Louisa Nicola Links Early Exercise to Reduced Alzheimer Risk

Louisa Nicola：及早运动可降低阿尔茨海默病风险 高强度训练和抗阻运动等生活方式干预，可在症状显现前很久通过维持脑容量与代谢能量，预防95%以上的阿尔茨海默病病例。 神经生理学家 Louisa Nicola 提出了一份关于大脑长寿的全面指南，强调超过95%的阿尔茨海默病病例源于生活方式的选择，而非单纯的遗传因素。她概述了切实可行的干预措施，包括通过5区有氧运动（Zone 5 cardio）和大重量抗阻训练刺激BDNF产生、补充大剂量肌酸以维持神经能量，以及遵循严格的睡眠卫生习惯以促进类淋巴系统清除毒性斑块。Nicola 还强调了显著的性别健康差异，倡导在围绝经期采取激素替代疗法和针对性的代谢支持。该讨论最终强调，主动付出身体上的努力并参与具有挑战性的任务，对维持脑容量和认知储备至关重要。 超过95%的阿尔茨海默病病例可通过健康生活方式预防，直接致病基因突变仅占约3%；该病理早在30多岁便在脑内悄然发展，但临床症状通常在60至70多岁才显现。 (2:58) 全球阿尔茨海默病患者中女性占70%，围绝经期雌激素水平下降会导致脑部葡萄糖代谢骤降30%，使神经元陷入严重的能量危机。 (41:43) 以约80% 1RM负荷进行大重量抗阻训练和Zone 5高强度间歇运动，能促进肌动蛋白与BDNF释放，有助于保护海马体结构并延缓大脑萎缩。 (17:26) 持续久坐会抑制脂蛋白脂肪酶活性并损害代谢，但每个工作小时完成10次自重深蹲，即可有效抵消久坐对心脑代谢的负面影响。 (22:58) 长期高血压会破坏单细胞厚度的脑毛细血管与血脑屏障紧密连接，造成“渗漏脑”并加速认知衰退，将血压控制在120/80 mmHg以内可有效保护脑灰质。 (35:21)

Neurophysiologist Louisa Nicola contends that Alzheimer's disease is an insidious, decades-long metabolic and vascular condition that begins in midlife but remains up to 95% preventable through targeted physical, environmental, and nutritional interventions. Midlife Pathology, Genetic Predisposition, and Female Risk (2:31) Although clinical symptoms typically surface in a patient's 60s or 70s, Alzheimer's pathology begins silently in the 30s following the brain's structural maturation. Nicola notes that global cases—currently at 60 million—are projected to triple to 180 million by 2050, with women representing 70% of current cases and an estimated 110 million by 2050. She rejects the notion that longevity explains this gap, identifying biological female sex as an independent risk factor. Deterministic genetic mutations such as PSEN1 account for only about 3% of cases, whereas the APOE4 allele raises susceptibility disproportionately: a single copy increases risk twofold to threefold in men versus roughly sixfold in women, while two copies increase risk tenfold in men versus fifteenfold in women. In addition, the menopausal drop in estrogen eliminates the natural inhibition of the enzyme that phosphorylates tau, accelerating neurofibrillary tangle formation, whereas men maintain a neuroprotective buffer as testosterone aromatizes into estrogen. High-Threshold Exercise and Midlife Cardiovascular Remodeling (13:47) Physical exercise represents the most potent defense against neurodegeneration, with resistance training offering the highest return on investment. According to Nicola, lifting heavy loads at roughly 80% of one-repetition maximum prompts skeletal muscle to release myokines—such as irisin, which induces brain-derived neurotrophic factor (BDNF) to foster hippocampal neurogenesis, and muscle-derived interleukin-6 (IL-6), which exerts anti-inflammatory effects in the central nervous system. Twin studies demonstrate that lower-body power correlates directly with preserved brain volume and gray matter integrity over a decade. Cardiovascular output directly dictates cerebral perfusion, with VO2 max operating as the strongest predictor of all-cause mortality. Nicola points to cardiology research by Dr. Benjamin Levine showing that a two-year regimen—incorporating the Norwegian 4x4 protocol (four intervals of four minutes at 90%–95% maximum heart rate) alongside resistance and moderate aerobic sessions—remodeled the left ventricle and reversed cardiac stiffness by 20 years in adults aged 47 to 55. However, this cardiac plasticity disappears after age 65, establishing midlife as an urgent therapeutic window. For sedentary individuals, breaking up extended sitting with ten hourly bodyweight squats prevents the shutdown of lipoprotein lipase and blunts glucose spikes. Glymphatic Clearance, Sleep Architecture, and Fuel Shortages (53:23) Nicola characterizes sleep as an irreplaceable neuroprotective mechanism, observing that a single night of sleep deprivation elevates brain amyloid-beta levels by 4% to 5%. During restorative deep sleep, supporting glial cells shrink, enabling cerebrospinal fluid to wash through the glymphatic system and flush misfolded amyloid and cellular debris. While historical sleep debt cannot be repaid retroactively, Nicola notes that individuals can buffer against anticipated deficits by banking sleep in advance. Sleep onset and maintenance require a 2° Fahrenheit drop in core body temperature, which can be supported through cooling protocols and glycine supplementation, while GABA helps quiet default mode network overactivity. In symptomatic or pre-Alzheimer's stages, the brain undergoes a profound energetic crisis characterized by impaired glucose transport. When neurons starve, glial astrocytes break down the axon's protective myelin sheath to generate emergency ketone bodies. Nicola explains that introducing external ketones via supplementation or a ketogenic diet can bypass damaged glucose pathways to fuel struggling neurons directly. Targeted Supplementation, Diagnostic Advances, and Reserve Capacity (74:29) Targeted supplementation can fortify brain bioenergetics. While standard 5-gram daily doses of creatine monohydrate saturate skeletal muscle, Nicola recommends higher doses (15 to 30 grams) to cross the blood-brain barrier, noting research linking higher dietary creatine to a 5% to 18% reduction in cancer incidence. She emphasizes requesting Cystatin C blood tests rather than serum creatinine, as standard creatinine artificially rises with supplementation and muscle mass. High-quality, third-party certified omega-3 fatty acids—stored cold to prevent the rancidity observed in roughly 95% of tested commercial brands—replenish docosahexaenoic acid (DHA) to maintain cell membrane fluidity and blood-brain barrier integrity, while maintaining vitamin D at roughly 60 ng/dL lowers dementia risk. Building cognitive reserve enables older adults to maintain clinical sharpness even in the presence of physical plaques. Neural reserve expands through challenging hand-eye coordination drills and activities that engage the anterior midcingulate cortex (AMCC)—the brain's willpower hub, which enlarges only when an individual overcomes friction and discomfort. Clinically, novel blood tests measuring P-tau 217 and amyloid beta now identify early neurodegenerative changes with roughly 90% of the accuracy of PET scans. Nicola emphasizes that while diagnosed Alzheimer's remains incurable, proactive lifestyle adaptations, hormonal tracking around age 40, and early biomarker screenings provide unprecedented control over cognitive longevity. However, broad systemic underrepresentation of women in clinical trials and widespread confusion surrounding therapies like HRT continue to hinder public health implementation.

神经生理学家Louisa Nicola指出，阿尔茨海默病是一种始于三四十岁但通常到七十岁后才显现症状的慢性神经退行性疾病；虽然临床确诊后尚无治愈手段，但超过95%的病例可通过中年期的生活方式干预予以预防。 流行病学现状与早期发病机制 (2:31) 全球目前约有6000万人罹患阿尔茨海默病，其中女性占70%；据预测，到2050年全球患病人数将增至1.8亿人，届时患病女性将达1.1亿人。Nicola驳斥了女性患病率高仅因寿命更长的观点，指出女性生理性别本身就是独立风险因素。在遗传层面，确定性突变（如PSEN1）直接致病的早发病例仅占约3%，绝大多数散发病例与后天因素相关。APOE4等位基因会显著增加患病风险，男性携带单拷贝风险增加2至3倍，双拷贝增加10倍；女性单拷贝风险则上升约6倍，双拷贝上升约15倍。 人脑重量约2磅，含有870亿个神经元，消耗机体20%的热量。阿尔茨海默病的发展通常始于30岁左右的大脑退化，缺乏睡眠、长期静坐、不良饮食与环境毒素会产生持续损伤。研究显示，仅一整夜的睡眠剥夺就会使脑内淀粉样蛋白（amyloid beta）水平激增4%至5%。长年累月的神经退行性累积会导致严重神经元流失和大脑萎缩，最终发展为轻度认知障碍（MCI）乃至临床痴呆。 认知储备与抗阻及有氧运动机制 (8:43) Nicola指出，认知储备（cognitive reserve）决定了个体在面临脑部病理损伤时能否维持正常功能。部分80岁老人即便脑内布满淀粉样蛋白斑块，凭借强大的神经元树突连接仍能保持敏锐。锻炼是提升认知储备与预防大脑萎缩最强效的手段。抗阻训练尤为关键，SMART临床试验证明，轻度认知障碍老年人每周进行2至3次阻抗训练可改善流体智力和信息处理速度，延缓灰质萎缩。对同卵双胞胎追踪10年的MRI研究同样证实，腿部力量更强的一方保持着更完整的大脑容积与灰质。 在大脑神经元保护方面，大重量负重训练（约80%单次最大重量1RM）要求最高的神经驱动力，并刺激肌肉释放肌动蛋白（myokines），例如鸢尾素（Irisin）能穿过血脑屏障诱导脑源性神经营养因子（BDNF）表达，驱动海马体神经发生；肌肉释放的IL-6则能减轻中枢神经炎症。Nicola首推硬拉和深蹲作为全身体素募集最佳动作。在心血管与代谢层面，高血压会破坏脑内单层内皮细胞毛细血管并破坏血脑屏障，引发“漏脑”现象。每周进行挪威4x4高强度间歇训练（90%至95%最大心率）有助于维持VO2 max、重塑左心室弹性并促进大脑血流；此外，每小时进行10次徒手深蹲可对抗静坐超过10小时所导致的脂蛋白脂肪酶抑制，快速平抑餐后血糖。 睡眠清除系统与雌激素保护作用 (53:23) 针对阿尔茨海默病的两大病理标志——细胞外的淀粉样蛋白斑块与细胞内的tau蛋白神经纤维缠结，Nicola阐明了神经生理层面的清除与保护机制。淀粉样蛋白自身具有抗微生物肽的生理功能，关键在于清除机制。在深度睡眠期间，由神经胶质细胞主导的脑部类淋巴系统（glymphatic system）被激活，脑脊液像“洗衣机”一样冲洗清除代谢废物；若睡眠长期受阻，清除通道受阻便会导致病理蛋白异常沉积。睡眠剥夺造成的神经损伤无法通过周末补觉逆转，但可在可预见的熬夜前进行“睡眠储备”。优化睡眠需要入睡时核心体温下降至少2华氏度，可借助甘氨酸调节体温，或补充抑制性神经递质GABA以平息大脑默认模式网络。 在细胞内部，tau蛋白负责维系轴突微管结构的稳定。当遭遇应激或激素急剧下降时，tau蛋白发生过度磷酸化并从微管脱落，聚集为神经纤维缠结，导致轴突崩解与信号传输中断。雌激素能直接抑制催化tau蛋白磷酸化的特定酶；女性在绝经期雌激素断崖式下跌，失去了该酶促抑制保护，导致tau蛋白缠结加速形成；男性体内的睾酮可在脑内局部芳香化为雌激素，从而提供持续保护。观察性数据显示，激素替代疗法（HRT，尤其是透皮贴剂）可通过缓解潮热盗汗、保护深睡眠架构以及维持肌肉合成代谢，间接降低女性最高达30%的阿尔茨海默病发病风险。 针对代谢危机的营养补充与生物标志物筛查 (41:43) 阿尔茨海默病患者大脑面临严重的“能量危机”，神经元转运和代谢葡萄糖的能力受损，星形胶质细胞被迫分解髓鞘以产生酮体充当应急燃料。Nicola建议通过生酮饮食或外源性酮体绕过受损的葡萄糖通路。在营养补充方面，肌酸（creatine）是改善脑细胞能量代谢的核心分子。人体肝脏和大脑每日仅内源性合成2至3克肌酸，常规5克剂量几乎全被骨骼肌消耗；针对阿尔茨海默病患者的试验显示，每日补充20克高剂量肌酸能够有效穿过血脑屏障，保护认知功能并缓解疲劳。针对经常被误读的血清肌酐指标，Nicola建议就医检测抑素C（Cystatin C）以准确评估真实肾小球滤过率。此外，高品质、经第三方认证且冷藏防氧化的Omega-3补充剂（富含DHA）可支持血脑屏障周细胞与突触膜流动性；血液维生素D水平维持在60 ng/dL有助于海马体保护，并与全因痴呆风险大幅下降相关。 在诊断和大脑韧性训练方面，医学界目前已可通过血液检测P-tau 217和淀粉样蛋白水平，其早期筛查准确率达到脑部PET扫描的90%左右；常规体检还应补充脂蛋白(a) [Lp(a)]以评估遗传性心血管风险。除生化手段外，通过斯特鲁普色词测试（Stroop test）可评估视觉信息处理与抑制控制；利用单眼遮罩、单腿站立掷接网球等手眼协调训练，可同时激活枕叶视觉皮层与小脑。Nicola进一步强调，主动迎难而上、克服心理阻力去完成艰苦任务，能促使大脑前中扣带回皮层（AMCC）体积增大，该区域被视为“意志力肌肉”，在长寿“超级老人”及高水平运动员群体中普遍更发达，构成应对逆境与衰老的重要储备。 Nicola总结指出，尽管阿尔茨海默病严重剥夺患者记忆与自我认知，且现代医学对于终末期病变仍显乏力，但中年期的血管维护、负重锻炼、深层睡眠管理与针对性营养干预为个体提供了切实的前置防护屏障。公众医疗认知的滞后与女性健康长期被忽视的现状仍是严峻瓶颈，科学赋能的生活方式转型是目前扭转神经退行性疾病上升趋势的最有效路径。

## Background 该视频由 YouTube 频道《The Diary Of A CEO》于 2026 年 2 月 5 日发布。节目简介指出，神经生理学家兼认知表现教练 Louisa Nicola 深入剖析了阿尔茨海默病的早期患病风险、为何肌酸能为大脑供能并提升记忆、深度睡眠技巧以及久坐为何是致命的隐形杀手等核心议题。 ## TL;DR Louisa Nicola 指出阿尔茨海默病在中年时期就已悄然发病，且多达 95% 的病例本可通过改善生活方式来预防。她系统阐释了女性因围绝经期雌激素断崖式下跌导致脑能量骤减 30% 的独特风险，并破除了大众对激素替代疗法（HRT）的致癌恐慌。围绕脑部保护，她提出了以挪威 4x4 高强度间歇训练重塑心脏和血脑屏障、大重量抗阻释放肌动蛋白抗癌抗衰的运动处方。此外，她力荐突破传统剂量的高剂量肌酸与高品质 Omega-3 来挽救脑代谢危机，并论证了主动迎接逆境对锻炼前中扣带皮层（AMCC）“意志力肌肉”的神经生物学意义。 ## Atmosphere & style 整场对话在严密冷峻的神经科学论证与极具冲击力的情感流露之间自如切换，节奏张弛有度。Louisa 既拥有顶级临床科研者的笃定与犀利，又在回忆祖母离世和直面阿尔茨海默病残酷剥夺时展现出令人动容的脆弱与愤怒。Steven Bartlett 的追问层层递进，既有现场测试认知处理速度的生动互动，也有关于生命执念、死亡与超越科学信仰的深沉叩问，为观众营造出一种既充满紧迫危机感又饱含实用希望的沉浸式体验。 ## Bulletin - [02:30](https://www.youtube.com/watch?v=0t_DD5568RA&t=150s) 阿尔茨海默病在出现临床症状前20至30年（即30多岁）便已静默发病，真正由基因完全决定的早发型病例仅占约3%，超过95%的病例可通过生活方式进行早期预防。 - [44:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=2661s) 全球阿尔茨海默病患者中女性占比高达70%，围绝经期雌激素断崖式下跌导致脑葡萄糖代谢率骤降30%，使神经元陷入严峻的代谢危机与髓鞘分解。 - [31:38](https://www.youtube.com/watch?v=0t_DD5568RA&t=1898s) 达拉斯运动心脏病学研究证实，中年久坐者坚持每周约4小时包含“挪威 4x4”高强度间歇的系统训练，可在生理层面将心脏物理结构逆转20年，但该塑形窗口在65岁左右关闭。 - [01:15:01](https://www.youtube.com/watch?v=0t_DD5568RA&t=4501s) 最新临床研究打破肌酸每日5克的传统认知，证实每日摄入15至20克高剂量肌酸可跨越血脑屏障，有效逆转睡眠剥夺损伤并重塑阿尔茨海默病患者的脑能量代谢。 - [01:35:52](https://www.youtube.com/watch?v=0t_DD5568RA&t=5752s) 前中扣带皮层（AMCC）被称为大脑的“意志力肌肉”，只有在主动克服主观阻力去做艰难之事时才会物理性增生，为应对逆境和延缓认知衰退提供神经储备。 ## Key takeaways - [05:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=321s) 阿尔茨海默病是30岁起步的慢性病变过程，单晚严重睡眠剥夺即可导致脑内β-淀粉样蛋白激增4%，日积月累形成不可逆损伤。 - [10:13](https://www.youtube.com/watch?v=0t_DD5568RA&t=613s) 高认知储备能让部分80岁老人即便脑内布满淀粉样蛋白斑块仍维持敏锐思维，而手写、阅读和体育锻炼是构建该冗余资本的核心支柱。 - [12:35](https://www.youtube.com/watch?v=0t_DD5568RA&t=755s) 刷短视频提供无门槛的即时多巴胺刺激，不仅无法积累认知储备，反而严重侵蚀人类维持深度专注与长时对话的神经耐力。 - [14:47](https://www.youtube.com/watch?v=0t_DD5568RA&t=887s) APOE4 是最强遗传风险因子，单份拷贝使男性风险增2-3倍、女性风险激增6倍，双份拷贝使女性风险飙升15倍，但基因并非不可干预的宿命。 - [16:30](https://www.youtube.com/watch?v=0t_DD5568RA&t=990s) 以80% 1RM强度进行大重量力量训练（首推硬拉）能调动脑部运动皮层，促使肌肉释放鸢尾素（Irisin）和IL-6，穿透血脑屏障驱动BDNF分泌与海马体神经发生。 - [21:01](https://www.youtube.com/watch?v=0t_DD5568RA&t=1261s) 每天30分钟有氧运动能动员天然杀手细胞（NK细胞）浸润肿瘤病灶，配合肌动蛋白抗炎机制显著下调包括乳腺癌和结肠癌在内的13种癌症风险。 - [23:26](https://www.youtube.com/watch?v=0t_DD5568RA&t=1406s) 每天累计久坐超过10小时会抑制脂蛋白脂肪酶（LPL）活性，即使有规律锻炼也属“主动久坐者”，每小时做10次深蹲可有效压制餐后血糖峰值。 - [25:42](https://www.youtube.com/watch?v=0t_DD5568RA&t=1542s) 女性在 Zone 2 低心率有氧上的时间回报率有限，中年女性应将有限时间优先倾斜给每周2-3次抗阻训练与突破极限的 Zone 5 高强度冲刺。 - [36:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=2211s) SPRINT临床试验确立了120/80 mmHg健康基准，收缩压超135 mmHg会摧毁单层细胞厚的微血管紧密连接，导致“脑漏”（leaky brain）与神经炎症。 - [40:13](https://www.youtube.com/watch?v=0t_DD5568RA&t=2413s) 阿尔茨海默病晚期致命根源在于大脑吞咽反射中枢崩解引发的吸入性肺炎或跌倒并发症，确诊后可通过生酮饮食绕过受损的葡萄糖代谢通路直接供能。 - [55:35](https://www.youtube.com/watch?v=0t_DD5568RA&t=3335s) 类淋巴系统仅在深睡眠期全功率启动，借助胶质细胞收缩由脑脊液冲洗细胞外β-淀粉样蛋白；围绝经期潮热导致的睡眠碎片化会直接阻断该排毒循环。 - [55:35](https://www.youtube.com/watch?v=0t_DD5568RA&t=3335s) 神经元轴突微管依赖 Tau 蛋白稳固，雌激素骤降或慢性压力会诱发激酶异常激活与 Tau 蛋白过度磷酸化，导致微管坍塌形成神经原纤维缠结。 - [01:03:44](https://www.youtube.com/watch?v=0t_DD5568RA&t=3824s) 入睡困难可通过 GABA 和晚餐后置复合碳水来平抑默认模式网络（DMN）狂奔；甘氨酸通过扩张外周血管促使核心体温下降2度以维持深睡。 - [01:09:16](https://www.youtube.com/watch?v=0t_DD5568RA&t=4156s) 市场上高达95%的主流鱼油产品存在过氧化指标超标问题，优质DHA补充剂必须经独立第三方认证并全程冷藏，以维护血脑屏障周细胞完整性。 - [01:13:53](https://www.youtube.com/watch?v=0t_DD5568RA&t=4433s) 将血清维生素D水平维持在约60 ng/dL可使阿尔茨海默病风险降低约80%，海马体中高密度的维生素D受体是维系记忆检索的关键。 - [01:23:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=5031s) 服用肌酸引起的肌酐轻度升高属于肌肉代谢自然产物，并不代表实质性肾损伤，临床精准评估肾功能应以不受肌肉量干扰的胱抑素 C（Cystatin C）为准。 - [01:37:26](https://www.youtube.com/watch?v=0t_DD5568RA&t=5846s) 前中扣带皮层（AMCC）的生理体积直接预测危重病患与手术受试者的幸存概率，迎击主观厌恶的困难挑战是重塑突触连接与意志韧性的唯一生物学途径。 ## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=0t_DD5568RA&t=0s) 白粉末与肌酸的神经保护潜力 访谈一开始，桌上摆着一罐神秘的白色粉末，神经生理学家 Louisa Nicola 脸上露出了抑制不住的笑容。她斩钉截铁地表示，无论你是谁、从事什么职业，都绝对应该摄入这种物质——它就是**肌酸（Creatine）**。令人震撼的最新科学研究表明，肌酸不仅是健身房里的增肌补剂，更具有强大的脑神经保护作用：你甚至能够通过补充肌酸来在生理层面上逆转或缓冲“睡眠剥夺”对大脑的损害。无论是预防和减轻脑震荡、中风，还是抵御长期慢性压力，肌酸都展现出了不可思议的神经弹性。 在一项针对阿尔茨海默病（Alzheimer's disease）患者的临床研究中，科学家们发现，补充肌酸的患者不仅保留了核心认知功能，更表现出整体能量状态的提升，并且能够进行更多日常锻炼。作为一名临床医生与神经科学学者，Louisa 在过去十多年间一直与全球最顶尖的神经外科医生并肩工作，深入探究人类大脑的奥秘。她此次的核心使命，就是正面宣战阿尔茨海默病。 - **肌酸的多维效益**：抗神经压力、缓冲睡眠缺失损伤、保护脑震荡与中风后的细胞代谢。 - **阿尔茨海默病危机**：全球已有约 6000 万人患病，其中高达 70% 的患者为女性。 - **久坐的隐形危机**：久坐已成为现代人的一种代谢疾病；研究表明，每坐一小时做 10 次自重深蹲（air squats），便能有效代偿久坐带来的血管与大脑负面效应。 - **视神经敏捷训练**：仅仅利用一个网球和一个眼罩，每天练习 5 分钟，就能显著提升大脑表现与敏捷度。 ```mermaid flowchart TD accTitle: 肌酸对大脑能量与病理损伤的防护机制 accDescr: 展示肌酸如何通过补充细胞能量储备来缓冲睡眠剥夺并保护神经功能。 subgraph S1["能量代偿"] A["口服肌酸补充"] --> B["提升脑内磷酸肌酸储备"] B --> C["维持神经元高能代谢"] end subgraph S2["压力应对"] C --> D["抵御睡眠剥夺损害"] C --> E["减轻脑震荡与卒中损伤"] C --> F["保留阿尔茨海默病患者认知"] end ``` --- ### [02:30](https://www.youtube.com/watch?v=0t_DD5568RA&t=150s) 对抗阿尔茨海默病的使命与女性的独特风险 当被问及自己的职业初心以及为何此时如此紧迫时，Louisa 拿出了一个大约 2 磅重的仿真大脑模型——她亲切地称它为“Henry”。她解释道，如果你亲手触碰真实的人类大脑，它的质感其实和一块豆腐非常相似。正是这团“豆腐”般脆弱而精密的组织，构成了你的一切记忆、性格与身份认同。全球目前已有 6000 万名阿尔茨海默病患者，预计到 2050 年这一数字将翻三倍，届时仅患病的女性就将高达 1.1 亿人。 Louisa 对此感到愤怒而痛心：“这种疾病会彻底剥夺你是谁，剥夺你的全部自我认同。”长久以来，医学界普遍存在一个误区，认为女性患者占 70% 只是因为女性平均寿命比男性更长。然而大量最新证据推翻了这一点：痴呆和阿尔茨海默病**绝不是**大脑自然衰老的必然过程。在去除寿命变量后，数据表明“女性本身的生物学特质就是该疾病的独立危险因素”。更令人扼腕的是，在这类认知障碍中，高达 95% 的病例本可以通过生活方式干预予以预防；但悲剧在于，一旦确诊，它就如同癌症晚期一样不可逆转。 - **遗传与生活方式的实际占比**： - 像亨廷顿舞蹈症（Huntington's disease）是 4 号染色体上的确定性突变，属于命中注定。 - 阿尔茨海默病虽涉及约 20 至 30 个相关基因，但真正由生殖细胞突变（如早老素 1 即 *PSEN1*、早老素 2 即 *PSEN2*、淀粉样前体蛋白 *APP* 基因突变）完全主导的早发型家族性病例**仅占约 3%**。 - 剩余 **95% 以上**的病例本质上都属于可预防的“生活方式与环境疾病”。 --- ### [05:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=321s) 从30岁开始累积的病理改变：大脑的复利机制 在公众的认知中，认知障碍通常被归类为老年病，但 Louisa 纠正了一个至关重要的观念：痴呆症（Dementia）是一个全能的上位总称，旗下涵盖了 Bruce Willis 患有的额颞叶痴呆（Frontotemporal dementia）、路易体痴呆（Dementia with Lewy bodies）、帕金森病痴呆以及血管性痴呆等，而阿尔茨海默病则是其中最常见的分支。阿尔茨海默病**本质上是一种在中年时期（30多岁）就已在静默中发病的疾病**，只是外在的临床症状直到 60 岁末、70 岁甚至更晚才爆发出来。 人类大脑在 25 到 30 岁之间达到完全发育的成熟峰值。大脑包含大约 870 亿个神经元，平均每个神经元拥有 5,000 至 10,000 个突触连接；在 Louisa 最喜欢的小脑中，浦肯野细胞（Purkinje cells）的连接数甚至超过 50,000 个。尽管大脑仅占人体体重的一小部分，它每天却要消耗人体摄入总热量的 20%，并且是全身血管最为丰富的器官。从 30 岁起，睡眠不足、劣质饮食、缺乏身体活动以及环境毒素，就像滴水穿石一样，日复一日地削蚀大脑的精细网络。 - **生理复利效应与睡眠杀手**： - 生物系统遵循残酷的“复利定律”（Compounding）。 - **仅仅一晚的严重睡眠剥夺**，就会导致脑内β-淀粉样蛋白（Amyloid beta，阿尔茨海默病标志性病理蛋白）水平上升 **4%**。 - 对于常年睡眠碎片化的新手妈妈、倒班轮班工人或高压住院医师而言，这种长达数年的病理蛋白蓄积最终将引发不可逆的神经元退行性死亡。 - **脑萎缩的可视化影像**： - Louisa 展示了健康大脑与病变大脑的矢状位（Sagittal view）切片对比： - **健康大脑**：脑皮层外层灰质厚实饱满，脑回间缝隙细密，脑室小而紧凑。 - **阿尔茨海默病/萎缩大脑**：大脑皮层明显变薄，脑回萎缩导致间隙增大，大脑表面与颅骨之间的空隙显著变宽，中央蝴蝶状的脑室发生代偿性病理性扩大。 - **轻度认知障碍（MCI）**：属于神经元广泛受损、局部脑萎缩后的“前痴呆阶段”。 --- ### [08:43](https://www.youtube.com/watch?v=0t_DD5568RA&t=523s) 60岁时的锋芒：认知储备与大脑容错资本 主持人提到了自己在访谈多位嘉宾时的切身体会：同样是 60 岁的人，有些人思维敏捷、谈吐精准、对数据和复杂故事信手拈来，其锐利程度甚至超越年轻人；而另一部分人却词不达意、记忆模糊、认知明显钝化。这种巨大分歧的根源究竟是什么？ Louisa 借此引出了神经科学中极为关键的概念——**认知储备（Cognitive Reserve）**。正如心肺耐力中的最大摄氧量（VO2 Max）反映了心肺系统在极限高强度下摄取和利用氧气的能力一样，VO2 Max 越强的人，面对感染、手术、创伤或熬夜等外界生理打击时拥有的身体冗余储备就越大；大脑亦是如此。认知储备就如同你在银行里存下的“神经抵抗基金”，当阿尔茨海默病病理损伤、氧化应激或外界打击袭来时，储备丰富的大脑能够动用备用神经网络维持正常运转，让外在表现始终保持在刀刃般的敏锐状态。 ```mermaid flowchart LR accTitle: 认知储备与衰老缓冲机制对比 accDescr: 解释生活方式如何通过构建认知储备缓冲神经病理损伤。 subgraph Reserve["认知与生理储备 (资本充足)"] A["高认知储备 / 高 VO2 Max"] --> B["多重备用神经通路"] B --> C["抵御病理蛋白与衰老打击"] C --> D["60岁依然思维敏捷"] end subgraph Depletion["储备透支 (无冗余)"] E["不良生活习惯 / 缺乏刺激"] --> F["神经元突触连接稀疏"] F --> G["无法代偿神经退行性病变"] G --> H["早期出现认知衰退与钝化"] end ``` ### [10:13](https://www.youtube.com/watch?v=0t_DD5568RA&t=613s) 认知储备与大脑连接：为什么有人满脑斑块却不失智？ Louisa Nicola 指出，常年持续的认知训练能在人们迈入60岁甚至更年长时，抵御各种有害的脑部侵蚀。在临床病理中经常出现一个令人震惊的反差现象：一个80岁的老人体内可能布满了阿尔茨海默病的标志性蛋白——淀粉样蛋白（Amyloid Beta，形成脑部斑块的致病蛋白），然而其认知能力却完好无损；反之，有些人体内几乎检测不到淀粉样蛋白，认知功能却已全面崩溃。导致这种巨大分歧的决定性因素就是“认知储备”（Cognitive Reserve）。 这种储备的物理基础在于神经元之间的突触连接。每个神经元拥有约5,000到10,000个连接，这些连接负责人的思维、处理速度与心智灵敏度。每次产生新的想法，大脑就会建立新的连接；接触的新鲜事物（Novelty）越多、见闻越广，大脑的神经网络就越丰富、越稳固。神经元末端的树突（Dendrites）就像树干，分叉出茂密的树突树（Dendritic Trees）连接邻近细胞。随着岁月流逝，那些长期得不到调动与使用的连接就会衰亡断开。因此，在30岁时就要主动通过各种刺激来积累储备，除了运动，近期研究显示75岁仍能保持敏锐认知的人往往保持着“手写”和“阅读”的习惯；然而，任何训练效果都无法与体育锻炼对大脑储备的强劲赋能相提并论。 ```mermaid flowchart TD accTitle: 认知储备的建立与衰退机制 accDescr: 展示新鲜刺激与运动如何促进树突分支建立储备，反之闲置则导致突触连接萎缩。 subgraph Stimulus ["积极认知与生理刺激"] A["阅读与手写训练"] B["高负荷身体锻炼"] C["新鲜体验与复杂思维"] end subgraph NeuralArchitecture ["神经元结构构建"] D["树突分支生长 (Dendritic Trees)"] E["每个神经元形成 5,000-10,000 个突触连接"] end subgraph ClinicalOutcome ["临床表现分化"] F["高认知储备: 即使有淀粉样斑块仍保留认知"] G["低认知储备/长期闲置: 突触脱落，轻微病理即引发失智"] end Stimulus --> NeuralArchitecture E --> F NeuralArchitecture -. 缺乏刺激与闲置.-> G ``` ### [12:35](https://www.youtube.com/watch?v=0t_DD5568RA&t=755s) 刷短视频对大脑的损耗与运动习惯的缺失 针对 Steven 提出的疑问——“如果我在社交媒体上刷短视频也是在看东西、学新知，这难道不能增加储备吗？”，Nicola 给出了截然相反的结论：刷短视频不仅无法建立储备，反而是在损害大脑功能。短视频内容依赖于高频、即时、短促的多巴胺刺激（Dopamine hits）。大脑演化的核心原始目标只有两个：生存与繁衍；当大脑习惯于频繁摄取无需门槛的廉价多巴胺奖励时，就会削弱长时间集中注意力、深读长文或展开深度对话的神经耐力。 更令人担忧的是公众对真正有效的健脑手段——运动的极度忽视。Nicola 痛心地表示，全美约有80%的人群每周连30分钟的锻炼都无法保证，这与官方推荐的“每周150至300分钟中高强度身体活动”相去甚远。在所有运动形式中，阿尔茨海默病预防与大脑健康投资回报率（ROI）最高的当属抗阻训练（Resistance Training）。例如著名的 SMART 临床试验表明，轻度认知障碍（MCI）患者在接受每周2至3次力量训练后，不仅保住了原有的认知功能，其处理速度、流体智力显著提升，且大脑皮层灰质（Gray Matter）的萎缩速度也得以大幅减缓。 - **大脑解剖构成辨析**：大脑由外层灰质（包含神经元胞体）与深层白质（包含有髓鞘包裹的神经纤维传导束）组成，长期缺乏保护会导致白质区域出现病理性缺血或变性病灶（White Matter Lesions）。 ### [14:47](https://www.youtube.com/watch?v=0t_DD5568RA&t=887s) 遗传宿命论打破：APOE4 基因与男女风险差异 许多人因为父母患有阿尔茨海默病而深感恐惧，Nicola 强调基因并非不可改变的宿命。在各类风险指标中，载脂蛋白E基因（APOE）是已知最强的单项遗传危险因素，该基因每个人从双亲各继承一个等位基因，主要存在三种变异：APOE2、APOE3 与 APOE4。知名演员克里斯·海姆斯沃斯（Chris Hemsworth）在体检中便被测出携带两份 APOE4 拷贝。 | 基因型组配 | 人群状态与男性患病风险变动 | 女性患病风险变动与特征 | |:--- |:--- |:--- | | **APOE2 携带者** | 具有天然的保护机制，降低发病风险 | 同样享有对抗阿尔茨海默病的神经保护效益 | | **APOE3 / APOE3** | 普通大众最常见的基因型（中性，不增加也不降低风险） | 基础对照风险 | | **杂合子 (1个 APOE4)** | 风险提升 **2 至 3 倍** | 风险提升约 **6 倍**（承受比男性同行高出一倍的易感风险） | | **纯合子 (2个 APOE4)** | 风险急剧飙升 **10 倍** | 风险呈毁灭性激增 **15 倍** | Nicola 呼吁大家前往医院通过简单的血液检测来筛查自己的 APOE4 基因型，以便及早布局针对性的生活方式干预。 ### [16:30](https://www.youtube.com/watch?v=0t_DD5568RA&t=990s) 强壮的双腿是健脑利器：大重量抗阻训练的生化级联 在所有力量训练部位中，双腿的力量对脑部健康的决定性最强。Nicola 引用了一项针对同卵双胞胎展开的里程碑式长达10年的追踪研究：在基因完全相同的前提下，腿部力量与爆发力更强的那一位双胞胎，在核磁共振（MRI）影像中展现出更大的大脑体积与更多的脑灰质容积，在多项认知测试中的表现也全面碾压力量较弱的同胞。 要想激活这种神经保护效应，训练强度至关重要。Nicola 强调，虽然轻重量高次数与大重量低次数都能实现肌肥大（Hypertrophy），但为了刺激大脑抗衰，必须采用达到自身一次极限重量（1RM, One Repetition Maximum）约 **80%** 的大重量负荷。当肌肉在高阻力下强烈收缩时，会释放一组被称为“肌动蛋白/肌肉因子”（Myokines）的生化信使分子： ```mermaid flowchart LR accTitle: 抗阻训练介导的肌动蛋白释放与脑部保护通路 accDescr: 肌肉在大重量收缩下释放鸢尾素与IL-6，穿过血脑屏障促进海马体神经发生并抗炎。 subgraph MuscleWork ["骨骼肌收缩 (80% 1RM)"] A["高阻力力量训练"] --> B["肌肉因子 (Myokines)"] end subgraph MyokineSignaling ["靶向生化信号"] B --> C["鸢尾素 (Irisin)"] B --> D["白细胞介素-6 (IL-6)"] end subgraph BrainBenefits ["穿透血脑屏障后的脑效益"] C --> E["促进脑源性神经营养因子 (BDNF) 表达"] E --> F["海马体新生神经元增殖 (对抗萎缩/巩固记忆)"] D --> G["转变为抗炎作用 & 抑制肿瘤细胞增殖"] end ``` - **记忆中枢海马体的抢救**：海马体（Hippocampus）负责记忆巩固与新学习，是阿尔茨海默病中最先受累萎缩的结构，导致患者最先丧失短期记忆；而规律训练促使脑源性神经营养因子（BDNF）大量分泌，驱动海马体生成全新神经元。 - **鸢尾素（Irisin）的使者角色**：作为信使分子跨越血脑屏障，指令并加速 BDNF 在神经中枢的高效表达。 - **白细胞介素-6（IL-6）的双重面孔**：尽管白介素家族通常作为机体感染或应激时的促炎细胞因子，但运动诱导肌肉分泌的 IL-6 却展现出强大的“抗炎”特性，不仅能平息脑部慢性神经炎症，还在现代医学研究中被证实具有下调与抑制肿瘤细胞生长的效能，使力量训练同时兼具防癌机制。 ### [21:01](https://www.youtube.com/watch?v=0t_DD5568RA&t=1261s) 运动的抗癌奇迹：肌动蛋白与“天然杀手细胞” 在谈及肌肉因子（Myokines）对人体的深远影响时，Louisa Nicola 强调，运动绝不仅仅关乎体能，它更是强大的防病手段。仅仅每天坚持 30 分钟的有氧运动，就能够显著下调（down-regulate）多达 13 种癌症的发生风险。在这些癌症中，研究最为透彻、效果最显著的当属乳腺癌、结肠癌和前列腺癌。 运动之所以具备如此惊人的抗癌功效，关键就在于肌肉收缩时释放的肌动蛋白。当我们运动时，身体会大量释放一种被称为“天然杀手细胞”（Natural Killer cells，简称 NK 细胞）的免疫卫士。这些 NK 细胞迅速涌入血浆并流经全身血液循环，一旦抵达肿瘤部位，便会精准执行其生物本能——“它们被造出来的使命就是杀戮”（"They kill"）。它们直接渗入肿瘤病灶内部展开清除，再配合阻力训练与有氧训练所带来的全身性抗炎效应，构成了坚不可摧的防癌屏障。Louisa 指出，各大跨国制药企业如今正耗费数十亿美元的巨资，试图在实验室里人工合成这些肌动蛋白并将其装入药瓶，但至今仍无法复制大自然通过运动赋予人类的奇迹。 ```mermaid flowchart TD accTitle: 运动抗癌机制流程图 accDescr: 展示运动刺激肌肉释放肌动蛋白与NK细胞进而杀灭肿瘤的生理通路。 subgraph S1["运动触发"] A["30分钟/天 有氧或阻力训练"] --> B["骨骼肌收缩与机械负荷"] end subgraph S2["分子与细胞级反应"] B --> C["释放肌动蛋白 (Myokines)"] B --> D["动员NK细胞进入血浆"] C --> E["全身抗炎效应"] end subgraph S3["肿瘤清除靶向"] D --> F["浸润肿瘤微环境病灶"] E --> G["抑制13种癌症 (乳腺/结肠/前列腺癌等)"] F --> G end ``` ### [22:24](https://www.youtube.com/watch?v=0t_DD5568RA&t=1344s) 大重量训练与大脑的“黄金地皮”：首选动作硬拉 除了抗炎抗癌，Louisa Nicola 强烈建议男性和女性都应该练习“大重量力量训练”（lifting heavy）。她将大脑的运动皮层（motor cortex）比作极其昂贵的城市房产（real estate）：在大脑这块宝地中，专门划出了一片区域保留给大重量力量负荷。当你尝试举起沉重的杠铃而非轻飘飘的小哑铃时，大脑必须调动更庞大的神经版图与神经元网络来完成招募。重量越大，大脑产生的“神经冲动”（neural drive）就越强，给大脑带来的结构性益处也就越大。 当被问及“如果余生只能挑选一项动作来保护大脑，你会选哪一个？”时，Louisa 毫不犹豫地回答：“硬拉（Deadlift）。”其核心原因在于，只要动作规范标准，硬拉几乎能一次性激活全身所有主要肌群：从竖脊肌（erector spinae）、臀大肌（glutes）、股四头肌（quads），到前锯肌（serratus anterior）乃至小腿比目鱼肌和腓肠肌。这种极致的复合动作所带来的神经募集效应，唯有杠铃深蹲（barbell squat）可以与之媲美。 ### [23:26](https://www.youtube.com/watch?v=0t_DD5568RA&t=1406s) “主动久坐者”的健康陷阱与微动作代偿 世界卫生组织（WHO）的最新数据表明，由于科技发展和屏幕依赖，现代人类正变得前所未有地久坐不动。克利夫兰诊所（Cleveland Clinic）2025 年的一项里程碑式研究更是揭露了一个残酷的真相——“主动久坐者”（active sedentary）群体面临巨大的健康风险。许多人虽然每天认真去健身房锻炼 30 到 60 分钟，但其余的 10 个小时却全天坐在办公椅上。研究证实，只要一天累计坐姿超过 10 小时，即便你完美完成了当周的推荐运动量，心血管疾病的风险依然会大幅飙升。 其生理学根源在于，长达数小时的连续久坐会直接关闭体内的“脂蛋白脂肪酶”（Lipoprotein lipase，LPL），而这种酶是人体燃烧脂肪、代谢并清除血液中多余葡萄糖的关键催化剂。Louisa 甚至将久坐直言不讳地定义为一种“现代疾病”。面对这种现实困境，她给出了一个极具操作性的破局方法：在每个工作小时内做 10 次徒手深蹲（air squats）。实验证明，每小时做 10 次深蹲、连续坚持 8 小时所带来的代谢激活效应，甚至超过了单次 30 分钟快步走。这种微运动能迅速钝化餐后出现的血糖峰值，强行唤醒代谢酶系统，将血糖平稳拉回基准线。 - **久坐的危害**：每天坐姿 ≥10 小时会抑制脂蛋白脂肪酶（LPL）活性，显著削弱脂肪燃烧和葡萄糖代谢能力。 - **微习惯处方**：工作期间设置闹钟，每 45 至 60 分钟起身完成 10 次标准徒手深蹲，全天累计约 8 次，能有效压制餐后血糖飙升。 ### [25:42](https://www.youtube.com/watch?v=0t_DD5568RA&t=1542s) 有氧训练的代谢机理与女性训练误区：破除 Zone 2 迷思 在有氧训练与阿尔茨海默病预防方面，社交媒体上目前掀起了一股铺天盖地的“Zone 2 训练法”（二区心率训练）狂潮，这让许多女性陷入了严重的认知困惑。Louisa 系统梳理了运动生理学的分区机制：Zone 1 代表平静静息状态；Zone 2 则通常对应约 60% 的最大心率，在这个强度下你可以慢跑并保持交谈，虽然开始喘气，但能量主要由线粒体通过氧化代谢产生三磷酸腺苷（ATP）。然而，一旦强度突破临界点进入 Zone 3、Zone 4 和 Zone 5，细胞质（cytoplasm）便会接管能量生产，通过糖酵解途径（glycolysis）极速分解葡萄糖，其代谢副产物正是乳酸（lactate）。乳酸不仅不是废物，还是一种强效肌动蛋白，更是大脑极其偏爱的核心能量燃料。 虽然 Louisa 认可所有形式的运动都有益处，但她指出男性与女性存在本质差异：中年人大多面临严苛的时间贫困（time-poor），男性或许能从大量的 Zone 2 训练中获得极高的投资回报率，但女性在 Zone 2 上的回报率却并不明显。因此，她极力主张女性走出 Zone 2 的舒适区，优先进攻高强度的 Zone 5： ```mermaid flowchart TD accTitle: 高效女性运动时间分配模型 accDescr: 展示建议女性优先进行的Zone 5、抗阻训练以及可选Zone 2的层级关系。 subgraph P1["第一优先级 (核心基石)"] A["Zone 5 高强度间歇训练<br/>(刺激心室重塑与乳酸释放)"] B["每周 2-3 次大重量力量训练<br/>(强化运动皮层与神经冲动)"] end subgraph P2["第二优先级 (时间充裕时补充)"] C["Zone 2 低心率有氧训练<br/>(促进BDNF分泌与平稳脑血流)"] end P1 -->|总耗时约 4 小时/周| D["维持核心脑健康与代谢"] D -->|若有额外富余时间| P2 ``` 长期慢跑确实能分泌脑源性神经营养因子（BDNF）并持续提供脑部血氧，但低强度运动根本无法对心脏的物理结构产生关键性的重塑。 ### [28:44](https://www.youtube.com/watch?v=0t_DD5568RA&t=1724s) 心脏结构衰老逆转：左心室肥厚与 Zone 5 的终极价值 在对比跑步机跑步与户外路跑时，Louisa 解释道，户外奔跑伴随着视线流动的“前向移动”（forward ambulation），能全面激活大脑视觉、听觉感知皮层，刺激多巴胺释放并降低系统性炎症；但如果要论对大脑和心脏重塑的最强刺激，短时间高强度的 Zone 5 依然占据压倒性优势。 Louisa 拿出一个心脏解剖模型，详细拆解了心脑连接的底层通道：心脏的左心室（left ventricle）扮演着整个循环系统的核心肌肉泵角色，承载着将富氧血液泵送全身的重任。极为关键的是，左心室搏出的血液首先供应大脑，大脑享有绝对的第一供血优先级，随后才是身体其他器官。然而随着人体衰老，主动脉与心脏血管壁开始僵硬失去弹性，左心室心肌逐渐出现代偿性增厚，即所谓的“左心室肥厚”（left ventricular hypertrophy）。心肌一旦变厚僵化，心室容积和收缩弹性便会退化，再也无法像年轻时那样有力地向大脑冲刷泵血。 达拉斯著名运动心脏病学家本·莱文博士（Dr. Ben Levine）的一项里程碑式研究颠覆了医学界对运动逆转心脏衰老的认知。他招募了一批年龄在 47 至 55 岁之间（平均年龄约 50 岁）的健康但久坐不动的中年男性，入组时通过精密的心脏超声心动图（echocardiogram）及高精度影像全面记录了他们已经出现僵硬退化的左心室状态。随后，研究团队为他们制定了每周累计仅约 4 小时的高度结构化运动干预处方——涵盖单次力量训练与高强度有氧运动，以探究心脏结构退行性变是否具有可逆性。 ### [31:38](https://www.youtube.com/watch?v=0t_DD5568RA&t=1898s) 逆转心脏衰老20年：莱文研究与挪威4x4高强度训练 在深入探讨心血管对大脑的影响时，路易莎·尼古拉（Louisa Nicola）详细引述了本杰明·莱文博士（Dr. Benjamin Levine）的一项里程碑式研究。该研究招募了一批中老年受试者，让他们遵循一套以中高强度为主的系统性训练方案，每周运动约4小时，持续整整两年。实验结束时的结果令人震惊：这些受试者的心脏结构被重塑了20年，几乎将50岁的心脏在生理机能和弹性上逆转回了30岁的状态。尼古拉强调，这种惊人的逆转“仅仅依赖于规律的身体活动本身”。 这套方案的核心环节之一，便是将心率提升至最大心率的90%左右，以刺激最大摄氧量（VO2 Max）。尼古拉指出，VO2 Max 与肌肉力量是预测全因死亡率最强大的两项独立指标。人类从大约35岁起，VO2 Max 就会进入逐年不可逆的生理性衰退。若想阻断这种衰退并获得心脏重塑的红利，每周至少需要进行20分钟的 VO2 Max 极限强度刺激。 提升 VO2 Max 的黄金标准训练法被称为“挪威 4x4”（Norwegian 4x4）。其操作模式极其严格：将心率拉升至最大心率的90%至95%，全力维持4分钟；随后彻底停下休息4分钟；整套流程重复4次。尼古拉分享了自己的日常训练习惯：“我自己每周会做两次，因为做越多获益越大。我通常在健身房的台阶机（stepper）上进行，目前设置在14档左右并持续进阶。我全力冲刺4分钟，然后完全停下休息4分钟，循环4次。”这种极限冲刺不仅将大量新鲜血液猛烈泵入大脑（shunting of blood to the brain），促使肌因子（myokines）与运动因子（exerkines）大量释放，还能重塑心脏、下调肿瘤细胞生长并直接提升认知功能。 ```mermaid flowchart TD accTitle: 本杰明·莱文博士每周4小时运动方案 accDescr: 包含挪威4x4高强度训练、长距离有氧运动、中等强度交谈测试运动与抗阻力量训练四大板块。 subgraph HIIT["高强度间歇 (VO2 Max)"] A["挪威 4x4 训练法<br/>4分钟冲刺 (90-95%心率) + 4分钟休息<br/>重复4次 / 每周1次"] end subgraph Endurance["耐力与中等强度"] B["长距离有氧运动<br/>徒步 / 骑行 / 网球<br/>60分钟 / 每周1次"] C["中等强度有氧运动<br/>维持交谈测试标准<br/>30分钟 / 每周1次"] end subgraph Resistance["力量负荷"] D["抗阻力量训练<br/>全身大肌群强化<br/>每周1次"] end HIIT --> E["综合重塑效应：<br/>逆转心脏结构老化20年<br/>维持血脑屏障完整性"] Endurance --> E Resistance --> E ``` ### [34:39](https://www.youtube.com/watch?v=0t_DD5568RA&t=2079s) 65岁的“生物保质期”与脑血管网络的脆弱平衡 史蒂文（Steven Bartlett）查阅该研究论文时指出了一项发人深省的发现：心脏的自我重塑能力存在严格的“生物保质期”（biological expiration date）。研究表明，心脏保持可塑性并能被逆转的生理窗口期截止于65岁左右。如果干预措施推迟到65岁之后才启动，心肌组织已经过于僵硬（stiff），无法再通过运动达成20年的生理逆转。尼古拉对此极为赞同，并郑重告诫：“中年正是大脑健康与长寿的关键机会窗口。” 随后，尼古拉从解剖学角度剖析了心脏与大脑之间紧密不可分割的血流网络。主动脉从心脏发出后，分化出两套至关重要的大脑供血干线： - **椎动脉（Vertebral arteries）**：沿颈椎上行，主要负责供应小脑及大脑后部区域的血液。 - **颈动脉（Carotid arteries）**：分布于颈部两侧，直接供给额叶及大脑中部的广大区域。 大脑是全身体积占比极小但血管网最密集（vascular-rich）的器官。在微观层面，维持神经元生存的并非粗大动脉，而是单层细胞厚度的毛细血管。这些极致脆弱的微小血管不仅直接向神经元输送氧气与营养，更构成了血脑屏障的基础物理支撑。一旦个体长期处于高血压等慢性血管压力之下，这些脆弱的毛细血管便会最先遭受物理性破坏并坏死，导致脑组织微循环灌注中断。 ### [36:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=2211s) “脑漏”危机、夜店保安比喻与 SPRINT 临床试验 尼古拉用生动的比喻阐述了“脑漏”（leaky brain）的形成机制。血脑屏障由内皮细胞和周细胞（pericytes）构成，彼此之间依靠“紧密连接”（tight junctions）紧紧锁死。“你可以把血脑屏障想象成夜店门口的保安，”尼古拉解释道，“他们肩并肩紧贴着站在门口，严格审查谁能进入、谁被拒之门外，坚决阻挡有害分子混入。” 然而，当微血管因高血压等代谢性应激持续受损时，微血管坏死会导致紧密连接松脱撕裂。这些原本严密的细胞间隙被迫拉开，导致血液循环中的各种大分子和毒性物质被动扩散渗透进脑实质，引发局部炎症与神经退行性病变。这种现象与消化系统中的“肠漏症”如出一辙，并在轻度认知障碍（MCI）患者的大脑扫描中被高频捕捉。 为了抵御微血管破坏，血压管理成为预防认知障碍的头等大事： - **核心标准与危害阈值**：著名的 SPRINT 临床试验确立了现代医学 120/80 mmHg 的健康基准。当收缩压超过 135 mmHg 时，单层细胞厚的微血管便开始成批崩溃消亡。 - **SPRINT 研究的启示**：试验表明，若通过降压药物（如 ACE 抑制剂）积极将高血压患者的血压压制在合理区间，能够极其显著地保护大脑灰质体积，遏制认知能力滑坡。 - **低成本干预建议**：尼古拉强烈呼吁每个人在亚马逊上花约25美元购买一台全自动电子血压计，养成每天清晨测血压的习惯。“如果不希望依赖药物，你就必须通过抗阻运动增强体质，并彻底管控由慢性炎症和皮质醇飙升所推高的高血压。” ### [40:13](https://www.youtube.com/watch?v=0t_DD5568RA&t=2413s) 阿尔茨海默病究竟如何夺走生命？确诊后的绝望与代谢应对 对话切入痴呆症残酷的流行病学现实。尼古拉揭示，痴呆症目前已成为英国女性的头号死亡原因，在澳大利亚更是男女两性共同的头号死因。面对史蒂文关于“健忘为何会致命”的困惑，尼古拉打破了大众的浅层认知，揭露了晚期神经退行的残酷真相： > “阿尔茨海默病就像癌症晚期。一旦拿到确诊通知书，就没有治愈的可能，没有回头路，不可逆转……真正令人心碎的是，患者最终并非直接‘死于阿尔茨海默病’本身。” 尼古拉解释，在轻度认知障碍（MCI）阶段，患者尚有长达20年的时间窗口去延缓病情恶化；但一旦跨入确诊阿尔茨海默病的门槛，脑功能便进入崩解阶段： - **反射机能失控**：大脑逐渐失去向咽喉肌肉发送吞咽反射信号的能力，导致食物或液体误入气道引发窒息，或是形成致命的吸入性肺炎。 - **神经运动失衡**：前庭与平衡中枢严重受损导致频繁跌倒，进而诱发致命性颅脑创伤或骨折并发症。 当史蒂文询问“如果你今天被确诊为阿尔茨海默病，你会如何改变生活”时，尼古拉不禁苦笑了一声，坦承在现有医学条件下确诊几乎意味着判决，但她绝不会束手就擒。她会立刻实施三项极端干预： 1. **激进的超高强度锻炼**：最大限度地强行刺激脑血流与神经营养因子的代偿释放。 2. **极其严苛的饮食管控**：坚决剔除任何加剧神经系统炎症的食物。 3. **全面转向生酮饮食（Ketogenic Diet）**：尼古拉解释，阿尔茨海默病患者的大脑正经历着极其严峻的“代谢危机”（metabolic crisis）——神经元逐步丧失了摄取和利用葡萄糖的能力，而酮体能够绕过葡萄糖代谢障碍，作为替代燃料直接为饥饿枯竭的神经元提供生存能量。 ### [42:28](https://www.youtube.com/watch?v=0t_DD5568RA&t=2548s) 大脑的代谢危机与髓鞘分解：生酮饮食作为救急燃料 当阿尔茨海默病来袭，或者女性步入围绝经期（Perimenopause）时，大脑神经元会遭遇一场灾难性的能源短缺——它们失去了将葡萄糖作为主要燃料来源的能力。面对这种代谢匮乏，受困的脑细胞为了存活，必须启动紧急自救机制。此时，充当大脑“后勤支持者”的星形胶质细胞（Astrocytes）开始被迫分解神经纤维外层的髓鞘（Myelin sheath），从分解产物中合成酮体（Ketone bodies），再将其输送给神经元作为替代能源。大脑其实极度喜爱酮体，甚至能比葡萄糖更高效地利用它，但葡萄糖终究是大脑默认的第一能源。 面对这种大脑代谢危机，需要采取一套极其积极的干预策略： - **摄入酮体**：采用富含酮体的生酮饮食（Ketogenic diet），或直接补充外源性酮体（Exogenous ketones），绕过受阻的葡萄糖代谢通路。 - **高强度运动与血脂管理**：积极进行抗阻与有氧训练，严密监控并管理血脂指标。 - **神经营养补充**：大量摄入 Omega-3 脂肪酸以支持神经元细胞膜。 - **激活认知储备**：只要认知尚完好，就尽一切可能走出门与人交际、开展深度且富有挑战的对话，甚至做一些“把网球砸向墙壁再接住”的敏捷性反应训练，多维度刺激大脑回路。 ```mermaid flowchart TD accTitle: 大脑能量代谢危机与应对机制 accDescr: 展示阿尔茨海默病与围绝经期雌激素下降导致脑葡萄糖代谢受损，进而迫使髓鞘分解产生酮体的病理机制及应对策略。 subgraph Crisis["能源危机触发"] A["雌激素下降 / 阿尔茨海默病病变"] --> B["脑葡萄糖代谢率骤降 ~30%"] B --> C["神经元面临代谢枯竭与攻击"] end subgraph Survival["细胞应急自救"] C --> D["星形胶质细胞分解髓鞘 (Myelin Sheath)"] D --> E["生成内源性酮体救急供能"] end subgraph Intervention["外部营养干预"] F["生酮饮食 / 外源性酮体"] --> G["直接向大脑供应替代燃料"] G --> H["缓解脑雾与神经元饥饿"] end ``` --- ### [44:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=2661s) 女性围绝经期的“断崖式下跌”：30% 脑能量滑坡与脑雾真相 女性在绝经与围绝经期所经历的变化，在生理层面甚至可以说是“毁灭性”的。随着体内雌激素水平暴跌，女性大脑的葡萄糖代谢能力会骤减整整 30%。脑内原本用于接收雌激素信号的受体开始凋亡，直接导致脑组织无法正常代谢葡萄糖，不得不依靠自噬髓鞘转化酮体勉强维持运转。正是这种能量代谢层面的断崖式暴跌，引发了大量女性常年抱怨却常被忽视的“脑雾”（Brain fog）。 脑内代谢物的失衡直接冲击了睡眠。大约 60% 至 65% 的围绝经期与绝经期女性会经历潮热（Hot flashes）或盗汗（Night sweats），在深夜频繁被热醒。下丘脑作为大脑的体温调节中枢，由于缺乏雌激素的稳定调控，对温度的敏感度陷入错乱：哪怕体温只上升了一丁点，下丘脑也会误以为身体过热，骤然拉高体温发出警报，随即又剧烈降温。这种机制让女性整夜辗转反侧。长期睡眠剥夺会直接导致大脑内淀粉样蛋白（Amyloid beta）的大量堆积。在所有已知的风险因素中，除年龄本身外，“女性”这一性别身份正是罹患阿尔茨海默病的第二大最高风险因素，其核心根源很大程度上就深植于雌激素暴跌引发的代谢连锁崩塌。 --- ### [46:55](https://www.youtube.com/watch?v=0t_DD5568RA&t=2815s) 激素替代疗法（HRT）的争议与真相：我是“中立的瑞士” 谈到通过外源性补充雌激素来力挽狂澜，甚至有人提议“只要把雌激素顶上去，脑健康不就恢复了吗？”然而事实远比这复杂。关于激素替代疗法（HRT，Hormone Replacement Therapy），目前的科学证据尚不能简单下绝对结论：大型随机对照临床试验（RCT）目前并没有确凿证据证实 HRT 能直接预防痴呆症，因此在这个议题上保持中立。然而，HRT 是一个强大的信号支持系统——多项研究证实，接受 HRT 的女性罹患阿尔茨海默病的风险可降低高达 30%。但这种获益并非因为雌激素本身直接杀灭了病灶，而是它扫清了导致阿尔茨海默病的上游诱因： - **平复下丘脑与挽救深层睡眠**：HRT 显著消除潮热和夜间盗汗，让女性得以重获深度睡眠，从而让大脑的淋巴排毒系统正常工作，清理日常积累的淀粉样蛋白。 - **肌肉合成的天然代谢合成剂**：雌激素对肌肉具有合成代谢作用（Anabolic），可刺激肌肉蛋白合成；同时人体骨骼和肌肉上均密布雌激素受体。雌激素能保护骨矿物质密度并增强肌力，直接筑起抵御神经退行性疾病的身体防线。 从女性身体的激素曲线上看，雌激素在 30 岁左右就开始逐渐下滑，通常在 42 至 45 岁左右开始面临更剧烈的下降，围绝经期往往会持续约 10 年之久。多数妇产科专家建议，女性从 40 岁起就应当定期去医院检查激素水平，及早评估身体状态。 --- ### [50:19](https://www.youtube.com/watch?v=0t_DD5568RA&t=3019s) 走出致癌恐慌：从 WHI 阴影到 HRT 的剂型选择与护肤奇效 很多人至今谈 HRT 色变，根源在于当年声势浩大的“妇女健康倡议”（WHI, Women's Health Initiative）研究。该研究发布的早期结论引发了公众对乳腺癌的剧烈恐慌，直接导致女性 HRT 的使用率从峰值的 40% 断崖式跌落至区区 4%。然而现实的数据是残酷的：女性一进入绝经期，心血管不良事件的风险就会激增三倍，患阿尔茨海默病的风险也大幅飙升。现代医学的大规模追踪研究已经表明，只要在专业医生指导下使用，根本无须对 HRT 产生过度恐惧。 谈到具体的摄入途径与形式，市面上涵盖了多种形态，各具特色： - **口服胶囊**：如雌二醇（Estradiol）与孕酮（Progesterone）复合制剂，其中的孕酮能起到极佳的助眠安神效果。 - **阴道雌激素（栓剂与乳霜）**：不仅针对局部黏膜萎缩，含有雌激素的乳霜甚至被一些人涂在脸上作为“最顶级护肤品”。由于人体皮肤组织布满了雌激素受体，外用能极大提升皮肤弹性、刺激胶原蛋白生成并增加真皮层厚度。 - **透皮贴片（Patch）**：这是目前绝大多数女性以及专家本人最青睐的形式。贴片吸收平稳、使用最为便捷，也是目前科研证据最详实的剂型。 --- ### [52:54](https://www.youtube.com/watch?v=0t_DD5568RA&t=3174s) 追溯百年阿尔茨海默病史：从奥古斯特·德特尔到两大核心蛋白 阿尔茨海默病究竟如何与其他类型的痴呆症区分开来？关键在于两大核心病理蛋白：**淀粉样蛋白（Amyloid beta）**所形成的斑块，以及由 **Tau 蛋白**异常磷酸化导致的神经原纤维缠结。 这一病理探索的历史最早可追溯至 1901 年。当时，德国精神病学家阿洛伊斯·阿尔茨海默（Alois Alzheimer）接诊了一位年仅 52 岁的女患者奥古斯特·德特尔（Auguste Deter）。她表现出严重的进行性记忆丧失、幻觉以及高级认知功能瓦解，这也是医学史上被记录的首例阿尔茨海默病患者。百余年来，人类对这两种标志性蛋白如何摧毁神经元的探索，正是从这位 52 岁女性的病例正式拉开帷幕的。 ### [53:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=3201s) 首位阿尔茨海默病患者与淀粉样蛋白级联假说之反思 Louisa Nicola 讲述了阿尔茨海默病在医学史上最初被记录的那一刻。当时，一名叫奥古斯特·德特（Auguste Deter）的女性与丈夫来到医院求诊。她深受寻词困难、语言流利度下降以及记不清钥匙放在哪里的困扰，丈夫甚至形容她“神志失常”。接诊的医生是一位名叫阿尔茨海默（Alois Alzheimer）的精神科医生。奥古斯特对医生说出了一句令人心碎的话：“我再也不知道自己是谁了（I don't know who I am anymore）。”Nicola 感慨道，这种疾病最残酷的地方，就是它剥夺了一个人最本质的自我。1906年，奥古斯特去世后，医生对其大脑进行尸检，首次在大脑中发现了异常的斑块，这是阿尔茨海默病被正式引入人类社会的起点。 此后一个多世纪里，医学界一直在努力攻克这一难题。到了 2000 年代，“淀粉样蛋白级联假说（amyloid cascade hypothesis）”风靡一时，医学界将阿尔茨海默病简单等同于“大脑里塞满了毒性淀粉样蛋白”，这种多肽蛋白因此被彻底妖魔化。紧接着，各大药企研发出了静脉注射药物（IV drugs），许诺能清除淀粉样蛋白从而治愈疾病。然而现实却极其残酷：在清除淀粉样蛋白的同时，这些药物往往会剥离正常的脑组织，导致脑微出血（microhemorrhages），部分患者甚至因此丧生。 如今医学界开始重新审视这一机制：淀粉样蛋白本身其实并不是原罪，它在本质上是一种抗菌肽（antimicrobial peptide），具有保护脑细胞的生理功能，因此 β-淀粉样蛋白并非天生是坏东西。真正的问题出在大脑的清理机制上。 ```mermaid flowchart TD accTitle: 阿尔茨海默病病理机制 accDescr: 展示淀粉样蛋白清理受阻与Tau蛋白过度磷酸化崩塌的大脑病理过程 subgraph Extracellular["细胞外部环境：类淋巴清理受阻"] A["正常生理：β-淀粉样蛋白（抗菌肽）"] B["进入深层睡眠 / 胶质细胞收缩"] C["类淋巴系统启动：脑脊液冲刷清除"] D["睡眠碎片化（如围绝经期潮热、失眠）"] E["淀粉样蛋白过度堆积成斑块"] A --> B --> C A -. 清理失败.-> D --> E end subgraph Intracellular["细胞内部结构：Tau蛋白过度磷酸化"] F["轴突微管（维持神经信号传导速度）"] G["Tau 蛋白结合（如同铁轨枕木稳固微管）"] H["雌激素缺乏 / 压力过载 / 酶异常激活"] I["Tau 蛋白过度磷酸化并脱落"] J["形成神经原纤维缠结（NFT）"] K["微管坍塌、轴突崩解、神经元凋亡"] F --- G G --> H --> I --> J --> K end ``` --- ### [55:35](https://www.youtube.com/watch?v=0t_DD5568RA&t=3335s) 类淋巴系统与 Tau 蛋白缠结：细胞内外的双重风暴 Nicola 深入解析了大脑在夜间的排毒机制。