July 3, 2025 • 28 mins
Is dementia really just a disease of old age? In this eye-opening episode of The Aging Well Podcast, Dr. Jeff Armstrong and co-host Corbin Bruton examine a major new study linking metabolic syndrome to a significantly increased risk of young-onset dementia—a condition that strikes before age 65. Drawing insights from nearly 2 million middle-aged adults over eight years, the findings are clear: your midlife health habits matter more than you think.
We unpack the connection between insulin resistance, chronic inflammation, and cognitive decline, explore the surprising risk factors—including in people who aren’t obese—and discuss practical steps you can take today to protect your brain health tomorrow. From nutrition and exercise to stress management and sleep, this episode delivers science-backed strategies for preventing early neurocognitive decline and investing in long-term wellness.
Whether you're in your 40s or 50s—or love someone who is—this conversation is a must-listen for anyone serious about aging well.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Welcome to the Aging Well podcast, where we explore the
science stories and strategies that help us live longer,
healthier and more purposeful lives.
I'm your host, Doctor Jeff Armstrong, PhD, exercise
physiologist, joined by my Co host Corbin Bruton.
In today's episode, we're breaking down what we call the
six pillars of health, span and longevity, A comprehensive
framework for aging well that goes beyond just living longer.
(00:26):
We're talking about living better with energy, clarity,
strength and connection. From physical fitness and
nutrition to mental resilience, emotional well-being, social
connection and spiritual purpose, these six pillars form
the foundation for a life that not only lasts, but thrives.
These six pillars include exercise and physical activity,
(00:46):
maintaining a healthy body composition, eating a nutrient
rich balanced diet, not smoking,practicing good sleep hygiene,
and cultivating purposeful social connections.
These aren't just good habits, they're foundational to
longevity and vibrant aging. Whether you're looking to add
years to your life or life to your years, this conversation is
(01:07):
packed with actionable insights,real life strategies, and a few
surprising truths about what it really means to age well.
Today we're diving into a large and important study out of Korea
that connects metabolic syndromewith an increased risk of young
onset dementia. What is that?
It's basically dementia that hits you before the age of 65.
(01:29):
Doctor Armstrong, let's start atthe top.
What struck you the most about this study?
I think what really struck me the most was the sheer size of
the study. This is nearly 2 million people.
That's not something you see every day when it comes to
scientific research, particularly medical research.
And with mean age of just 49, itreally challenges the standing
(01:49):
belief that dementia is strictlyan old age disease.
We're talking a lot of people that are still working.
These are people that are parenting and they're very
active individuals. That means that this isn't just
a medical issue, it's a social and an economic one too.
And it kind of reminds me of theconversations we've had with
people like Mitch and Emily Kaliansky.
That was in what I think it was episode 120 and 2:38.
(02:13):
And then also my recent conversation with dementia man
Samuel Simon in episode 253. Samuel would prefer we used
neurocognitive decline, but we're talking about a
progressive disease that probably starts decades before
we even see the first signs of the disease.
And I think Samuel might even have alluded to that a little
(02:34):
bit in his conversation. Yeah.
You know me working in that assisted living.
Now, I mentioned this before, but I've learned that dementia
and other neuropathic diseases, they really don't discriminate.
In fact, I remember there was this one gentleman who had full
on Alzheimer's. He was only, I want to say mid
(02:58):
to late 50s. He was, he was really young.
And so that's just something that I've learned that if that
disease wants you, it's, it's coming.
There's no, there's no discrimination.
Yeah. But I think as we'll talk about
there, there are ways that we can prevent, slow the progress
and, you know, really limit the opportunities for us to hit, hit
(03:19):
us. But you're right.
I mean, we it doesn't really differentiate between ages and
then we don't it's not somethingwe, you know, expected as we get
into our 80s that's going to come.
You know, it doesn't have to exist, but it also doesn't hit
us only in our older years. If you're enjoying the Aging
Well podcast, be sure to like, subscribe or follow on your
favorite platform so you will never miss an episode.
(03:40):
And if you find our conversations helpful, please
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viewers and listeners. Thank you.
(04:01):
And now back to the podcast. Doctor Armstrong for our
listeners and our viewers that they might be new to this term,
What exactly is metabolic syndrome?
Well, hopefully you recall from Physiology of exercise.
Metabolic syndrome is a cluster of conditions that tend to occur
together. So think of it as a warning sign
or warning system for your body's metabolic health.
(04:23):
And it includes 5 key markers. You have elevated waist
circumference, so think of Dunlap's disease or the muffin
top. If you're putting on weight
above the waistline or the beltline, that's generally
considered to be a risk. High blood pressure, elevated
fasting glucose, high triglycerides and low HDL, which
is considered to be the quote UNquote good cholesterol.
(04:45):
So if you have three or more of these, you're considered to have
metabolic syndrome. But here's the important part.
Each one of these markers on itsown has been linked to poor
brain health. So when they come together, the
risks really just seem to amplify.
The researchers found that 24% increased risk of all young
onset dementia. Now that seems pretty huge to
(05:06):
me, but let's break that down a little bit.
What types of dementia are we talking?
About good point. The study specifically mentioned
vascular dementia and Alzheimer's disease.
Both saw an increased risk in people with metabolic syndrome.
Now, vascular dementia in particular has a very strong
connection with cardiovascular and metabolic health.
It's often caused by impaired blood flow to the brain, you
(05:29):
know, small strokes or damage tothe small blood vessels in the
brain. And with Alzheimer's, the
dementia mechanisms are a littlebit different, but they're still
connected. Chronic inflammation, insulin
resistance in the brain, just sometimes now referred to as
type 3 diabetes, and the reducedability to clear beta amyloid
proteins all come into play. So it's a double edged sword.
(05:53):
Metabolic syndrome sets the stage for both types of
cognitive decline and the study only focused on the two.
And if you recall from our conversation with the Kleinsky's
that there's really numerous different types of dementia
things that can cause it. And so we can't necessarily
extend this to all forms of dementia, but it's very likely
that brain health is going to beimpacted by metabolic syndrome
(06:16):
no matter what the the type of dementia it might be.
