Why lifestyle, not genes, drives 70% of how you age

1. 0:00 – 2:04

   Intro

   1. RPDr Rhonda Patrick0:00

      Why do people not know that vitamin D deficiency can increase dementia risk by 80%? Why do people not know that having a lack of this mineral is affecting their long-term risk of cancer? Why do people not know that having a low omega-3 index is as bad for you, in terms of mortality, as smoking? And as a scientist, I've seen firsthand that 70% of the way you're aging is actually due to your lifestyle. And all these things are so easy to do. So for example, as we age, certain areas of the brain which is involved in learning and memory starts to shrink by about 1 to 2% per year. The good news is studies show that people being part of an exercise protocol, not only did they not have their hippocampus shrink, it actually grew by 1 to 2%. And there's more. There are other things that don't even require as much effort as exercise, like supplements. And it's been shown study after study that if you take someone and you sleep deprive them for 21 hours and give them 25 to 30 grams of creatine, not only does it negate the cognitive deficits of sleep deprivation, it makes people function better than if they were well-rested. And then there's magnesium. There have been studies showing that people with the highest magnesium levels have a 40% lower all-cause mortality. And over 300 different enzymes in your body need it to help with short-term survival. And yet, 50% of the population in the United States does not have adequate levels of magnesium. And there's still more. There's saunas, red light therapy, ketogenic diets, blueberries, electrolytes, and we can talk about all of 'em.

   2. SBSteven Bartlett1:23

      Please.

   3. RPDr Rhonda Patrick1:24

      Okay. So I've found when you go into the sauna, something happens that's incredible. So...

   4. SBSteven Bartlett1:31

      I see messages all the time in the comment section that some of you didn't realize you didn't subscribe. So if you could do me a favor and double-check if you're a subscriber to this channel, that would be tremendously appreciated. It's the simple, it's the free thing that anybody that watches this show frequently can do to help us here to keep everything going in this show and the trajectory it's on. So, please do double-check if you've subscribed and, uh, thank you so much. Because in a strange way, you are- you're part of our history and you're on this journey with us and I appreciate you for that. So, yeah, thank you. Dr. Rhonda Patrick,

2. 2:04 – 3:37

   My Mission to Improve People's Health

   1. SBSteven Bartlett2:04

      you strike me as a fairly obsessed person. What is it you're obsessed about and why are you obsessed about it? Because I can see from speaking to you previously how passionate you are about the subjects we're gonna talk t- about today. And so I was- I was, um, I was wondering what it is about these subjects that is driving you and what- what you're trying to accomplish?

   2. RPDr Rhonda Patrick2:28

      I've learned through my experience, so I have a PhD in biomedical science, I've done research on aging, on cancer, on metabolism, nutrition, neuroscience, a lot of different fields, very cross-disciplinary. And I've realized over, you know, the decades of doing research that there are many different small changes that can be made that have a really big impact on our health, what's called our health span. So this is essentially being disease-free, uh, throughout our life, being healthy, feeling good. And I'm sort of obsessed with trying to optimize that and find a protocol to optimize it and then share that information with the world. And it's funny because, you know, we live in a time now where we've got access to so much information, overwhelming amount of information, but the reality is is that simple important tools that people can do in their life right now to drastically improve the way they age are still not known to the general population. And so my mission is to get that knowledge to people so that they can make these simple changes and live healthier and feel better.

3. 3:37 – 5:09

   What Impact Will Rhonda's Research Have on People?

   1. SBSteven Bartlett3:37

      And what will be the impact on their lives if they understand that information and start to implement their in- that information on a real sort of specific practical... in a real specific practical sense?

   2. RPDr Rhonda Patrick3:48

      Well, there are things that people are deficient in, for example, that they could simply take a supplement, vitamin D is a- is a good example, that could affect their disease risk, their dementia risk. I mean, so you're talking about quality of life improvement right now and also later. So it affects mood, it affects depression, and it affects your neurodegenerative disease rick- risk like dementia and Alzheimer's disease. So there are low-hanging fruits, things that are simple that you can just basically fill these gaps. And then there are things that are also a little more effortful, and this is where exercise comes in, where you put in this effort and it just... If you could pill up what exercise does in a pill, I mean, it would be the biggest blockbuster miracle drug out there. I mean, it'd blow Ozempic out of the water. It'd be... I mean, just no comparison. So, um, I think- I think that, you know, again, that it's- it's these little things that you can do that is going to help with depression, help with mood right now, make you feel better right now, give you more energy, help you be more focused, help you be more motivated, but also affect your long-term disease risks, so that, you know, when you're older in life, you're not demented, and that affects you, it affects your family. So I think- I think it's- it's just an important... It's so important because there are easy things that can be done that people just don't

4. 5:09 – 9:53

   The Role of Genetics in Aging vs. Lifestyle

   1. RPDr Rhonda Patrick5:09

      know about.