在进入深层睡眠（deep sleep）时，人体会启动“类淋巴系统（glymphatic system）”。该系统的名字来源于神经胶质细胞（glial cells）。胶质细胞位于神经元外部，是脑部主要的免疫细胞。在深睡状态下，这些胶质细胞会主动收缩变小，让脑脊液（cerebrospinal fluid）在脑组织间顺畅流动，像一台强劲的“大脑洗衣机”，将白天悬浮积累的 β-淀粉样蛋白彻底冲刷带走。但在阿尔茨海默病患者中，这种冲洗循环从未真正完成。例如在女性围绝经期和绝经期，由于潮热（hot flashes）和夜间盗汗，睡眠被切得支离破碎，根本无法进入高质量深睡，导致淀粉样蛋白在胞外不断堆积。 与此同时，大脑神经元内部还在经历着另一场灾难，其核心是 Tau 蛋白。神经元就像一棵树，胞体是树冠，而由髓鞘包裹的轴突（axon）就像树干。轴突内部有无数条像铁路轨道一般的“微管（microtubules）”，神经信息和思维速度正是依靠这些微管轨道快速传递。而 Tau 蛋白的作用就像加固铁轨的枕木，牢牢绑定微管以维持树干结构的稳定。然而在面对慢性压力、代谢紊乱或激素失衡时，Tau 蛋白会发生过度磷酸化（hyperphosphorylation），脱离微管并聚集成团，形成“神经原纤维缠结（neurofibrillary tangles）”。失去支撑的微管随后崩塌，整个轴突瘫痪瓦解。因此，阿尔茨海默病是大脑在“细胞外被淀粉样蛋白包围”与“细胞内微管结构彻底坍塌”的内外夹击下的环境灾难。 - **为什么会出现过度磷酸化？** 神经元的轴突表面分布着大量雌激素受体。雌激素能极其聪明地阻断促使 Tau 蛋白磷酸化的激酶。如果围绝经期体内雌激素断崖式下跌，失去了这种刹车机制，激酶便会大肆磷酸化 Tau 蛋白。 - **男性为何具有某种保护优势？** 尽管男性体内的雌激素本身较少，但男性拥有高水平的睾酮，睾酮在大脑中能通过芳香化反应（aromatize）转化为雌激素，从而在神经保护方面为男性提供了一层额外的“防线”。 --- ### [59:45](https://www.youtube.com/watch?v=0t_DD5568RA&t=3585s) 睡眠是终极脑防御：补觉误区与“睡眠储备”策略 提到 Tau 蛋白磷酸化的另一大推手，Nicola 强调“睡眠剥夺”是目前被严重低估的阿尔茨海默病预防工具。很多人以为睡觉只是闭上眼睛让身体自发运转，但在充满干扰的现代社会，人们必须把睡眠当成一项需要主动训练的技能（"train for sleep"）。遗憾的是，相当多的人由于生活方式混乱，几乎很难进入能启动类淋巴排毒的深层睡眠。 很多现代人长期每晚只睡 5 个小时，甚至对此习以为常，Nicola 直言不讳地指出：“他们会在 60 岁和 70 岁时为此付出惨重代价。”医学研究表明，仅仅一整晚的睡眠剥夺，就会让大脑中的 β-淀粉样蛋白风险直接上升 4% 到 5%，其日积月累的复利破坏是不可逆的。不仅如此，缺觉还会打乱调节饥饿感与饱腹感的激素水平，使罹患 2 型糖尿病的风险大幅攀升。 针对平时熬夜、指望周末睡懒觉还债的“睡眠债务（sleep debt）”心理，Nicola 纠正道：大脑并不是银行，熬夜造成的脑损伤无法在事后用补觉来偿还。不过，Steven 提到睡眠专家马修·沃克（Matthew Walker）曾提出虽然“补觉”无法消除已造成的损伤，但如果是可预见的缺觉，提前“多睡储备（banking sleep）”却能起到缓冲作用。Nicola 对此表示赞同，她分享自己在面对洛杉矶到纽约，甚至是飞往澳大利亚的长途越洋飞行时，就会在行前的一整周里每天刻意多睡、储备睡眠额度，以应对飞机上的必然失眠。面对那些已经出现睡眠障碍、担忧脑排毒受阻的听众，Nicola 建议首先要审视白天的生活方式，并分清自己究竟是“入睡困难（trouble falling asleep）”还是“维持睡眠困难/中途易醒（trouble staying asleep）”。 ### [01:03:44](https://www.youtube.com/watch?v=0t_DD5568RA&t=3824s) 入睡困难与大脑镇静：GABA与夜间碳水策略 许多人在夜晚面临两大截然不同的睡眠障碍：一种是“难以入睡”，另一种则是“难以维持睡眠”。无论是女性还是男性，上床后大脑往往像开足马力的机器疯狂运转，默认模式网络（Default Mode Network, DMN）处于过度活跃状态，杂念接踵而至，根本停不下来。而无法维持睡眠的人，则多半是因为体内积热发烫、心头压力过大或是频做噩梦而半途惊醒。针对那些深夜思维狂奔、辗转反侧的人群，首要推荐的营养干预是引入GABA（γ-氨基丁酸）。作为中枢神经系统中最主要的抑制性神经递质，GABA就像是大脑神经元通信的刹车片，能够有效抚平杂乱的思绪，让亢奋的意识逐渐平静下来。 与此同时，晚餐的饮食结构也是调节入睡门槛的关键杠杆。很多人对夜间摄入碳水化合物抱有偏见，但实际上，将碳水后置（carb backloading）至晚餐时段对睡眠极具益处。选择红薯等淀粉类根茎蔬菜，有助于平稳提升血清素和褪黑素的前体水平，为大脑提供放松的神经生化信号。 - **默认模式网络（DMN）失控**：导致躺下后大脑不断反刍日常压力与琐事，是入睡困难的核心神经生物学特征。 - **GABA（γ-氨基丁酸）**：人体核心抑制性递质，直接抑制中枢神经过度兴奋，稳定脑电波。 - **后置复合碳水摄入**：建议晚餐加入适量低GI淀粉类食物（如红薯），有效促进神经系统向副交感状态倾斜。 --- ### [01:05:18](https://www.youtube.com/watch?v=0t_DD5568RA&t=3918s) 核心体温下调与甘氨酸的助眠延寿机制 睡眠不仅是闭上双眼那么简单，深层优化往往发生在生理机能的降温过程中。人体若想顺利入睡并维持不间断的深睡状态，核心体温必须下降至少2度。如果环境或身体锁热，深睡期就会遭到破坏并导致半夜频繁觉醒。为了实现这种精准的体温调节，可以使用控温床垫来动态抽走体表多余热量；而对于没有这类高阶设备的人，简单的方法同样有效，例如把双脚伸出被窝以利用肢端丰富的血管散热，或者直接将卧室空调设定在较低的凉爽温度。 在补充剂层面，甘氨酸（Glycine）被公认为温度调节与助眠的强力工具。甘氨酸能通过外周血管扩张机制促使体表散热，从而迅速下拉核心体温。除卓越的睡眠改善效果外，甘氨酸在抗衰老和寿命延长领域也展现出巨大的潜力，是目前已知的长寿分子中极具前景的研究对象。 ```mermaid flowchart TD accTitle: 核心体温调节与睡眠启动机制 accDescr: 展示体温下降如何促进深层睡眠启动并带来延寿协同效应 subgraph Cooling["核心体温下调机制"] A["睡前生理准备"] --> B["外周血管舒张 / 肢端散热"] C["甘氨酸补充"] --> B D["物理降温（控温床垫 / 冷气 / 脚露被外）"] --> B B --> E["核心体温下降至少 2°"] end subgraph Outcomes["神经与生理结果"] E --> F["深睡眠启动与维持"] E --> G["减少夜间惊醒与热醒"] C --> H["激活长寿信号通路"] end ``` --- ### [01:06:27](https://www.youtube.com/watch?v=0t_DD5568RA&t=3987s) 适应原的神奇平衡：南非醉茄与红景天调节皮质醇 当谈及夜间惊醒和压力过载时，南非醉茄（Ashwagandha）与红景天（Rhodiola）这两味经典适应原（Adaptogens）扮演了关键角色。适应原的精妙之处在于它的双向自适应调节机制：它不会盲目地抑制或亢奋神经系统，而是根据机体当下的生理偏差进行对冲修正。清晨醒来时人体皮质醇本该处于峰值，但若夜间皮质醇异常飙升，便会触发警觉惊醒与恶梦；适应原分子能够精准结合并平抑过量分泌的皮质醇。反之，若机体指标过低，它亦能辅助上调。 科研数据表明，即便一天规律服用三次南非醉茄，个体也不会产生嗜睡或认知疲倦。在日常应用中，它非常适合与咖啡因进行搭配（类似L-茶氨酸与咖啡因的协同组合），既能抵消中枢兴奋剂带来的心悸神经紧张，又能保留敏锐的专注力，为高压生活构筑平稳的生理缓冲垫。 - **适应原的双向调节性**：高则抑之、低则补之，动态维持下丘脑-垂体-肾上腺（HPA）轴平衡。 - **皮质醇夜间尖峰抑制**：阻止压力荷尔蒙破坏深层慢波睡眠，减少噩梦和惊醒。 - **协同叠加方案**：可与日间咖啡因或L-茶氨酸组合使用，维持专注的同时避免副反应。 --- ### [01:07:37](https://www.youtube.com/watch?v=0t_DD5568RA&t=4057s) 顺应昼夜节律的“睡眠马拉松”：红光与褪黑素诱导 高质量的睡眠不能指望在上床合眼那一秒突然发生，必须将其视为一场马拉松，并从晚上8点（或日落时分）便开始预热准备。这完全契合了古老的昼夜节律与光生物学规律——人类的内分泌轴心原本就随着太阳的升落而起伏。当夜幕降临，黑暗信号会触发松果体自然分泌具有催眠与神经修复功能的褪黑素。然而，现代人充斥着蓝光与垃圾光线的生活环境无情阻断了这一生化开关。 要重新校准这一节律，就必须进行严苛的睡前环境重塑： 晚上8点之后，彻底关闭工作邮箱，推迟所有沉重压抑的谈话，拒绝刺激性影视内容，让自主神经系统由交感状态完全平息下来。在物理光环境方面，可以将家中及卧室的所有照明光源替换为红光灯泡，彻底剔除高能蓝光；日落后配戴防蓝光眼镜也能提供辅助遮蔽。红光有助于神经系统下调唤醒阈值，促使褪黑素如期浪涌，使机体自然步入准备入眠的最佳生化状态。 --- ### [01:09:16](https://www.youtube.com/watch?v=0t_DD5568RA&t=4156s) 劣质鱼油的隐患：氧化风险、第三方认证与冷藏保存法则 在琳琅满目的营养补充剂中，Omega-3鱼油是唯一一个必须极其挑剔其标签背景与供应链的品类。鱼油富含高不饱和脂肪酸，其化学结构在高温环境下极其脆弱，极易发生脂质过氧化并变质酸败。全美一项针对最畅销的85款主流Omega-3补充剂的独立检测研究显示，竟然有高达95%的产品过氧化指标严重超标。服用这种已然变质酸败的油脂，不仅无法保护心脑血管，反而会向体内灌注大量致炎性的脂质过氧化物。 在挑选与使用鱼油时，必须恪守严格的安全法则： 1. **核验独立权威认证**：务必确认产品通过如NSF等外部独立监管机构的严格认证。此类机构会对重金属残留（汞、铅、砷）、氧化过氧化氢值（Peroxide Value）以及实际胶囊含量与标签真实性进行全面抽检。 2. **本土短链采购逻辑**：如同挑选特级初榨橄榄油一样，应优先选择距离所在地供应链更短、在当地压榨封装的高信誉品牌，尽量规避长途集装箱高温运输。 3. **到手即刻冷藏**：绝不可将鱼油随手扔在温度波动剧烈的灶台或温热橱柜中。收到鱼油的第一时间必须放入冰箱冷藏保存，用低温阻断其隐秘的氧化链条。 --- ### [01:11:18](https://www.youtube.com/watch?v=0t_DD5568RA&t=4278s) 脑部黄金燃料：Omega-3脂肪酸与DHA重塑神经突触与血脑屏障 在所有作用于大脑的营养干预中，高质量Omega-3脂肪酸被誉为"最强效的脑部刺激素之一"。从生化构成来看，人类大脑的脱水重量有60%都是脂肪，而这些脂肪组织中高达70%是由二十二碳六烯酸（DHA）构筑而成。可以说，补充DHA就是在从分子层面直接“更换并重塑你的大脑”。 ```mermaid flowchart TD accTitle: Omega-3在脑神经元与血脑屏障中的作用机制 accDescr: 展示Omega-3尤其是DHA如何通过膜流动性与血脑屏障修复保护认知功能 subgraph Synapse["突触与神经传导"] A["Omega-3 (DHA/EPA)"] --> B["提升神经元细胞膜流动性"] B --> C["突触间隙顺畅传递"] C --> D["多巴胺、五羟色胺、钙钾离子快速释放"] end subgraph BBB["血脑屏障与血管架构"] A --> E["特异性脑外膜转运蛋白转运"] E --> F["滋养血脑屏障上的周细胞 (Pericytes)"] F --> G["修复并加固血脑屏障完整性"] end subgraph Disease["临床干预效益"] B & G --> H["轻度认知障碍 (MCI) 延缓"] B & G --> I["APOE4 携带者神经保护"] B & G --> J["阿尔茨海默病退行性病变遏制"] A --> K["发挥媲美 NSAIDs 的强抗炎活性且无副作用"] end ``` Omega-3对脑功能的重塑机制主要体现在以下四个核心维度： - **维持细胞膜流动性与突触传递**：神经元与神经元交汇处形成突触，多巴胺、五羟色胺等神经递质的大量释放以及钙离子、钾离子的跨膜转运，全赖柔软、流动且富有弹性的脂质双分子层。DHA赋予了膜结构优异的滑动通透性。 - **媲美非甾体抗炎药（NSAIDs）的强效抗炎力**：鱼油具有与非甾体类抗炎药相当的全身性系统抗炎效力，但它却拥有媲美FDA批准药剂的卓越安全性，完全不存在药物伴随的胃肠黏膜损伤或毒副作用。 - **守护血脑屏障周细胞（Pericytes）**：在脑衰老和阿尔茨海默病病理过程中，血脑屏障的破坏是关键导火索。守护血脑屏障严密性的核心细胞——周细胞，需要源源不断的DHA作为结构支撑。 - **特异性脑转运蛋白摄取**：大脑外表面存在专门负责将DHA穿透屏障泵入脑实质的专用转运载体，临床试验证实，高剂量DHA补充对轻度认知障碍（MCI）患者、APOE4致病基因携带者以及阿尔茨海默病早期确诊者具有极高的神经挽救价值。 --- ### [01:13:29](https://www.youtube.com/watch?v=0t_DD5568RA&t=4409s) 维生素D受体与海马体：长寿与认知保护的新证据 除了必需脂肪酸，维生素D同样是维持高阶大脑功能的关键支柱。现代神经科学研究证实，维生素D绝非简单的维生素，而是一种强效的神经类固醇激素。在整个人类大脑实质和脑干中广泛分布着密集的维生素D受体（VDR），而这些受体最密集的区域恰恰集中在负责记忆形成、检索与学习功能的核心中枢——海马体（Hippocampus）。 在探讨极端长寿人群的生理特征时，针对中国百岁老人（Centenarians）的大型队列研究揭示了令人瞩目的现象：那些在百岁高龄依然能够保持敏锐认知状态、远离痴呆困扰的长寿老人，其血清维生素D水平普遍显著高于普通虚弱对照组。这为微量营养素与人类极限寿命及脑部神经保护之间的强关联提供了极具说服力的临床证据。 ### [01:13:53](https://www.youtube.com/watch?v=0t_DD5568RA&t=4433s) 维生素D的神经保护作用与神奇的“白色粉末” 在一项针对百岁老人的女性专项研究中，研究人员发现，那些成功保全认知功能且未患阿尔茨海默病的女性，体内均维持着极高的维生素D水平。维生素D缺乏在人群中相当普遍，而这种缺乏会导致全因失智症（all-cause dementia）的患病风险激增40%。相反，如果能将体内的维生素D维持在约 60 ng/dL 的理想高水平，患阿尔茨海默病的风险可大幅降低约80%。 谈完维生素D，桌上摆放的一罐白色粉末立刻吸引了两人的目光。看到这罐粉末，Louisa 脸上露出了难以掩饰的灿烂笑容。Steven 忍不住打趣道：“你脸上的笑容真灿烂，我从没见你这么兴奋过。” Louisa 毫不掩饰自己的狂热，坦言这是因为肌酸（Creatine）带来的益处实在太惊人了。她已经让自己71岁的父母全都在日常补充肌酸，父亲服用大剂量，母亲服用小剂量。尽管市场上充斥着各种品牌的补充剂，但肌酸无疑是目前科研界研究最透彻、最具性价比的强力补剂。 - **维生素D缺乏与风险**：维生素D缺乏会导致全因失智症风险升高 40%。 - **最优保护阈值**：血清维生素D水平维持在约 60 ng/dL，可使阿尔茨海默病风险降低约 80%。 - **家庭日常干预**：Louisa 让其71岁双亲均服用肌酸（父亲高剂量，母亲低剂量）。 --- ### [01:15:01](https://www.youtube.com/watch?v=0t_DD5568RA&t=4501s) 打破偏见：为什么大脑需要突破传统的5克剂量 Louisa 指出，肌酸是用极低成本全面升级生理（Physiology）与神经生理（Neurophysiology）机能的利器。然而，大众对它长期存在深深的误解与恐惧，主要集中在两点：一是担心造成肾损伤，二是担心导致脱发。人体每天由肝脏（以及极少部分大脑）自然合成约2至3克肌酸，但这仅仅能维持基础运转，远远不够。从1990年代到2000年代，健身界普及的标准补充量是每天一平勺（5克）。但随着脑健康领域研究的深入，科学家发现了一个关键难题：肌肉对肌酸有着极高的贪婪度，5克吃进去，全被肌肉“优先抢光”（first dibs），大脑根本分不到残羹剩饭；更何况肌酸穿越血脑屏障时还会损失部分生物利用度。 ```mermaid flowchart TD accTitle: 传统剂量与高剂量肌酸在大脑吸收中的差异 accDescr: 对比传统5克摄入与突破性高剂量摄入在肌肉吸收与穿透血脑屏障后的脑部留存差异。 subgraph LowDose ["传统补充模式 (5g/天)"] A["口服 5g 肌酸"] --> B["骨骼肌优先强力吸收"] B --> C["血液残留极低"] C --> D["穿透血脑屏障受阻/损耗"] D --> E["大脑几乎无法获得额外能量补给"] end subgraph HighDose ["脑健康优化模式 (15-20g+/天)"] F["分次口服 20g 肌酸"] --> G["骨骼肌达到完全饱和"] G --> H["充裕肌酸游离于循环系统中"] H --> I["跨越血脑屏障弥补损耗"] I --> J["重塑脑细胞 ATP 代谢与能量危机"] end ``` 突破性的转折发生在近期针对阿尔茨海默病患者的首个临床先导研究中。阿尔茨海默病患者的大脑正处于严重的“能量崩溃危机”，脑葡萄糖代谢异常，ATP 生成受阻，甚至分不清左右方向。研究人员给这批患者每天补充高达20克的大剂量肌酸（相当于整整4满勺）。为了避免肠胃负担，Louisa 建议将这20克分次摄入，例如早晨5克、上午5克、午后或活动前10克。令人震惊的实验结果显示：患者不仅保全了认知功能，身体精力明显充沛，而且运动能力显著提升。这项成果彻底震撼了 Louisa，因为肌酸的机制纯粹从细胞底层赋能，“不挑年龄、不分性别、不论体重、不论种族，更无关任何病理状态”，堪称零风险、纯回报的底层能量助推剂。 - **人体内源生成量**：人体每日仅合成约 2-3 克肌酸（主要来自肝脏）。 - **肌肉吸收优先权**：传统 5 克剂量几乎全部被骨骼肌吞噬，无法在跨越血脑屏障后为脑部提供足量底物。 - **阿尔茨海默病先导试验**：每天摄入 20 克肌酸，逆转脑部 ATP 代谢危机，显著保全患者认知与运动机能。 --- ### [01:18:23](https://www.youtube.com/watch?v=0t_DD5568RA&t=4703s) 抵御脑震荡与癌细胞：肌酸的深层保护伞 面对 Steven“肌酸到底在做什么”的提问，Louisa 解释其核心就是推动细胞能量代谢，加速三磷酸腺苷（ATP）的生成。因此，任何感到疲劳无力、遭受脑雾（Brain Fog）困扰的人都应该立刻补充肌酸。对于从事橄榄球等剧烈对抗性运动的运动员，每天摄入高达30克的高剂量肌酸甚至能形成神经“防弹衣”，大幅缓解外力冲击导致的脑震荡（Concussion）、中风及压力引发的脑损伤。正如 Louisa 所言，肌酸最绝妙之处在于它能在极端压力背景下默默撑起保护网。 听到这里，Steven 分享了一则身边真实而感人的经历。他的一位朋友在经历极其痛苦的癌症化疗后幸存下来，但整个人陷入严重的机能崩溃，感觉“再也回不到从前”。在听了 Steven 的建议坚持每天服用肌酸约5个月后，那位朋友由衷感慨：“我感觉我重新找回了自己的人生。” Louisa 紧接着引用了2025年发表的 NHANES 大规模研究（涵盖超过2.5万名成年人），该研究首次揭示了膳食肌酸摄入量与癌症患病率之间清晰的线性负相关关系： | 关键研究指标 | 具体临床/统计数据表现 | 机制与临床意义 | |:--- |:--- |:--- | | **推荐干预剂量** | 约 0.36 g / kg 体重（70公斤成年人约需 25 g/天） | 远超传统健身剂量，为全身体细胞及免疫系统提供超额抗压底物 | | **患癌风险降幅** | 膳食肌酸每增加一个标准差，患癌风险下降约 5% 至 18% | 充足的细胞能量强化免疫监视功能，精准清除异常肿瘤突变细胞 | | **核心获益群体** | 50岁以上中老年人群获益最为显著 | 随衰老进程加剧，维持高水平肌酸储备是维系线粒体与免疫防线的命脉 | Louisa 总结道，生存的本质全在于“能量”。不论是抵抗感染、抗击压力，还是维持机体运转与清除异常细胞，如果机体陷入能量赤字，任何严重疾病都会趁虚而入。 - **神经抗冲击损伤**：在每日约 30 克高剂量下，可显著减轻脑震荡物理冲击及脑卒中对脑组织的不可逆损伤。 - **抗癌大样本证据**：NHANES 2025（超2.5万人）显示，肌酸摄入与癌症发病率呈线性负相关，50岁以上保护效应最强。 - **重症康复反馈**：化疗康复期患者连续补充5个月肌酸，生活质量与精力呈现颠覆性恢复。 --- ### [01:21:57](https://www.youtube.com/watch?v=0t_DD5568RA&t=4917s) 睡眠剥夺解药与打破“肌酐肾毒性”谣言 除了防病抗癌，肌酸在对抗睡眠剥夺方面同样展现出惊人的效果。Louisa 提到，多项前沿研究证实，如果你因熬夜或失眠导致睡眠不足（只睡了4到6个小时），立刻补充15至20克高剂量肌酸，可以奇迹般地“把你自己从睡眠剥夺的负面效应中拉出来”（creatine your way out of sleep deprivation），有效抹平睡眠缺失引发的认知迟钝与身体倦怠。在服用细节上，肌酸极为稳定，溶于热水不会变质，也没有严格的时间限制，无论是运动前、运动中、运动后还是全天任意时刻服用都非常有效；目前科学界甚至在研究睡前服用是否能进一步改善睡眠质量。 在节目的最后，Louisa 严正澄清了困扰无数人的“伤肾”迷思。许多人在体检后被医生警告“肌酐（Creatinine）偏高”，社交网络上也到处是以此为由劝阻大家服用肌酸的误导性言论。Louisa 犀利地指出，血液中的肌酐虽然常被用作肾功能的初筛指标，但在高压力状态、剧烈高强度运动后，或者像 Steven 这样拥有丰富肌肉量（High muscle mass）的健身人群中，肌酐指标自然就会升高，这根本不代表肾脏发生了实质性病变。要客观精准地评估肾脏健康，医学上存在更优秀、更不受肌肉量干扰的检测指标。 - **逆转睡眠不足**：熬夜后摄入 15-20 克高剂量肌酸，可迅速逆转睡眠剥夺引起的脑力衰退与机能迟滞。 - **服用特性**：极耐高温（溶于热水不降解），全天任意时段或运动前后均可服用。 - **澄清肌酐误区**：血液肌酐水平升高常见于剧烈运动、高肌肉量群体及应激期，单纯由摄入肌酸导致的肌酐上升并不代表肾功能受损。 ### [01:23:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=5031s) 肌酸的评估标准、女性获益与品质选择 关于肾功能指标，Louisa 解释如果担心肌酸对肾小球滤过率（GFR）等检测的干扰，最准确的血液生化指标是胱抑素 C（Cystatin C）。只需让医生在验血项目中加入这一项；若胱抑素 C 偏高或不在正常区间内，才需要考虑停用肌酸。但就目前的科学认知而言，她认为没有任何理由不每天补充肌酸，每个人无论年龄多大都应将肌酸纳入日常补剂。 随后她提及一项最新针对围绝经期女性的随机对照试验（RCT）。研究将受试者分为四组：低剂量组（每天约 750 毫克）、中剂量组（每天约 1.5 克）、盐酸肌酸（Creatine Hydrochloride）与一水肌酸（Creatine Monohydrate）对比组以及安慰剂组。结果显示，哪怕是每天补充 1.5 克中等剂量的女性，其情绪与认知功能都出现了显著改善。科学界目前正全面探索肌酸在女性全生命周期中的价值，涵盖围绝经期、妊娠期、绝经期以及阿尔茨海默病等各个阶段。 谈及肌酸的选购标准，Louisa 强调了制造工艺上的两大铁律： - **NSF 认证（NSF Certified）**：确保生产流程严格、不含违禁与有害成分。 - **德国 Creapure® 原料**：全球公认的一水肌酸黄金标准。 现场看到 Steven 拿出的肌酸粉末时，Louisa 一眼便判断那不是 Creapure®：“我敢跟你赌一百万美元，绝对不是它。”她解释，真正的黄金标准 Creapure® 质地带有砂砾感（gritty），而很多厂商为了让粉末更容易溶解混匀，会加入添加剂，使其呈现像糖霜般的极细粉末。针对部分人服用肌酸后出现胃肠道不适（GI distress）的抱怨，Louisa 建议可以单次减量至 2 克或 3 克分次服用，但绝不能因此彻底停用。 --- ### [01:26:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=5211s) 生物年龄逆转与关键血液筛查指标 Steven 询问 Louisa 平时对自己做哪些健康检测以及检测频率。Louisa 透露她每 3 到 4 个月就会做一次全面体检，最近一次是在 12 月 15 日（她生日前一天）。此外，她每年都会测试一次生物年龄（Biological Age）。当被问及具体数字时，Louisa 透露其实际检测出的生物年龄仅为 22 岁，引得 Steven 惊叹不已。 在谈到常规体检最容易遗漏但至关重要的指标时，Louisa 重点强调了两类： - **心血管健康：脂蛋白(a) [Lipoprotein(a) / Lp(a)]** 这项指标属于强遗传性风险因子，水平过高会大幅增加心血管疾病与心脏急性事件的发病几率，通常只需一生筛查一次即可锁定风险。 - **痴呆症早期筛查：P-tau 217 与 β-淀粉样蛋白（Amyloid Beta）** 美国医学界如今已拥有通过血液检测精确筛查轻度认知障碍（MCI）与阿尔茨海默病病理标志物的方法。这项名为 P-tau 217 的血液检测，其诊断阿尔茨海默病特征病变的准确率已经达到了惊人的 90%，完全能媲美昂贵的正电子发射断层扫描（PET Scan）。 --- ### [01:27:54](https://www.youtube.com/watch?v=0t_DD5568RA&t=5274s) 斯特鲁普测试：大脑加工速度实测 Louisa 拿出一叠卡片，要在现场测试 Steven 和制作人 Jack 的认知处理速度。卡片上写着颜色名称，但文字本身的墨水颜色与字面含义相互冲突。她解释背后的脑科学机理：人类大脑处理视觉图像信息的反应速度比识别文字信息快整整 15 倍。 测试首先要求 Steven 忽略卡片上的文字，直接大声喊出卡片所呈现的实际颜色（如文字写着“Pink”，但若是绿色字体则需喊“Green”）。Steven 在快速热身后顺利完成了绿、橙、黄等一系列颜色的快速辨认；紧接着测试反转规则，要求只朗读卡片上印刷的词语本身。见 Steven 轻松通关，Louisa 随即把制作人 Jack 叫上前来，在 Jack 毫无防备的情况下进行突击测试，现场笑声不断。 --- ### [01:29:46](https://www.youtube.com/watch?v=0t_DD5568RA&t=5386s) 单眼网球协调训练：高强度锻造执行功能与认知储备 卡片测试只是前奏，Louisa 紧接着带 Steven 进行身体动态神经协调训练。她指出，训练位于枕叶（Occipital Lobe）的视觉皮层、加工速度、反应时间与手眼协调，是性价比最高的护脑运动之一。诸如网球、壁球等球拍类运动对脑健康极有益处，而每天仅需 5 分钟的单眼网球接发球训练，就能极大地充实大脑的“认知储备”（Cognitive Reserve）。 ```mermaid flowchart TD accTitle: 神经运动训练对大脑的多层级刺激路径 accDescr: 展示从单手接球到眼罩遮盖再到单腿站立的神经生理负荷递增机制。 subgraph S1["基础训练阶段"] A["双手/单手交替抛接网球"] --> B["激活执行功能与前额叶反应速度"] end subgraph S2["感知负荷加码"] B --> C["佩戴眼罩遮挡单眼 (遮蔽50%视野)"] C --> D["迫使枕叶视觉皮层在压力负荷下高强度运算"] end subgraph S3["多任务前庭整合"] D --> E["单腿站立平衡"] E --> F["强烈激活小脑 (Cerebellum) 与空间定向网络"] end subgraph S4["长期神经重构成果"] F --> G["建立突触新连接 / 强化神经网络 / 扩充认知储备"] end ``` 训练难度呈阶梯式升级： 1. **基础抛接**：手持网球以过顶/反手握法抛接，先用右手自抛自接，再双手左右交替，要求受试者至少能流畅持续一分钟，全面调动执行功能。 2. **剥夺单侧视野**：戴上眼罩遮住单只眼睛（直接切断 50% 的双眼视差与视觉输入）。Steven 戴上眼罩自嘲像个海盗，但重新尝试接球时瞬间感到难度飙升，连呼不可思议。Louisa 解释，这一步是在给视觉系统施加极强的神经压力载荷。 3. **单腿站立失衡**：在遮蔽单眼抛接的同时，要求受试者仅用单脚支撑站立。单腿站立会瞬间调动小脑（Cerebellum）参与平衡维持、姿势控制与空间定向，使多任务处理负荷达到顶峰。 随后 Louisa 换上眼罩亲自示范这一挑战。她透露，这套训练系统正是她此前为 NBA 职业球员定制的认知训练方案，专门用于缩减球员在球场上的反应时间并增强高压决策能力。普通人若能持之以恒地进行这种神经敏捷性训练，不仅能重塑大脑神经元之间的突触连接，更能强化神经回路，为晚年大脑筑起抵御退行性病变的深厚认知储备。训练结束后，Steven 开始引出接下来的话题与赞助商介绍。 ### [01:34:17](https://www.youtube.com/watch?v=0t_DD5568RA&t=5657s) 中场广告：Ketone-IQ 与 DOAC 对话卡片 Steven Bartlett 插入了一段中场赞助播报，分享了他与外源酮饮品 Ketone-IQ 的渊源。他坦言自己之所以成为该公司的联合所有者并接受其赞助，纯粹是因为一次机缘巧合：某天他来到办公室，发现桌上放着一盒寄来的样品，团队成员 Lily 告诉他这家公司曾试图取得联系。Steven 随后上楼亲自试饮，从此便彻底被其效果折服。他形容这款产品是“彻底的游戏规则改变者”（game changer），不仅大幅改善了专注力和日常精力，还显著提升了他的工作状态与工作效率。如今，该产品在全美的 Target 门店均有上架。 紧接着，Steven 提到了人与人之间深度联结的珍贵价值，并介绍了节目团队全新推出的第二版《DOAC 对话卡片》（Conversation Cards）。每一期节目尾声，受访嘉宾都会为下一位未知的访客留下一道直击灵魂的问题，团队以此为基础并加入了极具戏剧性的反转规则卡（twist cards）。在这一全新批次中，Steven 还首次放入了附带独家提问的限量版金色卡片，呼吁有兴趣的听众尽早入手。 --- ### [01:35:52](https://www.youtube.com/watch?v=0t_DD5568RA&t=5752s) 挑战极限：前中扣带皮层（AMCC）与大脑的“意志力肌肉” 话题切回到大脑长期健康的基石——“主动做艰难的事”（doing hard things）。Louisa Nicola 指出，人类如果在整个人生跨度中坚持迎难而上，大脑功能将会获得极为显著的跃升。从神经科学的角度来看，当你选择直面艰巨挑战时，实际上是在向大脑发送一个清晰的生理信号：“我有能力承受重压”。这背后依赖于大脑中一个结构紧凑却至关重要的区域——前中扣带皮层（Anterior Midcingulate Cortex，简称 AMCC）。 Steven Bartlett 闻言立刻表示自己对该区域早有耳闻，并请 Louisa 展开深度解析。Louisa 阐释道，科学界在针对“超级衰老者”（Super Agers）以及展现出卓越认知储备、超强自律饮食能力的人群研究中发现，他们的 AMCC 往往明显大于常人。这个区域就像是一块“意志力肌肉”，当个体去完成极具阻力、高度困难的事情时，它就会在刺激下物理性地肥大增生。这种储备是大脑留给生活遭遇风暴时的底牌，它让大脑建立起一种无坚不摧的心理韧性：无论未来遭遇何种挫折，自己都有底气张开双臂迎接挑战并一路死磕到底。相反，如果你在阻力面前习惯性退缩放弃，这一区域就绝不会增长。 ```mermaid flowchart TD accTitle: AMCC神经适应循环图 accDescr: 展示主动迎难而上与回避挑战对前中扣带皮层及神经突触连接的相反影响 subgraph Growth["正面强化路径：拥抱阻力"] A["遭遇高难度挑战 / 超负荷刺激"] --> B["强迫自身克服心理阻力"] B --> C["前中扣带皮层 (AMCC) 体积增大"] C --> D["意志力储备强化，突触与树突棘维持致密"] end subgraph Atrophy["负面退化路径：逃避阻力"] E["回避困难 / 沉迷安逸与即时快感"] --> F["AMCC 逐渐萎缩退化"] F --> G["放弃门槛降低，意志力崩溃"] G --> H["神经突触断裂 (由10,000骤降至2,000)"] end ``` - **AMCC 的本质**：前中扣带皮层是大脑应对逆境的神经储备库，被称为人体的“意志力肌肉”。 - **增肌机制**：唯有进行极具挑战性的神经激活训练、在健身房推举超出舒适阈值的重量或从事违反本能的艰难行动，才能迫使其生理性生长。 - **退化危机**：一旦生活陷入安逸、缺乏高强度挑战，该区域就会停滞不前甚至逐渐萎缩。 --- ### [01:37:26](https://www.youtube.com/watch?v=0t_DD5568RA&t=5846s) 并非意志薄弱而是神经生物学：超级衰老者与“求生意志”之座 谈及许多人在新年伊始雄心勃勃制定减重20磅的目标，却总抱怨自己“意志力不足”时，Steven 犀利地指出，这绝非单纯的道德或性格缺陷，其本质纯粹是“神经生物学问题”（neurobiology）。他特别引用了神经科学家 Andrew Huberman 的观点，认为 AMCC 的生理发现堪称过去一个世纪以来神经科学领域最激动人心的重大突破之一。Louisa 对此深表赞同，并感叹当今社会中许多人因为无法静心读完一本书、注意力涣散而痛责自己，甚至盲目给自己贴上 ADHD（注意力缺陷多动障碍）的自诊断标签，将原因完全归咎于外在环境，却全然忽视了根本症结在于大脑的状态与底层神经生物学机制。 Louisa 进一步解释了什么是真正的“超级衰老者”（Super Ager）：这类人群在生理和认知层面上实现了违背常理的高质量衰老。他们即便到了八九十岁的高龄，心血管系统依然健康，极少受心血管疾病困扰，认知功能维持得如同壮年，甚至其最大摄氧量（VO2 Max）水准能够比肩五六十岁的健康成年人。他们的共同特征之一，正是拥有异常发达饱满的前中扣带皮层。 随后 Louisa 抛出了一个极具颠覆性的关键科学细节：AMCC 的增长完全取决于“对抗主观阻力”。 - 如果一个人本身狂热地享受冰水浴，那么跳进冰水里对他的 AMCC 毫无刺激，大脑结构不会产生任何变化。 - 唯有当你发自内心地排斥、厌恶冰冷，却依然咬牙强迫自己跨入冰水池的那一刻，AMCC 才会真正受到刺激并开始生长。 - 长期久坐不动、习惯性在人生中“避险玩安全牌”的人，其 AMCC 会出现肉眼可见的物理性萎缩（atrophy）。 现今的神经科学家已经将 AMCC 视作人类“求生意志”（seat of the will to live）的神经中枢。无论是遭遇重大健康危机还是经历高风险外科手术，个体 AMCC 的体积大小与神经活跃程度，都直接构成了预测其能否在重大变故后幸存下来的强力指标。这不仅是生物学机制，更暗合了古罗马斯多葛学派哲学，正如马可·奥勒留（Marcus Aurelius）所践行的逆境哲学一样，古人在未曾探明脑区构造前，就已参透了“迎击艰难困苦方能铸造灵魂”的真谛。 --- ### [01:40:05](https://www.youtube.com/watch?v=0t_DD5568RA&t=6005s) 罗斯福的恶地历练与神经可塑性：为什么必须主动迎难而上 为了具象化这种逆境重塑机制，Steven 分享了美国前总统西奥多·罗斯福（Theodore Roosevelt）早年的传奇创伤。在一个悲惨的情人节当天，年轻的罗斯福在同一栋屋子里先后失去了新婚产子的妻子与自己的母亲。