The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
Lifestyle Medicine A Foundation for Brain Health with Legendary Drs. Ayesha & Dean Sherzai
Neurologists Dean and Aisha Sherzai share their groundbreaking research on preventing cognitive decline through lifestyle changes. Proving the power of Lifestyle Medicine. Their work reveals that 80-90% of brain disease is influenced by lifestyle factors, providing hope for people concerned about their brain health.
• The Sherzais discovered remarkable protection against dementia in Seventh-day Adventists following plant-based diets
• The brain is especially vulnerable to lifestyle factors as it's 2% of body weight but uses 25% of energy
• Their NEURO framework covers Nutrition, Exercise, Unwind, Restorative sleep, and Optimizing cognitive activity
• Continuing cognitive challenge is critical – "Don't retire, rewire" around your passions
• While Alzheimer's cannot be reversed once established, prevention is possible at any age
• The brain can grow new connections even at 99 years old with proper lifestyle habits
• Implementation requires community involvement at all levels rather than top-down approaches
Be ambassadors for lifestyle medicine and brain health—consider yourself a walking billboard for the profound impact of lifestyle changes on cognitive well-being.
Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. We're in Orlando at the ACLM Conference 2024. I'm your host, Justin Politti.
Speaker 2:And I'm Ellen Brown here at the American College of Lifestyle Medicine Conference and I'm totally fangirling right now. I'm just so excited at who we have on the show, so introduce yourselves.
Speaker 3:Thank you so much for having us. We are Dean and Aisha Shirzai. We're both neurologists and scientists, and we're so honored to be here. Our talk today was about the profound impact of lifestyle on brain health, and that's what the focus of our work is too.
Speaker 2:It's just beautiful, like I never thought in my lifetime that I would get to combine my work in healthcare on the payer provider kind of that side that a lot of people point fingers at and say is awful with my passion for lifestyle and health and food and trying to fix those things. I never in my lifetime thought I would get to combine the two and so to be sitting together with you guys it's just amazing and it just shows me the power of what's happening in healthcare.
Speaker 1:Well, one other thing, too is we've had a couple of guests on that brought up, in particular the speech that you guys did earlier today, and how memories are formed, associations are built. It was fascinating. People have walked out and they were like it's been very compelling, so I just want you to know that. Thank you so much.
Speaker 3:Thank you so much for sharing that. That means a lot.
Speaker 2:Yeah, so talk about your work, stum, and I guess I was thinking I was like, oh, I could just ask so many questions and we have so little time. But I guess one thing I would like is share your work please, because a lot of people won't be familiar with it necessarily, and it's just been such a powerful body of work for cognitive disease and and something that I think is so misunderstood and I think for me I mean I'll just tell you personally is that when I heard you all you know you were I was saying you were on the rich role podcast. That was the episode that I listened to. I you know you were. I was saying you were on the rich role podcast. That was the episode that I listened to. I really learned about your work, but it I didn't understand that cognitive function had anything to do with inflammation and cardiometabolic syndrome.
Speaker 2:I always thought it was this like did you, did you get the short end of the genetic lottery? And if you did you were, it was over game, over right, and so to hear from you and then fast forward. Now I have a mom who has progressively whatever you're going to definitely edit this, but progressive dementia rapidly progressing. There we go and now understanding that it was because she was an unchecked diabetic for many years, and so the work that you've done, and so, to have that all come full circle, I'd like to hear the lifestyle medicine right, how that sort of came into this for you all too as well. Do you have something to add? Sorry?
Speaker 1:I also have a very I mean as many people do. My grandfather passed away from Alzheimer's. He was very, very healthy. So I am like my grandfather passed away from Alzheimer's. He was. He was very, very healthy. So I am like he was obsessed with the food and vitamins that came into it Like no other, to a point where we were like, did he take something that you know he was doing that might've caused this? Our family still, to this day, debates that. But I'm super interested in your work, like from a personal level, around you know, around all of this. So yeah, yeah.
Speaker 4:Yeah, we met 20 years ago around this topic. We were in Afghanistan of all places. I had gone back from NIH, I was doing wonky work on stem cells into the brains of Parkinson's patients and I was in medical school. We had both independently gone back. We always did service. I did cleft palate surgery with Operation Smile In China and other places.
