Neuroscientists REVEAL The 6 Steps To OPTIMIZE BRAIN HEALTH Today! | Rangan Chatterjee

the stress hormones not only damage cells in the hippocampus they damage your microbiota in the gut in a very important sense you've reversed the functional aging of the brain they're also really incredibly important for brain function they literally supercharge your brain [Music] one of the many myths that i try to bust in the changing mind is that you can't grow new neurons after a certain age or you can't make new neural connections neuroplasticity the buzzword for making new neural connections new synapses that goes on your entire life and the more you can learn especially new things the more neuro-protective it is because you're building up neural and cognitive reserves so that could be anything though right you just learning anything whether it's music or sport or absolutely you know but it's a new language so this sounds like one of the key things we need to be thinking about as we get older is what keep trying new things yeah and in particular there's this new appreciation for what we call embodied cognition uh barbara traversky and scott grafton both have new books out about this the scots is called physical intelligence fantastic books the idea is that your body actually helps your mind grow through the experiences you have manipulating your body so learning a new language is neuroprotective but learning something that involves eye hand coordination um musical instruments being one not so much singing but playing an instrument or or taking up tennis or a ping-pong or you know anything that involves this kind of body intelligence very powerful is simply going for a walk on an uneven trail as you probably know some scottish doctors are now writing prescriptions for their patients go for a walk outside you know it's because as you're walking on an uneven surface your foot and your ankle and your legs and your vestibular system are making dozens of micro adjustments every minute uh you have to change the pressure and the angle and you have to get feedback about what's happening so you don't fall over and it's hugely important so would you say that you know would you therefore not be recommending as people age that they work out in a gym on a treadmill or on an exercise bike or can you do a bit of both well you can certainly do a bit of both uh i've i mentioned at the beginning of our conversation i've just changed a few things in my own life one was i didn't know about sarcopenia how would i as i say i i basically know about stuff from the chin up and a little bit of spinal cord but sarcopenia is to muscle what osteoporosis is to bone and so i've started doing resistance training i go to the gym i'm not trying to bulk up like arnold schwarzenegger but i do a round of 20 i'm sorry 12 different weight machines just to keep my muscles going i spend about 40 minutes there four or five times a week jane fonda has started told me she started doing the same thing do you enjoy it i do i do i can't i couldn't tell you why but i do and i also do the elliptical because i'm trying to get my heart rate up and i do what's called high intensity interval training but better than both of those really is the difference between sedentarism and moving outdoors if you only do one thing you should move outdoors but yeah adding the others is great yeah i mean that's that's great because there's a lot of information we're giving people and sometimes getting too many things to do too many things that are great to do can sometimes seem a bit overwhelming you have to prioritize now if you're in a wheelchair get somebody to take you out the visual stimulation of being in nature is neuro-protective not as much as if you're walking and if you can push your own wheelchair even better or walker yeah dan you've got a long history in music haven't you you're a music producer as well yes yeah and i heard you on an interview recently talk about you had the opportunity to meet sting once and you scanned his brain yeah so i'm interested you know sting well i don't know how old's thing is but he's a few years older than me i'm 62 i think he's 67 ish yeah so look i haven't seen a pictures thing for a while but the last time i saw him certainly there's no way i would have guessed that he was in his late 60s it's clearly someone who seems to be aging very well so sting has a lot of practices certainly that come across in the media that we read about how many of those are true that i don't know but when the tantric sex is not true it's not true no okay um do you know what he does i do i do um sting had read this is your brain on music and he reached out to me at some point in 2007 or eight and said he wanted to visit the lab and meet me and talk about the findings and so he came to montreal and i said you know while you're here if you want we can scan your brain and we can you know see what it looks like um it wouldn't be an actual study i guess it's a case study but not a proper experiment uh and he was into it and uh you know we we found that his corpus callosum is thicker than most people's that's the fiber track that connects the left and the right hemisphere and we often see thicker corpus callosi in people who are very creative who are shuttling information from the left to the right hemisphere we learned some things about how he organizes music in his memory that were quite novel we published a paper about it scott grafton and i the embodied cognition guy in a journal called neurocase it's available for free on my website as all my peer-reviewed papers are okay great and we'll link to all of them sure as well in the show not section so people can easily find that uh i mean it is a article written for other scientists but i think that the average person could glean the punchline from it uh and then uh we we kind of got a lot we got we got along well and he invited me to come and tour with him and the police reunion tour for a few shows you got to be kidding me it was terrific um oh wow and so i did get to see what his life is like he does yoga every afternoon he has you know for at least a couple of hours sometimes four he earmarks alone time apart from the yoga to either practice something musically or learn a new song or uh or write something just to experiment around he gives himself play time to play every day when he's on tour and then the other extraordinary thing was we we're talking about conscientiousness i've never met anybody with the work ethic that he has and you know i i i i'm i'm a professor i know a number of nobel prize winners most of the professors i know are workaholics we work 75-80 hours a week that's nothing compared to what sting does he is working all the time he enjoys himself but he his work ethic just to give you an example i asked him how is it that you play bass and sing at the same time i'm a bass player that's very difficult to do because it's not like strumming guitar finger picking where everything's in sort of lockstep time bass parts tend to be syncopated you know you're not always singing when the bass hits a note you're sometimes singing in between notes and in odd inter integer ratios uh and so just as as a demonstration of work ethic i said how do you do it he says well he says when i know that i'm going to go out on tour and i'm going to have to play these songs in the studio yeah you can track it differently yeah he played the bass first he sang second or vice versa if he's gonna have to do it live so he writes out on a piece of paper the lyrics and the the chords or the notes and he writes a kind of visual map for where the vocal note is versus the bass notes sometimes they're synchronized sometimes they're anti-phase and then he'll sit down and he'll practice one measure at about one-fifth the normal tempo and he might do that for half an hour that one measure and then he'll put it away and go to another song and the next day he'll come back and he'll add another measure and he says it could take him six months to work up a tune at the proper tempo and i thought wow oh my god is it a bit like you know some again i'm not trying to compare the two but just to sort of make it really relevant for people at home who maybe are not musical or don't play the bass and i never try to play the bass and sing at the same time you know like i'm sure it's the same in america we have the same way you have to try and um patch your stomach and sorry you know put your hand around your stomach and pat your head at the same time which some people find quite hard to do unless you but i think most people when they focus on it and practice well it requires what we call limb independence yeah so yeah is there something similar to that that's going on with sting when he's trying to just teach him maybe not limb independence but you know voice and hand independence yeah and we find this in a lot of activities flying an airplane requires limb independence you're using both feet using both hands um one of the things i did in order to adopt the advice that i gave others in the book is that i realized i had to push myself out of my comfort zone and so i took flying lessons and studied for my private pilot's license because it is very complicated it's not like playing drums you're doing this to help you age better i did yeah yeah uh and um because it's a new skill and it's it's sort of taxing your brain you and your brains have to fire up different neurons is that in a nutshell what it is it's exactly that it was taxing my brain in ways i hadn't texted before not only that but i'm i'm terribly afraid of heights and so it was a way for me to get some agency over my own uh feelings in life i mean i find if we just go back to sting for a second what i find really interesting is you started off talking about sting and saying that he make sure he does some yoga every afternoon sometimes for two hours sometimes for three or four hours he ensures that he's got some time alone and then you follow that up by saying he's one of the most if not the most productive and conscientious people you've ever had the had the opportunity to meet yeah and so a lot of people that won't make sense it will be like hold on a minute how can he be conscientious and hard working when he's got time to do yoga in the afternoon and he's got time to spend an hour by himself each day unless of course those are things that help him be productive and conscientious well it's exactly that uh it's if if i don't go to the gym in the morning um it's there's always this tension that i i like you probably i'm i'm way behind in my work i'll never catch up no matter what i do and i always feel that if i take 15 minutes off i'll fall 30 minutes behind and so when i wake up in the morning do i go to the gym and and basically lose 45 minutes well for me anyway if i do i gain that back later in the day in terms of productivity i get more done in an hour of work if i've had that and sting must have worked out that these things help keep him on an even emotional keel and help inspire him to to do his best you know the whole sting story reminds me of something else that maybe your listeners will be interested in i saw this fantastic magic trick it was the um it was the signature trick of a guy named glenn falkenstein who's passed away and i saw it several times and what he does is he goes into a a room you know it's usually a concert hall or a venue and he's on the stage and his assistant put some silver dollars over his eyes and then wraps them with uh plastic and then puts on some sort of uh um thing to block his vision even more and then she goes out in the audience and she asks somebody to without saying what they're doing pull something out of their pocket or their purse or off their table and hold it up and so i was a uh i was a participant in this a couple of times i love this trick uh one time i pulled out a credit card and she says to him uh okay uh you know this person is ready do you do you know what he has and the and glenn says well it's a credit card and she says okay what else can you tell us about and he says well it's a visa it's not a mastercard or a diners club or an amex she says what else uh can you tell us anything else he says well it's the chase bank and she says okay uh and um she says and uh now i'm wondering if you can read off the numbers the 16 digits and he does in groups of four after each one she says keep going or you know that's right uh what's next you know these kinds of things um now i imagined that this was a super high tech trick that she's got a hidden camera in her hand and the reason for all of this stuff around his eyes that he's got some kind of a screen or maybe he's got an earpiece and somebody is you know talking in his ear he can read off the serial number of a dollar bill people pull out a lipstick he can tell you it's an estee lauder and it's this color and it's it's amazing and so right before you retired i asked him how he did the trick and of course magicians aren't supposed to tell you but he had retired he worked on that trick with this assistant for five years everything she says is code when she says this person's ready that means it's a credit card she says are you ready to start that means it's a bill of some sort if she says um okay let's go that means it's a piece of silverware it's the most elaborate code you can imagine and they memorized it it took them five years of working on this two hours a day but in the end i mean to me that it's a marvel of conscientiousness and and and work ethic but in the end they had this amazing trick that nobody can figure out i mean it's incredible to hear that and it's incredible to hear the capacity of the human brain um it's incredible to hit that story sting story and just think how hard and how dedicated some people are to mastering their craft and then i'm always thinking about how can i bring that back to someone who's out on a run at the moment who's listening to this who maybe like the title of the podcast thought oh how i'm gonna age well and then what can they take from that into their own life and i guess it's as you said right at the start you know the number one trait that's going to help you age well there's conscientiousness so i guess can you finish a task you started so can you and can not only that but can you do the best possible job you can can you do not just good enough can you try to push yourself to do more to do better um can you can you grow in whatever it is that you're doing if it's keeping a garden um if it's cooking for yourself and your family if it's choosing vegetables learning which ones to choose at the market so you get the most flavorful and healthy ones with the most nutrients any area of a human endeavor where you can learn and keep learning is what's neuro-protective and um i mean it's fun it is fun yeah it's it's curiosity really which is a separate trait it's number two on the list after conscientiousness is it really people who are curious do better in life so conscientiousness and curiosity the two c's of aging well right and you know with this book like all my other books the version of it that got published was uh roughly uh version 52. that is i wrote the manuscript i went back over it and rewrote entirely 52 times i've never published anything that i had fewer than 12 revisions on those tend to be short articles or scientific papers where it's you know there's a formula but for you know for the books or for the new yorker articles or things like that it's always 40 or 50 drafts and i have this friend named mike lankford who is i think the best writer i know he published a wonderful book that i think you'd like called life in double time okay about his uh early years as a drummer in a touring band that nobody's ever heard of but it's hilarious and insightful and then he wrote another book which is both of the two of my favorite books of all time the other one is becoming leonardo it's a biography of da vinci it's so much better than walter isaacson's uh bio which came out at the same time and i said to mike um your books are so amazing how many drafts for becoming leonardo he said 75 he worked on it 10 years that's a masterpiece it couldn't be any better um i have much to learn and i guess all of these stories whether it's your friends their or yourself just the act of you writing this book forget about your other ones for a minute just this book and doing 52 or so revisions that is consciousness that is dedication that is actually i guess helping you to age well well and it's curiosity i'm curious to know what i can do to make it better i'm curious to know if there's a you after our conversation i'm gonna go right take notes because i get a chance between now and the paperback to do another few revisions yeah and in stimulating conversations like this i always think well there's probably something i can take and change it for the better and it's interesting i mean as we record this dan i mentioned just before we went on air my 100th episode of this podcast has probably gone live whilst we've been chatting congratulations yeah thank you it's uh it's again something