Redesigning Life with Sabrina Soto

SPECIAL EDITION: Dr. Steven Storage on Brain Health

• Sabrina Soto and Dr. Steven Storage • Episode 94

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In this enlightening episode, Dr. Steven Storage challenges the common belief that brain health is predetermined by genetics. Through his innovative research and clinical experience, he demonstrates how lifestyle choices can significantly impact cognitive function and neurological wellbeing—even for those with genetic risk factors.

The conversation explores how these evidence-based interventions can physically change brain structure within months, offering hope and practical solutions for anyone concerned about cognitive performance or decline. Dr. Storage emphasizes that with the right approach, we can take control of our brain health regardless of genetic predisposition.

Whether seeking to enhance everyday mental clarity or prevent age-related cognitive issues, listeners will gain valuable insights into caring for what Dr. Storage calls our most valuable asset: the brain.


To watch the segment with Dr. Steven Storage and Sabrina, The Sabrina Soto Show: 

https://www.sabrinasoto.com/the-sabrina-soto-show/

Connect with Sabrina on Instagram:

https://www.instagram.com/sabrina_soto


Connect with Dr. Steven Storage here:

https://www.amenclinics.com/team/steven-storage-md/

Dr. Steven Storage on Instagram:

https://www.instagram.com/drstevenstorage





Speaker 1:

Welcome to a special edition of Redesigning Life. Many of you know I have a new show called the Sabrina Soto Show Out and I was able to invite amazing experts in their fields just to come in and have a great conversation. But because it's a show, we have to edit it down. Now, these conversations, they were so good that I wanted to publish the raw, unedited version, and that's what this episode is. You're going to hear action and you may hear a crew in the background, but I wanted to publish this so you can really listen to the entire chat. So here you go. Hi, steven.

Speaker 2:

Hi, good to see you.

Speaker 1:

Good to see you too. I want to dive in. You are all about brain health, that's right, I want to dive in. You are all about brain health.

Speaker 2:

That's right.

Speaker 1:

And unfortunately it's top of mind. No pun intended for me now, because I just found out that I have the double gene of I believe it's APOE4. That's right and for people who know Chris Helmsworth right, he has the same thing and from what I've been told, it basically means that I was told that I will get Alzheimer's and dementia. Is that true?

Speaker 2:

That's absolutely not true, and this is actually the big part of our practice that we try to focus on, which is number one. Mental health is brain health, but number two is you're not stuck with the brain you have. So it is true that having the APOE4 gene increases risk of developing Alzheimer's.

Speaker 1:

What if I have the double?

Speaker 2:

It increases it a bit more. So if you have a single gene, it increases it by about 2.5 times and double it's about 10 times the risk. But that doesn't mean you're destined to get it, and there are things you can be doing even today that help prevent your brain from heading in that direction.

Speaker 1:

Yeah. So I took a test and I believe it was the Dutch test that came back with this Is that right? It may have been a genetic test, a genetic test, okay. So then I was told the information, then kind of never heard back from that doctor for any protocol. And I know that this is personal to me, but I feel like now more than ever people are talking about brain health because the brain controls everything, and I think for the last decade, or even more, we haven't. We've been talking more about muscles and just the things that you eat for losing weight. But can you explain to me exactly what this gene is?

Speaker 2:

Yeah, sure. So the APOE gene. There can be various different copies of it, and copy number four increases risk of developing things like Alzheimerzheimer's and also other cardiovascular issues. So if you have a one bad copy of the gene, uh, it increases risk of alzheimer's by about 2.5. Two copies, it increases the risk by 10. But here's the problem that's risk, that doesn't mean destiny, right? So if you have two copies, like you do, it doesn't mean you're destined to have alzheimer's disease and there's things you can do about it. Now, this is a problem with medicine. Historically, the way it's practiced is you get that report and then it's like okay, good luck on your way.

Speaker 1:

Yes, that's exactly what happened.

Speaker 2:

Which is awful, and it causes so much anxiety in people when in reality there are things we could actively be doing every single day to mitigate that risk.

