Welcome back to the Healing Pain Podcast with Dr. Steven Masley
For the body to be healthy the brain needs to be healthy. Join Dr. Steven Masley as he explains why having a healthy heart is a better brain solution. Learn how your heart rate tells a lot about your brain functions and how exercise is the best way to live healthy. But having a healthy body will require proper nutrition. Discover how all these factors make for a healthier version of you.
Each day, your brain fires up all your senses, brings you pleasure as well as pain, catalogues a lifetime of memories, solves an array of problems, and connects you to the world around you. You can live with one kidney, with a transplant of heart, liver and other organs, but nothing can substitute for a healthy brain. We know that chronic pain often interferes with the brain’s cognitive functions such as memory. We know that memory loss is a major concern for adults as they age. Joining us today to share how you can have a better brain is Dr. Steven Masley whose passion is to empower people to achieve optimal health through comprehensive assessments and lifestyle changes. He’s a physician, nutritionist, trained chef and author. You may know him as the creator of the number one all-time health program for public television, 30 Days to a Younger Heart. Today, we’ll be engaging in a conversation about perhaps our most vital organ, the brain.
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Better Brain Solution with Dr. Steven Masley
Dr. Masley, welcome to The Healing Pain Podcast. It’s great to have you back on.
I’m really glad to be back.
We’re going to talk about your book in today’s podcast. The topic of the brain is so important to the people who listen to my podcast, both patients who have pain as well as the practitioners who treat it, because we know that the brain is really the ultimate source of pain in our body. The healthier your brain is, the healthier you are overall, including chronic pain. As I’d known you now for a number of years, a handful of years back you wrote an awesome book called The 30-Day Heart Tune-up. I want to start today with asking how did the heart doctor become so passionate about brain health, memory and cognitive function?
I think you might know, when I see patients in my clinic, we do a holistic assessment. How does their brain function? How does their heart function? We measure the age of their arteries, their cognitive performance, their hormones, their blood tests, their fitness, their nutrient intake. It’s a holistic approach. At the same time, we were noticing our patients’ arteries were getting younger every year from following a protocol. They had less aches and pains. Their brain was getting sharper and quicker at the same time. We had published data. We had published several studies now looking at our database at what things predict; are you growing plaque or not? Is your brain sharp and quick or is it slow and sluggish? If it’s slow and sluggish, that leads to memory loss, probably more pain and misery and depression and anxiety as well. Not only can we see what predicts your brain function, we put that in scientific journals, we now have hundreds of people who both shrunk their artery plaque and improve their cognitive performance. One of the best predictors of improved brain performance is better artery health. They’re intimately connected. I think we’ve talked a lot about a gut-brain connection in all sorts of books, but there’s also a very strong heart-brain connection or circulation because when you improve your circulation, you help your heart, your brain, and even your romantic life. What’s better than that?
We have an aging population, as you are aware of. Let’s talk about the risk factors that people should be aware of when it comes to their memory and their cognitive function or their cognitive decline, shall we say.
The number one risk factor is elevated blood sugar. If you’re insulin-resistant, if your blood sugar is going up, you have signs of metabolic syndrome, you are much more likely to both have heart disease and cognitive decline. That’s the first. You have a family history of memory loss, that’s concerning because there are some jag things as well as lifestyle that impact that. I think surprising for me was like if you’ve had a concussion, which is associated with people with chronic headaches. A concussion increases your risk 300% to 400% of future memory loss; depression, almost 300% to 400% in women and man if you had a history of depression. Number one would be elevated blood sugar, not even diabetes, just mildly elevated blood sugar. There’s also an APOE4 genotype. All those things would make someone that has any of those risk factor, they would be high-risk for cognitive decline and memory loss.
You mentioned elevated blood sugar and you said not diabetes. My question would be, as a physician when you’re looking to educate people as well, are you looking at a range of say that’s pre-diabetic or are you looking at even before pre-diabetes in people where you start to say, “Let’s start to pay attention to this. Let’s start to make some lifestyle changes that will positively affect your blood sugar?”
That’s a really good question because we usually see 126 is like diabetes and there is this 100 to 126 where you’re elevated pre-diabetic. Even if you’re 85, you’re at lower risk, 95 and 100, there’s a 60% difference in your risk for getting memory loss. The lower the better. Here’s the other thing which I think you know that probably the listeners should hear. Ten years before your blood sugar is up, you have signs that you’re becoming insulin-resistant. During that time, you’re losing memory and losing brain function. In the ten years before your blood sugar is slightly elevated, then you’re already having cognitive dysfunction, brain fog, more forgetful. It’s the ten years before you ever have a mild increase that puts you at risk. Usually people think, “Am I diabetic or not?” It’s much more important these other signs of insulin-resistance we want to know much earlier because they’re so important.
