Ep 318 – The Age-Proof Brain with Dr. Marc Milstein

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0:01:32.0 Darren Buford: I'm Darren Buford.

0:01:33.2 Kristin Coverly: And I'm Kristin Coverly.

0:01:34.6 DB: And Welcome to The ABMP podcast, a podcast where we speak with the massage and bodywork profession. Listeners, here at the ABMP podcast, we obviously do podcasts about improving your massage, your body work practices, and occasionally we dip into podcast about simply being humans, today is one of the latter. Our guest today is Mark Milstein. Mark is the author of The Age proof brain, new strategies to improve memory, protect immunity and fight off Dementia. Mark specializes in taking the leading science research on brain health and presenting it in a way that entertains, educates and empowers his audience to live better, his presentations provide science-based solutions to keep the brain healthy, boost productivity and maximize longevity. Mark has a PhD in Biological Chemistry from UCLA, and has conducted research on topics including genetics, cancer biology and neuroscience. For more information about Mark and his book visit DrMarkMilstein.com. Hello, Mark and hello Kristin.

0:02:32.1 Mark Milstein: Hi, thanks for having me here.

0:02:34.3 KC: We are thrilled to have you here, let's jump right in 'cause we have so many great things to talk to you about today, let's start by getting to know a little bit more about you, please share your background and what inspires your passion for brain health.

0:02:46.4 MM: Oh yeah, that's a great question. So a couple of things really inspired, I guess my passion for brain health, one is some family members who were struggling with brain health, I had a grandmother who suffered from dementia, and it was very scary to see that, and also, I've had some of my own health issues that can raise the risk of brain issues down the road, so trying to really think about what are the things that I can do now to protect myself, and then also just in studying and academics when I was at UCLA, I was actually starting out in... I should say I was in a lab doing research on breast cancer, I was part of a team, and something that was involved with breast cancer, a specific protein that we were studying was also involved in memory. And at the time, that was really a new idea, that something that was involved in cancer was also involved in memory in the brain, and at this time, the field of neuro-science was just exploding with all these really just new ideas about what are the things that we can do to protect our brain, how can we sleep better, how can we manage stress, and the insights and the discoveries were really informing lifestyle choices and decisions, and so it was just really exciting to be able to take this information and pass it on to people, distill it, break it down.

0:04:06.2 MM: And so that's really what got me on this journey, and I just really enjoy analyzing the science, the research, and finding ways to make it really usable.

0:04:14.1 DB: Mark, one of the things I saw in the introduction to the book absolutely speaks to massage therapists and body workers, and that's how you were motivated by looking at the body as a whole body structure versus a part structure. Can you just speak about that for just a second.

0:04:29.6 MM: Yeah, absolutely. As I started several years ago, really doing deep dives into understanding the brain, it became very clear that it wasn't just happening, anything that we were concerned about wasn't just happening in the brain, it was happening in the relationship between your heart, your gut, your immune system, your stress response, and it was like this, all roads led back and forth in these two-way streets and modern medicine can get so specialized and so specific that sometimes it was overlooking this idea of this connection, there's an older way of looking at things through Eastern medicine and other practices where these ideas have been around for a while, but really bringing together the modern medicine with these older ideas and kind of balancing the two in ways that we can really realize that we can treat multiple aspects of our health, our brain health by really protecting our gut, our immune system our metabolism, and how these things are very much connected.

0:05:33.7 DB: Mark, I know listeners are gonna wanna know as we start to dive into the book a little bit, how do we assess our brain's age?

0:05:40.6 MM: Yeah, that's a good question. So there is a couple of things. There's the idea of getting a brain scan, and when we take a picture of someone's brain, we can see that if... Starting at the age of 40, the brain can start shrinking and that shrinking can have an impact on memory, focus and productivity, and a shrinking brain is essentially an aging brain, but we're really not at the point where everybody needs to go and get a brain scan, that's not realistic, it's not needed. In some cases, it's warranted if somebody has a family history or they're noticing some significant changes to their memory or their cognitive function, but just taking a self-assessment and just asking yourself a couple of key questions, really thinking about some things like, How's your balance? We can forget about that, but your brain is controlling your balance, how well can you move, how's your recall, how fast can you walk, you know the intensity of your walking speed, also thinking about how are you getting through the day, it's not normal to lose significant memory or cognitive function, do I really wanna get that message out that there was this idea in the past.

