June 30, 2025 • 24 mins
Neurologists Dean and Aisha Sherzai share their groundbreaking research on preventing cognitive decline through lifestyle changes. Proving the power of Lifestyle Medicine. Their work reveals that 80-90% of brain disease is influenced by lifestyle factors, providing hope for people concerned about their brain health.
• The Sherzais discovered remarkable protection against dementia in Seventh-day Adventists following plant-based diets
• The brain is especially vulnerable to lifestyle factors as it's 2% of body weight but uses 25% of energy
• Their NEURO framework covers Nutrition, Exercise, Unwind, Restorative sleep, and Optimizing cognitive activity
• Continuing cognitive challenge is critical – "Don't retire, rewire" around your passions
• While Alzheimer's cannot be reversed once established, prevention is possible at any age
• The brain can grow new connections even at 99 years old with proper lifestyle habits
• Implementation requires community involvement at all levels rather than top-down approaches
Be ambassadors for lifestyle medicine and brain health—consider yourself a walking billboard for the profound impact of lifestyle changes on cognitive well-being.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Reverse Mullet Healthcare
Podcast from BP2 Health.
We're in Orlando at the ACLMConference 2024.
I'm your host, Justin Politti.
Speaker 2 (00:09):
And I'm Ellen Brown here at the American College of
Lifestyle Medicine Conferenceand I'm totally fangirling right
now.
I'm just so excited at who wehave on the show, so introduce
yourselves.
Speaker 3 (00:21):
Thank you so much for having us.
We are Dean and Aisha Shirzai.
We're both neurologists andscientists, and we're so honored
to be here.
Our talk today was about theprofound impact of lifestyle on
brain health, and that's whatthe focus of our work is too.
Speaker 2 (00:38):
It's just beautiful, like I never thought in my
lifetime that I would get tocombine my work in healthcare on
the payer provider kind of thatside that a lot of people point
fingers at and say is awfulwith my passion for lifestyle
and health and food and tryingto fix those things.
I never in my lifetime thoughtI would get to combine the two
(01:01):
and so to be sitting togetherwith you guys it's just amazing
and it just shows me the powerof what's happening in
healthcare.
Speaker 1 (01:10):
Well, one other thing , too is we've had a couple of
guests on that brought up, inparticular the speech that you
guys did earlier today, and howmemories are formed,
associations are built.
It was fascinating.
People have walked out and theywere like it's been very
compelling, so I just want youto know that.
Thank you so much.
Speaker 3 (01:28):
Thank you so much for sharing that.
That means a lot.
Speaker 2 (01:31):
Yeah, so talk about your work, stum, and I guess I
was thinking I was like, oh, Icould just ask so many questions
and we have so little time.
But I guess one thing I wouldlike is share your work please,
because a lot of people won't befamiliar with it necessarily,
and it's just been such apowerful body of work for
cognitive disease and andsomething that I think is so
(01:54):
misunderstood and I think for meI mean I'll just tell you
personally is that when I heardyou all you know you were I was
saying you were on the rich rolepodcast.
That was the episode that Ilistened to.
I you know you were.
I was saying you were on therich role podcast.
That was the episode that Ilistened to.
I really learned about yourwork, but it I didn't understand
that cognitive function hadanything to do with inflammation
(02:15):
and cardiometabolic syndrome.
I always thought it was thislike did you, did you get the
short end of the genetic lottery?
And if you did you were, it wasover game, over right, and so
to hear from you and then fastforward.
Now I have a mom who hasprogressively whatever you're
going to definitely edit this,but progressive dementia rapidly
(02:36):
progressing.
There we go and nowunderstanding that it was
because she was an uncheckeddiabetic for many years, and so
the work that you've done, andso, to have that all come full
circle, I'd like to hear thelifestyle medicine right, how
that sort of came into this foryou all too as well.
(02:57):
Do you have something to add?
Sorry?
Speaker 1 (02:59):
I also have a very I mean as many people do.
My grandfather passed away fromAlzheimer's.
He was very, very healthy.
So I am like my grandfatherpassed away from Alzheimer's.
He was.
He was very, very healthy.
So I am like he was obsessedwith the food and vitamins that
came into it Like no other, to apoint where we were like, did
he take something that you knowhe was doing that might've
caused this?
Our family still, to this day,debates that.
But I'm super interested inyour work, like from a personal
(03:23):
level, around you know, aroundall of this.
So yeah, yeah.
Speaker 4 (03:27):
Yeah, we met 20 years ago around this topic.
We were in Afghanistan of allplaces.
I had gone back from NIH, I wasdoing wonky work on stem cells
into the brains of Parkinson'spatients and I was in medical
school.
We had both independently goneback.
We always did service.
I did cleft palate surgery withOperation Smile In China and
(03:48):
other places.
We went back to Afghanistan andin an expat party we met.
The first conversation wasabout her grandfather dying from
Alzheimer's and my grandfatherdying from Alzheimer's and after
that we dated and then a yearlater we were married and then,
coming back, we went to thenumber one neuroscience program
in the country at the time, ucsd, dr leon thal.
(04:09):
We did work I should did fmriwork, looking at brains, that
they're active, and I was doingpathology and patient care and
after a couple of years webecame a little disillusioned,
uh, with the studies that werecoming, failure after failure
after failure and and, by theway, I'm not putting down
studies or pharmaceutical andall that All that is incredibly
(04:29):
valuable.
But there was nothing beingdone on prevention.
So we looked around and, lo andbehold, we found out that 60
miles northeast is a city calledLoma Linda, where people are
living 14 years longer andhealthier than everybody else.
Specific men versus and we're alittle proactive.
(04:51):
People picked up the phone,called the president of
university.
I said we have these resumes.
We want to build a brain centerthere.
Would you have us?
He said of course, come back,come here.
We went there.
We.
I said I mean immediately.
We said we want three days offfor community work.
They said you're not going toget paid for that.
I said that's okay.
So we started a clinic.
(05:13):
We saw patients and did thecommunity work, figuring out
what's going on and I should dida dual residency family of
preventive medicine andneurology yeah.
Speaker 3 (05:23):
So, as you can see, it didn't come.
