“critical nutrients for, uh, related to cognitive function and risk of dementia. Um, the ones that we have the best evidence for, uh, vitamin D, iron, omega-3 fatty acids, uh, the B vitamins involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual.”
“between nutrients, which at least to my understanding are rarely explored. You know, you'll see studies of supplementing omega-3 or having people eat some fatty fish or less and so on, but rarely in the presence or absence of some other vitamin that, you know, that can potentially impact the same pathways.”
“range so let's take one of these things okay omega-3 fatty acids i i believe that the data are pretty compelling they can be helpful for health maybe even brain health certainly i believe that but”
“than we realize so um omega-3 fats is a really good example your adipose tissue your fat tissue is a depot you know it kind of stores excess omega-3s i actually wrote a paper on this with a colleague of mine rory heath a few years ago the long chain omega-3s that we have in our in our fat stores”
“during periods like you're doing exercise those then get really you know, the brain then has access to them. So there's some studies that show that when you, but this relates to the form of the omega-3s as well. So many people will tell you that you have to take omega-3s in the phospholipid form, which is like a special, it's a special supplement.”
“So if you're going to take just one day of supplement and you want to get as much of that omega-3 in your brain, yes, you should take the, we think you should take the phospholipid form. But the form that comes in seafood, which is primarily the triglyceride form, is regulated through the body's fat stores.”
“There was actually a very recent one that just came out of... Of USC, where they gave omega-3s for a long period of time. They measured omega-3 levels in the CSF, in the spinal fluid, these people, to show that the omega-3s were getting into the brain.”
“That is particularly the case for omega-3s and B vitamins that lower homocysteine. And so this is the interactions that you were talking about earlier. And this is the best one that we know of, although I'm sure there are many more.”
“with omega-3s didn't result in any benefit if people had elevated homocysteine. So that's just one example. And you can imagine, like you kind of said, there are probably lots of these. And if we're not going into a study actually looking like, well, what nutrients does this person need, and then supplementing with them, you're not going to find any effect.”
“where words are very important so that people can communicate with accuracy. And I also wonder whether, okay, if one gram of omega-3 EPA per day is good, but maybe three is better, even though I'm at upper range, upper reference range.”
“safety at whatever dose that you're taking. And then second of all, we don't know whether it works. O' For some we do, like creatine, omega-3s, magnesium. Yeah. And creatine is actually the best. So like omega-3s, we know that they're a critical nutrient. Creatine I think is the best example because we know it's very safe, right?”
“Yeah. So sleep was one. Then the other one was nutrient status. So they didn't talk about omega-3s, B vitamins, which we do actually have some quite high quality interventional and observational kind of epidemiological data for. So there was kind of some discussion as well of those things should have been included.”
“Any bioavailable form will be fine. Then, Omega-3 fatty acids. The evidence is a little bit better for like, there are now several studies in like, in like, collegiate American football players, where they take a couple of grams of Omega-3s every day, and across a season, you see less accumulation of biomarkers.”
“And then second of all, we don't know whether it works. O' For some we do, like creatine, omega-3s, magnesium. Yeah. And creatine is actually the best. So like omega-3s, we know that they're a critical nutrient. Creatine I think is the best example because we know it's very safe, right? Right. We know this idea of creatine responders and non-responders.”
“We know it's very safe. So then you can try it and see if it benefits you. So creatine is a great example, but there aren't that many others that kind of fit into that category. O' Interesting times. Mm-hmm. Again, I go back to, I love the idea of blood testing, tailoring supplementation”
“Then things that we have some, you know, reasonable evidence for immediately after concussion, creatine. At what dosage? The best trial was actually done in a pediatric group, although very broad. It was like one year old to 18 years old, but they gave 0.4 grams per kilo per day.”