Speaker 1:

I know I feel that's exactly how I feel, because I was given this diagnosis. I was just been like, oh, this is what it is. I have no protocol, I have no way, I don't know what to eat, I don't know what supplements to take. And I think you and I, last time we were talking, you were saying that the brain like when people talk about depression, they basically give medication but they don't look at the brain.

Speaker 2:

That's right. Yeah, it's the only field in medicine where doctors aren't really looking at the organ they're treating. So I'm a psychiatrist. Traditionally, the way a psychiatrist practices is the patient comes in, sits on a couch, talks about the symptoms they're having. You look at a checklist and you see how many of those symptoms match up with a particular diagnosis. You give that diagnosis and then you probably give a medicine to go along with it and that's it. And that's old school. That's how psychiatry was practiced when Abraham Lincoln was president.

Speaker 1:

So what's new school?

Speaker 2:

New school is actually looking at the organ that we're talking about. So in our clinic we do something called SPECT scans and that's a type of brain scan that looks at blood flow in the brain. Blood flow in the brain tells you about activity level in the brain. So if there's a part of the brain that has really high activity, it's going to have high blood flow, low activity, low blood flow and depending on what you see there, it can give you some really important clues.

Speaker 1:

And by looking at that brain scan you could see why people maybe are battling with depression or anxiety or any other ailment that's mental. But how does the brain affect you physically? What things can happen to your body when your brain starts to break down?

Speaker 2:

The brain controls absolutely everything. So the brain is the most miraculous, complex organ in our body. I'm biased, but that's really my belief. There's more connections in the brain than there are stars in the known universe. So 100 billion stars in our galaxy, one of 100 billion galaxies. Multiply those numbers together by another 100, and that's what's going on up here. 100 billion stars in our galaxy, one of 100 billion galaxies. Multiply those numbers together by another 100. And that's what's going on up here. So it's literally controlling every thought, every emotion, our goals, our physical health. It's controlling how our heart is beating, how we're breathing, our blood pressure. I mean, all of these things come back to brain health. So if the health of our brain is not on point, how can we be healthy?

Speaker 1:

period Well we can't, but I don't feel like anyone is really discussing this right. Am I wrong?

Speaker 2:

Well, no, you're not wrong, and I think people don't discuss it, in part because, even though we're using our brain to think about everything, we don't see it right, like it's hiding.

Speaker 1:

Right, but we see our muscles.

Speaker 2:

We see our muscles, we see our belly, we see all the other things that we focus on, but we don't really think about our brain, even though we really should be.

Speaker 1:

So if somebody is watching this and maybe they don't have what I'm dealing with, but just brain health in general is important for everyone, especially, I think, people in my age I'm perimetopause, and so what sort of foods or what supplements should we be looking at in order to optimize brain health?

Speaker 2:

Yeah, so great question. The best type of diet for brain health is a Mediterranean style diet that leans paleo. So what I tell people is there's a handful of things to avoid and then there's a few things to really try to optimize. The things you're trying to avoid are any types of foods that increase inflammation in the brain.

Speaker 1:

Which are.

Speaker 2:

Refined sugar. Okay, okay, refined sugar. We all know sugar is not good for us, but it turns out it's really, really not good for our brain. Processed foods. So if you read the label and you can't pronounce what's in it, or it's a really long list, or you couldn't buy one of those ingredients on its own at the same grocery store.

Speaker 1:

Oh, I like that tip. If you can't buy the ingredient on its own, you shouldn't be eating that food. That's right, okay.

Speaker 2:

And then also gluten. Actually, especially in the US, gluten can be very, very inflammatory, the way it's been grown over centuries.

Speaker 1:

Even if you don't have a sensitivity.

Speaker 2:

Even if you don't have a sensitivity.

Speaker 1:

Okay.

Speaker 2:

Yeah, even if you don't have a sensitivity and there are a lot of people walking around that do have a sensitivity and don't even realize it, and there's testing that can be done for that too.

Speaker 1:

Right. So gluten, sugar and processed foods what do you think is worse for your body, sugar or alcohol?

Speaker 2:

Oh, that's like picking. Would I rather be strangled or suffocated.