You know it wasn't offered on aplane Like here it is.
Here's a lifestyle program Iwant you guys to do prevention
and neurological diseases.
It was a lot of sacrifice and alot of strategy.
Talking to a lot of peoplereading papers on our own
speaking.
Remember Dr ElizabethBarrett-Connor Like she was this
amazing scientist.
(05:44):
She ran the Rancho Bernardostudy looking at the impact of
lifestyle on heart health and wesaid there's got to be some
research on brain health as well.
Speaker 2 (05:54):
We have to be able to look at that.
So was it the Loma Linda?
Was it just the fact that therewas such a difference in that
population?
They were like I have to gothere and research it and
there's got to be something here.
Yeah, Okay.
Speaker 4 (06:08):
Yeah.
So the Adventist health studyis one of the largest and
longest run well done studiesand IH supported, and they had
already found that a significantless risk of diabetes.
Significant less risk of thedementia I'm sorry, not dementia
.
One study on dementia thatshowed that, um, and significant
less risk of dementia Sorry,not dementia.
One study on dementia thatshowed that.
Significant less risk of heartdisease, and on and on and on
(06:29):
and on.
And cancers.
We said it's got to be thatrelation with brain as well, but
nobody had studied it and therearen't that many populations
that are that well studied andwell defined.
It's not Loma Linda, it's theseven-day Adventists that live
there and they're unique becausetheir religion is very
health-centered, not justplant-based food.
(06:49):
Everybody focuses on that.
But it's more than that, it'senvironment, it's walking, it's
community, all these things.
We had a half-a-day clinic inSan Bernardino.
If anybody's been in LosAngeles they know this.
San Bernardino is basically ahighway separating Loma Linda
and San Bernardino, so not anenvironmental difference.
(07:12):
In San Bernardino we would seepatients in their 40s and 50s
having vascular disease of thebrain.
In Loma Linda it wasbewildering no-transcript.
Over five years, 3,000 patients, and of these 3,000 patients
you expect one-third, becausethe majority of the seven-day
Adventists live there.
One-third of the population isseven-day, one-third of them are
plant-based and they're morelikely to go to their own
(07:35):
hospital.
Why would they go all the wayto USC or somewhere?
So you expect, of the 3,000dementia patients, at least
one-third to be plant-based andnormal 7-day amphetis.
Nope, 19.
19 people, 19 people out of3,000.
I was thrown off and we saidthis is unbelievable.
(07:56):
Yet in San Bernardino,40-year-olds with vascular
disease.
And then we did more research,shopping at the same grocery
stores almost yeah but thenbuying different things,
absolutely yeah so it's, and andwe knew that lifestyle it's
more than just food, but it'slifestyle has.
And so we then we went to cedarsinai and studied, and what we
(08:17):
found was that uh, lifestylebasically can, can affect 90, 80
to 90 of brain disease it'scrazy and it it.
Speaker 2 (08:24):
It's so fascinating to me because I did.
I was convinced until Ilistened to your research.
I was like, well, you're eithergoing to get it or you're not
right.
And if you get it, it's gameover.
And it was such an epiphany.
It was like, wait a minute,this is all related.
And it did really put thatlight bulb off of like.
We got to figure this out inhealthcare.
(08:45):
You know, it was like when thewheels started first turning for
me, where I was like, wait aminute, I'm running around the
country doing all the wrongthings with lifestyle in terms
of stress and sleep, trying toimplement outcomes-based
healthcare models, but yet we'renot actually delivering a care
model that's capable ofsupporting those models.
Speaker 3 (09:07):
So, something's wrong .
Speaker 4 (09:08):
It is.
Speaker 3 (09:08):
That's true.
I think there's a lag of whatwe know, and you know, when
scientists and doctors do a lotof studies and research, it
takes a very long time for thatinformation to come and be
applied in public health, likeyou were saying, ellen, earlier.
For a long time we thought, youknow, the brain is a completely
black box.
It's separate from the rest ofthe body and you might have to
(09:30):
take some supplements or somemedication for it.
But we now know that what isgood for our body is good for
our brain too.
The kind of foods that we eatfor our body affects our brain
too.
And so this information, youknow it took some time, but now
we actually know.
And it was back then when westarted, when we initially
thought about the concept ofpreventive neurology what can
(09:50):
people do to preventneurological diseases?
And lo and behold, you see ahuge overlap with the same risk
factors that affect the heart,the kidneys, the rest of the
body, affecting in the brain aswell.
So I suppose in many ways themedical community and the
scientific community has failedto disperse information about
(10:12):
health into our communities, andwe need to be that bridge, and
I'm so glad that ACLM is doingall of that.
We all need to be that bridgeof dispersing the information
and the message of health.
Justin had an idea, which is weshould all be wearing T-shirts
with results on it.
Speaker 1 (10:26):
Honestly and walking billboards.
Speaker 2 (10:31):
Gebra needs to be having a T-shirt that says I had
230 patients drop their A1C bythree points and I saved $5
million.
Speaker 4 (10:41):
Yes.
I love that.
I love that idea.
Speaker 3 (10:43):
You came up with that idea.
That's a brilliant one.
That's trademarkable, right?
Yes, I love that.
I love that idea.
Somebody, you came up with thatidea.
That's a brilliant one.
Speaker 4 (10:46):
I mean that's trademarkable, that's right
there.
No, but it has to be.
I mean on the brain side, justto get people excited.
Of course it's going to beaffected by lifestyle.
We're talking about athree-pound organ.
It's a jello.
It's a little hard jello threepounds but it's 2% of your
body's weight but consumes 25%of your body's energy.
(11:07):
It has one quadrillionconnections.
It does 60 trillion operationsper minute.
60 trillion, that's one ofthose numbers that you can't
even.
No, yeah.
And so all that work, all thatactivity, all that energy
(11:27):
utilization, all that oxygenutilization, of course if you
don't give it the right energy,it's going to be affected more
than any other body part.
Of course, if you give ittoxins, it's going to be
affected more than anybody.
Of course, if you do somethingthat affects its vasculature
vasculature it is the mostvascular organ.
