Ep. 232 The Genius Foods You Need For Mental Health & Cognition 

Cynthia Thurlow: Welcome to Everyday Wellness Podcast. I’m your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.

Today, I had the honor to connect with Max Lugavere, who’s a top health podcaster, wellness journalist, filmmaker and author. He wrote one of my favorite books, the New York Times bestseller Genius Foods. And earlier this year, the Wall Street Journal Bestseller Genius Kitchen. Today, we dove deep into his background and what developed his interest in brain optimization and cognition. We spoke about nonmodifiable and modifiable risk factors. We dove deep into the food compass nutrient profiling system. We spoke at length about a lot of the outdated, non-scientific guidelines that are written with regard to nutrition. We spoke about dogmatism in nutrition, what’s changed about our food, the influence of the processed food industry, seed oils, some of his favorite Genius Foods, the value of sleep, and so much more. I hope you will enjoy this discussion as much as I did recording it.

Well, Max, it’s a pleasure to have you on the podcast.

Max Lugavere: Cynthia, thank you so much for having me. What an honor and privilege it is to be here.

Cynthia Thurlow: Oh, awesome. Well, I think everyone’s backgrounds are really instrumental in their trajectory of our careers. And I know that your mom’s experience with her health were really an impetus to become profoundly interested in the role of cognition and brain health. And would you share with the listeners a bit about your mom’s story and how that really got you fueled and interested in this area of scientific information and research, and as it pertains to information that’s shared with the lay public.

Max Lugavere: Absolutely, a great place to start. So, I’d always been passionate about nutrition and fitness and supplementation. This is something that I’ve been really into for as long as I can remember, since I’m, I guess, 15, or 16 years old, I had a passion for understanding nutrition. And it was just something that I really loved. And I actually started college on a pre-med track, but ended up halfway through school realizing– well, a few things, one that I was a storyteller and that I had a creative streak. And then two, academically, I always kind of struggled, I got A’s, in the classes that I was interested in, like the sciences, but then I would get D’s in the classes that everybody typically took to get the A’s, to bring their GPAs up. And I just couldn’t excel in those classes because I wasn’t interested. 

So, realizing the way that my brain worked and making peace with that, I ended up pivoting to a double majoring in film in psychology. And that led to me becoming a journalist on TV, a really storied dream job out of college working for Al Gore on TV in the United States. And it was an incredible opportunity. But circling back to my mom, the real reason why I do what I do. When I left my position at this TV network, it was then in my personal life that my mom started to display symptoms that would ultimately be diagnosed as a rare form of dementia called Lewy body dementia for anybody who’s not familiar with it, it’s akin to having both Parkinson’s disease and Alzheimer’s disease at the same time. It actually has more in common in terms of the etiology with Parkinson’s disease than it does Alzheimer’s. But nonetheless, they typically prescribe the same drugs, regardless of the variant of dementia that you have, which is really a testament to how limited the tools are for those types of conditions. 

And I had no prior family history of any kind of neurodegenerative condition. My mom was young at the time she was 58, still had all the pep in her step, all the pigments in her hair that a middle-aged woman has. And so, seeing that develop in her was the hardest thing that I ever had to endure. And I remember distinctly I was at– we were at the Cleveland Clinic, we literally had to go to the Cleveland– I’m born and raised in New York City. And so, we had access to all these incredible medical institutions. But we literally had to make a pilgrimage to the Cleveland Clinic to finally get a diagnosis for a neurodegenerative condition. And that’s where my mom was prescribed drugs for both Parkinson’s disease and Alzheimer’s disease, at the same time. It was about the year of 2011. And I remember having a panic attack in the hotel room as I was googling these drugs, because again, I was a layperson. I still am, essentially a layperson. And I did what any millennial with a data plan would do. I just started googling the drugs and the panic washed over me like an awesome wave.

From that point on, I wasn’t unable to really think about anything else, but the dietary and lifestyle factors that might have predisposed my mom to developing this condition. And in tandem with that I became interested in what if anything could be done to help her at the stage that she was in, and also what could be done to prevent myself from ever having to succumb to what it was that she had developed. And so that was a journey that began about 10 years ago. And I realized over that time that I had a latent skill set and aptitude for understanding and aggregating and communicating science, which I think is what led to me having the opportunity to write the books that I’ve written like Genius Foods and the podcast and do all the TV appearances. But the core of what I do, it really is the fact that my mom is my why, and I had to see her succumb to this awful condition. And it’s my hope to help prevent, or at least move the needle, in the sense that it doesn’t– that other people perhaps listening to this won’t have to succumb to the same fate.

Cynthia Thurlow: I’m so very grateful that you have been so instrumental in helping to educate a population of individuals. And that paint a purpose story is really one that’s incredibly impactful. Like it’s really starting the conversation talking about what are the things that influence brain health, because I still think this is a poorly understood, poorly discussed topic with a lot of providers. And I say this, even as a nurse practitioner, some things we get really right, and some things we don’t do really well with talking to our patients. So, what are some of the common lifestyle choices, as well as genetic susceptibilities that can impact brain health and things that we can do around this to be proactive? And I think, I talk a lot about metabolic health, and many of those reasons why I’m so passionate about metabolic health, is that impacts brain health as well. So, this is probably a good place to start before we expand our conversation.