that started off as an idea um just over two years ago 100. yeah episode 100 okay a week one yeah pretty much one a week i have taken august off the last two years because you know for me i've got two young kids they're off in august i want to just switch off and be able to spend proper quality time with them when they're off school so um you know i i've done that the last couple years but what's interesting for me is the feedback we get the way it's grown so rapidly and the fact that people say look each week it's it's such a varied guess i'm learning new things it's making me think about my life in a different way i can't wait for the next one i'm really curious for what's coming next so i guess i'm thinking or i'm certainly hoping that actually people who listen to this podcast each week with that curiosity maybe in some way this is helping them to age well oh i hope so i believe so if if you can remain curious and learn new things that's neuroprotective it doesn't mean that you won't get alzheimer's or that you can reverse it or slow it down but it does mean based on the research that you may get it and nobody would notice it for years because you've built up this cognitive reserve think of it this way if you go to the gym and you can bench press 200 kilos on a bad day you could still do 50. i can't but you've got some muscle reserve same thing with the brain you build up this reserve through doing new things whatever they are just to bring this full circle the other third quality that we can all work on is gratitude yeah um i as you as you as you know i had the opportunity to meet with the dalai lama yeah in doing the research for the book and he meditates on gratitude and compassion two to four hours every day and he believes the real secret to happiness not necessarily longevity but happiness is to embrace gratitude if you're happy for what you have and you're not focused on what you don't have and feeling slighted or carrying around anger and such and how come so and so has a tesla and i don't or you know so and so got promoted and i didn't so and so spouse is better looking than mine all of that stuff throws our brain into a kind of fear mode it activates the amygdala it releases cortisol but you know warren buffett agrees the idea of experiencing gratitude my grandmother was a an immigrant to the united states from germany a holocaust survivor she escaped the nazis and she had written out on a piece of paper uh the things she was grateful for yeah and she recited them every morning when she woke up and every night before she went to bed she was not religious but we were talking about how you can affect change and we talked about meditation and medication and psychotherapy another thing that works is religion all the world's religions teach you that you can change yourself you can become more compassionate or generous or more tolerant or express more gratitude so she had this list and she told us that every day she woke up she told me me and my mom around the time she was 79 that she sang god bless america every morning god bless america written by another immigrant by the way irving berlin another jewish immigrant and she felt that it was her purpose to do that she had to express gratitude that her family was saved so for her 80th birthday my mother and i bought her a little 80 dollar electronic keyboard and i got pieces of masking tape and put them on the keys to play the song and i put numbers on them oh wow so she'd know what order to play them in and she loved it she'd never played an instrument before so she's going one two three four five six you know like this and then by the time it was her 81st birthday she had lifted the masking tape off and was playing it from memory by her 82nd birthday she'd worked out a rudimentary harmony with the left hand oh wow she kept improving she did this every single morning and every night before she went to bed until she died at 97 and we found the keyboard on her bed table wow [Music] but you're a neuroscientist and i know from doing some research on you that you have studied a lot of things about stress and depression and its impacts on particular parts of the brain including the hippocampus and that's an area that that can get affected quite powerfully by walking and what if you could expand yeah so you know i think one of the great discoveries of the of our rediscoveries of the last kind of couple of decades in neuroscience is the realization that the brain is a muscle or functions like a muscle it's plastic if you work it it changes dynamically in response to to what you do to it if you leave it it tends to atrophy so the parts of the brain that are concerned with learning and memory uh is a part of the brain called the the hippocampal formation it's also the same part of the brain that's involved in the processing of information about stress and it's also very badly affected by depression and here's i think one of the amazing discoveries we now know with absolute certainty as you as certain as we know anything in science that lots of aerobic exercise getting out and moving walking lots materially affects the volume of the hippocampal formation it gets bigger as the result of of exercise and the functions it supports get better as a result of exercise and you can demonstrate this in all sorts of ways we've done studies for example with sedentary college students and we've made them do forced exercise regimes on bicycles on on exercise bikes and shown that molecules that are expressed in the brain which float into the blood including brain derived neurotrophic factor go up and memory in these students goes up but even more dramatically um this capacity is retained right throughout life so it's never too late so i'll just pick on on one very important study art cramer's group in chicago have taken a group of about 120 people in their early 70s divided them into two groups one who were just left to live their life as randomly into two groups they live their life as they always live it and the other group are brought out for a walk three times a week that's all for about a mile and a half with a physiotherapist in small groups groups of of two and uh they're followed for a year or so and what you see is in the walking group improvements in memory improvements in attention an increase in the volume of the hippocampal formation an increase in the amount of this amazing substance bdnf in the blood and the 72 year olds start to perform on psychological tests at the same level as 68 year olds do so in a very important sense you've reversed the functional aging of the brain whereas the other group who just continue their sedentary tele-watching lifestyles they continue on a pathway of decline yeah i mean that's incredible and i like the the point you're making but it's never too late that's the important thing and i like to suggest that you only get old when you stop walking you don't stop walking because you're old yeah and i guess walking and i'm thinking about um people in my family now walking is something i think this is actually part of the problem as well and one of the reasons why i think you had to write this book is it's such a simple thing or is it you know we can we can discuss whether it's simple or not um but it is it's something that many of us don't think about we just put one foot in front of another and we're walking so we don't give it maybe the credence that it deserves and we don't we don't probably recognize its importance yeah but i think until we lose it what you've said though is the key point that we don't think about it we just put one foot in front of the other and that's the point i think that has gone wrong in how we've engineered our modern world we've made it easier for the default to be to get into your car what we should do is that all of the points of the day whenever you're moving around we should make it easy for you to just put one foot in front of the other without thinking about it yeah that's what we need to do yeah it's it's mind-blowing and um as you as you as you're describing all these benefits i'm i'm thinking about to see the i i went to nairobi in 2011 for the first time i've never been to africa before never been to kenya and my wife's uh father my father-in-law has a lot of his family living out there and they are jane's and it's really interesting that you know the environment in nairobi is certainly not set up for walking there's a lot of it's a busy city with lots of cars but this jane community they have a center and every evening at sort of dusk time everyone in the community seems to congregate there and for about an hour they've got this track they all walk together for an hour together just in i won't say in meditative silence but it's a very quiet it's a very reflective time and because it's done in the community because there's other people there i think it attracts people so they come each day and i guess there's social connection they're seeing your your friends your family but there's something about that daily walking together which is which is extremely powerful i think and you see this in italy uh in italian towns they have the wonderful phenomenon of the pasagiata at seven or eight o'clock in the evening in these car free centers people come out for a walk around together it's an amble they talk to each other they see each other uh if you go to some of the the uh squares in rome you'll see it happening but you particularly see it in in the smaller towns uh it's it happens in sicily and it's i think you know you're hitting on something really important there that this time that we can gather and chat and talk uh free from the clamor of the day and we can have also this wonderful thing companionable silence yeah it really gives you a great opportunity just you know sort things out in your head yeah and i guess in many ways it's never been more important than in the busy distraction-filled 21st century in which we now live where you know many of us you know any time we have a bit of downtime we pick up our phones we we're consuming we're reacting we are um you know we're not alone with our own thoughts and i think there is something powerful about walking i know you certainly talk about this i've written about this in the past as well about creativity and what happens when i was writing my books and i'm i'm i don't want to put words in your mouth but i would guess it was the same if you're coming across writer's block what do i do put everything down go outside for a walk you come back and before you know it problem solved right you're recharged uh yeah and in fact i wrote a lot of this book by making notes on a page of my on pages of my kitchen table numbering those pages and then going out and walking with a dictaphone and uh dictating it and wow what you often find uh apart from getting the weird looks as you're going along um is that you talk uh far past the notes that you've made and thoughts come to you that wouldn't have come to you had you been sitting at your keyboard and then you end up with this big slab of text which is too many pauses in it and yeah all the rest of it needs to be edited but uh um this is something that the many of the great writers of the ages uh have done um you know philosophers like emmanuel kant for example enormously productive he would go and he could set the clock by him apparently in regensburg um 3pm every day he went for a two-hour walk and then he came home and he wrote uh bertrand russell um the the great philosopher would went for long walking holidays and enjoyed the feeling of of not being in pain from 30 mile walks but for his regular writing he would get up make a few points on a page go for an hour's walk and then come back and compose stephen king the novelist um in his book on writing describes how he goes for very long country walks before he starts writing every day it really really does help yeah do we know the mechanisms by which we become you know more creative and we can solve problems when we go out we take a break and we go out for a walk do we know exactly what is going on so i think there are probably two or three different things going on here so i think we have a misperception about how we problem solve and we think problem solving is active it's time on the task it's banging your head against the problem and actually when we look at how the brain operates we have what's known as a kind of a a default mode sometimes called the default mode network where we're actually zooming back out we're looking at kind of the bigger picture and to do that we're not engaged with the environment and then we have what's called a task positive network where we're focused on the thing um and creative problem solving happens best when you're able to flicker between these two states where you're looking at the forest then you're looking at the trees and then you come back out so you're searching for the pattern and i have the suspicion um although i i can't prove this but i i would hope uh we would be able to soon that one of the things that happens when you're walking is that you're able to engage in kind of an active idle mode of thought where you can flicker in on the problem focus back out from it hone in on it again and come back in and out and walking facilitates this kind of rhythmic uh focusing defocusing on on a problem and i also think there's another thing going on when we're sitting as we're doing now our brain doesn't have to work very hard uh it doesn't have to work to maintain posture uh when we stand up one of the first things you have to do one of the first things you see is our blood pressure changes our heart rate changes our our breathing changes and the brain has a particular job of keeping you stable so there's a lot more activity going on so i think what's also happening when you're up and about more of the brain is active and ideas that would be kind of just below the level of consciousness previously are now just being brought above and into consciousness because the brain is a bit more active yeah and you mentioned at one point in your book that actually when we walk other senses are heightened yeah which i found you know it kind of makes sense oh i think what a lot of it intuitively makes sense but only when you say it exactly you don't think about it so what what happens to all these other senses yeah so again you know i think we've had this kind of view of how the brain works which is which is manifestly when you think again when you say it out loud it's wrong uh we think about the brain as something that passively takes in information from the outside does something to it and then we engage in a motor movement but actually the world is too complex for us to do that uh and instead a better way of looking at the brain is that it's it's kind of information hungry it's predicting things continually that are about to happen and it's searching for information about the world to allow us to predict what we're going to do next uh and it's engaged in the generation of possibilities and it does this all the time uh when we're moving around and if you if you imagine for example you're a cat uh imagine you're a mouse uh and i used this example in in uh in the book as a mouse you don't want to get eaten as a cat you want to eat the mouse so you're walking around and your job as the mouse is to detect the presence of the cat and what you find in the mouse's brain when it's moving like that uh activity in its visual areas are heightened activity in its areas that are concerned with with hearing and all of those parts of the brain are heightened when it's in movement they're not when it's not moving and the same is true of the cat because when you're moving that's how you're going to capture your prey uh you don't capture your prey passively if you're a catcher you're a predator you hunt uh so it makes sense that uh and you know again think about humans on out on the the african plains a hundred thousand years ago carrying a a fairly small spear is that yellow thing moving over there an antelope in which case i can go after it quickly or is it a tiger and should i run away or can i run away you need to make these decisions really really quickly they have to be really really fast so a selection effect in favor of a brain that anticipates uh what's about to happen makes a lot more sense i mean that that is incredibly um deep on one level because in in many ways what you've just articulated is saying that maybe if we're sat down all day or we're certainly not walking maybe our brain is only in first gear and maybe to get into second third fourth and fifth gear maybe we need movement we need walking so if we're living sedentary lives if we're sat down in our car to get to work if we're sat at a desk all day and we sit down to eat our lunch at our desk and we come back and we sit on the sofa in the evening that for many of us maybe our brains have not got out of first gear no no and uh the weird thing of course is that uh sitting around all day is tiring yeah and then you come home after not having done a day digging ditches sitting at your computer and