为了抵御近乎摧毁理智的巨大悲痛，他远走美国荒蛮残酷的达科他恶地（Badlands）生活了数年。在零下极寒的环境中，他在凌晨四点起床，在烈马冻毙的恶劣绝境中策马放牧、死磕求生。当他两年后重返纽约时，所有旧友都震惊于他的脱胎换骨。现代神经科学证实，他带回来的绝不仅是粗壮的筋骨，更是在极端残酷的逆境阻力中彻底重构了自己的神经回路，锤炼出了极其强大的 AMCC。这也为他日后成为美国历史上最年轻的总统、遇刺中弹后依然淡定完成长篇演讲、勇夺诺贝尔和平奖的传奇人生奠定了神经生物学底色。 Louisa 补充了更多严谨的临床科研数据： - **运动员群体**：职业运动员普遍拥有显著大于常人容积的 AMCC。 - **肥胖群体**：饱受肥胖困扰的个体通常 AMCC 偏小；然而令人振奋的是，一旦他们开始执行一项具有实质挑战性的饮食方案或运动干预，AMCC 就会立刻启动代偿性生长。 - **突触与树突棘退化**：神经生物学的核心法则是“给予系统刺激，系统方能适应并生长”。人类大脑神经元原本可以拥有 5,000 到 10,000 个突触连接，但如果长期缺乏挑战、逃避阻力，神经元上的树突棘（dendritic spines）就会大量凋亡断裂，导致突触连接暴跌至 2,000 甚至彻底归零。 这种机制构成了一个极其现实的因果闭环：不肯做难事，AMCC 就得不到滋养；AMCC 一旦萎缩，下一次面对困难时就会更轻言放弃。这就是为什么绝大多数人的“新年宏图”会在 2 月 1 日前彻底崩盘，也是全球肥胖危机与现代人执行力普遍瘫痪的神经学根源。从进化生物学的角度来看，人类之所以演化出这个结构，是为了在濒临饿死的绝境中，依然有强大的神经动力支撑肉体外出顶风冒雪追捕猎物；而在丰衣足食的安逸年代，人类基因组为了节省宝贵的能量，自然而然地选择下调了这块“意志力肌肉”。 --- ### [01:43:03](https://www.youtube.com/watch?v=0t_DD5568RA&t=6183s) 进化的悖论：“脑腐”、即时多巴胺与 AI 聊天机器人的冲击 顺着进化的脉络，两人将目光投向了当下数字时代所面临的空前危机。牛津词典将“脑腐”（Brain rot）评为 2024 年度词汇，这绝非偶然，它精准切中了现代人 AMCC 正在遭遇的退化浩劫。在现代生活里，大众整日沉迷于无休止地在手机屏幕上刷取毫无营养的碎片化短视频，这种行为正在残忍地训练大脑习惯于“零阻力、零付出”却能收获源源不断的微小多巴胺快感反馈。长此以往，大脑应对困难的耐受门槛被无限拉低，AMCC 也在安逸的刺激中加速退化。 顺应这一严峻趋势，Steven Bartlett 随即向 Louisa 抛出了一个更为尖锐的当代命题：如今几乎所有人都在依赖各种 AI 聊天机器人（Chatbots）来替自己撰写文章、代劳复杂思考与解决难题，这种全面外包智力劳动的现象，究竟会对人类的大脑带来怎样的实质影响？Louisa 慨叹道，这项技术本身虽然展现出了惊人的强大与不可思议，但其潜在的认知侵蚀同样处于一个极度危险的光谱之中。 ### [01:43:47](https://www.youtube.com/watch?v=0t_DD5568RA&t=6227s) 从纯数学到依赖 AI 计算小费：认知退化的日常警示 谈及技术对现代人大脑的侵蚀，Louisa Nicola 坦率地拿自己当成了反面教材。她回忆起自己攻读数学硕士时的巅峰状态，那时无论是复杂的三角学运算还是纯微积分，她光凭一支笔和自己的大脑就能行云流水地推演完成。然而到了今天，甚至连外出就餐计算一张账单上 20% 的小费，她都会下意识地掏出手机打开 ChatGPT 询问答案。这种强烈的反差让她忍不住反思：“我到底在变得多愚蠢？”这种依赖技术的便利性既有其价值，也暗藏危机。Louisa 指出，当下人们阅读严肃书籍和主动锻炼大脑的频率正在急剧下降，人类主动思考和动用认知资源的能力正在以肉眼可见的速度退化。 面对这个话题，Steven Bartlett 提出了一个深藏心底已久的疑问：Louisa 在神经科学与认知健康领域表现出的那种常人难以企及的热情，甚至称得上某种“近乎疯狂的执着（Obsessed）”，其背后的根源究竟是什么？ --- ### [01:44:57](https://www.youtube.com/watch?v=0t_DD5568RA&t=6297s) 沉默的牺牲：祖母的离世与被忽视的女性健康危机 面对 Steven 的提问，Louisa 揭开了深植于她内心的创伤与使命感。她激动地指出，我们所处的社会一直在无形中剥夺女性表达自我需求的权利：“我们生活在一个不允许女性索取她们想要的东西、更不允许女性开口索取她们所需之物的社会里。”而这种长期压抑的系统性代价是惊人的：全球 70% 的阿尔茨海默病患者是女性，80% 的自身免疫性疾病同样发生在女性身上，而这些疾病在极大程度上其实是可以预防的。学术研究长期将女性排斥在样本之外，而身边的女性则习惯性地轻描淡写自己的痛苦，害怕向医生启齿或向他人求助，甚至为自身的患病症状感到羞耻。 谈及此处，Louisa 忍不住红了眼眶，声音哽咽。她的全名正是继承自她的外祖母 Louisa——那是她一生中最好的朋友。她的家庭是从塞浦路斯移民到澳大利亚的第一代移民，家中的女性始终践行着“把自己排在最后、全心服侍家庭”的传统观念。当年祖母因卵巢癌转移为胰腺癌不幸离世，而在病发前很长一段时间里，祖母明明多次说过胃痛和身体不适，甚至食不下咽，却为了照顾家庭默默隐忍不发。 等到医生进行家庭出诊正式宣布确诊时，当时年仅 18、19 岁的 Louisa 就守在床边。祖母几乎不会说英语，却紧紧抓着医生绝望地恳求道：“求求你，我还有什么能做的吗？我不想死（Please, is there something I can do? I don't want to die.）。”而医生的回答冰冷而绝望：“对不起，已经无能为力了。”祖母在确诊后短短不到两个月内便撒手人寰。将近二十年过去了，Louisa 每天仍会想起祖母在医院的日日夜夜，至今仍为当年没能更早带祖母去做检查而深感自责与痛苦。 ```mermaid flowchart TD accTitle: 女性健康边缘化与认知倡导的因果链路 accDescr: 展示传统女性角色观念、医学研究盲区与早期干预缺失如何导致沉重的健康代价，并最终催生 Louisa 的科学使命。 subgraph Societal["社会与文化根源"] A["家庭牺牲观念与角色绑定<br/>（永远将自身需求置于最后）"] B["学术研究与临床试验中<br/>女性样本严重不足"] end subgraph DirectImpact["直接临床后果"] C["症状被忽视与隐忍瞒报<br/>（错过黄金干预窗口）"] D["医疗系统性认知偏差<br/>（误诊与预防性治疗缺失）"] end subgraph CrisisOutcome["健康危机与数据"] E["70% 阿尔茨海默病患者为女性"] F["80% 自身免疫性疾病为女性"] end subgraph LifeMission["个人觉醒与科学使命"] G["祖母 Louisa 的绝症悲剧与临终呐喊"] H["投身神经科学：打破女性健康信息茧房"] end A --> C B --> D C --> CrisisOutcome D --> CrisisOutcome CrisisOutcome --> G G --> H ``` - **女性在重大慢性疾病中的高发比例**：70% 的阿尔茨海默病患者为女性；80% 的自身免疫性疾病患者为女性。 - **医学研究的失衡**：在浩瀚的学术文献中，针对女性独特生理与荷尔蒙周期的研究长期严重不足。 - **科研投入的反差**：人类不惜斥巨资研制火箭探索火星，却迟迟无法攻克那些在很大程度上完全可以通过早期干预加以预防的慢性绝症。 --- ### [01:48:59](https://www.youtube.com/watch?v=0t_DD5568RA&t=6539s) 愤怒与幻灭：医疗系统的不公、信任崩塌与被误导的女性 当被问及是什么情绪将当年的痛苦炼成了如今体内的熊熊烈火时，Louisa 斩钉截铁地回答：“愤怒。”她愤怒于社会对女性的过分苛求——女性占据了总人口的 51%，却必须同时扛起母亲、看护者、职业女性和家庭支柱的多重重担。她也愤怒于医疗资源的不公：优质的医疗保健往往只向高社会经济地位的阶层敞开大门，但在疾病面前，每一个需要帮助的女性本该是超越政治的。 更让她深感挫败的是医疗系统中充斥的误导与公众信任的崩塌。她以激素替代疗法（HRT）为例：因为多年前对乳腺癌风险的夸大与错误宣传，导致如今只有仅仅 4% 真正需要 HRT 的女性敢于接受这一治疗。这种公众信任的瓦解在公共卫生政策的反复摇摆中被进一步放大——例如曾经公开宣称疫苗完全安全并成功消灭多种致命疾病的政客，随后又彻底颠覆立场宣称疫苗危险、告诫大众不要信任执业医生。对于许多连上网检索文献或预约专业血液检查都不知从何入手的普通弱势女性来说，要求她们“把健康全权掌握在自己手中”不仅脱离现实，更让她们深陷于信息混乱的深渊，错失防范乙肝或脑膜炎等疾病的保护屏障。Louisa 强调自己无意参与党派之争，“我是一名科学家，这不是宣传，也不是意识形态”，她所坚持的唯有一点：女性理应得到科学的事实真相与更平等的对待。 - **激素替代疗法（HRT）的利用率极低**：由于对致癌风险的长期污名化与误解，目前仅有约 4% 的女性使用 HRT。 - **女性面临的认知鸿沟**：大量基层与弱势女性缺乏辨别网络健康谣言和获取专业医学检测的渠道，极易成为伪科学信息的受害者。 --- ### [01:52:17](https://www.youtube.com/watch?v=0t_DD5568RA&t=6737s) 21岁解剖台上的顿悟、执着的代价与成功的定义 祖母在短短两个月内病逝的悲剧彻底击碎了 Louisa 原本的生活轨迹，让她对疾病管理产生了最初的执念。然而真正将她引向神经科学殿堂的转折点发生在 21 岁。当时在医学院的尸体解剖实验室（cadaver lab）里，她亲眼目睹了一颗从捐赠遗体中完整剥离的人类大脑。那一刻带来的巨大震撼让她无法自拔，解剖课结束后她主动留在病理实验室帮忙清洗和整理标本。正是那一天，她无比笃定地认识到：这就是自己愿意倾注一生的领域。在 Louisa 看来，大脑塑造了我们经验中的一切现实；而“元认知（Metacognition）”——即对思考本身进行审视的能力，赋予了人类突破思维盲区、克服一切艰难险阻的终极力量。 这种近乎痴迷的事业追求并非没有沉重的代价。现年 36 岁的 Louisa 坦承，自己依然在为这份执着持续支付成本： - **家庭的疏离**：她毅然离开了生活舒适、人口仅有 2000 多万的故土澳大利亚，独自搬到节奏极快、竞争残酷的纽约市，只为了能与世界上顶尖的神经外科医生和医学领袖并肩工作。 - **健康的透支与生活的牺牲**：为了在科研与临床咨询中高速运转，她长期透支自己的身体健康，因常年出差推进事业而缺席了无数次至关重要的家庭聚会。 即便如此，她依然表示自己无怨无悔，因为正是这些顶尖科学家的思想引领着她去追寻自己认定的生命价值。对话行至此处，Steven 抛出了一个直击灵魂的核心追问：“那么在最深的层面上，对你而言成功究竟意味着什么？如果十年后我们再次相聚，当你说出‘我的生活很成功、我是一个成功的女性’时，那意味着发生了什么？”留给观众无尽的深思。 ### [01:54:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=6891s) 控制大脑状态：高表现者的终极能力与个人生活的平衡 对于 Louisa Nicola 而言，所谓的终极成功与高表现（high performance），本质上是一个人自由驾驭和切换自身“大脑状态（brain states）”并在事后迅速恢复的能力。所谓的大脑状态，是指在需要高度专注与输出时能够瞬间“开机”，主动调动去甲肾上腺素（norepinephrine）、肾上腺素（adrenaline）和多巴胺（dopamine）等神经递质；而在任务结束时，又绝不让大脑长期处于过度紧绷超负荷的状态，懂得如何及时“关机”休息。米哈里·契克森米哈赖（Mihaly Csikszentmihalyi）的著作《心流》（*Flow*）对她的思维方式产生了深远影响，让她意识到高表现的核心正是学会在不同脑状态之间自如进退。 当 Steven Bartlett 问及她在专业事业之外的目标——比如孩子、家庭与日常生活时，两人相视而笑。Louisa 坦言建立家庭确实是一大挑战，她曾天真地以为只要自己想要孩子，孩子就会自然而然地到来，直到后来才深刻意识到：“哦，可我是个女人，我必须亲自去孕育并承担这一切。”生儿育女是一项巨大的牺牲，但同时也是一种无上的荣誉与特权。谈到未来的职业追求，Louisa 充满信心，直言自己牢牢掌控着节奏；她相信通过社交媒体的普及，大众能够获得免费且科学的健康教育，意识到每个人都能自主掌控自己的大脑健康。但她也清醒地指出，永远不要指望有某个人能突然降临并拯救所有人，通往健康的道路从来没有唾手可得的捷径。 ```mermaid flowchart TD accTitle: Brain State Regulation and High Performance accDescr: 展现高表现者在激活状态与恢复状态之间自如切换的神经调节闭环 subgraph Activation["激活状态 (Switch On)"] A["高负荷专注需求"] --> B["神经递质调动: 去甲肾上腺素 / 肾上腺素 / 多巴胺"] B --> C["心流输出 (Flow State)"] end subgraph Deactivation["恢复状态 (Switch Off)"] D["主动降噪与剥离"] --> E["副交感神经复原"] E --> F["认知能力修复"] end C -->|"任务结束及时关机"| D F -->|"准备好下一次输出"| A ``` ### [01:57:06](https://www.youtube.com/watch?v=0t_DD5568RA&t=7026s) 痴迷的代价与阿尔茨海默病的残酷本质 对话随即切入更深层次的内心剖白：像他们这样对事业极度痴迷的人，是否也有过希望自己“少一点执念”的时刻？Louisa 笑称，如果自己不那么痴迷，或许现在正留在家乡澳大利亚过着普通人的平淡生活。Steven Bartlett 坦言自己经常陷入这种思索：如果眼前有一个旋钮能把自己的执念调低一点点，自己会去拧吗？讽刺的是，做出这个选择的大脑本身就是一颗极度痴迷的大脑，因此当下的第一反应往往是“去他的，把它调得更高”。但他有时确实会怀疑，如果调低执念，整个人生是否会更快乐？毕竟古希腊哲学家强调“认识你自己”并追求更伟大的目标，可如果到了80岁躺在临终病床上，回顾一生却发现自己做了一笔极其糟糕的交易——牺牲了太多陪伴至亲的时光，那该如何面对？ 当被问及如果世界明天毁灭，今天最遗憾没做的是什么时，Steven Bartlett 坦言是“与深爱的人创造更多回忆”。Louisa 紧紧抓住这句话，指出这就是阿尔茨海默病最残忍、最令人作呕的地方：一个人耗费一生去经历、去创造所有珍贵的回忆，最终却眼睁睁看着这些记忆被病魔彻底剥夺。患者不仅无法认出自己的伴侣和孩子，甚至看着镜子都无法认出自己。在临床一线，Louisa 曾亲眼目睹一位女患者凝视着镜中的自己茫然发问“那是谁”；更令人心碎的是，两年前那位患者还能清楚认出 Louisa，如今却只能颤巍巍地问：“你是我的女儿吗？”每天直面这种“人虽活着、灵魂却已逝去”的残酷剥夺，让 Louisa 无法过上平庸的生活，逼迫着她不断深究医学、疾病与生命的终极意义。 - 执念与代价：高表现的追求往往伴随着对普通家庭生活和人际陪伴的巨大牺牲。 - 临终最大的悔恨：未能与所爱之人建立并保留更多的生命记忆。 - 阿尔茨海默病的阴暗面：它剥夺了人类最核心的身份认同与情感纽带，制造了至亲在眼前逐渐消逝却无能为力的绝望。 ### [01:59:47](https://www.youtube.com/watch?v=0t_DD5568RA&t=7187s) 科学尽头的信仰：神经外科中的奇迹与生命的精妙 面对 DOAC 节目的传统收尾环节——上一位嘉宾留给她的匿名提问“对你而言，上帝是什么？”，身为希腊东正教（Greek Orthodox）基督徒的 Louisa 给出了自己的理解：上帝是一种虽肉眼不可见、但你能够真切感知并抱有坚信的力量；它让你确信冥冥之中有人在护佑并指引着你，为你规划好了前行的道路。对此，来自严苛宗教家庭的 Steven Bartlett 表达了内心的困惑：在见证了大脑被疾病无情摧残的绝望后，祈祷往往显得无能为力；当看到世间巨大的苦难与不公时，人们对上帝的信仰很难不发生动摇。如果人们祈祷治愈阿尔茨海默病都毫无回音，那么去祈祷某支球队赢球便显得荒诞可笑。 Louisa 则从极为深刻的神经生理学角度给出了回应：如果一个人真正理解了从受精卵着床到神经系统发育的极其精密的分子过程，就会明白一个胎儿的成型需要多么苛刻、精准到分毫的条件。这种精巧绝伦与罕见，即便在数十亿人口的基数下，依然是纯粹的生物学奇迹。正是因为在科学与医学文献中钻研得越深，越难以忽视某种超越人类理解的高级力量的存在。医院里之所以设立祈祷室，正是因为当现代医学走到尽头、束手无策时，人们需要一种超越科学的信念来支撑自己走过黑暗——信仰就是在看不见结果时依然选择相信。Louisa 分享了自己在神经外科工作时的亲身经历：一位来自法国的78岁老妇人，脸部沿线长了巨大肿瘤，术前所有人都认为她凶多吉少；然而在完成大面积肿瘤切除后，这位老人在术后第二天不仅行动自如、认知功能完全正常，甚至连药物都不需要服用。这种现代医学至今无法完全合理解释的康复奇迹，正是让人在科学面前保持谦卑、承认生命存在神秘力量的原因所在。 访谈在 Steven Bartlett 的真挚致谢中走向尾声。他感慨道，普通人无法直接接触深奥的前沿论文与科研成果，正是因为有 Louisa 这样兼具学术执念与极高沟通天赋的传播者，大众才能获得保护大脑的实用认知。守护大脑，就是守护生命中一切真正重要的事物。 ### [02:04:32](https://www.youtube.com/watch?v=0t_DD5568RA&t=7472s) 算法推荐与尾声收官 节目进入尾声，主持人 Steven Bartlett 向屏幕前的观众进行了最后的收尾互动与视频推荐。他指出，平台的推荐算法已经根据每一位观众独特的观看历史与兴趣画像，精准匹配出了此时此刻最适合他们观看的下一支视频。由于每个人的推荐结果各不相同，Steven 鼓励大家立即点击屏幕上推荐的精彩内容，并充满信心地向观众打赌：“我敢说你一定会喜欢它（I bet you you might love it）。” 整期围绕阿尔茨海默病预防、女性脑健康、运动处方以及大脑认知韧性的深度对话至此圆满落下帷幕。 ## Notable quotes > [02:30](https://www.youtube.com/watch?v=0t_DD5568RA&t=150s) 这种疾病会彻底剥夺你是谁，剥夺你的全部自我认同。 — Louisa Nicola > [05:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=321s) 阿尔茨海默病本质上是一种在中年时期（30多岁）就已在静默中发病的疾病，只是外在的临床症状直到 60 岁末、70 岁甚至更晚才爆发出来。 — Louisa Nicola > [21:01](https://www.youtube.com/watch?v=0t_DD5568RA&t=1261s) 它们被造出来的使命就是杀戮（They kill）。 — Louisa Nicola > [34:39](https://www.youtube.com/watch?v=0t_DD5568RA&t=2079s) 中年正是大脑健康与长寿的关键机会窗口。 — Louisa Nicola > [36:51](https://www.youtube.com/watch?v=0t_DD5568RA&t=2211s) 你可以把血脑屏障想象成夜店门口的保安，他们肩并肩紧贴着站在门口，严格审查谁能进入、谁被拒之门外，坚决阻挡有害分子混入。 — Louisa Nicola > [40:13](https://www.youtube.com/watch?v=0t_DD5568RA&t=2413s) 阿尔茨海默病就像癌症晚期。一旦拿到确诊通知书，就没有治愈的可能，没有回头路，不可逆转……真正令人心碎的是，患者最终并非直接‘死于阿尔茨海默病’本身。 — Louisa Nicola > [53:21](https://www.youtube.com/watch?v=0t_DD5568RA&t=3201s) 我再也不知道自己是谁了（I don't know who I am anymore）。 — Auguste Deter > [01:21:57](https://www.youtube.com/watch?v=0t_DD5568RA&t=4917s) 把你自己从睡眠剥夺的负面效应中拉出来（creatine your way out of sleep deprivation）。 — Louisa Nicola > [01:43:47](https://www.youtube.com/watch?v=0t_DD5568RA&t=6227s) 我到底在变得多愚蠢？ — Louisa Nicola > [01:44:57](https://www.youtube.com/watch?v=0t_DD5568RA&t=6297s) 我们生活在一个不允许女性索取她们想要的东西、更不允许女性开口索取她们所需之物的社会里。 — Louisa Nicola > [01:44:57](https://www.youtube.com/watch?v=0t_DD5568RA&t=6297s) 求求你，我还有什么能做的吗？我不想死（Please, is there something I can do? I don't want to die.）。 — Louisa Nicola 的祖母 > [01:48:59](https://www.youtube.com/watch?v=0t_DD5568RA&t=6539s) 我是一名科学家，这不是宣传，也不是意识形态。 — Louisa Nicola ## Mentioned Louisa Nicola, Steven Bartlett, Henry, Bruce Willis, Chris Hemsworth, Dr. Benjamin Levine, Alois Alzheimer, Auguste Deter, Matthew Walker, Andrew Huberman, Theodore Roosevelt, Marcus Aurelius, Mihaly Csikszentmihalyi, Neuro Athletics, University of Washington, Cleveland Clinic, World Health Organization (WHO), Women's Health Initiative (WHI), Target, Ketone-IQ, Wispr Flow, Apple Card, Creapure, ChatGPT, DOAC Conversation Cards, Flow, SPRINT Study, NHANES ## Video description Alzheimer’s expert LOUISA NICOLA explains early Alzheimer’s risk, why creatine fuels brain energy and memory, deep sleep hacks, and why sitting is a silent killer! Louisa Nicola is a leading neurophysiologist and human performance coach who studies the brain and nervous system. She is the founder of Neuro Athletics, a consulting firm that provides scientific strategies for cognitive performance, and is also currently finishing her PhD at the University of Washington. She explains: ▪️Why 70% of Alzheimer's patients are women ▪️The "leaky brain" warning signs you are ignoring ▪️Why menopause triggers a 30% drop in brain energy ▪️How 20 minutes of Zone 5 training reverses heart aging ▪️Why your "willpower muscle" shrinks without hard challenges *(0:00) Intro* *(2:31) Why I’m on a Mission to Prevent Alzheimer’s for Millions* *(2:58) Alzheimer’s Might Be More Preventable Than You Think* *(4:34) How Lifestyle Habits Quietly Lead to Dementia* *(8:43) Why Some Older Adults Stay Mentally Sharper Than the Young* *(12:35) What Short-Form Content Is Doing to Your Brain* *(13:47) The Hidden Cognitive Power of Exercise* *(16:31) Why Strong Legs Might Be a Key to Brain Health* *(17:23) How Resistance Training Rewires Your Brain* *(21:08) Can Exercise Actually Help Suppress Cancer?* *(22:58) The One Exercise That Shields Your Brain Over Time* *(25:42) Can Aerobic Training Help Prevent Alzheimer’s?* *(28:47) What Cardiovascular Health Really Means for Your Brain* *(32:15) Why VO2 Max Could Predict How Long You’ll Live* *(34:45) The Best Exercises for Long-Term Brain and Mental Health* *(41:45) What to Do Right After an Alzheimer’s Diagnosis* *(45:05) Why the Ketogenic Diet Could Benefit Perimenopausal Women* *(50:12) What You Should Know About Hormone Replacement Therapy* *(52:31) How to Find the Best HRT for Your Body and Brain* *(1:00:24) Ads* *(1:01:56) The Overlooked Link Between Sleep Loss and Alzheimer’s* *(1:03:42) Why You Need to Rethink Your Sleep Habits Now* *(1:07:01) Can Ashwagandha and Rhodiola Really Reduce Stress?* *(1:10:02) The Most Potent Brain Supplement You’ve Never Tried* *(1:14:04) How Vitamin D Supports Longevity and Brain Health* *(1:15:03) The Most Affordable Way to Boost Brain and Body Function* *(1:34:34) Ads* *(1:36:27) Why Doing Hard Things Literally Grows Your Brain* *(1:43:28) Are Chatbots Causing Brain Rot? Here’s What We Know* *(1:49:03) The Truth Women Deserve to Hear About Their Health* *(1:57:39) What Happens When You’re Obsessed With Your Mission* Enjoyed the episode? Share this link and earn points for every referral - redeem them for exclusive prizes: https://doac-perks.com Independent Fact Check: https://stevenbartlett.com/wp-content/uploads/2026/02/DOAC-Louisa-Nicola-Independent-Research-further-reading.pdf Follow Louisa: Instagram - https://linkly.link/2ZgsR YouTube - https://linkly.link/2ZgsW X - https://linkly.link/2Zgsa Neuroathletics - https://linkly.link/2Zgsf Podcast - https://linkly.link/2ZmIF You can learn more about ‘BRAIN CODE’, here: https://linkly.link/2ZmIC The Diary Of A CEO: ◼️Join DOAC circle here - https://doaccircle.com/ ◼️Buy The Diary Of A CEO book here - https://smarturl.it/DOACbook ◼️The 1% Diary is back - limited time only: https://bit.ly/3YFbJbt ◼️The Diary Of A CEO Conversation Cards (Second Edition): https://g2ul0.app.link/f31dsUttKKb ◼️Get email updates - https://bit.ly/diary-of-a-ceo-yt ◼️Follow Steven - https://g2ul0.app.link/gnGqL4IsKKb Sponsors: *Apple Card* - https://apple.co/get-daily-cash Apple Card issued by Goldman Sachs Bank USA, Salt Lake City Branch. Offer may not be available everywhere. Terms and limitations apply. *Ketone -* https://ketone.com/STEVEN for 30% off your subscription order Wispr - Get 14 days of Wispr Flow for free at https://wisprflow.ai/DOAC [Source](https://www.youtube.com/watch?v=0t_DD5568RA)

[2:30] Louisa Nicola: 这种疾病会彻底剥夺你是谁，剥夺你的全部自我认同。 [5:21] Louisa Nicola: 阿尔茨海默病本质上是一种在中年时期（30多岁）就已在静默中发病的疾病，只是外在的临床症状直到 60 岁末、70 岁甚至更晚才爆发出来。 [21:01] Louisa Nicola: 它们被造出来的使命就是杀戮（They kill）。 [34:39] Louisa Nicola: 中年正是大脑健康与长寿的关键机会窗口。 [36:51] Louisa Nicola: 你可以把血脑屏障想象成夜店门口的保安，他们肩并肩紧贴着站在门口，严格审查谁能进入、谁被拒之门外，坚决阻挡有害分子混入。 [40:13] Louisa Nicola: 阿尔茨海默病就像癌症晚期。一旦拿到确诊通知书，就没有治愈的可能，没有回头路，不可逆转……真正令人心碎的是，患者最终并非直接‘死于阿尔茨海默病’本身。 [53:21] Auguste Deter: 我再也不知道自己是谁了（I don't know who I am anymore）。 [81:57] Louisa Nicola: 把你自己从睡眠剥夺的负面效应中拉出来（creatine your way out of sleep deprivation）。 [103:47] Louisa Nicola: 我到底在变得多愚蠢？ [104:57] Louisa Nicola: 我们生活在一个不允许女性索取她们想要的东西、更不允许女性开口索取她们所需之物的社会里。 [104:57] Louisa Nicola 的祖母: 求求你，我还有什么能做的吗？我不想死（Please, is there something I can do? I don't want to die.）。 [108:59] Louisa Nicola: 我是一名科学家，这不是宣传，也不是意识形态。

[12:35] Louisa Nicola: The more you exercise, the bigger your brain [25:42] Louisa Nicola: A lot of people in midlife are busy. They're time poor... I'm trying to push women to first work on zone five... then do two to three sessions of resistance training a week. [4:34] Louisa Nicola: It generally starts in our 30s, but the first symptoms show up in our late 60s, 70s, and beyond. [53:23] Auguste Deter: I don't know who I am anymore. [78:23] Steven Bartlett's friend: I feel like I've got my life back. [78:23] Louisa Nicola: creatine your way out of sleep deprivation [95:52] Louisa Nicola: Doing hard things tells your brain that you can do hard things [103:53] Louisa Nicola: How dumb am I actually getting? [104:38] Louisa Nicola's grandmother: Please, is there something I can do? I don't want to die [104:38] Doctor: I'm sorry, there's nothing you can do. [108:33] Louisa Nicola: a woman in need is apolitical. [116:43] Are you my daughter? [116:43] Steven Bartlett: What is God to you? [121:28] Louisa Nicola: we're born in a body, we die in a body. [121:28] Louisa Nicola: hard to ignore God and it's hard to ignore that there is a higher power out there. [121:28] Louisa Nicola: there's just some things that medicine can't answer.