Max Lugavere: Yeah. It’s a great place to start. We can look to myriad different sources as a starting place in terms of answering your question. But in 2020, the Lancet published the latest figure that should convince anybody, even the most ardent evidence-based practitioner listening to this, that at least 40% of Alzheimer’s cases are attributable to what are referred to as modifiable risk factors. So, when it comes to one’s predisposition to developing dementia, and Alzheimer’s, sometimes I use the two interchangeably. Just to be clear, Alzheimer’s disease is the most common form of dementia. And it affects about six million people currently in the United States, 50 million people worldwide. And numbers are expected to explode in the coming years by the year 2050, at least to triple.

When it comes to one’s predisposition to developing this condition, you have what are called non-modifiable risk factors and then you have modifiable risk factors. And the non-modifiable risk factors, there are essentially three of them. Your age, your genes and your gender. So, your age is still a number one risk factor for developing dementia, your genes, we have certain polymorphisms, like the APOE4 allele, which if you carry one copy, well, depending on whether or not you carry one or two copies, your risk increases in the United States to be clear. I mean, I can clarify what I mean by that anywhere between two and 14-fold. And then you have your gender. So, if you’re a woman, your risk is twice that of a man’s, unfortunately, and we’re just now starting to kind of unravel why that may be the case. But needless to say, those are the risk factors that you can’t really change, although you can influence the expression of those risk factors.

So, for example, your genes, as I sort of alluded to, if you carry the APOE4 allele, yes, in the United States, that puts you at anywhere between two and 14-fold increased risk for developing Alzheimer’s disease. But you can look to other parts of the world where the diet is less industrialized and the lifestyles are less sedentary. And you can see that the gene frequency is just as prevalent, but the risk that the influence that it has, the relationship that it has with Alzheimer’s disease is actually almost completely attenuated. So, what that implies is that if you’re genetically at risk in the United States, you might simply move to a place like say, Ibadan, Nigeria, and see that risk abolished. But really to simplify, if you live in the United States, it’s those three non-modifiable risk factors that you have to contend with.

Then we have 12 modifiable risk factors, and this is what’s so exciting is that at least 40% of Alzheimer’s cases might be– and that’s millions of people, might be able to modify their risk by changing these so-called modifiable risk factors. And a major one is metabolic health as you mentioned. So, if you are a type 2 diabetic, your risk for developing Alzheimer’s disease increases between 2 and fourfold. And type 2 diabetes is by and large a lifestyle condition. But even if you don’t have type 2 diabetes, insulin resistance is closely related to Alzheimer’s disease. In fact, 80% of patients with Alzheimer’s disease have a degree of insulin resistance. So, you want to make sure as part of your prevention strategy, you are as insulin sensitive as possible.

Some other modifiable risk factors include obesity, which is sort of part and parcel for this metabolic health conversation, you want to make sure that you’re not obese. Some of the obvious ones are, smoking, excessive alcohol consumption, brain injury, again, all modifiable. You don’t have to smoke, you don’t have to drink alcohol excessively, and you can protect your head. Some of the less obvious ones are hearing impairment is an interesting newer one to be discovered, the relationship between hearing loss and cognitive decline. But, yeah, by and large, I mean, we have a say when it comes to our cognitive health, and I love to talk about nutrition. I mean, nutrition is like, I’m obsessed with it, I eat, sleep, breathe, the topic of nutrition, and it’s just something that I love to geek out over. But exercise, sleep, stress, these are all factors that play a role in brain health, ultimately.

Cynthia Thurlow: Yeah, and I think it’s really important for people to understand some of these things we have control over, others we do not. And one thing that’s been interesting for me, because the bulk of the people, my niche is really speaking to women in middle age, and understanding that women in many ways are protected from Alzheimer’s until they go into menopause. So, I know that there are some interrelationships between estrogen and insulin sensitivity. And so understanding that maybe you are insulin sensitive into your 40s. And then women become menopausal, and then all of a sudden, we are more prone to developing diabetes, being insulin resistant, being less metabolically sensitive, less insulin sensitive. So, ensuring like I typically say everyone out there should be getting labs drawn through their provider every year. But one thing that I find particularly interesting, and you mentioned, these alleles, these APOE. And for people that are listening, that are curious about this, a lot of this is related to genetics, things that we inherit from our parents, inherit from our parents rather, and it was interesting, so there’s APOE2, three, and four. 

I know I actually have a APOE3, but I do have family members that have the APOE4 variant. And just because you have one allele doesn’t per se mean that that’s a correlation that all of a sudden, you’re then going to go on. But it is even a greater need to lean into the lifestyle piece, because as you very appropriately stated, nutrition, dietary choices, alcohol use, tobacco, stress, if you’re living in a really toxic environment around toxic people, that is not good for your mental health, nor is that good for your physical health. And so, I think on a lot of levels when we talk about nutrition with the understanding that we want anti-inflammatory nutrition, we want to consume less processed foods. And this is going to dovetail into a food compass nutrient profiling system that the White House conference on nutrition is going to be discussing this was developed at Tufts University. If you’ve been under a rock, maybe you haven’t heard about this, but I found this profoundly troubling when the data is inherently flawed, but it is heavily skewed, this food compass information is heavily skewed towards the processed food industry, forsaking healthy, nutrient dense Whole Foods. 