you're exhausted and the reason you're exhausted is because uh our bodies and brains need movement uh and and that movement generates all sorts of wonderful molecules that feed back on our sense of well-being that facilitate uh good things in terms of our musculature in terms of our heart rate and in terms of what's going on in the brain so actually somehow we need to break this i don't i don't have a solution for it except to say that we right at the outset need to bake into design principles for work for buildings for all the things that we do the schools for schools absolutely um no question about it the facilitating movement um and making sure that much more movement happens the other thing of course we have to do is uh honor sleep you know that the two things that will do the best for your mental health and for your physical health is to get lots of walking in get lots of proper quality sleep yeah i i don't deal with that in this book but there are many exercises i've dealt with that i might see but it's a great point it's such a good point and again you know my wife and i this summer we reflected on a lot of things and our um our children have moved school recently and it's a bit further away so the natural tendency would be or would have been to drive there and we've made a little bit of a vow in the family that we are literally going to be trying our very best every day to walk the kids to school even though it's probably 25 minutes i know that that is not long he talks to a lot of people and they'll be like you know people around the world walk way more than that to school every day but it's guess i guess it's how used we are to convenience and and quick short car journeys but we made a big difference and i think you have shared some research that suggests actually if we walk prior to doing some sort of intellectual task we perform it better if we have walked just before it yeah and we perform it more creatively which is the other thing we generate more ideas so a very simple way of demonstrating that is you know to take a common household object like a pen for example and i ask you to come up with as many uses for that as you can in the next three minutes and you might come up with seven or eight uses you might come up with 25 uses people vary and reliably vary in in this capacity but it's a very good measure of creativity uh knowledge workers creative artists high performing scientists will typically come up with many more uses for a common object and then somebody who's not uh working in those those kind of domains but here's the rub um for a hundred years or more psychology has explored creativity in people who come to a lab and sit down and do a creative task what psychology has not done is asked what would happen if we got people to move prior to getting them to do a creative task and what you find is that if you have people do a short period of movement walk for five or ten minutes prior to them generating these create new creative ideas they generate on average twice as many uh after having walked uh compared to those who are seated and the studies on this are very beautiful they're very carefully controlled there's one where they've had people sit on a treadmill on a chair and they've had them walk on the selfsame treadmill and again you find the same thing coming through that walking either on the treadmill or walking around an environment i you will on average generate about twice as many new ideas now here's the important thing it's often suggested that creativity diminishes with age and that doesn't appear to be entirely true but what is certainly correct is that if you get elderly people or people who are older in their 70s to walk prior to a creative idea generation they will generate twice as many ideas as sedentary 20 year olds who haven't walked so it i've already said it's never too late in terms of of changing what happens in in side your head as a result of walking neither is it too late where creativity is concerned it's mind-blowing isn't it we're seeing benefits for our physical health for our mental health for our creativity um how accessible is that you know walking before you do a task you know whether it's walking your kids to school whether it's before we get in the office whether it's simply a case of you know having a break at lunchtime where you go for a 10 or 15 minute walk it is it's not only that it's going to make you feel better it's going to make you more creative and so many of us are trying to actually become more creative solve problems that we have in our lives relationship problems all kinds of things it's always better after a walk yeah so the trick at least the trick i use uh is write down the few bullet points of what it is that you're trying to do um and that organizes your thoughts into a kind of a schema and then just put it down and go for a walk and come back to it yeah that's the way so you kind of almost signposted to your brain these are the four or five things that i need to worry about and then you forget about it just go for a walk and and let your deeply clever brain do the work for you yeah yeah if it hasn't worked as a result of the walk sleep on it uh yeah and uh you know there's john does pasos the novelist uh used to say whenever he had trouble with writing he would let the committee of sleep solve the problem for him um and uh it is clearly the case as well that for difficult problem solving you know having a good night's sleep can often not always but can often facilitate the problem-solving and having had a good day of movement before sleep helps you sleep yeah i think the the powerful message for me in in what you're talking about at the moment is that our brain is always trying to solve these problems for us if we allow it to yes and it's very powerful what you said that the two most important things we can do for our mental health is sleep well and walk lots yes and they're things that actually really are available to so many of us i know many people struggle with their sleep and i think that the human beings default states is to be able to sleep and generally speaking i was saying in my uh many years of clinical experience i would say that the majority of people who are struggling with their sleep are usually doing something in their lifestyle that they do not realize is affecting their ability to sleep at night it's very you know you do get primary sleep disorders but by and large i think it's it's rare compared to the people who are who are struggling because you know they're not moving enough or they're not switching off in the evening [Music] you said that dementia is not a disease of old age that's right it's so important for people to get that because you know i've spent a lot of time with professor dale bredesen in in california i'm sure you've seen some of dale's work and some of his research and you know he's said on many occasions that you know alzheimer's or other forms of dementia may be starting even 30 years before it shows up now i'm not you may or may not agree with that but he is he's sort of said that the idea being that when you get symptoms is not when this starts this starts a long way before and therefore there's an opportunity if we're aware of that to start taking preemptive and preventive action you know in our 30s and our 40s and our 50s not when we're suddenly getting the diagnosis at the age of 72 let's say so i want to just hammer home that the the things in your book that uh are based absolutely in science in terms of what people can do they're kind of relevant to everyone particularly women i would say no matter what your age writes i agree with you i i completely agree on everything you say alzheimer's disease is not like you you just all of a sudden catch a cold right it's not like tomorrow you go to the doctor and boom you have alzheimer's disease there's something that's been happening in your brain for a really really long time that eventually leads to the symptoms which again speaks to how resilient the brain is how strong these brains we have are because they can literally fend off a whole amount of pathology and insults and problems for years and years and years and your ability and your cognitive reserve of reserve right against these insults is really largely based on the way you live your life there is a genetic component our dna is part of whoever we are everything we are it's involved in everybody in neurological function however your medical report report card in your lifestyle matter just as much for the vast majority of people like even in patients with genetically determined alzheimer's even for those very rare patients who carry genetic mutations that cause alzheimer's at a young age just evidence that things like exercise can really delay the onset of dementia and for the vast majority of the population over 98 percent of people do not carry this genetic mutation so risk is really more about the interplay of factors like sure there are genetic risk factors your genes are important but your lifestyle is just as important your environment is just as important your medical health is just as important and those are the things that we need to take care of pretty much as soon as we're aware that they're important it's not like you're 50 and today you have to take care of your brain no this brain health should really be part of overall health we should really start thinking about our brains as our best friends and the part of us then it's nurturing and supporting that is doing so much for us right so i think it's really important that we make choices that really support the brain and i i usually like to say that i encourage everyone to think of their brains more like a muscle right there are things that you can do to make your brain stronger you can exercise it properly you can feed it properly you can take care of it properly and your brain will perform so much better for you at any age with it at any age yeah i mean i want to sort of get into this lifestyle piece because there's so much that people can do particularly the bit on movement as well where less might be more for women which i found really interesting and something i i've been thinking about for some time as well um before we do that i wonder if we could deal with hormones and in particular hrt yeah which is obviously a very hot topic it's a very divisive topic from you as a neuroscientist looking through the lens of the brain and with all the work you've done what are your views on hormones and how they can be used to help brain health my views are that hormones are important in that the field has not developed a way that one would hope especially as far as our brains are concerned and i i could talk about this for days to just give you the full detailed picture but i think the bottom line is that preventing alzheimer's or minimizing the depression and anxiety is not the same as treating hot flashes right so we know that hormonal replacement therapy is very effective at reducing minimizing and in some cases completely eliminating hot flashes for women who can tolerate the medications that women are not eligible for hormonal therapy for menopause but most women are and that is something that has been shown to be successful for like hrt can really help with hot flashes it also parodies your vaginal dryness especially for women who um undergo a hysterectomy or oophorectomy which is the surgical removal of the uterus and or the ovaries now when it comes to brain health things become really complicated because the research is just not there there have been clinical trials that looked at whether or not hormonal therapy could prevent dementia right and they showed that it cannot in women older than 65. so they were looking at women who were like 15 years post menopause and they were given hormones at that point which is too late it's just too late to start now more recently two very large clinical trials um tested the efficacy of hormonal therapy in women who were a little bit younger so within five years of menopause and they showed no adverse effects but also no benefit for cognition and i would argue that that is again too late we were talking about the locking the key the key in the lock analogy and the timeline is very important because what happens in physiology is that this system where the hormone locks to the receptor is really age dependent what happens to the receptors is that if you don't have hormones blocking for a really long time the receptor shuts down it just closes the lock is no longer a lock it just turns into a piece of door so if you try to get the hormones then nothing is ever going to happen right yeah you need to have plasticity you need to have the hormones and the receptors if the receptors said okay sorry guys too late there's no point giving hormones so what we're trying to do right now is to better clarify this window of opportunity for brain health and the way that we need to do it is not just by theoretically putting women in a clinical trial but we need to look at their brains we need to probe the system are these receptors working or not are they active or not does it make sense to give you hormones at this stage in your life as a woman so i think this is missing and it's hard for me to answer the question without the right information right now the question is we don't know maybe for some women especially women again who who do receive hysterectomies and oophorectomies prior to menopause the current recommendation is to take hormones because that's been associated with a lower risk of alzheimer's disease a lower risk of osteoporosis or how slash a lot of symptoms for other women the answer is that we don't quite know yet so so a couple of things there so again i don't want to quote professor bredesen he's not here and so i want to make sure i'm accurately describing uh some of his work but dale very much takes a multi-pronged approach when he's trying to help a patient so he's saying you know he he you know he he would try and change seven eight nine different factors together rather than typically it's we'll try this one thing does it work no that's shown it doesn't work we'll try something else and and again there's pros and cons of things but i quite like that method in terms of it's not about trying to put everything onto one thing it's doing multiple things and i think he was the first person who really tuned me into thinking maybe this maybe six six years ago or so that oh maybe women should be well not women should be maybe some women would benefit from taking estrogen in some form through and after the menopause to not to withdraw that sort of trophic support to the brain and i found that really interesting because you know as a husband i was thinking oh well when my wife gets to that stage no no oh genuinely what it was more oh once you know that you can't unknow it right so it's it's then it's like well should women be routinely taking that or should we be considering that with respect to brain health and then you know where i get conflicted in my head is that you know we've looked through the evolutionary lens before about what men and women used to do when our brains were evolving so i don't know if you're familiar with any work on this i'm not you know if you go to something like the hadza tribe in tanzania for example uh hunter-gatherer tribe who are still living at their traditional lifestyles right in terms of their hunting they're gathering they're very much living these low stress uh lives that are out in harmony with nature i i wonder you know do they have a word for the menopause do they suffer menopausal symptoms in the same way you know i don't know i wonder if you've come across that at all because i think that would be really interesting it is really interesting and and we do know that the experience of menopause really changes a lot depending on different cultures like in asia women do not report nearly as much discomfort as women in the united states of america so i think yes there's a genetic component but i think the lifestyle stress muscle right you you know dress is huge and this is probably a good time to get into stress yeah i can say this is you know this is not a scientific trial but in my clinical experience a lot of my female patients who come in with significant menopausal symptoms also have high degrees of stress in their life now of course makes sense to me it could be that symptoms are getting bad and are not getting treated which causes a stress i i absolutely recognize that but when i've really tried to unpick lifestyles for a number of years before it stress seems to play a really big role and i think as you've explained in the book with the pregnenolone steel you know there is a way that stress literally impacts and changes this kind of symphony of hormones in your body so i wonder if you could expand a bit on stress and what that does to the brain sure so stress can literally steal your hormones and that's because cortisol which is the main stress hormone is in balance with your estrogens because the the body uses the same molecule pigmenolone which you mentioned