Neurophysiologist Shares Top 3 Drivers of Alzheimer's Disease, How to Reduce Your Risk of Cognitive Decline at Any Age, and How to Build a Super-Brain with Louisa Nicola

This episode dives deep into the neurological science behind Alzheimer’s disease, discussing key lifestyle factors that influence cognitive health and the development of neurodegenerative diseases.

1. Physical Inactivity: Regular exercise is crucial, with aerobic activity aiding in the growth of new neurons, particularly in the hippocampus—a key area affected in Alzheimer's.
2. Poor Sleep Quality: Quality sleep is essential for the glymphatic system to clear neurotoxins like amyloid-beta, which are implicated in Alzheimer’s.
3. Inadequate Nutrition: A diet rich in omega-3 fatty acids and low in processed foods supports brain health and reduces inflammation, which can contribute to cognitive decline.
4. Sleep Regularity: Maintaining a consistent sleep schedule is just as important as sleep duration and quality in preserving brain health.
5. Preventative Measures: Engaging in preventative measures such as monitoring heart health and maintaining a healthy blood pressure can have indirect benefits on brain health.

1: Introduction

Louisa Nicola is introduced and begins discussing the alarming rise in Alzheimer’s cases globally and the limited role of genetics. Dhru Purohit: "It's mind-blowing that only 3-5% of Alzheimer's cases are genetically driven."

2: Unpacking the Drivers

Detailed discussion on the three main lifestyle drivers of Alzheimer's: inactivity, poor sleep, and inadequate nutrition. Louisa Nicola: "Sleep acts like a dishwasher for your brain, clearing out toxins nightly."

3: Deep Dive into Sleep’s Role

Exploration of how disrupted sleep affects brain health and the mechanisms behind it. Louisa Nicola: "During deep sleep, your brain clears out harmful proteins, protecting neuronal health."

4: Importance of Physical Activity

Nicola explains how physical exercise promotes brain health by fostering new neuronal connections. Louisa Nicola: "Exercise isn't just for your body; it's fundamental for a healthy brain."

5: Nutritional Needs for Brain Health

Focuses on the crucial role of nutrition, especially the impact of omega-3 fatty acids on brain structure and function. Louisa Nicola: "Omega-3s are crucial for reducing brain inflammation and supporting neuron function."

1. Integrate Physical Activity: Start with simple activities like walking, gradually increasing intensity.
2. Enhance Sleep Hygiene: Establish a regular sleep schedule and create a bedtime routine to improve sleep quality.
3. Optimize Nutrition: Focus on a diet rich in omega-3 fatty acids, reduce processed foods, and consider supplements if necessary.
4. Mental Stimulation: Engage in activities that challenge your brain, like puzzles or learning new skills, to boost cognitive reserves.
5. Regular Medical Check-ups: Monitor cardiovascular health and metabolic markers to indirectly support brain health.

This episode is brought to you by Momentous, Our Place, and Air Doctor.

We know that the seeds of Alzheimer’s disease are planted at least twenty years before a diagnosis. It’s never too early to think about the lifestyle changes that can influence brain health and reduce the risk of developing neurodegenerative diseases. With all the health and wellness advice out there, it can be challenging to know what to prioritize and what truly matters when it comes to protecting our brain health. Today’s guest breaks it down for us and gives us actionable steps we can implement immediately, regardless of age.

Today on The Dhru Purohit Show, Dhru sits down with neurophysiologist Louisa Nicola. Louisa shares the top three lifestyle factors that can influence our risk for Alzheimer’s disease. She helps us sort through the most current research and uncovers the biggest myths. She also shares the top two supplements that are critical for protecting brain health and the optimal prescription for exercise and resistance training. Looking to protect your brain health? Louisa shows us how.

Louisa Nicola, an Australian-born neurophysiologist and sports scientist, has made significant strides in the field of brain performance and human potential. In 2016, she founded Neuro Athletics, a consulting firm dedicated to optimizing brain health and performance for athletes, executives, and high performers. Louisa's innovative methods improve reaction times, decision-making, and mental acuity. Her vision is to expand Neuro Athletics' reach, empowering more individuals to achieve their full potential through enhanced brain function and mental resilience.

People

Louisa Nicola, Dhru Purohit

Guest Name(s):

Louisa Nicola

Content Warnings:

None

Dhru Purohit
Luisa, welcome to the podcast. You know, I want to start off with something pretty mind blowing that I learned from you. So, globally, we have about 50, 55 million people diagnosed with Alzheimer's disease. But the crazy part is, is that that's set to triple by think. 2050 is what I learned from you.

But even crazier than that is that only three to 5% of all diagnoses are driven by our genetics. So that begs the question for myself and our audience, what the heck is happening for the other 95% to 97% of people who, unfortunately, are ending up with this super scary disease? It is super scary. So you're right. 55 million people worldwide have Alzheimer's disease.

Louisa Nicola
That number will triple by the year 2050. And it seems to be a cascade of different factors that affect it. It's my sole understanding that it comes down to three factors. The first one being inactivity, so lack of exercise, lack of adequate sleep, and then lack of proper nutrition. Let's unpack those.

Dhru Purohit
Let's start off with the first one, which I actually want to kind of go out of order. Yeah, so let's start off with the first one and talk about sleep. Everybody sleeps, or you would hope so. But what is going on in our modern day society that we're not sleeping good enough that's impacting our brain? Well, we have to understand, first of all, the pathophysiology of Alzheimer's disease.

Louisa Nicola
So we know in these neurodegenerative diseases, okay, neurodegenerative. So they build up over time. More often than not, you're getting diagnosed with your first symptom of Alzheimer's disease around 65 years old. And the first sign is episodic memory. That is the first thing that starts to go.

What you did that day, somebody's name, somebody that you met, you know, that short term memory, that's the first thing to go. And then you actually get diagnosed at about 70 years old with the disease. And this is an accumulation of amyloid beta, which is a protein. I'm not gonna call it a toxic protein, I'm just going to call it a protein in the brain that we all have that aggregates, it clumps together over time, and it eventually leads to neuron cell death. So this is a long progression.

It starts around 25 years old, 30 years old. So the things that we're doing from our thirties impact how our brain will survive at age 70 onwards. Sleep is so fundamentally important for many reasons. One is, and we'll talk about the different sleep stages, but sleep is where you can repair your brain. You have to think of your brain.

It is an organ, but it's also like a muscle. Fundamentally, we need to rest our body, right? In order for our muscles to grow, regenerate, we need to rest them, we need to hydrate them, we need to fuel them. That's what sleep does for your brain. And sadly, we're going through an epidemic of sleep deprivation, which is classified as 6 hours or less.

Now, I live in New York. You probably look around you. Most people are sleeping around 6 hours or less. That's just due to the busy city life. But during sleep, we go through different stages, and the most important stages are deep, slow wave sleep, which is your stage three sleep.

Then we go into rem sleep, and that's stage four. And both serve very, very, very important factors for the brain, because during deep, slow wave sleep, and you can see this on an MRI and an fMRI, right, a functional imaging machine, your brain, we have different types of cells. You've got glial cells, which are immunity cells for the brain. We've got neurons. We've got many different other cells.

But these glial cells, right, they come from the greek word glue. It's because they stick and bind to neurons. And what happens during deep, slow wave sleep is they shrink in size, and then when they shrink, there's the passageway. It allows for the passage of the cerebral spinal fluid in your brain to flush and clean out all of the debris, all of the toxins that are build up throughout the day. Amyloid beta, you've got tau, another toxic protein in the brain that builds up and aggregates, that kills cells.

You've got environmental toxins that build up during the day. All these toxins build up during the day. And it's a natural. It's just a natural process of humans. But that's why we sleep.

We sleep to replenish the brain. So if we're not getting into deep sleep, deep, slow wave sleep, we're not getting the activation of the glymphatic system. So we're not able to clear out the debris. So what happens over time? It's like compound interest, okay?

We don't clean it out one night, it may not do any harm. But if we don't clean it out two, three days a week, and that compounds over the course of 1020, 30 years, what happens? It's like waste products. Just build up the garbage. You've got to throw out the trash.

If you don't, if the garbage man doesn't come and take the trash out. What happens? Piles and piles and piles, and out of nowhere, it becomes a clump. And that is then an amyloid beta, I would say ball in your brain that eventually leads to neuron death. This episode is brought to you by momentous creatine.

Dhru Purohit
You might have heard me talk about my love for creatine before. It's one of the most well researched and safest products on the market. In fact, randomized, placebo controlled studies show that creatine improves exercise performance, especially for short bursts of exercise like strength training. It's one of the supplements that I've actually seen improvements in my body composition and my brain function and my muscle mass. The brand I take is momentous creatine.

Their creatine is sourced from creepure, the purest form of creatine monohydrate available, and the gold standard of creatine. It's a single sourced ingredient from Germany with no additives, sweeteners, or other ingredients. Since taking this creatine, I've noticed huge gains in the gym. More energy and more mental clarity. My trust is in momentous because of their dedication to working with the best.

From their collaborations with experts, their unparalleled commitment to only using the highest quality ingredients. They've also heavily invested in third party testing, holding their products to a standard set by the most demanding organizations in the world, including names that you've heard of, the NFL and the NBA. You know there's a reason why the best athletes and experts that are out there use and develop momentous products. So if you're like me and you want to use and take the supplements that are recommended by the best and brightest out there, go to livemomentous.com and use the code drew Dash r U to get 20% off my favorite creatine today. That's livemomentous.com with the code Dashru drew.

That's me. To get 20% off my favorite creatine today, this episode is brought to you by our place. Did you know that one of the most toxic items in your house might be your cookware? So much cookware these days is made with highly toxic nonstick coatings that when heated, can leach into our food and end up in our bodies. I've been on a mission to swap out my toxic cookware with non toxic options, which is why I use the titanium always pan pro.

