times people are able to tolerate it.

Travis Richardson (30:00)
Yeah.

I like that. You said what I was trying to say not so elegantly, which is that geroprotective. That was the word I was searching for. All right. Well, you've got the three pillars that you center your work around. Those are risk factors, epigenetic inputs, and the third one is, course, my favorite, having fun. So yeah, I love that. I think that is brilliant. And I'd like you to go over the first two, kind of describe what those are, why they matter.

Cynthia Libert (30:11)
Mm-hmm.

Yay!

Travis Richardson (30:31)
fairly briefly and then and then of course get on to the having fun one because I think that's where the real where the real juice is

Cynthia Libert (30:35)
Yeah, super. Well, thank you for asking

about that. You know, the subtypes of risk factors I mentioned early on from Dr. Bredesen's work, that's where we use everything from history, physical exam, vital signs, brain MRI, if indicated, to conventional lab testing, and then functional lab testing to gather data to understand where people fall with their risk factors. So that's

An important first step to understand where you are. And then the second pillar is to optimize our epigenetic inputs. And I love, I love the term epigenetics. It's such a beautiful, hopeful science and discovery that we're not locked into our genes, that we actually have some degree of control over how our genes express themselves based on our environment and

the we make in terms of the people we surround ourselves with, the thoughts we allow to dwell in our brains and nutrition, stress, sleep, all the foundations of health impact our epigenetic expression. So we can turn genes on, turn genes off. And the more that we cultivate healthy lifestyle that...

that gets optimized. And then the third pillar is to create this lifestyle that you love to live that nurtures health through community, which is really key, through shifting your mindset and focusing on a growth mindset and realizing some of the false beliefs or

⁓ distorted thoughts that you might have that are holding you back. And then just leaning into the science of behavior change and setting up little micro habits to shift you in the direction that you want to go. And so that's my passion. That's, you know, our whole process is identifying risk factors, helping people optimize them, and then bringing in the support, the community, the coaching.

mindset shifts and habit change to help them actually do it, but do it in a way that's not sucking the life out of you. And this is, it's been, you know, a decade of working with Dr. Bredesen's protocol and trying to help people address this, you know, terrible neurodegenerative disease. And that can generate fear for people when either if you have

Travis Richardson (33:12)
Yeah.

Cynthia Libert (33:30)
family history and you're worried about ⁓ going down the same path that your parent has, or if you're having symptoms, it can generate a fear response and people can start to be compelled by fear to make changes, but that, it doesn't last and it's no fun. And so I try to bring joy and lightness and fun.

and meaning and purpose into the process. Because ultimately that's what we're trying to do is to be good stewards of our body so that we can feel well, that we have energy and vitality, that we can do the things that we are designed to do, that we feel called to do, and serve others.

Travis Richardson (34:22)
Yeah, well said. I think we're all really hard on ourselves and we have such high expectations of ourselves and that can be pretty damaging. And then of course, yeah, we are often isolated, feel alone more and more actually. Which is of course why I think it's great. We'll talk more about your rethink aging platform because I think that's a solution to some of that, especially when you have folks that are kind of interested in the same topic.

Cynthia Libert (34:26)
Mm-hmm.

Travis Richardson (34:52)
And I think groups like that where they can come together and have some shared ⁓ meaning, shared purpose, shared understanding, I that's really great. ⁓ And we also know that community is huge for longevity. We see all around the world, if you were to look at the blue zones, those places in the world where people live the longest, there's some form of built-in community.

⁓ In the West, we've had, whether you call it a privilege or not, I'm not sure, but the privilege of being able to financially separate from one another and create our own homes and have our own cars and have our own cell phones so that we can be in our own rooms and have our own meals and ⁓ all these ways that we've financially been able to kind of become separate are now really hurting us in a lot of ways.

Cynthia Libert (35:34)
Hmm.

Yeah.

Travis Richardson (35:50)
Anyways, that's another topic about that, but I wanted to get to your view on

midlife because I think that is, as you call it, the critical... ⁓

time period. ⁓ Can you talk to us about that? mean, you don't want to wait until you're 80 plus to start changes if you can. And now if you are 80 plus, it's never too late to make improvement. That's for sure. But what about this midlife ⁓ as being a critical window? What does that mean to you?

Cynthia Libert (36:17)
Sure.

