Food & Lifestyle to Preventing Cognitive Decline with Dr Dean Sherzai

Voice Over:

Welcome to the NIHR Dementia Researcher Podcast brought to you by dementiaresearcher.nihr.ac.uk, in association with Alzheimer’s Research UK and Alzheimer’s Society, supporting Early Career Dementia Researchers across the world.

Dr Sam Moxon:

Hello everybody, and welcome back to the Dementia Researcher Podcast and to our side show Food for Thought, where we talk about the best evidence-based diet and lifestyle changes you can action today to reduce your risk of developing dementia. My name is Dr. Sam Moxon. I’m a regular blogger here at Dementia Researcher, and I’m delighted to be joined by Dr. Dean Sherzai, who is co-director of the Alzheimer’s Prevention Program at Loma Linda University.

Dr Sam Moxon:

He co-directs this with his wife, Ayesha Sherzai, who sadly was caught up in surgery today and couldn’t join us, but we had a really interesting discussion about the best ways you can prevent your risk of developing dementia. They’ve just released a book called The 30-Day Alzheimer’s Solution, all about the evidence and the things you can do today to reduce your risk. It’s a great discussion, and I really hope you enjoy it.

Dr Sam Moxon:

So Dr. Dean Sherzai, welcome to the Dementia Researcher Podcast. Thank you very much for joining us. How are you today?

Dr Dean Sherzai:

Very well, thank you so much. Thanks for having me here. Would have loved to have my partner, my wife, Dr. Ayesha Sherzai to be here. I think we should be able to have a great conversation about this topic. That’s actually engulfed our life for the last 20 years.

Dr Sam Moxon:

I think that’s a nice place to start. So, just to give you some background about what we do on this podcast. So we do general Dementia Researcher Podcasts, but myself in particular, we’ve started this series called Food for Thought. It’s all about prevention of Alzheimer’s disease and dementia, and what we can do ourselves in terms of diet and lifestyle.

Dr Sam Moxon:

This all sparked through an interest from myself. I got diagnosed with ulcerative colitis a year and a half ago, and started to change my diet. In doing so, found all these other associations between the way you eat and the effects on not just your digestive tract but your heart, your liver, and in particular of interest to me was the brain.

Dr Sam Moxon:

We’ve had a couple of interesting guests on the past. We spoke to Neal Barnard. We spoke to Dr. Alan Desmond, who I know you know quite well. I came across your work about a year ago and found it really interesting. I thought now that you’ve released this wonderful book, The 30-Day Alzheimer’s Solution, it would be a great time to get you on to the podcast and let all listeners know who you are and what you do. So, perhaps we could start there.

Dr Dean Sherzai:

Absolutely. Thank you so much for having us. Our life around dementia started about 20 years ago. Although I was at the time working at NIH, National Institutes of Health on some really esoteric stuff. My interest at the time was Parkinson’s. I just graduated from residency from Georgetown University. I was working on Parkinson’s disease, and stem cell research, and things of that nature. At the same time, I started getting interested in Alzheimer’s.

Dr Dean Sherzai:

A fluke of history and life just ended up with me going to Afghanistan with the Health and Human Services for three months for just the stint to help out. Then that turned into a three-year stint where I actually helped create the healthcare system there. I was the deputy ministry.

Dr Dean Sherzai:

My wife had, well, she wasn’t my wife at that time, had gone back with Doctors Without Borders to help out. We traveled the world on our own helping different places. In a gathering of expats in a party, we sat next to each other and started having conversation.

Dr Dean Sherzai:

As it happened, the conversation quickly turned to our grandfathers who were amazing, amazing human beings who actually succumb to Alzheimer’s. In her case Parkinson’s, and dementia, and Alzheimer’s, and mine was Alzheimer’s and with vascular comorbidities as well.

Dr Dean Sherzai:

That conversation really was the beginning of our life because that turned to dates. That after a year we got married. Then we came back and we started our life at UCSD, which was the number one neuroscience program in the country at the time, and started working on clinical trials, FMRI studies, looking at these amazing tools that looked at the brain while the brain is at actually functioning, all these things.

Dr Dean Sherzai:

There was a bit of frustration in all of this because clinical trial after clinical trial, millions of dollars, lots of papers written. PIs with 800 publications under their belt and 900 publications under belt, but with nothing to show for it when it comes to dementia. We weren’t making a dent. We were not making a single dent.

Dr Dean Sherzai:

So, that’s when the two of us decided to look if there’s another path and looking around. There was a researcher, Elizabeth Barrett-Connor, amazing lady. Again, another person with 850 publications on it, but she was working on lifestyle. She had done some of the most formative work in the country and we worked with her. Lo and behold, we decided to go in that path.

Dr Dean Sherzai:

When we told our mentor who had set up our path to go to really big institutions starting a new research path, he said, “What are you doing? This is career suicide. Nobody talks about prevention.” So, that’s how we started our journey about 18 years ago towards prevention.

Dr Sam Moxon:

Prevention is such an important factor. I’d like to get into the vegan meat of the discussion, I’d like to say because I can see you’ve got your recipe books behind you. Food is going to be at the front and center of our discussion today. So I want to start off with a more light, easy question, which is what does a neurologist who’s working to prevent dementia eat for breakfast?