[0:00] And we have this white powder in front [0:02] of me. You've got a big smile on your [0:03] face. I do because I don't care who you [0:05] are, you should definitely be having [0:06] this. [0:08] So, let's talk about creatine. [0:09] Phenomenal research shows you can [0:11] creatine your way out of sleep [0:12] deprivation. It can protect your brain [0:14] against a concussion, stroke, from [0:16] [music] stress. And there was a study [0:17] done on Alzheimer's disease patients and [0:20] they found that patients not only [0:22] preserved their cognitive functions, but [0:24] they had more energy and they were able [0:27] to exercise more. And I know this [0:29] because I'm a clinician and over the [0:31] last decade I've been surrounded by the [0:33] greatest neurosurgeons in the world [0:35] studying the brain. And so, I'm here to [0:37] tackle one disease and that is [0:39] Alzheimer's because it generally starts [0:42] in our 30s and 60 million people [0:45] worldwide have Alzheimer's. [music] 70% [0:47] being women and I get angry and I get [0:49] passionate because women have been lied [0:52] to, they've been underrepresented, they [0:54] downplay their symptoms, or they're too [0:55] scared to ask their doctor for advice. [0:58] And what people don't really know is [0:59] that it is a preventable disease, but [1:01] it's like end-stage cancer. Once you get [1:04] the diagnosis, there is no cure. And the [1:06] fact that so many people are at the [1:09] mercy of a disease that is preventable [1:11] is not okay with me. And I don't think [1:13] people understand these [music] things. [1:15] Like people don't really know that we're [1:16] becoming more sedentary, which is a [1:18] disease. And there was a study that was [1:19] done on this that showed that if you do [1:21] 10 air squats every hour, this can [1:24] compensate for your sedentary lifestyle. [1:26] And then we have several lifestyle [1:28] factors that can lower your risk of [1:30] getting Alzheimer's disease. As well as [1:32] showing you what 5 minutes a day can do [1:34] for your brain performance just using a [1:35] tennis ball and an eye patch. [1:42] Guys, I've got a quick favor to ask you. [1:44] We're approaching a significant [1:46] subscriber milestone on this show and [1:47] roughly 69% of you that listen and love [1:50] this show haven't yet subscribed for [1:52] whatever reason. If there was ever a [1:54] time for you to do us a favor, if we've [1:55] ever done anything for you, given you [1:57] value in any way, it is simply hitting [2:00] that subscribe button. And it means so [2:02] much to myself, but also to my team cuz [2:03] when we hit these milestones, we go away [2:04] as a team and celebrate. And it's the [2:06] thing, the simple, free, easy thing you [2:07] can do to help make this show a little [2:09] bit better every single week. So, that's [2:11] the favor I would ask you. And um if you [2:14] do [clears throat] hit the subscribe [2:14] button, I won't let you down and we'll [2:16] continue to find small ways to make this [2:18] whole production better. Thank you so [2:20] much for being part of this journey. [2:22] Means the world and uh yeah, let's do [2:24] this. [2:26] >> [music] [2:28] >> Louisa, [2:30] what is it you do in simple terms? And [2:34] I guess most importantly, why is it that [2:36] you do it and why now? [2:38] Over the last decade, I've been studying [2:41] the brain. [2:42] I'm both a clinician and an academic. [2:45] So, I get to see the brain and I also [2:47] get to research it. And [2:49] I'm really here to tackle one disease [2:53] and that is Alzheimer's disease. Why is [2:55] this so important now? [2:57] Right now because 60 million people [2:59] worldwide have Alzheimer's disease. [3:02] That number is going to triple by the [3:04] year 2050. 110 million women will have [3:09] Alzheimer's disease by the year 2050. [3:12] This is a disease that robs you of who [3:15] you are, your complete identity. [3:19] So, we're going to get really into this [3:20] straight away cuz I brought Henry with [3:22] me, right? And for anyone that can't [3:24] see, Henry is a model brain that she's [3:26] holding in her hands. This is around 2 [3:28] lb and if you actually feel it and you [3:31] know, if you actually feel a real human [3:33] brain, it feels like tofu. [3:35] But this is everything you are. And the [3:37] fact that so many people are at the [3:40] mercy of a disease that is preventable [3:43] is not okay with me. It doesn't sit well [3:45] with me. We used to think that women [3:49] were disproportionately affected by [3:51] Alzheimer's disease because we lived [3:52] longer, because age played a role in it. [3:55] But we now have substantial evidence to [3:57] show that it's not the fact that women [4:00] live longer or people in general because [4:02] dementia and Alzheimer's disease are not [4:04] part of the natural brain aging process. [4:07] For women, and they differ from men and [4:09] we can separate the sexes and talk about [4:10] it. For women, it is purely because [4:14] being a woman [4:15] is [4:17] a risk factor for getting this disease. [4:19] Now, if we go through and we have a look [4:20] at all of the people that currently have [4:22] Alzheimer's disease, [4:23] 95% of them could have been prevented [4:26] because this is not a disease of [4:28] genetics, it's a disease of lifestyle. [4:31] 95% of it could have been prevented. [4:33] Correct. We're we're born with our with [4:35] our genetic makeup, meaning that for [4:37] example, if you have a genetic mutation [4:40] on chromosome 4, [4:43] you will get Huntington's disease. [4:45] There is nothing we can do about that. [4:47] That's how you were born. [4:49] But when it comes to Alzheimer's [4:50] disease, [4:51] there's around 20 to 30 genes involved [4:53] in the disease. [4:55] Only around 3% [4:57] of the disease cases right now were [4:59] driven through those genetic mutations. [5:03] The genetic mutations that you are born [5:05] with, you get them from mom and dad, [5:07] are presenilin 1, [5:09] presenilin 2, and the amyloid precursor [5:13] protein. [5:14] So, you if you have a genetic mutation [5:16] in one of these genes, you will get some [5:19] form of dementia. [5:21] What is the age range where people will [5:23] start to experience Alzheimer's? Let's [5:26] just actually take a broad overview of [5:27] what Alzheimer's disease is, okay? So, [5:29] you've probably heard of dementia. Yes. [5:32] So, dementia is the umbrella term. So, [5:34] Alzheimer's disease is sits under the [5:36] umbrella, it's a form of dementia. [5:38] There's frontotemporal dementia, which [5:40] is what Bruce Willis has. [5:42] There's dementia with Lewy bodies, [5:44] there's Parkinson's dementia, there's [5:46] vascular dementia. This disease, [5:48] dementia or Alzheimer's disease is a [5:50] disease of midlife. [5:53] And so, it generally starts in our 30s. [5:57] It starts in our 30s, but the first [5:59] symptoms show up in our late 60s, 70s, [6:03] and beyond. When you say starts? [6:05] >> Yes. Our brain fully develops at around [6:08] 25 years old, 25 to 30. And after that, [6:12] that's when we if we don't take care of [6:14] our brain, we start getting a decline in [6:17] these functions. Now, let's go back to [6:19] the brain. The brain is 87 billion [6:21] neurons, around 5 to 10,000 connections [6:24] per neuron. The my favorite area of the [6:27] brain is a cerebellum and the Purkinje [6:29] cells inside the cerebellum have upwards [6:31] of 50,000 connections per cell. So, [6:35] so tightly dense and there is so much [6:38] happening, it takes 20% of the total [6:41] calories that you consume every day to [6:43] power this thing. [6:45] And it's the most vascular rich organ in [6:47] the entire body. [6:48] Over time, through things such as sleep [6:50] deprivation, [6:52] poor diet, lack of physical activity, [6:55] environmental toxins, this slowly erodes [6:59] at the functioning of the brain. And [7:00] over time, this starts to compound [7:03] because that's what biology is. [7:05] Everything is compounding. One night of [7:07] sleep deprivation raises your risk of [7:09] amyloid beta, which is one of the [7:10] hallmarks of Alzheimer's disease [7:12] pathology, by 4%. That's just one night [7:15] of sleep deprivation. Imagine a new [7:18] mother or a shift worker or a physician [7:21] in their residency getting countless [7:23] nights of sleep deprivation day in and [7:26] day out. Imagine all of that [7:28] compounding. [7:29] And what happens? Well, we end up with [7:32] either neuronal loss, which is like the [7:35] complete atrophy of certain parts of the [7:37] brain, [7:38] and that's what is mild cognitive [7:40] impairment. Mild cognitive impairment is [7:42] a pre-dementia state. So, what is this [7:44] that I have here, this photo? Um [7:46] So, of a brain. You've got the sagittal [7:49] view right now of the brain and we're [7:50] looking at a healthy brain on here. As [7:52] you can see, I'm going to show it up [7:54] here. On the left-hand side, you can see [7:56] that the brain is thick. We can see that [7:58] the integrity of the gray matter, which [8:00] sits out here, is thick. It's [8:02] voluminous. [8:04] Okay? We can see that the ventricles are [8:06] smaller. [8:07] We go over here and we see thinning of [8:10] the cortex. You can see these big spaces [8:12] between the gyri. These are thick [8:15] because the gray matter has atrophied. [8:17] It's shrunk. You can see that the space [8:20] between the cortex itself and the skull, [8:24] there's a bigger space. You can see [8:25] these ventricles here, these [8:26] butterfly-shaped ventricles. This is [8:28] thicker. [8:29] This is thinner. We can see atrophy down [8:32] here. So, essentially, the brain is [8:35] getting smaller and smaller. [8:38] At the age of 30, if I do everything [8:40] right, [8:42] and you we were to sort of plot this on [8:43] a graph of where I land at 70, [8:47] what is the variance of where I'll end [8:48] up at 70? You know, my brain is quite [8:50] important to me and I do worry. I think [8:52] [ __ ] like [8:54] I think I worry in part cuz I I I sit [8:56] and interview a lot of people at a lot [8:57] of different ages. And one thing you [8:59] notice as an interviewer is [9:02] some people at 60 [9:04] have are razor sharp. [9:06] >> Mhm. And some people at 60 [9:08] are not as razor sharp. Yeah. [9:10] Their ability to articulate their words, [9:12] their memory recall, their ability to [9:14] understand stats and stories, all of [9:15] this. And I sit here and go, I wonder [9:16] what the difference is. Yeah. And that's [9:18] actually beautiful because it brings up [9:20] this important concept in neuroscience [9:22] called cognitive reserve. And that's [9:25] your brain's ability to withhold [9:28] capacity to overcome stresses, okay? So, [9:31] you've probably heard, for example, [9:32] let's use the analogy of physical [9:35] performance. Your VO2 max, which is a [9:37] measure of your peak respiratory [9:39] fitness, you know, how well you can [9:41] utilize oxygen Mhm. [9:43] >> [clears throat] [9:43] >> when you are at a at a high intensity [9:46] state. How well does your body utilize [9:48] oxygen? [9:49] The [9:50] the fitter you are, [9:52] the more reserve you have to overcome [9:55] stress. Stress such as an infection, [9:59] everyday stresses, sleep deprivation, [10:01] surgery. [10:04] The more reserve you have in your bank [10:05] to overcome that. The same is with your [10:07] brain. The more cognitive reserve that [10:10] you have, the more cognitive capacity [10:13] that you have been training year on and [10:16] year out, will save you at 60 from ha- [10:20] harmful insults such as you can get a [10:23] woman [10:24] at the age of 80 with a head full of [10:27] amyloid beta. Amyloid beta being the one [10:30] of the hallmarks of Alzheimer's disease. [10:32] You can get somebody with a head full of [10:34] amyloid. Which is like a plaque on the [10:35] brain. Yeah, it it's a protein that's [10:37] actually [10:39] it's a it's a protein that lives inside [10:41] the neuron itself and we can explain [10:44] what that is, which I will in a second, [10:47] but let me just tell you can have a head [10:48] full of amyloid in this person and they [10:50] have retained their cognitive functions. [10:53] Then you can have somebody else with [10:55] hardly any amyloid, but they've lost [10:57] their cognitive functions and this all [10:59] comes down to cognitive reserve. [11:02] And cognitive reserve lives where in the [11:04] head? You've got around 5 to 10,000 [11:06] connections per cell. Over time those [11:08] connections fail. Now those connections [11:10] are responsible for your thinking, your [11:13] processing speed. Every time you have a [11:15] thought you build a new connection. The [11:17] more connections that you have, the more [11:19] things that you see, the more novelty [11:21] that you give your brain, the richer it [11:24] gets, the more stable it gets. So the [11:26] ends of these of the neurons, we have [11:29] dendrites and coming off the dendrites [11:31] are these little trees. Imagine a a [11:33] branch, that's the dendrite and all of [11:36] the leaves that come off are all these [11:38] little dendritic trees if you will and [11:40] they connect to nearby cells. 10 to [11:43] 10,000 cells over time, those are the [11:45] connections that fall. [11:47] Those are the connections that fail. [11:49] They fail because you don't utilize [11:51] them. [11:52] So the way that one would build reserve [11:54] at the age of 30 is to is by exercising. [11:59] We can build reserve in a number of [12:00] different ways. In fact, there was a [12:02] really wonderful study that just came [12:03] out that I just read about and they [12:05] found that those who preserved cognitive [12:07] capacity at 75 years old were [12:10] handwriting and reading. [12:13] So handwriting and reading preserves [12:15] cognitive functions. [12:18] Exercise is one of the most potent [12:21] stimulus [12:23] for brain health and Alzheimer's disease [12:25] prevention and cognitive reserve. The [12:28] more you exercise [12:30] the bigger your brain. What about [12:32] scrolling on social media? Does it [12:34] improve my reserve if I'm watching [12:36] videos? It's in the opposite. [12:38] >> Why would that be? Cuz I'm still [12:39] learning stuff Yeah. [12:41] >> when I'm on the internet. Because what [12:42] you're doing then is you are relying on [12:44] short dopamine hits. Every time you [12:46] scroll, you're sending signals to your [12:48] brain that you're getting a dopamine hit [12:52] and your brain gets used to it. [12:53] Remember, your brain is only there for [12:55] two things, survival [12:57] and reproduction. So every time that you [13:01] stress your brain in the smallest amount [13:03] of times, you're giving it dopamine hits [13:05] it doesn't allow us to do other things [13:08] for a sustained period of time like [13:10] focus, read, have a conversation. [13:14] So writing and reading are good for [13:16] building up my neurological reserves. [13:19] >> Yeah, neurological reserves. It doesn't [13:21] compare to what exercise can do for the [13:24] brain. And it's so sad because around [13:28] 80% of the US population don't exercise [13:32] for at least 30 30 minutes a week, which [13:35] is actually quite scary. The physical [13:37] activity guidelines are 150 minutes to [13:40] 300 minutes of moderate to rigorous [13:42] physical activity per week. What's the [13:44] most compelling study you've ever [13:45] encountered that proves that exercise is [13:47] central to Alzheimer's prevention and [13:50] brain health? When we look at all of the [13:52] data, we can see that the biggest amount [13:56] of return on investment is from [13:58] resistance training. Resistance training [14:00] being strength training. One of the most [14:03] compelling studies was probably the um [14:05] the SMART trial where they uh took a [14:07] group of people with mild cognitive [14:10] impairment and gave them two to three [14:11] times per week of resistance training [14:14] and they not only preserved their [14:16] cognitive functions, they enhanced their [14:18] processing speed, they enhanced their [14:20] fluid intelligence and they had slowing [14:23] of the gray matter. The gray matter. [14:25] Yeah. So your brain consists of both [14:27] gray and white matter. So gray matter [14:30] are the cell bodies that lives on the [14:31] outer side outer portions of your brain [14:34] and the white matter is deep within the [14:36] brain and that's where all of our [14:37] myelinated neurons live. [14:40] And over time we see that we can have [14:42] little lesions in the white matter of [14:44] the brain. [14:45] So [14:47] a lot of the times people ask me [14:50] Steven, I'm scared. My mother had [14:52] Alzheimer's disease. I'm scared I'm [14:53] going to get it. [14:54] And we were talking about genetics [14:56] before. [14:57] And there's another genetic risk factor [15:00] that we didn't talk about. The APOE4 [15:02] gene uh is [15:04] one of the the strongest risk factors of [15:06] getting Alzheimer's disease, but it is [15:08] not a foregone conclusion that you're [15:09] going to get it. So Chris Hemsworth was [15:12] tested and he has two copies of this [15:14] gene. [15:15] So you get two copies, one from mom, one [15:18] from dad. It's the apolipoprotein [15:20] E gene and it comes in three main [15:23] variants. So you've got APOE2, [15:26] APOE3 and APOE4. [15:30] So I'm a 3 3 carrier. I've been tested. [15:34] And that's the general population, [15:36] they're 3 3. So it doesn't raise my risk [15:38] of getting the disease, but it also [15:40] doesn't protect me. If you've got a copy [15:42] of the APOE2 gene, it protects you [15:45] against the disease, but when you have a [15:47] copy of the APOE4 gene, it raises your [15:50] risk by two to three times. [15:53] If you have two copies of the gene, it [15:55] raises your risk by 10 times [15:58] if you are a male. [16:00] Here's the devastating thing. [16:02] If you are a female with one copy of the [16:05] gene, [16:06] you are at double the risk than your [16:08] male counterpart. So one copy of the [16:11] gene of APOE4 gene for a female raises [16:14] your risk by about sixfold, whereas two [16:17] copies raises your risk by 15-fold. [16:21] And how would one go and get checked? [16:23] You can get the APOE4 gene checked out [16:26] with your doctor. It's a simple blood [16:27] test. On this point of resistance [16:29] training, [16:30] I've heard you talk about how the legs [16:33] Mhm. are so important. Yeah. [16:35] >> Having strong legs. Having strong legs [16:39] is by far the most important tool in [16:41] your toolbox for the prevention of [16:44] Alzheimer's disease and this was made [16:47] certain to me when I read a study done [16:50] on identical twins. Exact same genetic [16:52] profile. Mhm. And they tracked them and [16:55] they did cognitive tests and MRIs. [16:58] And they tracked them over a 10-year [16:59] period and what they found was that the [17:02] twin who possessed the greatest strength [17:05] and the most leg power [17:08] had a bigger brain. [17:10] Larger gray matter volume. [17:13] They preserved their cognitive [17:15] functions. They uh did better on [17:18] different cognitive tests. Why is [17:20] resistance training increasing the size [17:23] of my brain? Resistance training does so [17:26] much for your brain. The first thing is [17:28] we have to think about the journey that [17:30] we're going on, right? So when you look [17:32] at all of the studies, I want to make it [17:34] really clear. All of the studies show [17:36] that in order to produce the neural [17:39] effects of resistance training, you need [17:41] to be lifting at around 80% of your one [17:44] repetition max. [17:46] So 80% of 1 RM. So that's quite heavy. [17:51] There is so much controversy on social [17:53] media right now. Should I lift heavy? [17:55] Should I lift light? And when it comes [17:57] to hypertrophy alone, so increasing [17:59] muscles muscle mass, muscle cell size, [18:02] you can get there. [18:04] Men can get there, women can get there [18:06] by lifting light, high reps [18:09] or you can get there by lifting heavy [18:11] and low reps. It just depends on who you [18:13] are and how much time you have. But when [18:15] it comes to the brain specifically, you [18:17] want to be lifting heavy for several [18:19] reasons. The first one is when we lift [18:22] heavy, when we literally like when we [18:24] contract our muscle like this, [18:27] we are releasing a whole set of [18:30] chemicals. They're called myokines. And [18:32] when they're released from the muscle, [18:33] they go up to the brain and they do [18:35] beneficial things for our cognitive [18:37] performance, our cognition and they help [18:40] with the growth and proliferation of new [18:43] neurons in the hippocampus. [18:45] And it's the first thing to go during [18:47] Alzheimer's disease. It actually [18:49] shrinks. This holds our memory. This is [18:52] where a lot of our memory consolidation [18:54] and learning takes place, which is why [18:57] short-term memory is the first thing to [18:58] go during this disease. Okay? And as we [19:01] get older and what we found is that [19:05] you can grow [clears throat] new neurons [19:07] in the hippocampus [19:09] from structured exercise and consistent [19:11] exercise. The biggest growth is going to [19:14] occur because of BDNF, brain-derived [19:17] neurotrophic factor. So this is a growth [19:20] factor for the brain and it gets [19:22] released when we exercise. It gets [19:24] released abundantly when we are doing [19:26] aerobic training, when we're running, [19:28] when we're cycling for long distances, [19:31] but it also gets released when we do [19:33] resistance training. Now here's the [19:34] beautiful thing about it. When we do [19:36] resistance training and we're releasing [19:39] all of these myokines, these myokines [19:41] are signaling molecules. They work [19:43] together. So we've got one called [19:45] irisin. Okay? And that's a messenger [19:48] molecule. So what it does is it actually [19:51] helps BDNF express itself. So, when we [19:54] release this myokine goes into the [19:57] brain, crosses the blood-brain barrier, [20:00] and it tells BDNF to express itself. So, [20:03] then BDNF goes in, and it helps grow new [20:06] neurons in the hippocampus. [20:08] But, then we've got another myokine. [20:09] Let's just take IL-6, interleukin-6. It [20:12] comes from the interleukin family. What [20:14] is that, sorry? The interleukin family [20:16] is a a class of pro-inflammatory [20:20] cytokines. So, these get released when [20:22] we are under stress, or you've got an [20:24] infection, or a virus, for example. [20:27] But, when we exercise, it depends on [20:30] where the site is, interleukin-6, [20:32] instead of acting as a pro-inflammatory [20:34] cytokine, Mhm. instead of creating [20:36] [clears throat] inflammation, it acts as [20:38] an anti-inflammatory cytokine. So, it [20:40] goes into the brain, and it lowers [20:42] inflammation. In fact, this is one of [20:45] this was one of the [20:47] first ever myokines to be studied, and [20:50] they showed that interleukin-6 is also [20:53] responsible for the down-regulation of [20:55] tumor cell growth. [20:57] So, exercise is a potent anti-cancer [21:01] intervention, as well, by way of [21:04] myokines. [21:05] How much exercise does one need to do to [21:08] avoid the cancer-related [21:11] side effects, but also the Alzheimer's [21:14] problem? Well, just 30 minutes a day [21:17] of aerobic physical activity can [21:19] down-regulate 13 types of cancers. [21:23] And the most prominent ones being breast [21:26] cancer, [21:27] colon cancer, [21:29] and prostate cancer. So, these three [21:31] have been studied most, and you get your [21:33] anti-cancer effects from the myokine [21:36] release. So, quite specifically, when we [21:39] exercise, we're getting a robust release [21:42] of something called natural killer [21:44] cells. [21:46] And when we get these natural killer [21:48] cells into the plasma, and into the [21:50] bloodstream, they go into the tumor [21:53] site, and they do what they were born to [21:55] do. [21:57] They kill. [21:58] So, they go into the tumor site, and [22:00] they start to kill the tumor. And this [22:02] is where you get your anti-cancer [22:04] effects of it. But, you can also get it [22:06] from the anti-inflammatory effects of [22:08] resistance training, anti-inflammatory [22:10] effects of aerobic training. [22:12] So, these myokines are really powerful. [22:15] In fact, pharmaceuticals are spending [22:18] billions of dollars trying to replicate [22:20] these myokines in a bottle, and they [22:22] can't do it. I want both men and women [22:24] lifting heavy, because you've got areas [22:27] in your brain, right across here, [22:30] lives your motor cortex. [22:33] Think of your brain as real estate. [22:35] There's real estate in your brain [22:36] reserved for lifting heavy. So, every [22:38] time you lift a heavy weight, as opposed [22:41] to a light weight, it takes more neural [22:44] real estate to lift that heavy weight. [22:48] So, the heavier you lift, [22:50] the greater the neural drive. The [22:51] greater the neural drive, the better it [22:54] is for your brain. If you had to do just [22:56] one exercise for the rest of your life [22:58] to protect your brain, and you could [22:59] only pick one, [23:00] what would it be? [23:02] Deadlift. [23:04] Why? If done correctly, the deadlift can [23:08] use almost every muscle in your body. [23:11] Erector spinae, you've got the glutes, [23:13] you've got the quads, you've even got [23:14] serratus anterior, you've got the you've [23:16] got your calf muscles. There is so much [23:19] compounding in that one lift, would [23:23] probably be comparable to a barbell [23:24] squat, as well. According to the World [23:26] Health Organization, we're getting [23:27] increasingly more sedentary. I we're [23:30] moving less and less, in part because of [23:32] technology, but also there was this [23:34] really interesting study done by the [23:36] Cleveland Clinic, [23:37] where they talk about people who are [23:39] active sedentary. And this [23:43] this felt a little bit personal, if I'm [23:44] honest. It says a major finding in 2025 [23:47] found a danger of being active [23:49] sedentary, which is people who exercise [23:51] for like 30 to 60 minutes, but sit for [23:54] the remaining 10 hours a day. [23:56] If you sit for more than 10 hours a day, [23:58] your risk of cardiovascular disease [23:59] increases, even if you meet weekly [24:02] exercise goals. [24:04] Because prolonged sitting shuts down [24:06] lipoprotein lipase, an enzyme essential [24:08] for burning fat and cleaning glucose [24:11] from the blood. [24:13] That wasn't that's annoying to read, [24:14] because I feel like that's me. Yeah, and [24:16] being sedentary is a disease. [24:19] You can [24:21] change the trajectory of your life by [24:23] doing [24:25] 10 air squats every hour on the hour. [24:28] And there was a study that was done on [24:30] this that showed that if you do 10 air [24:32] squats every hour, this can compensate [24:35] for your sedentary lifestyle, because [24:37] unfortunately, this is the life we're [24:38] living in. We are becoming more [24:40] sedentary in our day-to-day lives. We're [24:42] sitting more, we're not going out as [24:43] much. There is younger kids on video [24:46] games, they're scrolling. There's so [24:48] much happening that is involving our [24:50] sedentary lifestyle, which is obviously, [24:51] like you said, increasing our risk of [24:53] type 2 diabetes, cardiovascular disease, [24:56] etc. [24:58] Yep, you can do it. Like this? [25:01] There you go, 10 of those. If you do 10 [25:03] of those, [25:04] you can outweigh the benefits of a [25:06] 30-minute power walk. [25:09] Every hour? Yeah. For how many hours? [25:11] >> [snorts] [25:11] >> Eight. [25:12] Okay. So, I could set an alarm on my [25:14] phone. Every hour, just get up, or every [25:16] 45 minutes, get up and do an air squat. [25:19] And this is primarily because have you [25:21] heard that when you eat, you get a [25:23] massive spike of glucose. And the best [25:26] way to bring that glucose spike back [25:28] down is by doing any form of exercise. [25:31] You can either be go out, go for [25:34] a fast run, do an air squat, bring that [25:37] bring that glucose level back to [25:38] baseline. And do you think much about [25:40] aerobic training as a preventative [25:43] measure for Alzheimer's? I love aerobic [25:45] training. Women are facing a dilemma on [25:48] social media, because they're [25:50] being given so much information. [25:52] There is this huge uproar [25:56] of "Should I do zone two exercise, or [25:59] should I not do zone two exercise?" What [26:02] is zone two exercise? So, we can think [26:04] of physiology in zones. Zone one is what [26:08] you and I are in right now. Mhm. Right? [26:10] Zone two is that next level up. And [26:13] that's generally when we're looking at [26:16] exercising at around 60% [26:19] of our maximum heart rate. [26:21] That's where you can where you're [26:23] jogging, but you can have a [26:24] conversation, but where you're huffing [26:26] and puffing. When we're exercising, we [26:29] need to produce energy. And that energy [26:32] firstly starts in the mitochondria. So, [26:35] we need [26:36] all of our energy gets created, we [26:38] create ATP, and that's how we are able [26:40] to perform the given task. As soon as we [26:42] get out of that zone, and we go into [26:43] zone three, zone four, and zone five, [26:46] we're producing energy outside of the [26:48] mitochondria, in the cytoplasm. [26:51] And when we're doing that, in order to [26:54] do that, we're breaking down glucose so [26:56] fast via a pathway called glycolysis. [27:00] The byproduct of that is lactate. [27:03] And then we produce lactate, and that's [27:06] actually a fuel source for the brain. [27:08] It's also a myokine. Right? So, that's [27:12] when we're in zone three, zone four, [27:13] zone five. [27:15] So, a lot of women have been doing zone [27:19] two. They've been going to the gym, [27:20] they've been doing zone two. And I'm [27:22] trying to push women to get out of zone [27:24] two, for several reasons. [27:27] Not because it's not good for you. [27:31] I think all forms of exercise are good [27:33] for you. The more you move, the better. [27:36] Right? [27:37] But, let's be really honest. [27:39] A lot of people in midlife are busy. [27:42] They're time poor. Men actually get a [27:44] greater return on investment by doing [27:46] zone two. [27:48] Women don't get the same return on [27:49] investment from doing zone two. So, I'm [27:51] trying to push women to first work on [27:55] zone five, [27:57] zone three, zone four, zone five. If [27:59] they can, just do zone five, [28:01] then do two to three sessions of [28:03] resistance training a week. And if you [28:04] have time left over, that's right there. [28:07] I've just described around four hours of [28:09] exercise. If you have time left over, [28:12] then you can work in zone two. Now, zone [28:14] two is great. If you're going to go out [28:16] and go for a long run, you're doing many [28:18] things. You are secreting a lot of BDNF, [28:22] which we need. It's a growth factor for [28:24] the brain. You're getting a massive [28:27] amount of blood that's going into the [28:29] brain, which is great, as well. It's [28:30] sustained. Blood delivers oxygen and [28:33] nutrients to the brain. You're doing a [28:34] lot of things, right? But, what you're [28:37] not doing is having a complete effect on [28:42] the chambers of your heart. [28:44] Is it better for me to do 5 km on a [28:46] treadmill, or outside? [28:49] I would say it's better for you, for the [28:51] brain, to do a smaller amount of [28:54] exercise and a higher threshold. Cuz I I [28:57] was I think I read somewhere one time [28:59] that running outside is better for the [29:01] brain, because it stimulates the brain. [29:03] Of course. Well, you're outside, so [29:04] you've got so many things around you. [29:05] Imagine your brain. I told you, it's got [29:08] prime real estate. Every part of the [29:09] brain is responsible for a different [29:11] function, from what you see to what you [29:13] hear. You go outside, and you can see so [29:16] many things. You've got forward [29:18] ambulation, so that's going to help you [29:20] with drive, motivation, dopamine. But, [29:23] then you're also taking in the sounds, [29:25] the senses. It down-regulates [29:27] inflammation. So, you get so many other [29:29] things from doing that. Yes, but 5 km [29:33] outside, compared to 20 minutes of high [29:37] aerobic physical activity, [29:39] what is better for the brain? I would [29:40] say that the zone five is better for the [29:43] brain. The zone five training does a lot [29:45] for the chambers of your heart, as well. [29:47] Now, I'm going to grab this. We've got a [29:49] little model here. [29:50] And we can see that [29:52] we have uh a left chamber, we have a [29:55] right chamber. We have actually four [29:57] chambers of the heart, but we have [29:58] something in the heart called a [30:00] ventricle. We've got a left ventricle [30:02] and we've got a right ventricle. Now, [30:04] the left ventricle delivers oxygenated [30:07] blood to the entire body. It's really [30:09] interesting because the chamber of the [30:10] left ventricle is like a is like a [30:14] muscle, right? It's responsible for [30:17] pumping blood to your entire body. It [30:20] first gives blood to the brain, which [30:22] means it's the most important part of [30:24] your body. After it's done giving blood [30:26] to the brain, it goes through to the [30:27] rest of the body. [30:28] As we get older, [30:30] we get stiffening of these arteries, [30:33] okay? Stiffening of all of the arteries [30:36] in the heart, and we get we get [30:38] something called left ventricular [30:39] hypertrophy. So, that's when the [30:42] ventricle [30:44] the left ventricle, it starts to get [30:46] thicker. And when it gets thicker, that [30:48] means that we can't it's not