And so, how did these guidelines even become part of our narrative? Why are we as a nation, not making the correlate the connection between these highly processed hyper palatable foods being so proliferative in the food industry. And then we have guidelines coming down that are suggesting people should continue eating hostess fruit pies and Cheerios over having milk and eggs, and more nutrient dense options, which are going to be healthier, long term.

Max Lugavere: Yeah, because these dietary guidelines, I mean, we like to think that they’re developed in good faith for the betterment of the American people, the health of the American people, but they’re really instruments to sell processed food is really at the end of the day, how I’ve come to reconcile these sorts of things. I mean, there was a paper that just came out that one of the co-authors was Nina Teicholz, who’s another journalist who wrote the book, The Big Fat Surprise. And what she did was she looked at all of the conflicts of interest of the people on the committee for the 2020 Dietary Guidelines for Americans commission, and 95% of them had conflicts of interest with the food industry or the pharmaceutical industry. Companies like Barilla, Kellogg’s, General Mills, AstraZeneca, like you name it. So then something comes along like this nutrient profiling system, like the food compass developed at Tufts. Now, this isn’t the first nutrient profiling system. To the credit of the researchers behind this, nutrient profiling systems are thought to be potentially beneficial in terms of helping consumers steer clear of less healthy option and opt more frequently for healthier food items. I mean, we do have a public health crisis, we do live in a time where almost one in two people are not just overweight but obese.

So, there is value in the development of a system like this. And there are some systems at work, which I can speak to. But what came along recently was this so-called food compass nutrient profiling system that was devised at Tufts University. And it weights several different characteristics of foods. The micronutrient content, the fiber content, the protein content, the degree of processing that the food has undergone. But the weight given to each of these variables is a little bit suspect, when you actually go into the supplementary material that accompany this paper, which was very robust, lots of food items. I think, like a couple thousand food items, at least were scored. What you end up with is a system that places ultra-processed food items like Frosted Mini Wheats and Lucky Charms, and egg substitute fried and vegetable oil above ground beef, and milk and poached eggs.

To me, and one of the criticisms that Tufts fire back with is that, “Oh, these items are taken out of context.” Well, I’m like any nutrient profiling system has to be able to hold up to scrutiny. When you take individual items that a five-year-old would look at and recognize as being broken, like that an egg or grass-fed beef or a glass of milk is less beneficial, less good for you than Frosted Mini Wheats. To me, it’s just an instrument to sell ultra-processed foods. And so actually, a formal critique was written by scientists, Ty Beal and others was actually written and then submitted where they basically created this hierarchy of like some of the most ridiculous examples on this food compass. And it went completely ignored by Tufts, it went completely ignored. Well, one of the problems is that it dramatically underweights the value of protein. We know that protein is incredibly important. 

People tend to eat enough protein, as to avert deficiency. You don’t see a lot of protein deficiency in the United States, a lot of people will use that to say that we’re eating enough protein or we’re eating more than enough protein even. But that’s not the case. Our protein needs haven’t been updated in, I believe, over 20 years. And new research is showing us that the recommended daily intake for protein which is set at point eight grams per kilogram of body mass is not optimal. It’s a fine threshold to avert population deficiency. But it’s not optimal in terms of averting the crisis of skinny fat that we see now at the population level.

Protein was massively underweighted, the degree of processing of a food was massively underweighted, which is what led to all these low protein ultra-processed foods being really at the top of the list. And so it’s a huge problem. And then I guess, where the White House comes in is that the lead author, the principal investigator behind this paper has been invited to a summit at the White House on nutrition in September. A lot of people are concerned that this food compass is going to be implanted at the policy level, which I think is terrifying.

Cynthia Thurlow: Yeah, it absolutely is. And it’s interesting for anyone who’s interested in this information, we’re going to actually link it in the podcast notes, but it was 70 brand names, cereals were named in this food compass. And the project ranked 8000 foods and took three years to complete. And who knows how much time effort on the individuals that were reviewing the information. The irony is, I was going to talk about Nina, and you happen to actually address that National Academies of Sciences journal, which we will also link up looking at how biased the dietary guidelines are, and on a lot of levels, whether or not consumers are really aware of this, Nina’s points in that article were, as you appropriately stated.

They were talking about the contradictory information given about cholesterol, low fat, saturated fats, as well as the emission of major science literature in these outdated guidelines. So, a lot to unpack. But certainly, the influence of the processed food industry is a given. Unfortunately, we as consumers really have to do the work to be able to navigate the grocery store, making choices for ourselves when we go to a restaurant and we’re purchasing things for our home. But one thing that I find really interesting, that I’ve really watched over the last 10 years is the degree of dogmatism in nutrition. People like to be in a bucket, they’re keto, carnivore or plant based, whatever they are, and where do you think this degree of dogmatism is really stemming from? Is it because people want to identify with a bucket or with a label? What is really driving that?

Max Lugavere: Yeah. Well, I think it’s there are a few causal factors. One is that everybody eats, because everybody eats three times a day, everybody feels a sense of expertise, at least in their own diets. But when people find a diet that works for them, they tend to want to evangelize that diet. The other thing is that people typically want to have a moral framework to hang their hat on. Everybody wants to feel morally, like they’re better than the person standing next to them. When people adopt diets, like, I mean, the one that comes to mind is the vegan diet, because there tends to be this moral underpinning to people’s adoption of it. They feel morally superior to people. They tend to feel morally superior to people who are not on a vegan diet.