It's the first ever non stick technology that's coating free. And like all of the our place cookware line, made without PFAS, otherwise known as forever chemicals, otherwise known as super toxic for our body. This super durable pan has a titanium surface which is 300% harder than stainless steel, making it virtually indestructible and able to withstand up to 1000 degrees fahrenheit. This pan also is fully clad and tri ply and is constructed with quick heating, aluminum core and a durable titanium interior. It's also dishwasher safe and perfect for seasoning, flipping, deglazing, deep frying and so much more.

I love it. To personally pan fry sweet potatoes, sear steak and make crispy fish or the perfect omelet. This pan can handle all meals, making cooking at home easy and of course, non toxic. Our place is so confident that you'll love their cookware. They offer a free hundred day trial with free shipping and returns.

This way you can try it out risk free and see the benefits yourself. They also offer a limited lifetime warranty. If you want to reduce your toxic load, why not get started with your cookware and check out the titanium always pan pro. Right now, our place is offering my community 10% off. Just go to fromourplace.com and enter the code drew dhru at checkout.

That's from f r o m, our place. O u r p l dash a c e.com from ourplace.com with the code dash r u to get 10% off. So one thing that's important is, of course, making sure that we get six or more hours. Right. But also the other thing that I'm hearing from you that's just as important, if not more important, is that your different stages of sleep, especially deep sleep, are not disrupted.

Louisa Nicola
Correct. And a lot of people, even if they think they're getting six or more hours, you see this trend of disrupted sleep that everybody's going through. Exactly. And, you know, now the latest research is showing that even more important than quality and quantity is regularity of sleep. What time you go to sleep and what time you wake up, which makes sense when you understand the evolution of the brain, because your brain loves certainty, it loves regularity, it loves to know that you're doing the same thing over and over again.

So if you can be going to sleep at the same time and waking up at the same time every day, you're going to just naturally increase your deep and slow wave sleep because you're going to be waking up with the sun going to sleep when the sun is going down, and you're going to get this natural rhythm, if you will. Yeah, we wrote a newsletter about this, but there was that study from the UK. It was like 66,000 patients they looked at. And the people that had the most variation in sleep timing had a higher risk of all cause mortality. I believe it was only over 10% variation, wasn't it?

Dhru Purohit
Okay, you would know better than me. We'll link to it in the show notes so that people can see it. Yeah, correct. So you don't want a lot of variation. You want to make regularity.

Louisa Nicola
Regularity, exactly. And that's literally just to bank on the slow wave sleep, the deep sleep, stage three, and also the non REM sleep. That is non Rem sleep, and also Rem sleep, which is stage four. So just two quick things before we get into exercise and of course, diet, which you're going to break into, including, you know, one of your top recommendations for supplements. And I know you're not like a huge supplements person.

Dhru Purohit
You want them to be tailored, but there's one supplement that you're a huge fan of across the board. We'll get to that in a second. But before we go into that, um, as I mentioned, uh, exercise, a sedentary lifestyle, its impact on the brain, why being sedentary is so damaging. Give two quick tips on the topic of sleep. That's there.

One of them you just shared, which is try to maintain a schedule. Don't have too much variation. You know, maybe plus or -30 minutes is fine, but try to keep a standard sort of going to sleep time and a standard sort of waking time, right? That is correct. Yeah.

Louisa Nicola
You also want to ensure that you are warming up for sleep. If you treat sleep like a sport, then you got to think about it like, okay, it's 08:30 p.m. i want to be asleep by 10:00 p.m. that's the golden rule with me. Bed by lights out, 10:00 p.m.

asleep. If you want to have that as your sleep time, that means you're going to have to start warming up for sleep at 08:30 p.m. that may involve having your last meal at 08:00 p.m. it turning down the lights, getting relaxed, don't answer emails, don't be doing anything too chaotic, and of course, staying clear of alcohol and marijuana if you are a regular user. Yeah.

Dhru Purohit
Let's talk about the intersection of exercise or lack of exercise and the brain. I don't know many people that know as much about this topic and the combination of those two as you. We'll talk about your story in a second. But first, tell us why a sedentary lifestyle is so damaging for the brain, but also is so likely to increase your risk of getting Alzheimer's one day. The most powerful intervention that we have to slow the progression of these disease states is exercise.

Louisa Nicola
Exercise can be broken up into three categories. You've got resistance training, you've got aerobic training, and then you've got neurocognitive training. Aerobic training is absolutely fundamental for the brain, and for this specific reason, it can help with the growth and proliferation of new neurons. So you can literally grow new brain cells in your brain in specific areas that are involved in the degeneration of or the accumulation of Alzheimer's disease. So you've got a little area in your brain.

It's deep in the temporal lobes, which sit behind the ears. It's called the hippocampus. It's a seahorse shaped structure. That's when we hold. That's where we hold all of our memories.

Memory formation, learning as well. And that's the first thing to shrink. The structure of it shrinks. The volume, size, and the neurons inside it shrink. So, evidently, when that shrinks, any part of the brain that shrinks and dies off, we lose aspects of what that controls.

So that's why we lose our memory. But we've known now since 1960, to be exact, or the 1960s, that we can grow new neurons in the brain, which can help with better learning, better memory. We also know that through aerobic physical activity, I'm talking your long runs, your zone two cardio, we know that you can actually build greater connections so your brain cells synapse with each other. They connect with one another to provide our thoughts and our actions. And we can now see that with more exercise, you can get more connections between brain cells, so you can grow the cortex of your brain.

We've known that since the 1960s because the first studies ever done were on mice where they, you know, they subjected mice to a little shoebox, one. One group, you know, which didn't have much activity, much light. It was a very dull environment. They weren't doing much movement. Then they put another set of mice in this wonderland, if you will, where they had circuits.

They had so many things going on. And over the course of six months, they saw that these mice actually grew the cortex, the outer layer of the brain, and they grew new connections in the frontal part of the brain. The frontal part, drew, is what is responsible for our executive functions, information processing speed, your ability to think, your ability to make sound decisions. These areas grow thickness wise just through aerobic physical activity. Wow.

Dhru Purohit
That's incredible. So we've always known exercise is good, but what seems to be coming today, and the research that you're going to be talking about and presenting and already have been presenting, is that we're learning even more exactly the mechanisms of how exercise supports the brain. But also the other side of that coin is we're learning that when we don't have that, just how damaging it can be if somebody is living a sedentary lifestyle, which I think here in America, that's less than 4000 steps a day, right. And a lot of people actually don't know they're getting 4000 or less steps a day and they're not prioritizing some sort of movement. Aerobic training, resistance training, how bad is that for their brain?

Louisa Nicola
Absolutely detrimental. In fact, it's over 70% of us adults don't meet the physical activity guidelines. The CDC states that we need to be doing at minimum 150 minutes to 300 minutes of moderate to rigorous physical activity per week. I think that there is a nomenclature mishap there because physical activity a lot of people think is doing the gardening when I would lobby against that and say we should change the words to exercise because exercise is going out and stressing your body. You need to place stress upon a system in order for it to grow and that's what you do when you exercise.

So the mere fact that we are living this sedentary lifestyle, increasing the risk factors for Alzheimer's disease is detrimental. People think that, oh, I'm just going to exercise to look good. That's how I think we view exercise. Still. We don't go to the gym for our brain, we don't go to the gym for our heart.

Most people are going to the gym or exercising just to look good. So if you've got that in your head, you may think, well, I kind of look good today. I don't really feel like working out. And if you don't really understand how fundamental it is for the health of your brain and body and how you actually live your life, like quality of life, you're probably going to be sedentary. You know, for a lot of my audience, especially on YouTube, that's in the 50 plus age group, 50 to 60, 60 to 70, and shout out to everybody who's listening, who's 70 and above.

Dhru Purohit
They maybe didn't grow up exercising. It wasn't part of their culture. They didn't have a dad or a mom or a family member. They're not used to it and they're hearing about just how important exercise is. But then they hear the word gym and there's a little bit of nervousness that's there.

When it comes to tips to getting movement in, are there any things that you can recommend for people? Right. Anybody at any age group, especially with a little bit of training in the beginning, you can get into the gym and it doesn't have to be intimidating, but for the folks that are intimidated by it, what other things can they be doing to get that movement in? This is not new information for me. I often refer to my parents who are late sixties, okay, my father, early seventies.

Louisa Nicola
They didn't grow up exercising, but now it's an actual family law now that they are exercising. And the way that I got them to start was just walking, just getting your steps in. And that's the first thing you know. You don't want to shock your brain. I know that you know a lot about dopamine, and dopamine is that molecule.

It's that neuromodulator that gets released in pursuit of a goal. And if you set yourself up to achieve an unachievable goal, like going to the gym or going and doing a huge run, you're probably not going to achieve, and it's going to scare your brain and you're probably not going to wake up and do it the next day. I want everyone to start really easy. You can get so much benefits from walking. I don't know why we've demonized walking.

I consider walking one of the best exercises. It's not the only thing we should be doing. But if you are completely set entry only, meeting three or 4000 steps a day, set yourself a goal of just doing a walk. An extra walk, just walk. That's all you need to do to start.

Then maybe that walk gets a bit faster. Maybe that walk turns into a jog. Maybe it's a full walk with a ten minute walking lunges. If you will notice, I didn't use the gym there or weights. Nothing is scary about walking, even walking uphill.

That could be another way up a hill. Exactly. You want to stress yourself just a little bit. But even getting steps in, the amount of benefits it does for your brain and your cognition is. Oh, my God, it's unbelievable.

Dhru Purohit
I've heard a little bit about the origin of the 10,000 steps. It kind of was just like made up a little bit, just as a benchmark for people. But is that still a good thing to shoot for? Especially because we know that a lot of people are living a sedentary lifestyle, getting four to 5000 less or less steps a day. I think that we should be shooting for twelve and a half thousand.