Speaker 1:

I would rather be suffocated.

Speaker 2:

I would rather be suffocated. That'll be the lead in for that. I think both are not good for your brain and even a little bit of alcohol turns out to not be a brain healthy thing. I think the wine industry for a long time propagated that a glass of red wine at night is a good idea, and yes, there are some ingredients within wine that maybe could provide some benefit. But alcohol ethanol in and of itself is a real brain healthy amount.

Speaker 1:

So you don't drink at all.

Speaker 2:

I rarely, rarely drink.

Speaker 1:

Rarely, yeah, and I think I was thinking about this yesterday. Now we're all telling everybody, like obviously everyone knows not to smoke, and so everyone's saying drink responsibly. But what if we said smoke responsibly? It would sound ridiculous.

Speaker 2:

That's right yeah.

Speaker 1:

And I think that now it's more. People are talking about how alcohol is such a poison to your body. So now we have alcohol, gluten, processed foods and sugars, but you're eliminating as much as possible. Yeah, I mean, but you can just not eat processed foods. So if somebody is listening, it just seems like eliminating that completely out of their lives is almost impossible.

Speaker 2:

It can feel really, really hard and I'm not an extremist when it comes to diet. I think it's really important to be conscious about the decisions we're making. It's a nice idea to ask yourself before anything is this good for my brain or bad for my brain? Just as a simple exercise? And yes, sometimes you're going to have gluten, sometimes you're going to have sugar. You may have a drink every now and then, but just be conscious about it so it doesn't become a big habit and the mainstay for how you get your nutrients.

Speaker 1:

Okay, so now we know what to eliminate. What are the things that we could be incorporating into our lives either supplements or foods to help our brain optimize?

Speaker 2:

Yeah, so the best type of diet is a Mediterranean style diet. Which is okay, so like yeah tell me Lean protein, right, so assuming someone's not vegetarian or vegan. Yeah, salmon, wild caught salmon is loaded with omega-3s. Omega-3s are so important for brain health. You think about things like chicken you think about turkey eggs?

Speaker 1:

bison is a nice-. Wait a minute, dr Eamon said eggs are bad. No, eggs are okay Eggs are okay yeah. Oh my, I can't keep track, Okay, good, good, I'm glad because I can't.

Speaker 2:

So eggs are okay, and I give my kids eggs probably every other morning. Okay, plant-based proteins. In terms of healthy fats, the brain itself is 60% fat after you take the water out, so we really need to be eating good fats.

Speaker 1:

Tofu.

Speaker 2:

Tofu is a nice protein source, but but is it considered processed to you? Not necessarily.

Speaker 1:

Okay. So tofu's, okay Beans.

Speaker 2:

Yeah, beans, okay Avocados. You have some avocados on the tray here. Avocados are loaded with healthy fats which support brain health. You think about things like nuts seeds? The only two oils that I really recommend people using are avocado oil for high temperature and olive oil for low temperature. Other seed oils can be pretty inflammatory.

Speaker 1:

This is a new thing, too, that I'm hearing about. I have, I think, in the last six months, heard more about seed oils than I ever wanted to, but I still am confused. Which seed oils are okay, which are not, how can we use them, or should we be using them at all?

Speaker 2:

As a rule of thumb, I recommend sticking with avocado oil and olive oil.

Speaker 1:

But seed oil is in everything.

Speaker 2:

And it can be hard. It can be hard to filter through that stuff. This is why it's important to read labels, you know, because if you ever have the opportunity to make a choice between two options and one doesn't have a seed oil and one does then you can make that choice.

Speaker 1:

And the seed oils we're talking about, like canola oil, vegetable oil, all of the any. Yep, yeah, Okay, right, so none of that. What else? What else could like fruits? Are there specific fruits that are better than others?

Speaker 2:

You've got some great ones on the tray here. So, generally, what I recommend to people is try to eat the rainbow every day, right, so not Skittles, but you know, red orange, et cetera. So, um, berries are a great example of a brain healthy food. Berries are loaded with antioxidants, vitamin C that supports good brain health. Melons also are a really, really good option. Oranges that you have there great option loaded with vitamin C that prevents cognitive decline.