In fact, if, if you connectthey did that math on this
connect all the arteries in thebrain, end to end, it's 400
(11:48):
miles of vasculature Of courseit's going to be affected by
vascular factors.
So lifestyle is going to havemore of an effect on this
incredible organ than any other.
And on the positive side isit's also the most resilient
organ.
So if you give it a chance, itwill actually persist and grow.
(12:09):
We actually say something verycontroversial in basically our
next book your brain will getbetter as you get older If you
do the right things.
Speaker 3 (12:18):
It makes sense.
It's the only organ that getsbetter with age.
I love it.
Speaker 4 (12:22):
Yes, yes, I mean.
Think of yourself as a teenager, or myself as a teenager.
My God, you don't want.
I don't want to even think ofmyself as a teenager.
What was going on in that brain?
Speaker 1 (12:32):
Nobody wants to know, nobody wants to know I have a
pinball image going, that'sright, it's like ding, ding,
ding.
Speaker 4 (12:38):
Yeah, it was chaos and I was smart.
You know, I played soccer, Iplayed football.
That wasn't that smart.
I broke.
I broke my back.
Oh yeah, I played tennis.
Speaker 1 (12:48):
I played football without a helmet.
That was, you know, back in thebackyard back then in the
eighties.
Speaker 4 (12:52):
Yeah, yeah, oklahoma's without a helmet.
Yeah, that's right.
So it's it's.
It's terrible, but now I'molder, I have shoulder.
You know, I did some pushupsbecause I wanted to break some
record and I tore my shoulderand pain here, pain there and
all that.
But I am so much more secure,calmer, I'm able to organize
(13:13):
thoughts better, I have morethings to build on, we are much
better and we can get muchbetter, but we have to do
certain things to make sure thatthe infrastructure is.
So how do you?
Speaker 1 (13:23):
exercise your brain.
Speaker 2 (13:24):
I'm sorry so what are those things right?
Speaker 1 (13:27):
What are the exercises?
Speaker 3 (13:28):
Yes, so, if you know, we came up with this acronym
just based on all of the dataout there.
You know what are the thingsthat are good for brain health
and it?
You know, essentially it's the.
It's the, a variation of thistheme that I'm about to say.
Five factors nutrition,exercise, stress management,
sleep and cognitive activities.
(13:50):
And we came up with thisacronym called NEURO N is for
nutrition, e is for exercise, uis for unwind or stress
management, r is for restorativesleep and O is for optimizing
cognitive activity.
And we know that when peopleadhere to these lifestyle
factors it doesn't have to beall or none.
Even small, little incrementalchanges in any one of them
benefit the brain.
People actually do better.
(14:12):
They have lower risk ofAlzheimer's, other types of
dementia, stroke and mentally,as far as mental health is
concerned, they do better aswell.
Speaker 2 (14:20):
Is there a disproportionate like?
Is one more important than theother?
Speaker 3 (14:25):
It depends on an individual's factor, right?
So it just depends on what yourstrengths are, what your
limitations are, what yourresources are.
Some people do very well whenthey manage their, say, ldl
cholesterol significantly.
Some people do really well bystarting exercising.
So it just varies from personto person and it's really
important for the person andtheir healthcare providers to
(14:47):
kind of draw a picture of whattheir risk factors are Like.
For example, a lot of ourpatients and our community
members who come to us and theytalk about brain health, we
don't start by telling them goahead and eat green leafy
vegetables or kale.
We try to speak with them, wetry to understand where they are
, and a lot of patients tend tohave depression and anxiety,
(15:08):
which is such a huge risk factorfor cognitive impairment.
That's the first thing that weaddress, and so it just varies
from person to person.
Or they have sleep apnea.
Speaker 4 (15:17):
Oh yeah, if they have sleep apnea and it's not being
treated.
Several studies show as much as70% increased risk and that's
easily treatable.
Speaker 2 (15:24):
No, I know, when I prioritize sleep, I like I
always.
I came up with a new term.
We were in Las Vegas last weekat health and they always give
me a hard time because they'relike we must put her to bed Like
she's-.
Speaker 1 (15:38):
Turns into a pumpkin.
Right, I turn into a pumpkinand Vegas-.
Not at midnight, it's seveno'clock.
Speaker 2 (15:43):
No, but it's really brutal in Vegas because it's
three hours early, you know it'sthat whole thing and you want
to go out.
So I came up with a new term,which is slangry.
You know how everybody says I'mhangry.
Speaker 1 (15:54):
Yes.
Speaker 2 (15:55):
Slangry, oh, sleep angry, that's my new term.
I love that.
Speaker 1 (16:01):
I might steal that.
Yes, slangry.
Speaker 2 (16:03):
It's a new term.
Yeah, okay, it's a new term.
Yeah, ok, back to you, justin,sorry.
Speaker 1 (16:06):
No, the question I had was, you know, going back to
my grandfather.
He retired.
He was a, he was an engineerfor Sikorsky and helped develop
the Black Hawk helicopters.
He was dealing with verycomplicated implementations and
then all of a sudden he retiredand he wasn't like he didn't
have that to do anymore.
Like he, he did not have thoseextra.
(16:29):
I guess that.
And so the question is likedoes that contribute to?
Speaker 4 (16:33):
100.
So what a beautiful uh.
So thank you, thank you.
So mental activity is critical,but the old part, neuro.
So they've said they've seenthat people who have been very
mentally active, extremely, andthen they stop doing the same
things and for two years, eventwo years, they didn't do much
of that mental activity.
(16:54):
Guess what?
They had the steepest decline.
See, that's my mom.
Yeah, you know why?
Because this brain is now usedto being challenged.
Speaker 3 (17:00):
Yeah, you're here, you're used to this level, and
then you drop to a lower leveland the brain, just you know
starts shrinking faster thanaverage.
Literally and figuratively.
Speaker 1 (17:11):
Yeah, yeah.
So there's brain like have youguys done that, like measured?
Oh yes, yeah.
So we say, brain is actuallyshrinking.
Speaker 4 (17:20):
Yeah, no, no.
We said don't retire, Rewire,yeah, Find new things that push
you as much.
But around your passions.
One of our patients in ourfirst book it was this.
He was a VA guy.