“But like if you're seven, if you're 70 kilos, you know, 155 pounds or something like that, then that's 28 grams of creatine. So like it's a lot, but a few extra trips to the bathroom could be expected, but you may just spread it out across the day, right? Yes. So, well, one thing I'll say about that is”
“So for most people, it might be 20 to 30 grams of, of creatine spread, spread across the day. You know, for, if anybody's just like taking creatine for other reasons, I've, you know, this is a standard dosing protocol. I think it's fine. I thought you were gonna tell me I could get it to work that way.”
“and in older adults, um, some of those benefits happen at just like a traditional creatine doses. So you don't need to take massive doses, you know, think load loading doses, you can actually see some benefits of like five to 10 grams. So that's the creatine. So magnesium, so 400 milligrams once or twice a day, there've been some trials that shouldn't, um, what form?”
“Can I ask you a question? It's going to be a very controversial one, but there are people arguing, there are very smart people, I should say, arguing that the shingles vaccine is lowering rates of dementia significantly.”
“A, that the shingles vaccine decreases dementia risk, you have to have a clinical trial that's adequately powered to show that. And there is a trial like that being planned currently.”
“Became eligible to get the shingles vaccine. Whereas if they were born one day earlier, they weren't eligible. So you get what you call like a natural experiment where from one day to the next, those people shouldn't be that different otherwise.”
“Well, there was a big shift in the uptake of the shingles vaccine. And so what they can essentially consistently. Showed across all those different populations was that those who got the shingles vaccine or were eligible to have the shingles vaccine, depending on whether they had access to the data on whether the people got it or not had a decreased risk of dementia.”
“But there's a number of reasons why this might be the case. One, obviously. We know it reduces cases of shingles. Shingles can be very painful. It can, you know, can change how people interact with the world. You stay at home. You don't feel good.”
“But it doesn't map onto the dementia risk age that was seen in, seen in these studies. A final piece of this that I think is important and kind of goes beyond just the shingles vaccine is that if you want to maintain function over long periods of time, one of the best things you can do is minimize your, your chances of getting really sick.”
“involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual. Then there are some other nutrients that, you know, have some pretty good evidence for them.”
“B vitamins, the normal range might go up to like 15 or 16. But we know that risk is definitely elevated above 13, and is probably elevated above sort of 10 to 11. So what your target range really might be is it's probably lower than what the normal range might be.”
“cognitive decline. That is particularly the case for omega-3s and B vitamins that lower homocysteine. And so this is the interactions that you were talking about earlier. And this is the best one that we know of, although I'm sure there are many more.”
“status and B vitamin status interact, and they're dependent on one another. So if you give B vitamins to somebody who has elevated homocysteine, you bring down their homocysteine, but they have poor omega-3 levels, you don't see any benefit. And that's been shown in the data.”
“as well. So many people will tell you that you have to take omega-3s in the phospholipid form, which is like a special, it's a special supplement. You can get it from krill.”
“phospholipid form gets into the brain. Some of this, most of this comes from rodent studies. But what's interesting is that if you supplement over several days, it all kind of comes out in the wash because the triglyceride form cycles through the adipose tissue as a depot and then it gets released and the brain can then use it.”
“So if you're going to take just one day of supplement and you want to get as much of that omega-3 in your brain, yes, you should take the, we think you should take the phospholipid form, but the form that comes in seafood, which is primarily the triglyceride form is regulated through the body's fat stores.”
“responding to a stimulus. So for people that want to jump to the, okay, what do I do? Can we conclude, okay, if you like crossword puzzles, keep doing them, but do really hard ones for you. If you like lifting weights, continue to challenge yourself with those.”
“Yeah. Just like crossword puzzles, certain plasticity effect, maybe less than dance where there's a number of different things, social inputs, balance inputs, and on and on.”
“First of all, I would want to see evidence that it works. The majority of peptides don't have good quality evidence in humans, except the GLP ones, right? They're on the market. And the growth hormone secretagogues, but for reasons other than people are taking it. Yeah. Sarcopenia,”
“So I would want evidence that in humans it does what I want it to do. Most of those, if not all of them, except for the GLP-1s, don't have that evidence or for the thing that you're trying to get. Right. But beyond that, a question that you have to ask, and I like, I like this reframing.”