Louisa Nicola
Great to be. Talk about why I think so. It. It comes down to just how much you are pumping blood throughout your body, right. The way that this actually affects brain health actually comes from the heart, because what we're doing is your brain is the most vascular rich organ in the entire body, meaning it's got so many blood vessels, you've got capillaries, which are these one cell thick blood vessels.

You've got veins, and you've got these big arteries, okay? And every single vessel feeds the brain with blood. And the moment that that little vessel dies off, you will lose blood supply to that neuron. That neuron isn't fed with oxygen and nutrients, which is what blood does, so therefore it's got no use, so it'll die off. We've got around 87 billion neurons in the brain, and so if they start to die off over time, that's what we get with impairments in our cognition.

So walking is just a way to just keep flowing blood throughout the body and to the brain, because your capillaries are there, we need to be using them. So every time you are pumping blood, you know anything above your baseline. So, right now, we're probably, depending on how fit we both are, our resting heart rate may be in our fifties, right? So we're pumping, we're doing 50 beats per minute, whereas if you're just out there walking, you're probably reaching about 100, 110, 130. So you're getting more blood flow than if you were just sitting down.

That's my take on the 12,500 steps per day. I love that. And, you know, you have a fantastic quote. I don't know what order it's in, but what's good for the brain is good for the heart. What's good for the heart is good for the brain.

Dhru Purohit
What's good for the heart is what's good for the brain. But I guess both are true, right? Like, anything that you can do that's gonna be supporting your brain health, generally speaking, those things are all good for the heart, but in the way that you're talking about it, really, if you can prioritize your cardio training just by a vigorous walk, that's there, or other things that are supportive, and you start where you are and you build up further, sure, if you can work your way slowly up to resistance training, that's gonna be helpful. But those things are gonna be good for your heart, but they're also gonna be super powerful for your brain. Connect the dots of why would that be?

That all this movement would be supporting either a delayed diagnosis of Alzheimer's disease or hopefully, knock on wood, you know, not getting Alzheimer's disease in the first place. So let's actually take a bit of a physiology lesson, if we will. And I really want to go back to your previous comment about your viewership being in that 50 to 60 year old anabolic. YouTube on audio a little bit. But that's really important because I actually have, as a woman, I have a strong relationship with the association between postmenopausal women and dementia.

Louisa Nicola
We know that two out of three cases of Alzheimer's disease is women, right? So we have to understand why that is and we have to understand the role that estrogen plays, our dominant hormone. So if you are born a female with. If you are born with a uterus and ovaries, that's what I mean when I say female, you have more estrogen receptors in your brain. And evidently, as we go through, the women go through the menopausal stages, varies in age.

Maybe it's around 52. I think that's the global average age. You start to get less estrogen. We don't produce any more estrogen, therefore estrogen is if that is the most dominant hormone in the brain. We have a higher efficacy of getting these neurodegenerative diseases.

So we need to understand, especially as females, just how important exercise really is for a healthy, functioning brain, for a healthy brain in terms of function and structure. And I really think that females have been dramatically understudied when it comes to these diseases in academic medicine. We won't go into that because I have beef with Charles Darwin, so we won't go into that. But I really wanted to highlight that and the importance of ladies in their fifties, in their sixties who are leading up to that stage, how fundamental exercise really is. Is it too aggressive to say that a sedentary lifestyle, it impacts everybody, regardless of your gender, but in particular, because of our modern lifestyle, a sedentary lifestyle is going to take its biggest toll on women.

Dhru Purohit
Is that too aggressive to say? That's not too aggressive at all. So that's a true statement. That's a true statement from me. It's an important thing to talk about because we want to protect everybody in society, but it's important for women to know how they might be more vulnerable because of their unique situation with hormones.

Louisa Nicola
Yes. And when I said the statistic, two out of three Alzheimer's cases are female, we still don't know why because women are understudied in science. So we need greater advocacy for understanding that. Okay. We need to understand why that is.

But we do have a rudimentary understanding, and it does come down to estrogen. Yeah. There's a lot of really great researchers in that space, and I'm sure, you know, Lisa Moscone and other individuals that are doing some great work. But, yes, we need more of it. So let's go back to the physiology lesson, and we can understand why the heart plays a really important role as we age.

And this actually comes from Ben Levine, who's a sports cardiologist, and he's done absolutely foundational work when it comes to the structure of the heart. So what happens, just like the brain, as we age, the brain changes. Okay. It ages, too. We see a decrease in our cell size because as we age, we get a decrease in cell size.

It's just part of the natural brain aging process. You're never going to get to age 100 and see thicker cortical areas in your brain as opposed to a 20 year old. So we just know that the heart ages, too. So as we get older, we get stiffening of the arteries. The arteries, those big pumps that come out of the aorta, that pump your entire body of blood, they get stiffer as we age.

What also happens is we have a left ventricle of the heart. We've got a right ventricle. The right ventricle pumps blood to the lungs. The left pumps blood to your entire body, the organs, the muscles. That left ventricle, over time gets stiffer.

So we get something called left ventricular hypertrophy. So the walls of the left ventricle thicken as we age. Now, Ben Levine was really. He's wonderful. He did a study where he took 53 50 year olds.

He subjected them over the course of two years to maximal aerobic exercise. I think it was around three to 4 hours per week. Maximal aerobic exercise is when you're pushing past your limits. You know, you're huffing, you're puffing, you're going really hard. He pushed them to that zone.

And he took, you know, he took images of the hearts. He did echocardiograms. He did every image of the heart to see the structures over the two years. At the end of the two years, he re scanned the hearts of these 50 year olds, and he found that he reversed the age related changes in the heart by 20 years. Wow.

So these 50 year old hearts looked like 30 year old hearts. Specifically, what he saw was that left ventricle, it actually, the walls got thinner so the ventricle got bigger so he could allow more blood flow to come in. Therefore more blood to the muscles and more blood to the brain. And over how much of a period of time? That was over two years and that was maximal.

And we'll go into to that as well because we haven't even touched on resistance training. But we know that you can change the structure of your heart. It's actually called cardiac remodeling. You can remodel your cardiac system. So what happens when we do that?

We get a stronger heart, a stronger foundation to pump blood through the aorta. Now your aorta comes up and out of the aorta we've got branching of two main sets of arteries. You've got the carotid arteries on both sides, obviously, and they supply the frontal part of your brain, the anterior part of the brain with blood. Then you've got the vertebral arteries, they supply the posterior aspect of your brain. So the better structured your heart, the better structured your aorta, the more blood will pump more efficiently to the brain.

Dhru Purohit
So two years of vigorous exercise led to an almost biological age. Reversal of the heart of 20 years. I don't know anybody that wouldn't want that. Absolutely. So what does that mean?

Louisa Nicola
Let's go back to aerobic training. You can't just perform maximal exercise. That is just, that is silly. I would never get a 65 year old who is completely sedentary to go from that to maximal exercise. You don't go from zero to 100.

Correct. That's why you want to walk, you want to set the foundations. Everything is done in levels. You set the foundations, you build up some angiogenesis, the creation of new blood vessels. You build up your muscles, you build up your tolerance to CO2, right?

Then what you want to do is you want to pick it up a notch. Maybe you jog, maybe you get on a bike, you go a bit harder, and then you build yourself up to be doing maximal aerobic exercise. That's fascinating. Another thing on the topic of exercise, that's that you've been known to talk about. In fact, I think it's one of your most viral clips.

Dhru Purohit
You connect the dots between gray matter in the brain and exercise. Can you chat about that? And a lot of our audience give them a refresher on what gray matter is, why it's so important. This episode is brought to you by air doctor, you probably think that the home you're in is pretty safe from air pollution, right? But did you know that indoor air is often two to five times more polluted than outdoor air.

Crazy. I know. Buying new furniture, installing new carpets, painting your living room, and even owning a pet can dramatically affect the air quality inside our homes. Toxins found in polluted air can contribute to everything from cardiovascular disease to neurodegeneration. When I found out how toxic the air in my home could be, I started to use the air doctor professional air purifier.

And I saw notable improvements in how I felt immediately and when I measured the quality of the air in my home using special devices. Air doctor has an ultra HEPA filter that's 100 times more effective than any ordinary HEPA filters. Plus, it removes 100% of airborne particles and the vast majority of volatile organic chemicals and gases like formaldehyde and ozone. It's the best home air purifier I've found, and it can be used in any room in the house. Right now, air doctor is offering my community $300 off.

So just go to druprowet.com filter to clean up your home's air quality and feel better today. That's Drupurewit dash rupurohit.com filter to clean up your home's air quality today. So we've got gray matter in the brain, and that sits on the outer cortex, and they are the cell bodies of the neuron. So the neuron being the chief brain cell and the only electrically active brain cell consists of a cell body, just like the cells in your body. And then you've got this axon that comes off it.

Louisa Nicola
The axon has the mice sheath, and that's where that's called the white matter. Okay? So that's the white matter of the brain, and that's where we have speed of thought. Okay? We call it conduction velocity in neurophysiology.

So that's where our myelinated neurons are. That's the white matter. The gray matter is the cell bodies that sits on the outside. And we know now that around 70% to 80% of brain gray matter is modifiable by exercise. Modifiable.

Now, the cell body has these little legs that come out. They're called dendrites. And those dendrites will stick to other dendrites of nearby cells, and when they connect, they create a synapse, an electrical, electrical chemical reaction that happens, and that's what produces our thoughts and our actions. But over time, those dendrites die off. But we can grow new dendrites, and that's what is responsible for greater cortical area and greater cortical mass.

And we do that through exercise. So you get greater connections between these cells. So more connections. Therefore, speed of thought is happening, greater capacity to hear, to learn, to remember, to tell yourself to go to sleep. All of this matters.

Dhru Purohit
So if you care about brain health, you have to care about exercise. If you care about your brain, you have to love exercise. Oh, I love exercise. And treat it like hygiene just the same as you brush your teeth. That's super powerful.