It makes me think of the prevention almost before the prevention even that we’re talking about, which I think is really so important. You mentioned briefly the APOE4 genotype. I was going to leave this to the end but you brought it in the middle, so let’s talk about it now. How concerned should someone be about that genotype? Should they get tested for it? What kind of lifestyle should they begin to think about and follow if they specifically have that genotype?
Let’s put it in perspective. There’s APOE 2, 3 and 4 genes. If you have the APOE 2 or 3 or a combination of them, your risk of getting Alzheimer’s disease is 9% in your lifetime. It doesn’t mean whether you could get it and not have the gene. If you have one of the APOE4 genes, that’s 20% of the population. For those 20% of people, their risk of Alzheimer’s is 30%, so that’s a lot more than 9%. It really does increase your risk about 300%. If you have it, it means several things. 200,000 or 300,000 years ago, everybody had the APOE4 gene and we’ve had these mutations in the last 200,000 years, in the last 80,000 to 90,000 years to these other genes.
The APOE4 makes you better at fighting infections. If you’re running around in the bush, stepping on things and cutting yourself and being bitten by animals, you’ll fight infections off better. This is really important to me. I have family with APOE4. I personally don’t but I’ve got loved ones who do. It increases the risk then what can they do? Exercise is really important for them. They do extremely well. They do very poorly if they have elevated blood sugar. That’s a terrible burden for people with the APOE4. They do not tolerate insulin-resistance and high blood sugar levels. That makes my program more important for them. They do really well with fish oil but they need double the dose. They don’t uptake it well, but when they get it, they get more benefit than an average person. A double-dose is more important for an APOE4 than a regular person. Normal blood sugar, extra fish oil, definitely exercise, and they seem to do really well with some partial fasting a few days a week, skipping breakfast and getting a fasting state then. Those are the four things that are probably more important for people with the APOE4 genotype that other people don’t have to focus as much on.
I love the way you just tell that, just those four important concepts. People can really write those down and start to implement those into their life. You mentioned exercise, which is a whole big topic in and of itself when we were talking about memory loss or cognitive problems. What kind of exercise are you recommending for patients?
This showed up in our data point. We’re publishing on this. The number one predictor of better brain function being higher processing speed, executive function, thinking quicker, preventing memory loss appears to be aerobic performance, so when you get your heart rate up aerobically. Strength training also had an independent benefit. It’s both you want to do aerobic stuff like ride a bike, go for a jog, power walking, swim, dancing, whatever is fun, do something fun to rev up your heart rate. Strength training has an additional added benefit that’s independent. We want muscle mass. When you add more muscle mass, it helps your brain grow. I think the aerobic part makes your brain faster and quicker. Literally, when you do strength training, build muscle mass, it lowers insulin-resistance and helps your blood sugar, your brain grows larger. I think both are critically important.
With the aerobic exercise, because I think we’ve gone through this period where we have found love with aerobic exercise and now just recently over the course of maybe the last five years or so, we’ve pushed it to the wayside. Is the benefit of aerobic exercise cardiovascular, meaning it’s helping your heart and lungs? Or is it really profusing your brain, which has certain kinds of biochemical changes that happen?
I think it’s both. Probably that’s your area of key interest too. I think we benefit both ways, that you’re increasing the circulation to your brain and brain flow and there’s biochemical and hormonal impacts in our brain, neurotrophic factors that increase and stimulate the brain to grow and develop and repair itself. Exercise is just one of the key pillars of having a healthy, functioning, quick brain. It’s also really good for preventing and reversing depression. Same things that reverse depression are really good at improving cognitive function and preventing memory loss.
The other key pillar, as you know as a chef and a nutritionist and an integrative physician, is nutrition and how important that is for memory and cognitive function.
In the program, I read almost close to a thousand articles, medical published articles on foods and nutrients and which ones are the most predictive of helping improve cognitive performance and prevent cognitive decline. That was really one of the finest parts of the program is helping identify what foods you should have.
That’s leading to my next question. We focus so much on what not to eat but I’m always like, “What’s delicious and healthy I can put on my plate?” What would I put on my plate if I want to work on slowing down or completely preventing any kind of memory loss that might happen?