Dr Dean Sherzai:

Oats, lots of fruits, lots of complex carbs, clean complex carbs, some protein in the form of soy or something of that nature. Mostly lots of long term energy for the day, and clean energy not with sugar. Avoid sugar at any cost and reduce saturated fat at any cost. That’s what we’re eating, any form of that.

Dr Dean Sherzai:

My wife, who’s a neurologist and a stroke specialist, also a culinary artist, you’re missing the best part of the two of us. Sorry, for the audience. Actually, 75 of her recipes are in the cookbook here. One of the things she has is the mindful muffin, which has all the healthy items but without the negative foods that we’ve added in the 20th century.

Dr Dean Sherzai:

So, that’s basically what we eat. We don’t feel tired. We don’t feel the fatigue that comes out of eating a lot of sugar, that food coma. You feel energized. You feel motivated. Food matters from moment to moment, to long term. We’ll get into that.

Dr Sam Moxon:

I can attest to the importance of food and how it does make you feel because since taking more care of my diet and switching to this, this whole food plant-based approach. So like the energy levels that I have, they’re just incomparable to what I was.

Dr Sam Moxon:

Before we get into this, I’d like to just shout out a couple of things for any listeners who listen to this discussion today and would like to hear more. You do have The Brain Health Revolution Podcast, which I would recommend giving a listen to on any of the things we talk about today in terms of the foods you can eat and the research behind it. They can find on your website or through the book, The 30-Day Alzheimer’s Solution, which is on sale now. It’s a great book and I definitely recommend it.

Dr Sam Moxon:

I want to sort of shoehorn into this discussion about to what extent we can prevent these diseases with diet. I noticed that there’s a stat that 3% of all cases about Alzheimer’s disease are only genetic. 3% of all the cases, that’s a small amount. So does that mean, upwards of 97% of cases are potentially either preventable or not necessarily reversible, but we can ease the suffering a little bit with diet?

Dr Dean Sherzai:

About 12 years ago, we actually made the statement that 90% of Alzheimer’s is preventable and that was incredibly controversial. In fact, we got such huge pushback. We understand. I was the director of all research education for Loma Linda University, not just for neurology but for all of research.

Dr Dean Sherzai:

I was the director of research for Loma Linda, so I understand the importance of approaching things in a data-driven way, not making huge extrapolation. Social media is full of bombastic extrapolation. So, we were very aware of it. Every time we make a statement, we make sure that we speak to the weight of the truth, not just the truth that we think it is. We even said that, that’s extrapolation, but it’s a pretty powerful and sound extrapolation.

Dr Dean Sherzai:

There was a huge pushback. People saying that at the time, people were saying that no amount of Alzheimer’s is preventable. Then a few years ago, some papers came out and said, “Oh no, about 30%.” Then, that number grew to 60%. We kept saying that when we say 90%, it means that if you lived the optimal life, and long enough, and early enough, then yes. For majority, even 50% would be amazing.

Dr Dean Sherzai:

This is a devastating disease that’s rapidly growing. Given the aging population, given that our food is terrible, given that our environment is becoming less and less conducive for health, given that we’re moving less, all the factors that contribute to brain health are being attacked. Even if we change that by 20%, that’s a bigger factor in healthcare than anything else we’re doing.

Dr Dean Sherzai:

So, 90% comes from that 3% and we’re being actually kind and generous when it comes to that 90%. It should be higher percent, but we’re saying, “Okay. Even 90% is amazing,” because only 3% is driven by the kind of genes that are 100% penetrant. Meaning that if you have these genes, you will get the disease.

Dr Dean Sherzai:

There are diseases like that, like on Huntington’s. Huntington’s disease, if you have the gene, that little miscue on chromosome 4, you will get the disease no matter what you do. You can affect it a little bit, but that’s 100% penetrant gene. There are other diseases like that as well.

Dr Dean Sherzai:

Alzheimer’s is not like that. Only 3% of Alzheimer’s is driven by a high penetrant genes, such as PSEN1, PSEN2 and APP. I’ll tell you a little bit about those as well. Even APP, which has to do with Down syndrome, we looked at the data on Down syndrome individuals. People who had Down syndrome, but they control their diabetes, and cholesterol, and hypertension, which is actually fairly common in that population, they pushed the disease back even in that population.

Dr Dean Sherzai:

So that gives you an idea that the rest of us, which are not driven by those three genes have tremendous control on manifestation of this disease.

Dr Sam Moxon:

It’s fascinating. It’s such an interesting topic to look into. One thing I’d like to set out in terms of how this discussion is going to go. One of the things that I noticed from your work is you talk a lot about not just preventing, but also in some cases reversing some level of cognitive decline.

Dr Dean Sherzai:

Right.

Dr Sam Moxon:

Obviously, there is a stage at which the damage is too great. Sadly with something like Alzheimer’s disease, that’s usually the point at which a patient gets diagnosed.

Dr Dean Sherzai:

Correct.