before to make cortisol and the sex hormones so if you're super stressed out like chronically stressed your body will necessarily have to shift production of cortisol by taking the pregnenolone away from your sex hormones and then you're going through menopause so with perimenopause you're stressed out because you're a middle-aged woman with most likely a job a family elderly parent you have no time for yourself you're having hot flashes or you're not feeling well because of hormonal changes and then you also have the stress in your life and your hormones are going down further so it really kind of turns into a vicious circle right where the more stressed you are the more symptoms you get and who knows how we can stop it but i think sometimes hormonal therapy might be a great way to break the cycle sometimes more about lifestyle you know there are things that we all can and should do to keep stress at bay and that is so important not just for hormones but also really for brain health because something we don't talk about enough i think as a society is that too much stress is not only bad for your heart it's also literally bad news for your brain and there's this incredible study came out last year with hundreds probably thousands of people who got brain scans and they were middle aged like 40 to 65 and what they showed is that if you have high cortisol levels that really correlates with brain shrinkage already in mid life and with a worsening in memory performance so high stress can really negatively impact your ability to recall information already when you're 50 years old and what i thought was particularly scary is that the brain shrinkage when they actually looked at gender they found out that the brain shrinkage was only found in women who would pause menopause which is again you know the gender bias they didn't look at gender as a predictor they were trying to remove the effects of gender but then they realized that there was something really hard to get rid of and it turns out that it was the fact that only women and not men only highly stressed women show brain shrinkage i mean that this is you're basically saying that stress affects the brains of women differently differently than the brains of men that's right it looks like men's brains are more resilient to stress at least to meet lives and again these studies are all the average right we're comparing the average man to the average woman it tells you nothing about outliers and women who can tolerate stress beautifully and men who really suffer but on average women's brains tend to shrink they meet lives when your levels when stress levels are really high and when you say middle life are you specifically talking about what was that sorry 40 to 65 40 to 65 so yeah coming into that age of the perimenopause i guess yeah and beyond that i guess that really really begs the question for me and i have you know men and women of all ages listening and watching this show but if that really is the case then in some ways that turning point to 40 is quite a significant one in the sense of look you know of course it's going to be different in different people and of course these are just generalities and it's you know we can't say that's the same for everyone but it's almost like saying hey look between your 20s and 40s you know while you're building up life you know figuring out who you are what you want to be you know tolerating all these kind of stressors maybe there needs to be again like a step change in the way we view stress particularly let's say for women at the age of 14 go hey look maybe i could get away with it 20 to 40. but over the next 10 20 years i've got to be careful that i take some time for myself i take some time to switch off that i don't take on too much so that i know it's hard because culture is pushing us away from this and i think that's another big piece of the puzzle here which we sort of touched on at the start which is you know i think i think i think a lot of people have it tough in society but i think women have got it super tough you know even in this pandemic lisa yes we do in my network right and the patients i've spoken to and in my network and if i'm honest in my house have taken on the bulk of the caregiving duties they're sort of child care duties of course it's not in every case no for sure but i think that would be that that i know has been incredibly stressful for sure for sure you know we we got six months of lockdown i thought it was going to lose my mind um but it's hard regardless of pandemics i think and it's really it's really about you being able to deal with stress because there's always going to be something that is stressful in your life right now everything is really much more difficult but there's always going to be stresses for everyone and i think it's really important to start looking at strategies to reduce stress and really make it part of a culture which is it's not part of our culture we know in some schools kids are being taught yoga and meditation which i think is phenomenal i wish i had it yeah i learned to meditate by myself actually dr rudi tanzi yeah taught me into that as soon as i moved to new york and that really changed my life i thought he was like kind of excuse me i didn't do a scientist so were you scared this is i love both and they have an incredible incredible beneficial impact on the health of my brain for sure but also now we have actual clinical studies showing that they really change the functionality of your brain if you do it consistently enough and according to specific traditions or specific practices and one practice they describe in the book is the kirtan kriya which is a form of kundalini yoga but is actually a meditation that's been scientifically proven in clinical trials to improve blood flow to the brain reduce cortisol levels and improve memory function specifically in women during mid life and after and it's an 11 minutes meditation that is very you probably i had some kundalini yoga classes last year uh with my wife actually we had this instructor to come uh every friday evening we'd do that for a while and you know i was i do that meditation as well it's so fascinating for me to hear the skeptical scientists i was so skeptical kundalini yoga you know it's brilliant yeah i'm not into running a motorbike runner but then yes and i think it's fantastic and i think there are tools that may not work for everyone but i i think there are so many different options in so many different forms it's like exercise yeah there's something that will work for you it's just a matter of finding out what you enjoy what you can do consistently over time because if you do it for three days it's not the same as really having a regular practice and i think a lot of people have a hard time putting in the effort with regularity yeah but the beauty about this meditation is that it's literally only 11 minutes 12 10 minutes because there's loads on youtube if people want to follow it you can just look it up on youtube and follow one along and people want to try it i mean lisa look we've not even got into your eight pillars yet and i have about 10 minutes left so i i know my audience is going to love this lisa we'll see when we get through and i might be able to persuade you for a part two at some point uh because i really think people will enjoy this but the things i thought we'll get through more if we can but i found that the stuff on phytoestrogens and soy yes really interesting i don't think people on my show have heard much about that before so i don't know if you could expand a little bit on those yes so um we were talking about hormonal replacement therapy and which makes total sense right so as a woman you're losing some of your estrogens and the idea is to replace them with estrogens that come from the outside now the source of the estrogen is something that a lot of scientists are looking into because where are these hormones coming from right in the very early formulations of estrogen replacement therapy and still in some formulations today the hormones were coming from the urine of pregnant horses which is not attractive perhaps in some ways but it's a very reasonable source they have to come from something right so they can come from animals or they can come from plants and something that i find very beautiful is that estrogen or estradiol is arguably the most ancient of hormones which means that is shared across all living beings plants animals humans as we also animals that we tend to forget about so what that means is that plants make estrogens they're called phytoestrogens from greek estrogens from plants and they are so bioactive and so easy to share across species that the estrogens made by a flower or a plant really works the same way as the estrogens made in our own body they're just milder the effects are minded they're more gentle so sometimes people wonder and some people are looking into this right now myself included if a diet that includes a lot of phytoestrogens from safe sources could be a gentle replacement to hormonal therapy and the answers from culture probably seems to be probably yes so where are these phytoestrogens coming from the most abundant source is soy and soy is very controversial but like we were talking about before women in asia do not suffer the kind of hot flashes and nice threats and neurological symptoms of menopause the same way that women do here in industrialized countries it is possible that there is a genetic component it is possible that the high quantity of isoflavones from the soy in their diet could also make a difference isoflavones are a very strong source of phytoestrogens yeah now soy here is different it's polluted gmo genetically modified is more it's more of an allergenic for us than for asian populations so that may not be the best way to think about phytoestrogens but there are a ton of other foods that contain a different kind of phytoestrogens they're called lignans and those foods are perfectly safe and they're found very often in the mediterranean regions and we know the women on a mediterranean diet have a much lower risk of heart disease heart attacks strokes depression anxiety breast cancer and dementia when women are like a western type diet so there's something about this diet that seems to be quite protective and quite supportive of women's health and the key nutrients are sesame seeds great source of phytoestrogens flaxseeds also great source dried apricots believe it or not for some reason all sorts of legumes especially chickpeas and beans some fruits especially strawberries melon cantaloupe all the sweets and vegetables are really rich in phytoestrogens and they have a whole list because i'm a scientist so i have a whole table in the book with all different sources by group and their activity so i think for me personally that's the way i eat and i've done so much research using brain scans where we show quite clearly that if you're like a 50 year old woman your brain looks at least five years younger if you are on a mediterranean diet i'm going to say this again if you're a 50 year old woman on a mediterranean diet your brain looks at least five years younger as compared to a woman who's also 50 years old but who's been on a western diet for most of his life i mean you can see them you can see the brain scans you can see the way the brain doesn't change when you follow a mediterranean style diet and the way your brain literally shrinks at age 50 when you are on a western style diet and do we know obviously you mentioned one component some of those foods there are obviously very prevalent in mediterranean style diets the term mediterranean style diet gets misinterpreted quite a lot and lots of people use it to make the yeah to make different kinds of foods and so i wonder and i appreciate you've written a whole book brain food on different foods for your brain which which is well worth reading and said lots of practical advice in that and lots of specific foods but you know is there some general broad principles of what you're talking about when you say the mediterranean diet yes and i think again it's important to say mediterranean style diet because otherwise it becomes really impractical even for me i can't find the same foods here that i used to eat in italy growing up but the point is plant-centric so vegetables some fruit and grains and legumes are really the focus of the diet when we use condiments they're more like unrefined vegetable oils like extra virgin olive oil flax oil flax oil is incredible for vegans i know there are so many vegans in england and a lot of your followers are vegan as well i i'm on and off vegan forever flax oil is the oil with the highest concentration of polyunsaturated fatty acids even more than extra virgin olive oil and one concern about veganism is that unless you take supplements your omega-3s could be quite low because especially the kind of omega-3s that are so important for brain health to the dha because plants contain aha that the brain needs to convert into dha and up to 70 is lost yeah in the conversion so just one tablespoon of flax oil is pretty much more than half of all the omega-3s that you need for the day wow so just the tape because i was very excited when i found out i did a lot of research on that but that's a great practical tip for people yeah great practice because that's something people can do right now if they you know after this podcast they can actually order something and actually start bringing it into their diet every day right yes it's very yellow it tastes really nice it's great with salads so why not fantastic that's a good tip yeah also fish is a big part of the mediterranean diet whereas meat and dairy products are considered more like a treat like an occasional treat it's a very flexible diet it's a very reasonable diet it's not you know it is not in any way suggesting deprivation or food restriction which i find very sensible as a scientist we always talk about diversity in the diet has been real key to health why is social networks so important well uh there's i have a lot to say about this but i'll try to say less um what you and i are doing right now wrong gun is the most complicated thing for the brain that we know of having a conversation with somebody you don't know it activates more regions of the brain than anything else that we know of um it's requires turn taking uh we can't be both talking at once uh it requires uh empathy and compassion i have to read your body language so if you say to me that's interesting and you're looking right in the eye that's different than if you say that's interesting and you roll your eyes on the top of your head i've got to be keeping track of all these signals talking to somebody on the phone or through texting or through social networking is not the same actually talking to somebody is very very important and you know we talk about changing your life in a becoming more resilient or more of anything that you want many of us don't need psychotherapy or meditation or drugs we need it uh simply to have friends and family who are spurring us on and uh you know my wife will say to me every once in a while you haven't been to the gym in a couple of days and i i don't feel like she's nagging me we don't have that kind of relationship but she's spurring me on helping me to remember the things that i want to do and i hope i do the same for her social support networks the other thing is that one of the biggest killers in old age is loneliness which is not the same as solitude because you can feel lonely in a crowded room and you can feel not lonely when you're by yourself but loneliness uh is the biggest predictor of fatalities and an interesting way to not get lonely is perhaps counter-intuitive it's to have what barb fredrickson from stanford now at the university of north carolina she know her stanford students together again serendipity i had this great education and i learned about her work back then she finds that micro communications just conversations with people on a bus or in the checkout line at the store just a little 15 second hi how are you how how's the weather i see you bought these uh new cookies i've never tried them do you like them having a few of these micro conversations throughout the day is a real cure for loneliness even for people who say i could never do that yeah no i i love that and this whole thing about loneliness i mean you mentioned the elderly it's you know that if you look at the research in the uk yes the elderly loneliness is a big problem men between the age of 30 and 45 in this country are one of the loneliest groups in society which absolutely is uh a big contributing factor to the growing tide of mental health problems in that age group and the growing rates of suicide and i i sort of can't help thinking but the digital world is in some way for all its benefits is contributing to this problem and you mentioned that that digital communication is not the same as human connection do you know why that is no we don't know why it is but it keeps showing up yeah um i think it may have to