   2. SBSteven Bartlett5:09

      Is there a psychological element to this where we kind of see aging as an inevitability, so we don't fight it? Because we only seem to interfere with and fight and are motivated by things in life that are- where we feel like we've got an element of control. And we see- we see everybody get old and we see everybody start to, you know, lean over a little bit and struggle to walk and get a little bit more frail. So I think 'cause we've observed that so much over the last couple of decades, you know, I'm 30 years... I'm just over 30 years old, I assume that'll happen to me. So I've seen my dad, you know, get older, get a little bit more large, lose his lean muscle. So I think, well, I'm like my dad, I've got the s- some- some of the same genetics, that's inevitable for me.

   3. RPDr Rhonda Patrick5:52

      So genetics does play a role in the way you age, but it's a small role. In fact, 70% or more of...The way you're aging is actually due to your lifestyle. Let's just imagine two 70-ish-year-old men, okay? John and Rob. And John, you know, he's razor sharp. He can carry groceries to his car. He doesn't get out of breath, you know. I mean, he is, he's feeling healthy. He is able to... He can walk efficiently, right? And then there's Rob, and Rob is forgetting his words, you know. He's not cognitively sharp. He's out of breath just from walking to his car. He has a really hard time carrying groceries. Genetics only plays a, a small role in, in th- those two different outcomes for those two men. The biggest, I would say, thing that's dictating the way these two men age is their lifestyle, with a huge part of that actually being exercise.

   4. SBSteven Bartlett6:50

      Mm-hmm.

   5. RPDr Rhonda Patrick6:51

      And, you know, I know we've all heard it from our mother or grandmother, great-grandmother, you know. "Exercise is, is good for you. If you eat healthy and you exercise, you're gonna, you're gonna be healthier." And that's like a general statement. But the reality is, it is so true that exercise affects everything, you know, down to the molecular level in terms of, like, the way you're aging. So, um, no, it's not just dic- dictated by genetics, and it's not inevitable, and there are things that you can do to dramatically age better.

   6. SBSteven Bartlett7:23

      So let's play a little, a little game here. So imagine that I listened to your advice and the things that you know about health, longevity, aging, um, and I followed all of them, which is very hard to do because, you know, implementation is, is not the same thing as knowledge. So imagine that's person A, that's Steve A., and then there's Steve B. I do the exact opposite. Based on what you know about the science and about outcomes and expected outcomes, how would Steve A, that followed your advice, live his, uh, live his life as he ages, and how would Steve B, how would his outcomes be as he ages? Like, what would you... If you had to... Obviously this is like super... You're, you're forecasting here, and it's not hypothetical, but what do you think the variance in these two people's lives would be?

   7. RPDr Rhonda Patrick8:08

      Well, if you're talking about the extreme ends, like if Steve B was like eating sugar and smoking and drinking and just obese and sedentary, everything that you don't want to-

   8. SBSteven Bartlett8:19

      Which is like a lot of the population.

   9. RPDr Rhonda Patrick8:20

      I mean, then you're talking like a 14-year difference in life expectancy, which is pretty big. But not just life expectancy. The way... Your, your independence, right? Your, your mind. So you'd be forgetful. I mean, it would just be... It would, it would be a, a terrible quality of life, right? So it's not only are you gonna die earlier, you're not... You're just not gonna live a good quality of life. So, so Steve A might be into his 90s and out surfing, you know, because you're... You've exercised. You've, you've given your body, like, the right nutrients that it needs. You've gotten good sleep. You're not overweight. You're not eating a lot of refined sugar. All these things that sort of accelerate the aging process, and we can talk about different components of this and how they do affect the way we age and our disease risk. But I mean, there's, there's studies that show even like a 14-year difference in life expectancy for like someone who's morbidly obese versus lean.

   10. SBSteven Bartlett9:21

       So Steve A could be out surfing at 90, and Steve B would be potentially dying at 75, but also his quality of life would... His health span would diminish probably in his 40s and 50s.

   11. RPDr Rhonda Patrick9:34

       Right.