I’ve eaten with you many times. This is how you and I eat. It’s fabulous food that tastes great. Number one on the list was green leafy vegetables. Somebody who eats green leafies every day, their brain is eleven years younger than someone who doesn’t eat them at all. Eleven years and we’re only talking one cup a day. That should be a slam dunk no-brainer. Other colorful vegetables, especially beets, that contain pigment in red beets, really does improve brain flow and protect your brain, especially for the memory center. Nuts. There’s a whole bunch of healthy fats that are good for our brain.
I think the data has been pretty conclusive a low-fat diet is hard on your brain. The long chain Omega-3 fats from wild salmon or sardines and nuts are really good for your brain. Extra virgin olive oil is awesome for your brain. Those are healthy fats we want more of. Spices and herbs are anti-inflammatory and they’re good for your brain, things like rosemary or curry spices, especially turmeric. Example would be rosemary or one of my favorites is Italian herb seasoning or mixed curry spices. Red wine showed at, in moderation, not in excess, that one or two servings a day improve brain function, help prevent memory loss. Green tea is really good for your brain. There’s a long list of food we should focus on adding that are really good for us. They make our food taste better like olive oil and spices and herbs. That should be easy no-brainer.
Once we perfected our palate and we go into a supermarket and we’re filling our grocery cart with the healthy food, which is obviously winding up on our plate at night, and we’re educating our self about what to eat when we go out at night, are there supplements that are proven through evidence-based medicine to help with cognitive function and memory?
Some of the ones that were most important, like if you miss them you have accelerated brain loss and cognitive decline, were vitamin D, long-chain Omega-3 fats like fish oil or DHA. If you’re vegetarian, then maybe DHA seaweed supplement. A good quality multi-vitamin with adequate mixed folates, you need not just folic acid but mixed folates, and adequate B12 if you’re B12 low, especially as we get older, a lot of people have low B12 levels. Adequate B12, mixed folates, some chromium so you’re not blood sugar deficient and magnesium. Magnesium is a really good predictor of brain function. Maybe that essential core, I would throw in a pro-biotic to help your gut. That gut-brain connection is really important. That would be my initial. It would be insane not to get your vitamin D like 2,000 mg a day. In the program we go through how do you get them and what doses with fish oil, magnesium, a good quality, multi, pro-biotic, that would be my core, plus there are some other things you can add that I think have additional benefit.
Can you tell us about some of those? I think so often people focus on vitamins, but there are other types of nutrients and herbs that can be beneficial. What are other kinds that you recommend for?
I would say it’s a total slam dunk, nobody should be B12 or vitamin D or magnesium deficient. That’s just insane. We’re getting into more theoretical. It’s been studied in trials for people. There have been some studies that show that if you use it for people with mild cognitive loss and impairment, their memory got better, and the people who weren’t on it kept getting worse. Curcumin is that extract that comes from turmeric, the curry spice. I use it for pain. It’s such a great pain drug because it lowers inflammation. It’s been used in clinical studies to help prevent, reverse cancer or cognitive decline. I take it myself for arthritis. When I’m taking that and my fish oil, I don’t have any joint symptoms at all. As a pain mediator and an anti-inflammatory, I think it’s awesome. I thought I could get it in food, I was trying to get it in food first and I figured out the dosing. To get 500 mg to 1,000 mg of curcumin that’s well absorbed in a capsule, you have to have three tablespoons of turmeric every day. I thought, ” I could do this, three tablespoons into a cup of yogurt,” and Joe, there’s no way. It’s a lot. I’m much happier just taking a pill a day with 500 mg to 1,000 mg. I still like curry spices but I gave up having it from food.
It reminds me I tried to do that once in a protein shake, and it was great, but after a while, that much turmeric every morning, you can be like, “I want a different flavor this morning.” Sometimes there are pills that make a lot of sense and that would be one of them actually. Can you tell me about some of the testing you’ve done on patients? How do you test to see how their cognitive function is improving when you do these trials with them and the entire program that you have?
We have a brain symptoms course so we ask questions like, are you losing things? Do you lose your car in a parking lot? Can you remember a phone number long enough to dial it? A brain symptoms course which we have and we make available to people is a nice tool. I should go to the other extreme first. The standard thing that doctors do in clinics and hospitals is the Mini-Mental Status Exam. What year is it? What city do you live in? What state are you in? By the time you don’t know those, you’re gorked. Sad to say but that’s standard medicine. Wait until you’re totally gone to intervene. You should have identified someone ten or twenty years before. Much I prefer, we do cognitive test in my office where we do a pretty challenging memory, both words and visual-shape memory. We help people go through a maze of different symbols that they have to match with other words and things. Thirty-minute cognitive test you can do on a computer to measure your brain processing speed, that to me is ideal. I wish everybody can identify how does the brain function? Are they sharp and quick or are they slow and sluggish? Slow and sluggish brains progress to memory loss. I’d rather identify ten to twenty years before someone had cognitive decline that they were trying to slip, and then take steps then to reverse it early on. That’s the kind of testing I like to do.