Speaker 4:We went back to Afghanistan and in an expat party we met. The first conversation was about her grandfather dying from Alzheimer's and my grandfather dying from Alzheimer's and after that we dated and then a year later we were married and then, coming back, we went to the number one neuroscience program in the country at the time, ucsd, dr leon thal. We did work I should did fmri work, looking at brains, that they're active, and I was doing pathology and patient care and after a couple of years we became a little disillusioned, uh, with the studies that were coming, failure after failure after failure and and, by the way, I'm not putting down studies or pharmaceutical and all that All that is incredibly valuable. But there was nothing being done on prevention. So we looked around and, lo and behold, we found out that 60 miles northeast is a city called Loma Linda, where people are living 14 years longer and healthier than everybody else.
Speaker 4:Specific men versus and we're a little proactive. People picked up the phone, called the president of university. I said we have these resumes. We want to build a brain center there. Would you have us? He said of course, come back, come here. We went there. We. I said I mean immediately. We said we want three days off for community work. They said you're not going to get paid for that. I said that's okay. So we started a clinic. We saw patients and did the community work, figuring out what's going on and I should did a dual residency family of preventive medicine and neurology yeah.
Speaker 3:So, as you can see, it didn't come. You know it wasn't offered on a plane Like here it is. Here's a lifestyle program I want you guys to do prevention and neurological diseases. It was a lot of sacrifice and a lot of strategy. Talking to a lot of people reading papers on our own speaking. Remember Dr Elizabeth Barrett-Connor Like she was this amazing scientist. She ran the Rancho Bernardo study looking at the impact of lifestyle on heart health and we said there's got to be some research on brain health as well.
Speaker 2:We have to be able to look at that. So was it the Loma Linda? Was it just the fact that there was such a difference in that population? They were like I have to go there and research it and there's got to be something here. Yeah, Okay.
Speaker 4:Yeah. So the Adventist health study is one of the largest and longest run well done studies and IH supported, and they had already found that a significant less risk of diabetes. Significant less risk of the dementia I'm sorry, not dementia. One study on dementia that showed that, um, and significant less risk of dementia Sorry, not dementia. One study on dementia that showed that. Significant less risk of heart disease, and on and on and on and on. And cancers.
Speaker 4:We said it's got to be that relation with brain as well, but nobody had studied it and there aren't that many populations that are that well studied and well defined. It's not Loma Linda, it's the seven-day Adventists that live there and they're unique because their religion is very health-centered, not just plant-based food. Everybody focuses on that. But it's more than that, it's environment, it's walking, it's community, all these things. We had a half-a-day clinic in San Bernardino. If anybody's been in Los Angeles they know this. San Bernardino is basically a highway separating Loma Linda and San Bernardino, so not an environmental difference.
Speaker 4:In San Bernardino we would see patients in their 40s and 50s having vascular disease of the brain. In Loma Linda it was bewildering no-transcript. Over five years, 3,000 patients, and of these 3,000 patients you expect one-third, because the majority of the seven-day Adventists live there. One-third of the population is seven-day, one-third of them are plant-based and they're more likely to go to their own hospital. Why would they go all the way to USC or somewhere? So you expect, of the 3,000 dementia patients, at least one-third to be plant-based and normal 7-day amphetis. Nope, 19. 19 people, 19 people out of 3,000. I was thrown off and we said this is unbelievable. Yet in San Bernardino, 40-year-olds with vascular disease.
Speaker 4:And then we did more research, shopping at the same grocery stores almost yeah but then buying different things, absolutely yeah so it's, and and we knew that lifestyle it's more than just food, but it's lifestyle has. And so we then we went to cedar sinai and studied, and what we found was that uh, lifestyle basically can, can affect 90, 80 to 90 of brain disease it's crazy and it it.
Speaker 2:It's so fascinating to me because I did. I was convinced until I listened to your research. I was like, well, you're either going to get it or you're not right. And if you get it, it's game over. And it was such an epiphany. It was like, wait a minute, this is all related. And it did really put that light bulb off of like. We got to figure this out in healthcare. You know, it was like when the wheels started first turning for me, where I was like, wait a minute, I'm running around the country doing all the wrong things with lifestyle in terms of stress and sleep, trying to implement outcomes-based healthcare models, but yet we're not actually delivering a care model that's capable of supporting those models.
Speaker 3:So, something's wrong.
Speaker 4:It is.