as strong, [30:50] it can't pump a lot of blood as much as [30:53] it could when it was younger to the rest [30:54] of the body. [30:56] Ben Levine, Dr. Ben Levine, he's a [30:57] sports cardiologist, and he did this [30:59] landmark study which changed how I [31:02] thought about zone five training. He [31:05] took a group of sedentary males, [31:09] average age, I think it was around 47 to [31:11] 55, so around 50 years old. And he [31:14] scanned their hearts. He did, you know, [31:16] he looked at he did echocardiograms, he [31:18] took photos of the heart, he did [31:20] everything he could to see when I was [31:22] first starting the protocol, what does [31:24] their heart look like? [31:25] He then subjected them to around four [31:29] hours of exercise per week. And that was [31:31] stratified against he did one resistance [31:34] training session a week, one was [31:36] high-intensity physical activity at [31:38] around 90% of the maximum heart rate, [31:40] the VO2 max heart rate. And then in [31:43] between he did some long sessions as [31:45] well, right? But it was all moderate to [31:48] rigorous exercise. And that was done [31:51] over two years. At the end of those two [31:53] years, what he found was that he [31:56] remodeled the heart [31:58] by 20 years. So, he reversed the [32:01] age-related effects and defects of the [32:03] heart by 20 years, essentially turning [32:06] the 50-year-old hearts into 30-year-old [32:08] hearts just from physical activity [32:12] alone. Four hours a week for two years. [32:14] Four hours a week for two years. [32:16] And what kind of exercise was it? So, he [32:18] got them to do like let's say for [32:20] example, one of the um [32:22] one of the protocols was exercising at [32:24] 90% of your maximum heart rate. So, when [32:27] we do this, we're generally looking at [32:30] increasing our VO2 max. So, you've [32:32] probably heard that VO2 max along with [32:35] strength, but VO2 max is the strongest [32:38] predictor of all-cause mortality, right? [32:41] So, if you want to improve your VO2 max, [32:44] and if you want to get the heart-related [32:47] changes that he did, [32:49] what you want to do is you want to do 20 [32:51] minutes of VO2 max per week just to keep [32:54] your VO2 max because it does decline [32:56] year on and year out starting at the age [32:58] of around 35. We start to see a decline [33:00] in VO2 max. [33:02] So, if we want to work on our VO2 max, [33:05] we want to be doing [33:07] a what we call the Norwegian 4 by 4. [33:11] It's the gold standard of increasing [33:13] your VO2 max. So, you want to get your [33:14] heart rate elevated to 90 to 95% for 4 [33:18] minutes on, 4 minutes off, repeat four [33:22] times. [33:23] So, how do I do this? Well, I actually [33:26] do this twice a week because the more [33:29] you do, the better. I do this on a [33:32] stepper, I do this at the gym, and I put [33:36] my stepper on to I think I'm at like a [33:38] level 14, and I'm working my way up, and [33:41] I'm staying on there for 4 minutes, [33:44] and then I'm having a complete stop and [33:46] a complete rest for 4 minutes. [33:48] And I'm repeating that four times. [33:51] Mhm. So, [clears throat] what I'm doing [33:53] in that moment, I'm not just getting a [33:56] massive shunting of blood to the brain, [33:59] okay, which is good. [34:01] I'm not just getting a massive release [34:03] of myokines and exerkines to the brain. [34:07] I'm also remodeling the heart. [34:09] I'm downregulating tumor cell growth. [34:12] I'm improving my cognitive performance. [34:15] I'm doing so much more than just [34:16] exercising alone. [34:18] So, that's once once a week in Levine's [34:22] study that reversed these guys' hearts [34:24] by 20 years. [34:25] >> Yeah. Um [34:26] that you do that once a week. [34:28] >> You only have to do that once a week, [34:29] but he also did um he did around 70% of [34:33] maximum heart rate for around two hours [34:34] a week, and he also threw in one [34:36] resistance training session. [34:39] So, consistency is key. I'm just looking [34:42] at some of the findings of that study, [34:43] and one of the surprising things is [34:46] it showed that there is a biological [34:49] expiration date, per se, for the [34:52] reversal of the heart, and then the [34:54] heart retains its plasticity, the [34:56] ability to remodel itself until the age [34:57] of 65. If this intervention had started [35:00] after the age of 65, the heart was too [35:02] stiff to be physically remodeled to get [35:04] that 20-year reversal. Yeah. You have to [35:07] start in late middle age. Exactly. So, [35:10] midlife is the window of opportunity for [35:13] brain health and for longevity. I didn't [35:16] realize you could [35:17] sort of remodel the heart yourself. [35:19] That's interesting. [35:20] >> Yeah, you can remodel the heart. And the [35:21] heart is amazing, okay, because what you [35:23] see with the aorta, right? So, the aorta [35:27] goes up, and we've got we've got two [35:29] we've got the main blood supply for the [35:31] brain exist in the vertebral arteries, [35:33] okay? So, there's branching off of the [35:35] aorta, comes from the heart, vertebral [35:37] arteries which supply the posterior part [35:40] of the brain and the cerebellum with [35:41] blood. And then you've got the carotid [35:44] arteries, one on one on each side, [35:46] branching off the aorta, which supply [35:47] the uh frontal and middle part of your [35:50] brain with blood. The brain is the most [35:52] vascular-rich organ in the entire body. [35:54] In times of stress, such as [35:57] hypertension, okay? [36:00] That is elevated blood pressure. [36:03] We see that we can actually kill off the [36:07] tiniest parts of the blood vessels, [36:09] which are called the capillaries. You [36:10] can see the capillaries up here. They [36:12] supply even the blood-brain barrier, so [36:14] they supply mainly the outer cortex of [36:17] the brain with blood. When we have [36:19] elevated blood pressure, [36:22] we are starting to kill off those tiny [36:24] little capillaries of the brain. Those [36:26] capillaries are feeding different [36:29] neurons in the brain and also feeding [36:32] the blood-brain barrier. So, when we get [36:35] breaking off of these, we lose the blood [36:37] supply, we lose the oxygenation, we get [36:40] a breakdown of the blood-brain barrier [36:42] itself, which is scary, and we see that [36:45] in patients who have got mild cognitive [36:47] impairment. You can call you've heard of [36:49] leaky gut, we can call it leaky brain. [36:51] If you have a leaky brain, what happens [36:54] eventually is so, your blood-brain [36:56] barrier sits like this, okay? And there [36:59] are cells, and we call them parasites, [37:01] for example, and they're bound together [37:04] by tight junctions. That's what the [37:05] blood-brain barrier is. It's like a [37:08] you think of the blood-brain barrier as [37:11] the bouncer of a nightclub. They are all [37:13] standing there like this, responsible [37:15] for who can come in and who can't, and [37:17] they don't allow some molecules to get [37:19] in. But over time, when this starts to [37:22] degrade and become leaky, they start to [37:24] spread apart. And when they do, you can [37:27] have the passive diffusion of all these [37:30] molecules coming in, and that's really [37:32] bad for your brain. So, we want to [37:34] maintain the integrity of the [37:36] blood-brain barrier by maintaining the [37:38] capillary health. We don't want the [37:40] capillaries to die. They're one cell [37:42] thick. Any type of damage can damage [37:45] them and kill them. Hypertension, there [37:47] was a really great study. It was called [37:49] it was actually the SPRINT trial, and it [37:51] was it's now the gold standard for the [37:54] recommendation of 120 over 80. So. So, [37:58] when you have your blood pressure taken, [38:00] we get the systolic over diastolic. And [38:03] you've probably I don't know if you take [38:04] your blood pressure, but doing your [38:06] blood pressure every day is a really [38:08] great, inexpensive, and effective tool [38:11] for maintaining good brain health. So, [38:15] you measure your blood pressure, and if [38:17] you are hypertensive, [38:19] this is anywhere over 135, [38:24] okay? Systolic over 135. [38:27] That's when things start to break down. [38:31] That's when we start to get the [38:32] breakdown of those small, one cell thick [38:35] capillaries. So, in this trial, in the [38:38] SPRINT trial, what they found was that [38:40] when they aggressively manage these [38:43] patients, and they bring their blood [38:45] pressure down, they did it [38:46] pharmacologically through something [38:48] called an ACE inhibitor, it's a [38:49] medication to drive down blood pressure. [38:51] When they bring it down [38:52] pharmacologically, these patients [38:54] preserved their brain gray matter and [38:57] their cognitive functions. So, we now [39:00] have a gold standard, and this is what I [39:02] would recommend anybody. [39:03] On Amazon, it costs about $25 for a [39:07] blood an automatic blood pressure [39:08] monitor. Do it every single morning, and [39:11] watch your blood pressure. And then if [39:13] it's high, what do I do about it? [39:15] Well, outside of pharmacology, if we [39:17] don't want to take a medication, we want [39:19] to get stronger, and we want to do this [39:21] via exercise. [39:23] Stress is one of the biggest things [39:25] driving high blood pressure. Manage [39:27] stress, manage cortisol, manage chronic [39:29] inflammation by way of exercise, sleep, [39:33] all of the things that Mother Nature [39:34] gave us. [39:35] I was just looking at the um the study [39:37] that reversed uh the heart by 20 years, [39:40] and trying to figure out what exercises [39:41] they did. and as you said the first one [39:43] was a high intensity workout the 4 by 4. [39:46] Um then they did a long aerobic exercise [39:48] again this is all once a week so 60 [39:50] minutes once a week doing a longer [39:53] exercise like it could be hiking or [39:55] tennis or cycling. A moderate intensity [39:57] workout 30 minutes where they did the [39:59] talk test you should be able to break a [40:01] sweat but still be able to speak. So [40:03] that was once a week and then lastly [40:04] strength training once a week. So it's [40:05] really a variety of exercises that [40:08] caused such a profound impact on [40:10] the heart. [40:13] And I think cardiovascular diseases are [40:15] the single biggest killer. Yeah, [40:17] cardiovascular disease [40:20] dementia is the number one killer [40:22] of women in the UK. The number one. [40:25] Really? It's the number one cause of [40:26] death in Australia for both men and [40:29] women. How does it kill you? Cuz we all [40:31] think about memory loss and stuff like [40:33] that but And so this is the actual [40:35] devastating part. We don't die of [40:38] Alzheimer's disease specifically. Over [40:40] time what happens is in these patients [40:43] you have to remember Alzheimer's disease [40:45] is like end-stage cancer. Once you get [40:49] the diagnosis there is no cure. There is [40:51] no going back. There is no reversal. You [40:54] have the disease and that's the scariest [40:57] part. Mild cognitive impairment you can [40:59] slow the progression of that. Like I [41:01] said to you it goes for 20 years mild [41:04] cognitive impairment. You can slow the [41:06] progression of mild cognitive impairment [41:08] but as soon as you get diagnosed on that [41:10] awful day that your mother or your [41:12] friend gets diagnosed with Alzheimer's [41:15] disease it's a sad day. And what ends up [41:17] happening with these patients is you can [41:20] die of asphyxiation. You can die of you [41:25] your brain loses the signal to swallow. [41:29] It loses the signal to maybe you fall [41:32] because you've lost balance. It's very [41:35] it's a really scary [41:36] moment but it's not like you die of [41:39] Alzheimer's disease specifically. [41:42] If you were diagnosed with Alzheimer's [41:44] disease [41:48] It's an interesting reaction. [41:50] >> [snorts] [41:51] >> Because I would have no hope. [41:53] I think a a better question is [41:56] You'd have no hope? If I was diagnosed [41:59] with Alzheimer's disease there is [42:00] nothing I could do. [42:03] How would that change [42:06] your life and the decisions you make or [42:08] would it at all? I would aggressively [42:11] aggressively exercise. I would monitor [42:15] my diet. I would aggressively monitor my [42:17] diet and I would potentially have a [42:20] ketogenic diet because what we've found [42:22] is that during this metabolic crisis [42:26] that happens in your brain. Okay where [42:28] you lose the ability to use glucose as [42:31] your primary fuel source. So the brain [42:34] doesn't know how to use glucose as its [42:36] primary fuel source so it's under [42:38] attack. During Alzheimer's? During [42:40] Alzheimer's but also during this window [42:43] in [42:44] for women as well in the perimenopause [42:46] state. So the brain cell when it's under [42:48] attack and it can't utilize glucose [42:50] effectively and it doesn't have any [42:51] energy it starts to think about [42:54] survival. It starts to think what can I [42:56] do I'm under attack. So it starts to [42:59] break down the myelin sheath and in that [43:02] moment it's actually the astrocytes [43:04] they're the supporters of the brain so [43:06] of the brain cells so they start to [43:08] think okay let's break down the myelin [43:10] sheath from that the astrocytes [43:13] produce ketone bodies and then the [43:16] ketone bodies get shuttled into the [43:17] brain and that's how we use [43:19] energy in the brain. So [43:22] in that state of metabolic crisis I [43:25] would make sure that I am having a [43:28] ketone rich diet or I may be getting [43:31] exogenous ketones. I would aggressively [43:33] exercise. I would aggressively manage my [43:36] my lipids. I'd have a high intake of [43:38] omega-3 fatty acids and I would preserve [43:41] if I could any form of cognitive [43:44] function by way of [43:46] talking to people by going outside, [43:48] socializing, having hard conversations [43:51] if I was intact and I could do so. I [43:54] would [43:55] throw tennis balls to the wall. [43:58] So on that point of the ketogenic diet [44:02] the reason is because ketones are an [44:03] alternative fuel source to glucose. [44:06] Yeah. And the brain likes ketones. The [44:10] brain loves ketones and actually [44:12] utilizes them more effectively than [44:14] glucose but glucose is the primary fuel [44:17] source for the brain. And here's what's [44:19] really interesting [44:21] and devastating if you will for females [44:23] during the onset of perimenopause right? [44:27] When we see a decline in estrogen. [44:30] Right? We see a decline in estrogen what [44:32] happens is a 30% reduction in brain [44:36] glucose metabolism. So when these [44:39] receptors start to die because we don't [44:41] have [44:42] we don't have a lot of estrogen [44:43] circulating in the bloodstream anymore [44:47] what happens? Well we can't utilize [44:49] glucose as effectively. So during that [44:52] state that's when we start to get the [44:54] breakdown of the myelin sheath to use [44:56] that as as ketone bodies as an [44:59] alternative brain fuel source. [45:02] So do you think women going through [45:03] menopause should be [45:06] considering a ketogenic diet? [45:07] >> Yes I do think that. I think that women [45:10] who are going through perimenopause and [45:12] who are at the mercy of this brain [45:16] energetic crisis should be adopting if [45:18] they can a ketogenic diet. It's one of [45:21] the best diets for the brain. [45:24] I didn't really understand this idea [45:25] that during menopause there was a [45:28] glucose [45:30] deficiency or metabolism problem in the [45:32] brain. [45:32] >> 30% reduction in brain glucose [45:34] metabolism. Is this why women report [45:36] having brain fog and all these kinds of [45:38] things? [45:39] >> Yeah absolutely because when the brain [45:41] can't utilize its fuel source [45:43] effectively [45:44] what happens? Well metabolites start to [45:47] shift. We don't sleep properly around 60 [45:51] to 65% [45:53] of women in menopause report having a [45:56] hot flash or night sweats. It wakes them [45:58] up at night that's also causing [46:00] cognitive decline and brain fog. So I [46:04] mean this graph's pretty shocking. Mhm. [46:06] >> [clears throat] [46:06] >> Um can you explain what it shows? Oh [46:09] this is showing the [46:11] um estrogen levels at birth going [46:13] through all of the life cycles that a [46:15] woman will go through puberty, [46:17] perimenopause and then eventually [46:19] menopause. There is one thing that is [46:21] certain. [46:23] After age I mentioned earlier being a [46:26] woman is the next strongest risk factor [46:29] for getting this disease. [46:31] For [snorts] getting Alzheimer's? For [46:32] getting Alzheimer's. And that largely [46:35] lies in our in our menopausal shift that [46:39] occurs the downsizing of estrogen. [46:42] However [46:43] we do have forms [46:45] of estrogen that we can you know [46:47] supplement with. So I just need to keep [46:49] the estrogen up. Yeah. Because then the [46:51] brain health is going to be up and [46:53] normal. This is where the controversy [46:55] lies. Yes and no. So I want everyone to [46:57] understand I am seeing right now. So my [47:00] entire doctoral thesis is focused on [47:02] women and Alzheimer's disease and I'm [47:05] Switzerland right now when it comes to [47:07] hormone replacement therapy. That is [47:09] replacing [47:11] your hormones. You're Switzerland? I'm [47:13] Switzerland meaning that there is no [47:16] evidence to suggest right now we don't [47:18] have large-scale randomized control [47:20] trials to show that hormone replacement [47:22] therapy prevents dementia. [47:25] So what I will tell you is this. It is a [47:26] signal. It is a supporter. It will help [47:30] you do the things that can lower your [47:34] risk of dementia. [47:35] We've seen multiple times that [47:38] having hormone replacement therapy can [47:41] reduce your risk of getting Alzheimer's [47:43] disease by up to 30%. We know that but [47:46] it's not because [47:48] estrogen alone is minimizing your risk. [47:51] It's because when you have estrogen [47:54] it helps get rid of the hot flashes. It [47:57] helps with the night sweats because [47:59] during menopause when we actually have a [48:01] dysregulation [48:03] of the of estrogen in our brain what [48:05] happens in the hypothalamus which is an [48:08] area in the brain that controls our [48:10] temperature regulation. [48:12] When we lose the ability to monitor our [48:15] temperature for a woman [48:17] what will happen is when she feels the [48:20] slightest bit hot her temperature you [48:24] know is rising a little bit the [48:25] hypothalamus doesn't know what to do so [48:27] it signals I'm super hot so it'll raise [48:29] your temperature right up and that's a [48:31] hot flash and then it'll bring it right [48:32] down. And as a result this is keeping [48:35] women up at night and we know that sleep [48:37] deprivation is a risk factor for [48:39] Alzheimer's disease of course it is. [48:41] Compounding sleep deprivation [48:44] will accumulate amyloid beta in your [48:47] brain. So if we can replace if we can [48:50] use hormone replacement therapy as a [48:52] signal and as a support to help us sleep [48:56] at night then that's a good thing. [48:58] Another thing [49:00] estrogen is anabolic to muscle. [49:03] What does that mean? It means that it [49:05] helps with muscle protein synthesis. So [49:08] it helps me make muscle. Yeah we've got [49:09] estrogen receptors on our bone. We've [49:11] got estrogen receptors on our muscle. So [49:14] if estrogen is anabolic to muscle if [49:17] estrogen helps with muscle protein [49:21] synthesis if if estrogen helps with bone [49:24] mineral density then replacing estrogen [49:27] during that menopause state is going to [49:29] help us with all of the risk factors of [49:31] Alzheimer's disease. [49:33] So when does [49:34] estrogen I mean it really in this image [49:36] drops off a cliff. And And yeah, and it [49:38] varies. So, it tends to generally happen [49:41] at around 45 years old as an average, [49:43] and that that perimenopause stage lasts [49:47] around 10 years. But, it starts going [49:49] down on this graph at about 30. It [49:51] starts to go down, and everyone's [49:52] different, okay? You can have a woman in [49:55] her late 30s going to perimenopause, or [49:58] the general age is around 42 to 45. Most [50:01] OBGYNs that I've spoken to say that you [50:04] need to start checking in with your [50:07] doctor at around 40 years old to check [50:09] for this. So, do you think thinking [50:11] about my fiance now, do you think that [50:14] someone like her should go on hormone [50:17] replacement therapy at like 40? Well, so [50:19] that's the that's the big question. [50:20] That's the elephant in the room. Should [50:21] you go on hormone replacement therapy, [50:23] or should you not? And that's definitely [50:24] a conversation between you and your [50:26] physician. However, we've got [50:28] large-scale studies right now to show [50:31] that we don't have to be afraid of [50:34] hormone replacement therapy. [50:36] And without going too deep into the [50:37] weeds, there was a massive study that [50:39] was done, the Women Women's Health [50:41] Initiative, that scared women out of [50:43] taking hormone replacement therapy in [50:46] fear Right. of getting breast cancer. [50:48] Correct. We went from having 40% of [50:51] women on hormone replacement therapy to [50:54] just 4% of women on hormone replacement [50:57] therapy. We know that even at the onset [51:00] of menopause, [51:01] a woman's risk of having a heart-related [51:05] event triples. [51:07] A woman's risk [51:09] of getting Alzheimer's [51:11] disease [51:12] increases. [51:14] So, there is something to posit here [51:16] about the benefits of hormone [51:17] replacement therapy that we still [51:20] haven't yet studied. [51:22] Would you do hormone replacement [51:24] therapy? I definitely will. And what [51:26] kind of hormone? [51:26] >> And look, so this is really interesting. [51:28] So, um this was given to me by a friend, [51:30] and there's this is the um this is the [51:32] capsule. So, this is estradiol and [51:35] progesterone. Okay? So, progesterone is [51:37] that one that's going to help you sleep [51:39] at night. This one here is vaginal [51:42] estrogen. So, this is a cream that [51:45] actually gets uh [51:47] you know, depending on how it is, it can [51:48] get inserted, and the vaginal estrogen, [51:50] apparently, if you put it on your face, [51:54] is probably the best form of skin care [51:56] that you could ever have. Yeah, we have [51:58] estrogen receptors all over our tissues, [52:01] including our skin. These are estradiol [52:04] inserts. So, that's not the cream [52:05] itself, but if you get vaginal estrogen [52:08] in the form of a cream, you can put it [52:09] on your face, and it can help with skin [52:11] elasticity, collagen, uh dermal [52:14] thickness. This is why I'm actually most [52:16] excited about it. [52:18] So, I mean, is this Are these the only [52:19] ways that one can do hormone Can No, [52:22] there's also um a patch, and that's what [52:24] most women are opting in for. What would [52:26] you do when the time comes? [52:28] >> I will probably do the the the patch. [52:31] Why? [52:32] Because it's the the easiest that's the [52:35] one that um I've researched the most. Uh [52:37] I'm not afraid of hormone replacement [52:39] therapy in the slightest. You do have [52:40] to, you know, everyone has to check with [52:42] their doctor, but [52:44] I definitely think that this is going to [52:46] be one thing that is going to help with [52:48] the Alzheimer's disease crisis that is [52:50] occurring. [52:53] Go ahead. [52:54] I mentioned earlier plaques, right? [52:58] So, a lot of people ask, "Well, what [53:00] distinguishes Alzheimer's disease from [53:03] the rest of the dementias?" And it comes [53:05] down to two proteins, amyloid beta and [53:09] tau protein. And here's where it gets [53:11] really interesting, and actually dates [53:13] back to 1901. The first ever Alzheimer's [53:16] disease patient, Auguste Dete, she was [53:19] 52 years old, and she went to the [53:21] hospital, her and her husband went, [53:23] complaining of difficulties of word [53:26] finding, [53:28] word fluency, and she couldn't remember [53:30] where she put her keys. And her husband [53:34] said, "She is delirious." [53:36] And Auguste told the doctor on board, he [53:40] was a psychiatrist, his name was Alois [53:43] Alzheimer. [53:44] She said to him, and I quote, "I don't [53:47] know who I am anymore." [53:50] As I mentioned, this disease robs you of [53:52] who you are. [53:54] In 1906 [53:56] Auguste Dete died. [53:58] And [53:59] that was the first ever patient to be [54:02] recorded of having Alzheimer's disease. [54:06] And so, postmortem, they cut her brain [54:09] open, and they found that she had these [54:11] plaques in her brain, and they didn't [54:13] really know they didn't really [54:13] understand what it was, but that was the [54:15] first ever induction of this disease in [54:19] society. And ever since then, [54:21] ever since then, we are still trying to [54:23] tackle this disease. [54:25] In the 2000s, we had this notion that [54:28] Alzheimer's disease was the amyloid [54:30] cascade hypothesis, meaning that great [54:33] Alzheimer's disease means when you get a [54:35] headful of amyloid, this toxic protein [54:37] that builds up. So, we were demonizing [54:39] this protein. [54:41] We were demonizing this peptide protein [54:43] that builds up in the head, and so then [54:45] came the medications, okay? In the form [54:49] of IV drugs. So, you go to the hospital, [54:52] you get an IV in the promise that it [54:55] will clear out amyloid. Great, we've got [54:57] a cure. But, what they found was that [54:59] when they were taking out the amyloid in [55:02] these brains, they were taking with them [55:04] brain tissue and causing [55:06] microhemorrhages. [55:08] And in some patients, it was resulting [55:10] in death. [55:13] So, [55:14] we now know that [55:16] the problem here isn't amyloid. In fact, [55:22] amyloid is a antimicrobial peptide. [55:26] So, amyloid is actually a good thing. [55:30] Amyloid beta is a good thing because it [55:32] protects the brain cells. Now, here's [55:35] what happens. We have this beautiful [55:37] process during sleep that occurs. When [55:40] we get into deep sleep, we activate the [55:43] glymphatic system. [55:45] Okay? So, the glymphatic system comes [55:47] from the word glials, glial cells. We [55:50] have glial cells in the brain. They sit [55:53] outside of the neurons, and this is what [55:56] uh is responsible for immunity. They're [55:59] a chief um immune response cell. [56:02] During deep sleep, they shrink. And when [56:04] they shrink, all of this amyloid beta [56:06] that's floating around in the [56:08] cerebrospinal fluid gets washed out. So, [56:11] it's like a washing machine that occurs [56:13] in your brain. [56:14] Right? [56:15] But, what tends to happen in Alzheimer's [56:17] patients is they don't get a chance to [56:20] wash out the amyloid. [56:22] What happens in perimenopause and [56:25] menopause due to the hot flashes, you [56:27] don't get to get into deep sleep because [56:29] you're having a fragmented sleep because [56:30] you're waking up due to hot flashes and [56:32] night sweats. So, that is what's do That [56:35] is what's causing the buildup of [56:37] amyloid. Now, stick with me. We've got [56:40] another protein [56:42] that is a hallmark of Alzheimer's [56:44] disease. It's tau protein, and tau lives [56:47] in the axon of the cell, the one that I [56:51] said is covered in the myelin sheath. [56:53] And what happens under times of stress, [56:57] what happens is this tau protein [56:59] phosphorylates. [57:01] So, [57:02] it breaks off, and basically, tau [57:05] protein stabilizes the microtubules. [57:08] Okay? Imagine these railway road tracks [57:11] in the axon. Okay? Just going up and [57:13] down the axon. The axon's in the in the [57:15] cell or in the brain? Uh so, the the the [57:17] brain cell itself, the neuron, is the [57:20] neuron cell body, and the axon is like [57:22] the trunk of the tree. Okay. [57:25] Right? Yeah. So, holding up the tree are [57:27] microtubules. And those microtubules are [57:31] bound by tau proteins. The The tau [57:33] proteins keep the microtubules intact, [57:35] so the trunk of the tree is stabilized, [57:38] and it sits there. Why does it need to [57:40] be stabilized? Because that's how speed [57:42] of thought travels. Information [57:44] processing speed travels up there. [57:47] When the tau protein phosphorylates, [57:50] it starts to form tangles. They're [57:53] called neurofibrillary tangles. So, that [57:56] happens in the axon. And when all these [57:58] tangles [57:59] clump together, we get the collapse of [58:02] this axon, the collapse of these [58:05] microtubules. So, we're not just having [58:08] a cascade of environmental disaster [58:12] inside the cerebrospinal fluid of the [58:14] brain and inside the brain outside the [58:15] cells, we've also got this cascade [58:17] happening inside the cell body itself. [58:20] So, the brain is under attack inside the [58:23] cell and outside the cell. Why? [58:26] Why exactly why? Why does this happen? [58:29] Because of how we treat our brains. [58:32] Because of how we treat our brains. [58:33] >> Yes. [58:34] The reason why your brain is [58:36] hyperphosphorylated, [58:38] and the reason why these tau proteins [58:39] are hyperphosphorylated, is because of [58:41] many things. One is [58:44] we have seen time and time again [58:47] that we have estrogen receptors [58:50] that are on in the brain cell [58:52] themselves, in the axon. So, when we [58:55] don't have adequate estrogen, estrogen [58:57] actually is so smart, what it is doing, [59:01] it's blocking an enzyme that is [59:04] responsible for phosphorylating [59:07] the tau. So, if we don't have the [59:10] estrogen there, [59:12] then the tau the enzyme is there to [59:15] phosphorylate the tau. [59:17] And break it down and cause these [59:18] neurofibrillary tangles. But, let's just [59:20] say you're a man, and you don't have you [59:23] don't need the testos you don't need the [59:25] estrogen there. Although, testosterone [59:26] is neuroprotective. Testosterone [59:28] actually aromatizes into estrogen, which [59:32] is why you actually have an extra added [59:35] protection in your life. [59:37] Um [59:39] What else causes this? Well, stress. [59:41] >> You're talking about sleep deprivation. [59:42] >> Yeah. So, sleep is, I think, by far the [59:45] most underrated [59:47] Alzheimer's disease prevention tool that [59:50] we have. It's underrated because [59:53] we have been doing it all our lives and [59:55] we think that we can just go to sleep [59:57] and the magic happens. But, I think now [59:59] in 2026, we actually need to train for [60:03] sleep. So, [60:05] uh during deep sleep, we activate the [60:07] glymphatic system. And sadly, a large [60:10] proportion of us aren't getting into [60:12] deep sleep. [60:13] >> [snorts] [60:13] >> So, sleep is uh one of the reasons. How [60:16] do you sleep? [60:18] Yeah, I sleep I make sure I sleep 7 and [60:20] 1/2 hours a night. [60:21] All I had to do was brain dump. Imagine [60:23] if you had someone with you all times [60:26] that could take the ideas you have in [60:28] your head, synthesize them with AI to [60:31] make them sound better and more [60:32] grammatically correct, and write them [60:34] down for you. This is exactly what [60:36] WhisperFlow is in my life. It is this [60:38] thought partner that helps me explain [60:40] what I want to say, and it now means [60:42] that on the go, when I'm alone in my [60:44] office, when I'm out and about, I can [60:46] respond to emails and Slack messages and [60:48] WhatsApps and everything across all of [60:50] my devices just by speaking. I love this [60:52] tool. And I started talking about this [60:53] in my behind-the-scenes channel a couple [60:54] of months back, and then the founder [60:55] reached out to me and said, "We're [60:57] seeing a lot of people come to our tool [60:58] because of you. So, we'd love to be a [61:00] sponsor. We'd love you to be an investor [61:01] in the company." And so, I signed up for [61:03] both of those offers, and I'm now an [61:04] investor and a huge partner in a company [61:06] called WhisperFlow. You have to check it [61:08] out. WhisperFlow is four times faster [61:11] than typing. So, if you want to give it [61:12] a try, head over to whisperflow.ai/doac [61:16] to get started for free. And you can [61:18] find that link to WhisperFlow in the [61:20] description below. [61:22] A lot of people struggle with sleep, and [61:24] um they've just kind of gotten used to [61:26] it. [61:27] I I I hear this from friends of mine [61:28] that will say, "You know, I slept in a [61:29] bad sleep." People sleep for 5 hours, [61:31] and they kind of have just gotten used [61:32] to it. Do you think [61:34] that's okay? No. [61:37] And [61:38] they will pay for this in their 60s and [61:41] 70s. How do you know? [61:43] Because I know that just one night of [61:45] sleep deprivation is raising your risk [61:46] of amyloid beta by at least 4 to 5%. [61:50] Just one night? Just one night. [61:53] So, you can imagine the accumulation of [61:55] this. Not only that, we know that you're [61:58] interrupting with the hormones that are [62:00] responsible for hunger and society. We [62:02] know So, [62:04] for hunger and satiety, we know that [62:06] you're increasing your risk of type 2 [62:08] diabetes with um sleep deprivation. [62:12] But, not just that, we also see that [62:15] this compound effect can't be reversed, [62:18] meaning that [62:20] a lot of people think, "I'll just sleep [62:22] for 6 hours a night and then just bank [62:24] on it on the