That’s so interesting because I feel like when I think back in my life, obviously we had IQ tests, maybe you had your SAT test, maybe some tests in college, but then after that, you really stop assessing what your cognitive function was. When you go to the typical, the average primary care physician, they’re not really going to test your cognitive function much beyond what year is it and what’s your address, which most people remember.
When you’ve lost that, it’s almost too late.
You have a collection of books, you’ve written a lot of books, but why is this book probably your most important work?
This is the biggest crisis facing not just the US and Canada but the world today. Cognitive decline is increasing rapidly. Here’s the amazing thing: Right now it’s the number one cause of expense for healthcare in America today. We spend more money on memory loss than any other problem. That problem, which is our number one biggest problem, is going to double in twelve years. It’s scary. Memory loss doesn’t just affect us if we get it. We become disabled and a burden to our family and the people we love. If you’re not functioning at your full capacity, if you’re sluggish and have brain fog and are forgetful, when you could be sharp and quick and productive, that’s a huge loss. Decades before we’re actually suffering, that’s a huge loss not to be at your full potential. I want people to be sharp, quick.
Our average patient going through our program has been showing to be 25% sharper. We can prevent the number one cause of misery and disability, the scare. I think we can prevent most of the scariest disease on the planet, which is going to double in just the next twelve years. No matter what your age, it doesn’t matter who couldn’t benefit from being sharper, quicker, more productive. I think anybody with a brain needs help in protecting it and improving it. After all, who wouldn’t want a better brain?
Of course, we all have brains from children all the way up to the elderly. It’s a really great book. I’ve been talking to Dr. Steven Masley. He’s the author of a book called The Better Brain Solution. You can find him at www.DrMasley.com. Steven, can you tell people what you planned for the release of your book that they might be interested in?
I have a Better Brain Challenge. My goal is to join together with colleagues like you, brilliant minds out there who are doing the right work. I think we can work together. I’m trying to create a Better Brain Challenge, give people five easy steps to take to have a better brain in just 30 days. That’s what I’d like to do with you and many others, to work Better Brain Challenge. What are the five things people could do? Just a short time, 30 days, their brains are better, they are quicker, they are sharper, they’re more productive. We’re preventing the scariest disease on the planet at the same time. That’s my goal. That’s what I want to have seen accomplished. How can we take the scariest disease and try to vanquish it, and feel better and be more productive? Probably by having a healthier brain, I think it would lower pain and depression and other things that are so common today as well.
I’m up for the challenge for 30 days to a better brain. Make sure to check out Dr. Steven Masley’s book, The Better Brain Solution. You can find it of course at all local retailers and of course online at Amazon, Barnes and Noble, any online retailer, and of course on his website at DrMasley.com. I want to thank Dr. Steven Masley for being on The Healing Pain Podcast this week. Make sure to share this episode with your friends and family on social media. Please log on to iTunes and give us a five-star review so we can help spread the message. Thank you very much. This is Dr. Joe Tatta. We’ll see you next week on the podcast.
About Dr. Steven Masley
Steven Masley MD is a physician, nutritionist, trained-chef, author, and the creator of the #1 all-time health program for Public Television, 30 Days to a Younger Heart. He helps motivated people tune up their brain, heart, and sexual performance.
Dr. Masley is a fellow with three prestigious organizations: the American Heart Association, the American College of Nutrition, and the American Academy of Family Physicians, and is a Clinical Associate Professor at the University of South Florida. His research focuses on the impact of lifestyle choices on heart health, brain function, and aging.
Dr. Masley’s passion is empowering people to achieve optimal health through comprehensive assessments and lifestyle changes. As a best-selling author, he has published several books: Ten Years Younger, The 30-Day Heart Tune-Up, Smart Fat, and his latest book, The Better Brain Solution, plus numerous scientific articles. His work has been viewed by millions on PBS, the Discovery Channel, the Today Show, and in over 500 media interviews. He continues to see patients and publish research from his medical clinic in St. Petersburg Florida, and he offers weekly blogs on his website, www.DrMasley.com.
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