Speaker 3:That's true. I think there's a lag of what we know, and you know, when scientists and doctors do a lot of studies and research, it takes a very long time for that information to come and be applied in public health, like you were saying, ellen, earlier. For a long time we thought, you know, the brain is a completely black box. It's separate from the rest of the body and you might have to take some supplements or some medication for it. But we now know that what is good for our body is good for our brain too. The kind of foods that we eat for our body affects our brain too. And so this information, you know it took some time, but now we actually know.
Speaker 3:And it was back then when we started, when we initially thought about the concept of preventive neurology what can people do to prevent neurological diseases? And lo and behold, you see a huge overlap with the same risk factors that affect the heart, the kidneys, the rest of the body, affecting in the brain as well. So I suppose in many ways the medical community and the scientific community has failed to disperse information about health into our communities, and we need to be that bridge, and I'm so glad that ACLM is doing all of that. We all need to be that bridge of dispersing the information and the message of health. Justin had an idea, which is we should all be wearing T-shirts with results on it.
Speaker 1:Honestly and walking billboards.
Speaker 2:Gebra needs to be having a T-shirt that says I had 230 patients drop their A1C by three points and I saved $5 million.
Speaker 4:Yes. I love that. I love that idea.
Speaker 3:You came up with that idea. That's a brilliant one. That's trademarkable, right? Yes, I love that. I love that idea. Somebody, you came up with that idea. That's a brilliant one.
Speaker 4:I mean that's trademarkable, that's right there. No, but it has to be. I mean on the brain side, just to get people excited. Of course it's going to be affected by lifestyle. We're talking about a three-pound organ. It's a jello. It's a little hard jello three pounds but it's 2% of your body's weight but consumes 25% of your body's energy. It has one quadrillion connections. It does 60 trillion operations per minute. 60 trillion, that's one of those numbers that you can't even. No, yeah.
Speaker 4:And so all that work, all that activity, all that energy utilization, all that oxygen utilization, of course if you don't give it the right energy, it's going to be affected more than any other body part. Of course, if you give it toxins, it's going to be affected more than anybody. Of course, if you do something that affects its vasculature vasculature it is the most vascular organ. In fact, if, if you connect they did that math on this connect all the arteries in the brain, end to end, it's 400 miles of vasculature Of course it's going to be affected by vascular factors. So lifestyle is going to have more of an effect on this incredible organ than any other. And on the positive side is it's also the most resilient organ. So if you give it a chance, it will actually persist and grow. We actually say something very controversial in basically our next book your brain will get better as you get older If you do the right things.
Speaker 3:It makes sense. It's the only organ that gets better with age. I love it.
Speaker 4:Yes, yes, I mean. Think of yourself as a teenager, or myself as a teenager. My God, you don't want. I don't want to even think of myself as a teenager. What was going on in that brain?
Speaker 1:Nobody wants to know, nobody wants to know I have a pinball image going, that's right, it's like ding, ding, ding.
Speaker 4:Yeah, it was chaos and I was smart. You know, I played soccer, I played football. That wasn't that smart. I broke. I broke my back. Oh yeah, I played tennis.
Speaker 1:I played football without a helmet. That was, you know, back in the backyard back then in the eighties.
Speaker 4:Yeah, yeah, oklahoma's without a helmet. Yeah, that's right. So it's it's. It's terrible, but now I'm older, I have shoulder. You know, I did some pushups because I wanted to break some record and I tore my shoulder and pain here, pain there and all that. But I am so much more secure, calmer, I'm able to organize thoughts better, I have more things to build on, we are much better and we can get much better, but we have to do certain things to make sure that the infrastructure is. So how do you?
Speaker 1:exercise your brain.
Speaker 2:I'm sorry so what are those things right?
Speaker 1:What are the exercises?
Speaker 3:Yes, so, if you know, we came up with this acronym just based on all of the data out there. You know what are the things that are good for brain health and it? You know, essentially it's the. It's the, a variation of this theme that I'm about to say. Five factors nutrition, exercise, stress management, sleep and cognitive activities. And we came up with this acronym called NEURO N is for nutrition, e is for exercise, u is for unwind or stress management, r is for restorative sleep and O is for optimizing cognitive activity. And we know that when people adhere to these lifestyle factors it doesn't have to be all or none. Even small, little incremental changes in any one of them benefit the brain. People actually do better. They have lower risk of Alzheimer's, other types of dementia, stroke and mentally, as far as mental health is concerned, they do better as well.