do with attention um i i don't know of any work on the blind uh or the deaf which is which would be helpful to have to sort this out but if you and i are in the same room i can tell whether you're checking facebook on the side or if you're texting somebody uh and you know if we're just um communicating digitally in some fashion it's different there's different requirements yeah but non-verbal communication i mean i don't depend on which stat you reads and you may know the you know some more current research than me but it's something like 60 70 percent of communication is non-verbal right right so it's it's all that body language um that obviously you can't pick up over a computer or over your phone um and i love that thing about micro communication it's something i've written about uh quite a lot and in my latest book which is all about five minute things that people can do um there's a section all on hearts what i call heart which is not really about the physical structure of the heart it's about human connection yes and there's so many suggestions i made but one of them is look if you're if you drink coffee every day and you go to a cafe and pick it up and you you're in a russian you get in a takeaway okay if you have to get it in a takeaway say something nice to the barista you know just say hey i really appreciate that or you know hey the latter you made me yesterday was amazing i hope this one's as good today whatever it's amazing when you struck at this little micro what did you call micro communications yeah micro context whatever i've always liked doing things like that and you know if you if you work like sometimes if i'm getting an early train to london i'm up early that's how i'm feeling a bit tired and you you grab a drink on the way and you do that you you feel different right change you've had a bit of meaningful human interaction and it changes the way you feel you don't feel quite as insular or stuck inside your heads right in in a big city um like manchester or london or any big city um generally our experience is we see all these people and we don't know any of them yeah and we feel like we're on the outs we're not part of the fabric of this community and so just having a couple of quick conversations with somebody in the street you now feel like you're an insider you're you're you're part of the community and people who know the names of their neighbors and chat with them a few times a week are happier than people who don't now people always say well i could never do that i'm too shy or i'm too nervous or people won't like me or you know but what we find is that if they can get over that could be through therapy or just willpower or inspiration or going out with a friend and letting the friend start the talking and then you ease yourself into it uh that makes a huge difference yeah yeah absolutely and i think once people get over that hump and start it's actually a lot easier than you think you know because we're wired for that social connection that the other human you're interacting with also is highly likely to want and crave that human interaction as well because we're all walking around you know pretty lonely certainly compared to how we used to be as a society of course there's individual differences and i think once you start you find actually people want that they really do so i think that's another key takeaway for people social connections are important i wouldn't want to talk to you about memory and i think there's a certain societal narrative which i know your king's a challenge about what happens as we get older is it true that our memory declines as we get older well you know i think that globally the societal narrative is that after you're born you begin acquiring skills and abilities you know when you're an infant you begin to learn to talk and then when you're a toddler you begin to crawl and walk and you learn to share when you're a young child and you know it's it's a matter you've got a university or a trade school and you pick up a bunch of skills and the idea is that you keep adding and adding and then at some point you start to fall off a precipice maybe it's 50 60 70 but you know depending on your own story that you hold in your head that aging is accompanied by inevitable decline and that's not true the the brain does slow down it can take longer to solve problems or retrieve a word but there's no evidence that most of us will experience a real memory deficit now of course memory deficit is a hallmark of alzheimer's but alzheimer's is rarer than we appreciate or realize you can go through your 80s and 90s with no with no memory decrement apart from the fact that it might take you a little while longer to retrieve a memory but if it was a memory impairment you'd never get it it would be lost it just takes a little longer because of demyelination and other factors so why is it then that so many of us think and take as fact that our memory declines as we get older well i i don't know i think um part of it is that the story was developed for the way we lived maybe 40 years ago we're living longer and healthier than ever before when my grandfather was 65 in 1966 he wasn't particularly healthy uh a 65 year old today is in general much healthier he had been everybody he knew he was a doctor they all smoked i mean in fact you know at least in the u.s there were ads that doctors would recommend smoking yeah that they were good for your brain you know it's just it is so crazy to think of that now isn't it i mean yeah but that wasn't that long ago really no it wasn't um and i think that you know the way that older adults are portrayed in them in movies and in jokes is that they're daughtering and that they are losing their memories it almost becomes a self-fulfilling prophecy doesn't it in the sense that if that's what the movies are telling you and that's what media is telling you and then let's say you're in your late 40s or early 50s and you forget something you then will say to yourself well that's cause i'm getting older and it almost is reinforcing that belief and is that part of the problem like rather than actually i think there's an example you use either in the book or an interview i've heard you say before that we just create a different narrative around it when we're older yeah so i you know i i i teach college students and 19 year olds are uh very forgetful they lose their cell phones and their keys they forget their computer passwords this happens to 79 year olds too uh but the story is different when a 19 year old you know has one of these memory lapses lost my cell phone can't find it they just say oh i've got to get more sleep or i've got too much on my plate the 79 year old or even 59 year old says it's alzheimer's i know it i think it's downhill from here part of the problem is that um if you forget something and you obsess about it or stress about it that's going to release cortisol and adrenaline which are going to shut your memory down and they make it even worse so if you're trying to find a word and you're just beating yourself up and say oh i have it here it's you know that's the worst thing you can do it's better to let go now we we do know that when older adults have this memory lapse or delay in getting a word or a name it's not actually the concept that they've forgotten it's what's called the um the phonological word form that peculiar set of vowels and consonants that represent the word that's what you lose and there's a very particular area of the brain that is a little bit decremented as we get older so you might know that you're thinking of a flower and you can picture it and you know its use but you can't get the name gladiola but sooner or later you'll get it it's that and you might even know it starts with g it's uh four syllables i mean we've had this tip of the tongue kind of a phenomenon uh but the uh the proof that it's not really a memory deficit per se is that you get it eventually and and you know just don't stress out about it let it let it go i mean can we train that to be better let's say we we're thinking of that flower we can't think of gladiola is there something we can do to make it more likely that we can think of the word we don't know uh other than just letting go uh and moving on it's not that most of the time it's not that important that you get exactly the right word and i think that's important isn't it that whole idea that that really circles back to something you said right at the start of this conversation about um you know as long as he says something about diet you don't stress about it too much and you're saying now when you stress about it and you release cortisol cortisol in itself when you know too much of it for too long a period of time will be detrimental to your memory so chronic stress is detrimental to your brain right absolutely it's it's it's an i mean we've been listening big killers chronic stress uh is is a huge killer uh yeah the the fact is though you do need a little bit of stress yeah um stress is actually neuroprotective and it kick-starts the immune system um the this is why i say you know if you if you retire from something you should retire to something else you need the modicum of stress that requires you to get up out of bed in the morning and groom yourself and go be with other people and make some work product that's got a deadline all these things are important as long as they're not stressing you out completely without that small amount of stress we often see a great decline in mental and physical health but yes chronic is it's like with everything in the body there's this goldilocks zone yeah you know too little is no good too much is no good you've got to come right just right in the middle you know what i teach um a course i created with with uh some colleagues of mine called prescribing lifestyle medicine accredited course that we teach to you know gps and specialists and other healthcare professionals about the science of various lifestyle factors and how we can use them to help our patients and i i share this graph i think it's from a 2015 journal i can't remember the name the learning memory i i can't remember the name of the journal but again there is a journal of learning and memory i think one of our big journals i think it's that one and there's this beautiful graph showing stresses impact on the brain and how again it's that you know you start off stress increases your brain function is improved um but then you start to get diminishing returns and then it starts to become detrimental and we know that you know chronic stress you know kills nerve cells in the hippocampus and when we saturate the brain so as you say it is that goldilocks zone you need enough to get you engaged in life but not so much that you're worrying about every little thing i think you you actually mentioned the book don't you people who ruminate a lot that go over and over things and worry and and um become anxious about it you're saying that actually makes your body awash with those stress hormones that can actually be detrimental to aging well yes that's exactly right yeah i mean super super interesting and and the um the stress hormones not only damage cells in the hippocampus they damage your microbiota in the gut they get it out of balance and you know your microbiome is is creating 95 percent of the serotonin that ends up in your brain and doing all other kinds of things in terms of immune function yeah i mean it's incredible um i mean dan there is so much that we could talk about going back to before before we close it off um with some really practical tips for people um you know one thing i i really was absorbed with in your book was that was the stuff on pain and i think you quite a statistic saying that pain is the source of eighty percent of doctor visits in the us or something like that which was really staggering and it's interesting also that the way we treat pain today is basically the same way we've treated it for two thousand years with the bark of a tree aspirin or it's its synthetic equivalents or the seed of a poppy opiates and their synthetic equivalents we we have not made advances in 2000 years well i wonder if that's because we're looking at it maybe through the wrong lens and what i mean by that is um you say in your book that pain and why this is so important is we're talking about health span versus lifespan sure you can live to 100 but if your last 10 years are in chronic pain you know that is going to influence the quality of your life and how much enjoyment you get and what you're going to get out of that life and you say that pain is influenced by cultural environmental historical and cognitive factors isn't that interesting so in the u.s doctors all know especially er doctors emergency room doctors you call them something else here i think yeah well a e or emergency departments all of them know that if you're a member of a certain cultural or ethnic group on the standard pain scale of one to ten if you say that your pain is three and you remember this particular group they prepare the operating table these are people who are not um accustomed to expressing pain you know zero is no pain ten is a lot of pain if they say three it's time to prep the operating room there are other people who they'll say they have a nine and it means you can you know just let them sit in the waiting room for a few hours there are these different ways we have of being in the world that are cultural and i guess in many levels pain well not many levels pain is subjective right so what's absolutely that yeah so therefore if we're using a subjective scale naught to 10 to tell the doctrine in front of us or the healthcare professional how much pain we're in of course my three may be different from your three absolutely and you know and and it's it's a matter of uh context so if i'm hiking and i've got a rock in my shoe and it keeps pressing on this part of my foot i'm really annoyed and i'll i'll stop and take the rock out but i might pay 40 quid to go to a massage therapist to press on exactly that part of my foot and give you the same level of pain so it could be let's say a seven with a rock it could be a seven with a with a with a vigorous and strong massage but you will interpret that differently weren't you oh this is good for me because there's tension here that the massage therapist is releasing as opposed to oh something's there and i guess in a nutshell we could do two hours on just pain alone it's it's that complex because there is it's very clear now isn't it it's it's not just it's certainly not just mechanical at all there are emotional uh stress psychosocial components absolutely do with pain which makes it very challenging to treat um for some of you but it's interesting quite a lot of my talks um both for doctors and the public i've had chronic pain consultants come along and i've often had chats with them afterwards and they've said to me you know ronga we really like um a lot of your work in a lot of the books because we can use these tools with our patients with chronic pain because ultimately we realize the medications often they don't work um we sometimes they do of course as well but it's really fascinating this whole idea of pain um you know how come you wrote a chapter on pain well um again i think part of it was that um a lot of what we know about pain hasn't trickled down to the average person a lot of it came out of mcgill where i uh ran a lab for 20 years from ron melzack and in fact i include the melzack pain scale in the book because if people can refer to it before they go to see their doctor or go to the a e they're using the terms that doctors might be expecting them to use for example is the pain stabbing or is it dull is it uh focused or is it um is it based on pressure or based on uh laceration these kinds of things but the other reason i wrote about it is that again part of this societal narrative is that as we age we're going to be miserable and in pain and actually the available evidence is that yes we do get aches and pains and they get worse and worse and then they start getting better there's a point of inflection it depends on the person but around 75 or 80 are the aches and pains somehow disappear for many of us or become manageable yeah and that's that's a very optimistic note which is a it's a great way to start ending this conversation that i've really really enjoyed and i wish we did have another two hours um you mentioned i think another another very exciting statistic is that 82 is the happiest age statistically that's what i read in your book yeah incredible i mean so that gives us for anyone who's listening to this podcast or watching on youtube right now who is under the age of 82 which is probably many if the majority certainly i would guess that's pretty exciting it means our happiest days are still to come right and i think we can push that out another 10 or 20 years if we can get rid of ageism and treat older adults with more dignity and respect not allow them to fall into complacency and learned helplessness i think 82 is is movable yeah well i love