Dr Sam Moxon:

So, what sort of results are we looking at? What stage can we take some of this reversal? At what stage is the damage too great? We’re looking at reversing things like mild cognitive impairment as opposed to more mature dementia. What sort of effects can we have?

Dr Dean Sherzai:

That’s a very complex question because every individual is different. What I mean by that is that your reserve matters. How much you’ve done to build the reserve, which means that connections between the brain. We’ll talk about what that is about. How much damage have you done prior to all this? Not just the memory that you’re starting to lose, but the infrastructure underneath. The food, the exercise or lack thereof, the stress, the lack of sleep, all of that, all that matters.

Dr Dean Sherzai:

In general, if you’re pre-dementia stage in the MCI stage, which is mild cognitive impairment stage, there’s great hope in being able to reverse it. Not just our work, but many other studies have shown that even exercise at MCI stage has done significant reversal. Nutrition has had significant effect on reversal as well. So even at MCI stage, which is mild cognitive impairment stage, there’s great hope.

Dr Dean Sherzai:

I don’t want to give false hope, but even in early dementia and those that have done the work as far as some of the other elements such as cognitive reserve, we’ve seen those people actually reverse their cases. We don’t want to make a statement like Alzheimer’s is reversible because some of the other doctors have done that. They’re pill pushers and vitamin concoction pushers, and we’re not going to name names.

Dr Dean Sherzai:

You have some holes in your brain and if you take these vitamins, you’re going to fill. No, it’s not going to be vitamins. It’s a comprehensive approach. Definitely for a great majority at the MCI stage, it’s reversible. Definitely, if you’re just beginning to feel memory issues, that’s when you can do a great deal of good.

Dr Dean Sherzai:

Now the reality is, the 90 to 95% applies to those that are in their 30s, and 40s, and even early 50s who don’t have any symptoms but have the wherewithal to say, “I’m going to start the prevention at this stage.” If they do at that early stage, of course you’re going to get the full benefit of lifestyle.

Dr Sam Moxon:

I think that’s the key thing to address is how early we should start this. I’ve heard you talked in the past about, so in America you’ve seen children with white matter disease as a result of diet. If those changes can be starting that early, then it’s imperative that we get this message of healthy eating as early as possible because this disease is long time to manifest but the effects are devastating.

Dr Dean Sherzai:

It bewilders me that we talk about children’s attention deficit, which is important topic. I’ve spoken about it. We have to speak about it. Sometimes it’s over diagnosed but when it is diagnosed right, it can be affected. It can be influenced.

Dr Dean Sherzai:

We don’t talk about all the other damage we do to children. This is a group whose brain is growing faster than ever in their life. At every stage in childhood and of course, first nine months is doubling every few months. Then in the first three years, it’s connectivity actually is faster than ever afterwards. Then from three on, you’re actually building those connections. Then in your teen years, you’re myelinating the nerves. That’s an incredibly important period of life.

Dr Dean Sherzai:

When have you heard about a true plan of healthy eating for children? You don’t. You don’t ever hear the right way. Yet, we feed these children, these terrible breakfasts full of sugar, full of fat. They’re very quick and easy, but they’re poisons. That’s why when you look at teenagers who have cholesterol and even pre-diabetes, they have white matter disease. Something that doesn’t happen until your 60s. So, we really have to address the importance of food very early on.

Dr Sam Moxon:

Well, let’s get into some of the specifics then about this sort of things we can avoid. I notice in your book, you’ve got this nutrition spectrum that rates things from beneficial to harmful. One of the things that recurrently comes up is this issue of too much sugar, and this idea that Alzheimer’s disease is maybe a sort of type three diabetes. I know you’ve published a couple of studies on linking diabetes and dementia, but also insulin resistance to dementia.

Dr Dean Sherzai:

Correct.

Dr Sam Moxon:

So is sugar a good place to start in terms of things to try and put out of your diet, if you want to improve your brain health?

Dr Dean Sherzai:

Where to start, it depends on you. Success is critical. Success because to us, I’m a behavioral neurologist. Habit creation is central to everything. Habit has to do with success, and your success, and your proclivities, and your tendencies, and your addictions. So if you think that the first place to start is sugar because I can identify it easier, where am I getting the sugar from? I can identify it. It’s the one that I can give up easier, yes, that’s where you start.

Dr Dean Sherzai:

If on the other hand it’s saturated fat, by the way it can’t be all of saturated fat. What category? Is it the meats? Is it the cheeses? Is it the butters? Is it something else? Then it should be that. So if identify between these two things, saturated fat containing foods and sugar containing foods, and inflammatory foods.

Dr Dean Sherzai:

Once you identify those, then you look at yourself and say, “Where can I truly succeed?” If it’s sugar, absolutely. Now, realize that fat and sugar are addiction foods. They’re survival foods. They’re not thriving foods. So, it’s not like we didn’t need them when we were running around in the savannas and running away from lions, tigers, and bears.

Dr Dean Sherzai:

For the majority of our existence, we lived to age 30 if we were lucky. We didn’t care about atherosclerosis. Sugar and fat was survival food, but they were not thriving foods. So the thriving foods are lots of vegetables, and greens, and beans, and fruits, and all of that thing with fiber, and fiber, and fiber.