Speaker 2:Is there a disproportionate like? Is one more important than the other?
Speaker 3:It depends on an individual's factor, right? So it just depends on what your strengths are, what your limitations are, what your resources are. Some people do very well when they manage their, say, ldl cholesterol significantly. Some people do really well by starting exercising. So it just varies from person to person and it's really important for the person and their healthcare providers to kind of draw a picture of what their risk factors are Like. For example, a lot of our patients and our community members who come to us and they talk about brain health, we don't start by telling them go ahead and eat green leafy vegetables or kale. We try to speak with them, we try to understand where they are, and a lot of patients tend to have depression and anxiety, which is such a huge risk factor for cognitive impairment. That's the first thing that we address, and so it just varies from person to person. Or they have sleep apnea.
Speaker 4:Oh yeah, if they have sleep apnea and it's not being treated. Several studies show as much as 70% increased risk and that's easily treatable.
Speaker 2:No, I know, when I prioritize sleep, I like I always. I came up with a new term. We were in Las Vegas last week at health and they always give me a hard time because they're like we must put her to bed Like she's-.
Speaker 1:Turns into a pumpkin. Right, I turn into a pumpkin and Vegas-. Not at midnight, it's seven o'clock.
Speaker 2:No, but it's really brutal in Vegas because it's three hours early, you know it's that whole thing and you want to go out. So I came up with a new term, which is slangry. You know how everybody says I'm hangry.
Speaker 1:Yes.
Speaker 2:Slangry, oh, sleep angry, that's my new term. I love that.
Speaker 1:I might steal that. Yes, slangry.
Speaker 2:It's a new term. Yeah, okay, it's a new term. Yeah, ok, back to you, justin, sorry.
Speaker 1:No, the question I had was, you know, going back to my grandfather. He retired. He was a, he was an engineer for Sikorsky and helped develop the Black Hawk helicopters. He was dealing with very complicated implementations and then all of a sudden he retired and he wasn't like he didn't have that to do anymore. Like he, he did not have those extra. I guess that. And so the question is like does that contribute to?
Speaker 4:100. So what a beautiful uh. So thank you, thank you. So mental activity is critical, but the old part, neuro. So they've said they've seen that people who have been very mentally active, extremely, and then they stop doing the same things and for two years, even two years, they didn't do much of that mental activity. Guess what? They had the steepest decline. See, that's my mom. Yeah, you know why? Because this brain is now used to being challenged.
Speaker 3:Yeah, you're here, you're used to this level, and then you drop to a lower level and the brain, just you know starts shrinking faster than average. Literally and figuratively.
Speaker 1:Yeah, yeah. So there's brain like have you guys done that, like measured? Oh yes, yeah. So we say, brain is actually shrinking.
Speaker 4:Yeah, no, no. We said don't retire, Rewire, yeah, Find new things that push you as much. But around your passions. One of our patients in our first book it was this. He was a VA guy. He came to me depressed, cognitive decline, significant decline, but not dementia but pre-dementia. But by the way I'm going to say this a couple of times there are going to be people that said that they've reversed dementia, They've reversed Alzheimer's. Nobody reverses Alzheimer's and I'm going to stand by that because that's a way to pick on people's hopes and sell them things. If not now, tomorrow they'll sell them things. And we were told when we were ready to get our first book out just hint at the fact that you can reverse Alzheimer's and nobody checks anymore. You know nobody, nobody. What can they do to you? And you will sell 2 million extra. We can, we can't, because we know what happens when that at that stage, Good for you.
Speaker 2:Thank you.
Speaker 4:No, and, and nobody should be saying that, because when we've had two grandparents dying from Alzheimer's, you want, hope you have hope.
Speaker 4:You want hope, but you don't want charlatans to take that hope. Yeah, and sometimes when a person has Alzheimer's, they let them go through their journey of decline with dignity, with honor, with not always desperate for the next person that's selling them the next thing. No amount of kale is going to cure Alzheimer's and I'm going to lose friends here. I'm going to lose friends. I don't care. It's about those people, those individuals. But prior to dementia there's so much you can do to prevent and that's important enough. And cognitive activity is critical. Cognitive activity is the good stress. I made a joke there. It's like you have 87 billion neurons, one quadrillion connections. Do you think all of that was just to mate and find food? No, it took that much for me to get her, but that's a separate issue. But for most people it's less five, six neurons, but the most successful reproducers are bacteria. That's funny. Yeah, you want to win.