And then they throw that into the myth that they have this sense of taking the moral high ground, which is absolutely not necessarily the case. You could say you’re just as moral by wanting to feed your children the healthiest food for them, regardless of where it comes from. So, I think that there’s a lot of dogmatism in the nutrition space. There’s a lot of tribalism, whether it’s the vegan community or the carnivore community, or the paleo community, or the keto community, people tend to, as you alluded to make their diets their identities. It’s the one thing that people tend to put in their profile bios on social media. Why should your diet be so ingrained in your identity that you feel the need to point it out in your bio, it’s virtue signaling at the end of the day.

I think that’s a big problem, because then when people diets don’t work out for them, or things shift in their lives that make those diets less optimal, or less sustainable, then it creates cognitive dissonance, which can make it really uncomfortable to then pivot. And that’s just not how I think we should approach these kinds of things that are so important. I mean, nutrition is like– there was that Lancet paper published a couple of years ago that found that some crazy percentage of deaths these days– well, the World Health Organization says that 60% of deaths these days come from non-communicable diseases of civilization. These are the kinds of diseases that are contributed to by our diets and of course, also our lifestyles. So, you’ve got to be willing to make the pivot when your diet ceases to work for you. 

And so, yeah, the tribalism, I think, it’s multifaceted. It’s a big problem, it’s pervasive. But I think if you’re willing to just take a more scientific approach to your diet and tinker, and iterate and tweak, and always be willing to challenge your assumptions and your beliefs about food, then I think you’re more likely to find a path that works for you, not just in the short term, but in the long term.

I regularly challenge my own beliefs about various food items. Most recently, I’ve been integrating a lot more dairy into my diet. I know a lot of people in the wellness industry think dairy is inflammatory, dairy is not good for you. But when we actually check those claims, they don’t necessarily always stand on solid ground. And so that’s one of the areas that I looked into. When I first got started writing nutrition, there’s the dogma that dairy is just something that it’s not clean, it’s something worth avoiding. Everybody’s going to have their own reaction to dairy, so I’m not making the claim that everybody should go out and start, like loading up on it, but it’s something that I think works for me, and it’s one of the most nutrient dense foods and easily accessible foods that your average person is going to have within reach. And, yeah, I think it’s always important to just be willing to do that to just check your assumptions and your beliefs about various things and pivot when new and better information presents itself.

Cynthia Thurlow: Well, I love your transparency, because I think on a lot of levels, people feel so much stress about stepping outside whatever bucket they’ve put themselves in. And for full transparency, I had a nutrigenomics test done and met with the provider a little while ago. She was actually encouraging me. I’ve been dairy free for four years. She was saying, “I think you can actually tolerate some dairy. Maybe we should try to integrate some dairy into your lifestyle.” And I said, “I’m completely open minded.” Obviously, I’ll share my experiences as I know you do. But it’s important for all of us not to be so rigid, because I see so much of this, especially on Twitter.

There are people who are afraid to say, “I didn’t eat carnivore today,” or, “I decided to eat some vegetables,” or someone who is technically eating a ketogenic diet suddenly wants to have integrate more root vegetables or have a higher carbohydrate diet. And they almost feel like they have to hide what they’re doing. And yet, it allows us all to see that we are all ultimately, individuals, we’re all human, and we should be our own experimentation, we should do some degree of experimentation.

Now, when we talk a lot about the processed food industry, and I’ve given this a lot of thought, and I’ve actually asked several guests this, where do you think that we as an economy, as a society got so off the rails about our nutrition? I sometimes reflect on Ancel Keys work and how he bastardizes this Seven Countries Study. But where do you think that really stems from? Do you think that that was a starting point as the processed food industry was starting to rise, and they were suppressing information about what was actually driving a lot of the health problems they were seeing in the 1950s?

Max Lugavere: Yeah. It’s a good question. I think that money plays a big role in this. And I think, again, we believe that science is this good faith endeavor led by people who really have humanity’s best interests in mind at all times. Unfortunately, that’s a naive standpoint, that’s a naive perspective. It’s hard to communicate this without undermining confidence in science, which is not my intent. I love science, my work relies on science, I worship at the altar of science. And that’s why I’m so disappointed when you see things come out like this food compass paradigm. But at the end of the day, there are bad apples in science, which is an industry just like any other. A lot of people end up becoming medical doctors or scientists, because it’s just a career path. They’re not passionate about service, or making the world a better place.

They want to build reputations, and they’ll fiercely guard those reputations once they have them. So, a great example of this is, there was a 1972 New England Journal of Medicine paper that came out. I’m really putting the nail in the coffin on the issue of whether it was sugar or fat, that was a major contributor to the epidemic of heart disease that we were seeing in this country in the middle of the century. And this New England Journal paper came out off the heels of the Ancel Keys, Seven Countries Study and other work at that time, that really silenced people who were really imploring the scientific community to look at sugar, look at the role that all this influx of added sugar in the standard American diet was having on cardiovascular health and lipids and things like that. And it was the nail in the coffin. And it was published in the New England Journal of Medicine, which is like winning an Oscar if you’re a researcher to be published in that journal.