0:06:50.0 MM: Oh, it's just part of the aging process that the brain slows down significantly, but it really shouldn't... That shouldn't be happening. And so we want to catch things early, wanna be on top of things if we notice any changes, and one other question that we can ask ourselves is, it sounds silly, but how old do you feel? And what we see is that people's assessment of how old they feel, if you then take a picture of their brain with a brain scan, there is some correlation there, and by thinking about feeling younger, doing more youthful activities, there's this really interesting evidence that people who say they feel younger and they have that assessment of themselves have about a 50% lower chance of developing dementia, and so we realize there is a mind-body connection here, it's not the whole puzzle, but it's a piece of the complex puzzle.

0:07:36.5 DB: Mark 50 going on 18. [laughter] Why fast walking? I'm so curious, the speed at which you're walking.

0:07:45.9 MM: Yeah, so walking in general is really good for the brain, there's all these studies and they just keep coming in that show that if you can walk about 30 minutes a day, you significantly lower your risk of dementia, memory loss.

0:07:58.0 MM: And so that's really a big part of the book is, how do we lower risk? How do we put together these little things that can have a big impact, and there's also these studies that show that if you take that 30 minutes and even for 5 minutes of the 30 minutes, 'cause the 30 minutes of walking doesn't have to all be done at the same time to have an impact, and if you take a few of the minutes and you put people in a study and you have them walk fast for just a couple of minutes, two minutes of basically like, you don't have to power walk everywhere you go, but a little burst even between street signs, they've done these studies and they found that people who not only do a little bit of faster walking within their daily walking, not only is their memory tends to be better, significantly better also, people who have a faster gait and that's like walking speed, tend to have a lower risk of dementia, and what we believe is happening is multiple things here is it's good for your aerobic exercise, is good for your heart.

0:08:52.3 MM: Getting good oxygen in your brain, all that's important, but we also believe that just the act of walking is really deeply tied to memory, and not to go on a tangent here, but it's just kind of fun to think about your ancestors like a long, long, long, long time ago, if they went for a walk and they had to use this walking, they had to walk, they had to remember how to get home, and if they couldn't remember how to get home, they didn't pass on their genes, so we're the offspring of those that walked and remember, the people who walked and forgot, they didn't make it, so it's just deeply embedded, and it's something we can lose sight of, it's so simple, but we just wanna make sure in a world where we tend to sit more than we might want to or might be aware of just to get some walking in and give a little bit of a pace from time to time.

0:09:34.0 KC: Well, huge shout out to my dog Zozo for getting me out there walking couple of hours a day. I appreciate you more than I know. [laughter]

0:09:41.8 MM: Yeah. Dogs are so good for your brain.

0:09:43.8 KC: Right, right. Okay, you mentioned memory loss, let's sort through and dive into some of these terms that we may have heard and talk about some definitions. So talk to us about mild cognitive impairment, Alzheimer's disease and dementia.

0:09:57.1 MM: Yeah, it's a really important point, 'cause these terms have been used interchangeably for years, so it can be very confusing, but now we wanna really clarify. So let's start with mild cognitive impairment, and so that is the idea that... Actually, let's take one step back, let's say that it's normal to have moments where you can't remember where you parked your car, put your keys, What was I just doing? There's things you can absolutely do to improve those little memory issues day-to-day here or there, but if they're starting to have increasing frequency or they're starting to interfere with your ability to get through the day, missing appointments more consistently, forgetting to pay bills consistently. We call that mild cognitive impairment, and that is a warning sign that we don't want to ignore. Again, going back to this idea, we don't wanna say that that's just a normal part of the aging process, it can significantly increase the risk of dementia, which is the next step and mild cognitive impairment. There's a study that came out about a year ago that found that people over the age of 65, about 12%-18% of them have mild cognitive impairment, many of them don't know.