“critical nutrients for, uh, related to cognitive function and risk of dementia. Um, the ones that we have the best evidence for, uh, vitamin D, iron, omega-3 fatty acids, uh, the B vitamins involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual.”
“So the best advice, if you have access to it, is to test your levels. Test your vitamin D levels. Test your hemoglobin and iron levels. Test your omega-3 levels. Test your homocysteine levels, which is a marker of B vitamin status, which we know is a risk factor for cognitive decline dementia as well.”
“Not magnesium? So magnesium is absolutely in there too, um, and in general, I think, so magnesium, zinc, then theres some of the structural”
“safety at whatever dose that you're taking. And then second of all, we don't know whether it works. O' For some we do, like creatine, omega-3s, magnesium. Yeah. And creatine is actually the best. So like omega-3s, we know that they're a critical nutrient. Creatine I think is the best example because we know it's very safe, right?”
“a multivitamin that seemed to work fairly well was the COSMOS study people may have heard of. It was thousands of people... Of older people. Of older adults. And they were given either a multivitamin or a flavonoid supplement.”
“doses of anything. And in that study, those who got the multivitamin saw changes in cognitive function that suggested some improvements. But that was literally just covering the bases, right? No massive doses, the most basic multivitamin.”
“And they're like, Should I be taking low dose? Should I be microdosing Tirzepatide or Retatrutide? I'm like, Retatrutide is not even released yet. They're like, where can I get it? Like, are you kidding me? You know, but it's like, it's incredible what's happened in the last few years.”
“particularly at higher doses. They're not the super popular ones. I think the super popular ones are, besides the GLPs, and Retatrutide is a GLP and other things, but I would say microdosing of Retatrutide and Tirzepatide, one category for weight loss, fat loss. I would say BPC-157, people are taking it without even knowing what the desired effect is.”
Also filed under GLP-1 Agonists
“critical nutrients for, uh, related to cognitive function and risk of dementia. Um, the ones that we have the best evidence for, uh, vitamin D, iron, omega-3 fatty acids, uh, the B vitamins involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual.”
“So the best advice, if you have access to it, is to test your levels. Test your vitamin D levels. Test your hemoglobin and iron levels. Test your omega-3 levels. Test your homocysteine levels, which is a marker of B vitamin status, which we know is a risk factor for cognitive decline dementia as well.”
“zeaxanthin, astaxanthin. If it comes from seafood, that's, that's what makes a shrimp and salmon pink. Um, and then, you know, some other aspects like dietary fiber seems to have, you know, some, some benefits as well.”
“Distractions is really important. And again, I, uh, returned to Gloria Mark's work. She wrote an excellent book called attention span. If anybody's like really interested in this, um, but you get used to a pattern of distraction such that when you're, um, not actually being distracted, you will distract yourself. Right.”
“Then there are some other nutrients that, you know, have some pretty good evidence for them. Um, so many of the antioxidant, uh, polyphenols, things that you get from berries, coffee, tea, chocolate, the carotenoids that make things orange, yellow, and red, um, lutein, zeaxanthin, astaxanthin. If it comes from seafood, that's, that's what makes a shrimp and salmon pink. Um, and then,”
“uh nisha supplements that do have some evidence the one that probably has the most evidence for it is boswellia boswellia uh yeah uh which is a frank indian frankincense uh but there's an extract of boswellia that's been tested in i think three different clinical trials after tbi showed some benefit and Enzogenol which i think is a pine extract slightly less evidence than boswellia”
“Of older adults. And they were given either a multivitamin or a flavonoid supplement. It was like a Centrum-type vitamin. Yeah. It was Centrum Silver. Like the most basic multivitamin, just 100% of the recommended daily allowance, no massive doses of anything. And in that study, those who got the multivitamin saw changes in cognitive function that suggested some improvements.”