Speaker 2:

Pomegranate loaded with polyphenols, which also reduce oxidative stress in the brain and help maintain brain health. And then, in terms of vegetables, really you're not going to go wrong with anything. I mean broccoli is. If I had to pick one vegetable, I would go broccoli, just because it's loaded with all of the essential, many of the essential vitamins and minerals that we need for our healthy brain. And then for carbohydrates, really you want complex carbohydrates. So things like Brown rice Brown rice is a good idea, especially if you rinse it beforehand to get the arsenic out. All these things to remember. I know it's a lot to juggle. Sweet potatoes are a great example of something that provides you with a sustained glucose level, because our brain does need glucose. It runs on glucose. You just don't want the sugar spikes and crashes. That's what really robs us of our cognitive abilities over the course of the day.

Speaker 1:

So then, what sugar do you eat? Monk fruit okay, is stevia okay.

Speaker 2:

Stevia. Like of the sugar substitutes, I'd say stevia is probably the best bet. Monk fruit is pretty solid too. Erythritol has some data that it can upset sort of the gut microbiome, so not great. And then obviously things like aspartame you don't really want to touch.

Speaker 1:

Right, I think everyone knows that by now. Yes, I lived through the 80s. And then what about when it comes to supplements?

Speaker 2:

So I think everybody should be on a brain-directed multivitamin, and by that I mean something that has all the essential minerals and vitamins that you need. I think omega-3s are critical. Most people aren't getting enough omega-3s in their diet, even if they're eating plenty of fish, it's hard to maintain an adequate omega-3 level. And then also vitamin D. Vitamin D is pretty important. Most of us are vitamin D deficient or insufficient, and vitamin D has been linked with cognitive decline, overall executive functioning, and so it's important to maintain a good balance there.

Speaker 1:

And I've seen also, because then that can get complicated, because Ds sometimes come with other ones. So just a regular D, a multivitamin and An omega-3. An omega-3. That's it Just starting there.

Speaker 2:

Be just as a baseline for most people and obviously consult with your physician, because different people are different and maybe someone has a high vitamin D. You don't want to go too high because then that starts robbing you of calcium from your bones, so it's important to make sure that you're talking to someone about everything, so walk me through.

Speaker 1:

I mean, you are the expert in this field, so sort of just walk me through a typical day for you. Is there movement? Is there meditation?

Speaker 2:

There's movement almost every day. I try to get at least 20 minutes of high intensity cardio most days out of the week, and the reason I choose that is because that has the best data for supporting brain health. So anything that gets us to a heart rate that's like close to 80% of our maximum heart rate and we sustain that for about 20 minutes or so is linked with improved cognition and a slowing of cognitive decline, Because the problem is, as we all age, our brain is slowly declining.

Speaker 1:

Is that why I have brain fog now? Well, like in perimenopause and menopausal women, does the brain fog come because we're aging, or is it because of the hormones?

Speaker 2:

Or is it because of life changes, too, that are happening at the same time? I think it's all of the above, because women going through perimenopause are often experiencing sleep disturbance, which has a huge impact on brain health, hormonal fluctuations, which has a huge impact on brain health. A lot of times, people who have ADHD type symptoms notice them first when they're entering perimenopause, and so that can feel like distractibility, difficulty with organization, these types of things, and so I see a lot of people in our clinic who are feeling like for the first time ever, they're not able to focus, when that wasn't an issue for them before.

Speaker 1:

Yeah.

Speaker 2:

When they're in perimenopause.

Speaker 1:

And what about sleep? You mentioned sleep. I have heard anything between you know some people don't need as much sleep and then some people you're supposed to get eight to nine hours. I mean, that's just not possible for a lot of people. So how does the lack of sleep attribute to brain damage?

Speaker 2:

Well, interestingly, sleep is a very active process for our brain. It's not just that our brain turns off. Actually, it's cleaning itself and in fact, it's eliminating some of those amyloid beta plaques that build up. What is that we talked about?

Speaker 1:

the Apo Pretend I'm a five-year-old.