0:11:01.3 MM: They don't know that, they're thinking out that this is just normal. Again, we wanna be on top of this early, so that's early signs of memory loss, things are getting worse, essentially. Dementia is not a disease, but it's the symptoms of memory loss, having trouble making a decision, changes to one's personality so much so that's interfering with the ability to get through the day, it's now reached that point, and there's many causes of dementia, there can be hormone imbalances, vitamin deficiencies, head injuries, vascular issues, not enough blood to the brain, but the most common specific disease that causes dementia that causes the loss of memory, is Alzheimer's disease, and that is just one very specific disease where we can look at a brain scan, and there is some controversy here about Alzheimer's and just one cause, but the classic hallmark of Alzheimer's disease is these plaques and tangles in the brain, and it's the build up of essentially what we call waste or trash that interferes with the brain cells' ability to talk to each other and communicate. It's not the only thing that's happening in Alzheimer's disease, again, this is something that is related to multiple parts of the body and things that are happening and impacting the brain, but that's a way that we can identify and say that, Well, this is one specific disease that we call Alzheimer's, they can cause the symptoms of memory loss or dementia.

0:12:22.9 DB: Mark, with cognitive impairment, is it more likely that you yourself would notice that, or people around you, or both, I suppose?

0:12:32.1 MM: It could be both. It can be hard, it's such a delicate oftentimes emotional topic to talk about, but we need to talk about it, we wanna think about it in terms of being more empowered, that there's things we can do, we have this evidence now that if we can catch things early. We wanna have these conversations because we have evidence, we can slow down the progression, we couldn't say that scientifically, just a couple of years ago, but now we have this evidence that through things that are discussed in the book and things I'm sure we're gonna talk about today, that there are things that we can slow down the progression of the symptoms. We can't quite say that we can slow down the progression of exactly what's happening in the brain, but what's interesting about Alzheimer's disease, is that what's happening in the brain isn't always directly related to the symptoms, and so there's things that we can do to lessen the progression of the symptoms, and so that's where we have a lot of hope.

0:13:29.1 KC: Let's take a short break to hear a word from our sponsors.

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0:14:45.5 KC: Let's get back to our conversation. Mark, in the book, you talk about ways we can age proof our brains and slow the progression of dementia starting with sleep. Why is sleep so critical to brain health?

0:15:00.4 MM: So sleep is pretty much as close as we have to a magic pill in terms of multiple things that sleep is doing to protect your brain. When you're asleep at night, while you're dreaming, you actually make the memories of the things you learn that day stronger, but one of the most powerful aspects of why sleep is so important, and one of the most bizarre is that when you go to bed at night, while you're sleeping at certain points during the night, your brain actually essentially shrinks down, it constricts and it squeezes out garbage, waste, trash and toxins. So to put this in perspective, your brain's about three pounds and it makes five pounds of waste, trash, garbage a year. And what is this waste and trash. Well, it's just left over chemical reactions, by-products, proteins that are broken down in the brain, it's normal to have this waste, but as we get older, it can be harder or less efficient for our brain to get rid of the waste, and so it can build up and just like a house or an apartment that is filled with too much waste or garbage, it's hard to find things, it's hard to focus, same thing in the brain.

0:16:03.2 MM: So while you're sleeping, one of the ways that you basically keep your brain clean is you squeeze out this trash every night by your brain shrinking down like a sponge, and then fluid comes up from spinal cord and washes all this trash away, so every single night you give your brain a squeeze and basically a wash, and that's a really important part of keeping your brain protected, and you notice that the next day, if you don't get a good night sleep, you have that fuzzy kind of foggy feeling at its essence, part of what's happening there, we believe is that left over trash, it hasn't been efficiently cleaned away or washed away, and over time, the buildup of that trash significantly ages the brain and raises the risk, it's a factor in raising risk for memory loss.

0:16:42.9 DB: So Mark, can you give our listeners kind of a sleep cheat sheet more or less.

0:16:50.3 MM: One of the biggest, most impactful tips is think about something that you do, not right before bed, but think about what you do when you wake up in the morning, and there's just all of this really interesting insights, these studies, it's actually, part of this won the Nobel Prize that basically, you have this clock in your brain, and it's... Think of it like a count down timer to when you're gonna fall asleep at night, and you have to start the count down every day.