weekend." But, sadly, [62:26] that's not how our brain works. It's not [62:28] like debt that we can repay to the bank. [62:31] I heard from Matthew Walker the other [62:32] day though that we can save it up. He [62:34] said um he said you can't make up for [62:36] lost sleep. [62:37] >> Exactly. But, if on Monday I've got [62:39] something where I know I'm going to be [62:40] deprived, he says on the weekends, like [62:43] Saturday and Sunday, if I got a huge [62:45] amount of sleep, kind of like [62:47] I can use that. [62:48] >> Yeah, it's kind of like Yeah, it's kind [62:50] of like the reserve. Yeah. Actually, I [62:52] do this. I do long-haul flights. I'll be [62:54] at like 6 hours between LA and New York, [62:57] but also to Australia. And so, if I know [63:00] I'm going on a long-haul flight, I'll [63:01] bank on my sleep for about a week [63:04] leading up to that. Cuz I know I'm going [63:06] to be sleep deprived on the plane. So, [63:08] if you were one of those people that [63:09] struggles with sleep, that's listening [63:10] right now, and they're slightly [63:11] concerned that, you know, you talked [63:13] about this um glymphatic system, which [63:16] sort of comes out at night and cleans up [63:17] the brain. And they're hearing, you [63:19] know, [ __ ] my glymphatic system isn't [63:21] going to be optimal if I'm not sleeping. [63:22] If that was you, and for whatever reason [63:25] you start sleeping poorly, Mhm. what [63:28] would you do about it? [63:29] I would get really serious about [63:31] examining my lifestyle the day before. [63:35] So, this generally involves two things. [63:37] You have to ask yourself, are you having [63:39] trouble falling asleep, or are you [63:40] having trouble staying asleep? A lot of [63:44] women report trouble falling asleep, [63:48] meaning they've got a racing mind. Men, [63:51] too. They've got this racing mind. They [63:52] can't, you know, just stop that default [63:55] mode network and the the racing thoughts [63:58] that happen. That's one thing. [64:00] And then there's the I can't stay [64:03] asleep, meaning that uh I'm waking up [64:05] due to heat, I'm waking up because uh [64:08] I'm stressed and I'm having bad dreams. [64:10] There's all different reasons as to why [64:12] you wake up. So, for the person who is [64:14] having trouble falling asleep at night, [64:17] I would strongly recommend [64:20] introducing [64:21] a supplement called GABA, which is [64:24] gamma-aminobutyric [64:26] acid. It's our chief inhibitory [64:29] neurotransmitter. [64:30] And when you have this, it really helps [64:33] stabilize all those thoughts. It helps [64:35] with a racing mind, and it can help calm [64:38] you down at night. [64:40] The next thing I'll do is I will think [64:43] about what I'm eating. Actually, it [64:45] turns out that um eating starchy [64:47] vegetables, something that's going to [64:49] make you like, you know, sweet potatoes, [64:51] for example, it's going to have a better [64:53] benefit uh backloading uh your carbs at [64:56] night for helping you sleep. [64:59] If you start training for sleep, as if [65:02] sleep is your marathon, and start [65:03] preparing for that at 8:00 p.m. at [65:05] night, getting off, you know, don't [65:08] email, don't have any hard [65:09] conversations, don't watch anything [65:11] crazy at night, you'll settle your mind [65:14] down. You'll settle your nervous system [65:16] down. [65:18] But, where I think uh most of the [65:20] optimization occurs is when you're [65:23] actually [65:25] in sleep. [65:26] I would also work on um sleep [65:28] regulation. So, what we know is that in [65:30] order to fall asleep and stay asleep, [65:32] our core body temperature needs to drop [65:34] at least 2°. [65:36] And I'm doing this with a [65:38] temperature-controlled mattress cuz it's [65:39] working on thermal regulation. A lot of [65:41] people who don't have that can do uh [65:45] several things, like sleeping with their [65:46] feet outside of the sheets, or turn [65:49] turning the the air conditioning on the [65:51] thermostat on to cooling the room, to [65:53] cooling down your body temperature, core [65:54] body temperature. One thing that um you [65:57] can supplement with is glycine, [66:00] which I think is amazing because it [66:01] helps with sleep by way of temperature [66:04] regulation. It can bring down your core [66:06] body temperature. And in fact, and I [66:08] don't know too much about the mechanism [66:09] behind this, glycine itself has [66:13] one of the greatest [66:15] longevity benefits for improving [66:18] lifespan. So, taking glycine can also [66:21] help with that. Now, in terms of the [66:23] person who is having trouble staying [66:26] asleep, [66:27] What about this one? You didn't talk [66:28] about the um the old [66:30] ashwagandha? Oh, yeah. Ashwagandha is [66:33] great. Okay. Ashwagandha is going to [66:36] help you with stress, [66:38] and you've got here ashwagandha [66:40] rhodiola. So, what they both are, they [66:43] are adaptogens. [66:45] And basically, an adaptogen is great [66:48] because it it goes in and it adapts to [66:51] what is happening in your body. So, [66:52] let's just say you have elevated [66:54] cortisol. And this tends to happen, you [66:57] know, during different cycles, during [66:59] the mainly during the uh daytime when we [67:01] wake up, where cortisol levels are at [67:02] its peak. But, it can also happen at [67:05] night. Having this can actually [67:07] stabilize that cortisol because it can [67:09] go in, it can bind to cortisol, and [67:11] bring it down. Likely, if something is [67:14] not elevated and it's low, it can bring [67:16] it up. So, it's really good. It's an [67:18] adaptogen, and [67:20] studies show that you can actually take [67:22] this three times a day, and you won't [67:24] feel fatigued. It doesn't disrupt [67:26] anything, and it pairs really well with [67:29] caffeine, for example, so does theanine. [67:31] So, this is actually a really great um [67:34] adjunct to your supplement stack. [67:37] And you really talk about how you need [67:39] to sort of warm up [67:40] to warm down, or warm up to go to sleep. [67:42] >> Oh, yeah. Starting at like 7:00 p.m. [67:45] Yeah, starting at like 8:00 p.m., and [67:46] that's in line with circadian rhythm and [67:48] circadian biology. You want to try and [67:51] when it comes to sleep and your [67:53] circadian rhythm, [67:55] you kind of want to mimic the sun and [67:57] mother nature. And when does the sun [67:59] start to go down? It starts to go down [68:01] at around 8:00 p.m., depending on where [68:03] you are in the world. [68:05] And [68:06] when this happens, we also get the [68:09] natural release of I love that you're [68:11] taking that, by the way. You must be [68:13] stressed right now. [68:14] You get the natural release of [68:16] melatonin. [68:17] So, melatonin is that sleepy hormone [68:19] that gets released in response to [68:21] darkness. This may also be another [68:23] reason why some somebody is having [68:25] trouble falling asleep and staying [68:27] asleep. So, we want to get the natural [68:29] release of that. So, these biohacks that [68:32] occur right now, sleeping with our red [68:34] light mask on, dimming the lights. Look, [68:36] dimming the lights is great. Um I've [68:38] actually replaced all of my light bulbs [68:41] um at home with in my bedroom as well [68:44] with red light bulbs. So, I'm getting um [68:47] I'm getting rid of the blue light, the [68:49] junk light. I'm replacing it with red [68:51] light to help downregulate the nervous [68:52] system. [68:54] Yes, I do wear blue light-blocking [68:56] goggles, or glasses, I should say. Do I [68:58] think that they're providing an [69:00] immediate and huge benefit? I don't [69:03] know. But, they could have a minor [69:06] benefit there. So, warming down involves [69:09] doing these things that are going to [69:10] help you [69:12] downregulate your nervous system so you [69:13] can fall asleep faster. [69:16] Sticking on supplements for a second, [69:20] omega-3? Yes. Um I've got some omega-3 [69:23] here. I've only got two of them here. [69:25] Mhm. But, when I brought both of them [69:27] out, you said that I've got to be quite [69:28] careful about what brand I buy, but also [69:31] something about temperature. So, by far, [69:33] out of all of the supplements, omega-3 [69:36] is probably the only one that you have [69:40] to make sure that you look at the [69:43] supplement label for. Um there there was [69:45] this study that was done that showed [69:48] that [69:49] around 95% [69:51] of the most popular omega-3 supplements [69:54] in the US, and there was about 85 of [69:56] them that were tested, exceeded the [69:59] normal oxidation level, meaning that [70:03] these pills, because they're omega-3 [70:06] fatty acids, they come from fish oil, [70:08] they're oil, they can become rancid and [70:11] oxidized. And they usually do this when [70:14] they're in an heated environment. There [70:16] are the Here are the rules of thumbs. [70:18] One, you want to look for a manufacturer [70:20] that is highly credible and that is [70:23] certified. [70:25] Certified? Yeah. So, NSF certified. So, [70:29] it's an external governing uh board that [70:32] certifies them on, you know, everything. [70:34] Heavy metals, they make sure that the um [70:37] oxidation levels are met, and they make [70:38] sure that, you know, what's in the [70:40] capsule is actually in the capsule. [70:42] That's another thing that is scary. The [70:43] supplement industry is highly [70:45] unregulated. And I treat my omega-3s the [70:48] same way I treat my olive oil. [70:51] You want to get oil that is sourced in [70:54] the area that you are. We're in [70:56] California right now, so you might want [70:57] to find an omega-3 that is sourced in [71:00] California. Do I want to put it in the [71:02] fridge? [71:02] >> You want to put it in the fridge the [71:03] moment that you get it. Really? [71:05] >> Yeah. Why does nobody talk about that? [71:06] I'm not sure, but um it's just the same [71:09] as olive oil. You don't want the olive [71:11] oil to become rancid, so you don't leave [71:13] it near the near the stove. You want to [71:15] put it in a cupboard away from the [71:17] stove. [71:18] And these are good for the brain? [71:20] Omega-3s, by far, uh [71:23] one of the most potent stimulus that you [71:24] could have for the brain. They help with [71:26] cell membrane fluidity. So, where your [71:29] cells meet, neuron to neuron, they [71:31] create something called a synapse. And [71:33] in order for that to occur, we have a [71:35] massive influx of all of these [71:37] neurotransmitters, [71:39] dopamine, serotonin. We've also got [71:41] calcium and potassium, and these help [71:45] our brain cells communicate, okay? [71:47] We want to make sure that our membranes, [71:50] the cell membranes, are fluid, and they [71:53] glide in order to help with that [71:54] synaptic transmission. [71:56] Another thing that they do is [71:59] they [72:00] are comparable to an NSAID, an [72:04] anti-inflammatory [72:06] medication. [72:07] These have massive anti-inflammatory [72:10] effects. In fact, I think that these [72:13] have the safety profile of an [72:16] FDA-approved drug, [72:19] and there's only benefits from it. [72:21] There's no side effects from it. Uh not [72:23] just that, 60% of our brain is made of [72:27] fat. [72:29] 70% of that is made of DHA. [72:34] And DHA comes from omega-3 fatty acids. [72:38] So, why do I not want to replace my [72:41] brain, [72:42] or the fat in my brain, with what it's [72:45] made of? And that's what you do when you [72:47] have omega-3 fatty acids. In fact, [72:49] there's been several trials um [72:51] to show that omega-3 fatty acids are [72:54] most beneficial and most effective for [72:58] mild cognitive impairment patients, [73:01] people who have the APOE4 gene, [73:05] and people who have got Alzheimer's [73:06] disease. Because when I told you that [73:10] our we get the breakdown of the [73:12] blood-brain barrier, those pericytes on [73:15] the blood-brain barrier require DHA. In [73:18] fact, there's a transporter [73:20] on the outside of our brain that allows [73:24] the um that allows the DHA to come in [73:27] and get into the brain. [73:29] And I know you're a big fan of uh [73:30] vitamin D as well, because there's been [73:32] some very encouraging studies done [73:33] there. [73:34] >> Oh, vitamin D is phenomenal. We have [73:36] vitamin D receptors all over our brain, [73:39] brainstem, and and they're abundantly [73:42] found in the hippocampus and the memory [73:44] centers of our brain. And there was this [73:48] There was actually a study done [73:50] on centenarians in China. Centenarians? [73:53] >> Yeah, those who live to 100, but it was [73:55] done in women. And they showed that the [73:58] women who preserved their cognitive [74:00] functions [74:02] and who didn't get Alzheimer's disease [74:04] had high levels of vitamin D. So, they [74:07] weren't vitamin D deficient. In fact, [74:09] being vitamin D deficient can increase [74:12] your risk of all-cause dementia by 40%. [74:16] Likely, being having a high level of [74:19] vitamin D, which is around 60 ng/dL, [74:23] can [74:24] lower your risk of getting Alzheimer's [74:26] disease by around 80%. [74:29] And then we have this white powder in [74:31] front of me. [74:34] You've got a big smile on your face. [74:36] I do, because [74:37] there is just so much benefit to this, [74:41] depending on which brand you've bought, [74:42] of course, but [74:44] I can't say enough about creatine. I [74:48] have my parents on creatine, they're 71 [74:51] years old. I've got my dad on high-dose [74:53] creatine. I've got my mother on low-dose [74:55] creatine. [74:56] It's the most widely studied supplement [74:58] on the market. I've never seen you this [75:00] excited. [75:01] >> I'm so excited because I think that this [75:03] is a really cheap and effective way [75:07] to get everything you want from both [75:09] your physiology, an upgrade on your [75:11] physiology, and your neurophysiology. [75:14] So, let's actually talk about creatine, [75:16] because [75:17] I know it gets a lot of airtime, but [75:19] women and men are still scared of it. [75:22] And they're scared of it for two [75:23] reasons. One, they're scared it's going [75:25] to cause kidney damage, and two, it's [75:28] they're scared their hair is going to [75:29] fall out. And I'm going to address both [75:32] of those fears. But first, let's talk [75:34] about what it is. So, creatine is a [75:37] naturally occurring molecule. We It's We [75:40] get We produce around 2 to 3 g of [75:42] creatine per day. Gets secreted from a [75:45] bit from the brain, but a lot from the [75:47] liver. [75:48] And [75:49] 2 to 3 g a day is great, but it's not [75:51] enough. So, we have to supplement with [75:53] it. And all through the '90s and all [75:55] through the 2000s, people were [75:57] supplementing with 5 g a day. That is [75:59] this scoop here. 5 g of creatine per [76:01] day. [76:02] Now that we're getting more uh rigorous [76:05] with our brain health studies, we have [76:07] found that creatine has enormous [76:10] benefits for the brain. But here's the [76:12] problem. [76:13] When you have 5 g of creatine, you're [76:16] saturating the muscles. Okay, remember, [76:19] the muscles are so hungry, so they get [76:21] first dibs, and they take up all of that [76:23] creatine. So, then there's none left for [76:25] the brain. [76:27] We also lose a bit of the [76:28] bioavailability when the creatine goes [76:30] into the brain. It crosses the [76:31] blood-brain barrier, but when it goes [76:33] into the brain, we lose some of it. So, [76:36] we have to supplement with more than 5 [76:39] g. [76:40] And one of the studies that changed my [76:42] thinking came out last year. It was the [76:44] first ever pilot study done on [76:47] Alzheimer's disease patients. You're [76:48] talking about patients whose brains are [76:51] under attack. They're in an energetic [76:54] crisis. They cannot produce energy [76:57] effectively. ATP is all skewed. Brain [77:00] glucose metabolism is skewed. They don't [77:02] remember left from right. Cognitive [77:04] functions are declined. They put them on [77:07] uh 20 g of creatine per day. Which is [77:10] how much a day? That Well, [77:12] actually, that is four of this. So, you [77:16] want to go one. [77:18] And I don't know if they did this all at [77:20] once, that's two, or if they did it like [77:23] me, [77:24] over four separate intervals throughout [77:26] the day. There we go. That's a lot of [77:27] creatine. [77:28] >> That's a lot, which is why you probably [77:29] want to have this skewed throughout the [77:32] day, which is what I did. I had 20 g [77:34] today. I had 5 g in the morning, five [77:37] mid-morning, and then I think I had 10 [77:39] all at once before I got here. [77:41] So, that is a lot for all at once. And [77:44] what they found was that these patients [77:47] not only preserved their cognitive [77:51] functions, but they had more energy, and [77:54] they were able to exercise more. [77:57] And it blew my mind that [78:01] it does not matter how old you are. [78:04] It doesn't discriminate based on gender. [78:06] Creatine doesn't discriminate based on [78:08] age. It doesn't discriminate based on [78:11] weight. It doesn't discriminate based on [78:14] pathology or disease states or [78:17] ethnicity. [78:19] It is just there. It is there to support [78:21] you. It's the most widely studied [78:22] supplement on the market. [78:23] >> What does it do? [78:24] >> all risk. What is it? [78:26] >> it's all reward. There is no risk. [78:28] It's helping with cell energy [78:30] metabolism, so basically, it's helping [78:33] ATP [78:34] create energy. [78:37] So, if you're someone that is low [78:38] energy, you should definitely be having [78:40] creatine. I don't care who you are, you [78:42] should definitely be having creatine. [78:43] >> People with brain fog and [78:44] >> Yeah, people with brain fog. You know, I [78:47] think one of the greatest benefits are [78:50] men who are [78:52] in football, football players. [78:54] You can actually It's actually a [78:56] protective molecule. So, what studies [79:00] has shown is that at high doses of [79:03] creatine, around 30 g a day, [79:05] it can protect you against insults. [79:09] Insults meaning you take a hit to the [79:11] head, like a concussion. [79:13] Hm. [79:14] >> [clears throat] [79:14] >> It can protect your brain against a [79:15] concussion. It can protect your brain [79:17] brain against a stroke. It can protect [79:19] your brain from stress. The best thing [79:21] about creatine is it works in the [79:23] background of stress. Hm. I think that's [79:25] where most That's where you'll get most [79:28] of the benefits from. [79:30] After hearing so much about creatine on [79:31] this podcast, I started recommending it [79:33] to all of the people in my life. There's [79:34] one particular person actually that's [79:35] probably out out out there in my house [79:37] at the moment who had gone through uh uh [79:41] cancer treatments. Yeah. [79:43] >> And had survived cancer treatments and [79:45] in their words wasn't the same on the [79:47] other side of the cancer treatments. And [79:49] I talked to her about um creatine and [79:52] she said to me the other day she I think [79:54] the exact quote was [79:56] "I feel like I've got my life back." [79:58] Because it's she's been taking creatine [80:00] every single day for the last I'd [80:02] [snorts] say 5 months or so. [80:04] It's funny you said that because just [80:06] recently in the last 2 weeks, [80:09] uh this study was done to show the [80:11] anti-cancer [80:13] effects of creatine. And if my memory [80:16] serves clear, they uh they dosed it at [80:21] they dosed it at 0.36 g [80:25] per kilogram of body weight. So, if you [80:27] are a 70-kilo person, if my mathematics [80:30] is correct, you're looking at around 25 [80:32] g of creatine per day that can have the [80:35] effects the anti-cancer effects. So, the [80:38] the study you're referring to I'll put [80:39] up on the screen as well for anyone that [80:40] wants to see it. It's um the Nantz 2025 [80:43] study which is a major study involving [80:44] over 25,000 adults found a linear [80:47] negative association between dietary [80:49] creatine and cancer prevalence. [80:51] For every standard deviation increase in [80:53] dietary creatine intake, the risk of [80:55] having cancer decreased by roughly 5% to [80:58] 18% depending on the demographic. [81:00] That is wild. [81:03] This protective association was [81:04] strongest in adults over the age of 50 [81:07] suggesting that as we age, maintaining [81:09] higher creatine levels might be more [81:11] critical for cellular health and immune [81:13] surveillance. [81:15] Hmm. Well, if you think about life and [81:17] think about energy, um we need energy to [81:21] survive. We need energy to fight off [81:24] infections. We need energy to fight off [81:27] stress, preserve our our normal normal [81:30] bodily functions. So, when we are at the [81:33] mercy of a low energy crisis, we can't [81:36] fight off [81:37] tumor cells. We we can't fight off these [81:41] uh debilitating diseases. So, it [81:42] actually makes sense that with more [81:44] energy and with more functional energy, [81:46] meaning that if our cells can function [81:48] better, it makes sense that you can see [81:50] a reduction in cancer incidence. Likely, [81:53] you can see a reduction in Alzheimer's [81:54] disease incidence. When I said that [81:57] creatine works in the background of [81:59] stress, [82:01] also there was uh there's been [82:03] phenomenal research to show that you can [82:08] basically creatine your way out of sleep [82:11] deprivation. So, if you've had a uh if [82:13] you've had a a long night and you've [82:15] you're sleep deprived, maybe you slept [82:17] 4, 5, 6 hours, you're sleep deprived, [82:20] you can take uh [82:21] you can take high-dose creatine in the [82:23] form of around 15 to 20 g a day and you [82:26] can reverse the negative effects [82:28] associated with that sleep deprivation. [82:31] Does it matter what time you take the [82:33] creatine? It doesn't matter what time [82:35] you take the creatine. It doesn't [82:37] degrade in hot water. [82:39] It uh you can take it anytime throughout [82:42] the day [82:43] and it doesn't matter whether you're [82:45] taking it right before exercise, during [82:47] exercise, after exercise, it works [82:49] phenomenally. Some people uh researchers [82:52] are now uh wondering if taking it at [82:54] night before bed helps with sleep [82:56] performance and I think that that's a [82:58] really exciting area. But the one thing [83:00] that I want to tell everybody because a [83:02] lot of people are scared of this [83:05] biomarker called creatinine. Meaning [83:08] that Oh, my doctor said that to me. [83:10] Yeah, so [clears throat] meaning that [83:11] you've got a a high creatinine level. [83:15] And this is a marker of it's one marker [83:18] of kidney function. But this is where I [83:21] find it uh really invaluable. And this [83:23] is where a lot of the nonsense comes [83:25] around on Instagram and social media. A [83:28] lot of people say, "Well, I had so much [83:30] creatine that my doctor told me to get [83:31] off it because my creatinine levels were [83:33] high." But creatinine levels are high [83:35] during times of stress, during times of [83:37] intense physical activity. Uh and also [83:40] people who have a lot of muscle mass [83:43] That's me. [83:44] >> higher muscle mass, that's you, have [83:46] higher creatinine levels. What you want [83:48] to test a greater marker of kidney [83:51] function and GFR [83:53] is cystatin C. So, all you have to ask, [83:56] it's really easy, ask your doctor, [83:59] "Could I please get cystatin C in my [84:02] blood work?" And if that is elevated and [84:06] without not within normal range, then [84:09] maybe get off creatine. But right now, I [84:12] cannot see [84:15] any reason as to not have creatine every [84:18] single day. I think [84:20] every single person, no matter what age [84:22] you are, everybody should be [84:23] supplementing with creatine. Now, there [84:26] was this uh recent study that came out [84:29] on menopausal women [84:31] and [snorts] it was a really small [84:33] study. It was a randomized control trial [84:36] and they [84:38] split women into four groups. And these [84:41] were perimenopausal women. They split [84:44] them into low-dose creatine where I [84:46] think they were having 750 mg a day, [84:50] medium dose which was around 1.5 g a [84:53] day. [84:55] Then they had them supplement with a [84:58] range of both creatine monohydrate and [85:01] creatine hydrochloride. This was a [85:03] hydrochloride creatine study. And then [85:06] there was a placebo group. What they [85:08] found, it's a very small study, very [85:10] small group, what they found was that [85:13] those in the medium [85:15] range having the 1.5 [85:17] had substantial increases in their mood [85:20] and their cognitive functions. So, [85:23] creatine is now being explored in [85:26] females across the lifespan as it [85:28] relates to perimenopause, pregnancy, [85:32] menopause, [85:33] and dementia. [85:34] So, there's just there it's it's it's [85:37] phenomenal. [85:39] The only thing I want to point out, what [85:40] you want to look for when it comes to [85:42] creatine are two things when it comes to [85:44] manufacturing standards. [85:46] You want to look A, has it been NSF [85:49] certified? [85:50] And B, [85:53] you want to look for is it Creapure? And [85:55] that's the gold standard of creatine and [85:58] it comes from Germany. And a lot So, the [86:01] one that you've got there, I can tell [86:03] it's not Creapure. Excuse me. I know my [86:05] creatine. Stay away. [86:06] >> what it is by looking at it? I can just [86:08] tell. I can I I I bet you a million [86:11] dollars that it is the brand that I [86:13] think it is because it's got this [86:15] powdered icing sugar substance. If it [86:19] was pure gold standard Creapure, it [86:22] would be gritty. [86:23] The reason why it's like this is because [86:26] a lot of manufacturers want to add these [86:29] different agents in there in order for [86:31] it to mix well. This probably mix mixes [86:34] really well. A lot of uh people also [86:36] complain of feeling uh GI distress when [86:40] they take it. And all I have to say is [86:42] that's not a reason to stop taking it. [86:45] Maybe take 2 g at a time. Maybe take 3 g [86:48] at a time. But don't stop taking it. [86:51] What do you test for with your own [86:53] health and how frequently do you test? I [86:55] test every 3 to 4 months. What do you [86:58] test? Oh, I do everything. Um [87:01] Oh, I've I I just did um lab work uh [87:04] December [87:05] 15th. [87:07] The day before my birthday. I do it, you [87:09] know, around that age. But every year, [87:10] funnily enough, I test my biological [87:12] age. What is your biological age? It [87:14] came back as 22. [87:16] [ __ ] hell. What's the most important [87:17] test they don't typically do that you [87:18] think everybody should be doing? [87:20] Lipoprotein little A raises your risk of [87:23] having a heart-related event or raises [87:26] your risk of getting cardiovascular [87:28] disease, but it's hereditary. And then [87:31] for for dementia? This is a really [87:33] exciting part. At least in the US, we [87:35] now have a predictable way of picking up [87:38] on mild cognitive impairment and picking [87:40] up on these Alzheimer's hallmarks. Tau [87:43] protein, P-tau 217 it's called on blood [87:46] work, and amyloid beta. So, we can now [87:49] pick up on this with 90% accuracy of a [87:53] PET scan. [87:54] What are those cards over there? [87:56] >> [laughter] [87:57] >> These are here to test your processing [88:00] speed. [88:01] Pink. [88:02] So, It says pink on it. Yeah. So, this [88:04] is actually a great measure of brain [88:06] function. Your brain processes visual [88:07] information 15 times faster than written [88:11] words. And so, this is going to test [88:12] your uh brain function, okay? [88:15] So, what I want you to do is you're [88:16] going to see the color. Yeah. I want you [88:18] to actually say the color of the card, [88:19] not the word. Okay. Let me just program [88:21] my brain. [88:23] Say the color, not the word. [88:25] >> Yeah. [88:25] >> Okay. Are you ready? [clears throat] [88:26] Green. [88:28] Orange. [88:29] Yellow. [88:31] Green. [88:32] Orange. [88:35] Green. [88:37] Orange. [88:38] Yellow. [88:40] Pink. [88:41] Orange. [88:42] Green. [88:43] Now, let's do the reverse. I want you to [88:45] say the words. Uh wait, let me [sighs] [88:46] just program [88:48] Okay. [88:49] Yellow. [88:50] Blue. [88:52] Green. [88:53] Black. [88:54] Purple. [88:55] Brown. Okay, so you're good. Thank you. [88:58] Let's do it to Jack. Jack, you come Sit [88:59] in the chair. [89:00] >> [laughter] [89:02] >> You caught him off guard. And he hasn't [89:03] got creatine. That's unfair. [89:06] He it's an unfair advantage. [89:09] >> [laughter] [89:10] >> Okay, are you ready? Wait, so what am I [89:12] doing? Just say the color of the card. [89:14] Okay, just the color of the card. Okay. [89:17] Green. [89:18] >> Uh orange. [89:20] Pink. [89:21] Yellow. [89:23] Yellow. [89:25] Yeah, orange. [89:27] Pink. Now, let's reverse. Reverse. I [89:29] want you to say what's on the card [89:31] itself. So, just read it. [89:32] >> Okay. Brown. [89:33] Purple. [89:34] Pink. [89:36] Green. [89:37] Black. [89:39] Yellow. Okay. So, now we're going to [89:41] test it even more. That was the starting [89:43] point. Not too bad. It's not too bad. [89:46] So, I want you This is actually involves [89:48] us standing up and using a tennis ball. [89:50] So, we're going to train your visual [89:52] cortex, which sits at the back here in [89:54] the occipital lobe. We're going to train [89:55] your um processing speed, your reaction [89:58] time, your hand-eye coordination. One of [89:59] the best exercises that you can do, [90:01] physical exercises, is actually hand-eye [90:03] coordination drills, tennis, racket [90:06] sports. But, I'm going to show you what [90:08] 5 minutes a day can do for your [90:10] cognitive reserve and your brain [90:12] performance just using a tennis ball and [90:15] an eye patch. Okay. [90:17] So. [90:19] >> [clears throat] [90:21] >> First things first, [90:23] I'm going to give you this tennis ball. [90:24] And for the whole time, I want you to [90:26] throw the ball [90:27] with an overhand grip. [90:29] >> Oh, like this? [90:30] >> Yep. [90:31] Okay. So, I want you to just throw it [90:32] with the right arm and catch with the [90:34] right arm. [90:35] Over? I mean, what's this one called? [90:37] >> That's underarm. I'm just checking the [90:38] wall. Okay. [90:40] Okay. So, like this? [90:41] >> So, you might want to move back where [90:42] the chair is. Okay, no, you're good. [90:45] Cut that. Cut that out. [90:50] Good. So, now throw with the right and [90:53] catch with the left and alternate. [90:55] Yep. Uh okay. [91:02] You've got it. So, what we're doing, [91:03] we're engaging almost all the executive [91:06] functions. Now, you've got hand You [91:08] should be able to do this for a minute. [91:10] Okay? Now, we're going to make it even [91:12] harder. It's like placing weights. [91:14] Well, I'm not going to do the one with [91:15] the eye patch. I'll do the next one. [91:17] Okay. So, basically, what you want to do [91:21] And if you do it with a black ball, it's [91:23] actually Oh, even better. [91:26] So, now we're going to make it a bit [91:28] hard and a bit neurally demanding. We're [91:30] going to put an eye patch on you, which [91:31] is really going to block out like 50% of [91:34] the vision. [91:35] Okay. [91:36] Which eye? Any eye. [91:38] Let's do the left one. [91:39] Oh, let's see how many you can do. You I [91:41] think you we counted around eight [91:43] before. I'm a pirate. I'll just get you [91:44] to look there. [91:46] What? [91:47] Wait, [laughter] this is not flattering. [91:49] It feels like [91:51] Okay. Cool. [91:52] >> Let's go. Oh, that's so different. [91:53] >> Yep. [91:54] Wow. [91:55] This feels significantly harder. I know. [91:57] Let's go. This feels No, this feels like [91:59] really hard. Let me just double check. [92:00] [ __ ] hell. [92:02] Uh [92:03] That's That's really That's so hard. [92:07] This is [92:08] There you go. You've got it. [92:10] >> I'm joking. [92:13] Okay, let's alternate now. [92:16] Left hand, right hand, like this? Yep. [92:21] You're training your visual system to [92:23] work under load and under stress. So, [92:26] when you do this, [92:28] I'm interrupting you. No, it's okay. [92:32] You've got it. You've got it. You've got [92:33] it. [92:34] Good. Good. Good. And then to even make [92:35] it even harder, okay? [92:37] >> [clears throat] [92:38] >> Stand on your right foot. Yeah. [92:40] >> Put your other foot there. There you go. [92:41] What? On one leg? [92:42] >> Yep. Standing on one leg is now engaging [92:45] the cerebellum. [92:47] Okay. We're getting spatial awareness. [92:49] Let's go. Posture. [92:51] Yep. [92:53] Oh my gosh. [92:59] You've got it. [93:00] I want to see you do it. [93:02] With the eye patch on? Yeah. Wow. [93:07] I mean, [93:09] I can bet Great, my eyelashes have gone [93:11] now. It's okay. We can AI that out. This [93:13] actually looks great. Mhm. Okay, [93:15] [clears throat] we're ready? [93:19] Well, I blame my nails. [93:21] I blame my nails. Let's do it. [93:25] Okay. [93:27] It's hard. It's so hard. [93:29] >> And so, what is this doing? It's This is [93:31] engaging [93:32] executive functions, processing speed, [93:34] hand-eye coordination. And you did this [93:37] with NBA players? [93:38] >> I did this with NBA players to improve [93:41] uh their executive functions, decrease [93:43] their reaction time. [93:45] And this will This will change my brain [93:47] if I do this frequently. [93:48] >> Not just that, but you're also improving [93:50] cognitive reserve. You're building new [93:52] connections between the brain cells. [93:54] You're