Does your gut need a reset?

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Do you want to start feeling better?

Yes, Where Do I Start?

The Gut-Brain Connection with Dr. David Perlmutter

The health of your gut has a massive impact on the health of your brain. Today we speak with doctor and author David Perlmutter to elaborate on this connection and expand upon strategies for optimizing your brain health.

In This Episode

Episode Intro … 00:00:42
Prevention of Alzheimer’s … 00:06:07
Homocysteine Levels … 00:17:18
Gut/Brain Impact … 00:19:42
Low-Carb and IBS … 00:24:43
Social Interaction and Stress … 00:28:27
Stem Cell Therapy … 00:35:48
Episode Wrap Up … 00:39:55

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Episode Intro

Dr. Michael Ruscio: Hey, everyone. Welcome to Dr. Ruscio Radio. Today, I am here with Dr. David Perlmutter, who’s a pretty well-known author, amongst other pretty impressive things on his list of credentials. And we’re going to be talking about the gut-brain connection. So, David, welcome to the show.

Dr. David Perlmutter: Well, Michael, I’m delighted to be with you today.

DrMR: Tell people a little bit about your background. I’m sure people have probably heard your name before, but can you give us a brief synopsis for anyone who hasn’t?

DrDP: I’d be delighted to. I am a neurologist. I’m also a fellow of the American College of Nutrition. So right off the bat, I’m disruptive, as it were. I feel that our lifestyle choices play a huge role in terms of brain health.

And I’ve really focused my efforts in the past 25 years or so to the notion of really getting out the best information I can to people who want to make changes in their lives in order to prevent the very diseases that we fear the most.

And as it relates to things in my field, like autism, Alzheimer’s, ADHD, depression, you name it, I think that we’ve got a long way to go to really raising the bar in terms of public understanding that things that we choose to do in our lives—the food that we choose to eat, for example—these choices play huge roles in determining whether our brain will be healthy and functioning well. Or we’ll succumb to a potentially lethal issue.

DrMR: Brain disorders are scary. I think definitely as people get past acute symptoms and worrying about, “Boy, I have reflux. I have bloating. I have constipation” —once they get past those immediate symptoms and they’re really thinking about prevention and things that are scary to think about as they age, I think some of the neuro and cognitive-decline-centered diseases like Alzheimer’s are definitely scary. So I think this is a good conversation for us to be having.

DrDP: Well, I agree with you. I think it’s the right conversation to have. But even those thing that you just mentioned, those bowel-related issues, have an immediate and direct contact to things going on that are brain-centric.

DrMR: Right.

DrDP: So we’ve got to move past this notion that the bowel is one thing and the brain is another. They are intimately related.

DrMR: Yep. I am in complete agreement with you. Absolutely. Now, we before we get into some of the particulars, I thought it might be interesting for people to hear a little bit about the other side of you, still within academics and medicine.

But I know that you’ve published some research. And I know that you’re working in clinical capacity now. So can you tell people a little bit about more than just you, the author, but the other part of you, the scientist and the clinician?

DrDP: Hard to say where I go with that. A lot of my work really does center around publication, around public outreach. I’ve written a number of books, do a lot of public television specials. I am grateful for this opportunity today to speak with you.

So really a lot of what I do is take the most well respected, peer reviewed literature and really leverage that to create programs that not only I but other clinicians are able to implement in terms of treating people day to day to really finally bring an end to the notion that we should live our lives come what may and then hope for the best as it comes to a pharmaceutical cure for not just neurological problems, but things like cancer, diabetes, coronary artery disease, you name it.

These are issues that are related fundamentally to the same mechanism, which is inflammation, which generally has its genesis in things that are gut-related.

So I take the meaning of the word “doctor” very seriously. And the meaning is actually teacher, not healer. So anyone who is out there getting information out to the public, making it available—good information that is well respected, coming from good research—I think is fulfilling what that term means, regardless of what his or her degree may be in.

We see wonderful literature out there by whomever. As long as it’s based upon science, I’m all in. And interestingly, so much of the really good information comes from people involved in research who may not be an M.D., may not be a Ph.D., even some are what we call citizen scientists who are out there getting information.

So my job, like yours, is to look at all of these things that are becoming available over time and really sift through them, vet them, and make sure that we apply a strong metric of what is scientifically meaningful, and then do our best to get that information out to the public so that people can at least make informed decisions well beyond what they may be told to do by watching the advertisements on the evening news.