0:17:13.7 MM: You do this every day, your brain clock, it's called your suprachiasmatic nucleus, and we clearly see now that you start the count down in the morning by getting outside in the presence of natural sunlight for about 10 or so minutes, within about a half hour of getting up and that natural light, your brain notices it and it starts the count down that's gonna help you fall asleep at night. Again, it sounds so simple, and we often think about, sleep is something I prepare for 5, 10, 20 minutes before bed, but you're actually preparing for every night sleep in the morning by getting outside, and we've actually seen in the last couple of years more issues with sleep, and also more memory issues, and we believe part of this is over the last couple of years where you haven't been getting out as much, we've been spending more time at home, less commuting time, so something that's really simple and actual as walk, walk the dog in the morning. Go to the front yard, the backyard, the balcony, just that little bit of light in the morning starts a countdown, it's also a fascinating area of science and medicine now called Chrono biology, 'cause that brain clock, as we talked about earlier, it doesn't just control your sleep, it plays a role in your mood, your metabolism, very much this idea of how things are very much connected, so something...

0:18:19.3 MM: Again, an idea of something so simple, a little bit more morning light can have this powerful impact on your mental, physical health.

0:18:25.7 DB: Can you tell us a little bit... I find it really interesting, the idea of sun setting your room...

0:18:31.1 KC: Yes, me too.

0:18:32.6 DB: That's so cool. Yeah, I've never even thought of something like that.

0:18:34.2 KC: Yeah.

0:18:35.0 MM: Yeah, absolutely. So I like to think of it like create a sunset in your bedroom at night, so it's the opposite of giving your brain that light in the morning, and our rooms, when you go back to your room tonight, look around, is it dark? Or is it modern dark? And we've gotten so used to our rooms being illuminated with all these different types of lights in the room. They seem so silly and insignificant, but especially in the hour before bed, and also while we're sleeping, but thinking about, about an hour before bed, 45 minutes before bed, create a sunset in your room, 'cause we miss the sunset nowadays because our rooms are so lit up and our lives are so lit up, so start lowering the lights, and what that is doing is your brain clock, which is so important in the morning, is also critical at night to recognize darkness, and as you're lowering the lights, the brain clock goes, Oh, it's night time and it starts your brain releasing melatonin, and that melatonin plays a key role in helping you fall asleep and really stay asleep, so think of your bedroom as catching that sunset, and don't...

0:19:37.3 MM: It's so easy to have... You know, Looking at a screen, have all the lights on, you turn everything off, you jump in bed and you're like why am I having trouble falling asleep? Well, our brain needs this time to let the melatonin essentially flow, and it does that by getting our brain prepared for darkness.

0:19:53.2 DB: Mark, will you tell our listeners about what tennis player, Pete Sampras does? I love that part.

0:20:00.5 MM: Oh yeah, yeah. So Pete Sampras is... He... I like to say that he beat brain scientists to a major discovery by quite a few years, and what he did was when he was on the tour and he was playing a big match and he checked into a hotel room, he would take black masking tape and he would cover up every light source in his hotel room, and he did this, not only turning everything off, but there's that little light on the TV and it's that little red dot, he'd cover that up and everything he could cover, and he found that if he slept in true darkness, not only did he play better, he was more focused, he had more energy, he just felt like... Felt so much better. And at the time, people thought, Oh, this is bizarre. It's almost like Primadonna behavior, but he was on to something, those little bits of light in our bedrooms that seem so insignificant, Studies came out just a few weeks ago, that they had people sleep in a room where it was just the amount of light where you couldn't read by the light, it wasn't enough to read, but it was enough to sort of navigate the room, and they tested people's blood pressure, their heart rate, their insulin response, and all the numbers were off, and what we believe is happening is our brain...

0:21:02.8 MM: If there's these little bits of light in the room, these artificial lights that our brain is not allowing us to get into deep stages of sleep, it's like our brain is thinking wait, what's going on? It's almost like I'd say in a fight or flight response, even if it's subtle, and so that can keep us from getting into the deeper stages of sleep where we have that brain wash take place, and so it's just this idea of how just these little things like taking a moment, assess your room, you don't have to mark it up with black masking tape, you don't have to go that far tonight, but think about unplugging something, move a device to another room, you might wanna try an eye mask or a clean shirt or towel and just experiment with making the room a little bit darker. People are often surprised. I feel more refreshed the next day.

0:21:42.6 DB: Boy, shout out to my college roommate, Chris, who would tape aluminum foil to all of the windows allowing zero light in. Way ahead.