Yeah, absolutely. So it's my experience that human nature, we like to wait until there's a crisis to intervene. Just, you know, I guess that's how our brains work. We want to expend the least amount of energy to go through life. because

Alzheimer's disease and many other chronic degenerative changes happen 10, 20 or more years before you actually have any symptoms. It's really critical in midlife to address all your individual risk factors, whether it's hypertension or hearing loss or vitamin deficiency, any number of things.

if we intervene in midlife, it can shift the whole trajectory of your health long-term and actually prevent Alzheimer's disease and at the same time, many other things. So ⁓ I love working with people in their 40s, 50s, 60s to be proactive, to identify what's going on with their brain.

I recommend everyone get an annual brain checkup, a cognoscopy. Dr. Redison coined that term to kind of play off of the term colonoscopy, which is not a pleasant test. But I find that an annual brain health checkup is actually a pleasant, ⁓ empowering thing for people to do midlife. About 40, 45 is a great time to start that too.

Travis Richardson (37:52)
You

Cynthia Libert (38:04)
just understand what your risk factors are. Maybe you have a family history and that might be a big genetic risk factor, but even if you don't have a family history, there are so many other contributing factors that start to emerge in midlife and that are very actionable and can be preventive.

Travis Richardson (38:25)
So hormone optimization, I thinking back from something we talked about earlier, ⁓ you mentioned hormones and how those, in middle age, obviously, that's when hormones start to go all kinds of sideways for lots of us. ⁓ And so that becomes something that's really on folks' radar in middle age. What role do hormones play specifically in either ⁓

Cynthia Libert (38:40)
Mm-hmm. ⁓

Travis Richardson (38:55)
the protection, cognitive protection or cognitive deterioration? How does hormones work that way?

Cynthia Libert (39:01)
Yeah, so, ⁓

you know, a majority of people that end up with Alzheimer's disease are actually women, unfortunately. And we know that the perimenopausal and menopausal transition is huge for ⁓ vascular changes, cardiometabolic metabolic changes that can set us up for cognitive decline later in life. The

the body is covered in estrogen receptors, the brain is covered in estrogen receptors. And so when you have that period usually starting in the 40s, where there's a decline in estrogen, that can start the disease process. And so ⁓ in all my patients I check, estradiol, DHEA, progesterone, testosterone.

thyroid hormones, stress hormones, and make a plan to address them. Not always bioidentical hormone replacement therapy, although we do a fair amount of that, but there are many lifestyle measures, herbal, nutritional support that can help with our hormone balance. And men, we don't want to leave the men out. ⁓ Men go through a more gradual...

transition with hormones, it's called andropause, where the testosterone declines over time. And that can also have a profound impact on brain health and muscle strength and vigor, vitality, sexual health for men. And so we are always checking that and replacing hormones, testosterone if needed.

Travis Richardson (40:44)
Yeah, and ⁓ just ⁓ do you recommend strength training for most people if they can do it in their middle ages? Because I know that we have lots of ⁓ muscle loss starting even already in our 30s. of course, having muscle would help burn glucose. And that helps with the type 3 diabetes thing, right?

Cynthia Libert (40:54)
Yeah.

Mm-hmm. ⁓

Yeah, yeah, actually

building and maintaining muscle is one of the number one strategies for aging well. Muscle is the organ of longevity. It really functions more like an endocrine organ. It secretes things into our bloodstream to help with ⁓ our metabolism and blood sugar regulation. It's like a sponge for

for sugar and ⁓ so there's so many reasons why muscle, maintaining your muscle mass will help you age and potentially ward off ⁓ chronic degenerative diseases like Alzheimer's. ⁓ So yes, strength training is a big part of my personal lifestyle medicine plan and what I encourage my patients to do as well.

There's a mindset shift that needs to happen often. And, you know, people tend to be resistant to that unless they've had a history in athletics or fitness. They think of like, I'm not a gym person, but the reality is that we're meant to be moving and bending, twisting, lifting, pushing, pulling, you know, carrying heavy things. That's how we maintain our health. And since we tend to have a more sedentary

comfortable life in the modern world, we have to purposefully stress our body and do strength training to keep ourselves healthy and well as we age.

Travis Richardson (42:48)
Yeah, I always tell people like, look, if you don't want to go to the gym, you know, that's there's other ways you can do things at home. You can go. You can do things in nature like if you're me. I actually like to sometimes I'll just go find a sounds funny, but I'll go find a tree branch and I'll just hang from the tree branch and and just like, you know, feel my you know what I mean? And I'll or I'll do little pull ups on them or I'll just then I'll and so I kind of integrate it into spending time outside and being in nature. And I think having a way finding a way

Cynthia Libert (42:55)
Mm-hmm.