You know, we were going through your list of three most important things if we want to avoid Alzheimer's disease or at least greatly reduce our risk for it. And we already covered the first two. Let's talk about the third one, which is nutrition. Okay. Nutrition is a topic that a lot of people are concerned about and care about, but there's a lot of confusion around the topic.

So what are the most fundamental pillars, regardless of what diet people choose to partake in? Not partake in when it comes to eating, to support your brain health? I really love this topic. A, because I'm nowhere in the nutrition space, that's why I love it so much, and b, because I really want to demystify some of the myths that I see on Instagram and other social platforms. The first one being, you ever think about how your brain is, what it's made up of?

Louisa Nicola
Do you ever think about that? All the time. I do, too. It's interesting because I've seen the brain. I'm an operative neurophysiologist, so I go into brain surgery, so I get to see brains and spinal cords.

And it's pretty fascinating when you look at it, and it's like tofu, the consistency of tofu. And you look at it and you know that most of it is made around 60% to 70% of it is made of fat, and the rest is water. And then we've got this growing body of work that shows that cholesterol, you know, it is made of cholesterol, but that doesn't mean that dietary cholesterol is made for the brain. And I constantly see that on social media, you know, constantly see that people think that dietary cholesterol is what is feeding your brain. But I have to say to you that the cholesterol molecule cannot actually penetrate the brain.

It can't cross the blood brain barrier unless your blood brain barrier is compromised. And that's when you've got more issues. Leaky brain. Correct. And you would know what that is.

But that's the first thing that we need to demystify cholesterol. Dietary cholesterol does not go into your brain and feed your brain. Even though your brain predominantly is made of fat, 20% of the total lipid content in your brain, the total fat content is actually made from DHA. DHA is omega three fatty acids. So this is why I advocate for high omega three fatty acid content.

Omega three fatty acids are made of EPA, DHA and Ala, but I'm going to stick to the most important ones being EPA and DHA. We've seen numerous studies now, clinical studies on humans, showing that if you feed your brain four to 6 grams, some people would argue that's too much. But we know that 4 grams of EPA and DHA is absolutely fundamental for brain health. And that's what I'm having every day, 4 grams. So 2 grams of dHA, 2 grams of.

Dhru Purohit
And just so people are following along, that could come obviously from food. It can come from supplementation. How is your mix? How are you getting to that? Four to 6 grams a day?

Louisa Nicola
If I was living in a little island in Greece, I probably wouldn't be supplementing. And that is because the fish there is fresh. They're catching it from the ocean that is not polluted with plastics and God knows what else. So you can't really rely on getting 4 grams of EPA and dha from fatty fish alone. You'd be having tons of it.

And I'm. I'm sorry, I'm not too sure that in this country, in the United States, that we're actually getting the recommended dose, even minor dose of EPA and Dha from fatty fish due to the way that it is actually served to us. So that's why we have to turn to supplementation. I'd be the, you know, I don't like putting pills in my mouth. I don't.

I would rather get it from food, but we just can't. So we have to be getting it from supplements. I like taking my pills. It makes me feel good. It makes you feel good?

Yeah. But I'll tell you what else it does. You're not just feeding your brain. I would say that the omega three or the EPA and DHA has a safety profile of an FDA approved drug, so it's completely safe to take. This is why I recommend this for everybody.

But what it has is it just feeds your brain and your body in so many ways. One thing that it does is we know that it can decrease inflammation. Who wants to be in a chronically inflamed state? We know that it can really decrease inflammation. We're seeing studies of it, ameliorating, getting rid of and clearing out amyloid beta, which is that toxic protein in the brain that builds up in Alzheimer's disease.

But we also know that it can help with cell membrane fluidity, the way that your cells are moving throughout your body and in your brain. So it does so much. I could list, you know, about a thousand things that the omega three fatty acid pill does. So the most important thing for people to take away from this is that EPA DHA in these omega three fatty acids. Yes.

Dhru Purohit
We can get it from consuming fish, hopefully high quality. But often, to get to that four to 6 grams you're talking about, we need a little bit of supplementation. It's neuroprotective. It is neuroprotective. So it's going to be helping us, again, delay that diagnosis, God forbid, or help us.

In my case, I'm not trying to get Alzheimer's at all, so I'm trying to do all the things that are there so hopefully reduce your risk that we know for sure. But in an optimal world, if we're doing everything, do you think it's possible that, you know, if your genes are not those particular ones that you talked about before, that maybe you could live your entire life and you don't get Alzheimer's? Do you think that's possible? I want to first clarify. I think this is really important to understand the difference between genetic mutations and genetic risk factors.

Louisa Nicola
So when we have genetic mutations, let's just say we have, you know, we've got around 25,000 genes in the human genome. If we have a. A miscalculation on one of those genes, you will have a certain disease. You know, if you've got a mutation on chromosome four, you'll get Huntington's disease. A genetic mutation in the dementia space involves three genes.

You've got presenilin one, presenilin two, and the app gene, right? They are mutations. So if you have these three genes, we know that you are going to get some form dementia. The other risk factor genes, which I know that you know what they are, we've got two of them called apoe four. If you have the apoe four allele, you know, you get one from mum, one from dad, it raises your risk of getting the disease.

So they are risk genes. So I think it's really important to differentiate between the two. So what's happening now is that out of that 55 million people that have the genetic risk factors for Alzheimer's disease, only three to 5% have the apoe four gene, either one or two. So they have a higher risk of getting the disease, but the other 95% are getting diagnosed with Alzheimer's disease without having the mutations or the risk genes. So that begs the question of why you could live your entire life and not get Alzheimer's.

Correct. Even, you know, regardless of genes, by the way, regardless of not having the genes, I truly believe that. I do believe at end of life, we are going to die of something. But Alzheimer's disease is a preventable disease, so you can slow the progression if you've got mild cognitive impairment, or you can completely prevent it through precision medicine, lifestyle interventions. Yeah, I asked my dad one time, I was like, do you remember any of.

Dhru Purohit
And I think he even knew his great grandmother. Do you remember any of your grandparents, great grandparents having cognitive decline to the degree of how we see Alzheimer's today? And he says he can't think of one person that was in the family tree that had that. And then you have to question why that is. Now, there was a really famous study, and I hope I don't butcher this study, but there was a famous study that was done in Nigeria, where they did find that there was a large population per capita that actually possessed the apoe four gene.

Louisa Nicola
Okay. The two alleles, you got one. Some of them had. It was a high population that had two. However, they didn't get the disease.

Why is that? It most likely is because of their lifestyle interventions, which are much different to those in the United States. So, true. What else do you want to say about nutrition? You're talking about how protective having EPA and DHA in your diet is.

Dhru Purohit
And actually, one follow up question for you on that. We're going to dive deeper into some of these topics, but do you recommend that people do something like an omega index test to get a sense 100% where they stand and how much EPA, DHA, or even things like trans fats they have in their body. Yeah. So the omega three index test, which was formulated by doctor Bill Harris, it's a great test. It measures the amount of omega three s in a red blood flow.

Louisa Nicola
This is different from if you go to your PCP and ask for an omega three test that is not the same, I would generally recommend getting. And it's a really simple test. It's just a pinprick test. And it's like $59 is like, the cheapest version. I think it's $99.

Dhru Purohit
If you want to see the full profile, which I like, because it shows you if you have, like, trans fats if you're consuming too much of those. No affiliation. I've had doctor Bill Harris on the podcast and I've talked about my own experience. I actually took that test when I was still deciding about whether or not I wanted to be a vegan many, many years ago. And my results came back and they showed me that actually I need to have fish in my diet because my ratio was completely off.

Louisa Nicola
Oh, wow. See, there you go. You want a correct ratio, but you also want to be shooting. I don't know if you remember what your percentage was. I have to dig it up.

So mine. So what we know now is that most of the us population is around 4% or less, which is scary because you are increasing your mortality rate with an omega three index test of 4% or less. We want to be aiming for an omega three index score of 8% or more. Yeah, I'm about 8.5 or something like that right now, but back in the day, I was probably even less than four. And that's scary, right?

I actually tested, I was 10.5. That's amazing. It is. I am. But I am very, I'm very meticulous with my supplementation.

Yeah. So I do believe everyone should get that, but on that as well, I think everyone should be getting a blood test standardized every. If they can do it twice a year just to see what is happening. You know, something as simple as having a vitamin D deficiency is crucial as well. Like, you don't want to have a vitamin D deficiency, you don't want to have a magnesium deficiency.

We now know that we have vitamin D receptors on the brain. In fact, that there are vitamin D receptors on our brainstem, and this is very much correlated with sleep. So we want to have a good understanding of what is happening in our body. And I would caution against taking any supplement other than omega three fatty acids and creatine outside of a blood test. So don't just take vitamin D because you think it's good for you.

Go and check. Yeah. Fantastic. Now, on the topic of nutrition, one thing that we didn't talk about, even though that's not your primary wheelhouse, is what are the most damaging over consumed foods or nutrients that are causing damage to the brain. Anything that you could talk about at.

The highest level, the standard american diet. We know that we want to stay far away from your fried foods, from your packaged foods, from your sugary foods. We don't want that, what your brain loves, because we didn't actually touch on this. Your brain loves, it. Turns out, antioxidants specifically vitamin E, vitamin C, selenium, you know, blueberries, raspberries are some of the most important things for your brain.

Your brain loves that. Have it, feed it what it loves. And I think instead of talking about what's damaging for the brain, let's stay away from that. Why not talk about what is good for the brain? And what are you doing to eat that?

Are you eating antioxidants every day? It does love plants. In fact, I'm an omnivore. I eat everything. I don't subscribe to any specific diet, but I would say now my diet.

Dhru Purohit
Is around 70% plants by volume, not by calories. By volume, yes, 70% plants. I do have red meat. I love red meat, and it is not bad for the brain. I do have a lot of fish as well.