   12. SBSteven Bartlett9:35

       So it's really... So it's, so it's a 14-year reduction in life span, but potentially a 30, 40 year reduction in health span.

   13. RPDr Rhonda Patrick9:42

       And quality of life and health span, being able to be functionally independent, being able to be cognitively sharp, feel good, right, in your mood. I mean, all these things are affected.

5. 9:53 – 15:15

   The Future of Aging, Longevity, and Gene Therapy

   1. RPDr Rhonda Patrick9:53

   2. SBSteven Bartlett9:53

      You must be sitting on some, some crazy ideas because as a biomedical science-

   3. RPDr Rhonda Patrick9:57

      Mm-hmm.

   4. SBSteven Bartlett9:57

      ... you can kind of see... As a biomedical scientist, you can see some of the research and technology that's coming down the pipe. So I'm wondering, before we get into the, the conversation, are there any big ideas about the future of aging and longevity that are in your mind that you think about that are actually really important to know? Because as Bryan Johnson has often said to me, "You want to live to, to see these breakthroughs."

   5. RPDr Rhonda Patrick10:25

      Yes, yes. I am excited about some gene therapies and being able to sort of reprogram our, our cells to be more youthful. So, you know, this is, this is something that was pioneered back in 2006 by Shinya Yamanaka from Japan, and he actually won the Nobel Prize. Why his research was so important for the field of aging wasn't really known at that time. What he had shown is that you could take a cell that's old, and it could be a c- any cell. It could be from an 85-year-old person with Parkinson's disease, for example, and you get it... You know, we're constantly getting skin cells and sloughing them off every day. You can take one of those cells and add four different proteins to them. They're called transcription factors. Essentially, all that means is they're kind of like master orchestrators of many different genes in your body and how genes are activated and turned on and doing what they're supposed to, or they're turned off and quiet for the time that they're supposed to be quiet. And it's... You, you add those four proteins, and you can take that 85-year-old cell, skin cell from a person with Parkinson's disease, and you can make it into what's called an embryonic stem cell. And it does that by sort of wiping out the what's called epigenome. So people are familiar with their DNA, right? Well, the epigenome is something that sits- sort of sits on top of your DNA, and it regulates, you know, how your genes are being expressed or turned on and off, right? And it sort of brings it back, reprograms it to this youthful state where it becomes an embryonic stem cell, and then that embryonic stem cell can then form any type of cell in the body. It can form a heart cell or a liver cell or a brain cell or a cell from your eye.And so this is called induced pluripotent stem cells. And this was a breakthrough at the time because it's, it was so important, it's important for cell regenerative therapies. Okay, let's say someone does have Parkinson's disease and you want, you know, Parkinson's disease people are losing dopaminergic neurons in their substantia nigra. So these are dopamine-producing neurons. And dopamine is important for motivation and it plays a role in our, you know, cognitive function, but it's also important for movement, right? So, um, people with Parkinson's disease are losing those at a rapid rate and they lose control of their motor capabilities. And so you wanna be able to take an old skin cell from someone, reprogram it to become a dopamine neuron and then inject it into that person, right? It's their own cell, so they're not gonna reject it, right? So that was, like, the big thought at the time. Fast-forward, you know, a decade or so and a, a whole handful of brilliant aging scientists have discovered that instead of taking these old cells and putting these four proteins on it to become this sort of stem cell, they can pulse it, just a quick little pulse.

   6. SBSteven Bartlett13:21

      What is a pulse? Like an electronic shock?

   7. RPDr Rhonda Patrick13:22

      No. What I mean is (sighs) it's just not incubated for as long of a time period. So it's a shorter time interval that you're putting these four different transcription factors on top of the cell that reprogram it, right? And the reason for the shorter time is that you don't want it to lose its cellular identity.

   8. SBSteven Bartlett13:41

      Mm-hmm.

   9. RPDr Rhonda Patrick13:42

      So let's say it was a skin cell. You want it to stay a skin cell, not become an embryonic stem cell. But you want it to be a skin cell from a one-year-old, not an 85-year-old.

   10. SBSteven Bartlett13:53

       Mm-hmm.