He came to me depressed,cognitive decline, significant
decline, but not dementia butpre-dementia.
But by the way I'm going to saythis a couple of times there
(17:41):
are going to be people that saidthat they've reversed dementia,
They've reversed Alzheimer's.
Nobody reverses Alzheimer's andI'm going to stand by that
because that's a way to pick onpeople's hopes and sell them
things.
If not now, tomorrow they'llsell them things.
And we were told when we wereready to get our first book out
(18:02):
just hint at the fact that youcan reverse Alzheimer's and
nobody checks anymore.
You know nobody, nobody.
What can they do to you?
And you will sell 2 millionextra.
We can, we can't, because weknow what happens when that at
that stage, Good for you.
Speaker 2 (18:14):
Thank you.
Speaker 4 (18:15):
No, and, and nobody should be saying that, because
when we've had two grandparentsdying from Alzheimer's, you want
, hope you have hope.
You want hope, but you don'twant charlatans to take that
hope.
Yeah, and sometimes when aperson has Alzheimer's, they let
them go through their journeyof decline with dignity, with
(18:36):
honor, with not always desperatefor the next person that's
selling them the next thing.
No amount of kale is going tocure Alzheimer's and I'm going
to lose friends here.
I'm going to lose friends.
I don't care.
It's about those people, thoseindividuals.
But prior to dementia there'sso much you can do to prevent
and that's important enough.
And cognitive activity iscritical.
(18:57):
Cognitive activity is the goodstress.
I made a joke there.
It's like you have 87 billionneurons, one quadrillion
connections.
Do you think all of that wasjust to mate and find food?
No, it took that much for me toget her, but that's a separate
issue.
But for most people it's lessfive, six neurons, but the most
(19:22):
successful reproducers arebacteria.
That's funny.
Yeah, you want to win.
Speaker 2 (19:27):
Justin's like this is great.
Speaker 4 (19:29):
The most successful reproducers are bacteria One
cell.
The most successful foodgatherers are viruses.
No, you know, it's not aboutthat.
The brain wants to bechallenged, the brain wants to
be pushed, but around yourpassion.
So this guy was a veteran.
The first question I asked himwasn't what's your blood
cholesterol level?
I said what did you used to do?
(19:50):
He said before military, I usedto rebuild cars in my garage.
I said what do you do now?
He said I retired and I went towork for a car shop and all I
do is change mufflers over andover again.
I was like that's what'skilling you.
I said go retire, have fun,enjoy.
He came back six months later,completely different.
(20:11):
No pills, not that I'm againstpills, but he didn't need it.
He's so happy.
I said what are you doing?
Oh, I'm building cars in mygarage, but in my own terms.
So building and pushing yourbrain around your passions in a
way that really satisfies youand pushes you is what connects
those neurons.
Speaker 2 (20:28):
That's me right now, like these guys know, like I
can't stop.
No, I just once I startedfinding how to connect all these
different folks, all thesedifferent solutions, all this
knowledge together to say wehave sick care, we need
healthcare, and to me, lifestylemedicine as a board
(20:50):
certification is that bridgethat can help us create that.
Speaker 1 (20:56):
and and once I that got in my belly, it's like I
just I can't stop because it'slike we can do this I am going
to say one thing though do youguys have any secrets on
shutting it off so she can go tosleep?
Speaker 4 (21:14):
Yes, yes, I don't know if it's secret there's a.
I'm a big proponent, I'm apsychology background and a big
proponent of cognitivebehavioral therapy.
I think that should be taughtin schools.
It's basically, it's verysimple.
It's about how to know your ownthoughts and how to manage your
own thoughts.
Speaker 2 (21:27):
You can't manage emotions, own thoughts you can't
manage emotions.
Speaker 4 (21:29):
Oh yeah, you can't manage emotions.
Emotions are like amoeba.
How do you put your hand aroundemotion?
I'm going to be more happy.
That's not going to work.
But what you can do thethoughts and behaviors that lead
to unhappiness, you can addressthose.
The thoughts and emotions thatcontinually run in your head,
you can start managing them.
Speaker 2 (21:49):
Well, somebody said to me last week I loved the
analogy.
He said it's like I can't stopthinking, I have all these ideas
and it's so great, you know.
And he said yeah.
And I said, but sometimes Ijust want to turn it off.
And he said, yeah, it's likeyou went into the Matrix and you
took the blue pill.
Speaker 3 (22:07):
Yes.
Speaker 2 (22:08):
That's exactly it so, um, well, I really I know you
guys have places to be.
It's a this is a short eventand but a short period that we
have you, but, um, we would loveto try and do a full episode
and I'd love to talk with youmore about really how this whole
cognitive science and its linkwith lifestyle medicine, how we
(22:33):
can look at it from the lens ofhealthcare, how we look at it
now, how we could look at it inthe future.
You know we've had a lot ofconversations on some of things,
like, you know, full body scansand different type of
diagnostic tools up front, andjust how do we move the system
right?
How do we take all of thisknowledge that you all have been
(22:53):
amazing at creating andactually change the way we
deliver healthcare as a societyright?
Like, how do we leverage that?
Speaker 1 (23:02):
And I'd love to jump into, like you mentioned, a
couple of different examples oflike people who, like you know,
they stopped, they did somethinga little bit different, like
what's the window of time whereyou can actually act on this and
really influence it before itgets too far?
And it's not, you know, you'renot able to reverse it, and
always, anytime, except whenAlzheimer's is in place.
Speaker 3 (23:23):
Okay, obviously it's better if it's as soon as
possible, as early as possible,but we've seen, and you know,
there's evidence for protectionof the brain and growth of the
brain and reconnecting betweenneurons even as late as 99 years
of age.
So it's never too late eitherand there's a lot of hope.
(23:43):
And as far as implementation isconcerned, I think essentially
being ambassadors of lifestyleand brain health, each and every
one of us and you know, eventhough it takes a long time to
move a large ship, but theselittle tugboats of you know,
individuals, communities, comingtogether, speaking about it,
(24:05):
groundless level ofcommunication and really truly
involving the community.
We've underestimated thecommunity leaders, the
faith-based communities,individual social workers
spreading this message.