Louisa Nicola
But really understanding the antioxidant profile, vitamin A as well, your brain loves that. So if you can just stick to that, first and foremost, it kind of takes care of itself. You don't need to be eating the foods that we know are fundamentally going to cause mitochondrial dysfunction, metabolic dysfunction. And we also want to maintain a good lipid profile. That is understanding your lDl, your apob, you know, the plaque that forms in the arteries.

That's again, what is good for your cardiovascular system is good for your brain. So you don't want to be overloading yourself with these fats that are going to infiltrate the arteries of the wall. Now, you quickly touched on it, but it deserves its own little segment here on the podcast, which was one of your other top supplement recommendations. You're so excited about the supplement, you actually put your parents on it, even though they're not bodybuilders. And that supplement is creatine.

Dhru Purohit
Why are you so excited about creatine? Oh, my gosh. Creatine. Creatine has got to be the best thing that you can be taking for cell energy, metabolism, for the energy of your brain. I think everyone should be taking at minimum 5 grams of creatine per day for several reasons.

Louisa Nicola
You mentioned a word earlier, neuroprotection. We want to protect our brain, protect it from something that might occur, whether that is getting hit in the head or just protecting it from our life. Like, let's admit as 2024, every single day we have to wake up. It's like the Hunger Games. Like we are getting so many things thrown at us, notifications, stressful events where we're trying to navigate this food system, where we're trying to find healthy food.

So our brain is under attack 24/7 protecting your brain with creatine is fundamentally so incredibly important. What it does is it, first of all, the cell energy metabolism, it helps create ATP, which is our energy source, our energy currency. I love it for several reasons as well. It's because we used to think of it as the bodybuilding drug, but we now know that this can be implicated in neurodegenerative diseases. We're seeing mouse models being studied where they're dosing them up with like 15 grams of creatine per day, and we're seeing great benefits.

We're also seeing postmenopausal women who were on the track to becoming osteoporotic, actually reversing that because they're able to work out more due to creatine. And actually, doctor Darren Kandao was the one who did this wonderful study with women where he dosed them. I think the dosage was 12 grams a day. And he increased their bone density and their muscle mass. We increased bone density, we increase muscle mass because muscle is an endocrine organ and we're going to get into what that is.

You have better brain health, greater leg size, greater leg strength, bigger brain. So it's all intertwined. So if there are people listening and they think, oh, my gosh, but I'm scared to take creatine, I'm scared that it's going to make my hair fall out, there's been no, that is just a myth. It does not increase DHT. So, fellas, you can take your creatine.

Ladies, it's not going to make you big. A lot of ladies are scared that they're going to get big and bulky. It's not going to do that. Yeah. If it did that to women, every guy in the gym would be jacked.

Exactly. And I can tell you, not every guy is. And they're all taking creatine. And I got to tell you, it is also, it's the most widely studied supplement on the market, so it is the safest. So just a couple questions about that, because people see all sorts of things on the market.

Dhru Purohit
They'll see creatine gummies, they'll see that recommendations of types of creatine, and then dosing and anything people should be aware of when it comes to dosing creatine. Yeah. So there was actually a study where they actually looked at the creatine gummies and they found that there was no creatine in the actual gummies. Because what happens is it's got a short half life. You want to be taking creatine monohydrate in powder form, and you actually don't want to mix it with anything.

Louisa Nicola
And I'm seeing now, like this, this rise in creatine research. Okay. So many supplement companies are becoming attuned with the science, which is great, but they're now creating drinks. You know, I think they're energy drinks where they're mixing creatine. And you should know that creatine actually dissolves and you don't get the benefits from it.

So you actually, if you're putting creatine with another drink and you're mixing it and you're having it a day later or two, three days later, you're not actually getting creatine. What if I have, like, creatine and my electrolytes? I typically would do that and I'd mix it and I drink it through straight away. Yes, you can do that. But if it's left, you don't want.

Dhru Purohit
To have it standing around. You do not want to have, you. Don'T want to buy creatine already in a pre made drink. Correct. Because it's impacting the degradation of the creatine.

Louisa Nicola
That is correct. Instead, just get the powder. Get the creatine monohydrate. Yeah. And you can mix it and drink it pretty much right away to get the benefits.

Doesn't have any taste. The best way to do it is put it in your morning coffee. That's what I do with my parents. Wow. Yeah.

So put in your morning coffee, go about your day. Have it every day. Some people ask, should I have it prior to a workout? It doesn't matter when you have it, as long as you do have it. I do have it prior to my workout.

Dhru Purohit
It's maybe getting too in the weeds on it. But if it's so sensitive that it can degradate, does heat impact that at all? No, not really. It doesn't? No.

Louisa Nicola
It's just time. Yeah. And I know this because I interviewed the founder of Momentous, which is a supplement brand where they do heavy research on this one product. So back to the gummies. You don't want to be having gummies because the degradation has already disappeared.

Dhru Purohit
Wow. Yeah. That's great dosing. Sometimes you hear people talk about how if you're not used to taking creatine and you jump to, you know, taking 5 grams immediately or five to 10 grams immediately, you can get some loose stools. I've anecdotally heard that happen to some folks.

I think even my, a family member was trying it. And so it's been recommended for some people. You know, you can start small and work your way up. Do you believe that? Of course.

Louisa Nicola
Anything is better than nothing. And you gotta remember, we get creatine naturally in our body already, but we also get it from beef, we get it from liver. We just can't get just like the omega three fatty acids. We can't be having that much beef and liver in one day to get the necessary creatine that we need. If you start on 2.5 grams a day, then that is fine.

If you can tolerate it, you should always start with a small amount of anything, really, even omega three fatty acids, if you can tolerate it. If you don't get any distress, I know a lot of women may even feel discomfort with it. You just have to try it out for yourself. If that does well for a week, two weeks, up the dose, and then it's also dependent on body size. You know, I wouldn't recommend a LeBron James being how big he is, having the same as maybe me or a smaller female.

So it's all dependent on body size, what you're doing. You know, there are some men who are having 20 grams per day and they're not experiencing any kidney issues. I just want to put that out there. Yeah, that's fantastic. You know, I want to zoom out for a quick second before we share a little bit about your story and the work that you're involved in.

Dhru Purohit
Is what are some of the still biggest misconceptions you see about Alzheimer's disease today? The biggest misconceptions that I see with Alzheimer's disease is that it is just something you get as we get older. But I have to say that dementia is not part, not a natural aging disease. We do not have to get this disease. It is completely preventable.

A lot of people think you're living your life, you're healthy, and then one day you just get it. And that's not true. That is not true. The earliest signs of Alzheimer's disease can be seen ten, maybe even 20 years before you end up with a diagnosis. Is that accurate?

Louisa Nicola
Yeah. So what you end up doing, you get a pre dementia state is called mild cognitive impairment. And we can test this. I've done several brain scans and I've picked up on mild cognitive impairment impairment. It's a pre dementia state.

So now you've reached healthy to pre dementia. So if we are in that category, then it becomes, how can we slow the progression of getting Alzheimer's disease rather than getting it in ten years or 15 years? How do I eventually get it in 30 years. So these diseases start in your thirties. For somebody who is listening today, who is in their fifties or sixties or seventies and beyond, and they're listening to you nodding their head in agreement in excitement.

Dhru Purohit
But then they're also thinking, I have not been doing these things. Is my brain basically effed at this point? No. Look, there is. It's always a good time to start working on your brain.

Louisa Nicola
One thing I will tell you, if this is not going to shock people, is we've just had in the United States a new FDA approved drug that came out on the market. This was around two weeks ago, lecanumab, or lekembe, and it's a monoclonal antibody. It's done via an iv. So if you have the disease, what it does is you put the iv in, and over some time, it can apparently ameliorate the amyloid beta, freeing up the brain to get back to its normal state. So many things wrong with that.

First and foremost is, while that may be true, in the process of it doing that, you. We've seen patients actually get brain bleeds and affecting the ventricles of the brain. So even though you may be ameliorating some of the amyloid beta, which, by the way, it's a very small amount. A very small amount. In that time you've wasted, it's around $60,000 a year for that drug.

You're also increasing your risk of hemorrhaging, like, you know, brain bleeds affecting the ventricles of the brain. And so I think to myself, no matter what, you do not want to get the disease, because it's not going to be good for somebody who you're living with. It's not going to be good for your economic status because it's around $60,000 a year, and at the end of the day, it's having maybe a 0.1% change in your brain. Yeah. And, you know, based on the accounts that you read out there, the FDA sort of felt pressured to approve it because they didn't want to discourage pharmaceutical companies from continuing further innovations in Alzheimer's, even though they know that the benefit is so low compared to the cost and the risks that are there.

Dhru Purohit
And the Alzheimer's category has had a few drugs in this space. What was the other one? Adjuvant or something like that? Yeah. Correct.

Louisa Nicola
Yeah. Aducanumab. Yes. Kanumab from Biogen, which was actually retracted. Yeah, it was retracted, and all these insurance companies came out and said, we're not gonna pay for this.

Dhru Purohit
If everybody who had the potential of getting Alzheimer's was on it because it was so expensive, it would have bankrupted our country. Exactly. And this goes to a larger area. Before we get into your why, of what drives you and how you got into this space, is that I feel that partly the reason that you're here to talk to our audience is that while modern science is so amazing, we are not even close to being able to deal with this tripling of Alzheimer's disease that's well on its way. That's happening.

That's greatly and disproportionately impacting women that are out there through any pharmaceutical intervention. So if we wait for somebody to save us, we're going to be waiting forever, and our brain is going to be dying along the way. So we have to take our health back into our own hands. Is that correct? That is correct.

Louisa Nicola
And you, we are all at the mercy of these massive conglomerates that are putting the narratives of our life together and essentially dictating how we are going to live for the rest of our lives. And that is because if we get our information from the CDC, the government, where does the government get funded to give us this information? Through mainstream media. They are getting their money from the pharmaceutical industry, from the big food conglomerates, and then from the industrial military complex. So if the pharmaceutical company is feeding the.