DrMR: Well said. Now, we’ve talked a lot on this podcast about the gut, and I know the audience has come to really expect and appreciate a good conversation about the gut. And I know we’re definitely going there.

Prevention of Alzheimer’s

There were a couple things I wanted to lead into our conversation with that were more brain-based and then segue our way into the conversation on the gut.

And one of the aspects was regarding Alzheimer’s. I know you’ve been a little bit critical about the effort for finding a “cure” for Alzheimer’s. So can you elaborate a little bit on that?

DrDP: Absolutely. I have never been critical about efforts to cure Alzheimer’s. Believe me! I think that if there were a cure for Alzheimer’s we’d be singing its praises from the highest mountaintop. I would have used it with my father who died of Alzheimer’s disease for that matter.

So I think I am all in as it relates to finding a cure for this horrendous disease that affects over 5.5 million Americans as we have this conversation, a disease for which we currently have no treatment—certainly no cure, and no meaningful treatment. So I’m all in as it relates to research trying to find a cure for the problem.

But what pulls at my heart strings is the fact that we know right now today that significantly, Alzheimer’s is a preventable disease. And that’s something we should be paying attention to well before we have conversations related to finding a cure for something.

If we can prevent a disease, there’s no need for a cure. And when we see research being published by Dr. Kirk Erickson at UCLA showing that just regular aerobic exercise is associated with a 50% reduction in the risk of Alzheimer’s, that’s important information that the public certainly needs to be aware of in light of the fact that there is no meaningful treatment.

When Dr. Melissa Schilling at NYU publishes a study in the Journal of Alzheimer’s Disease indicating, again, a 50% reduction in risk of Alzheimer’s in people who don’t develop type 2 diabetes, that’s really important information.

It’s why I interviewed her and put her interview on YouTube, because people need to know this. Here’s a situation for which there’s no treatment but yet may very well be preventable.

But unfortunately, how our society is set up economically, for instance, is one that doesn’t work to reward the prevention of something, only the heroic treatment of something in a way that is highly monetizable.

DrMR: Yeah, I agree with you. And that is a sad state of affairs. And I wish that people lived more so by the—what’s the old adage there? “An ounce of prevention is worth a pound of cure.” And in this case, I think that holds true.

DrDP: That’s right. And it’s far more than a pound of cure. It’s a ton of cure.

DrMR: Right!

DrDP: A ton is being expended in trying to find a cure for this disease and is absolutely barking up the wrong tree, even as it relates to curing it. We now know that efforts, for example, by researchers like Dr. Dale Bredesen ad UCLA demonstrate that there’s not a single magic bullet for the reversal of Alzheimer’s.

And yet, it has been reversed now by using a multitude of different parameters being leveraged at the same time—optimizing vitamin D level, reducing dietary carbohydrates and sugar, going gluten-free, regaining exercise, reducing stress, social interaction, the use of various herbs, optimizing hormone levels, as an example of a few of his 36 points.

So this is yet another way of flying in the face of the paradigm that is accepted that we should have a magic treatment for which any physician can write a prescription. It doesn’t exist.

And yet leading-edge researchers like Dr. Bredesen are really challenging the orthodoxy and indicating that there are other ways to look upon the problem and ways that are demonstrating effectiveness in getting us through these challenging times.

DrMR: So you mentioned a number of things, diabetes and exercise being two, and so certainly keeping a healthy metabolism. So there are components of this—exercising, preventing type 2 diabetes, of which exercise and a healthy diet (namely one that is probably a little bit lower in carbs) are pretty important, vitamin D.

You also mentioned herbs. Are there any herbs that you have found or the research shows to be particularly helpful in the prevention?

DrDP: It’s difficult to say that specifically turmeric, for example, has been demonstrated to be effective in the prevention of Alzheimer’s disease.

But taking a step back, we do know that turmeric is a powerful anti-inflammatory, that it changes gene expression to reduce inflammation, increase anti-oxidant production, and also aid fairly dramatically in detoxification.

More so, turmeric augments the brain’s production of a growth hormone, if you will, called BDNF that actually leads to the increased growth of new brain cells in the area where we need the most, in the areas that deal with memory, with a study being published in the Journal of the American Medical Association showing that those individuals with the lowest level of BDNF have the highest risk for developing Alzheimer’s.