0:21:50.0 MM: He was way ahead. Yeah. Yeah.

0:21:55.5 DB: Okay Mark, the people wanna know, You write about how lifestyle factors like mindfulness, exercise, diet and social connection have an impact on our brain health, what are some important key takeaways that listeners need to know?

0:22:08.3 MM: Yeah, the key thing to think about is that it's the accumulation of these things, so it's not just one thing. The studies just keep coming out. A week ago they found people in China for several decades, and they just keep seeing that it's the combination of these key factors, and that we just wanna do whatever we can to leverage the odds in our favor. And so, for example, if we talk about diet, diet is definitely individualized and people find within the parameters of what's brain healthy, what works for them, but if you just want some really simple... I like everything to be as simple as possible in all this complexity, and just something that's really simple, as if you just think about the foods that you're eating, if they're just... If they're gonna spoil... Are they gonna spoil some day... You're in a good track, because I tell the story in the book of the Twinkie at the Museum in Chicago, that they unwrapped like l0 or 12 years ago, and it looks like it would be delicious to eat today, those are the foods that... The foods that never spoil, they're so filled with additives and preservatives. Those additives and preservatives get down into our gut, and they can cause inflammation that can impact the brain, it's just another example where one thing that you might not think is connected is connected, and so just thinking about most of the time, even 80% of the time, studies might suggest it is.

0:23:24.1 MM: It doesn't have to be 100% of the time, but about 80% of the time eating whole, natural foods, things like fiber, fruits, vegetables, nuts, olive oil, a Mediterranean-like diet, there's this data that people who follow like a mind diet, which is very much a Mediterranean like diet people eat these foods most of the time, if they sort of follow this diet, they lower the risk by about 35%, if they strictly follow the diet, they lower the risk by about 53%. So we see a powerful impact of food on our gut health and thus our brain health, it also plays a role in heart health, again, this idea that all of these factors are connected and we are seeing the diet does play a role, so just coming back to this idea of really simple, little changes can be impactful.

0:24:05.9 KC: That's significant. I'm just still really letting that sink in.

0:24:12.3 DB: That's huge.

0:24:12.4 KC: Yeah. Hello, Mediterranean. Here I come. [laughter] Okay, so for all of the listeners who are starting to really get excited about everything you're sharing and they want to start making change, you very smartly answered the question now What? In the book, because you end the book with the seven day challenge, your brain boot camp which gives great tips for how to incorporate diet, exercise and mindfulness into our daily routines, you actually break each of the seven days out step by step, from the time you wake up to the time you go to bed with all sorts of great tips. What advice would you want to leave our listeners with? What tips do you really wanna resonate from this podcast today?

0:24:51.5 MM: You know, I think that it's important to have these conversations. I appreciate you having me on because some of these things are hard to talk about, but I think that in all of this data that we're seeing, really bringing it back down to a couple of key things that we don't want to ignore fun, because fun is really good for your brain. So think about what do you love to do? If you love to sing, that's really good for your brain. If you like to dance, that's really good for your brain, you like to play sports, like to get a massage, that's really good for your brain, you like to learn new things, socialize, it's not always about taking things away, and I wanna really get that message out that sometimes people think, Oh, so I'm gonna have to eat kale all day and run a marathon, it's really about just looking at your day and saying, be happy with the things you're doing that are great, and where can I make some small changes? Or maybe start with one change, take a morning walk, if that's something you're not doing, if you are doing, keep doing it.

0:25:52.3 MM: If you are not doing it, think about a morning walk and then the book goes through all these other little things that just have this big impact that sounds simple, but in our modern world, we can easily push to the side or say, I know I should do that, but I'm not quite doing it. So bringing these little things back can be very impactful for not only our long-term brain health, but day-to-day brain health.

0:26:11.4 DB: I wanna thank our guest today, Mark Milstein. To find out more information about his work and Mark's book, visit drmarkmilstein.com. Thanks, Mark, and thanks Kristen.

0:26:21.2 MM: Thank you.

0:26:23.5 KC: Mark, thank you so much for this really inspiring podcast, you shared a lot of really important information, but also left us with a lot of tips and tools that we can incorporate right away. Thank you so much.

0:26:34.0 MM: Oh, thanks. I appreciate that, thank you.

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