The government, and the government is going to mainstream media with their information, and we're looking at mainstream media, really, you are putting your life and the course and the quality of your life in the hands of a pharmaceutical company who really are just banking on you getting this disease. So you can be giving them a yearly subscription of $60,000 to feed them. They are just the same as Netflix. Netflix is, you know, you need to be paying, what is it, $17 a month? And that's how they thrive as a massive conglomerate in and of itself.

We're all. We've all got Netflix. It's a subscription. Pharmaceutical company also needs a subscription of some kind. So if mainstream media is what you are watching, we need to get out of there, and we need to get into the free market, which is podcasts like yours, getting information that is true, that is going to help you survive, that is going to help you stave off these neurodegenerative diseases so you can have a healthy life.

Dhru Purohit
You know, as I mentioned earlier, you're one of the top experts in this space. I want to know, and the audience wants to know, what's your. Why? Why is a young person like yourself so passionate about this topic of Alzheimer's disease? I get asked often, did somebody in your family have it?

Louisa Nicola
And the truth is, no. My father, in 2019, had a stroke. But. And I've seen some cognitive decline there, but it's actually more of a systemic issue that I feel like I'm fighting here. And to tell you the truth, there's not a lot of us fighting this big fight, and it's a huge fight.

This epidemic is big. And it comes from a patient that I saw. You know, I mentioned to you that as a neurophysiologist, we do a lot of brain scans. You know, you often see if you've had an epilepsy, for example, or a seizure. You go and see a neurophysiologist, they'll scan your brain.

That was my primary role. Scan brains. I think I've done around 1000 plus. But there was one woman who stood out to me, and she was. We'll call her Betty, 52 years old, and she kept coming in with complaints of memory decline, brain fog, by the way.

We'll keep hormones out of this. We'll keep the menopausal conversation out, because we're just looking at her brain. And she was given all the recommendations from the CDC. Just eat a balanced diet. Look at the food pyramid, do your exercise, which was the CDC guidelines.

She was just doing what she thought was good, really. Not exercising, not properly, hydrating, not sleeping well. Over time, she ended up getting the disease. And it was a scary thing, because this disease is the only disease that robs you of who you are. When you have end stage cancer or cardiovascular disease, at least you can understand who you are as a person.

Your soul, your brain. You go to sleep with your brain, and you wake up with your brain, and it's just yours. No one else is in there. Imagine losing that. And I saw that because Betty looked at me and said, who are you?

Who am I? Where am I? And it had this. It had this effect on me. And it was scary because she would look at her kids and she'd be like, who are you?

And so that's when I thought to myself, this is larger than just Betty. Because if Betty was living a healthy life and she didn't have the apoe four genes, she's living such a healthy. In her head, a healthy life deemed by the information she was receiving then this is why it's affecting so many people. And let me tell you, Alzheimer's disease doesn't just affect the person affected. It affects the family around you.

Somebody's going to be a carer, your money is going to go just to medications, and you lose everything. So that's why I'm so passionate about it, because I know there is. There is information out there that we have to show that you don't have to get the disease. It upsets me that we are at the mercy of these huge conglomerates that are banking on us getting the disease so they can profit, so we can put money in their pockets, so they can have a wonderful life, while the people down here who may not have the correct education may not know how to get the resources to understand the education. They're the ones that are suffering, and it doesn't have to be that way.

Dhru Purohit
Which is why I think you're so incredible at making sure that all the advice that you give is clear, but also actionable and doable when you add up the list of the things that you've been recommending. And we'll do a little bit of a recap here just so our audience can follow along with us. It's not crazy, but the crazy thing is, is that a lot of us are not even doing the basics. So just give us a little bit of a reminder of the three categories that you had, some actionable things that we can all do today to at least delay the onset if we're gonna get a diagnosis. But an ideal world for many people who want to stay committed over the long haul, hopefully never get a diagnosis of Alzheimer's disease in the first place.

Give us a little bit of a recap. Okay. You want to be exercising resistance training. If you can find a trainer or just start lifting weights or doing body weights if you haven't done that, if you're starting from complete zero, you want to be doing aerobic training every day. Move your body.

Louisa Nicola
Make it like hygiene, the same way that you brush your teeth. That's the first aspect. The second one is work out your sleep. You don't want to skimp on sleep, making sure that you're improving quality, quantity, and regularity of sleep. Then at the top of my pyramid, you've got nutrition, antioxidant rich foods.

You want to maintain a good cholesterol, panel your lipids, you know, test them aggressively, because even if you are, if you do have the apoe four gene that is involved, that is the gene that helps transport the cholesterol around the brain. So if that becomes misfolded and it doesn't work well, which is what happens when you've got apoe four, then you really need to protect your brain. From. From a high lipid profile. So you really want to protect your brain in that way?

Above that as well. We also have in nutrition is hydration. I really love electrolytes. When I mentioned that your brain cells synapse together. They use a sodium and potassium pump, that they are electrolytes, maintaining good hydration throughout the day.

That's your pyramid, right. Then we've got accessory items. It's like the icing on the cake. They are only there to do if you've achieved the pyramid. They are saunas, ice baths, things like that that are going to maybe just put a 1% change.

Dhru Purohit
Can we talk about a couple of those things? We'll pull on this thread a little bit further. So, on the topic of sauna, I think one of the reasons that a lot of folks who care about their aging parents, and I know you're in this category, my mom turned 70 this year, my dad turned 75, and they have been working on getting more active. You know, we come from traditional indian lifestyle. The highest achievers in sort of our, you know, category of family and community were the people who sat at a desk all day and became a doctor and studied, or a computer scientist or an engineer or CEO.

There wasn't a lot of examples growing up of people being incredibly fit. That's changing in a lot of categories and different demographics that are out there. My parents, especially my mom, they are working and slowly heading in that right direction. Doing the first thing that you shared earlier that you have your parents doing, which is just walking more. I'm very proud to say my mom gets at least 10,000 steps a day and probably many days over 12,000.

My dad is a big walker and is probably getting about 18,000 steps a day now. For them. The reason that I'm so excited about sauna is that I think I heard from Doctor Rhonda Patrick that if your parents aren't working out at the moment, and the goal is definitely to get them to work out, the closest thing to taxing the body in a healthy way, healthy stress, would be sauna at the recommended levels, which I think are at least two times a week at that hundred 50 degrees, I think it is. And being in there for at least 20 minutes, what's your take on that? Is there truth to that?

Louisa Nicola
There is. And it's often said that you can mimic the effects of cardiovascular training. So in case you've had, let's just say you've sprained your ankle, and instead of being completely sedentary, you can mimic the effects of cardiovascular training with these heat shock proteins, these heat shock proteins that are released when you are hot. It's basically signaling to your brain and your body. Guys, she's very hot right now.

We need to activate certain systems to cool her down. So it does put you in a stressful situation. Remember the word stress? You know, there's a term called allostatic load. You want to stress your body in a good way.

You don't want this chronic stress. You want to stress it in a good way. And that's what heat stress does. It literally is a stressor, but it's a good stressor. And the way that it mimics cardiovascular.

Cardiovascular training is through the blood flow, because if you are increasing your heart rate because you're getting hot, that means you're getting more blood pumping, and you can actually look at your heart rate. I've measured it, and I'm sitting around my zone three when I'm in there, that's above aerobic zone, moving into threshold zone. So I'm in that zone three. So my body is pumping blood. What is that doing?

That means my heart is getting worked out. Left ventricular hypertrophy is going down. I'm increasing the. The. The thickness of that arterial wall, because the arteries have got muscles around them, so they're squeezing together, so they're getting a workout.

You're doing a lot. And we've also got studies that show that you can also have an effect on the amyloid beta in the brain. Again, another way to just completely down regulate that system. So you operate in two worlds, and one of the worlds is your outward communication to a lot of individuals, like that patient that you had one day who ended up getting Alzheimer's disease, of the most evidence based things that people can do to, again, delay that diagnosis or optimally avoid it in the first place. So, that's Alzheimer's disease prevention and avoidance.

Dhru Purohit
But you also maintain a practice where you work with some of the top, most elite athletes, as well as the highest performers, CEO type individuals. I want to talk about what a lot of those individuals care about, and they're coming to you for brain optimization. Now that we've covered a lot of the basics. And the basics, as you mentioned, that's the foundation that's there. And then there can be things that are icing on the cake.

What are some of the most exciting things? Let's start off with biomarkers or tests that you care about when it comes to optimization, whether you're an athlete, whether you're a high performer or somebody that wants to kind of operate like those individuals. What do you care about the most when it comes to biomarkers? The most exciting part of the practice when I work with these people is doing a brain scan, which consists of an EEG and a QEG. So we're measuring the electrical activity in the brain, but we're also time locking it, meaning that we're picking up on their processing speed, their reaction time, and their visual acuity.

Louisa Nicola
We know that the eyes are just two pieces of the brain on the outside of our body. So we can do so much by understanding how well is your brain functioning from this eeG. So that's one thing that we do, and I'll go into that a bit more. The second most exciting part of it is doing a Vo two max test. Now, I love this because I truly believe that the Vo two max is the strongest predictor of longevity that we have.

We know that maintaining, which is a measure of your peak aerobic fitness, basically measuring how well does your body utilize oxygen when you are at your peak zone. And it's just like a 15 minutes test, which is actually quite grueling. I don't know if you've done wrong. I've done it, yeah. Were you in the elite category?

Dhru Purohit
I was elite for my age group, and I've talked about this on the podcast a little bit. I've written about it. I scored a 45 six somewhere right around there. I placed you in the elite category. Yes, it placed me in the top.

I gotta look at the chart. Okay. But for my age, I'm 40. I'm about to turn 42. I did it when I was 41.

It placed me at the top percentile for my age group. Brilliant. And I also end up having to end the test a little early. So I went to a place shout out to Trifit here in Santa Monica in Los Angeles. And there's different ways to do the test.

As you know, you could do it running. Some people do it on a bike, and then some people do it rowing. I really hate running, and I have probably bad. I don't probably. I definitely have bad biomechanics.