So that’s a bit of what we call inferential data. We do know that in countries where they eat a lot of turmeric, especially curried foods, their incidence of Alzheimer’s is dramatically less. Is it because of other lifestyle factors? Who knows? So that’s yet more data.

And finally, the laboratory interventional trials using turmeric on the genetic modified rodent that will get Alzheimer’s and develop a lot of what we call plaque in its brain, turmeric is clearly and profoundly effective in keeping that from happening.

That’s not a test that says we’re going to give turmeric to Alzheimer’s patients and treat them and see who gets better and who doesn’t.

But you know what? There is so much of the other type of data that’s available that I feel very comfortable standing on two feet and telling people, “Look. You want to reduce your risk? Take turmeric.”

Do I have a particular study that’s double blinded that can show us that? No. Would I ever allow patients to participate in that type of study? Never, because I think these are studies that are going to take years and years to complete. And I’m not going to deprive anybody of what I think is a very, very powerful approach to keeping your brain healthy.

DrMR: Sure. Sure. And what you’re saying reminds me of something I’ve said on the podcast before, which is we should be evidence based but not evidence limited.

DrDP: That’s right. I think there’s enough evidence to support the rationality of recommending something, for example like turmeric. But again, this notion of a double blind, placebo control study being the gold standard I think is so unfair to people, especially people who have a significant disease like Lou Gehrig’s disease.

Would I put patients some on a ketogenic diet and some not on a ketogenic diet? That’s not going to happen. I know darn well that the animal studies on the ketogenic diet and my understanding about how important it is for nerve cell preservation makes me say everybody needs to go on that kind of a diet, with ALS or so many other problems. And I’m not waiting around for somebody to finally do that study. I’m disruptive in that regard. And I am proud to say.

DrMR: Well, I think it’s totally understandable, especially when we think about turmeric is fairly inexpensive. We don’t need testing to justify its use. It’s got literally no side effects except for maybe a few very mild, mild gastrointestinal ones if people are sensitive to it for some reason.

So yeah, I’m in agreement. It’s certainly not something that’s hard to make a justification for.

DrDP: Well, that’s right. But there are studies that show, for example, that turmeric improves memory in patients who are pre-diabetic, for example. And those are the people who are very likely at much higher risk for developing Alzheimer’s disease.

So we do see some interventional trials already in groups that are, dare I say, destined to get Alzheimer’s or at least more likely. We know that becoming a type 2 diabetic, for example, is associated with a fourfold increase of developing this untreatable disease which we call Alzheimer’s.

And this is a study that dates back to October 2014, where a group of pre-diabetic individuals were actually given turmeric. And they followed these individuals in terms of their memory function on a number of different types of tests. And sure enough, those who were on the turmeric had better brain function.

DrMR: Sure, yeah. No, it’s exciting. It’s also making me think back to when Dr. Kara Fitzgerald came on the podcast, and she described turmeric as a methylation adaptogen, which I thought was really fascinating. Meaning, it won’t over or under methylate you, but it’ll help adapt or balance your methylation. So I wonder if there’s an aspect of that that’s also at play here.

DrDP: Well, I think there is. And really, for your listeners, what we’re talking about here is the fact that when we talk about methylation, we’re talking about really two important things that actually do relate to the brain.

First, we’re talking about a pathway that tends to reduce the production of a chemical that’s dangerous in the body called homocysteine that is associated with inflammation. It’s associated with vascular disease of the brain and perfectly correlates with risk of Alzheimer’s dating back to a study that appeared in the New England Journal of Medicine back in 2008.

And beyond that, we also know that methylation is a pathway that regulates the expression of genes. And so again, we’re getting to the understanding that the foods that we eat—in this case, an herb called turmeric—is, in fact, a way that we can regulate the expression of our life code, our DNA.

That’s a pretty heady kind of consideration. But we know that about 70% of the genes that code for health and longevity are actually under significant influence of our lifestyle choices, the most important of which are our food choices.

DrMR: Now, you mentioned homocysteine. And so this might be a nice bridge into some of the gut aspects of this conversation. I was recently reading a study that showed that a probiotic—I believe it was a Lactobacillus/Bifidobacterium mixture—was able to lower homocysteine.

Homocysteine Levels

So I’m curious as to what your thoughts are on, I guess, homocysteine. And then let’s use that as a bridge into the gut and some of the effects the imbalances in the gut may have on homocysteine. And then we can launch into the gut from there.