Yeah. And that kind of makes sense
with insulin resistance, especially with the early signs
of, as you call it, Dunlapse disease, because that, that
that's a, that's a sign of insulin resistant as well.
Let's dive back into the articlea bit.
Now, the researchers also mentioned that certain people
(06:39):
were at an even higher risk, like women, people who were
younger and even those who weren't obese or who didn't
drink. Now, to me that seems a little
counterintuitive. Yeah, it really does flip some
of our assumptions on their head.
We often associate the risk for dementia with being older, male,
overweight and so on. But the researchers found that
(07:01):
higher risks among people aged 40 to 49 compared to those in
their 50s and among women. So the researchers found also
that there's an increased risk in people who didn't drink and
those who weren't obese. And that tells us that we can't
just rely on what's visible. We can't just rely.
And like you said, the Dunlap's disease you have, if you have
poor metabolic health, health, even if you're not overweight,
(07:24):
that's a problem. And it's what some people call
metabolically obese, normal weight.
This is kind of, I think you've maybe heard me talk about skinny
fat and you know, the role of this role fat, especially how
belly flat plays kind of a silent role in all of this.
Yeah, actually, I remember when I was in your course, we were
utilizing the bod pod to determine our potty fat
(07:46):
percentage. And there was 1 gal in
particular. And she physically, on the
outward appearance, looked really, really lean.
And I remember when she got intothe bod pod, her percentage was
actually high. And she's like, how is that
possible? And you had mentioned you're
like, well, it's not the scientific term, but the term
is, you know, skinny fat. And basically it's a good thing
(08:08):
we're mentioning now because we can get on top of it because
although a certain individuals look leaner on the outside,
there's more fat, there's more of that visceral fat around the
organs, which is more dangerous.And so certain people are like,
oh, I look good, I look lean, but they're not recognizing
that, hey, there could be an even a higher level of you being
(08:31):
at risk due to that visceral fat.
Yeah, I think, you know, that's really important thing for
people to look at, especially aswe look at things like BMI, you
know, body mass index where, youknow, talk to people and say,
well, I weigh the same as I did in high school, but you go and
do the skin folds on. I'm like, I did skin folds on
this woman who looked rather slender.
She was probably probably in her60s at the time.
(08:51):
But I grabbed the tricep foldingon the back of the arm and it
was like 2 inches. And I'm like, I can't be right.
I got I must have muscle in there.
So I'm doing all the stuff to kind of make sure that had
muscle or had only fat in the skin.
And Yep, sure enough, it was, itwas just skin and fat and it was
like no muscle on that bone. It was just all fat.
But, you know, from outside appearances, she looked like she
(09:12):
was fine. And so that's again, what we
would define is that skinny fat.And so, and even, you know, if
it's not necessarily a high percentage of body fat, people
can still have insulin resistance and other signs of
metabolic syndrome and even highblood pressure, you know, high
cholesterol. All those types of things can
still be present when a person isn't obese.
OK, so how do we get this? We get ahead of this.
(09:36):
What can people do in their 40s or 50s and what can they do now
to reduce their risk? Well, there's a lot people can
do and that's hopefully a positive part of this story is
one thing that they can do is follow this podcast.
Of course, you know, the we talkabout these things all the time,
but the Korean study reinforces what we've known from other
(09:59):
research that lifestyle factors matter and they matter early.
So exercise, of course, is a bigone, especially strength
training and aerobic exercise. Again, I mentioned, you know,
woman with seemingly normal body, very little muscle mass,
that's going to contribute to metabolic syndrome.
And in nutrition too, you know, we often recommend the
Mediterranean style eating. We don't necessarily see the
(10:21):
metabolic or Mediterranean diet because I think it is a
Mediterranean style where we take those basic principles and
apply them to our own cultural norms.
But eating that more Mediterranean style eating is
recommended because it supports metabolic in brain health.
We talk a lot about sleep. Sleep is another pillar.
Poor sleep is a risk for both metabolic dysfunction and
(10:43):
cognitive decline, and we can't overlook stress management.
And we know that chronic stress elevates cortisol levels and
that can wreak havoc on the blood sugar and our inflammation
levels. So.
Do you think you could give a couple samples of brain healthy
eating? Brain healthy heating.
I mean, I think again, we just go back to that Mediterranean
(11:04):
style we had in a recent episodewhen I had Lewis Burdis on and
talking about reversing diabetes, he really emphasized
the plant based diet. I don't think we have to
necessarily go one hundred 100% plant based, but he emphasized
the the critical role of eating whole fruits, whole vegetables,
(11:24):
legumes, eating, getting healthyfats and proteins from nuts and
eating whole grains. And it's very much within kind
of the framework of the metabolic diet or the
metropolitan, ah, what it's thatdiet called the Mediterranean
diet. And so eating those types of
foods, I think if we can learn more into a flexitarian style of
(11:45):
eating, you know, where we're eating a limited amount of meat,
eating limited red meat, eating more oily fish and eating, you
know, more kind of white meat like chicken, lower fat meat,
eating healthy oils, you know, getting those healthy oils from
things like avocado, olive oil, you know, again, the
Mediterranean types of oils, eating more root based foods.
(12:08):
It kind of takes us more into that Nordic diet.
Those are all things that are going to tend to feed the brain
a little bit more effectively. Now, there could be an argument
for the ketogenic diet as being a bit more of a brain healthy
diet. And I, I would lean into that as
well, although I'm a little leery of too low of the fruits
and vegetables that can come from people eating more of a
(12:30):
ketogenic diet. I would definitely not lean into
a carnivore diet. And I don't know that I would
lean 100% into a purely vegetarian diet because unless
we can we're able to get our proteins more effectively.
Do you? Think though with like the
insulin resistance being one of the warning signs of early onset
of dementia, that a low carb diet at first just to help
(12:54):
regulate insulin levels would would be more beneficial.
Maybe not carnivore, but per SE,but you know, at least low carb.
Well, yeah, I think if the weight is an issue and obviously
you're not eating for performance like an athlete
would, that an initial period oftime on a ketogenic diet can
help to get that weight off quickly, which should help to
(13:16):
bring in line the insulin resistance and obviously
increasing exercise in that process.