Speaker 2:Justin's like this is great.
Speaker 4:The most successful reproducers are bacteria One cell. The most successful food gatherers are viruses. No, you know, it's not about that. The brain wants to be challenged, the brain wants to be pushed, but around your passion. So this guy was a veteran. The first question I asked him wasn't what's your blood cholesterol level? I said what did you used to do? He said before military, I used to rebuild cars in my garage. I said what do you do now? He said I retired and I went to work for a car shop and all I do is change mufflers over and over again. I was like that's what's killing you. I said go retire, have fun, enjoy. He came back six months later, completely different. No pills, not that I'm against pills, but he didn't need it. He's so happy. I said what are you doing? Oh, I'm building cars in my garage, but in my own terms. So building and pushing your brain around your passions in a way that really satisfies you and pushes you is what connects those neurons.
Speaker 2:That's me right now, like these guys know, like I can't stop. No, I just once I started finding how to connect all these different folks, all these different solutions, all this knowledge together to say we have sick care, we need healthcare, and to me, lifestyle medicine as a board certification is that bridge that can help us create that.
Speaker 1:and and once I that got in my belly, it's like I just I can't stop because it's like we can do this I am going to say one thing though do you guys have any secrets on shutting it off so she can go to sleep?
Speaker 4:Yes, yes, I don't know if it's secret there's a. I'm a big proponent, I'm a psychology background and a big proponent of cognitive behavioral therapy. I think that should be taught in schools. It's basically, it's very simple. It's about how to know your own thoughts and how to manage your own thoughts.
Speaker 2:You can't manage emotions, own thoughts you can't manage emotions.
Speaker 4:Oh yeah, you can't manage emotions. Emotions are like amoeba. How do you put your hand around emotion? I'm going to be more happy. That's not going to work. But what you can do the thoughts and behaviors that lead to unhappiness, you can address those. The thoughts and emotions that continually run in your head, you can start managing them.
Speaker 2:Well, somebody said to me last week I loved the analogy. He said it's like I can't stop thinking, I have all these ideas and it's so great, you know. And he said yeah. And I said, but sometimes I just want to turn it off. And he said, yeah, it's like you went into the Matrix and you took the blue pill.
Speaker 3:Yes.
Speaker 2:That's exactly it so, um, well, I really I know you guys have places to be. It's a this is a short event and but a short period that we have you, but, um, we would love to try and do a full episode and I'd love to talk with you more about really how this whole cognitive science and its link with lifestyle medicine, how we can look at it from the lens of healthcare, how we look at it now, how we could look at it in the future. You know we've had a lot of conversations on some of things, like, you know, full body scans and different type of diagnostic tools up front, and just how do we move the system right? How do we take all of this knowledge that you all have been amazing at creating and actually change the way we deliver healthcare as a society right? Like, how do we leverage that?
Speaker 1:And I'd love to jump into, like you mentioned, a couple of different examples of like people who, like you know, they stopped, they did something a little bit different, like what's the window of time where you can actually act on this and really influence it before it gets too far? And it's not, you know, you're not able to reverse it, and always, anytime, except when Alzheimer's is in place.
Speaker 3:Okay, obviously it's better if it's as soon as possible, as early as possible, but we've seen, and you know, there's evidence for protection of the brain and growth of the brain and reconnecting between neurons even as late as 99 years of age. So it's never too late either and there's a lot of hope. And as far as implementation is concerned, I think essentially being ambassadors of lifestyle and brain health, each and every one of us and you know, even though it takes a long time to move a large ship, but these little tugboats of you know, individuals, communities, coming together, speaking about it, groundless level of communication and really truly involving the community. We've underestimated the community leaders, the faith-based communities, individual social workers spreading this message. I think it takes a whole entire team of people spreading this message, instead of us waiting for the top-down model.
Speaker 1:So we'll get the t-shirts printed for you all, and then we'll. We've got the messages ready, to go Ready.
Speaker 3:I'm going to be a billboard. I'd be happy to be a billboard. Yeah, thank you guys. I'm so excited. It's our pleasure. Thank you so much for having us.