DrDP: Sure. Well, it looks as if every species of Bifidobacter that has been studied augments the production of folic acid. So we know that folic acid—like B6, B12, and trimethylglycine as the supplement, for example—these are what we call methyl donors.

And as such, they tend to reduce homocysteine, which may be elevated as a consequence of medications. It may be elevated as a consequence of a genetic predisposition for people who have what we call SNPs or variations in certain gene expression.

So we know that Bifidobacter across the board do increase the production of not just folic acid but other B vitamins. And as such, you would expect then that they would help reduce homocysteine. And in fact, that’s what’s been observed.

The relationship of homocysteine to atrophy or shrinkage of the brain is not new. That information was published in the journal Brain 13 years ago, back in 2003, demonstrating that those individuals with a higher homocysteine level had a more shrunken brain.

And specifically, the area of the brain that was looked at way back then is called the hippocampus, the brain’s memory center. And there are strong correlations between shrinkage of the hippocampus and memory decline and even Alzheimer’s disease. So these are studies talking about relationships that go way back.

And having said that, again, that’s why homocysteine is certainly one of the many parameters that we talk about in terms of maximizing a variety of different issues to keep the brain as healthy as we possibly can.

Gut/Brain Impact

DrMR: And as we talk about gut…Gosh, there are so many angles by which the gut can negatively affect one’s health or, if it’s healthy, contribute to one’s health.

Now, you mention the immune system. And I know on the podcast we’ve talked before about the small intestine and how important the small intestine is because it represents over 50% of the GI tract. And it has the highest density of immune cells in the entire body.

So the gut is definitely positioned to have a huge impact. In my opinion, the small intestine may be the most pivotal area of the gut. But tell us more about what you’re finding in regards to the gut and how that impacts the brain.

DrDP: Well, I’d be delighted to. In just the idea that you’re asking me “How does the gut impact the brain?”, I guess for most of your listeners, that’s a very reasonable question and certainly a place where you and I can go with comfort.

But by and large, even to this day, the notion that somehow things going on in the gut are going to affect the brain—that notion is pretty much rejected or at least not embraced by most physicians.

And certainly even the general public, I think, remains unaware of this profoundly intimate relationship between so many issues going on in the gut, whether it’s the chemicals made by the gut bacteria, the integrity of the gut lining, the helping manufacture of neurotransmitters, the role of what are called short chain fatty acids in regulating immunity and regulating inflammation. So it’s a very, very long list.

Those of your listeners who are keeping up with this realize that we no longer can segregate the brain on one hand and the gut on the other hand. They are intimately related as the gut relates to the heart, the immune system, the liver, the risk for cancer, diabetes, coronary artery disease, you name it.

And I think the biggest issue here is that we understand that the central mechanism that underlies, for example Alzheimer’s, Parkinson’s, autism, multiple sclerosis, is inflammation.

The beginnings of inflammation are found in the gut. The gut regulates what is called the set point of inflammation. Inflammation is a consequence of changes and loss of integrity of the lining of the gut.

When the gut lining is messed up, then chemicals get from inside the gut into the systemic circulation, amp up the immune cells, which start to secrete inflammatory chemicals, which make their way to the brain and are central to the production of the changes that we call Alzheimer’s, that are central to the changes that we call coronary artery disease, diabetes, and even cancer.

So it’s time that we really focus on the gut from my perspective as a brain specialist but from the perspective of any specialist dealing with the human body and health.

This mechanism of inflammation underlies all of our chronic degenerative conditions, which the World Health Organization indicates to us is the number one cause of death on the planet, not infectious disease, not trauma, not war. It’s this chronic falling apart of the human body that’s killing most humans on the planet.

The mechanism is that when the gut is permeable, again we amp up inflammation. So we need to do everything that we possibly can to maintain the integrity of the lining of the gut.

And most of all, it’s important to recognize that that is the job of our friendly gut bacteria. They spend their days and their nights making sure that that gut lining is completely intact or as best as it can be.

And they are highly influenced by our food choices. When we choose foods that are inappropriate, that don’t nurture our gut bacteria, we run the risk of increasing the leakiness of the gut, the permeability, amping up inflammation. Again, that’s the central mechanism for virtually every chronic disease that you don’t want to get.