But once we kind of get that weight down, shifting to a more
healthy, higher carbohydrate, more plant based diet is
probably going to be the healthier choice now.
You also mentioned healthier fats and I personally I love
(13:36):
Omega threes. I've actually been adding them
into my just normal dietary supplements.
Like mid lunch I'll pop a coupleOmega threes and it almost like
gives me a brain booster and I don't think people are utilizing
that enough. And I know we've also mentioned
like creatine and stuff like that, but what are some
(13:57):
underrated brain boosters that people might be missing to help
with their cognitive function? Well, I think definitely
creatine should be in there, theOmega threes.
I would recommend getting Omega threes more through the diet as
opposed to supplements because especially you know, the, the
cheaper quality of supplements you might be buying out there
(14:18):
are going to tend to possibly berancid because it is an oil and
you know, if it's not refrigerated, it's going to lose
some of its potency. But you're better off getting it
from the Whole Foods. I would think others, just your
general nutrition is going to beprobably a better brain booster.
There's not a ton. I mean, I I think if you can do
(14:38):
like, say the topical glutathione that Nam Patel
recommends could be a good option.
Think secondary to that might besomething more like a Glynac ET.
You know, that one is going to be more bioavailable as opposed
to just, you know, eating, you know, taking a glutathione
supplement. But, you know, I think
(14:59):
creatine's probably one of the top ones that I would recommend.
And in just getting that diet inorder is probably one of your
best ways of brain boosting. And I would also add to that,
you know, in terms of insulin resistance, moderate to lower
fat is going to be much healthier as well.
Typical recommendations have been about 20 to 30% of your
caloric intake. Louis Burdis was pretty specific
(15:22):
in saying that 10 to 15 was muchmore effective in terms of
reversing diabetes and lowering that insulin resistance, which
we tend to think of high carbohydrate as being the the
enemy there when it comes to insulin resistance.
But in fact, it could be fat. And so we want to make sure that
we're eating whole fat, whole carbohydrates, and really
limiting our fats to good healthy fats and a little bit
(15:45):
less of them. Now, one thing that I know that
you're super passionate about, Doctor Armstrong, it's not just
giving people information, but motivation.
So if someone is listening and feels a little overwhelmed by
these stats, what would you say?I get that I can see that the
data can be quite overwhelming and even scary for people,
especially, you know, if they'regoing to doctor Google.
(16:07):
So kind of just it's always goodto just go back to the idea of
small wins. You know, baby steps.
If you take just a 10 minute walk after meals, that's going
to help improve your insulin sensitivity.
If you swap sugary drinks for water or green tea, you're
reducing inflammation, and adding anti-inflammatory foods
like turmeric to the diet can bebeneficial.
(16:30):
We've already talked about adding Omega threes.
These aren't monumental changes,they're just doable shifts that
overtime can help protect our brain.
I've started putting just a little scoop of turmeric in my
coffee in the morning and barelytaste it.
It is a little bit messier because that yellow orange color
can get on everything if you're not careful.
But and you're going to be a little bit more cautious about
(16:52):
brushing your teeth in the morning.
So you don't have yellow teeth going to work.
But it really seems to help. And it's one of the best
supplements out there to help kind of reduce that
inflammation. And just including that a lot
more in just our food, just putting it in food.
I mean, you can sprinkle that inalmost any kind of food and it's
not going to add tremendously tothe taste of it, but it's going
(17:12):
to give you the benefits of the tumor.
Yeah, I recently, actually recently read something and I
don't know if it was just satire, but it said turmeric is
actually one of the causes of fatty liver.
And I'm like, what? You mean to tell me They've had
hundreds and hundreds and hundreds of literature and
research out there that have allsaid that it's really good for
(17:35):
inflammation and it's backed up by all these trials and clinical
studies. And, and this one, and I just, I
just stopped reading it midway because I was like, that just
doesn't make any sense. And I actually, I tried to look
up other things to, to see if itcould back it up.
There wasn't, I couldn't find anything that could back that
up. So.
Yeah. And I think that's, you know, a
(17:57):
cautious caution we should really under score for our
listeners and viewers is for something, you know, we want to
be promoting with better scientific literacy.
And you know, when we read thesearticles, don't just go by
something you see on social media or somebody's blog page,
go to the original article, but also read other articles as
(18:17):
well. You know, Google is a great
source for finding multiple different articles and
scientific journals that can support or refute some of the
information that we're getting if we just take a little bit of
time to do that. And you know, The thing is,
don't try to make these big steps.
Don't try and, you know, think that one science article is is
(18:37):
the end all. You know, look for the little
things that we can do on a dailybasis that's going to improve
our health. You know, what can we do to to
reduce our body composition justa little bit, 2 lbs a week, you
know, and just increase our steps.
If we're not doing our 10,000 steps, hitting 5000, shoot for
6000 and shoot for 7000, you know, just little incremental
changes. Baby steps.
(18:58):
A baby steps, right? What about Bob?
You know, we often think of aging and cognitive decline is
inevitable. But what this study really and
others like it show us is that it's how we live in midlife and
I would argue even earlier in life.
And we talk often and that, you know, aging well begins at
conception, you know, from the moment we are born and we start
(19:20):
forming habits, those habits aregoing to lead into our health as
we get into midlife and beyond. And so it matters a lot more
than people tend to realize. You know, more active we are,
the healthier we're ultimately going to be.
Wow, that's that's such a powerful message.
Hey doctor, I'm sorry. Before we wrap things up, were
there any limitations in the study that we should keep in
(19:41):
mind? Yeah, I'm glad you asked that.
And again, as we talk about science, scientific literacy, we
have to look at the limitations in the studies as well as the
information we're getting because no study is perfect.
I have yet to see a perfect scientific study out there.
There's always going to be limitations.
In this particular study, I think the sample size being as
large it is, is a big plus. But the study didn't include
(20:02):
genetic data like APO E4 status.Which is a well known risk for
Alzheimer's. It also didn't account for
education level, which educationlevel has correlation to
Alzheimer's disease, hearing loss, also, you know, past head
trauma. These are all factors that The
Lancet Commission has identifiedas major modifiable risks.
(20:24):
And it was based on a Korean population.
So we also have to be cautious about how the findings apply to
other groups may be very different for other populations.