Well, what was revealed 30 years later, if not more, 30-40 years later, was that all of the scientists that contributed to that paper were paid the equivalent of $50,000 in today’s money by the Sugar Research Foundation. And that was not revealed in the paper, that was not disclosed, which in scientific research, you have to disclose where your funding comes from. So as to alert readers and the reviewers like, where your biases lie. So, it’s just across the board you see this time and time again. And it has to do with the fact that in science, you have these personality types that are fiercely territorial, obstinate, stubborn. It’s why there’s that saying, Max Planck said, he’s a physicist that “science advances at one funeral at a time.” It’s true. You’ve got these personalities that guard their insight. And we saw this most recently in the field of Alzheimer’s disease, which is a topic that I have been talking about quite a bit recently.

I hate to undermine confidence in science, but it really is that there’s bad apples. And, unfortunately, it can steer scientific inquiry in the wrong direction for decades. It’s one of the reasons why for so many years, we thought it was the fat that was responsible for heart disease. And it’s not that fat is completely innocent, there are certain fats that play a role. It’s never black or white, it’s not always going to be sugar, it’s not always going to be fat. But to take the blame fully off of the added sugar situation, and I think was majorly unethical. And it was because money really was at the cause. So, it’s a big problem

Cynthia Thurlow: It’s interesting, because when I was first practicing as an NP in the early 2000s, the information I gave my patients which is woefully incorrect, and I will continue to apologize for that. But it was the best information we had at that time. I would talk about nonfat, low fat, the seed oil spreads were far superior to any of these truly healthy based fats, and we let a whole generation arrive. They were woefully under eating protein, they’re eat way too many hearts healthy grains, they were consuming copious amounts of seed oils. And seed oils is probably the one food substance that for me, I feel like if people do nothing else, irrespective of what nutritional dogma you embrace or lean towards, eliminating seed oils is one of the most important things people can remove from their diet. The sad thing is, is that soybean oil is now the number one consumed fat in the United States, not butter, not avocado, as much as we would love for it to be that case, not nuts, but actually soybean oil because it proliferates in the processed food industry. And as we all know, the more processed foods we’re consuming, the more likely we are to be exposed to these inferior seed oils.

Max Lugavere: Yeah. For every 10% increment in ultra-processed foods, a person consumes their risk of early mortality increases 14% their risk of developing dementia. This is a paper that just came out increases 25%. It’s the ultra-processed foods. And actually one of the nutrient profiling systems that I think is actually worth consideration, but of course, it would never be adopted because the food industry simply wouldn’t let it is the NOVA nutrient profiling system which was actually devised in Latin America and Brazil, I believe. And basically, what the nervous system is actually how we classify ultra-processed foods. So, group one, are the foods that are– it’s either well, I’m actually forgetting the hierarchy. But basically, what it says is that the foods that you want to eliminate are the foods that have myriad– extremely long ingredients lists, and are ultra-processed. So, all the foods that line the aisles of our supermarkets would qualify as the ones that you want to minimize, but the food industry, we just never let that happen. And then the foods that you want to actually consume more of are the minimally processed foods. Regardless of whether or not it comes from animal products, or plants or fruit, what have you. If it’s minimally processed, then it’s a food that you could basically you can’t go wrong eating. We’ve adapted to whole foods. It’s the ultra-processed foods that are essentially alien to our bodies, and are what caused all of these different problems. 

A lot of it has to do with the, whether it’s the added sugar, or the fact that the refined grain products, whether it’s straight glucose, or the refined grains hits have rapidly digested glucose at the top of the small intestine, which is just a lot for our livers to have to contend with. I think when you remove nutrients from the food matrix, our bodies respond to them differently. And this is, I think, especially true for energy, whether it’s carbohydrates or fat, I think it can create problems. The less processed your food is, I think, the better and that’s where that like NOVA scoring system comes from. But, of course, it’s not good enough here in the United States, and the food industry wouldn’t let it fly. So, then we have to like develop newer, more convoluted profiling systems like the Tufts one, but it’s a big problem. Money is like everything. 

Most recently, Alzheimer’s disease and how fraud in the field of Alzheimer’s disease derailed research for almost two decades. That’s something that I think is like really worth talking about, because Alzheimer’s disease is this condition, as I mentioned, that affects six million people in the US alone. And the tools to treat it are minimally effective. There is no disease modifying treatment. And what we do have available to us are mere biochemical band aids, if that. And again, we see the influence of money and reputation and how it can really steer good science in the wrong direction, ultimately, to the detriment of scientific inquiry, and coming up with real viable solutions for patients. That’s a big problem.

Cynthia Thurlow: No, it’s an enormous problem, and one that will continue to be problematic. It’s interesting, because I am personally affected by this right now. I have a family member that was initially diagnosed with vascular dementia, she has pretty significant vascular disease. She’s in her very late 80s, really wonderful person, but she has now regressed so much cognitively, that they believe that what she actually has is Alzheimer’s. And every medication because I’m always involved in her consults with her neurologist. She’s now in an Alzheimer’s unit. And the one thing that I have consistently heard from her healthcare providers is we need to be intervening 20 to 30 years before patients start becoming symptomatic. And so we’re really talking about whether you’re male or female, we’re really talking about your 40s, really kind of checking in with people way before they’re ever going to be developing symptoms. And I think on a lot of levels, even as a licensed healthcare provider, we do a great job in the United States with emergent urgent issues, we do a really crummy job with prevention and chronic disease management. And we really do need to be intervening way, way before people start developing some cognitive deficits, or you start noticing something is not– someone’s acting beyond like their normal behavioral aptitude or something has changed. 