Super.

Travis Richardson (43:18)
Maybe people would listen to this podcast while they're at the gym. Hey, so now you're doing something that you enjoy while you're doing something that maybe is little less enjoyable. ⁓ However you do it, I always recommend people please ⁓ consider finding a way to be strength training. Especially, again, I mentioned my mom who ⁓ is, ⁓ at the same time she's becoming pre-diabetic, ⁓ which I think she's,

Cynthia Libert (43:23)
Mm-hmm. Mm-hmm.

Travis Richardson (43:48)
We've made a lot of progress and. ⁓

in that way, part of that also is that there's a sarcopenic element. So her losing muscle, right? So these things are happening at the same time. So you've got to really ⁓ kind of combat them with whatever you have, proper protein and whatnot. Okay, so I think we've covered a lot. I want to hear more about your rethink aging platform and community that you have.

is it, ⁓ what's it like to be a part of it, and what's the future of that for you? Yeah.

Cynthia Libert (44:27)
Well, thank you for asking, Travis.

So last year I found in my own YouTube channel, it's called Rethink Aging with Dr. Lybert, and it's just to put some education out there in the world and help people with their mindset and inspire them around healthy habits and give some education around the approach to cognitive decline prevention and treatment. So that's a free worldwide resource.

And I also wanted something that I could share widely that wasn't dependent on my medical license in the states where I'm licensed, which is in the Southeast. So I founded the Rethink Aging Community that's available to anyone in the United States where we do annually, we do a biologic age test to see our biologic age versus our chronological age.

and our pace of aging. And then each month we have a longevity topic that we meet online together, live for a master class. And people have, we do a Q and A and then there's also a community forum that's private and we all interact there. So it's a way to just ⁓ dig in and engage with a group of people that are highly motivated, educated, proactive.

about their brain health. And I come from a Christian perspective. And so it also brings in the faith component, which I find to be very helpful for people to be able to incorporate that, to see not, we're not just chasing after health just for vanity or just to randomly live longer, but we're doing it to try to be good stewards of our body and to.

show up well and love and serve others. And so it's a beautiful community. I invite anyone to join who wants to be a part. And then of course we have my clinical work where I see someone one-on-one for that two to an half hour visit to learn about you and to formulate an initial plan diagnostically and therapeutically. And then I have just launched a

very structured program for a prevention tract. We call it the Brain Health and Longevity Membership. And that's where you get an annual cognoscopy with me, along with a whole slew of laboratories, and you get a lot of intensive coaching. I have a functional genomics coach in my practice, and she meets with people once a month within that program, and then a wellness coach that helps with meal planning and...

I prescribe the therapeutic diet and then she helps with the planning and the shopping list and things like that. We also have a weekly functional fitness class, a corrective exercise class, which is fantastic. We do soul care once a month, so it's very holistic, designed to address the whole person. And then I have a very small practice of helping people with

actual cognitive decline. So mild cognitive impairment, early stage Alzheimer's disease. I have an intensive 12 month treatment program for those individuals. And ⁓ I've structured it in a way that ⁓ lets them have access to all the tools that we have and then reserves my time to be able to help them.

Travis Richardson (48:17)
Nice. Well, it sounds like you have something for everyone. And I do like the holistic approach where you're trying to address all of the components that I think are important for not just brain health, but overall health and happiness, especially with the faith component. We also see in the blue zones, there's often a faith. We know the Seventh Day Adventists in California have that strong faith component that seems to be protective for them as they age.

Cynthia Libert (48:32)
Mm-hmm.

Mm-hmm.

Yeah,

Travis Richardson (48:47)
as well. Yeah.

Cynthia Libert (48:47)
the spiritual dimension of health is really foundational. So I think it's critical.

Travis Richardson (48:53)
Yep.

Awesome. I know there's you have was looking at your YouTube at Cynthia Lybert MD. That's the YouTube handle for those that are listening. And there's a particular episode, episode five, which is my approach to cognitive decline, prevention and treatment. So I recommend everyone go out there, ⁓ find Dr. Cynthia and check out that particular episode. That might be a great starting point for those that want to learn more. I'm always like, let you of the viewpoint

that you there's like an educational piece when it comes to learning more about somebody before you go to work with them and so I think that that's really amazing that you have a YouTube channel so that way people can go experience you before they do anything else right before they sign up for a program they can go learn about is this right for me through the things that you talk about there so that's really cool

⁓ okay. This last part here is a couple of you rapid fire questions, which is just, ⁓ I've got three questions for you personally. And here we go. What's one food that you eat every single day that supports your brain, or do you have something that you eat every day that supports your brain?