strengthening neural networks. [93:56] And you're doing something incredible. [94:00] You know, every once in a while, you [94:01] come across a product that has such a [94:04] huge impact on your life that you'd [94:05] probably describe it as a game changer. [94:09] And I would say [94:10] for about 35 to 40% of my team, they [94:14] would currently describe this product [94:16] that I have in front of me, called [94:17] Ketone-IQ, which you can get at [94:19] ketone.com, [94:21] as a game changer. But, the reason I [94:23] became a co-owner of this company and [94:24] the reason why they they now are a [94:25] sponsor of this podcast is because one [94:28] day when I came to work, there was a box [94:29] of this stuff sat on my desk. I had no [94:31] idea what it was. Lily in my team says [94:33] that this company have been in touch. [94:34] So, I went upstairs, tried it, and quite [94:37] frankly, the rest is history. In terms [94:38] of my focus, my energy levels, how I [94:41] feel, how I work, how productive I am, [94:44] game changer. So, if you want to give it [94:45] a try, visit ketone.com/steven [94:48] for 30% off. You'll also get a free gift [94:50] with your second shipment. And now, you [94:52] can find Ketone-IQ at Target stores [94:54] across the United States, where your [94:56] first shot is completely free of charge. [95:00] If there's anything we need, it is [95:02] connection, especially in the world [95:04] we're living in today. And that is [95:05] exactly why we created these [95:07] conversation cards, because on this [95:09] show, when I sit here with my guest and [95:10] have those deep, intimate conversations, [95:13] this remarkable thing happens time and [95:15] time again. We feel deeply connected to [95:18] each other. At the end of every episode, [95:20] the guest I'm interviewing leaves a [95:21] question for the next guest. And we've [95:23] turned them into these conversation [95:25] cards. And we've added these twist cards [95:27] to make your conversations even more [95:28] interesting. And there are so many more [95:31] twists along the way with the [95:32] conversation cards. This is the brand [95:33] new edition. And for the first time [95:35] ever, I've added to the pack this gold [95:37] card, which is an exclusive question [95:39] from me. But, I'm only putting the gold [95:42] cards in the first run of conversation [95:45] cards. So, get yours now before the [95:46] limited edition gold cards are all gone. [95:49] Head to the link in the description [95:50] below. [95:52] So, [95:53] doing hard things [95:56] is what is going to improve brain [95:58] function over the lifespan. [96:00] Doing hard things tells your brain that [96:04] you can do hard things. Meaning, have [96:06] you ever heard of this um [96:09] brain area, a little area in the brain [96:11] called the anterior midcingulate [96:13] >> cingulate cortex. Yes, I have. What do [96:16] you know about it? [96:17] I'll let you say it. Well, it's shown [96:19] that it's larger in what we call super [96:22] agers and people who age really well and [96:25] who can uh withhold a lot of uh [96:28] cognitive capacity. And it's really [96:31] profound in people who can diet well. It [96:34] gets bigger when we do hard things. So, [96:37] when we do really hard things, this area [96:39] in the brain gets bigger. And basically, [96:42] what that is, it's reserve for when life [96:46] gets hard. It means It basically tells [96:48] your brain that no matter what happens, [96:51] no matter what event comes my way, I [96:54] have the ability to go in, welcome it, [96:57] and push through it, no matter how hard [96:59] it's going to be. [97:01] When you give up or when you don't do [97:04] hard things, [97:05] this little area doesn't grow. It [97:08] doesn't get bigger. [97:09] So, doing these neural activating uh [97:13] drills that we just did, going to the [97:15] gym and pushing well above your [97:18] threshold and pushing really hard is [97:20] going to help uh grow this little area [97:22] of the brain. And they call this the [97:24] willpower muscle. [97:26] >> This is why I think that um when people [97:29] go out to set their goals during the [97:31] year and they say, "I'm going to lose 20 [97:33] lb. I'm going to do this. I'm just going [97:35] to increase my willpower." I think [97:38] it's not willpower, it's neurobiology. [97:41] I think it's really important to just [97:43] spend a little bit of moment talking [97:44] about this part of the brain, cuz when I [97:46] discovered it, I found it absolutely [97:47] fascinating. And I think it was Andrew [97:49] Huberman who said either to me or he [97:52] said publicly that he thinks it's one of [97:54] the most fascinating or important [97:55] discoveries of the last century. Of [97:58] course. Well, you think about how we're [98:00] living our lives. We're we're punishing [98:02] ourselves for not being able to read a [98:06] book, for not being able to pay [98:07] attention. How many you know, people are [98:09] now diagnosing self-diagnosing [98:11] themselves with ADHD, low attention [98:13] spans. And they're blaming it on [98:16] environment. They're blaming it on [98:17] circumstances when they should be [98:19] blaming it on neurobiology and they [98:21] should be blaming it on their brain [98:23] state. This area of the brain, [98:26] if you can push in This is why these [98:28] super agers seem to have [98:30] >> What's a super ager? A super ager is [98:33] somebody who is aging well. So, they're [98:35] going through life uh low uh [98:38] cardiovascular disease state. They have [98:40] maintained their cognitive functions. [98:41] They're at the age of 80, 90 with [98:45] a VO2 max profile of maybe a 50 or [98:48] 60-year-old. So, they're aging quite [98:50] well [98:51] biologically. [98:53] So, [98:54] these, you know, super agers have many, [98:56] many different facets to them. And one [98:58] of them is a larger [99:00] midcingulate cortex. [99:03] Conversely, the AMCC, anterior [99:06] midcingulate cortex, shrinks in people [99:08] who live sedentary lives or avoid [99:11] challenges. It literally atrophies if [99:14] you play it safe in life too often. [99:16] Growth only occurs during resistance. If [99:19] you love taking ice baths and you take [99:20] one, your AMCC doesn't change. If you [99:23] hate the cold, but force yourself to do [99:26] it anyway, Yeah. the AMCC grows. [99:28] Scientists now view the AMCC as the seat [99:31] of the will to live. Its size and [99:33] activity level are strong predictors of [99:35] how long an individual will survive [99:37] after a major setback in their life, [99:39] whether it's a health setback or a [99:40] surgery. [99:43] There's something really philosophical [99:45] about that, as well. You know, if you I [99:47] don't know if you read um stoicism or [99:50] anything, but it it it really dates back [99:53] to how the stoics lived their life, [99:56] especially Marcus Aurelius, with being [99:58] able to push through hard times. Little [100:01] did they know that it was this little [100:03] area in the brain. [100:05] Yeah, I think [snorts] I was telling the [100:06] story the other day of Roosevelt [100:08] and what happened in his life as a young [100:09] man when he came home one day on [100:11] Valentine's Day and found that his [100:12] mother and his wife of who had just had [100:15] his newborn baby had both died, one [100:17] upstairs, one downstairs. And he went [100:19] off to the Badlands for two year I think [100:20] it was two to four years. The Badlands [100:22] in America were just this like horrific [100:24] um [100:25] natural place where he'd get up at 4:00 [100:27] a.m., ride these like horses in the [100:29] freezing cold where like the horses [100:31] would literally die standing still [100:32] because it was so horrific. He did that [100:34] to two years to like deal with the [100:35] grief. But when he came back to New York [100:37] City after these two years in the [100:38] Badlands, all of his friends said he was [100:40] just a completely different man. And [100:42] they had like what they now know [100:44] from a neuroscience perspective is that [100:46] he didn't just build his muscles, he [100:47] literally like rewired his his brain. He [100:49] went on to become the youngest US [100:51] president of all time. He got shot um [100:53] during a speech and carried on doing the [100:54] speech. He led the charge in various [100:57] wars. He's just this unbelievable but I [100:58] think he won the Nobel Prize. [101:00] And they point at those two years in the [101:01] Badlands and say actually that that [101:03] forged not just the man, but his his [101:05] brain, his AMCC. [101:07] The studies also show that athletes [101:08] consider consistently show much larger [101:11] AMCC volume. And studies show that [101:14] individuals struggling with obesity [101:15] often have smaller AMCCs. But it begins [101:18] but it but it begins to grow the moment [101:21] they start a successful challenging [101:22] dietary or exercise intervention. That [101:25] it's that word challenging because when [101:27] you place stimulus upon a system, [101:31] it adapts and grows. And that is [101:34] neurobiology [101:36] at its most infinite source. [101:39] And this is why we get the breakdown of [101:42] these synapses. This is why we get into [101:45] a place of going from 5,000 to 10,000 [101:49] connections to 2,000 or no connections. [101:51] These dendritic spines end up breaking [101:54] down because we don't do the hard thing. [101:57] And also think [101:58] being deep rooted in neurobiology, you [102:00] can see that everything is cause and [102:02] effect and it's a cycle. Uh if you don't [102:05] do the hard thing, you don't grow the [102:08] AMCC. You don't grow the AMCC, you don't [102:10] do the hard thing again. And it's just [102:13] this loop and it's this cycle, which is [102:15] why so many resolutions, New Year's [102:17] resolutions, end by February 1st. It's [102:21] why we have the obesity epidemic. It's [102:25] largely why I think we've got a a crisis [102:28] of people not being able to [102:30] uh meet their goals. [102:33] I'm just fascinated from an evolutionary [102:34] perspective as to why we needed one and [102:36] like why it wasn't just always big. [102:38] In the pursuit uh you know, [102:40] evolutionarily uh in the pursuit of [102:42] hunting [102:44] and going out and and hunting for food [102:46] sources and being motivated to do that [102:48] in a near starvation state when times [102:52] were tough. [102:53] And so when times got easier, we didn't [102:55] need it as much, so we could conserve [102:59] I guess our energy, so we could like [103:00] scale down our willpower when times were [103:02] good. Well, it's interesting that you [103:04] say that because this brings up the [103:05] whole brain rot and AI era. Just like [103:08] with you know, in [103:10] uh 2024, Oxford Dictionary I think named [103:12] brain rot the word of the year. [103:15] And [103:16] it's interesting because it plays into [103:19] evolution and what's happening with this [103:21] AMCC, meaning like we're just there [103:23] scrolling at mindless information every [103:27] day, training our brain to get these [103:29] small dopamine hits, these small rewards [103:32] from doing absolutely nothing. [103:35] What do you think of these uh chatbots [103:38] that everybody's using at the moment to [103:40] write for them and think for them, etc.? [103:41] Oh my god, I think it's [103:43] uh [103:44] on the spectrum of being so incredible, [103:47] but being so detrimentally harmful. I [103:51] know this with myself. So, I was a [103:53] mathematician. I did my master's of [103:55] mathematics and I was able, Steven, to [103:58] the trigonometry and pure calculus that [104:01] I could do back then with just my head [104:03] and a pen was fascinating. Now, I'm [104:06] going to I'm going out and I'm [104:08] calculating on ChatGPT the bill, the [104:12] the 20% tip on top of this bill. How [104:14] much does it cost? And I think, how dumb [104:16] am I actually getting? So, I think it's [104:19] both good and bad. I think the rate of [104:22] decline we're seeing in people reading [104:24] books and exercising their brain is [104:26] declining um and our ability to [104:30] think [104:32] and and use our our cognition is [104:35] declining. [104:38] Louisa, I've I've waited [104:40] a long time to ask you one particular [104:41] question. [104:43] Which is I think is very important. [104:46] Which is you're clearly very passionate [104:47] about this stuff. [104:49] One might say you're pretty obsessed [104:51] with it. [104:52] You come across as pretty obsessed. [104:54] Do I? You do, yeah. [104:56] Why? [104:57] We are living in a society [105:01] that doesn't allow women to ask for what [105:05] they want. We're living in a society [105:07] that doesn't allow women to ask for what [105:10] they need. [105:12] And when this happens, it results in 70% [105:16] of all Alzheimer's disease cases being [105:17] women. It results in 80% of all [105:21] autoimmune diseases being female. [105:24] And [105:26] these are largely preventable diseases. [105:28] And when I ask why and I hear that women [105:31] are wildly misrepresented in academic [105:34] literature. When I when I see women who [105:38] downplay their symptoms or they're too [105:40] scared to ask their doctor for advice or [105:42] they're too scared to ask somebody else [105:45] for advice because of what they're going [105:46] through or they're ashamed of some of [105:48] their symptoms, I get angry and I get [105:51] passionate. And it reminds me of my [105:54] grandmother who uh she was my best [105:57] friend. Her name was Louisa. [105:59] And You're named after her? I was named [106:01] after her, yes. And we spent every day [106:04] together. And and I'm getting emotional [106:06] now because I remember her. And she [106:09] sadly died of pancreatic cancer. It was [106:11] ovarian cancer that went to pancreatic [106:13] cancer. [106:14] And [106:16] she never asked for what she wanted and [106:18] she [106:19] never asked for what she needed, which [106:21] was help. She didn't understand her [106:23] symptoms. She didn't go to the doctor [106:27] when she needed to [106:28] because she was just [106:30] more [106:32] inclined to look after the family and [106:35] look after the household. [106:38] And when the time came that she was [106:40] given her diagnosis, I was sitting there [106:42] with her. It was um [106:44] it was at home and the doctor came, she [106:46] did a house call. And my grandmother [106:48] looked at her. She hardly spoke that [106:50] much English and she said, [106:53] "Please, is there something I can do? I [106:55] don't want to die." [106:56] And the doctor said there is [106:58] "I'm sorry, there's nothing you can do." [107:00] And I spent every day with her in the [107:02] hospital. [107:03] And I think about that. It's been [107:06] almost 20 years now, but I think about [107:07] that moment and I kick myself thinking, [107:11] "Why didn't we [107:13] why didn't we get her a scan?" She told [107:15] us several times that her stomach was [107:18] hurting. She told us several times that [107:20] she felt pain. [107:22] She never she hid her symptoms. She [107:24] hardly ever ate at one point and we [107:26] never stopped to think about why and she [107:29] never stopped to think about why. So, I [107:31] think about her every day. [107:33] And then I think about my mother, too. [107:36] And [107:37] these women, you know, first generation, [107:40] they came uh [107:42] we migrated to Australia from a country [107:43] called Cyprus. And they've just been so [107:49] they put themselves second and they they [107:52] just look after the family and I can't [107:55] stand that. And when I see women coming [107:57] in as patients [107:59] or caregivers, I think to myself, "Do [108:02] you not know [108:03] that there is something for you to do?" [108:05] And most women don't. [108:07] And I I can't believe the amount of [108:09] money that we are spending that is going [108:12] towards [108:14] putting us on rockets to go to Mars, but [108:16] we haven't yet found a cure for this [108:20] disease that is largely preventable. [108:23] It's just not okay with me. [108:25] And I would hate to see women go through [108:28] this. [108:29] The emotion is still very present in [108:31] your face. [108:32] Even though it was so long ago. [108:33] >> It was so long ago. I mean, I I was very [108:36] close to her. I'm very close with my [108:37] mother. I I check in with her [108:40] twice, three times a day. And I just [108:42] don't think it's fair. I think women [108:44] deserve the truth. [108:46] They've been lied to. They've been [108:48] underrepresented. And [108:52] we need to change that. With Louisa, [108:54] your grandmother, [108:55] what what [108:56] are those range of emotions that have [108:59] turned into this incredible fire you [109:01] have? Anger. [109:03] Anger is one of the emotions. [109:06] Anger at [109:07] society that places women to be [109:11] everything. [109:13] To be a a mother, a caregiver, to go to [109:17] work, to [109:19] represent the family. Women represent [109:23] 51% of the total population. [109:26] And then it becomes, I feel, political, [109:29] if that's an emotion. Because you think [109:32] about health care, [109:33] you think health care should be [109:34] accessible to everybody, but it seems as [109:37] though, especially in this country, that [109:39] health care is only really accessible [109:42] by those with a high socioeconomic [109:43] status, and that I'm not okay with. So, [109:47] it does become political, even though [109:49] health care [109:50] I guess health care is political because [109:52] policies have been set, but [109:54] a woman in need is apolitical. [109:58] And my grandmother was apolitical. [110:01] And [110:02] her needs [110:04] just [110:05] were not met. [110:07] Anger? [110:09] Frustration at the system. Frustration [110:12] at the fact that we still have only 4% [110:15] of women taking hormone replacement [110:18] therapy in fear that they're going to [110:20] get this disease, uh that they're going [110:22] to get breast cancer. [110:24] Utterly frustrated at the cycles of [110:27] administration who vouched to help you. [110:31] You look to your, you know, your [110:33] government and your administration [110:36] to look up to to guide you when you have [110:40] Secretary Kennedy in 2014 go on national [110:44] television and say, [110:46] "Vaccines are totally safe. I had all my [110:48] kids vaccinated. They've eradicated some [110:51] of the most deadliest diseases [110:53] that have plagued this world. Vaccines [110:55] are so safe." To fast forward to 2025 [110:59] saying, "Vaccines are so unsafe. Do not [111:02] trust your medical doctor. You need to [111:04] take your health into your own hands." [111:07] You start to lose trust. [111:11] And it's not that we're uninformed. [111:13] It's the fact that we are confused [111:16] because we hear, "Vaccines are bad. Oh, [111:19] vaccines are good. Vaccines are are [111:22] really good. Take them. Don't get your [111:24] kid vaccinated." You've got women here [111:27] who don't even know they're they they [111:30] don't even know how to get on the [111:32] internet or order a blood test and [111:34] you're expecting them to take their [111:36] health into their own hands. So, it [111:38] upsets me that you see women who are so [111:40] vulnerable [111:41] being sold [111:43] a vaccine lie, which could potentially [111:46] save them from a disease, which could [111:49] potentially save them or their child [111:52] from getting [111:54] the flu, hepatitis B. [111:58] Meningitis, which was just eradicated [112:00] from the vaccine schedule. Um I'm not [112:03] This is not meant to be political. I am [112:06] I am a scientist. I am not This is not [112:08] propaganda. This is not ideology. This [112:11] is just [112:12] women who deserve to be treated better. [112:17] You're 36. [112:21] Louisa passed away when you were how [112:23] old? Oh, I was [112:25] probably 18 at the time. You were 18 [112:28] when Around that, 18, 19. When she got [112:30] the diagnosis? Yeah. It was very fast. [112:33] It was within a 2-month time frame, not [112:36] even. And had she not got that [112:38] diagnosis, and had you not sat there and [112:40] watched her ask that doctor if there's [112:41] something that she could do, [112:45] do you think your career would have [112:46] taken this course? [112:48] I became utterly obsessed with disease [112:50] management, but [112:53] when I first saw a human brain, I was [112:55] 21. I was in a lab, and we had to go [112:59] into a cadaver lab, and I saw a brain [113:01] being harvested from a body that was [113:04] donated, and I stayed back that day, I [113:06] remember, [113:07] and I helped in the pathology lab, and [113:11] when I saw that brain, I knew that I [113:13] wanted to dedicate my life to it. [113:15] So, ever since then, I've been in OAZ, [113:17] and it's where I feel most alive. Why? [113:20] Why did you want to dedicate your life [113:22] to it? Uh because when you know what the [113:24] brain is, that it is responsible for the [113:26] life that we have, and you can use it [113:28] for your advantage to overcome any [113:31] obstacle that comes your way, you become [113:33] obsessed with understanding it. [113:35] Metacognition is [113:38] thinking about your thoughts. And every [113:41] day, if you can think about why you [113:42] think about the things you think about, [113:46] you can challenge yourself to overcome [113:50] any adversity. [113:51] Is there a cost to your obsession and [113:53] your passion? Yes. What's the cost? I [113:55] moved away from my family to be [113:57] surrounded by the greatest neurosurgeons [113:59] in the world, which I am, and I'm very [114:02] thankful for that. I moved away from a [114:03] population of 22 million to come to the [114:06] hottest city in the world. New York? New [114:09] York City. Are you still paying a cost? [114:11] I'm still paying a cost. My health pays [114:13] a cost. [114:15] I've missed family events, traveling for [114:18] my career. [114:21] But I wouldn't have it any other way. [114:24] Because the people that I've met have [114:26] forged the way for me to live the life [114:28] that I want. I'm surrounded by [114:30] incredible thought leaders in health and [114:32] medicine, and [114:36] So, what is success to you then? [114:38] At the deepest possible level, what is [114:40] success? You We meet again in 10 years' [114:41] time, you say, [114:43] "My life has been a success." Or I feel [114:45] successful. I'm a Louisa says, "I am a [114:48] successful woman." What does that mean? [114:50] What happened? [114:51] Being able to control my brain states. [114:56] Being able to control your brain states? [114:58] I think that the ultimate form of [115:02] success and high performance, or being [115:05] able to perform at your peak, [115:07] is being able to go from brain state to [115:10] brain state and then be able to recover. [115:13] What do you mean by brain state? Meaning [115:15] like being able to get switched on when [115:18] you need to be switched on and invite [115:20] the neurotransmitters involved in that, [115:22] norepinephrine, adrenaline, dopamine, [115:25] but not having that in constant [115:27] overdrive, and being able to know when [115:29] to switch off. And I think that that is [115:30] what high performance is. The book that [115:33] changed my mind on that was Flow by [115:35] Mihaly Csikszentmihalyi, which actually [115:37] speaks about the flow state. So, being [115:38] able to [115:40] know how to uh separate yourself in [115:44] these states. [115:45] Any goals outside of your professional? [115:48] >> [laughter] [115:49] >> Kids, family, life. [115:51] >> family? Yeah. [115:53] Definitely. [115:55] It's tough, isn't it? [115:57] It's tough. I was saying earlier to my [115:58] friend that you know, I kind of just [116:00] thought [116:01] the minute I wanted to have kids, they [116:02] would just appear, but it's not so [116:03] straight [116:03] >> That's what I thought till until I [116:05] realized, "Oh, but I'm the woman." [116:07] >> [laughter] [116:08] >> Mhm. [116:09] I actually have to bear the the children [116:12] as well. [116:13] Which is a big sacrifice. And an honor [116:15] >> It's an honor and a privilege and a [116:17] sacrifice that I think everybody Yeah, I [116:20] I mean, I think I I definitely want. [116:23] Are you hopeful [116:25] for all of your professional endeavors? [116:27] Yes. You are hopeful? [116:29] I'm in control. [116:33] You think we're going to move in a good [116:34] direction [116:35] as a society as it relates to [116:38] Mhm. Alzheimer's and [116:40] >> [sighs] [116:41] >> Yes, I I'm hopeful for that. I'm hopeful [116:45] for the message that I'm getting across. [116:47] I think uh [116:48] social media is providing the platform [116:50] for free education and for people to [116:52] understand that they have agency over [116:55] their brains. [116:57] Uh I'm not hopeful for um anybody saving [117:01] us or coming in and giving us a easy way [117:04] forward. Do you ever have days where you [117:06] wished you were less obsessed with your [117:08] craft? [laughter] [117:10] Has there ever been a day where you're [117:10] like, "You know, I wish I was just a [117:11] little bit less captivated by this."? [117:16] I'd be probably back home in Australia [117:19] living an average person's life. I'm not [117:22] saying that that's it. I'm just saying, [117:23] you know, maybe I would [117:25] have done it done my life differently. I [117:27] have days like that where I think [117:29] if [117:30] obviously cuz [117:31] the obsessed brain is the one making [117:33] this decision, so it's quite difficult [117:34] to detach, but like if you put a knob in [117:37] front of me and I could just turn it [117:38] down just a little bit, would I? [117:41] Now, my obsessed brain is is the one [117:43] making this decision, so my obsessed [117:44] brain is now like, "Fuck it, turn it [117:45] up." But I think I do wonder sometimes. [117:48] I am the way that I am, right? Um but I [117:50] do wonder sometimes if I would be [117:54] happier overall [117:56] if I could just turn it down a little [117:57] bit. But isn't the whole [118:01] point of life to know thyself and in [118:03] pursuit of something bigger and better? [118:05] Yeah, it is, but I just sometimes worry [118:07] about what I'm sacrificing and whether [118:09] at some point, I don't know, when I'm on [118:11] my deathbed at 80 years old, I'm going [118:12] to look back and say, "Actually, [118:15] I made a bad trade." [118:17] Well, exactly. And but we're never going [118:19] to know that. I I think about that [118:20] often. I know. [118:21] I you think about that often, and you [118:23] think, "Well, if the world came to a a [118:25] collapse tomorrow, what would you regret [118:27] today not having done?" [118:31] I think it would be like making more [118:32] memories with people I love. I think [118:33] that's one of the big ones. I think Did [118:35] you hear what you just said? Making more [118:37] memories. [118:38] And imagine losing those. Imagine a life [118:41] full of Unthinkable. you [snorts] know, [118:44] creating these experiences and these [118:46] memories to have them being taken away [118:49] from you. [118:50] Yeah. [118:51] To not being able to recognize your [118:53] wife, your kids, and looking in the [118:56] mirror and not being able to recognize [118:58] yourself. [118:59] That's why Alzheimer's is just such a [119:01] disgusting sinister [119:04] like horrific thing cuz [119:07] Yeah, it's just [119:08] It's the most heartbreaking thing to [119:11] to lose someone while they're still [119:12] alive. Yeah, and to lose yourself. We've [119:15] got this one woman who looks in the [119:17] mirror and she says, "Who's that?" [119:20] Really? [119:21] >> Yeah, and you know, it's it's sad [119:22] because 2 years ago she knew who I was [119:24] and now she asks, "Are you my daughter?" [119:27] And when you're confronted with that [119:30] every single day, it gets you thinking. [119:32] You don't live a normal life. You don't [119:34] live an average life because you do [119:36] think about every facet of medicine. You [119:39] think about history. You think about [119:41] diseases and then you think about life [119:43] and the people that you spend the most [119:44] time with. [119:47] We have a closing tradition where their [119:48] last guest leaves the question for the [119:50] next not knowing who they're leaving it [119:51] for. [119:52] And the question left for you is what is [119:54] God to you? [119:56] God is [119:58] that power that you feel and have faith [120:02] in that you cannot see. [120:05] The power that um [120:09] basically makes you feel like there is [120:12] somebody there that has you and that is [120:14] guiding you. [120:17] That [120:20] always has a a path for you knowing You [120:23] you believe in God? Yes, I'm I'm I'm a [120:25] I'm I'm Christian. I'm Greek Orthodox. [120:27] When you see the brain deteriorating in [120:30] such a way [120:31] and you think about this concept of [120:33] prayer like asking God to help me with [120:34] something, [120:36] doesn't it feel pretty [120:38] I mean, it's the definition of like [120:39] hopelessness is watching your brain [120:41] deteriorate and I think some part of my [120:43] struggles with religion since I was an [120:46] 18-year-old and came from a very [120:47] religious family was [120:49] seeing injustice in the world and [120:50] there's [120:51] doesn't seem to be much greater [120:52] injustice than watching someone's brain [120:53] just deteriorate in front of [120:55] their family. [120:56] Yeah, or somebody going through losing [120:59] their child and you start to think about [121:01] God. [121:02] People pray for I can't find my keys or [121:05] want my football team to win and I go [121:06] there's no point. If people praying for [121:08] an Alzheimer's cure having no luck, then [121:11] maybe I should stop praying for [121:12] Manchester United to win. Yeah. [121:14] If [121:16] you understood the intricacies of how we [121:19] were actually brought into this world [121:22] from the point of conception [121:25] from the point of a conception to the [121:28] point of neural development how a baby [121:30] is formed and how precise everything has [121:34] to be for you to come out the way you [121:37] did. [121:39] It is so beautiful and so miraculous and [121:42] so rare even though there are billions [121:45] of people in this world [121:47] that [121:48] you can not just turn to biology [121:51] anymore. You have to turn to something [121:54] bigger. And I used to, trust me, even as [121:56] a as a as a Christian [121:59] who's read the Bible, [122:01] I [122:02] even in my early 20s when I was getting [122:04] into medicine and science, I I was so [122:06] gung-ho about [122:09] we we're born in a body, we die in a [122:11] body, but then when you get so deep into [122:15] the literature of science and medicine [122:17] and biology, [122:19] it's hard to ignore [122:21] God and it's hard to ignore that there [122:23] is a higher power out there. And why is [122:26] it that there are chapels in hospitals? [122:32] Cuz people want to go to heaven? [122:34] Because people want [122:36] an ulterior an alternative method of [122:40] getting through whatever it is that they [122:42] can get through. Something that science [122:44] and medicine cannot offer. [122:47] And believing in something that is not [122:49] there or something that hasn't occurred [122:51] yet is having faith. [122:56] I work in neurosurgery and some of the [122:58] cases you think this person's not coming [123:00] out of here alive. And the fact that [123:02] they do and they preserve their [123:04] cognitive functions and they look next [123:06] to normal after they've had a massive [123:08] tumor resected, which is a true story [123:11] from here. The tumor was going all along [123:13] this one woman's face who was 78 years [123:16] old who traveled here from France to [123:18] have the tumor resected. [123:21] How is it that she's walking and she's [123:22] cognitively normal and she's not even on [123:24] any medication the next day? How is that [123:26] possible? Is it God? Is it just [123:29] miraculous and neurosurgeons? There's [123:31] just some things that medicine can't [123:33] answer. [123:35] I agree with that. [123:36] I am [123:37] >> [clears throat] [123:38] >> I don't think I'm arrogant enough to say [123:39] that I know. [123:41] And I'm curious [123:44] and I think I'll never know. Yeah. So, I [123:46] guess that's where we need to have [123:47] faith. Yeah. [123:48] Louisa, thank you so much. Um it's very [123:50] important that you do the work that you [123:51] do because uh it's people like yourself [123:53] that are so passionate, so obsessed, and [123:55] so good at communicating [123:56] that um [123:58] help average people who aren't who don't [123:59] have access to the wisdom and the [124:00] research and the studies and information [124:02] that you have understand all of these [124:04] things. And it's through this [124:05] understanding that we can make better [124:06] choices and preserve our life, preserve [124:07] our brains. And if we preserve our [124:09] brains, we preserve everything that [124:10] matters. Correct. Thank you. [124:12] >> So, thank you for doing what you do and [124:13] I appreciate your passion and dedication [124:14] to it cuz it's very very important. And [124:16] I know it comes at a cost. So, I feel [124:18] obliged to tell you that as a normal [124:20] person who isn't involved in your field, [124:21] we're grateful. Thank you so much, [124:23] Steven. Thank you. [124:24] YouTube have this new crazy algorithm [124:26] where they know exactly what video you [124:28] would like to watch next based on AI and [124:31] all of your viewing behavior. And the [124:32] algorithm says that this video is the [124:35] perfect video for you. It's different [124:37] for everybody looking right now. Check [124:39] this video out. I bet you you might love [124:41] it.