that dan i absolutely love that and um you know i always like to close off the conversations with tips for people so um the podcast is called feel better live more when we feel better in ourselves we get more out of life and i think the tips that you are you know the habits you're talking to people about in your book yes it's going to help them age better but it's also going to help them feel better today yeah i agree and that's what's really exciting so i wonder you know you've done a lot of talks we've been on a book tour for over two months now um from everything that you have put into this book from all the feedback you've had at events you know what are some of your top four or five tips that people can think about applying into their everyday lives immediately to improve the way that they feel well follow healthy practices a moderate diet there's no one diet that's been clearly shown superior to the others the mediterranean diet the keto the paleo none of them have panned out you know statistically or research-wise and actually as you say and we didn't get a chance to cover this but you say as i absolutely agree with that often it's more important what you don't eat than what you do eat right don't eat heavily processed foods and it's also more important than we realized when you eat yeah uh your metabolism is linked to your biological clock that funnily named suprachiasmatic nucleus and if you eat at the same time every day you're going to digest the food and draw the nutrients out of it more completely yeah so moderated lifestyle in terms of diet eat more plants than you usually do probably but a varied diet and um get a good night's sleep a movement which i see as the imprisoned corollary of exercise it's not about whether you get an extra 20 minutes on the treadmill it's about whether you actually get outside and move your whole body uh especially in nature so that's three things uh the healthy practices of diet exercise and sleep yeah and then i would uh talk about mindset trying to cultivate curiosity openness to new experience conscientiousness and resilience and then the final thing number five is to associate with new people especially younger people as you get older keep your social networks and i don't mean your digital ones i mean your in-person ones going because that is really an important part of uh brain health and brain happiness sorry to interrupt if you're enjoying this conversation there's loads more like it on my channel please do press subscribe and hit that bell now back to the conversation [Music] how important is walking for our mood for our happiness and for our overall mental health yeah so there are two different ways of looking at this so let's look at it kind of on the positive side first um if you ask people to rate before they go for a walk how how they're feeling now uh on a scale of one to five they might say i'm feeding it around about a two and if you ask them to rate how they'll feel after they've gone for a walk they'll say probably about a two then you bring them out for a walk for 20 minutes and you ask them to rate how they feel they'll now say a four so we persistently underestimate how good a walk will make us feel um and that's true even for people who dread walking who dislike walking and they underestimate just how much uh or the positive effect of a walking uh in kind of raising your your mood uh at the moment now a for a much more difficult uh population are a more a more difficult problem uh which is really a blight in modern life major depressive disorder and the the lifetime risk for males and females combined is about 10 percent uh which is astonishingly high way way way too high and and a recent remarkable study in australia uh following i think about 35 000 adults looked at the risk of succumbing to major depressive disorder uh as a function of the amount of walking that the adults were doing and for every level of walking above the most sedentary in the population the risk of falling or succumbing to depression falls so the lesson there is that you're less likely if you do not have a have major depressive disorder you're much less likely to succumb to it if you are walking more it's a simple prescription that kind of acts to inoculate you against that the likelihood of of succumbing to depression uh what we don't know is whether or not walking uh is a good and uh effective treatment for people who are already depressed um there are no good studies that i've been able to find in the literature where this is concerned um i have a sense though that uh when you look at the effect of very long-term walking you know i mean weeks uh in nature what you see from the the kind of deep case studies that have been done uh people's uh that a whole series of inflammatory factors in the blood the interleukins and a bunch of other things they all fall and fall really dramatically um after walking after walking substantial periods you know so for four or five or six weeks i mean i think on that point i think just to really amplify it we've we've spoken many times on this podcast before how chronic unresolved inflammation is at the heart is that the root cause of so many of the chronic problems that we see today whether it's many cases of depression whether it's type 2 diabetes high blood pressure um obesity isn't a it's an inflammatory disease on so many levels and what you've just said is that prolonged periods of walking can have an anti-inflammatory effect yeah yeah there's no question about this uh the the problem is uh few people have the capacity or or the means to to undertake a six-week walk uh in the wilderness yeah and there's an ethical issue of course if you've got somebody who's who's succumbed to major depressive disorder they need treatment and they need treatment now um organizing a nature walk for them and uh yeah doing this over a six-week period is it would be a very very difficult thing indeed to do but um i think that the kind of the more causal issue uh still is there we we see in those people who do these very long periods of walking all these inflammatory factors fall in their blood and ed bulmer and others have posited the kind of theory that one of the key drivers of depression is inflammation in the brain and his recent book the inflamed brain actually argues that this is the case and and you see and we've been doing studies on this in humans uh and others are sorry humans who are treated with drugs like interferon alpha for uh cancer and other things become ver and hepatitis c they become are often become very uh acutely depressed as the result of the treatment with inter interferon alpha which is a pro-inflammatory uh cytokine so there may well be uh you know at least one sub class of major depressive disorder which is inflammatory or inflammation related yeah i interviewed ads um six nine months ago or so on this podcast we had a great conversation people really responded very warmly to to our chat and um i think mechanistically we can now start to put these things together and understand yes we want more data of course we always want more and more robust research but i think mechanistically there's enough there to to be suggesting that you know walking potentially could be used as yeah you know an adjunct at least yeah you i've spoken about two hunter-gatherer groups in the book which i find super fascinating because i always think when we can go back into our evolutionary history observe how humans have lived how they've evolved how we've evolved how we've thrived in a variety of different environments it helps to put into perspective many of the problems we're having today i have written about the hadza tribe um but more specifically in relation to their diet and in terms of the amount of fiber they're getting and the impact it's having on their gut microbiome but you shared some insights on the hadza tribe and another tribe as well actually that i found very surprising i wonder if you could elaborate on that yeah so the the other tribe are the samani in south america um and the average 80 year old samani has uh the coronary artery health of a 50 year old american because they spend so much time out and about and moving and what what's remarkable is uh you know when you look at the the kind of diets that they have they certainly have meat in their diet there's no question about that but they have almost no processed food or we basically have zero processed food they have a very high fiber diet they forage for nuts and berries and the the sweeteners they use are typically either crushed fruits or honey and their calorie intake is typically lower than the calorie intake of of a westerner um it's not that they're burning more energy in fact actually when you look at the the amount of energy burned by uh hadza or zamani it's it's more or less the same as a westerner and we that's really interesting that just say that again because i think that will surprise people yeah and i was just going to elaborate on it so the the amount of energy they burn is approximately the same as a as a westerner and the reason for this is that we overestimate the effects physical exercise have on energy burn uh and our on our metabolism during the course of the day so here's an easy way to think about it the the the kind of recommendation for males is that they consume 2 500 calories per day so let's call that 2400 for the sake of of uh easy mass ease so that's 100 calories uh in a per hour for a 24 hour cycle that 100 calories has to take care of your breathing your heart is beating 60 70 times a minute or whatever it happens to be um your brain burns an astonishing amount of energy 20 percent of the cardiac output of the heart goes to the brain and the brain needs energy being pushed into it all the time the liver burns an enormous amount of energy and the energy that we use for running and all of these other functions turns out to be a very limited amount of the energy that we burn during the course of the day because housekeeping in our body absorbs so much of it so what happens in in these other groups is they just eat less uh and the calories that they eat are the the the sources of calories come from foods where the available calories require extra work by the body so if you're eating calories that are bound up in fiber your body has to work to extract those calories whereas you know you get a cheesecake you get the hit from the cheesecake within a couple of minutes uh so the highly processed foods that we're consuming really are a major problem um what we really need to do is is to try and shift away from the the very highly processed foods uh in favor of foods that are are where the calories are a little bit less accessible where we have to work a little bit harder and i i describe it in the book ironically there's a diet that's used in lab animals and its nickname is the western diet and the western diet is amazing it's a a diet that consists of a fat and sugar kind of uh yeah and rats go nuts for it they will eat it until they are bloated um and humans love this stuff as well we call it ice cream we call it a cheesecake chocolate if you have we don't eat spoons of sugar uh it'd be quite disgusting thing to do we don't eat spoons of fat but if you mix fat and sugar together in the right proportions and you emulsify them just right they become highly palatable sources of direct energy that we can eat really really easily and this is actually the problem so sugar tax to my mind you know might modify behavior a bit it might take down the the amount of sugar in a in a fizzy drink but actually the issue is is to do with something much more subtle to do with the fat sugar ratios that we're we're consuming yeah and as i said many times before the the thing that is consistent with many populations around the world who seems to have really good health outcomes when we look at their diets is that they're having minimally processed foods yeah that seems to be more consistent than whether we're looking at the fat content or the carb content or you know other any other sort of reductionist type approach we might take generally speaking they're minimally processed and i guess that already fits in with what you're saying is that there's a bit of effort that we have to use in our bodies to actually extract the energy from them which we're trying to think about the smoothie don't eat the smoothie or drink the smoothie eat the fruit that goes into the smoothie it's better for you and your body has to work a bit harder to get the calories out of it yeah for sure just going back to energy expenditure in these hunter-gatherer tribes um are you saying that actually when we walk or when we run we're not burning as many calories as we think we might be absolutely yeah so this whole idea that oh you know i went to the gym after work so i can now chill out on the sofa and actually treat myself with you know a b or c it's even worse than that because uh you've gone to the gym your body thinks i've persistence hunted i deserve a reward uh so you you've done your hour of running and you've run down the antelope and there's the meat so actually your body is saying to you after exercise um we're gonna have a period of inactivity now so you have this phenomenon known as exercise induced inactivity and during that period of inactivity especially in the evening um we're much more likely to eat and we're also likely to feel hungry because of course the hunger hormone ghrelin is increased in our in our blood uh in the evening before we go so this is another reason why we should go to bed on time because as we stay up this hormone is there and it makes us want to eat um but we we do have this exercise induced inactivity phenomenon so to expand that even further in some cases i need to be careful how i wear this but in some cases could it be that going for your run after work or going for your intense gym session after work may potentially be counterproductive if it then leads to you um feeling that you've expended more energy than you had at least you feeling more hungry and eating more than you otherwise would have done could in some cases that can happen and yeah yeah you have a psychological license effect uh so what you really have to do is look at the total energy expenditure across the day you know so if you're engaging in very little activity you're sitting down all day you do this big spike of activity and then you're back again um of course you're going to eat more whereas if you're engaging in high levels of activity during the course of the day distribut excuse me distribute it across the day that would be better for you because that's what we're designed to do we're designed to mooch about more or less every hour during the course of the day that echoes many studies we're seeing now which are suggesting at least that you really can't out do the the negatives of sitting down all day simply by going to the gym for one hour afterwards no it doesn't work it just simply doesn't work again just to be super clear i'm not telling people and i don't think you are either not to go after work we're not saying that we're saying look at the total energy expenditure across your day and the total pattern of activity across your day uh the gym can be a very important part of that but if you're sitting down all day and then going to the gym for an hour don't expect it to be a magic cure yeah shane do we sometimes think that walking is a little bit too easy it's a little bit too simple like we're looking for those um you know we get more excited when we hear about the latest new gym fad that's come out you know the the i don't know the boxer size or the cross trainer or whatever and i'm not i'm not i'm not absolutely you know i'm not trying to say that those things don't have value i'm just saying have we missed what is sitting right in front of us by looking for more exciting forms of movement and physical activity is it is it sitting right there in front of us and have we i don't know is it is it reflexive culture and where we're at there we're always looking for the new gimmick the new thing that's going to somehow you know reverse our our biological age and get us fitter and healthier whereas walking probably does all of the above and more yeah well humans are novelty seekers there's no doubt about that and we are status seekers of course you know people buy cool pieces of gym kit so they can look down on the people who don't have them um but you know we we can leverage this in other ways you know one of the are some of the best experiences you can ever have of walking or when you're walking with another person um you know so it is something that's very easy for us to do it's in front of us um but you know have a walking group have a text group uh have a whatsapp group or whatever it happens to be and we can get the benefits of it very easily and you know it's something that i think you know it should be engineered invisibly into our lives it's it's not yeah you know it should just simply be the default that we have it as something that we don't have to think about but it happens naturally all the