Speaker 2:

Sure, we talked about the ApoE4 gene earlier. When people have two copies of the ApoE4 gene, they accumulate a plaque called amyloid beta in their brain at a higher rate, and so during sleep that plaque is cleared in part. So maintaining important sleep helps you clear out that junk.

Speaker 1:

So that you can keep the health of your brain. So how many hours are we?

Speaker 2:

looking at? Clear out that junk so that you can keep the health of your brain. So how many hours are we looking at? Even more important than hours is quality of sleep. So I think on average, somewhere between seven or eight hours is a nice sweet spot for most people. But a lot of people are sleeping for seven or eight hours and they're not actually getting into deep sleep.

Speaker 1:

What are they doing?

Speaker 2:

They're scrolling, so I mean the main like tips that I tell people for sleep is wake up the same time every day, no matter what, and get sun on your face. Wake up time is even more important than when you go to bed, why it sets your circadian rhythm for the next 24 hours but what if it's the weekend and I want to sleep in? You'll pay for it.

Speaker 1:

So what if you have a busy schedule and you don't? Maybe you work different jobs that's not on the same time. How do you get into a rhythm like that?

Speaker 2:

So If you ever deviate from the rhythm, the rule of thumb is however much sleep you've missed, you need to overcompensate the next night by about 50% of the amount of sleep you missed. So, for example, if you're trying to get eight hours a night, one night you only get two. You're at a deficit of six. So the next night you want to try to get three extra hours, if possible. Now that might not be possible and you might accumulate that deficit over time. Yeah, but it's a question of what am I prioritizing in my life?

Speaker 1:

And eating before sleep lots of sugar. Even alcohol can disturb your sleep.

Speaker 2:

So a hundred percent. Yeah, alcohol, especially alcohol, disturbs REM sleep, which is the part of sleep where really most of the action's happening. So people who drink alcohol might fall asleep faster, but they're usually going to notice that the sleep is more restless or they're going to wake up earlier than they intended. So wake-up time's really important. The other one is only use the bed for sleep or romantic activity, that's it. Wait wait, hold on.

Speaker 1:

Stephen, you can say sex.

Speaker 2:

Okay, or sex, sleep or sex.

Speaker 1:

That's it, rom, steven, you can say sex Okay, or sex, sleep or sex. That's it Got it. Romantic activity what are you? 80?

Speaker 2:

You might have kids watching. I don't know.

Speaker 1:

Okay, wait, and then I have a problem falling asleep. Is it okay to take melatonin?

Speaker 2:

It's okay to take melatonin sometimes, but the brain is really only producing about 0.1 milligrams of melatonin a night. So when we're taking over-the-counter stuff that's like 5, 10 milligrams, it's actually way more than necessary. So if you take melatonin, take a low dose, like a milligram or two, but don't take it too often because it's a hormone disruptor and it can affect your body's natural way of producing melatonin. So instead, magnesium glycinate is a great example. So magnesium glycinate is healthy. You're not going to mess anything up taking magnesium glycinate and for most people, 200 to 400 milligrams of that before bed can be very, very helpful.

Speaker 1:

What about valerian root?

Speaker 2:

Valerian root can be okay too.

Speaker 1:

Every day.

Speaker 2:

I would probably not use it every day. Okay, yeah, yeah, I think if you were to think about a supplement to use every day for sleep, magnesium glycinate would be the go-to.

Speaker 1:

Right before sleep. Yeah, Because there are so many different magnesiums so you have to find the right one.

Speaker 2:

Yeah, if you take magnesium citrate before sleep, you might just-.

Speaker 1:

That's for constipation. Yeah, that is for constipation, but also a good tip. If you're constipated, look for that.

Speaker 2:

But maybe take it in the morning Right, right, not before sleep.

Speaker 1:

I swear he said that not to start your day off with eggs. I don't know why, but of course then I think eggs are really important to people. Yeah, eggs. Eggs are important to people.

Speaker 2:

Eggs are really good.

Speaker 1:

But organic eggs obviously. Yeah, I've heard from other experts that eggs are inflammatory and not great for you, but that's not the case.