   11. RPDr Rhonda Patrick13:53

       So the way to do that is what's called partial reprogramming. And so they, basically, researchers have found that you can just sort of what I call pulse, it's partial reprogramming, you're kinda putting it on for, like, a shorter period of time. And then that cell keeps its identity, but it's youthful. It wipes out all the damage, everything that's accumulated over those, those 85 years. And this has been shown in animal studies, in rodents, that if you, if you add these four different transcription factors and you give 'em to mice, you can rejuvenate many of the different organs. So essentially turning back the aging clock in different organs in these mice. Now this obviously has to be translated to humans, but I think it's super exciting and I do think it's the future in terms of solving aging and rejuvenation, re- rejuvenating our organs. And so it's something that I'm pretty excited about and following closely.

   12. SBSteven Bartlett14:50

       And are they then living longer?

   13. RPDr Rhonda Patrick14:53

       Some of these studies were done in animals that are what's called accelerated aging.

   14. SBSteven Bartlett14:57

       Wow.

   15. RPDr Rhonda Patrick14:57

       So yes, they were living longer in that background of accelerated aging. Um, the question is, you know, can they live longer if it's just a normal mouse that's not, like, an accelerated aging model? And, and these are things that are all being done right now. These sorts of studies are in progress.

6. 15:15 – 22:17

   Death-Related Risks of Being Sedentary

   1. RPDr Rhonda Patrick15:15

   2. SBSteven Bartlett15:15

      Where do you think is the most important place for us to start this conversation, based on everything you know? And maybe some of the... Presumably there's some, like, foundational stuff, right?

   3. RPDr Rhonda Patrick15:24

      I do. I think the import- important place to start would be we're talking about, we're talking about aging as a disease, and I think being sedentary is a disease. And I think that's a good place to start. What I mean by being sedentary is not physically active. Someone who doesn't engage in any type of physical activity.

   4. SBSteven Bartlett15:48

      And what is the spectrum there of, you know, someone who doesn't move at all for, you know, 24 hours a day versus, or you've got obviously someone that's constantly running marathons and doing crazy stuff? But where is, where are most of us on that scale, and are we moving enough?

   5. RPDr Rhonda Patrick16:01

      Most of us are not moving on that enough. And most of us are, if you're talking about globally, we're on that sedentary scale where we're just not physically active. We sit at our computer or our desk or our cubicle, you know, all day, and we're not, we're not actually moving around a lot. Um, and I say, I say sedentarism is a disease because it's actually been shown to increase the risk of early mortality even more than diseases that we know of, like type 2 diabetes, cardiovascular disease, or even terrible habits like smoking. So being sedentary actually could predict early mortality even more than those diseases. But it, it, it... Let's take a step back. It's even bigger than that. There (sighs) there's this amazing study, it's called the Dallas Bed Rest Study. And the study started back in the 1960s, and this is done by probably the world's most talented cardiovascular exercise physiologists. And so Ben Saltine, uh, Jerre Mitchell were involved in this early study in the 1960s. And what they did was they took five men, they were college students, and they put them on bed rest. And this is, like, three weeks of legitimate bed rest. We're talking they couldn't get up to go to the bathroom, so they had a catheter in them. They did not move for three week. The researchers wanted to find out what happens to your cardiovascular system if you are not moving around for three weeks. And now if you think about it, you know, there's a lot of people that are undergoing surgery or they have some sort of bad illness, influenza or something, that keeps them bedridden for... It's not unusual to be three weeks, to be honest. So it's not completely irrelevant. And what was found is after that three weeks, you know, their cardiovascular system was just tanked. And one of the major... Th- they were probably the, some of the most well-studied men at the time, and, um, one of the biggest factors that was measured was their cardiorespiratory fitness. This is often called VO2 max, and essentially it's the maximum amount of oxygen that you can breathe in and your lungs then bring that oxygen to your muscles. And it's measured during maximal exercise. You're putting in a maximal effort, and that's called your cardiorespiratory fitness. And we can talk a little bit more about that. But their cardiorespir- respirator fitness tanked.And now, I mentioned this was in the 1960s. About 30 years later, and this is where, uh, Ben Levine came into the study. He's at the UT Southwestern in Dallas. He's also very, uh, one of the most famous, you know, cardiovascular exercise physiologists out there right now. They found these five men from 30 years earlier, and they measured their cardiorespiratory fitness and a variety of other parameters that they had measured at the time. And what they found was that three weeks of bed rest was worse on their cardiorespiratory fitness than 30 years of aging. So essentially, their cardiorespiratory fitness was no worse 30 years later than it was after their three weeks of bed rest. Which is kind of amazing because you would think that the 30 years of aging would be worse on your cardiorespiratory fitness than the three weeks of bed rest.

   6. SBSteven Bartlett19:20

      And it's the same, the same individuals?