day are all during the course of the day every day yeah for sure i was struck by something i heard you say once um and that was that we've been trying to get robots to be able to walk for a long period of time but but we just we just can't or we find it very very difficult and i think that really made me think that is walking is putting one foot in front of the other as simple as we think it is or is it actually deceptively complex in in such a way that actually we can't train robots to do it yeah it is horribly complex so it's easy to put a robot on wheels and it can get around very very well on wheels um but to get a robot to to walk with the facility and ease that humans can that has been a really really difficult thing for uh roboticists to engineer and again we we all kind of overlook the long period of training that we engaged in when we made that transition from being crawlers to walkers it took about a year we had to do 15 or 16 000 steps a day across all sorts of terrain we fell 50 70 times a day and we had to develop range and movement we had to learn how to uh get balanced we had to learn how to carry the dolly to mommy when our daddy or whatever it happened to be when we were moving around we had to learn that certain areas of the kitchen were dangerous you know there were all those kinds of things that that happen during that early phase and robots don't get that training phase you know so it may well be the case that a in future years roboticists will just say look we just we can defeat the problem if we can have robots that learn and that's fine or it's just easier to build things that have wheels or tracks and i suspect you know that's the rush that they will probably go down because that's they're easy to control in a way that learning to walk isn't it seems that at its core what we have here is that walking has got a pr problem um your book clearly in praise of walking is trying to solve that problem and give it more pr but i guess if if we look at it as a pr problem shane and we think about why how we can make walking more attractive to people if you were head of a advertising company and you are two minutes to actually um you know talk about why all of us should walk more than we do what would you say i oh i would say you'll feel better you look better you'll think better all of those things will happen um but unfortunately i don't think it's a problem for pr i i really think it's a problem for the invisible system that's around us why are our footpaths so narrow why do we give so much space uh to cars uh why do we make it so difficult for elderly people to cross the road because we've engineered the the the crossing uh time to be slower or to be faster than they can they can walk it's all of those kinds of problems i i think walking will happen naturally and easily if we facilitate it and it doesn't when we don't i i i i do think we should all be walking more but i think we individually run into a collective action problem which is that we need our society our urban world to be designed better for us and this is a common theme that i think keeps coming up in the social commentary around health it keeps coming up on this podcast i had chris boardman the olympic cyclist on this podcast a little while ago and again he's very keen to try and raise the profile of cycling and he's again trying to get these cities to make cycling easy exactly so that people you know and the whole helmet issue is a separate issue but chris almost makes the case i think that actually let's make it safe so that people don't feel they have to put on helmets every time they get on a bike let's just make it easy let's make it um not something that's a real pain for people to have to do every time they want to go and cycle to work just make it the easy thing and you know you're saying a very similar thing when walking let's engineer our environment so that the behavior we want is easy so the behavior we want is the default option exactly around the world do that's what all the blue zones have they're not trying to be healthy the environment is set up in such a way that health is the easy option um but the problem is a kind of a public health one isn't yeah you know public health isn't sexy but public health has actually delivered the kind of great health gains of over the the past 100 or 200 years we don't think about sewerage anymore uh 200 years ago you could not walk this city we couldn't have walked the city in dublin or whatever because people didn't have uh public sewers you know they had chamber pots and they threw whatever out the window um and there was disease rampant and all of the problems so we we've engineered that problem away and i think the challenge for architects for town planners and others is to do exactly the same thing take the public health issue seriously and engineer the way our cities and towns are designed so that people can actually walk easily around in them yeah absolutely shane in terms of your own behavior i'm really intrigued you've written this great book on walking by writing that book by going into the research i think you already knew but no doubt you you dove a little bit deeper when you were writing the book did writing it actually change your behavior in any way are you doing anything differently now than before you wrote the book i i don't think so it's the honest truth um i've always walked and walked lots i think what's changed for me most in the recent years where walking is concerned is the presence of a pocket held pedometer in my phone and i'm now very obsessive about checking the number of steps that i take every day and i'm much more conscious i think of how good i feel on days when i've had lots of walking and when occasionally as it does happen in life you have a couple of days where just it's raining too much there's too many things happening and i just haven't managed to get my 15 000 steps in um how bad uh i feel well not bad but you know just a slightly silted up i feel on those days well let's just briefly touch on technology here because i think you brought with a very good point so you track your daily steps and um you know whether we should be tracking our daily steps or something that people seem to have quite um quite powerful views about either way and you made the case in the book that it's a good thing to track your daily steps and one of the things i can see from hearing that story in terms of what you do is you're helping to almost tap into your own intuition you're you're seeing hey when i've done 15 000 steps actually i feel better my mood's better i'm sleeping better whatever it might be and when i don't hit the same amount actually i don't feel as good so i guess that's one thing i think a lot about is can we use modern technology in a way to help tap into our own intuition it sounds like you're doing that yeah use it to support how you're functioning you know the the reality is if i ask you how many steps did you walk last thursday fortnight no i had no idea how many steps did you walk yesterday no idea no idea we are not designed to remember either the periods of time that we walk for are the number of steps that we take because our bodies and brains are too busy doing other things uh so we do need to record them and it's easy to do i cannot see a meaningful argument in the world that says that we shouldn't and what we know is when we look at the self-report data of what people say they do against what we know they've done because we've got the smartphone data people under and overestimate really terribly how many walking steps they take every day how fast they walk where they've walked people are awful at this um and that's fine our brains are not designed to remember this kind of stuff but we've designed little pocket held robots to do it for us so we should use them i think the flip side is and i guess blood pressure monitors a great example of this i think they work beautifully well for half my patients the other half they're actually problematic in the sense that if you're the kind of person who uses it once a week to see how you're getting on and it motivates you to make positive lifestyle choices i think it's great some people on the other hand will check it three or four times a day they'll really stress themselves out every time they see you know a slight increase in the reading and actually for many of those patients it starts becoming counterproductive yeah i don't necessarily think walking um tracking your walking steps is is the same i don't either i think i think you know this is a kind of a just a passive record of yeah what you're doing over the course with my patients i've found actually it's more positive motivating factor actually it's like if they set a goal um of let's say they want to do 8000 steps a day and if if by dinner time they've both done six thousand steps off on it it's a motivator for them to go hey you know what after dinner i'm just gonna go for a quick 20 minute walk yeah yeah because they want it they want to meet that sort of standard that they've set for themselves the other thing i wanted to just briefly touch on at the end of this interview about technology is you mention all the benefits of going out for long walks um in terms of what it does for our brain and our minds now i'm conscious when i ask this question that many people are listening to this conversation right now whilst out walking or at running but is there something to be said for going out and walking without headphones in your ear without you know losing yourself in music or a podcast yes so i listen to podcasts when i walk sometimes i when i'm i'm walking what i'll do is i listen to a podcast for the first half and i stop listening to it for the second half um so i i simply don't know i i i think you know the best experiences i've ever had of walking have been walking with other people um you know so i think if listening to the podcast gets you out for an hour that you will otherwise have spent sitting in a chair go for it i think it's great um if you're trying to problem solve uh if you're trying to think through a difficult problem i think having the auditory distraction is a bad idea um especially if you want to have a quiet conversation with yourself about something yeah you know you want to think through why did i say that or you know you know you're going to have a difficult problem to deal with tomorrow how do you approach it what are the the ways you're going to approach the person you have to talk to about it i think in in those cases but i think we just need to be a little bit self-conscious about this um yeah and we also need to think our ears need to rest from time to time so maybe you know keep the uh the sound down a bit yeah i love that if you're trying to solve a problem maybe you know what go out with nothing on but if you're just going to set a home list to a podcast and you have an hour want to go out and walk once absolutely right so i think it's useful because it's not like demonizing technology it's just sort of saying hey just think about what you're trying to achieve or or what your current state of mind is and then do the appropriate behavior yeah shane i've really really enjoyed chatting to you um i think you've written a brilliant book this podcast is called feel better live more when people feel better in themselves i think they get more out of life i think this conversation many ways you're very very strongly making the case that when we walk more we live more yes it's the environment yes we'd love it if urban settings and cities and workplaces and schools could be set up in a way that makes it much easier for all of us to walk having said that i wonder if on an individual level you can provide some tips some actionable tips that people listen to this podcast can think about applying into their own life immediately to improve the way that they feel yeah so i always have a comfortable pair of shoes clothes you know if you're wearing high-heeled shoes to work keep a pair of runners under the desk uh so you can go out for a walk at lunch time set your computer if you're working at a computer to have the alarm go off every 25 minutes which i do and get up and go for a walk around if you find that you have to drive your car to somewhere park as far away as you reasonably can and walk that extra distance if you're taking the train to work as i do get out two stops early and walk that last uh remaining distance um those kinds of things just very very simple changes if you're going out to get lunch at lunchtime don't go to the closest shop you know use google to help you do the restaurants near me or the shops near me and try and find somewhere new that's a little bit further away so that you just get in an extra 1200 steps here an extra 800 steps there so that at the end of the day somehow you've racked up 10 or 12 or 14 000 steps and you haven't thought about it at all [Music] and what's really important and what my research has shown consistently which i'm very happy about is that our brains age differently that we think about aging as something that is quite linear and that is pretty much the case in men it's just great it's a great thing for women it's more like a stepladder there are some very important turning points that accelerate aging and slow down aging accelerate aging slow it down and the scientists and as clinicians we're just never told that this is the case we're not told that we age differently and we're not told why that is the case and one of the big answers that we have come up with is that our hormones are really key for brain aging especially in women yeah that is it's a lot of information it is but i think what you have just said there lisa is so profound and so important because actually if society is not aware of that if scientists if doctors are not aware of that that we can start to put that bias in to how we talk to people how as a doctor i treat my patients you know that that that bias can infiltrate and actually i guess there's a broader philosophical point for me as i'm reading your book and you sort of do cover this in your introduction you know actually what we're talking about on some level is a form of discrimination really isn't it yeah clearly so it starts with darwin you know the father of evolution and all modern theories of biology he was incredibly misogynist and he would say that women's brains are inherently inferior to men's brains and this is pretty much the framework that scientists were operating under for centuries just trying to prove that women's brains were not as good as men's brains and that was really based on observations of size so if you do compare a number of brains male and female brains female brains women's brains are smaller but that's because women are smaller than men on average right our head size is smaller so it makes sense that our brains are also smaller once you account for head size there's really not much difference in volume what we do find is that there are very specific subtle differences in some parts of the brain that are also correlated with behavior which i think is really nice when we say for example that we know that women have better verbal memory than men this is related to some differences in the structural and functional cognitivity of the brain it is slightly different to women than in men can you explain verbal memory yes verbal memory is their ability to remember verbal information so if somebody tells you something you as a woman remember it i'm laughing because we have this you know with my husband i literally had to repeat the same thing five times before he actually even pays attention to me um well he's a man right so verbal memory is inferior to yours as a woman yeah it's not his fault right um but then it is true that men have better visualization abilities on average again this is not an absolute but better sense of direction for example and there's a lot of um debate over whether that is the case or not but it does seem to be to be true and it is also reasonable if you think about evolution right a long time ago our ancestors um used to go out hunting the male right the man used to go out hunting and needed to be able to go back home whereas the women would stay back and nurture the children and take care of the elderly so it makes sense then those parts of the brain that are involved in direction finding would be more developed in men to some extent in those parts of the brain that are more about nurturing and raising a family might be a little bit more um i'm not going to say developed because that's unkind to to fathers were incredibly wonderful but they're just built a little bit differently in women they're wired a little bit differently i would say wired is a good word our brains are somewhat wired differently and that really starts from the moment of conception because our genes are different right women are born with the xx genotype which is also the title of my book the xx brain men are born with an x and the y chromosome and it's really interesting that these chromosomes are quite different like the x chromosome is so much