I also have another family member that recently lost her wallet and didn’t realize it for three days. And so, this was a big sign for family members to step in and see what else might be going on. So, if people are listening, and you’re curious, what are some of the things– we alluded to some of the things that were modifiable versus nonmodifiable in the beginning? But what are some of the best things we can do for brain health? We’re really leaning into the Genius Foods. I love your first book that you wrote and enjoyed reading it a second time in preparation for this conversation, but what are some of your favorite genius foods, the foods that people should be integrating into their diets without exception?

Max Lugavere: As I mentioned, I think the best foods are the ones that are minimally processed. And what I’ve done with Genius Foods was to identify categories of foods that I think are going to give you the most bang for your buck in terms of the highest quality macronutrients, whether we’re talking about carbohydrates or dietary fiber or protein, which we know is important or micronutrients. So, I mean, for me grass finished beef, I think is really important. And I will admit that beef is a controversial recommendation to make, particularly with regard to brain health because there’s very little evidence with regard to the role that red meat has on direct evidence with regard to the role that red meat has on brain health, and specifically what I’m referring to a randomized control trials, but we see that people, for example, who consume more choline have a risk reduction for the development of Alzheimer’s disease by about 30%. And choline, by and large is found in animal products, it could almost be considered a surrogate marker for animal product consumption because you also find it in plant products, but it’s in much lower concentration.

Red meat, when you actually break it down and look at what’s in it, great source of highly bioavailable protein, carnitine nutrients like creatine which supports brain energy metabolism. We know specifically in the setting of Alzheimer’s disease brain energy metabolism is diminished by about 50% of the brain’s ability to generate energy from glucose. It’s typical substrate when in the fed state is reduced by about 50%. And so creatine is this nutrient which helps support brain energy metabolism. And we see creatine is diminished in the brain with age and also among carriers of the APOE4 allele. So, I think it’s a really important nutrient, with regard to brain health. Also, vitamin E, we know that vitamin E is one of the primary roles of vitamin E is to protect fats from oxidation. Medically, it’s the term is lipid peroxidation, which is a major inciting factor in Alzheimer’s disease, you see, basically lipids becoming oxidized at the level of the cell membrane. And vitamin E, one of its most important roles is to help prevent that. 

In fact, the more polyunsaturated fats you ingest, the higher your need for vitamin E. And we live in a time where 90% of Americans consume inadequate levels of vitamin E. So, we’re consuming more polyunsaturated fats than ever before in human history because of their prevalence in grain and seed oils. But we’re under consuming vitamin E. And I think that’s leading to big problems. We don’t have the long-term longitudinal data to show that grain and seed oils directly contribute to the epidemic of Alzheimer’s disease. But for me, that’s a hypothesis that I think is definitely worth exploring and reason enough for me to avoid them in my own personal diet. I’m also by that token, a big fan of avocados which contain the highest concentration of fat protecting antioxidants of any fruit or vegetable.

An avocado is literally like a bomb in terms of its ability to deliver fat protecting nourishment to the brain, which we know is a crucible for oxidative stress., because of the prevalence of these kinds of fats, polyunsaturated fats in the brain, in a container that makes up 2% of the body’s mass, and yet metabolizes 25% of the body’s oxygen. So, avocados are great, dark leafy greens are great, you can’t really talk about brain health without mentioning the role of fatty fish. Fatty fish, I think is crucially important, because of the concentration of omega-3 fatty acids that they contain, particularly to ducosahexanoic acid or DHA fat and eicosapentaenoic acid or EPA fat.

We see that people that have the highest levels of DHA in their blood cells have a 49% risk reduction for the development of Alzheimer’s disease, specifically, to the degree that having higher levels of DHA in the blood, which is thought to correlate with brain levels was the equivalent of about five years of out of additional Alzheimer’s free life, at the end of life. So wild fatty fish, I think is a great food to integrate on a regular basis. And then berries are wonderful. I’m a huge fan of whole fruit. I mean, honestly, I think that like any fruit that you’re eating is great. But berries tend to have a lot of research on them, primarily because they’re funded by dairy producers that research which is kind of how nutrition research works, you’ve got to take the good with the bad.

And it’s also for that reason that we know that cacao is really beneficial from the standpoint of the brain. So dark chocolate is another brain food that I try to regularly consume. So that’s just sort of like broad strokes. I try to eat as minimally processed a diet as I can. Although perfection is not the goal here, you can’t let perfect be the enemy of the good. So, I definitely indulge now and then, which I think is an important part of being human. But the more you can base your diet around these minimally processed whole foods, I like to say 50% whole plants, 50% animal products, like good high quality animal protein. That’s generally a pretty good, I think, parameter for building like a strong dietary template for good brain health.

Cynthia Thurlow: It’s so important, and I’m curious, how do you handle traveling? Are you someone that will fast while you travel? Do you make sure that you have options available to you while you’re traveling, in case you get stuck in an airport? I know you’re on the West Coast. I always say that I always have salted macadamia nuts and beef jerky if I need it, but what are your like go-to travel things that you’ll bring with you?