I also, prior to that test that I did with the Vo two max, I don't know when the last time it was that I ran with, like, shoes on. I love sprinting at the beach. I love these short bursts. I wore the wrong shoes. I wore my vivo trainers that I wear at the gym.

And so at the very end, I was talking to, with the mask on and everything, I was talking to the individual who was facilitating the test. And I was like, my knee really hurts. I think I wore the wrong shoes that, and I ended up having to stop the test before I was fully sort of gassed out. So I'm gonna go back and do the test. There's a doctor here in Los Angeles that also does a test.

Shout out to doctor Mary Perdi, who people can hire, and you can, you know, do the test at her clinic. I wanna do it again because I felt that I really should have been. And we'll test the hypothesis. I thought I would have been at least at about a 50, which would have put me at, I think, Elite. I think I was in the top percentile for my category, but I don't think I was at Elite for the age group.

I think I would have had to score a 50 to be in the elite category. Did you gas out? I didn't gas out. My knees kind of were hurting so much, I had to stop early. And I wasn't gassed out at that time, but I still scored pretty well.

I'll have to go back. I shared it with the audience, but it was right around somewhere between a 44 and a 46. On our intake forms, we often ask, what are you just naturally good at? So I love running, so I will do mine running. But the really wonderful thing about it is, if you scored in the.

Louisa Nicola
Let's just say you scored in the average and you want to go up a category just by going from average to elite, or whatever sits between average and elite, let's just say you want to jump that category, you can actually get a 45 day life extension just from going from average to elite. So you can increase, I believe it's 45 days, or it's actually more than that. It even goes up to five years. From going up below average to elite, you can get a five year increase in life expectancy. So you can increase your longevity from this.

And so when we do this, it's really beautiful to see the changes in somebody. And that's because, and I want to be clear about this. When you get a blood test, okay, and just say someone comes back with a vitamin D deficiency, we can up that. Let's just say they've got 20 nanograms per deciliter for their vitamin D. We dose them with 5000 ius per day.

Maybe we test them three months later and we'd see an increase in vitamin D. Whereas to go from average to elite for Vo two max, the process that you must take is so beautiful because you have to increase mitochondria during training, you have to increase your lung capacity, you have to increase stroke volume. The amount of things that you increase during the journey of improving your Vo two max is the name of the game there. So it's not about the metric, it's not about gaining the 50 or the 45. It is the journey that I'm going to take to get there, because that's what's going to increase your life expectancy.

Dhru Purohit
That's fantastic. Anything else in that category of what. What elite individuals are coming to you for that are things that our audience could benefit from hearing about. That is also protective to the brain, the body, the heart? Yeah, I think the elite part really comes down to doing, we do blood, urine, stool, saliva samples.

Louisa Nicola
So we're getting to know every single piece of you through all these different metrics. You know, we're doing around 16 different tests, but if we can understand all of the areas in your body through blood work, we can understand genetic profiles, we can cross correlate that with your blood biomarkers, we can put you on a. We can do a calculator to figure out your mortality risk. If we put that together with the brain scan. Now, we're also doing full body mris, we're also doing the DexA scan, which is coming out with bone density, muscle mass.

We get to know the entire individual. The thing that really separates it is actually, we've worked really hard on the emotional aspect of our component, and I don't think a lot of people think about that. There was a Harvard study done where they tracked individuals over the span of 80 years to see, well, what is the number one thing that can improve brain health as you age? And it turns out that the number one thing is social connections. So we want to ensure that your emotional aspect of who you are is thriving, because if we can get that right, it'll improve sleep, it'll improve exercise, it'll improve your relationship with food, the quality of your relationships with other people.

The way that you go out and see the world. Your brain wants to see different things. It loves nature, it loves. It loves seeing so many things, holding different things. So if we can do that, then that's truly what's going to make you a high performing individual in your life.

Dhru Purohit
And I'll share about my own. What are a couple of ways that you make sure to keep that strong social connection going that reminds you that you're not alone in this world and that people have your back. I maintain extremely beautiful friendships that are like relationships, if you will. To some extent, I have a close, close group of girlfriends who I, you know, I don't treat them really any differently than I would a partner. Just, you know, they're like family.

Louisa Nicola
They're like family, correct. But I maintain them to an extent where I do put in a lot of time and a lot of energy and understanding who they are. And I always say this, whenever one of us goes through something, we all go through it. And so I really, I really put them in that category of, like, they are family. So I try and maintain them over a long period of time, but then also just social connections.

You know, I live in New York. I'm here in LA for two weeks. Every day, I'm meeting with people who are in my network who share the same vision as me for health and performance. And when I'm with them, it feels like I'm getting a burst of energy that's powerful. I've talked about this on the podcast before, but I'll add in something for the last, almost eight, nine years here in Los Angeles.

Dhru Purohit
When I moved from New York City, I used to live in New York. I didn't have a solid group of friends here because I didn't know a lot of people that were here. And when I would meet, anytime I'd meet another guy who I thought was interesting and also women that I was coming across, too, I would organize sort of like a impromptu, informal weekly hike. And then for one month, there was a group of guys that kept on showing up. And one of my friends who was there, Nirav, was like, this is pretty great.

Like, we're all going and hiking on Thursday morning. Maybe we make this like man morning, right? A group of supportive men who all get together, were doing something like a hike or a walk. And it naturally led to, because it's a bunch of interesting people, it naturally led to somebody asking a question of the day. Eight, nine years later, we've kept this up, and we have man morning every Thursday here somewhere in Los Angeles, we'll meet together.

There's a captain of the month who then brings a question of the week, something that allows the group to open up. And when we don't have a standard question, when we don't have a specific question, we ask a general question, which is, tell us one thing in your life you're celebrating, and tell us one thing in your life you're navigating. As you know, women are so much better at that social glue and opening up, and there's this crisis of men that's happening today. Where men are more likely to commit suicide, they're more likely not to have a best friend above the age of 50. They're more isolated than women.

They're really struggling in this camp in general. So we're trying to be both an example, but also support our own selves, you know, inspired by this Harvard data and some of the studies that are out there showing that if you have people in your life who you feel have your back, you're so much more likely to feel that resilience, especially as you age. So, yeah, we just ask each other, what are you celebrating? What are you navigating? We stole that question from this group called Summit Series that I'm part of.

And it's the thing that I look forward to. One of the top things that I look forward to the most is every Thursday morning, us group of guys getting together. And whether somebody wants to create a goddess morning or whatever it might be, maintaining these friendships takes work, but it's one of the biggest return on investments that you can get in life. Absolutely off air, we were mentioning one of my dearest friends, who is Casey means, Doctor Casey means, who I know that. That you've interviewed.

Louisa Nicola
Casey came into my life when I actually interviewed her, and she's remained, you know, and when we. I interviewed her for my podcast, and this was back before she had a book, and she was talking to me about blood glucose, and this was back in very early 2020, and we. It was like an instant connection. And when I'm with her, it is like, you know, we share so much about the world and about health and performance, metabolic dysfunction. But I describe her, her book.

It's funny, her book is called good energy. But when I describe her, she gives me energy, and that's what I look for. It's like a life force, and it's a really beautiful thing. When you do put in the time and effort to find your people, you do get a high roi from it. Did you ever read or hear about the story of that town in Pennsylvania, Rosetta?

No. Okay, so this is worth mentioning. I've shared the story a couple times on the podcast. But there was a town in Pennsylvania, and in the 1950s, around 1940s, fifties, I think, it was founded, and it was called the town of Rosetta. And it was primarily filled with italian immigrants who all moved to this region and were trying to figure out and make a life for themselves here in America.

Dhru Purohit
And one of the interesting things was there was a local physician who was kind of, you know, the main physician for this group of people that were there in this town, and one day he went to a conference about the latest practices in medicine, and he was at a bar grabbing a beer, and he was talking to one of the researchers that were there, and he said, you know, there's something really interesting. Not one person in this town that I take care of has died of a heart attack under the age of. I think it was like 65 or 70. And the researcher was like, huh, that is really interesting. Because at that time in America, there was this whole craze about focusing on heart disease and what was going on, Teddy Roosevelt, et cetera.

So the researchers got together and they said, let's study this town. What is it? Is it the water they're drinking? They had all these different hypotheses over a period of time as they tracked this town. What they found out is that it wasn't necessarily the water.

I'm sure maybe food. They were eating a little bit more closer to the diet that was there. There's not as much ultra processed food, especially back then. So I'm sure food played a little bit of a role, but they rolled out food comparatively to what everybody else was eating, and they actually found that it was social connection. Yes.

The people that were living in this town of Rosetta, the italian immigrants, they were living in multi generational households. They often would have young grandkids and a grandparent all in the same household with parents that were there. The average guy, I think, was in two social clubs. And they had this sort of town center piazza type replication, where every evening the town would kind of gather together. And the interesting thing is that as the years went on and they continued to track this town into the sixties, seventies and beyond, as they started to lose that social framework that was there.

And Malcolm Gladwell has written about this. We'll link to a couple of documentaries below, too. They started having the same level of heart disease as the rest of the population in America. And now the town is largely non existent in its traditional form, and the population set just looks like the regular part of America. This effect was so profound that this was.

Was nicknamed the Rosetta effect, that our social relationships, our friendships, our closeness with our family could have such a protective effect over our health that it could. This was the theory from the researchers, potentially protect us from something like cardiovascular disease. Oh, my gosh, that is so beautiful. I'm so happy that you mentioned that to me. Cause now I'm gonna be just looking this up and, like, researching it and probably putting it out there.

I'm putting the message talk about it on another part. I'd be remiss, though, if we don't actually touch on. And I'm moving away now because my juices are flying. I'm just very excited. We didn't even touch on resistance training.

Let's talk about that. Let's talk about that, because that is my actual thesis. And I just had a review article get published, which is all based on resistance training. So what we know is that resistance training is absolutely crucial for the brain. We know that it can build better brains.