   7. RPDr Rhonda Patrick19:21

      The same individuals. The same five men. Um, now, after the three weeks of bed rest, you know, back, back in the 1960s, they were able to get their cardiorespiratory fitness back up again once they started exercising and moving around, and it took a while. But when you look at their baseline levels, their baseline cardiorespiratory fitness, and you compare it to their cardiorespiratory fitness baseline 30 years later, it wasn't worse than what happened when they, they compared it to the three weeks of bed rest. And you might go, "Well, why is that so significant, the cardiorespiratory fitness dropping?" We know that cardiorespiratory fitness is one of the best predictors of longevity, so there are studies that have shown that people with a high cardiorespiratory fitness live five years longer than people with a low cardiorespiratory fitness. That's, you know, pretty big difference. They're, they're basically 80% less likely to die of many different causes of, of death, so cardiovascular disease, cancer, respiratory disease, things like that, than people with a low cardiorespiratory fitness. So they're, you're really getting, you know, a five-year increased life expectancy. You're sort of pushing and delaying those age-related diseases like cardiovascular disease, you know, like cancer, for example. You're pushing 'em down later in life, so you're not, you're not dying from them sooner. And we do know that really just going, getting anywhere out of that low cardiorespiratory fitness, so people with a low cardiorespiratory fitness are people that are sedentary. And if you just move anywhere above that, even if you're going low, from low bad to, like, low normal, you're gaining about two years increase in life expectancy. And that's not really that hard to do, but if you think about cardiorespiratory fitness, like right here just having this conversation, actually even just sitting quietly, it takes about three milliliters of oxygen per minute per kilogram body weight to do that. To carry groceries to your car, it takes about 11 milliliters of oxygen per minute per body weight, per kilogram body weight.

   8. SBSteven Bartlett21:29

      Mm-hmm.

   9. RPDr Rhonda Patrick21:29

      And so as you're aging, you're kind of heading towards this cliff, right? Because your cardiorespiratory fitness goes down with age. It does. That's what happens naturally. If you're at the point where you don't work on your cardiorespiratory fitness, if you're not being physically active, and there are certain exercises that are better at improving cardiorespiratory fitness than other, others. If you're not, uh, trying to improve it, you're going to be heading towards that cliff faster, and then everything becomes a maximal effort. You're out of breath just talking. You're out of breath carrying groceries to your car. Everything is a maximal effort, and you don't wanna be there. You do- that, that quality of life is not good. It's not good, right? And then on top of that, you're also gonna die sooner, so you're talking about two things here, talking about decreased health span and decreased lifespan.

7. 22:17 – 25:32

   How to Improve Your Cardiorespiratory Fitness

   1. RPDr Rhonda Patrick22:17

   2. SBSteven Bartlett22:17

      So yeah, we should be moving more.

   3. RPDr Rhonda Patrick22:19

      Right, and the question is, well, how do you improve your cardiorespiratory fitness, right?

   4. SBSteven Bartlett22:23

      Yeah.

   5. RPDr Rhonda Patrick22:23

      I mean, do you lift weights? Do you go for runs? Do you bike? What is it that is really good at improving cardiorespiratory fitness? And that's the question that a lot of exercise physiologists have answered over the last couple of decades. You want to do and engage in what's called vigorous intensity exercise. So this is the kind of exercise where you're not able to have a conversation when you're engaged in it, right? So, so your heart rate is going up to about 80% your max heart rate. You're not able to really talk. And it's, I would say, you know, it's something that can be done in intervals, so you can do high intensity interval training. So you have these intervals where you're getting your heart rate up, you're doing vigorous exercise, and then you have recovery periods where you're kind of resting, you're, you're lowering your heart rate, you're not doing that max- that maximal s-s-sort of exercise. And I say this because there have been studies, multiple studies, that have shown people that engage in moderate intensity exercise, so this is the kind of exercise when you can, you're breathy but you can still kind of have somewhat of a conversation while you're doing it.

   6. SBSteven Bartlett23:31

      Like, like the StairMaster.