I think it takes a whole entireteam of people spreading this
message, instead of us waitingfor the top-down model.
Speaker 1 (24:27):
So we'll get the t-shirts printed for you all,
and then we'll.
We've got the messages ready,to go Ready.
Speaker 3 (24:33):
I'm going to be a billboard.
I'd be happy to be a billboard.
Yeah, thank you guys.
I'm so excited.
It's our pleasure.
Thank you so much for having us.
Welcome to the Reverse Mullet Healthcare
Podcast from BP2 Health.
We're in Orlando at the ACLMConference 2024.
I'm your host, Justin Politti.
Speaker 2 (00:09):
And I'm Ellen Brown here at the American College of
Lifestyle Medicine Conferenceand I'm totally fangirling right
now.
I'm just so excited at who wehave on the show, so introduce
yourselves.
Speaker 3 (00:21):
Thank you so much for having us.
We are Dean and Aisha Shirzai.
We're both neurologists andscientists, and we're so honored
to be here.
Our talk today was about theprofound impact of lifestyle on
brain health, and that's whatthe focus of our work is too.
Speaker 2 (00:38):
It's just beautiful, like I never thought in my
lifetime that I would get tocombine my work in healthcare on
the payer provider kind of thatside that a lot of people point
fingers at and say is awfulwith my passion for lifestyle
and health and food and tryingto fix those things.
I never in my lifetime thoughtI would get to combine the two
(01:01):
and so to be sitting togetherwith you guys it's just amazing
and it just shows me the powerof what's happening in
healthcare.
Speaker 1 (01:10):
Well, one other thing , too is we've had a couple of
guests on that brought up, inparticular the speech that you
guys did earlier today, and howmemories are formed,
associations are built.
It was fascinating.
People have walked out and theywere like it's been very
compelling, so I just want youto know that.
Thank you so much.
Speaker 3 (01:28):
Thank you so much for sharing that.
That means a lot.
Speaker 2 (01:31):
Yeah, so talk about your work, stum, and I guess I
was thinking I was like, oh, Icould just ask so many questions
and we have so little time.
But I guess one thing I wouldlike is share your work please,
because a lot of people won't befamiliar with it necessarily,
and it's just been such apowerful body of work for
cognitive disease and andsomething that I think is so
(01:54):
misunderstood and I think for meI mean I'll just tell you
personally is that when I heardyou all you know you were I was
saying you were on the rich rolepodcast.
That was the episode that Ilistened to.
I you know you were.
I was saying you were on therich role podcast.
That was the episode that Ilistened to.
I really learned about yourwork, but it I didn't understand
that cognitive function hadanything to do with inflammation
(02:15):
and cardiometabolic syndrome.
I always thought it was thislike did you, did you get the
short end of the genetic lottery?
And if you did you were, it wasover game, over right, and so
to hear from you and then fastforward.
Now I have a mom who hasprogressively whatever you're
going to definitely edit this,but progressive dementia rapidly
(02:36):
progressing.
There we go and nowunderstanding that it was
because she was an uncheckeddiabetic for many years, and so
the work that you've done, andso, to have that all come full
circle, I'd like to hear thelifestyle medicine right, how
that sort of came into this foryou all too as well.
(02:57):
Do you have something to add?
Sorry?
Speaker 1 (02:59):
I also have a very I mean as many people do.
My grandfather passed away fromAlzheimer's.
He was very, very healthy.
So I am like my grandfatherpassed away from Alzheimer's.
He was.
He was very, very healthy.
So I am like he was obsessedwith the food and vitamins that
came into it Like no other, to apoint where we were like, did
he take something that you knowhe was doing that might've
caused this?
Our family still, to this day,debates that.
But I'm super interested inyour work, like from a personal
(03:23):
level, around you know, aroundall of this.
So yeah, yeah.
Speaker 4 (03:27):
Yeah, we met 20 years ago around this topic.
We were in Afghanistan of allplaces.
I had gone back from NIH, I wasdoing wonky work on stem cells
into the brains of Parkinson'spatients and I was in medical
school.
We had both independently goneback.
We always did service.
I did cleft palate surgery withOperation Smile In China and
(03:48):
other places.
We went back to Afghanistan andin an expat party we met.
The first conversation wasabout her grandfather dying from
Alzheimer's and my grandfatherdying from Alzheimer's and after
that we dated and then a yearlater we were married and then,
coming back, we went to thenumber one neuroscience program
in the country at the time, ucsd, dr leon thal.
(04:09):
We did work I should did fmriwork, looking at brains, that
they're active, and I was doingpathology and patient care and
after a couple of years webecame a little disillusioned,
uh, with the studies that werecoming, failure after failure
after failure and and, by theway, I'm not putting down
studies or pharmaceutical andall that All that is incredibly
(04:29):
valuable.
But there was nothing beingdone on prevention.
So we looked around and, lo andbehold, we found out that 60
miles northeast is a city calledLoma Linda, where people are
living 14 years longer andhealthier than everybody else.
Specific men versus and we're alittle proactive.
(04:51):
People picked up the phone,called the president of
university.
I said we have these resumes.
We want to build a brain centerthere.
Would you have us?
He said of course, come back,come here.
We went there.
We.
I said I mean immediately.
We said we want three days offfor community work.
They said you're not going toget paid for that.
I said that's okay.
So we started a clinic.
(05:13):
We saw patients and did thecommunity work, figuring out
what's going on and I should dida dual residency family of
preventive medicine andneurology yeah.
Speaker 3 (05:23):
So, as you can see, it didn't come.
You know it wasn't offered on aplane Like here it is.
Here's a lifestyle program Iwant you guys to do prevention
and neurological diseases.
It was a lot of sacrifice and alot of strategy.
Talking to a lot of peoplereading papers on our own
speaking.
Remember Dr ElizabethBarrett-Connor Like she was this
amazing scientist.
(05:44):
She ran the Rancho Bernardostudy looking at the impact of
lifestyle on heart health and wesaid there's got to be some
research on brain health as well.
Speaker 2 (05:54):
We have to be able to look at that.
So was it the Loma Linda?
Was it just the fact that therewas such a difference in that
population?