Beyond our food choices, things like antibiotics, other medications, proton pump inhibitors, non-steroidal anti-inflammatories, chronic stress, lack of exercise, sleep issues have all now been demonstrated to be associated with negative changes in the gut bacteria that translates into increased gut leakiness, paving the way for inflammation, which is about the last thing you want to do.

Low-Carb and IBS

DrMR: Well said. Now, I want to throw you maybe a little bit of a curveball or a more detailed question, but I know that there are going to be many people listening who are wondering this.

Lower carb certainly seems to be very helpful for people with high blood sugar, metabolic syndrome, and has shown for various reasons to be protective to the brain.

Now, this can sometimes be problematic because lower carb diets can sometimes be lower in fiber. Or if someone has IBS or IBD, they may be fiber or prebiotic sensitive, and so they may not be able to eat lots of the fruits and vegetables, especially if they’re higher in FODMAPs.

So sometimes, people feel a little bit conflicted where they want to feed their gut bacteria, but they don’t respond well when they do feed their gut bacteria. Have you come across anything that helps with that quagmire?

DrDP: Yeah. When you say quagmire, I’m thinking of Family Guy. But that said—

DrMR: Love Family Guy, yes.

DrDP: I love Stewie. But the truth is that what you say is very true. You hear the standard recommendation for those who are suffering from autoimmune conditions as well as the inflammation bowel conditions.

We really want to rebuild gut integrity to stabilize immune function, which is operative in both of these instances because these inflammatory bowel diseases are, in fact, autoimmune conditions.

But we can add to this list Hashimoto’s thyroiditis—any number of autoimmune conditions. And truly, some of these individuals do not respond positively in terms of tolerating some of the fiber-rich foods.

And so that said, I think that their issue is that we still need to limit sugar and simple carbohydrates from their diets. We still need to ensure that they’re getting adequate amounts of healthful fat. And we’ll talk about that in a little bit.

We need to nurture their gut bacteria. So there are ways of giving them the types of prebiotic fiber that they will, in fact, tolerate and tolerate really well.

And I think the best choices are prebiotic fibers that are made from the acacia gum, the gum of the acacia tree, which is that tall canopy tree that we see in Africa where the giraffe seeks shade during the noontime hours.

This tree secretes a gum that is a highly complex collection of fructose molecules bound to each other. And so it dramatically nurtures gut bacteria. It’s wonderfully tolerated as opposed to the other supplement forms like fructooligosaccharides, for example inulin.

Another great source that’s often found in products containing them both would be the baobab fruit. So you can go to a health food store and buy baobab fruit and acacia gum as a powder organically produced, non-GMO, harvested sustainably—checking off all the boxes. And that’s a terrific way to nurture your gut bacteria in conjunction with fermented food as well as a really comprehensive probiotic supplement.

But truthfully, that is not an uncommon question. It’s not an uncommon question in dealing with individuals and certainly at conferences as well.

DrMR: Sure. Okay. Well, that was a great answer and a few good resources for people there to look into.

Social Interaction and Stress

Now, I know you’ve also talked about stress and social interactions. So why don’t we jump into that. And tell us a little bit about what some of the important factors regarding stress, social interactions are and how those can be helpful for people’s brain health.

DrDP: Sure. So generally, I think that there’s pretty good unanimity in terms of stress is bad. And right off the bat, I’ll take a step back and say that we always have to be careful how we characterize things in the body as being bad and good.

Some of the players on the bad list include inflammation and cholesterol and free radicals, for example. Most people would say, “Those are on the bad list for sure.”

Well, in reality, cholesterol is fundamentally important for immune function, brain health, cellular function. It’s a brain oxidant. And it’s very important for building brain cells. Inflammation is a wonderful process by which the body is able to protect itself against injury or invasion of organism.

And these ideas, I think, are contextual. What is the context that we look at free radicals, for example? We don’t want to quench every free radical that’s made in our bodies. Of course not!

Free radicals are produced by our white blood cells to help our bodies rid themselves of bacteria. Free radicals are produced when cancer cells are present to help kill those cancer cells and induce what’s called apoptosis.

So again, it’s important to contextualize what is good and bad. And when we talk about stress, similarly. A low level of stress in a short period of time is actually a positive event in terms of the brain.

A low level of stress with a low level of cortisol being secreted from the adrenal glands is actually what we call trophic. It actually enhances the functionality of hippocampal, or memory center, brain cells allowing that individual, perhaps, to remember that stressful event so she or he might not walk down that road the next time or learned a little something about an event that lead to that stress.