But even with those caveats, thestudy's design and that sample
size being as large as it is, they had a pretty good follow up
period. They were operating off of a
National Health database makes it a pretty strong piece of
(20:46):
evidence, at least to consider maybe how it might generalize to
other populations. It's not the final word, but it
certainly is a meaningful one. Wow.
OK, Doctor Armstrong, final thoughts.
What do you want listeners and viewers to remember from this
conversation? Well, first thing is that they
need to be watching and listening to the Aging Well
(21:06):
podcast and be sure to subscribeand follow depending on which
platform you're on and share thepodcast.
But above and beyond that, I think the message I really want
for the listeners and the viewers is that prevention is
powerful and it doesn't have to require perfection.
Metabolic syndrome is the coexistence of insulin
resistance, hypertension, and dyslipidemia, as you recall from
(21:28):
Physiology of exercise. I stress in that class that
obesity is a central factor in metabolic syndrome.
But it's also important to recognize that this is not the
only contributing factor. Normal weight individuals can be
metabolically unhealthy. And it warrants having our blood
checked once in a while and see where our glucose levels are.
Maybe, you know, investing in a continuous glucose monitor for a
(21:50):
period of time just to try to track how are our sugar levels,
you know, outside of going to the physician once every year or
so. And it's also important to
recognize that neurocognitive decline is not a condition that
is limited to the oldest of America.
If you are in your 40s or 50s now, now is the time to invest
in the future of your brain health. 1020, thirty years ago
(22:11):
might have been an even better time to invest in your brain
health. But know your numbers.
Move your body, eat real food, get quality sleep, stay socially
connected. Sounds pretty familiar to our
six pillars. And these things aren't just
good advice, they're really yourinsurance policy against
cognitive decline. Hey.
Speaking of investing in your overall mental health, we stress
(22:36):
that aging it. We stress that aging well begins
at conception. So it almost seems like it would
behoove someone to invest in brain health before they're even
born. Well, it's kind of a hard choice
for the individual to make for themselves.
But as parents, as prospective parents, you know, somebody
that's trying to have kids, we want to be very aware of what
(22:57):
are we doing, you know, particularly for the mother.
But you know, I think there's, as we've talked about some
epigenetic studies in recent, inrecent podcast episodes, we
talked about one in, you know, the trauma, the fact that trauma
has on the epigenetics. We don't know what our habits,
what impact that's going to haveon our future offspring, whether
it's our kids or our grandkids. And so particularly when we are
(23:20):
going through puberty, as we arein our childbearing years, our
parenting years, we want to be very aware of how we are living
because may have an impact on our kids.
But also, you know, think about the long term health of your
child from an early age. You know, what are we feeding
them? How are we feeding them?
Are we allowing them to eat the crappy foods that are being out
(23:41):
there, the processed foods and all the chemicals and
everything? Or are we just kind of
expecting, well, when they hit 30 or 40, they'll figure it out
and they'll start eating healthyand start exercising.
You know, we need to have schools that are promoting
healthier diets, having more physical activity and the arts
like music and other creative arts.
All of those things are early things that we can do for brain
(24:04):
health. And the Kliansky's have
mentioned numerous times that it's important too for the
developing brain to consider theimpacts that marijuana use and
alcohol use can have on the brain development.
And so considering that is important as well.
And even, you know, as we consider marijuana use and, you
know, other recreational drugs and alcohol and those types of
(24:27):
things, even in our 20s, 30s andbeyond, those are all having
potential impacts on our overallbrain health.
So I think it behooves us to really have a very conscious
awareness of what are we puttinginto our bodies?
How are we using our bodies to protect our brains in the long
run? Yeah, it doesn't have to
necessarily be drugs and alcohol.
(24:48):
It can be just preservatives that are in our food as well,
which is crazy if you think about it, because usually people
are like, oh, I'm young, like won't have any effect on me.
I can, I can get away with, you know, XY and Z.
And there's also a pretty controversial statement, but the
whole my body, my choice. But realistically, if you want
(25:11):
to have kids in the future, whether it's near future or down
the road future, what you're doing to your body now could
have an impact on them. That that is a, that is a, that
is a whole deep level of thing. Really.
You're not just planning for your own future health, but
you're planning for Children's Health and possibly your
(25:32):
grandchildren's health as well. That's that's a concept that a
lot of, I don't think a lot of people can really.
I think they can. I just don't think it's brought
to their level of awareness. And I think, you know, people
just we tend to be a society that lives in the now and we
don't look at the future. You know, we, you know, we look
back, we'll blame everything in the past.
(25:54):
We'll blame our parents for stuff, but we don't look at, OK,
well, what am I currently doing to screw up my kids?
And I deal with that every day. It's like, what am I doing to
screw these kids up? What, what is my fault here?
But, you know, I think it's important that we, we be very
considerate of future generations and what our, our
(26:15):
choices are making, not only forour own kids, but really for
society as a whole. Because if we don't take care of
our brains, we have an aging population.
And if more and more people are going to be getting dementia,
who's left to care for them? You know, there's not as many
kids being born, right? More and more aged people.
We, we're not going to be able to care for each other if we're
all, you know, lacking in brain cognitive ability.
(26:37):
And so it behooves us to take care of it earlier rather than
later, yeah. It also kind of sounds like the
best way to take care of it is to just stand on our six pillars
and just really recognize the importance for future brain
health. I mean stick with exercise and
physical activity, maintain a healthy body composition, eating
(26:59):
a healthy diet, good sleep hygiene, not smoking and that
purposeful social connection. Yeah.
And, you know, it's it's interesting and we're have a
follow up episode on the six pillars of aging well, But I was
talking with my class this week and, you know, I started
thinking smoking is not as big of an issue in our society
anymore. You know, fewer and fewer people
(27:20):
are smoking, particularly younger people.
But you know, where might we need to kind of fit into our
pillars, you know, moderate healthy alcohol consumption.
And I think that's something we can kind of elaborate on a
little bit more in regards to what that does for brain health.
But we all want to age well, andthat includes staying sharp,
keeping engaged, being purposeful for as long as
(27:41):
possible. And again, that starts with the
choices we make today, right? Well, thanks for breaking this
down with so much clarity and compassion.