They were like I have to gothere and research it and
there's got to be something here.
Yeah, Okay.
Speaker 4 (06:08):
Yeah.
So the Adventist health studyis one of the largest and
longest run well done studiesand IH supported, and they had
already found that a significantless risk of diabetes.
Significant less risk of thedementia I'm sorry, not dementia
.
One study on dementia thatshowed that, um, and significant
less risk of dementia Sorry,not dementia.
One study on dementia thatshowed that.
Significant less risk of heartdisease, and on and on and on
(06:29):
and on.
And cancers.
We said it's got to be thatrelation with brain as well, but
nobody had studied it and therearen't that many populations
that are that well studied andwell defined.
It's not Loma Linda, it's theseven-day Adventists that live
there and they're unique becausetheir religion is very
health-centered, not justplant-based food.
(06:49):
Everybody focuses on that.
But it's more than that, it'senvironment, it's walking, it's
community, all these things.
We had a half-a-day clinic inSan Bernardino.
If anybody's been in LosAngeles they know this.
San Bernardino is basically ahighway separating Loma Linda
and San Bernardino, so not anenvironmental difference.
(07:12):
In San Bernardino we would seepatients in their 40s and 50s
having vascular disease of thebrain.
In Loma Linda it wasbewildering no-transcript.
Over five years, 3,000 patients, and of these 3,000 patients
you expect one-third, becausethe majority of the seven-day
Adventists live there.
One-third of the population isseven-day, one-third of them are
plant-based and they're morelikely to go to their own
(07:35):
hospital.
Why would they go all the wayto USC or somewhere?
So you expect, of the 3,000dementia patients, at least
one-third to be plant-based andnormal 7-day amphetis.
Nope, 19.
19 people, 19 people out of3,000.
I was thrown off and we saidthis is unbelievable.
(07:56):
Yet in San Bernardino,40-year-olds with vascular
disease.
And then we did more research,shopping at the same grocery
stores almost yeah but thenbuying different things,
absolutely yeah so it's, and andwe knew that lifestyle it's
more than just food, but it'slifestyle has.
And so we then we went to cedarsinai and studied, and what we
(08:17):
found was that uh, lifestylebasically can, can affect 90, 80
to 90 of brain disease it'scrazy and it it.
Speaker 2 (08:24):
It's so fascinating to me because I did.
I was convinced until Ilistened to your research.
I was like, well, you're eithergoing to get it or you're not
right.
And if you get it, it's gameover.
And it was such an epiphany.
It was like, wait a minute,this is all related.
And it did really put thatlight bulb off of like.
We got to figure this out inhealthcare.
(08:45):
You know, it was like when thewheels started first turning for
me, where I was like, wait aminute, I'm running around the
country doing all the wrongthings with lifestyle in terms
of stress and sleep, trying toimplement outcomes-based
healthcare models, but yet we'renot actually delivering a care
model that's capable ofsupporting those models.
Speaker 3 (09:07):
So, something's wrong .
Speaker 4 (09:08):
It is.
Speaker 3 (09:08):
That's true.
I think there's a lag of whatwe know, and you know, when
scientists and doctors do a lotof studies and research, it
takes a very long time for thatinformation to come and be
applied in public health, likeyou were saying, ellen, earlier.
For a long time we thought, youknow, the brain is a completely
black box.
It's separate from the rest ofthe body and you might have to
(09:30):
take some supplements or somemedication for it.
But we now know that what isgood for our body is good for
our brain too.
The kind of foods that we eatfor our body affects our brain
too.
And so this information, youknow it took some time, but now
we actually know.
And it was back then when westarted, when we initially
thought about the concept ofpreventive neurology what can
(09:50):
people do to preventneurological diseases?
And lo and behold, you see ahuge overlap with the same risk
factors that affect the heart,the kidneys, the rest of the
body, affecting in the brain aswell.
So I suppose in many ways themedical community and the
scientific community has failedto disperse information about
(10:12):
health into our communities, andwe need to be that bridge, and
I'm so glad that ACLM is doingall of that.
We all need to be that bridgeof dispersing the information
and the message of health.
Justin had an idea, which is weshould all be wearing T-shirts
with results on it.
Speaker 1 (10:26):
Honestly and walking billboards.
Speaker 2 (10:31):
Gebra needs to be having a T-shirt that says I had
230 patients drop their A1C bythree points and I saved $5
million.
Speaker 4 (10:41):
Yes.
I love that.
I love that idea.
Speaker 3 (10:43):
You came up with that idea.
That's a brilliant one.
That's trademarkable, right?
Yes, I love that.
I love that idea.
Somebody, you came up with thatidea.
That's a brilliant one.
Speaker 4 (10:46):
I mean that's trademarkable, that's right
there.
No, but it has to be.
I mean on the brain side, justto get people excited.
Of course it's going to beaffected by lifestyle.
We're talking about athree-pound organ.
It's a jello.
It's a little hard jello threepounds but it's 2% of your
body's weight but consumes 25%of your body's energy.
(11:07):
It has one quadrillionconnections.
It does 60 trillion operationsper minute.
60 trillion, that's one ofthose numbers that you can't
even.
No, yeah.
And so all that work, all thatactivity, all that energy
(11:27):
utilization, all that oxygenutilization, of course if you
don't give it the right energy,it's going to be affected more
than any other body part.
Of course, if you give ittoxins, it's going to be
affected more than anybody.
Of course, if you do somethingthat affects its vasculature
vasculature it is the mostvascular organ.
In fact, if, if you connectthey did that math on this
connect all the arteries in thebrain, end to end, it's 400
(11:48):
miles of vasculature Of courseit's going to be affected by
vascular factors.
So lifestyle is going to havemore of an effect on this
incredible organ than any other.
And on the positive side isit's also the most resilient
organ.
So if you give it a chance, itwill actually persist and grow.
(12:09):
We actually say something verycontroversial in basically our
next book your brain will getbetter as you get older If you
do the right things.
Speaker 3 (12:18):
It makes sense.
It's the only organ that getsbetter with age.
I love it.
Speaker 4 (12:22):
Yes, yes, I mean.
Think of yourself as a teenager, or myself as a teenager.
My God, you don't want.