   7. RPDr Rhonda Patrick23:32

      Like the StairMaster, yeah, exactly. Um, even people that are engaging in that type of exercise for two and a half hours a week, so this is following the physical activity guidelines, 40% of those people can't improve their cardiorespiratory fitness. And it's like, well, I don't know about you but, like, I don't want it to be a coin toss in terms of, like, if I'm doing that kind of exercise, well, I have a 50% chance of not improving my cardiorespiratory fitness if I'm doing this. I want the sure thing, and the sure thing is you take those people and then you have them engage in high intensity interval training, and they're able to improve their cardiorespiratory fitness. And that's because you, you're putting a stronger stress on your cardiovascular system, and so the adaptations are greater. And part of the adaptations are you're able to bring in more oxygen, carry it to your muscles, carry it to your c- your, you know, other, other tissues better, and so that's your cardiorespiratory fitness. Uh, and so, and so that's, that's really, I would say, um...The bottom line here is engaging in even just once or twice a week, and I would- I would say that the most well-researched protocol for that would be something called the Norwegian four by four, and that is where you're doing a longer interval, it's a four-minute interval, and it's best done on either a stationary bike or maybe a rowing machine. And you're going as hard as you can and maintain that intensity for four minutes, and then you're gonna go down to light exercise and recover for four minutes and let your heart rate go down. And you do that four times. So it's a four by four, and that is probably one of the most robust ways to improve cardiorespiratory fitness. But there are other ways, even doing, you know, one minute on, one minute off. So you do one minute as hard as you can go, again, for that entire minute. You're not going all out, but as hard as you can and maintain that for the entire minute, and then you rest a minute, and you do that, you know, 10 times. So it's a 20-minute workout.

8. 25:32 – 30:01

   Best Workout Routine to Improve Cardio Health

   1. RPDr Rhonda Patrick25:32

   2. SBSteven Bartlett25:32

      So w- for the several million people that are listening right now, if you had to prescribe them all something to do and it was the minimum they had to do, tell me what exactly the workout would look like and how frequent it would be on a weekly basis.

   3. RPDr Rhonda Patrick25:48

      I would say the minimum effective dose would be once a week.

   4. SBSteven Bartlett25:52

      Okay.

   5. RPDr Rhonda Patrick25:53

      And it would probably be the one minute on, one minute off if you want, like, the upper end robust effects of improving cardiorespiratory fitness. You can still improve it with something like a Tabata.

   6. SBSteven Bartlett26:08

      What's a Tabata?

   7. RPDr Rhonda Patrick26:09

      Where you're doing a 20-second interval-

   8. SBSteven Bartlett26:11

      Yeah.

   9. RPDr Rhonda Patrick26:11

      ... and you're going more all out 'cause it's shorter time, and then you're recovering for 10 seconds. So it's a 20-second on, 10-second off. You do that eight times, and, um, if you repeat that twice, so it's essentially a 10-minute workout. That's also something that can improve cardiorespiratory fitness. But I would say, and I'll tell you- I'll tell you why there's the minimum, right? So the one minute on, one minute off, but I would say the Norwegian four by four is the gold standard. And that's because it's not only improving cardiorespiratory fitness. This is probably one of the most exciting th- pieces of evidence I've seen with respect to, you know, exercise and aging, and that is that being part of an exercise protocol was shown to reverse the structural changes that occur with age in the heart by 20 years. So, what do I mean by that? I mean, people that were 50 years old that were sedentary, so they weren't really going to the gym, they weren't engaging in any sort of physical activity, but they weren't, you know, they didn't have diseases, they didn't have type 2 diabetes, they didn't have cardiovascular disease. I would argue sedentary- being sedentary is a disease, but putting that aside, they didn't have any diseases, right? And they're 50, so they're midlife, and, um, this was, again, this was done by Ben Levine outta UT, uh, Southwest at- in Dallas. He took these, you know, 50-year-olds and put them on a pretty intense exercise routine for two years, or a stretching routine. This was like the- the control. And this type of exercise routine was progressive, so they started out lighter and sort of worked their way up, right? Like you don't wanna just, uh, start with the Norwegian four by four-

   10. SBSteven Bartlett27:59

       (laughs)