“in a very controlled kind of clinical yeah you have to be heart rate monitor yeah i began it's not legal in the united states although things things are shifting but choline is another thing particularly acetylcholine so um uh best evidence is for one to two grams a day um of choline of”
“Choline is another thing, particularly Citicoline. So best evidence is for one to two grams a day of choline in the form of CDP choline or Citicoline, which is the same thing.”
“probably a reasonable strategy. But what they also showed was that supplementing with this antioxidant cocoflavanol was only beneficial in those who tended to have a poor quality diet to start with, right? So they just weren't getting many of these kinds of compounds for their diet.”
“So, so like the, the, some of the studies that use traditional, like creatine, monohydrate. Look at creatine levels in the brain. They did use a loading protocol for, for a week, and then you see significant increases in brain creatine, but the creatine having other effects on the brain, you know, potentially improving mood, improving, uh, memory”
“and Enzogenol which i think is a pine extract slightly less evidence than boswellia”
“heard of. It was thousands of people... Of older people. Of older adults. And they were given either a multivitamin or a flavonoid supplement. It was like a Centrum-type vitamin. Yeah. It was Centrum Silver. Like the most basic multivitamin, just 100% of the recommended daily allowance, no massive doses of anything.”
“There's no human evidence as far as, no good human evidence. And then there are these other kind of dot, dot, dot ones, I would say GHK copper, for skin appearance. Those are the three biggies that seem...”
“passage of creatine into your cells as opposed to drawing water into the gut? In the 90s, we would take five grams of creatine four times a day in an ounce or two of pure grape juice. And you draw a lot of water into your muscle cells.”
“many people will tell you that you have to take omega-3s in the phospholipid form, which is like a special, it's a special supplement. You can get it from krill.”
“seems to be a prerequisite of plasticity, which is why things like caffeine and stimulants and L-tyrosine and all these things that you can find some evidence for them improving plasticity, but it's very likely to be indirect, right?”
“Those studies actually use magnesium oxide, surprisingly. Um, but I would probably use magnesium glycinate. Um, the it's very bioavailable. Um, athletes usually need a bit more glycine anyway, but any bioavailable form will, will be fine.”
Also filed under Magnesium
“might become a little bit specific to, uh, the symptoms that you're experiencing. So if you have sleep issues, then, uh, there's studies that have used a melatonin and that's, that's shown improvements of branch chain amino acids at high doses for sleep.”
“ethanolamine that you might get from um nuts and seeds or eggs they have some slightly less like less evidence really when you're looking at um brain changes over time and dementia risk”
“involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual. Then there are some other nutrients that, you know, have some pretty good evidence for them. Um, so many of the antioxidant, uh, polyphenols, things that you get from berries, coffee,”
“They're not really thinking about it. And there's similar data from other stimulants too. So, there was a paper that came out in Science a couple of years ago giving people methylphenidate, some of the, or some of the other like ADHD medications in people who don't have ADHD. These stimulant medications again show this dissociation between, so they feel great.”
“zeaxanthin, astaxanthin. If it comes from seafood, that's, that's what makes a shrimp and salmon pink. Um, and then, you know, some other aspects like dietary fiber seems to have, you know, some, some benefits as well. Not magnesium. So magnesium is absolutely, absolutely in there in there too. Um, and in general, I think, um, and that.”
“ethanolamine that you might get from um nuts and seeds or eggs they have some slightly less like less evidence really when you're looking at um brain changes over time and dementia risk”
“There's now a newer version called Shingrix, which is a recombinant vaccine. And there was a study done. In the US that compared people who switched from, you know, there was a similar switch from Zostavax to Shingrix and saw that Shingrix was associated with a lower risk of dementia compared to Zostavax.”