I don't want to even think ofmyself as a teenager.
What was going on in that brain?
Speaker 1 (12:32):
Nobody wants to know, nobody wants to know I have a
pinball image going, that'sright, it's like ding, ding,
ding.
Speaker 4 (12:38):
Yeah, it was chaos and I was smart.
You know, I played soccer, Iplayed football.
That wasn't that smart.
I broke.
I broke my back.
Oh yeah, I played tennis.
Speaker 1 (12:48):
I played football without a helmet.
That was, you know, back in thebackyard back then in the
eighties.
Speaker 4 (12:52):
Yeah, yeah, oklahoma's without a helmet.
Yeah, that's right.
So it's it's.
It's terrible, but now I'molder, I have shoulder.
You know, I did some pushupsbecause I wanted to break some
record and I tore my shoulderand pain here, pain there and
all that.
But I am so much more secure,calmer, I'm able to organize
(13:13):
thoughts better, I have morethings to build on, we are much
better and we can get muchbetter, but we have to do
certain things to make sure thatthe infrastructure is.
So how do you?
Speaker 1 (13:23):
exercise your brain.
Speaker 2 (13:24):
I'm sorry so what are those things right?
Speaker 1 (13:27):
What are the exercises?
Speaker 3 (13:28):
Yes, so, if you know, we came up with this acronym
just based on all of the dataout there.
You know what are the thingsthat are good for brain health
and it?
You know, essentially it's the.
It's the, a variation of thistheme that I'm about to say.
Five factors nutrition,exercise, stress management,
sleep and cognitive activities.
(13:50):
And we came up with thisacronym called NEURO N is for
nutrition, e is for exercise, uis for unwind or stress
management, r is for restorativesleep and O is for optimizing
cognitive activity.
And we know that when peopleadhere to these lifestyle
factors it doesn't have to beall or none.
Even small, little incrementalchanges in any one of them
benefit the brain.
People actually do better.
(14:12):
They have lower risk ofAlzheimer's, other types of
dementia, stroke and mentally,as far as mental health is
concerned, they do better aswell.
Speaker 2 (14:20):
Is there a disproportionate like?
Is one more important than theother?
Speaker 3 (14:25):
It depends on an individual's factor, right?
So it just depends on what yourstrengths are, what your
limitations are, what yourresources are.
Some people do very well whenthey manage their, say, ldl
cholesterol significantly.
Some people do really well bystarting exercising.
So it just varies from personto person and it's really
important for the person andtheir healthcare providers to
(14:47):
kind of draw a picture of whattheir risk factors are Like.
For example, a lot of ourpatients and our community
members who come to us and theytalk about brain health, we
don't start by telling them goahead and eat green leafy
vegetables or kale.
We try to speak with them, wetry to understand where they are
, and a lot of patients tend tohave depression and anxiety,
(15:08):
which is such a huge risk factorfor cognitive impairment.
That's the first thing that weaddress, and so it just varies
from person to person.
Or they have sleep apnea.
Speaker 4 (15:17):
Oh yeah, if they have sleep apnea and it's not being
treated.
Several studies show as much as70% increased risk and that's
easily treatable.
Speaker 2 (15:24):
No, I know, when I prioritize sleep, I like I
always.
I came up with a new term.
We were in Las Vegas last weekat health and they always give
me a hard time because they'relike we must put her to bed Like
she's-.
Speaker 1 (15:38):
Turns into a pumpkin.
Right, I turn into a pumpkinand Vegas-.
Not at midnight, it's seveno'clock.
Speaker 2 (15:43):
No, but it's really brutal in Vegas because it's
three hours early, you know it'sthat whole thing and you want
to go out.
So I came up with a new term,which is slangry.
You know how everybody says I'mhangry.
Speaker 1 (15:54):
Yes.
Speaker 2 (15:55):
Slangry, oh, sleep angry, that's my new term.
I love that.
Speaker 1 (16:01):
I might steal that.
Yes, slangry.
Speaker 2 (16:03):
It's a new term.
Yeah, okay, it's a new term.
Yeah, ok, back to you, justin,sorry.
Speaker 1 (16:06):
No, the question I had was, you know, going back to
my grandfather.
He retired.
He was a, he was an engineerfor Sikorsky and helped develop
the Black Hawk helicopters.
He was dealing with verycomplicated implementations and
then all of a sudden he retiredand he wasn't like he didn't
have that to do anymore.
Like he, he did not have thoseextra.
(16:29):
I guess that.
And so the question is likedoes that contribute to?
Speaker 4 (16:33):
100.
So what a beautiful uh.
So thank you, thank you.
So mental activity is critical,but the old part, neuro.
So they've said they've seenthat people who have been very
mentally active, extremely, andthen they stop doing the same
things and for two years, eventwo years, they didn't do much
of that mental activity.
(16:54):
Guess what?
They had the steepest decline.
See, that's my mom.
Yeah, you know why?
Because this brain is now usedto being challenged.
Speaker 3 (17:00):
Yeah, you're here, you're used to this level, and
then you drop to a lower leveland the brain, just you know
starts shrinking faster thanaverage.
Literally and figuratively.
Speaker 1 (17:11):
Yeah, yeah.
So there's brain like have youguys done that, like measured?
Oh yes, yeah.
So we say, brain is actuallyshrinking.
Speaker 4 (17:20):
Yeah, no, no.
We said don't retire, Rewire,yeah, Find new things that push
you as much.
But around your passions.
One of our patients in ourfirst book it was this.
He was a VA guy.
He came to me depressed,cognitive decline, significant
decline, but not dementia butpre-dementia.
But by the way I'm going to saythis a couple of times there
(17:41):
are going to be people that saidthat they've reversed dementia,
They've reversed Alzheimer's.
Nobody reverses Alzheimer's andI'm going to stand by that
because that's a way to pick onpeople's hopes and sell them
things.
If not now, tomorrow they'llsell them things.
And we were told when we wereready to get our first book out
(18:02):
just hint at the fact that youcan reverse Alzheimer's and
nobody checks anymore.
You know nobody, nobody.
What can they do to you?
And you will sell 2 millionextra.