Max Lugavere: When I travel, whether it’s via air or even if I’m just sitting in my car in traffic like on a commute to somewhere, I think it’s always good to have snacks around. I like a good low sugar, beef jerky, or there’s now even products on the market that are like just beef or chicken even and salt. So, it’s like not even really jerky, but they’re like crisps made of either beef or chicken or even pork or lamb I’ve seen with just added salt and their shelf stable, you can just eat them out of the bag, and they’re super tasty, great source of protein. I’m a big fan of that. I think nuts are great. The issue with nuts, I mean, nuts are very healthy, but I like to integrate them into recipes as opposed to just eating them out of container because to me, they’re very prone to being over consumed. And we don’t have to shell nuts anymore like our ancestors did. You can just buy a whole bag of nuts. And if you actually like, look at the back and look at the calorie count, sometimes in a container of nuts, you get like 2000 calories, which are very easy to eat in one sitting, especially if you’re sitting bored on an airplane. So, I tend not to buy nuts super frequently, just because of the caloric density of them. I like to rather keep them in the house and then use them in recipes, like salads and use them to crust like fish and stuff like that because they’re so fatty, they make a wonderful coating for lean proteins like chicken or lean fish and things like that.

I’ve been known to travel with canned fish, like canned sardines, things like that. Sometimes I’ll throw an avocado in my bag, sprinkle at any airport or wherever you happen to be, it’s always pretty easy to buy a salt or to get a salt packet and then like a spoon. So, you just sprinkle little bit salt on avocado, eat it with a spoon. I also love, as I mentioned whole fruit. So, generally when I travel, you’ll always find Honeycrisp apples in my backpack. I love to travel with them. So, it’s a nice like midday treat. It’s one of my favorite fruits. What else is there? Oh, I love to travel with protein shakes. I’m a big fan of whey protein. I think it’s super– yes, it’s a processed food, but it’s essentially, it’s processed in the way that like extra virgin olive oil is processed. To make extra virgin olive oil, you crush olives to get whey protein, it’s a byproduct of cheese making. And it’s among the highest biological value protein that exists. Tons of great research on it, that it can help lower insulin resistance, which can help support metabolic health.

It can even support immune function by increasing glutathione because it’s a rich source of cysteine and which are, it’s like a sulfur containing amino acid. So, I will go to like my local Whole Foods actually and I buy these like single serve packets of whey protein. And I buy them before any trip, like one baggie for each day of travel. And I always have them on the road with me, so I can do like a protein shake or two when I’m on the road. My goal is to keep my protein up when I’m traveling because typically, when I travel for work, I tend to be moving around a lot more. So, I’m getting a lot more meat, which is non-exercise physical activity, non-exercise activity thermogenesis, typically when I’m on the road. And what I really aspired to do is to hold on to the muscle that I’ve worked really hard in the gym to build. Protein is a really great way to do that to keep my protein levels up. Also, proteins very satiating, it’s the most satiating macronutrient. So, it makes me less prone to craving junk food, and the like. So, yeah, I think that’s a fairly comprehensive look at how I travel.

Cynthia Thurlow: It was a frequent question that came up when I mentioned to listeners that we were going to be connecting. They wanted to know what do you travel with. And I said, “I will absolutely ask that question, because I’m curious myself.” So, let’s talk a little bit about the interrelationship between brain health and sleep. I think there are many of us, and I’m certainly one of these people. I was like, “Oh, I’ll sleep when I’m dead. Sleep’s not really important.” As I’ve gotten older, I’ve started to realize how critically important sleep is. But let’s talk a little bit about the glymphatic system and key hormones that are properly regulated when we’re getting sufficient high-quality sleep and how that impacts our cognitive function.

Max Lugavere: I mean, sleep is so important, just subjectively when I’m under slept, I feel horrible the next day. What we’ve now seen over the past decade is that sleep really, when it comes to the brain, it’s a non-negotiable, we essentially cleanse our brains while we sleep, thanks to the activity of this newly discovered glymphatic system, which is named after the lymphatic system because it kind of resembles the system of ducts that we have throughout our body, but it’s in the brain. And the reason why it is only been identified recently is that it’s essentially non-existent when we’re awake. And then when we sleep, these ducts swell to make way for cerebrospinal fluid, which swooshes throughout our brains, cleansing our brains of the amyloid protein, which is really serves as the backbone for amyloid beta, which is the plaque that’s associated with Alzheimer’s disease.

Amyloid beta as a causal player in Alzheimer’s disease has not been clearly established, and especially with the revelation that a lot of these early amyloid papers were fraudulent, that’s now even more the case that this sort of the role that amyloid plays in the etiology of Alzheimer’s disease is now has sort of come under fire. But because it’s associated with aging and associated with inflammatory processes in the brain, the less we have around I think the better. And so, when we sleep we know that this compact system is really working diligently to get these proteins out, these toxic byproduct proteins out of our brains, to the degree that just one night of poor sleep, you see in cerebrospinal fluid a 50% increased concentration of amyloid in CSF, which is thought to, again, correlate very tightly with brain levels.

We also know that sleep plays a role in metabolic health, to the degree that on one night of shortened sleep, you’re essentially pre-diabetic the next day, I think insulin sensitivity declines by about 25%. This is temporary, but important, nonetheless also can lead to worse dietary choices, it tends to cause our emotions to be somewhat dysregulated the following day on short sleep, because of overactivity, the amygdala, which is the fear processing center of the brain, under activity in the prefrontal cortex, so that can lead to worse sort of dietary choices. So, the sleep is like the rising tide that lifts all the boats in your harbor, it’s crucially important. And when it comes to sleep, there’s like two variables that I think people need to be aware of, sleep duration is definitely important.