And to our listeners and viewers, if you found this
helpful, share it with someone who might benefit.
Because when it comes to brain health, it's never too early or
too late to start aging well. Aging well.
(28:01):
Thank you for listening. Hope you benefited from today's
podcast and until next time, keep Aging well.
Welcome to the Aging Well podcast, where we explore the
science stories and strategies that help us live longer,
healthier and more purposeful lives.
I'm your host, Doctor Jeff Armstrong, PhD, exercise
physiologist, joined by my Co host Corbin Bruton.
In today's episode, we're breaking down what we call the
six pillars of health, span and longevity, A comprehensive
framework for aging well that goes beyond just living longer.
(00:26):
We're talking about living better with energy, clarity,
strength and connection. From physical fitness and
nutrition to mental resilience, emotional well-being, social
connection and spiritual purpose, these six pillars form
the foundation for a life that not only lasts, but thrives.
These six pillars include exercise and physical activity,
(00:46):
maintaining a healthy body composition, eating a nutrient
rich balanced diet, not smoking,practicing good sleep hygiene,
and cultivating purposeful social connections.
These aren't just good habits, they're foundational to
longevity and vibrant aging. Whether you're looking to add
years to your life or life to your years, this conversation is
(01:07):
packed with actionable insights,real life strategies, and a few
surprising truths about what it really means to age well.
Today we're diving into a large and important study out of Korea
that connects metabolic syndromewith an increased risk of young
onset dementia. What is that?
It's basically dementia that hits you before the age of 65.
(01:29):
Doctor Armstrong, let's start atthe top.
What struck you the most about this study?
I think what really struck me the most was the sheer size of
the study. This is nearly 2 million people.
That's not something you see every day when it comes to
scientific research, particularly medical research.
And with mean age of just 49, itreally challenges the standing
(01:49):
belief that dementia is strictlyan old age disease.
We're talking a lot of people that are still working.
These are people that are parenting and they're very
active individuals. That means that this isn't just
a medical issue, it's a social and an economic one too.
And it kind of reminds me of theconversations we've had with
people like Mitch and Emily Kaliansky.
That was in what I think it was episode 120 and 2:38.
(02:13):
And then also my recent conversation with dementia man
Samuel Simon in episode 253. Samuel would prefer we used
neurocognitive decline, but we're talking about a
progressive disease that probably starts decades before
we even see the first signs of the disease.
And I think Samuel might even have alluded to that a little
(02:34):
bit in his conversation. Yeah.
You know me working in that assisted living.
Now, I mentioned this before, but I've learned that dementia
and other neuropathic diseases, they really don't discriminate.
In fact, I remember there was this one gentleman who had full
on Alzheimer's. He was only, I want to say mid
(02:58):
to late 50s. He was, he was really young.
And so that's just something that I've learned that if that
disease wants you, it's, it's coming.
There's no, there's no discrimination.
Yeah. But I think as we'll talk about
there, there are ways that we can prevent, slow the progress
and, you know, really limit the opportunities for us to hit, hit
(03:19):
us. But you're right.
I mean, we it doesn't really differentiate between ages and
then we don't it's not somethingwe, you know, expected as we get
into our 80s that's going to come.
You know, it doesn't have to exist, but it also doesn't hit
us only in our older years. If you're enjoying the Aging
Well podcast, be sure to like, subscribe or follow on your
favorite platform so you will never miss an episode.
(03:40):
And if you find our conversations helpful, please
share the podcast with a friend because aging is something we're
all doing and we're better at doing it together.
And support our guests in this podcast financially by visiting
the affiliate links in the episode description below and
use the links or codes provided for discounts on products we
have vetted and feel comfortablerecommending to our valued
viewers and listeners. Thank you.
(04:01):
And now back to the podcast. Doctor Armstrong for our
listeners and our viewers that they might be new to this term,
What exactly is metabolic syndrome?
Well, hopefully you recall from Physiology of exercise.
Metabolic syndrome is a cluster of conditions that tend to occur
together. So think of it as a warning sign
or warning system for your body's metabolic health.
(04:23):
And it includes 5 key markers. You have elevated waist
circumference, so think of Dunlap's disease or the muffin
top. If you're putting on weight
above the waistline or the beltline, that's generally
considered to be a risk. High blood pressure, elevated
fasting glucose, high triglycerides and low HDL, which
is considered to be the quote UNquote good cholesterol.
(04:45):
So if you have three or more of these, you're considered to have
metabolic syndrome. But here's the important part.
Each one of these markers on itsown has been linked to poor
brain health. So when they come together, the
risks really just seem to amplify.
The researchers found that 24% increased risk of all young
onset dementia. Now that seems pretty huge to
(05:06):
me, but let's break that down a little bit.
What types of dementia are we talking?
About good point. The study specifically mentioned
vascular dementia and Alzheimer's disease.
Both saw an increased risk in people with metabolic syndrome.
Now, vascular dementia in particular has a very strong
connection with cardiovascular and metabolic health.
It's often caused by impaired blood flow to the brain, you
(05:29):
know, small strokes or damage tothe small blood vessels in the
brain. And with Alzheimer's, the
dementia mechanisms are a littlebit different, but they're still
connected. Chronic inflammation, insulin
resistance in the brain, just sometimes now referred to as
type 3 diabetes, and the reducedability to clear beta amyloid
proteins all come into play. So it's a double edged sword.
(05:53):
Metabolic syndrome sets the stage for both types of
cognitive decline and the study only focused on the two.
And if you recall from our conversation with the Kleinsky's
that there's really numerous different types of dementia
things that can cause it. And so we can't necessarily
extend this to all forms of dementia, but it's very likely
that brain health is going to beimpacted by metabolic syndrome
(06:16):
no matter what the the type of dementia it might be.
Yeah. And that kind of makes sense
with insulin resistance, especially with the early signs
of, as you call it, Dunlapse disease, because that, that
that's a, that's a sign of insulin resistant as well.
Let's dive back into the articlea bit.
Now, the researchers also mentioned that certain people
(06:39):
were at an even higher risk, like women, people who were
younger and even those who weren't obese or who didn't
drink. Now, to me that seems a little
counterintuitive. Yeah, it really does flip some
of our assumptions on their head.