Dr Dean Sherzai:

You start where you think you can affect and succeed in getting rid of one element, one small specific, measurable element. Although goals are important, smart goals, make sure that your smart goals are very specific and very well-circumscribed. Then, make sure that all your environment is set to make sure you win that battle. Because if you win one habit battle, it’s more likely that you’re going to win two, three, four, five, six. That’s critical.

Dr Sam Moxon:

It’s about making those changes sustainable as well.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

Also, trying not to feel like you’re depriving yourself. You want to actually enjoy what you’re eating because you’re more likely to carry on.

Dr Dean Sherzai:

Yeah, absolutely. Deprivation is failure. Deprivation is going to, because your natural state of the force that moves you, that dopamine force that moves you is driven by your habits. Your natural state that was created throughout your life. Most of it, it’s bad habits. It’s terrible foods and all of that.

Dr Dean Sherzai:

So if you’re relying on willpower, guess what? That willpower will fail you one day, one fight, one stress, one job stress, one bad movie, one whatever. Then, you’re going to succumb to the will of that. So, it has to be a system in place where this new behavior is sustainable.

Dr Dean Sherzai:

It is not a sense of deprivation. You have alternatives that actually take the place of that thing. Actually, if not completely take the place of it, does a good enough job that you can see yourself living with this thing. Most importantly, it’s long enough that you become habituated to this new behavior. That’s a little planning. That’s strategy.

Dr Sam Moxon:

There was a really interesting piece that was run. I think it was a few years ago by the BBC here, where a doctor, I’m not sure what kind of specialist he was. He switched to a fully processed diet for, I think it was four weeks. What was interesting is we got some of the effects you would expect things like weight gain, but also his brain started working differently.

Dr Sam Moxon:

It was releasing hormones to tell his body that he needed more food. So basically, the more processed food he ate, the more processed food he craved. It was this vicious cycle and you have to break out of that cycle to try and get into more healthier living.

Dr Sam Moxon:

I think it’s something that is sometimes quite hard to digest. I’ve noticed in work, you try and make it easier for people to work out what’s good and what’s bad. You’ve got things like, I might touch your memory here, the neuro nine, the nine important components. I wonder if you can go through those that are important to include in your diet.

Dr Dean Sherzai:

That’s more of my wife’s. Definitely start with greens. Something as simple as greens, imagine that. All the greens, if you add two servings of greens into your diet, two heaping servings of green, you’ve changed your life. We’re talking about 11 years of living longer and healthier. That’s not a number that’s just made up. This number is coming to us from multiple studies of adding just greens.

Dr Dean Sherzai:

By the way, if you work on adding something instead of taking away something at first, it’s going to work because there is a zero sum economics to your stomach hopefully. When you eat greens, it does one of the things. It satiates because more space is taken up. More space is taken up, so that’s one of the three ways that you feel satiety and fullness is space. So, greens do that.

Dr Dean Sherzai:

Then all of its anti-inflammatory, antioxidant, glucose regulating, and lipid-regulating capacities are incredible. Those are the four processes that we talk about, oxidation, inflammation, glucose dysregulation, lipid dysregulation as the cause of disease. Greens counter that profoundly.

Dr Dean Sherzai:

Also, are beans. Beans are amazing. Just ahead of time, I’m going to get rid of this myth that somebody started by lectins. The lectins are real, but their danger has been overstated profoundly. Lectins are in a lot of foods and just washing the food gets rid of these. These are the anti-metabolize they call them. It gets rid of them. Cooking gets rid of them. Fermenting definitely gets rid of a lot of them. So most of the foods that we eat, the beans they’re cooked, that’s it, the lectins.

Dr Dean Sherzai:

Then you’re left with some of the highest ratio of fiber, some of the best quantity and quality of protein, and all of the other nutrients you can imagine in beans. In fact, some of the healthiest places in the world, the one common denominator is beans of all kinds. So beans, add that to your food.

Dr Dean Sherzai:

Then, cruciferous vegetables. Cruciferous vegetables including kale and all these others are just remarkable for their nutrients, for their flavonoids, all these chemicals that actually help with inflammation. Some of the best foods as far as inflammation is concerned. So greens, beans, lentils, grains.

Dr Dean Sherzai:

Grains, they’ve been demonized. If I would write a book, it would be grains for your brains. There is the 1% that have celiac disease that should religiously avoid grains. Right now when you talk about grains, the consequences that people might actually feel from grains, everybody thinks they have a problem with grains. They don’t. Majority of the society has lived with grains prior to the processed foods, and they’ve actually thrived with it. So grains for majority of us are fantastic source of vitamins, nutrients, as well as fiber.

Dr Dean Sherzai:

Then, you have the berries. All fruits are great, but some of them are better than others. Berries are absolutely amazing foods that have lots of anti-inflammatory qualities. All berries, blueberries, we have found that other berries are beneficial as well.

Dr Dean Sherzai:

Then, you have the herbs and spices. Pound for pound, they are some of the most beneficial foods when it comes to inflammation, and oxidation, and all of this stuff. More importantly, my wife actually our social media The Brain Docs, just released the video on this. More importantly, the product that’s actually affected us most negatively in the last few decades is salt. Salt has affected our blood pressure, has affected our cardiac disease risk, our stroke risk, our kidney problem risk.