   11. RPDr Rhonda Patrick27:59

       ... people that ne- never exercise. I mean, that's gonna be tough. So it was a progressive sort of building up to that, but, um, towards the ends of about the first six months, these people were exercising about five to six hours a week, and that included one to two sessions of the Norwegian four by four, and it also included a lot of, you know, they're- they're doing moderate to vigorous intensity cycling or running and some- some strength training as well. And they did this for two years. Their hearts were looked at, and so as we age our hearts shrink and they get stiffer, and that plays a role in causing cardiovascular disease. I mean, that's the number one killer in the United States. It also affects cardiorespiratory fitness, right? Why does the- the heart, you know, stiffen with time? Well, it has a lot to do with actually being exposed to a lot of glucose. When you're eating a lot of refined sugar and refined carbohydrates, you're having a lot of glucose around in your system. This causes a chemical reaction called glycation. So you get these advanced glycation end products that sort of react with your collagen that's lining your heart, in your myocardium, and it causes it to stiffen. And so now the heart can't really respond to stress well. It's stiff. And that plays a role in, like, heart attacks, for example. So exercise is one of the best things you can do to move glucose outta your vascular system and get it to your muscles, and so that's- that's one of the things that it does and helps with not causing that stiffening of the heart. And so essentially, these 50-year-olds had their- their heart, the structure, so it was bigger and less stiff after two years of this, you know, exercise protocol. It essentially made their hearts look like 30-year-olds, and I mentioned they were 50-year-olds. I mean, that's amazing. That's incredible that you can take someone midlife, put them on a two-year training protocol, and reverse the aging of their heart by 20 years.

9. 30:01 – 32:28

   Norwegian 4x4 Training Explained

   1. RPDr Rhonda Patrick30:01

   2. SBSteven Bartlett30:02

      So on this Norwegian four by four, you've convinced me to give it a shot, but specifically, how I- how I do that? So it's f- it's I do my warmup and then I do four minutes of hard exercise. I take a break, and the exercise I'm doing in those four minutes can be any number of things, but I just have to get up to 85, 80% of my exertion levels, e- e- 80% difficulty?

   3. RPDr Rhonda Patrick30:27

      So the way it works is, as I mentioned, it's- it's best if you're doing a cardiovascular type of exercise, so like-

   4. SBSteven Bartlett30:33

      The assault bike.

   5. RPDr Rhonda Patrick30:35

      You could do assault bike, yeah, assault bike. You can do a rowing machine. You could do a stationary cycling machine as well.

   6. SBSteven Bartlett30:42

      Could I run?

   7. RPDr Rhonda Patrick30:43

      You can, but that is, is, it's definitely, um, it's, I think it's better on, on doing, like, maybe a bike or assault bike or something. Um, but you can run. Like, what, whatever it is that you like to do, and you are going h- as hard as you can for that four minutes and maintain within that four minutes, so it's not an all-out. Or it's far from all-out, right? But you're not really having a conversation while you're doing it. And then the four minutes of recovery, you're, if you're running, you kinda go down to walking. If you're on the rowing machine or the assault bike, you're just going very slow. You're just really going slow and you're letting your heart rate come down, you're letting your muscles kind of recover, your cardiorespiratory fitness, you know, kind, your, your cardiorespiratory fitness system recover somewhat. And then after that four-minute recovery, you go back to the four minutes of, like, intense again. And you're doing that four times. It's not easy, but, you know, people can start out, they don't ... I mean, even if you start out with not going super, super hard in those four minutes where you just, maybe you can have a conversation, but you're still going hard, harder than you're used to pushing yourself. And I think for people that haven't really engaged in any type of high intensity training before, that's a good idea, where you kind of, you gotta, you can't just start doing it-

   8. SBSteven Bartlett32:01

      Mm-hmm.

   9. RPDr Rhonda Patrick32:01

      ... right out the gate. You wanna kinda work your way up that. So, doing the four minutes, do just try to put in as much effort as you can, right? During those four minutes. And then you do your recovery and you repeat that four times, but then work your way up as you, as you do it one week, two weeks, th- you know, a month later, two months later, and really try then to get to that point where during those four minutes, you're getting, you know, you're pushing as, yourself hard where you're not really able to have that conversation.

10. 32:28 – 38:14

    How the Body Generates Energy and Exercise Intensity

    1. RPDr Rhonda Patrick32:28

    2. SBSteven Bartlett32:28

       And physiologically, what is going on in my body when I get to that 85, 90% effort range and I, and I stay there for a couple of minutes that doesn't occur when I'm doing my StairMaster?

    3. RPDr Rhonda Patrick32:40

       I mean, so many things are, are happening. I mean, there's a lot of different, I would say, physiological responses that are-

    4. SBSteven Bartlett32:48

       You've got a big smile on your face when I was like this.

    5. RPDr Rhonda Patrick32:49

       Yes, I do, because it's, you know, one of my favorite things to talk about, and it has to do with when you're, when you're pushing yourself really hard, you need, you need to make energy, right?

    6. SBSteven Bartlett33:00

       Mm-hmm.