We often associate the risk for dementia with being older, male,
overweight and so on. But the researchers found that
(07:01):
higher risks among people aged 40 to 49 compared to those in
their 50s and among women. So the researchers found also
that there's an increased risk in people who didn't drink and
those who weren't obese. And that tells us that we can't
just rely on what's visible. We can't just rely.
And like you said, the Dunlap's disease you have, if you have
poor metabolic health, health, even if you're not overweight,
(07:24):
that's a problem. And it's what some people call
metabolically obese, normal weight.
This is kind of, I think you've maybe heard me talk about skinny
fat and you know, the role of this role fat, especially how
belly flat plays kind of a silent role in all of this.
Yeah, actually, I remember when I was in your course, we were
utilizing the bod pod to determine our potty fat
(07:46):
percentage. And there was 1 gal in
particular. And she physically, on the
outward appearance, looked really, really lean.
And I remember when she got intothe bod pod, her percentage was
actually high. And she's like, how is that
possible? And you had mentioned you're
like, well, it's not the scientific term, but the term
is, you know, skinny fat. And basically it's a good thing
(08:08):
we're mentioning now because we can get on top of it because
although a certain individuals look leaner on the outside,
there's more fat, there's more of that visceral fat around the
organs, which is more dangerous.And so certain people are like,
oh, I look good, I look lean, but they're not recognizing
that, hey, there could be an even a higher level of you being
(08:31):
at risk due to that visceral fat.
Yeah, I think, you know, that's really important thing for
people to look at, especially aswe look at things like BMI, you
know, body mass index where, youknow, talk to people and say,
well, I weigh the same as I did in high school, but you go and
do the skin folds on. I'm like, I did skin folds on
this woman who looked rather slender.
She was probably probably in her60s at the time.
(08:51):
But I grabbed the tricep foldingon the back of the arm and it
was like 2 inches. And I'm like, I can't be right.
I got I must have muscle in there.
So I'm doing all the stuff to kind of make sure that had
muscle or had only fat in the skin.
And Yep, sure enough, it was, itwas just skin and fat and it was
like no muscle on that bone. It was just all fat.
But, you know, from outside appearances, she looked like she
(09:12):
was fine. And so that's again, what we
would define is that skinny fat.And so, and even, you know, if
it's not necessarily a high percentage of body fat, people
can still have insulin resistance and other signs of
metabolic syndrome and even highblood pressure, you know, high
cholesterol. All those types of things can
still be present when a person isn't obese.
OK, so how do we get this? We get ahead of this.
(09:36):
What can people do in their 40s or 50s and what can they do now
to reduce their risk? Well, there's a lot people can
do and that's hopefully a positive part of this story is
one thing that they can do is follow this podcast.
Of course, you know, the we talkabout these things all the time,
but the Korean study reinforces what we've known from other
(09:59):
research that lifestyle factors matter and they matter early.
So exercise, of course, is a bigone, especially strength
training and aerobic exercise. Again, I mentioned, you know,
woman with seemingly normal body, very little muscle mass,
that's going to contribute to metabolic syndrome.
And in nutrition too, you know, we often recommend the
Mediterranean style eating. We don't necessarily see the
(10:21):
metabolic or Mediterranean diet because I think it is a
Mediterranean style where we take those basic principles and
apply them to our own cultural norms.
But eating that more Mediterranean style eating is
recommended because it supports metabolic in brain health.
We talk a lot about sleep. Sleep is another pillar.
Poor sleep is a risk for both metabolic dysfunction and
(10:43):
cognitive decline, and we can't overlook stress management.
And we know that chronic stress elevates cortisol levels and
that can wreak havoc on the blood sugar and our inflammation
levels. So.
Do you think you could give a couple samples of brain healthy
eating? Brain healthy heating.
I mean, I think again, we just go back to that Mediterranean
(11:04):
style we had in a recent episodewhen I had Lewis Burdis on and
talking about reversing diabetes, he really emphasized
the plant based diet. I don't think we have to
necessarily go one hundred 100% plant based, but he emphasized
the the critical role of eating whole fruits, whole vegetables,
(11:24):
legumes, eating, getting healthyfats and proteins from nuts and
eating whole grains. And it's very much within kind
of the framework of the metabolic diet or the
metropolitan, ah, what it's thatdiet called the Mediterranean
diet. And so eating those types of
foods, I think if we can learn more into a flexitarian style of
(11:45):
eating, you know, where we're eating a limited amount of meat,
eating limited red meat, eating more oily fish and eating, you
know, more kind of white meat like chicken, lower fat meat,
eating healthy oils, you know, getting those healthy oils from
things like avocado, olive oil, you know, again, the
Mediterranean types of oils, eating more root based foods.
(12:08):
It kind of takes us more into that Nordic diet.
Those are all things that are going to tend to feed the brain
a little bit more effectively. Now, there could be an argument
for the ketogenic diet as being a bit more of a brain healthy
diet. And I, I would lean into that as
well, although I'm a little leery of too low of the fruits
and vegetables that can come from people eating more of a
(12:30):
ketogenic diet. I would definitely not lean into
a carnivore diet. And I don't know that I would
lean 100% into a purely vegetarian diet because unless
we can we're able to get our proteins more effectively.
Do you? Think though with like the
insulin resistance being one of the warning signs of early onset
of dementia, that a low carb diet at first just to help
(12:54):
regulate insulin levels would would be more beneficial.
Maybe not carnivore, but per SE,but you know, at least low carb.
Well, yeah, I think if the weight is an issue and obviously
you're not eating for performance like an athlete
would, that an initial period oftime on a ketogenic diet can
help to get that weight off quickly, which should help to
(13:16):
bring in line the insulin resistance and obviously
increasing exercise in that process.
But once we kind of get that weight down, shifting to a more
healthy, higher carbohydrate, more plant based diet is
probably going to be the healthier choice now.
You also mentioned healthier fats and I personally I love
(13:36):
Omega threes. I've actually been adding them
into my just normal dietary supplements.