An adult should aim to get between seven and nine hours of sleep per night, but there’s also sleep quality. Sleep quality, it’s not just the amount of hours that you spend in your bed, you want to make sure that those hours are spent getting high quality sleep. And so, it’s not just blocking out the appropriate window to be in bed, but you want to make sure that you’re sleeping optimally. And so, making sure that your bedroom is cool and dark, that you’re not exposing your eyes to excessive light in the evening hours. We used to think that it was exclusively blue light that could disturb sleep, but now we see that it’s just bright light in general.

When I’m winding down for the evening, I try to make sure that the only bulbs in my house that are on are very dim. And I have actually went to a light bulb store and I bought red bulbs. So, I’m not overexposed my eyes to light. I also tend to wear like blue light blocking. They’re blue light blocking glasses, but they also dim all of the light that’s coming in, like all of the different wavelengths of light. So yeah, that definitely can help with sleep quality. And then if you’re looking to go even to the next level, you can dabble with things like mouth taping. I’m a big fan of using like the nose expanding strips to when I sleep, I think that those can be a very useful way of improving sleep quality. But, yeah, those are the two variables that I think that people really ought to examine, with regard to sleep, very important.

Cynthia Thurlow: Oh, I totally agree. And I’m humored because I think most of us in the health wellness space have Oura rings. When I get up in the morning, one of the first things I want to know is exactly how much deep sleep did I receive, and how much REM sleep did I actually get. And I’m constantly tinkering, like, I’ve become the sleep biohacker because I’m always trying to improve my deep sleep, which, in my stage of life, I found that if I do things like PMF, and if I take a certain type of magnesium, and if I do a couple certain things right before I go to bed, my deep sleep is profoundly much better than if I just hop into bed and do my usual blue light blockers and a sleep mask. And I think we take for granted that sleep is effortless, until it starts becoming a little more challenging, at least for me it was in my 40s, definitely became a whole lot more challenging. I had to think a whole lot more thoughtfully about it, what did I need to do to get my body ready to go to sleep.

Max Lugavere: Yeah. You want to do things over the course of the day that cause an accumulation of what’s called “sleep pressure.” And so, if you’re sedentary all day, if you’ve spent the whole day sitting at your desk working, I understand you’ve got to get the bills paid, but what that does is it disallows sleep pressure to build, which at the end of the day, literally, your brain is going to have, your body’s going to have less of a necessity to get to sleep in a prompt manner. So, you might have lengthened what’s called “sleep latency,” it might take you an hour, or even a half an hour to get to sleep. Whereas for somebody who’s accumulated adequate sleep pressure over the course of the day, they hit the hay and it’s like 15 minutes, and they’re in Lalaland. So, you want to make sure that you’re exercising. 

A study was published a couple weeks ago, that actually compared the effects of aerobic exercise on sleep pressure to resistance training. What they found was that resistance training was actually more effective at building sleep pressure. So, it led to, I believe, deeper quality, better quality sleep, but also lower sleep latency, which is the time to actually– that it takes to actually get to sleep once your head hits the pillow. Resistance training, I think is crucially important. It’s important for many different reasons. And not least of which we’re now seeing, improving sleep quality. Light exposure, as precarious as it can be in the latter half of the day, particularly in the hour or two before bed, it’s just as important, but from another standpoint earlier on in the day in the sense that it helps to anchor your body’s circadian rhythm. And so, it helps you feel more alert during the day and awake and rejuvenated, it helps activate the prefrontal cortex, which is the portion of your brain responsible for helping get things done, that makes sense. But it also sets off that timer that determines when you’re going to get tired at the latter half of the day. 

So, getting bright light in through your eyes, crucially important, that’s what all the sleep experts are saying these days. I mean, it’s like the research is now at a robust enough level where we can actually make recommendations based on it. And so, yeah, making sure that soon after you wake up, you’re allowing the ambient light of day to enter your eyes without sunglasses on or without a tinted window in the way. Crucially, crucially important.

Cynthia Thurlow: I love that you brought that up, because that is part of my non-negotiables for my morning routine is getting outside, getting light exposure, walking our dogs, and catching up with my husband. Well, Max, I could talk to you for hours. But I would love for you to share with listeners how to connect with you, tell them a little bit about your new book, which I’ve been thoroughly enjoying your recipes. Let everyone know how to connect with you, your amazing podcast, etc.

Max Lugavere: Thanks so much. Yeah, so my latest book, Genius Kitchen just came out, which is a 50% wellness guide, 50% cookbook. So, you’re getting essentially two books in one. It’s got beautiful photography, and I’m super proud of the recipes. So that’s available wherever you get your books. And then I’m very active on Instagram @maxlugavere. And then my podcast is called The Genius Life. I had the honor of having Cynthia on it. And that was a great conversation all about fasting, among other things, but yeah, Instagram and the podcasts are the two primary ways to stay in touch.

Cynthia Thurlow: Awesome. Thank you again.

Max Lugavere: Thank you.

Cynthia Thurlow: If you love this podcast episode, please leave a rating and review, subscribe and tell a friend.