Also filed under Shingles Vaccine
“them. Um, so many of the antioxidant, uh, polyphenols, things that you get from berries, coffee, tea, chocolate, the carotenoids that make things orange, yellow, and red, um, lutein, zeaxanthin, astaxanthin. If it comes from seafood, that's, that's what makes a shrimp and salmon pink. Um, and then,”
“Tommy recently released a new book that he wrote entitled, The Stimulated Mind, Future-Proof Your Brain from Dementia and Stay Sharp at Any Age.”
“Should I be microdosing Tirzepatide or Retatrutide?. I'm like retatrutide has not even released yet.”
“just don't be really hot. If you get a fever, which you might do after a more significant injury, you know, Tylenol or something like that to help maintain thermoregulation will be really important. The next is blood sugar regulation. So we know that after a significant brain injury, you have increases in blood sugar.”
“involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual. Then there are some other nutrients that, you know, have some pretty good evidence for them.”
“involved and the B vitamins involved in methylation. So particularly B12 and folate also potentially B6 and riboflavin, although that might depend a little bit more on, on the individual. Then there are some other nutrients that, you know, have some pretty good evidence for them. Um, so many of the antioxidant, uh, polyphenols, things that you get from berries, coffee,”
“from Zostavax to Shingrix and saw that Shingrix was associated with a lower risk of dementia compared to Zostavax, although both were associated with a lower risk than none. When you look at some of these trials”
As referenced on air, with the quote and the moment. Reported, not evaluated.
“The Maintain Your Brain study was actually, it was sort of midlife, kind of 50s and 60s mainly. And they actually had interventions across four different domains, based on risk factors within that given individual.”
“There was something similar done in the POINTER trial, which was in older adults, now 60s and 70s, that was done here in the US. That was a replication of an older trial called the FINGER trial that was done in Finland.”
“That was a replication of an older trial called the FINGER trial that was done in Finland.”
“Some of that evidence goes all the way back to an older trial called ACTIV that was done in the US in the 90s. It was still the biggest ever trial of like pure cognitive brain training.”
“probably the biggest one looked at data that came from the implicit association test people might have heard of where you get show these pictures of different things.”
“They took some of the data from that. This is published in one of the Nature journals a few years ago. And what they showed was that you can separate out reaction time versus processing speed”
“there are meta-analyses of these interventions in older adults showing that ballroom and line dancing have the greatest effect on cognitive function”
“It came out of the Rush Memory and Aging Project.”
“this is very similar to the diet they used in the SMILES trial, which was the first randomized controlled trial in depression that showed significant improvements in mood symptoms.”
“so this is very similar to the diet they used in the smiles trial which was the first randomized controlled trial in depression that showed significant improvements in in mood symptoms”
“There was actually a big trial of the mind diet. It was published in the New England Journal of Medicine a couple of years ago.”
“there's a big one that came out of the UK biobank was that they, um, took out individual diets”
“There was actually a very recent one that just came out of... Of USC, where they gave omega-3s for a long period of time.”
“It was originally shown in the VitaCog trial that was run out of the University of Oxford.”
“It was then replicated in the B proof trial.”
“the other side has also been shown, in the omega-AD trial, they showed that a supplement with omega-3s didn't result in any benefit if people had elevated homocysteine.”
“Potentially the one recent example of just giving a broad-based set of nutrients with a multivitamin that seemed to work fairly well was the COSMOS study”
“And I like this reframing. I heard it recently from Jeffrey Bland, which is that if you're going to consider injecting or taking something, the first thing you should want to know is, is this safe?”
“So, there was a paper that came out in Science a couple of years ago giving people methylphenidate, some of the, or some of the other like ADHD medications in people who don't have ADHD.”
“in fact a 2020 study by the environmental working group estimated that more than 200 million americans were affected by tap water in the past year”
“And the kind of the best accepted review of all of this is run by the Lancet Commission on Dementia Prevention, overseen by Professor Jill Livingston.”
“One was the adult changes in thought study done at the university, university of Washington and Seattle”
“a similar thing was shown in the rush memory and aging project”