We can, we can't, because weknow what happens when that at
that stage, Good for you.
Speaker 2 (18:14):
Thank you.
Speaker 4 (18:15):
No, and, and nobody should be saying that, because
when we've had two grandparentsdying from Alzheimer's, you want
, hope you have hope.
You want hope, but you don'twant charlatans to take that
hope.
Yeah, and sometimes when aperson has Alzheimer's, they let
them go through their journeyof decline with dignity, with
(18:36):
honor, with not always desperatefor the next person that's
selling them the next thing.
No amount of kale is going tocure Alzheimer's and I'm going
to lose friends here.
I'm going to lose friends.
I don't care.
It's about those people, thoseindividuals.
But prior to dementia there'sso much you can do to prevent
and that's important enough.
And cognitive activity iscritical.
(18:57):
Cognitive activity is the goodstress.
I made a joke there.
It's like you have 87 billionneurons, one quadrillion
connections.
Do you think all of that wasjust to mate and find food?
No, it took that much for me toget her, but that's a separate
issue.
But for most people it's lessfive, six neurons, but the most
(19:22):
successful reproducers arebacteria.
That's funny.
Yeah, you want to win.
Speaker 2 (19:27):
Justin's like this is great.
Speaker 4 (19:29):
The most successful reproducers are bacteria One
cell.
The most successful foodgatherers are viruses.
No, you know, it's not aboutthat.
The brain wants to bechallenged, the brain wants to
be pushed, but around yourpassion.
So this guy was a veteran.
The first question I asked himwasn't what's your blood
cholesterol level?
I said what did you used to do?
(19:50):
He said before military, I usedto rebuild cars in my garage.
I said what do you do now?
He said I retired and I went towork for a car shop and all I
do is change mufflers over andover again.
I was like that's what'skilling you.
I said go retire, have fun,enjoy.
He came back six months later,completely different.
(20:11):
No pills, not that I'm againstpills, but he didn't need it.
He's so happy.
I said what are you doing?
Oh, I'm building cars in mygarage, but in my own terms.
So building and pushing yourbrain around your passions in a
way that really satisfies youand pushes you is what connects
those neurons.
Speaker 2 (20:28):
That's me right now, like these guys know, like I
can't stop.
No, I just once I startedfinding how to connect all these
different folks, all thesedifferent solutions, all this
knowledge together to say wehave sick care, we need
healthcare, and to me, lifestylemedicine as a board
(20:50):
certification is that bridgethat can help us create that.
Speaker 1 (20:56):
and and once I that got in my belly, it's like I
just I can't stop because it'slike we can do this I am going
to say one thing though do youguys have any secrets on
shutting it off so she can go tosleep?
Speaker 4 (21:14):
Yes, yes, I don't know if it's secret there's a.
I'm a big proponent, I'm apsychology background and a big
proponent of cognitivebehavioral therapy.
I think that should be taughtin schools.
It's basically, it's verysimple.
It's about how to know your ownthoughts and how to manage your
own thoughts.
Speaker 2 (21:27):
You can't manage emotions, own thoughts you can't
manage emotions.
Speaker 4 (21:29):
Oh yeah, you can't manage emotions.
Emotions are like amoeba.
How do you put your hand aroundemotion?
I'm going to be more happy.
That's not going to work.
But what you can do thethoughts and behaviors that lead
to unhappiness, you can addressthose.
The thoughts and emotions thatcontinually run in your head,
you can start managing them.
Speaker 2 (21:49):
Well, somebody said to me last week I loved the
analogy.
He said it's like I can't stopthinking, I have all these ideas
and it's so great, you know.
And he said yeah.
And I said, but sometimes Ijust want to turn it off.
And he said, yeah, it's likeyou went into the Matrix and you
took the blue pill.
Speaker 3 (22:07):
Yes.
Speaker 2 (22:08):
That's exactly it so, um, well, I really I know you
guys have places to be.
It's a this is a short eventand but a short period that we
have you, but, um, we would loveto try and do a full episode
and I'd love to talk with youmore about really how this whole
cognitive science and its linkwith lifestyle medicine, how we
(22:33):
can look at it from the lens ofhealthcare, how we look at it
now, how we could look at it inthe future.
You know we've had a lot ofconversations on some of things,
like, you know, full body scansand different type of
diagnostic tools up front, andjust how do we move the system
right?
How do we take all of thisknowledge that you all have been
(22:53):
amazing at creating andactually change the way we
deliver healthcare as a societyright?
Like, how do we leverage that?
Speaker 1 (23:02):
And I'd love to jump into, like you mentioned, a
couple of different examples oflike people who, like you know,
they stopped, they did somethinga little bit different, like
what's the window of time whereyou can actually act on this and
really influence it before itgets too far?
And it's not, you know, you'renot able to reverse it, and
always, anytime, except whenAlzheimer's is in place.
Speaker 3 (23:23):
Okay, obviously it's better if it's as soon as
possible, as early as possible,but we've seen, and you know,
there's evidence for protectionof the brain and growth of the
brain and reconnecting betweenneurons even as late as 99 years
of age.
So it's never too late eitherand there's a lot of hope.
(23:43):
And as far as implementation isconcerned, I think essentially
being ambassadors of lifestyleand brain health, each and every
one of us and you know, eventhough it takes a long time to
move a large ship, but theselittle tugboats of you know,
individuals, communities, comingtogether, speaking about it,
(24:05):
groundless level ofcommunication and really truly
involving the community.
We've underestimated thecommunity leaders, the
faith-based communities,individual social workers
spreading this message.
I think it takes a whole entireteam of people spreading this
message, instead of us waitingfor the top-down model.
Speaker 1 (24:27):
So we'll get the t-shirts printed for you all,
and then we'll.
We've got the messages ready,to go Ready.
Speaker 3 (24:33):
I'm going to be a billboard.
I'd be happy to be a billboard.
Yeah, thank you guys.
I'm so excited.
It's our pleasure.
Thank you so much for having us.
Popular Podcasts
United States of Kennedy
United States of Kennedy is a podcast about our cultural fascination with the Kennedy dynasty. Every week, hosts Lyra Smith and George Civeris go into one aspect of the Kennedy story.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com