bigger than the y chromosome it's got 1098 genes as compared to the 78 genes in the y chromosome so women are literally born with a thousand genes more than men which are important for reproduction but also for brain function so from the moment we're born our dna is telling our brains as women that our brains really respond to a reproductive organ in a very strong way and that is really such an important underlying mechanism for our entire research on brain aging because it's really the interactions between the brain and the reproductive organs that in many ways drive brain aging in women yeah you said before that for women as they age there's often a stepwise change you know with men it's more gradual what you know are there key moments in life where these step changes start to happen and if so what are they they are the the three p's puberty pregnancy petty menopause so puberty is obviously common to both men and women and is really the beginning of our life as adults right so the brain from the moment of conception the brain has been growing growing growing growing growing at light speed but once we hit puberty there's a moment these are called neuroendocrine transition states and what the word means is that is a neurological system or brain and they're endocrine systems that are in transition together so something is changing you're maturing from a sexual perspective but so is your brain in ways to go above and beyond reproduction so during puberty there's this explosion of hormonal power the in a very interesting way leads to the brain losing volume you would think the brain would explode as well instead it's exactly the opposite the brain says okay that's it enough growing i need to specialize and so a number of synapses which are the connection between neurons are just being discarded because the brain doesn't need them anymore at that point you know how to lace up your shoes right you know how to ride a bike you don't need to remember all the the different little steps those neurons can go those connections can go and the brain gets smaller but more efficient and those there's neurons that you have in your brain once you're an adolescent are pretty much all the neutrons you'll have for the rest of your life your synapses will change will grow will get discarded but your mutants pretty much are final and then for men things remain pretty stable over time and i want to just clarify that these changes are mediated by our hormones and we all know the hormones differ between men and women right men have more androgens like testosterone women have more estrogens like estradiol which is the most potent over estrogens and what's important is that these hormones are not just key for reproduction and fertility they're also really incredibly important for brain function they literally supercharge your brain so when the levels of these hormones are high your brain energy is also high yeah i mean it's it it's really profound because we you know i mean in common parliaments we often talk about our puberty and how people start you know obviously what it means for boys and girls when they go through puberty we know about these different stages in life but we often think about them through the lens of hormones and even you know the general public will talk about it as hormonal changes but we often don't make the link never the hormones that are changing in our body also have an impact on our brain and and so i think what you're doing with your work is really you know almost getting that conversation up on a path saying yes it's hormones you you know it's hormones but those hormones actually change the way your brain functions as well yes those are the same hormones and it's just not common knowledge i find even with scientists i i studied neuroscience i have a phd in neuroscience and nuclear medicine and not once did anyone mention hormones to me menopause yeah you know we know that that happens to women but how and why nobody seems to care about to really talk about so it's interesting for me that i i literally work at the intersection between neurology neuroscience and women's health and it's a really strange space to work in and there are many people who work in neuroscience and there are so many people who work in women's health but they don't talk to each other so if you go to a brain person like me we understand the brain we don't really understand the ovaries or reproductive systems and then you go to an ob gyn or a women's health doctor and they don't fully understand how the brain works so i think it's so important to to have this conversation and make sure that people are aware that the brain is not an isolated organ but rather that there there there's a constant communication going on between our brains in the reproductive organs every day of our lives so the health of the ovaries for women in the health of the reproductive organs for men and women is so crucial for brain health and the other way around i mean i think one of the the reasons i've always been drawn to your work and really really connected with it is because you very much do see the body as a system you know that that's one thing that i really like it's very very aligned with how i look at the human body as well but you also as you write about in your latest book you know you don't believe in this sort of one-size-fits-all approach um which again is completely aligned with with how i think and i think a lot of the tips towards the end of the book which are so practical i think it really helps people trying to identify what are the right approaches for them what they can experiment with to see if it works for them so yeah i i think it's a super super interesting point and i i've got to be honest i think it's one of my frustrations with with medicine as you know there's there's a lot within the profession i'm proud of but actually i do think on some things we've got slightly off track and we've got very very microscopic through one lens looking at a particular organ without seeing the big picture and your work highlights that so beautifully thank you i used to be very vertical in my work you know just one topic and go really really deep and i find as you start going horizontal it's so much more interesting and so much more satisfying to really think about you as a person not as a bunch of bits and pieces they magically work together you know we are systems like you said and i think we as a society we have a tendency to think of our brains as not being part of the system whereas i think it's so important to understand that everything that happens in your body has an effect on your brain as well so by taking care of your body you take care of your of your brain and your cognition and your mood and your aspect and your sleep and everything you need for life do you remember when exactly that changed for you and the reason i asked that lisa is because you know i always talk about the fact that i'm a clinician okay so i'm not a researcher so i've spent you know nearly 20 years seeing patients and so i always listen carefully i observe what's happening who's getting better who's not getting better what's going on why do people come in with three or four different symptoms and if i can let's say help them change various aspects of their lifestyle all three or four of them start to get better as well and you think okay hold on a minute what's going on here so my perspective that everything is connected comes very much from what i've seen with patients you know a lot of scientists by nature the scientific method i guess has to be slightly reductionist at certain times so what happened to you do you remember that exact moment when you started less vertically and start to move out horizontally i do i do and it was it was in some ways it was frustrating but so i was i was studying alzheimer's disease again trying to understand what causes alzheimer's disease and this is this is particularly important because alzheimer's is the most common form of dementia on the planet affecting almost 6 million patients in the united states alone in um a similar two to one ratio is fun pretty much you know countries that we have data for which means for every man suffering from alzheimer's there are two women which is something we never talk about right so we know that women have a higher risk of breast cancer for sure and breast cancer gets the pink ribbon and everybody clearly understands breast cancer is a women's health issue but a woman who is 60 years old is almost twice as likely to develop alzheimer's disease in the rest of her life than she is to develop breast cancer and nobody talks about alzheimer's disease it's something that women should be concerned about or should know about and when i started working in this space and we got so much pushback like the whole time the whole time i was always well sweetheart you know the thing is i always get this sweetheart you know the condescending yes girls but women live longer than men and alzheimer's disease is a disease of old age so it's inevitable the more women than men develop alzheimer's disease and it took a really long time for me and for other scientists to really prove that that is just a bias we're just not thinking about it correctly number one women don't live that much longer than men but most importantly alzheimer's disease is not a disease of old age we tend to associate it with the elderly because the symptoms develop usually when people are like in their 70s the average age and onset here in the united states is 71 years old but in truth alzheimer's disease starts with negative changes in the brain years if not decades prior to the cognitive symptoms it's a very insidious disease is a silent disease that starts in midlife and accumulates over time and then eventually the damage is so severe that you get clinical symptoms and so the question changed to given that alzheimer's disease is a disease of mid life a middle age what happens in midlife only to women and not to men it could potentially explain why more women than men have alzheimer's disease and we just showed recently that what happens to women is that we tend to develop alzheimer's plaques before men do at an earlier age the men do and specifically during the transition to menopause and that created a chaos let me show that there was like a like whoa because we never ever talk about menopause as something that could be associated with alzheimer's disease we never talk about menopause as something that could potentially impact their brains right let alone increase risk of alzheimer's in women so that was a big deal and for me i was not expecting that to be honest so that was my aha moment we have to shift gears here and just start completely from scratch yeah i mean lisa as you sort of talk through that it makes sense it makes complete sense and i have i have a sort of whole different range of emotions um from anger to frustration to you know feeling this is very very unfair i guess i'm slightly clouded at the moment that my my elderly mum's not going through a great time at the moment with sheila's by herself she's falling a little bit my brother and i are helping out loads of trying to get things uh back on track but but you know occasionally i i i talk to my brother and go hey is mum is mom still kind of you know have you noticed something and then a few days later she's better again so like you know it's and i'm too close to it to be objective but i guess the point i'm trying to get to is you think this research if you wound it back and let's say it was done 50 years ago 400 years ago right yeah how many women's lives might have been changed preemptive action could have been taken and again look that's the nature of progress that's the way the world goes i get that but i do get this sense and i think these things are particularly acute at the moment you know as you mentioned in the book the metoo movement we've seen this year with the sort of racial tensions in america and around the world but there's that theme of discrimination and unfairness and trying to create a more equal society and although you've written a health book to help women actually there's a political aspect to this as well there's a you know there really is it's about equality and science about not looking through the world and i appreciate i'm a man saying this but you know a very male focused world yeah but i think some everybody reacts this way men and women and nobody wants to treat women poorly nobody is aware that women are being discriminated in research and they i think it doesn't take a scientist to denounce the fact that women's social financial and physical security remains inequitable not doing that but it does take a scientist or a doctor to denounce the fact that women are also overlooked medically where our needs go way too often unacknowledged and unaddressed especially as far as our brains are concerned women's brain health remains one of the most under-researched under-diagnosed under-treated fields of medicine and is really a direct consequence of the reductive understanding of what a woman is in the first place and that i take personally and i find it incredibly offensive i talk about bikini medicine in the book and i think it's it's an interesting term that really speaks to the fact that historically medical professionals and scientists truly believed that women were essentially smaller men with different reproductive organs so from a medical standpoint it was really like saying that the only thing that makes a woman a woman from a medical perspective is the reproductive organs those parts of the body that you can cover under a bikini and that means that women's health is inherently flawed and biased because all the attention is really about the reproductive organs you go to a women's health doctor they'll draw blood to check your hormones to do a pap test to check your cervix for cancer if you're over 40 for the two you get a mammogram to make sure your breasts are okay and that's great we should we should we should take care of all we should take advantage of all those tests it's incredible progress but nowhere in the conversation our brains mentioned and i just want to to clarify for context that alzheimer's is only alzheimer's disease which is one part of a much bigger picture where women are twice as likely as men to be diagnosed with an anxiety disorder or depression we're three times more likely to develop an autoimmune disorder including those that attack the brain like multiple sclerosis we're four times more likely to suffer i'm going to underline suffer from headaches and migraines we're more likely far more likely to develop amino geomet which is the most common form of brain tumor especially after menopause and we're far more likely to die of a stroke and still when we talk about women's health we very specifically do not talk about our brains yeah absolutely lisa and you know as you were going through those statistics which i i am sure will be brand new information for a lot of my listeners and viewers you can't help but thinking if men were much more at risk of these things i suspect we would know about them and you know it's i want to make clear that whoever's listening to this or watching this on youtube right now this is a conversation that's relevant for all of us men and women your book actually lisa is relevant for men and women you know no but it is it's kind of mental no need to know that yeah unapologetically for women but i think it's so important for all men to be aware of these facts right because it's never it's never about women without men it's never women against men or women instead of men it's just that's not the point lisa i think men will enjoy this book no because actually we've all got mothers right we may have daughters we may have girlfriends wives we make friends aunties you know it's not as if we live you know we live in our silos as just men no we kind of i think a lot of us would be super interested in learning wow the female brain is different maybe this is going to help if men read it help them understand and have more maybe more compassion for what a partner or a female friend might be going through at a particular time of life do you know what i mean i think that's why it's so important for all of us if you enjoyed that conversation i really think you're going to enjoy the one i had with professor bj fogg from stanford all about habits it's right there so give it a click and let me know what you think the feeling of success is what wires in the habit emotions create habits and specifically in tiny habits what we focus on is

Channel: Dr Rangan Chatterjee

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Keywords: the4pillarplan, thestresssolution, feelbetterin5, wellness, drchatterjee, feelbetterlivemore, ranganchatterjee, 4pillars, drchatterjee podcast, health tips, nutrition tips, health hacks, live longer, age in reverse, self help, self improvement, self development, personal development, motivation, inspiration, health interview

Id: 0VX_5S0MIjo

Length: 151min 45sec (9105 seconds)

Published: Fri May 21 2021