Dr Dean Sherzai:

Yes, some salt is necessary because we’ve fortified it with iodine and iodine is necessary, but the amount of salt we’re getting is just tremendous. To replace salt is difficult because it has an incredible power. Well, we’re addicted to that as well. Herbs and spices do just that. They replace salt efficiently but instead of this negative thing, you actually add an amazing food that has all the anti-inflammatories.

Dr Dean Sherzai:

Then water and green tea are absolutely amazing foods that have the same kind of properties as well. I don’t know if I went over all of them, but those are some of them and they can read the rest in the book. Then we have the thoughtful 20 which is the neuro nine or foods that people should try to consume every day.

Dr Dean Sherzai:

The thoughtful 20 is foods that they should have in their cupboards that really will help them live that life. Mushrooms are my favorite foods in the plant. In fact, mushrooms are the most remarkable foods period, because of their texture, because their ability to absorb taste, because of their ability to morph themselves into anything you want.

Dr Dean Sherzai:

My wife just made a shawarma. Before, when we used to eat a lot of meat, I grew up in Pittsburgh. I used to eat meat seven times a day. Giving up shawarma was difficult. Oh my goodness, making shawarma out of mushrooms just is remarkable. Then you get the benefits of the mushrooms and all the things that come with that. So, there’s so much food that you shouldn’t feel deprived if you just strategize and plan a little bit.

Dr Sam Moxon:

I did a complete U-turn on mushrooms. I really didn’t like them. Now they’re some things that I enjoy greatly, especially I went for breakfast recently. My favorite thing on the breakfast was the mushrooms because of the way they were cooked, the herbs they were cooked in. They were just absolutely delicious.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

It’s interesting when you talk about the neuro nine and highlight these key foods. They come up in a lot of other things because it’s all about and particularly in the case of things like blueberries. It’s about anti-inflammatory properties and a remarkable amount of diseases are caused by inflammation.

Dr Sam Moxon:

When I look at the neuro nine, I may as well be reading the nine best foods for inflammatory bowel disease because again, it’s that anti-inflammatory property getting that fiber, getting those unprocessed foods.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

The one that I didn’t expect to turn up, and I saw this in one of Ayesha’s talks was turmeric. The potential for turmeric to have these beneficial properties for the brain is not something I expected to come across.

Dr Dean Sherzai:

When we were directors of Brain Health Institute in Cedar-Sinai, one of the lifestyle studies we were doing and was on effect of curcumin, which is one of the products within turmeric. We were looking at curcumin binding to amyloid. Amyloid is one of the bad proteins that accumulates in Alzheimer’s. Using a special device because the human retina is a continuum of the central nervous system.

Dr Dean Sherzai:

So what are happening in retina is continuous with what’s happening with the rest of the brain. When you looked at the retina with the special device, you saw the curcumin actually bind to amyloid, which was remarkable. In fact, if you go to Google Scholar and put that in, you’ll see our paper, two of them that just came out. Then, the body would remove it.

Dr Dean Sherzai:

So curcumin and turmeric being as well, a continuum of that has anti-inflammatory effects on its own directly and antioxidant. More importantly or just as importantly, it also binds to amyloid, which is presumed to be removed by the body once it binds in that complex form. So, lots of benefit.

Dr Dean Sherzai:

Usually if you’re going to take that, take it with piperine or pepper because it increases its bioavailability. You can take it in food form which we do, or you can take it in pill form. So, that’s something to be aware of.

Dr Sam Moxon:

I notice today, I find fascinating because it’s the potential to affect your life in a positive way without, obviously in the UK, we’re very fortunate to have the NHS. So, a lot of our treatments are either free or a massively reduced rate of works out about $15 per prescription.

Dr Dean Sherzai:

Wow.

Dr Sam Moxon:

Obviously in America, you have the healthcare system of insurance. A lot of people have to pay out of pocket. These are things that you can action just by changing your shopping bill. What I find frustrating is people, particularly scientists who will dismiss this idea without looking into the literature. So, you almost have to exert a lot of energy to try and get these. People to think actually this could be of benefit and there is no downside to doing something like this really.

Dr Sam Moxon:

So I guess my question to you is, if you had someone who was perhaps skeptical about this, are there any population studies or any other data sets that you would direct them to say, “If you look at this, you can see there actually is quite compelling evidence of at least a correlation, if not a causal link between these dietary changes and improving your brain health”?

Dr Dean Sherzai:

There are tremendous number of studies. The Framingham Heart Study, which is a heart study, which is the one in Harvard over several decades that has repeatedly shown the effects of lifestyle, specifically cholesterol and fatty foods for its harm, and healthy food for its benefits, more plants. The MIND study which was with Martha Morris, which showed that a plant predominant food diet actually reduce your chance of Alzheimer’s by 53%.

Dr Dean Sherzai:

The Adventist Health Study, that’s why we came actually to Loma Linda because the Adventist Health Study studied 96,000 people over 50 years, and a larger percentage of them being vegetarians and whole food plant-based repeatedly, whether it was cancer, whether it was heart disease, whether it was longevity, whether it was now the cognitive decline, all across all of these repeatedly it’s been shown that people who’ve had a plant dominant diet had a much lower risk of those diseases. It’s consistent across every study that you look at.