Like mid lunch I'll pop a coupleOmega threes and it almost like
gives me a brain booster and I don't think people are utilizing
that enough. And I know we've also mentioned
like creatine and stuff like that, but what are some
(13:57):
underrated brain boosters that people might be missing to help
with their cognitive function? Well, I think definitely
creatine should be in there, theOmega threes.
I would recommend getting Omega threes more through the diet as
opposed to supplements because especially you know, the, the
cheaper quality of supplements you might be buying out there
(14:18):
are going to tend to possibly berancid because it is an oil and
you know, if it's not refrigerated, it's going to lose
some of its potency. But you're better off getting it
from the Whole Foods. I would think others, just your
general nutrition is going to beprobably a better brain booster.
There's not a ton. I mean, I I think if you can do
(14:38):
like, say the topical glutathione that Nam Patel
recommends could be a good option.
Think secondary to that might besomething more like a Glynac ET.
You know, that one is going to be more bioavailable as opposed
to just, you know, eating, you know, taking a glutathione
supplement. But, you know, I think
(14:59):
creatine's probably one of the top ones that I would recommend.
And in just getting that diet inorder is probably one of your
best ways of brain boosting. And I would also add to that,
you know, in terms of insulin resistance, moderate to lower
fat is going to be much healthier as well.
Typical recommendations have been about 20 to 30% of your
caloric intake. Louis Burdis was pretty specific
(15:22):
in saying that 10 to 15 was muchmore effective in terms of
reversing diabetes and lowering that insulin resistance, which
we tend to think of high carbohydrate as being the the
enemy there when it comes to insulin resistance.
But in fact, it could be fat. And so we want to make sure that
we're eating whole fat, whole carbohydrates, and really
limiting our fats to good healthy fats and a little bit
(15:45):
less of them. Now, one thing that I know that
you're super passionate about, Doctor Armstrong, it's not just
giving people information, but motivation.
So if someone is listening and feels a little overwhelmed by
these stats, what would you say?I get that I can see that the
data can be quite overwhelming and even scary for people,
especially, you know, if they'regoing to doctor Google.
(16:07):
So kind of just it's always goodto just go back to the idea of
small wins. You know, baby steps.
If you take just a 10 minute walk after meals, that's going
to help improve your insulin sensitivity.
If you swap sugary drinks for water or green tea, you're
reducing inflammation, and adding anti-inflammatory foods
like turmeric to the diet can bebeneficial.
(16:30):
We've already talked about adding Omega threes.
These aren't monumental changes,they're just doable shifts that
overtime can help protect our brain.
I've started putting just a little scoop of turmeric in my
coffee in the morning and barelytaste it.
It is a little bit messier because that yellow orange color
can get on everything if you're not careful.
But and you're going to be a little bit more cautious about
(16:52):
brushing your teeth in the morning.
So you don't have yellow teeth going to work.
But it really seems to help. And it's one of the best
supplements out there to help kind of reduce that
inflammation. And just including that a lot
more in just our food, just putting it in food.
I mean, you can sprinkle that inalmost any kind of food and it's
not going to add tremendously tothe taste of it, but it's going
(17:12):
to give you the benefits of the tumor.
Yeah, I recently, actually recently read something and I
don't know if it was just satire, but it said turmeric is
actually one of the causes of fatty liver.
And I'm like, what? You mean to tell me They've had
hundreds and hundreds and hundreds of literature and
research out there that have allsaid that it's really good for
(17:35):
inflammation and it's backed up by all these trials and clinical
studies. And, and this one, and I just, I
just stopped reading it midway because I was like, that just
doesn't make any sense. And I actually, I tried to look
up other things to, to see if itcould back it up.
There wasn't, I couldn't find anything that could back that
up. So.
Yeah. And I think that's, you know, a
(17:57):
cautious caution we should really under score for our
listeners and viewers is for something, you know, we want to
be promoting with better scientific literacy.
And you know, when we read thesearticles, don't just go by
something you see on social media or somebody's blog page,
go to the original article, but also read other articles as
(18:17):
well. You know, Google is a great
source for finding multiple different articles and
scientific journals that can support or refute some of the
information that we're getting if we just take a little bit of
time to do that. And you know, The thing is,
don't try to make these big steps.
Don't try and, you know, think that one science article is is
(18:37):
the end all. You know, look for the little
things that we can do on a dailybasis that's going to improve
our health. You know, what can we do to to
reduce our body composition justa little bit, 2 lbs a week, you
know, and just increase our steps.
If we're not doing our 10,000 steps, hitting 5000, shoot for
6000 and shoot for 7000, you know, just little incremental
changes. Baby steps.
(18:58):
A baby steps, right? What about Bob?
You know, we often think of aging and cognitive decline is
inevitable. But what this study really and
others like it show us is that it's how we live in midlife and
I would argue even earlier in life.
And we talk often and that, you know, aging well begins at
conception, you know, from the moment we are born and we start
(19:20):
forming habits, those habits aregoing to lead into our health as
we get into midlife and beyond. And so it matters a lot more
than people tend to realize. You know, more active we are,
the healthier we're ultimately going to be.
Wow, that's that's such a powerful message.
Hey doctor, I'm sorry. Before we wrap things up, were
there any limitations in the study that we should keep in
(19:41):
mind? Yeah, I'm glad you asked that.
And again, as we talk about science, scientific literacy, we
have to look at the limitations in the studies as well as the
information we're getting because no study is perfect.
I have yet to see a perfect scientific study out there.
There's always going to be limitations.
In this particular study, I think the sample size being as
large it is, is a big plus. But the study didn't include
(20:02):
genetic data like APO E4 status.Which is a well known risk for
Alzheimer's. It also didn't account for
education level, which educationlevel has correlation to
Alzheimer's disease, hearing loss, also, you know, past head
trauma. These are all factors that The
Lancet Commission has identifiedas major modifiable risks.
(20:24):
And it was based on a Korean population.
So we also have to be cautious about how the findings apply to
other groups may be very different for other populations.
But even with those caveats, thestudy's design and that sample
size being as large as it is, they had a pretty good follow up
period. They were operating off of a
National Health database makes it a pretty strong piece of
(20:46):
evidence, at least to consider maybe how it might generalize to
other populations. It's not the final word, but it
certainly is a meaningful one. Wow.