Speaker 2:

That's not the case and obviously if you dive into any specific food, if too much of that is consumed, it's going to present some kind of problem. So this is where it goes back to moderation and being reasonable with how much we're eating. So if someone's eating a dozen eggs every morning, it's probably not going to be great for them, but a couple eggs here and there, you know. I think it's totally fine.

Speaker 1:

When it comes to not eating before bed. What if somebody is hungry or they wake up in the middle of the night hungry and it helps them to eat to go back to sleep?

Speaker 2:

Oftentimes the reason that people wake up in the middle of the night hungry is because they've had a lot of simple carbohydrates for dinner, because usually what happens is you get a big insulin spike, your sugar drops soon afterwards and then you've got the hunger cue. So what I recommend to people is try to have a lot of protein and a lot of healthy fat with your dinner, because that's going to sustain you for longer. And if you do have carbs complex carbs like sweet potatoes, quinoa, millet, wild rice as examples.

Speaker 1:

Do you do intermittent fasting?

Speaker 2:

I do.

Speaker 1:

Okay, so that's okay.

Speaker 2:

Yeah, that's totally okay. I'm doing something right, I'm a fan of the 16-hour intermittent fast, six days a week.

Speaker 1:

Okay, yeah. So even if somebody is eating the paleo Mediterranean diet, all the good foods. So even if somebody is eating the paleo Mediterranean diet, all the good foods, you still recommend a vitamin D.

Speaker 2:

Vitamin D for sure, because it's really really hard to get vitamin D just from food alone, and for multivitamins it sort of depends, right Like, the healthier we are and the more balanced of a diet we consume, the less reliant we are on a multivitamin. But, that being said, food is not as nutrient dense as it once was, and so it probably behooves us to take a multivitamin.

Speaker 1:

Wait, what do you think about caffeine?

Speaker 2:

That's a very, very personal subject, because I am reliant on caffeine to a degree, but we also know that excess caffeine constricts blood flow to our brain. So my place that I've landed is I'll have a cup or two of black coffee each morning and then that's my caffeine intake for the day, and then beyond that you don't really want caffeine after you know two o'clock because it's going to make it very, very hard to fall asleep.

Speaker 1:

Okay.

Speaker 2:

Noted.

Speaker 1:

Noted. Then my last question about supplements. There are supplements that are brain health, you know, like that's what they are, like brain optimizers. Should I be taking that? Should people be taking that at home?

Speaker 2:

I think it depends on what the person is trying to accomplish and what risk they're trying to overcome. So you opened by talking about the ApoE4 gene mutation. I think for you there are some specific brain supplements that would be helpful to take Things like Ginkgo, things like Hooperzine, things like N-acetylcysteine and you and I can talk about that offline, but it depends on who the person is and what they're trying to accomplish.

Speaker 1:

Okay, I think this is good. I now know what to eat, what not to eat, how much sleep is. I have to stop taking melatonin. I really do take 10 milligrams a night.

Speaker 2:

Anything beyond five has been shown in studies to actually not do much of anything.

Speaker 1:

I feel like it does a lot, and I watch the Golden Girls in bed and that's not romantic activity, let me tell you. Thank you. Thank you, dr Storridge, seriously, and I'm glad that you're in my life because I need all the help I can get.

Speaker 2:

I'm happy to help.

Speaker 1:

I appreciate your time.

Speaker 2:

Thank you.

Speaker 1:

I feel like I've gotten smarter since you've known me. No, no, I think that I've learned a lot from our conversation. I know our viewers have learned a lot, because it's never too late. I know you've told me and there are things that we could do. So the top three exercise, foods and sleep.

Speaker 2:

Absolutely and ultimately. We're not stuck with the brain. We have no matter what. No matter what and we've proven this in our research you can have someone do a scan of their brain at one point and have them redo that scan six months, 12 months later and you can see a very different looking brain. So we do have a lot more control than we realized.

Speaker 1:

That gives me so much hope. Thank you so much. You're welcome, Nice meeting you no you can't say that we're friends, oh, okay.