Dr Dean Sherzai:

Now, what the people that want to oppose this concept are saying is, “Oh, these are epidemiological studies. This is a marketing ploy.” For people who don’t know science, they’re actually marketing. They’re creating a mindset that as if epidemiology is not research, which is amazing power of how people can reframe reality.

Dr Dean Sherzai:

Epidemiology is the same science that made you wear seat belts because we never did randomize clinical trials of people driving with and without seat belts. That would be unethical. The same studies that should show that bullets kill you. We would never do randomized clinical trials of bullets being killers or not killers. There’s a good retrospective correlational data there.

Dr Dean Sherzai:

We never did perspective randomized clinical trials of cigarette smoking because that would be unethical. We never do randomized clinical trials of cyanide. That would be unethical. This doesn’t make sense. Strong, consistent, across the board, well-powered, well-controlled or addressed for studies that look at strong correlations have been the benchmark of everything we’ve done. All the positive things around you has been based on those most of them.

Dr Dean Sherzai:

So, to talk about randomized clinical trials as the only path is so myopic and almost nefarious because I think it doesn’t take that much thinking to figure out that, that can’t be. By the way, you can’t do randomized clinical trials on studies that require 20 years of data to look at long term effect. You will bankrupt an entire nation by doing that with one study.

Dr Dean Sherzai:

So, it’s just plenty. In fact, the amount of the number of data, the studies are just overwhelming speaking to the effect of whole food plant based or at least plant predominant.

Dr Sam Moxon:

I think a good measure for me, a good marker of whether or not something should be at least debated and considered is the person who tied this information trying to sell me something. So many times when I look at these talks about if the benefits of eating healthy, no one’s trying to sell me something. If you look at who sponsors the studies, it’s not some big dairy conglomerate or some big meat conglomerate, it’s funded by interest.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

You can find the information for free. It’s out there to try and benefit people. So, I always think that’s a good thing to look at because usually when someone is trying to say, sell a supplement, you can tell by the way they present the research. What this is, it’s out of genuine desire to help people and help reduce the burden of these diseases because prevention is so much better than cure in this case.

Dr Dean Sherzai:

Even there, I want to just for transparency’s sake. So people, they believe it. Even on the healthy food side, there are times where companies actually sponsor. For example, nut companies or olive oil companies. We’ve had some pushback against us saying that, “Oh, but olive oil is not whole food.” Well, anything that’s got used processed a bit can be considered not whole food.

Dr Dean Sherzai:

The data for extra virgin olive oil is there in small amounts and that amount has to be better determined. It’s not harmful and it might be actually beneficial. At the same time, some of the studies are sponsored by those companies. So, we have to distill those out and see what data is still left.

Dr Dean Sherzai:

You’re absolutely right. If people just do the due diligence and find out where the interests lie, and where the body of information, the bulk of information lies, then it makes sense.

Dr Sam Moxon:

It’s interesting. You’ve talked about the MIND study in the past as one of the diets. What I find interesting there is if you look at the results of that and the foods that came up as important, it does sound very similar to a diet. We will reveal in a second just being the best.

Dr Sam Moxon:

If you look at high amounts of leafy green vegetables, other vegetables, berries, whole grains, a small amount of fish, and we can talk a little bit later about why you can maybe cut that out. Poultry, beans, nuts, and no more than one glass of wine a day, sounds very similar to the diet we’re perhaps going to name in a second.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

That is obviously the whole food plant-based diet that the weight of evidence seems to be that eating that. It seems strange that it can sometimes be controversial to say, “Eat more vegetables and you’ll be healthier,” but that’s where the weight of the evidence lies.

Dr Dean Sherzai:

I think with the MIND diet, there are times where the data is … So, let’s talk about the fish component. There’s no question that the data on fish is for the most part positive. Let’s be honest, especially small fish like salmon, mackerel, and all of those. My wife and I, and our children, we don’t eat fish or any meat but we have to stand by the data. The data shows that eating small amounts of meat of fish is good for you. That’s the data.

Dr Dean Sherzai:

What is it about fish? What it is, is omega-3. People may make an argument that no, it’s something beyond that. It is not. When you really distill the data, it’s omega-3. So, whether you get your omega-3 from fish or in our case from food or even supplements. Now what happens, people become purists. It’s like, “Oh no, it’s not completely natural. I’m not going to eat it.”

Dr Dean Sherzai:

Well, there’s a lot of things around you that are not natural. You’re going at 75 miles an hour while sitting in a chair is not natural, but you’re still using it. So where the data is strong and if they can’t get the alternative, they should get omega-3 from pill form. Most of the time you can get it from chia, flax seed, nuts, lots of other foods that will do the job for you.

Dr Dean Sherzai:

In the plant form, usually it’s ALA. That means that the body has to convert it. So, be aware of how much you’re getting and be aware of the fact that, that enzyme that actually converts ALA to EPA, and DHA, which is the form that’s needed especially for the brain, can be overwhelmed if your diet is also full of omega-6 or your liver is overtaxed with alcohol or some other drugs. So just be aware of that and you’ll be fine.