OK, Doctor Armstrong, final thoughts.
What do you want listeners and viewers to remember from this
conversation? Well, first thing is that they
need to be watching and listening to the Aging Well
(21:06):
podcast and be sure to subscribeand follow depending on which
platform you're on and share thepodcast.
But above and beyond that, I think the message I really want
for the listeners and the viewers is that prevention is
powerful and it doesn't have to require perfection.
Metabolic syndrome is the coexistence of insulin
resistance, hypertension, and dyslipidemia, as you recall from
(21:28):
Physiology of exercise. I stress in that class that
obesity is a central factor in metabolic syndrome.
But it's also important to recognize that this is not the
only contributing factor. Normal weight individuals can be
metabolically unhealthy. And it warrants having our blood
checked once in a while and see where our glucose levels are.
Maybe, you know, investing in a continuous glucose monitor for a
(21:50):
period of time just to try to track how are our sugar levels,
you know, outside of going to the physician once every year or
so. And it's also important to
recognize that neurocognitive decline is not a condition that
is limited to the oldest of America.
If you are in your 40s or 50s now, now is the time to invest
in the future of your brain health. 1020, thirty years ago
(22:11):
might have been an even better time to invest in your brain
health. But know your numbers.
Move your body, eat real food, get quality sleep, stay socially
connected. Sounds pretty familiar to our
six pillars. And these things aren't just
good advice, they're really yourinsurance policy against
cognitive decline. Hey.
Speaking of investing in your overall mental health, we stress
(22:36):
that aging it. We stress that aging well begins
at conception. So it almost seems like it would
behoove someone to invest in brain health before they're even
born. Well, it's kind of a hard choice
for the individual to make for themselves.
But as parents, as prospective parents, you know, somebody
that's trying to have kids, we want to be very aware of what
(22:57):
are we doing, you know, particularly for the mother.
But you know, I think there's, as we've talked about some
epigenetic studies in recent, inrecent podcast episodes, we
talked about one in, you know, the trauma, the fact that trauma
has on the epigenetics. We don't know what our habits,
what impact that's going to haveon our future offspring, whether
it's our kids or our grandkids. And so particularly when we are
(23:20):
going through puberty, as we arein our childbearing years, our
parenting years, we want to be very aware of how we are living
because may have an impact on our kids.
But also, you know, think about the long term health of your
child from an early age. You know, what are we feeding
them? How are we feeding them?
Are we allowing them to eat the crappy foods that are being out
(23:41):
there, the processed foods and all the chemicals and
everything? Or are we just kind of
expecting, well, when they hit 30 or 40, they'll figure it out
and they'll start eating healthyand start exercising.
You know, we need to have schools that are promoting
healthier diets, having more physical activity and the arts
like music and other creative arts.
All of those things are early things that we can do for brain
(24:04):
health. And the Kliansky's have
mentioned numerous times that it's important too for the
developing brain to consider theimpacts that marijuana use and
alcohol use can have on the brain development.
And so considering that is important as well.
And even, you know, as we consider marijuana use and, you
know, other recreational drugs and alcohol and those types of
(24:27):
things, even in our 20s, 30s andbeyond, those are all having
potential impacts on our overallbrain health.
So I think it behooves us to really have a very conscious
awareness of what are we puttinginto our bodies?
How are we using our bodies to protect our brains in the long
run? Yeah, it doesn't have to
necessarily be drugs and alcohol.
(24:48):
It can be just preservatives that are in our food as well,
which is crazy if you think about it, because usually people
are like, oh, I'm young, like won't have any effect on me.
I can, I can get away with, you know, XY and Z.
And there's also a pretty controversial statement, but the
whole my body, my choice. But realistically, if you want
(25:11):
to have kids in the future, whether it's near future or down
the road future, what you're doing to your body now could
have an impact on them. That that is a, that is a, that
is a whole deep level of thing. Really.
You're not just planning for your own future health, but
you're planning for Children's Health and possibly your
(25:32):
grandchildren's health as well. That's that's a concept that a
lot of, I don't think a lot of people can really.
I think they can. I just don't think it's brought
to their level of awareness. And I think, you know, people
just we tend to be a society that lives in the now and we
don't look at the future. You know, we, you know, we look
back, we'll blame everything in the past.
(25:54):
We'll blame our parents for stuff, but we don't look at, OK,
well, what am I currently doing to screw up my kids?
And I deal with that every day. It's like, what am I doing to
screw these kids up? What, what is my fault here?
But, you know, I think it's important that we, we be very
considerate of future generations and what our, our
(26:15):
choices are making, not only forour own kids, but really for
society as a whole. Because if we don't take care of
our brains, we have an aging population.
And if more and more people are going to be getting dementia,
who's left to care for them? You know, there's not as many
kids being born, right? More and more aged people.
We, we're not going to be able to care for each other if we're
all, you know, lacking in brain cognitive ability.
(26:37):
And so it behooves us to take care of it earlier rather than
later, yeah. It also kind of sounds like the
best way to take care of it is to just stand on our six pillars
and just really recognize the importance for future brain
health. I mean stick with exercise and
physical activity, maintain a healthy body composition, eating
(26:59):
a healthy diet, good sleep hygiene, not smoking and that
purposeful social connection. Yeah.
And, you know, it's it's interesting and we're have a
follow up episode on the six pillars of aging well, But I was
talking with my class this week and, you know, I started
thinking smoking is not as big of an issue in our society
anymore. You know, fewer and fewer people
(27:20):
are smoking, particularly younger people.
But you know, where might we need to kind of fit into our
pillars, you know, moderate healthy alcohol consumption.
And I think that's something we can kind of elaborate on a
little bit more in regards to what that does for brain health.
But we all want to age well, andthat includes staying sharp,
keeping engaged, being purposeful for as long as
(27:41):
possible. And again, that starts with the
choices we make today, right? Well, thanks for breaking this
down with so much clarity and compassion.
And to our listeners and viewers, if you found this
helpful, share it with someone who might benefit.
Because when it comes to brain health, it's never too early or
too late to start aging well. Aging well.
(28:01):
Thank you for listening. Hope you benefited from today's
podcast and until next time, keep Aging well.
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