That said, low level stress over a long period of time or a high level of stress even in a short period of time changes that dynamic to one in which the cortisol production becomes toxic to the hippocampus, damages the brain cells in our memory center, and leads to not only direct effects upon the hippocampus but also changes the diversity and the array of living organisms in the gut, the microbiome, and also directly makes the lining of the gut more leaky, more permeable.

And that sets the stage for increased inflammation, the production of chemicals called cytokines that are damaging to the brain and, obviously, other parts of the body.

So I think that low levels of anything stressful, whether it’s sleep deprivation, stress, or caloric restriction are what we call hormetic events. They’re a low level of stress that actually proves to be somewhat positive in terms of gene expression, for example.

So I think it’s always important to look at these things in their context, in terms of their severity and their time course.

DrMR: It reminds me of something that Chris Kerouac said to me. And Chris Kerouac was on the podcast a number of months ago. He was a mentor to me. When I was young college student thinking about going into medicine, I shadowed him in his clinic before I knew anything.

And I was on this really fervent, 22-year-old, high-energy-induced craze about how stress is bad for you. And he looked at me. And he said, “You know, Michael? Stress is to life as tension is to the strings on a violin. You need to have the appropriate amount of tension on the strings for the instrument to play. Too much and they’ll snap. And not enough, and it won’t be in tune. And the same thing for stress.”

So that just reminds me of that quote when you were going through the appropriate level of stress.

DrDP: Exactly. It’s what we call a U-shaped curve—

DrMR: Yeah.

DrDP: Where at low, low levels, it might not be a good thing. Medium levels, probably a good thing. And high levels, obviously a bad thing.

But again, I just think for the podcast listeners, we really have to get away from the notion of characterizing things as bad or good. There was a time in our history long, long ago when—I know you won’t remember this. And I guess your listeners probably won’t remember. But there was a time long ago when we were told that dietary fat was a bad thing.

And that was ancient history. But there are still some pockets around the world where people still believe that notion.

DrMR: Right.

DrDP: Again, getting back to being a dichotomy of bad versus good. So again, it’s the context—the context of what type of fat are we talking about?

Some people say red meat is bad. Dr. Collin Campbell and the China study will say red meat is bad based upon, for example, studies that look at populations who eat red meat versus those who don’t. Those who eat red meat have higher risk of colon cancer, other issues versus those who don’t.

And how do we contextualize that information? Well, we do so by recognizing that, in fact, there was no contextualization at all into that conclusion. It’s not the red meat. It’s the type of meat that people eat. And by and large, when we talk about red meat, the type that people are eating is crap. And you shouldn’t eat it. And Dr. Campbell is absolutely correct.

But to extrapolate that and say that, therefore, all red meat is bad isn’t fair. It’s like saying, “We’re going to do a study to determine is alcohol good or bad. And we’re only going to look at drinking Jack Daniels and not make that any different than drinking a nice, organic merlot which we know might have some good health benefits.”

DrMR: Right. Yeah.

DrDP: And it’s so unfair because then the message is that meat is bad. And that’s data that comes from people eating meat that has been fed GMO grains, that has been treated with antibiotics. The grain has been sprayed with glyphosate.

The cattle haven’t been able to get the precursors for various nutrients that would then build better meat, meat that has higher levels of good omega-3 DHA, for example, as opposed to having high levels of pro-inflammatory omega-6.

But we just, unfortunately, categorize these things broadly by doing epidemiological studies. And unfortunately, that’s what makes the evening news. And people don’t really tease these studies apart.

DrMR: Right. No, you’re very dead on with that. It’s the guilt by association sort of science that can be very problematic.

Stem Cell Therapy

You’ve also spoken about stem cells. And I was curious. Do you have any interesting information regarding stem cells?

DrDP: I do. And I will just relate to your listeners that there is leading-edge research that people can take advantage of now in regards to stem cell therapy for the brain. It’s extremely expensive in terms of what you have to spend up front.

You have to go out and buy a pair of sneakers. And then when you use those sneakers and exercise for 20 minutes each day, you turn on the genes in your body to make a chemical called BDNF (brain-derived neurotrophic factor, B-D-N-F) that stimulates stem cell therapy to occur in your brain.