Dr Dean Sherzai:

By the way, the only kind of fat that your brain needs is omega-3. There are those people that are saying your brain is made of fat, therefore you need fat. Eat lots of fat. Nope, that’s wrong. Brain does not have storage fat. The brain does not have any kind of metabolic fat. It’s favorite form of energy is glucose in an even keel. So, that’s the data on brain and energy.

Dr Sam Moxon:

It’s interesting. You mentioned chia and flax seeds, a good way to incorporate those into diet. I find is to put them in a smoothie or put them into your morning bottle of oats. Actually, it gives a nice, thicker texture. You start to really enjoy that extra texture element with the seeds in there and you know you’re benefiting yourself.

Dr Sam Moxon:

Now, you touched upon alcohol. As a British person, we have a culture of drinking over here. I try to avoid drinking now. I set myself one night a week. I’m allowed two glasses of wine, partly for my gut but also for my overall health. Is alcohol something we should avoid completely, or is it something that we can moderate? What’s the data show on alcohol?

Dr Dean Sherzai:

So I’ll start by saying that my wife and I we drink a glass of wine here and there, but we’re not going to fit science to fit our lifestyle. The data so far, and my favorite phrase that we’ve actually taught our kids. This little bit of uncertainty is the best thing about science. So, absolute certainty is not science. So to the best of our knowledge today, that’s the phrase. To the best of our knowledge today, the amount of alcohol that’s beneficial for your brain is …

Dr Sam Moxon:

Zero?

Dr Dean Sherzai:

Zero.

Dr Dean Sherzai:

I don’t think a glass here and there is going to harm you. Even if it does, I’m not going to change the science to fit my lifestyle, which is what we all do. So we say that if you can avoid it, avoid it. If you’re going to eat it, drink a few glasses here and day per month just because it’s a good social lubricant, absolutely go ahead. Don’t start drinking alcohol for your health benefit. That’s not the way to talk.

Dr Dean Sherzai:

One of the most controversial videos we ever made was on alcohol and me saying just that. It got shared 150,000 times immediately. It wasn’t all nice, let’s just say that. Truth is truth. I do a lot of things that might not be beneficial for my life, but I’m not going to search the internet.

Dr Dean Sherzai:

There’s a saying that people love hearing good news about their bad habits, or they actually go find news about their bad habits but that’s the reality. I’m going to live with a glass of wine here and there.

Dr Sam Moxon:

The classic example is the idea that red wine is good for you, but it’s actually the polyphenols that you can get just by eating red grapes and by avoiding the alcohol and the inflammatory properties of it.

Dr Dean Sherzai:

Exactly. Not to speak about all the other things that socially it does to us as a society, yes.

Dr Sam Moxon:

I think another good philosophy, I believe it’s Michael Greger. He called it the better than philosophy. So, is giving up alcohol better than drinking? Yes. If you can’t, is having one glass of wine a week better than drinking every night? Yes. Start there and see how you go.

Dr Dean Sherzai:

I fully agree, 100%.

Dr Sam Moxon:

So, we’ve talked a lot about food. That’s been the focus and vitamins, and whether or not we should supplement vitamins. There are other important factors that I think we should just touch on before we close. So you talked about this idea of the importance of clearing amyloid out the brain and optimizing those processes. So, I guess that brings that in sleep as another important factor for reducing the risk of Alzheimer’s because that’s when a lot of that clearance takes place. So, how much of an issue is sleep?

Dr Dean Sherzai:

I’m going to say it in a way where actually it’s almost a eureka moment to a lot of people. It’s like, “Why would evolution have introduced something such as eight hours where you’re knocked out and paralyzed?” I mean, literally physiologically paralyzed one third of your life if it wasn’t that important?

Dr Dean Sherzai:

In fact, it is so important that it’s more important than one third of your survival benefit from predators. That’s how important it is. What it does is multiple things. It’s the most important period of your day where brain actually cleanses. We get invited to these events for cleansing this and cleansing juice. You hear all these mediums and all selling the juices for cleansing and all that.

Dr Dean Sherzai:

The only two cleanses I know are water, and most importantly sleep because the brain actively changes the shape to clean itself. In fact, the vessels shrink. There’s greater space created in the brain during sleep, especially deep sleep so that the cleansing takes place. The glial cells, the microglia, which actually outnumbered neurons significantly get activated during night to clean the brain.

Dr Dean Sherzai:

Now if you don’t get good night’s sleep, even a couple of good night’s sleep, those glia actually go awry and start eating away from good brain. That’s why people who’ve had bad sleep for many years actually have smaller brains, well, one of the reasons. So, that’s why sleep is important.

Dr Dean Sherzai:

The second thing it does is helps with memory. Helps with short-term memory and long-term memory, better than any memory trick, better than any book of some guru that’s teaching you memory devices. Get a good night’s sleep. A good night’s sleep helps with consolidating memories short term and long term.