Louisa Nicola
But the mechanism is. What I want to talk about. Does growing bigger muscles, or is simply the journey of growing bigger muscles improve brain health? It turns out that when we exercise our muscles, let's just say we're contracting our muscles. Our muscles are like a storage sink of these amazing pharmaceutical molecules.

They're called myokines. So they're muscle based proteins. They live in the cell body of the muscles. And when you contract your muscles, they get excreted, they go out into the, into the blood, and they go into necessary organs. They go, they pass the blood brain barrier, these little molecules, and they help with the growth and proliferation of BDNF.

So BDNF is brain derived neurotrophic factor. It's one of the key ingredients in growing new brain cells in that hippocampal region. Another one called irosin, which was named after the greek God of Iris. It's a messenger molecule. So when that gets excreted from the muscle belly and goes into the brain, it actually tells BDNF to express itself even more.

We've got cathepsin, b, myostatin, we've got Il six, interleukin six, which is originally a pro inflammatory cytokine, but when it's released from the muscle, specifically, it becomes anti inflammatory. So there we go. We're going to be down regulating inflammation from resistance training, so you can build a better brain through resistance training alone. We're now even seeing maximal aerobic exercise and resistance training having an effect on circulating circulating tumor cells. So when a tumor is formed, for example, this is a really great study in cell press.

It was to do with prostate cancer and the inhibition of prostate cancer via these myokines. But what happens is, let's just say you form a mass, if you will, at stage one that tends to break. And I'm not an oncologist, but I'm reading the research that tends to break off, and you get these, these circulating tumor cells, and they end up going and aggregating and forming another cell forming another tumor, which ends up becoming metastases. Right. We now have evidence that the sheer force and shunting of blood flow through aerobic and maximal exercise can ameliorate these circulating tumor cells.

And not just that these myokines can inhibit the growth of these prostate cancer cells. So you're not just having an effect on the brain. We're now seeing exercise and cancer, this cross talk between the two. So we're just probably at the early stages of that. But resistance training should be part of your hygiene as well, your daily hygiene.

Dhru Purohit
That's incredible. I've heard you talk about this as you've been getting into it, and it's so fascinating, and I've learned a lot. I'll get back to what I learned in a second as I'm navigating some aspects of my health. But I first want to come back to the first part of the episode was all about how do we make sure we get the basics, especially for age groups and individuals who might be looking after their parents and the idea of jumping to resistance training. They still have a few steps to take before they get there, that you can start at any age.

And we've had examples. We had the oldest american ninja warrior who didn't start training until she was in her late sixties because she was diagnosed with osteopenia and in a matter of months became like a competing athlete and is now a super ripped grandmother who competes in all these competitions. Ginny was on the podcast. We're linked in the show notes below. So you can do resistance training safely at any age.

But at the beginning of the podcast was, how do we make sure we have the basics? So now for those that are in the category who are like, hey, I want to shoot towards optimal, what is the resistance training dosages that we should be shooting for on a weekly basis? You want to be shooting for three to four days a week of resistance training. But here's the caveat. You have to be going hard.

Louisa Nicola
We know that more is better when it comes to how much, how many myokines are released. So when I say more, meaning that you really want to stress the muscles of, you really want to stress your biceps, for example. So you want to be lifting at around 75% to 80% of your one repetition max. A lot of people may be saying, well, what that? What is that?

Basically, you want to be lifting to the point where you get to prep six. It's really difficult. Like, you're shaking. So you really want to be working hard out. You want to be doing three to four days a week of resistance training alone.

You want to be doing 3 hours a week at minimum of aerobic zone two training. That's fantastic. I've been cheering with my audience. I've been on that journey for the last two years. I didn't grow up working out.

Dhru Purohit
I wasn't eating enough protein as a vegetarian, and then later vegan. And so when I was getting close to turning 40 and really starting to even learn more in this category of wellness, I said, I have to step into this. I was always active. I'd play tennis. I'd go hiking, other stuff.

I've always been generally very lean, even sometimes like, skinny fat, because that's a big problem in the indian demographic that's there. But as I've gotten super into the resistance training piece, I can say definitively I've never felt better. Not just in my body, but my brain health has never felt better. And the number one motivator for me for working out is having a clear head and feeling energized mentally. When I feel that way, it becomes addictive.

Louisa Nicola
Yeah. You know, going back to these, what did you call them? Myo. Myokines. Myokines.

Dhru Purohit
You know, one of the things that I've been digging into my blood work and why I was so fascinated to see you talking about this is I didn't know that about interleukin six. I know my Il six, since I've been working out pretty intensely compared to the baselines that I had years ago, has been a little elevated. So I'd been working with my cardiologist of, he would say, you know, did you just have Covid or did something go on? Were you sick recently? It's not super elevated.

It's just a little elevated. I don't remember the number offhand. And I thought, okay, I was avoiding dairy for a long time. Is it because I've been having more whey protein? Is that it?

Is it something else? But it stayed elevated. And what I'm taking away from you, not that I'm asking for a diagnosis or anything, is that it might be worth digging into a little bit more. Because if it's just slightly elevated, could it be a good thing as a byproduct of just me working out more if everything else in my blood work, especially when it comes to, like, CRP or something else, is in a good place? Right.

Is that possible in the way that I'm understanding it, yeah. And the way that they measured this, Benta Peterson was the one who actually coined the term myokine. And her first work was done, I believe she's an endocrinologist, was done on Il six. She was doing it for immunity purposes. She was doing immunity studies.

Louisa Nicola
And when she found that Il six is elevated in the blood, I mean, I think there was a half life to it as well. Like she was doing it probably three or 4 hours after intense training. So I don't know how far it would be, but it would be elevated to some extent. Got it. Yeah.

Dhru Purohit
So it might have something to do with what I'm dealing with, but I think more likely, probably not because my blood work, you know, they tell you not to intend not to exercise so intensely right before sometimes you get your blood work. So I still need to do a little bit more digging. Exactly. But bottom line there is that. That resistance training is.

Louisa Nicola
It serves as this, I guess, as this protective shield for your brain and your body as you get older. Yeah. And just touch on this for a second. Connect the dots here. Why is that's important for everybody, man or woman?

Dhru Purohit
But is there anything specific that you wanna say for the female demographic that's listening when it comes to specifically about resistance training and why it's something now more than ever? You want that category, you want everybody to do it, but why is it so important for women especially? I think women have been served with this fear that they may get big if they lift weights, which is a very big misconception. And I want females to understand the relationship between bone density and estrogen because there is a reason why post menopausal women are more prone to osteoporotic fracture. It's because of the loss in estrogen.

Louisa Nicola
Therefore, we need to increase our bone density in the way that we do that, apart from nutrition, is via resistance training. It's the best way to improve bone density. Because when you are obviously lifting weights and you are contracting your muscle, that muscle is pulling on the tendon and the tendon is connected to the bone. So you're getting. Your bone is stressing.

And what happens when we stress? A system breaks down and it builds back stronger. So resistance training, fundamentally important for these, for women everywhere because of this reason. That's fantastic, Luisa. I could probably go for another hour, but I know you have a hard stop.

Dhru Purohit
You got to get to West Hollywood. This has been a fantastic conversation and there have been so many actionable items for people in all sorts of different life stages or backgrounds. And that's why I was so pleased. Shout out to our mutual friend Joe, who's been on this podcast. Doctor Joe Zindel, Joseph Zendel for recommending you on today's episode.

I couldn't think of a better person to connect all the dots in this category. You know, you said it best yourself. Alzheimer's disease and anything that impacts the brain or contributes to cognitive decline is truly the most scary thing anybody could imagine because you're losing your sense of self. If I've always known you as one type of person who's bubbly, sharp, smart, remembers my birthday, you know, has great conversations, and now as a caretaker, I'm seeing you decline and you're not yourself. It's taxing not only on the individual that's going through it, but it's taxing for the family as well.

And let's create a world, which is what your episode is about today, where it doesn't have to be that way. And a lot of that is available through us, through lifestyle changes, which you're here to remind us about. I'll give you the opportunity. We're going to link to your podcast below. People should check that out or follow you on YouTube.

There is your practice as well. And I know you don't work with a lot of people, but if people have interest, can they reach out to you? 100%. But there's a subcategory of our practice, which is we're also an education company. So we teach coaches, trainers, executive coaches about these six fundamentals of performance and longevity.

Louisa Nicola
So if anybody's interested in that, definitely give that a look at two. So you're educating the educators? Yes. So if you're a physician, a health coach, even a biological dentist, anybody who's intersecting with people at any level of health and you want to go deeper into this and learn the latest, you guys have courses for that. The Neuro athletics coaching certificate.

Dhru Purohit
Amazing. So we'll link that below and then remind us, what's the podcast? The neuro experience. Amazing. Anything else that you want to direct our audience to before we give you.

Louisa Nicola
The final word, come over to Instagram and say, hi, Louisa, Nicola, incredible. Some final thoughts from you before we conclude today. You have the power to change the course of your life every single day. You have the opportunity to refabricate your brain through lifestyle choices. Your brain is made from the foods you eat and the exercise you do and the quality of sleep that you have.

So bank on those because it will be the greatest investment in your life that you can ever have. Luisa, thank you for your work that you do. You and your team, thank you for coming on this podcast. And it's a pleasure to finally meet in person. Thank you, Drew.

You too.

Dhru Purohit
Hi, everyone. Drew here, two quick things. Number one, thank you so much for listening to this podcast. If you haven't already subscribed, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me.

And it's the number one thing that you can do to support this podcast is share with a friend. Share it with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter, and it's called try this. Every Friday.

Yes, every Friday, 52 weeks a year, I send out an easy to digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free, and get my weekly step by step protocols for whole body health and optimization, click the link in the show notes that's called try this. Or just go to druprowit.com, that's dash Rupurohit.com, and click on the tab that says try this.