So I’m all in as it relates to stem cell therapy. But it’s the endogenous type that’s going on in every one of your listeners right now. And all they have to do to increase their stem cell therapy is to gain some aerobic exercise each day, take a little bit of turmeric, maybe drink some coffee.

There’s a new nutritional supplement called whole coffee fruit concentrate that does it, lots of things, DHA as in omega-3, caloric restriction. All of these things enhance the body’s ability to make BDNF. And that stimulates the growth of new brain cells.

It’s the reason that Dr. Erickson’s study, in my opinion, at UCLA recently published demonstrated that those individuals who availed themselves of this form of stem cell therapy by getting a little exercise have a 50% reduction in their risk for becoming an Alzheimer’s patient. So yeah, I think it’s very, very exciting.

DrMR: Yeah, and the basics go a long way.

DrDP: That’s right. And there’s so much more benefit from everything I mentioned well beyond the brain. Why wouldn’t you do it?

DrMR: Right. Right. Now, you mentioned coffee. And then you mentioned some sort of coffee fruit bean I think. Do coffee and both that other compound offer the same benefit? Or are they a bit different?

DrDP: Well, clearly, coffee does, whether it’s decaf or regular, offer up an ability to augment a couple of important—many genes. But a couple of important ones are—

DrMR: Oh, so not caffeine dependent.

DrDP: Pardon me?

DrMR: So it’s not caffeine dependent then, some of the benefits.

DrDP: Not caffeine dependent, no.

DrMR: Gotcha. Good to know.

DrDP: It’s more, I think, related to the polyphenols or possibly caffeic acid. And tea can do the same thing. So this augments the epigenetic transcription of the genes that make this BDNF.

Why do you want more BDNF? Well, the Journal of the American Medical Association has told us that those individuals with lower levels of BDNF have a much higher risk of developing Alzheimer’s.

And a more recent study appearing in the Journal of Neurology correlated low levels of BDNF with cognitive dysfunction—in other words, a brain that doesn’t work really well.

So you want to do everything you can to have a higher level of BDNF. And by far, the best thing you can do is to adopt an exercise program. Start doing physical exercise. We know that, again, omega-3 fatty acids can enhance BDNF production as well as can turmeric. But again, exercise is a terrific way of getting that to happen.

The other thing that turmeric can do, for example, is also augment another pathway called the NRF2 pathway. Not to be too technical, but this is a pathway that reduces inflammation, enhances detoxification, enhances the production of antioxidants, and as mentioned, turns on the production of BDNF so you can grow new brain cells. Why would a person not want to do that?

Episode Wrap Up

DrMR: Right. Why not? Now, I know in your newest offering, The Grain Brain Whole Life Plan, a lot of these things are put together into a plan for people. So tell us a little bit more about that and also where people can track you down and follow you if they wanted more information.

DrDP: My website—and we update that virtually every day with blogs and a robust searchable science library—is Who knew? I post to Facebook every single day. And that’s David Perlmutter, M.D.

We have a YouTube channel, which is The Empowering Neurologist, where I post videos each week interviewing thought leaders from around the world, our most well respected institutions.

My new book that you mentioned is called The Grain Brain Whole Life Plan, and it is a follow up to my two most recent books, which are both Grain Brain and Brain Maker. The former dealt with the influence of carbohydrates and sugar and gluten upon the brain, and the latter deals now with the microbiome, the gut bacteria, and how important it is in terms of the brain.

Those books were more about the why. What’s the science that underlies what Dr. Perlmutter is saying?

The new book is far more about how. How do you implement? What do you do with the science now to leverage it and create lifestyle programs and changes so that you can be healthy? You can stave off these horrendous, chronic, degenerative conditions that are so prevalent.

And it’s really about how I do it as a 60-year-old male whose father died of that specific disease, Alzheimer’s. And what do I do knowing that I’m at risk. Day to day, what’s my exercise regimen like? Here are a dozen exercises that I’ve put in video for people free of charge on the web so people can know how to exercise.

So we have a very big outreach on the web that’s, I think, very, very user friendly, obviously completely free, that’s just there for anyone to gain this information and really have, I think, a different view about things that he or she may be getting by watching the evening news.

DrMR: Sure. No, I love it. Well, there you have it, folks. David Perlmutter, making waves with keeping your brain healthy.

David, thank you so much for taking the time for today’s call.

DrDP: Alright. Michael, I appreciate you having me today and hope to see you soon.

DrMR: You, too. Take care.

DrDP: Bye-bye.

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