Dr Sam Moxon:

That’s so important. You do feel the benefits when you start out your sleep schedule. It is not just critical for the brain, but you’d be surprised about how many things suddenly start to get better when you start getting enough sleep and start getting up early, getting up at the same time every day and then starting to eat well.

Dr Dean Sherzai:

Yes.

Dr Sam Moxon:

So I feel like this is something we could talk about for hours, but obviously in the interest of time, I think we have to wrap this up sadly so shortly. I want to ask you as a take home message to the people who are listening today and want to try and affects their life in a positive way.

Dr Sam Moxon:

What is the main piece of advice you’d give to somebody who wants to try and live a healthier lifestyle, increase the longevity of their healthy lifestyle because we now know, Alan Desmond mentioned this in our last episode. That the food we eat is the number one cause of loss of healthy years lived. So, what is the main piece of advice you would give to our listener who wants to try and make some of these changes?

Dr Dean Sherzai:

First of all, the NEURO concept: nutrition, exercise, unwind, or stress management, restorative sleep, and optimizing mental activity. Learn about that. Optimizing mental activity means living a mentally challenged life around your purpose. Find a purpose that really pushes your brain. Those connectivity, the connectivity between neurons are so important.

Dr Dean Sherzai:

We have 87 billion neurons. Each of them can make a couple of connections or 30,000 connections each. You make those connections when you challenge your brain around your purpose. It could be learning a musical instrument. You’re learning music. Running a company that you always wanted to, volunteer, complex behaviors, that challenge all parts of your brain.

Dr Dean Sherzai:

It’s driven by your purpose because the other part of it when it’s not driven by your purpose that is stress-filled, actually damages your brain. We speak about that quite a bit. It’s a very important concept. Find your purpose and build a life around it.

Dr Dean Sherzai:

Then nutrition, exercise and all of that stuff. You know what it is, whole food plant-based. Exercise is a little more than you thought. You got to get tired. You got to get the aerobic in there and you got to get the leg strengthened there as well, and then sleep.

Dr Dean Sherzai:

For each of these others, identify what your goals are clearly, but take one goal at a time and inculcate it into the system of your life. Goals by themselves are great but then when they to become part of your life, then they become you. So if it’s eliminating sugar, it shouldn’t be a diet plan that eliminates sugar. No. How am I going to live my life from here on not feeling deprived as finding the replacement for sugar and eliminating sugar for my environment? That’s a system and a goal that’s achievable and becomes part of your life.

Dr Dean Sherzai:

Then, as far as meat is concerned. As far as cheese, cheese is an amazing thing. Let’s be honest. Can I find cheese alternatives that have very low or no saturated fat, have close or the same taste and can become part of my life? Yes. Then you inculcate it into your life and set clear goals for yourself.

Dr Dean Sherzai:

When you do it that way, it can be your life as opposed to next diet plan, new year resolution, next thing that will fail you.

Dr Sam Moxon:

I think it’s important to try and you disassociate from this idea of fat diet. This is not a diet. This is a lifestyle change-

Dr Dean Sherzai:

It is.

Dr Sam Moxon:

… a lifestyle improvement. Well, I think this has been a really fascinating discussion and I’d like to direct our listeners. If they’re interested in what they’ve heard today, direct into your website, teamsherzai.com. On the website, they can find your book, The 30-day Alzheimer’s Solution. They can also find links to your podcast, Brain Health Revolution Podcast.

Dr Sam Moxon:

Also, something we didn’t get to touch on today is your NEURO plan where you can give these people a more personalized approach for trying to make these improvements. I think that’s an important thing as well for people to check out. If you want to speak on that, I think that would be interesting before we go.

Dr Dean Sherzai:

Those are all great. One of the things we are so proud of is what we do for non-for-profit part of our work, which is healthymindsinitiative.org. We want to start community-driven endeavors throughout the world. We’ve started in Germany. We’ve started in Spanish-speaking countries. We want to start it in UK, and it’s about lifestyle in the communities. It’s not-for-profit. We won the National Academy of Medicine Award for our work in the African-American churches. That’s near and dear to our heart because it’s everything we do is towards that endeavor.

Dr Dean Sherzai:

So, go to healthymindsinitiative.org. If you want to volunteer, if you want to donate, if you want to start a community, online community for UK, we would love that. Then of course we do everything else, which is The Brain Docs on social media. The Brain Docs, D-O-C-S. In there, we’ll talk about the NEURO plan and other endeavors that we have going on at this point. We’re so glad to be connected to you guys.

Dr Sam Moxon:

It’s really great. It’s been a pleasure to have you on. So, I think all we could do now is thank you very much for joining us. It’s been a fascinating discussion. So, thank you. It’s been a privilege. I hope you’ve enjoyed yourself. Thank you to all listeners as well for tuning into this episode. I hope you found it useful.

Dr Sam Moxon:

If you would like to reach out to Dean or Ayesha, I’m sure they’d be happy to answer any questions you have. In the meantime, thank you all for listening and we’ll see you next time.

Dr Dean Sherzai:

Thank you.

Voice Over:

Brought to you by dementiaresearcher.nihr.ac.uk, in association with Alzheimer’s Research UK and Alzheimer’s Society, supporting Early Career Dementia Researchers across the world.

END