Cynthia Libert (50:05)
I do, do.

Maybe about five years ago, we started the habit in our family to make raw veggie bags and berry bags. And so they're like our little grab and go snacks. And so every day I have blueberries, raspberries, occasionally strawberries, and then raw veggies, cauliflower, cucumbers, bell peppers. And sometimes I have two bags of veggies.

Travis Richardson (50:33)
Ha

Cynthia Libert (50:34)
And I think that that has been a huge upgrade for the health of our family to have those.

Travis Richardson (50:41)
So smart, yeah, food prep is everything. Sunday is like our day for food prep. And yeah, I'm a nuts and seeds kind of prepper. I like to have a specific amount of nuts and seeds of various types as well. ⁓ Okay, one habit or practice that you think is underrated for longevity.

Cynthia Libert (50:44)
Mm-hmm.

Yeah.

Yeah, Sabbath, taking at least one 24 hour period to unplug from your computer, your cell phone, to just be out in nature, to dwell on spiritual things, to do reading, to be with your family, to have fun. And that has been also a practice that I've...

I've gone kicking and screaming into because, know, we're being a business owner, there's always something to do, but I've found that it is so vital and that's one that I treasure now.

Travis Richardson (51:40)
Nice. How about one book ⁓ that has changed how you think about aging or medicine or brain health?

Cynthia Libert (51:50)
Well, there's so many, I'm a bibliophile. ⁓ it would be hard to narrow it down to one. Of course, the Bible is my foundational book. I'm reading like five books right now. ⁓ I'm reading a book by Dallas Willard called Renovation of the Heart or something to that effect right now. And it's about all the components of the human person or soul, mind, body.

Travis Richardson (52:00)
What's the most recent?

jeez.

Cynthia Libert (52:18)
spirit and it's really profound. ⁓ And then I've recently read a book by Dr. Arianna Malloy. She's a PhD in communications and it's called Healthy Calling and it's about how to find meaning and purpose in your work without burning out. her key message is that it's about humility. She brings in that virtue.

you know, look at burnout through that lens. And that's been just a really powerful insight. But in terms of more health and wellness, ⁓ you know, I have Dr. Bredesen's The Ageless Brain on my shelf here. ⁓ Breath by James Nestor. That's ⁓ breath work. We didn't touch on that, but that is a huge way to shift your nervous system and to bring...

grounding ⁓ into your body. ⁓ The longevity nutrient, that's ⁓ Dr. Stephanie Van Watson. That's about C15, which is a newly discovered essential fatty acid. So really, I can't settle on one. I just love learning.

Travis Richardson (53:31)
⁓ What's your

favorite cheese? ⁓ Do you have a favorite cheese that contains that? Well, because that C15 is a saturated fatty acid and there's cheeses. Are you aware of the best cheese or do you have a cheese that contains that that you eat specifically to get that C15?

Cynthia Libert (53:42)
My favorite cheese.

Sure.

I know whole

milk is a good source of C15, but of course there's some other, some inflammatory challenges with whole milk and it doesn't, a lot of people don't do well with milk due to lactose intolerance. I don't try to supplement with cheese. I use the C15 product. There's a blood test. You can check your levels to see if that's something you're deficient in. And so I use that.

Travis Richardson (54:05)
Yep.

Cynthia Libert (54:25)
targeted supplementation. ⁓ But I love all cheese. I just try to eat it in moderation because the calories and trying to maintain my weight.

Travis Richardson (54:32)
Yeah.

Well, ⁓ Dr. Library, it's been awesome chatting with you today. think there's a lot more we could talk about, of course, and maybe we'll do another episode down the line. Is there any final words that you have for the listeners? Anything you'd like to finish up with?

Cynthia Libert (54:54)
Yeah, well, I think that there's always hope. Even if you have some early symptoms or a strong family history of cognitive decline, there's always something that you can do to improve your health and to shift your trajectory. And so just tending to yourself, don't stick your head in the sand.

get a brain checkup in midlife and just really lean into community and fitness would be my parting words.

Travis Richardson (55:32)
Yeah, I love that. Thanks for being on the show today. I really appreciate you and your perspective and everything that you're doing for the community in Asheville and beyond. Appreciate you.

Cynthia Libert (55:42)
Thank you, Travis.

Appreciate it.