    7. RPDr Rhonda Patrick33:00

       And the way that most of our cells make energy, like our muscles, is by using our mitochondria. These are tiny organelles inside of our cells that produce energy, but they need oxygen to do it. So, that's where the oxygen comes into play. You, when you start to push yourself really hard, you can't get the oxygen to your muscles quick enough, but you need to make the energy. And so your body decides to make energy in the form of ATP without the mitochondria, and it uses glucose to do that. And you're not making as many of those ATP energy molecules, but you're still making 'em and you're making 'em quick, and that's what your, your body wants to do. And, and, and so, it's using glucose to do that without the mitochondria, but as a byproduct, it's making something called lactate. And this is what gets me so excited because, you know, for the longest time, lactate was thought to be this just metabolic byproduct of glucose metabolism. You know, where you're, when you're pushing yourself really hard, anaerobic, it's called anaerobic. By the way, you're not, you're not only anaerobic, you're just some- somewhat anaerobic. You're still u- producing energy with your mitochondria, it's just you're also producing without the mitochondria. It's not like a, a sort of black, black and white sort of thing, right? It's a little bit gray.

    8. SBSteven Bartlett34:18

       Mm-hmm.

    9. RPDr Rhonda Patrick34:19

       But the reality is you're producing something called lactate. For the longest time, it was thought this lactate, oh, it's just, it's bad because, you know, it can form lactic acid and that burns your, forms that burn in your muscles, and, you know, this was, you know, decades ago. And we now know from the work of George Brooks outta UC Berkeley that lactate itself isn't causing the burn. And not only is it not causing the burn, it's like a miracle molecule that's being made. This metabolite, lactate, gets into your circulation, and it gets consumed by your heart, by your brain, by your liver. And it's used for energy. It's very, it's, it's very much similar to beta-hydroxybutyrate, that ketone body that you always hear about, people talk about when they're fasting or doing a ketogenic diet. It's actually very similar to that. It gets used, it gets transported through the same transporter, and it's used like energy very similar to that. Um, but what's more exciting is that lactate is a way for your muscles to communicate with other organs, like the brain, and it's called the signaling molecule. So it's, your muscles are going, "I'm working really hard. This is really hard. We have to respond to this work. We have to adapt." And so your body goes, "Okay, I gotta, like, turn on all this awesome stuff that I have because I'm working so hard, I need to respond to that so that, like, I'm, I'm good, right?" And so what happens is the lactate, this has been shown, it gets consumed a lot by the brain. And in the brain, it m- it activates something called brain-derived neurotrophic factor, BDNF. And this is kind of like a Miracle-Gro for your brain. So essentially, it's able to increase the growth of new neurons, which is amazing. It's called neurogenesis. It increases the connections between neurons, so it improves memory, cognition. And then, um, it's involved in what's called neuroplasticity, so the ability of your brain to adapt to a changing environment. This is all from lactate. Um, and it also increases neurotransmitters like norepinephrine, so focus and attention, serotonin, your, your mood, you're feeling better, you're, you know, motivated. All these things are happening because of lactate. And there's been studies in humans showing that people that are compared working hard, working out hard, vigorous exercise versus sort of moderate to light exercise, they make more lactate, and that lactate...You know, it's been shown that high levels of lactate are correlated with improved cognition scores, uh, improved impulse control. So serotonin plays a role in impulse control. So you're able to not just go on your impulse, right? You're, you're able to kind of like... which is great if you want more focus and attention, right? So this is, this is all really exciting stuff because it all comes down to just, it's, it's like your muscles are these little chemical pharmaceutical factories, and the way to make them make these pharmaceuticals is to work them, to challenge them. And that can be done with an easy high-intensity interval training protocol. A variety of them at Norwegian four by four can increase brain-derived neurotrophic factor. That's been shown. The one minute on, one minute off protocol also has been shown to increase that, again, through the lactate. So that's one of the big sort of, I would say, differences between vigorous intensity exercise and more of that moderate intensity or like low intensity exercise. And I honestly think, you know, I think the guidelines, you know, all, everyone's sort of obsessed with steps. "I need to get my 10,000 steps in, my 10,000 steps," and they have wear- wearable devices and I think that's great, but I think we need to change the 10,000 steps to at least 10 minutes of vigorous intensity exercise. Like you could do 10 minutes of, you know, any type of exercise that's really gonna get your heart rate up and it's gonna be so much better.

    10. SBSteven Bartlett38:10

        So this is a really s- dumb question, but it's the question that I had in my mind, which is if lactate

11. 38:14 – 41:09

    Why We Can’t Drink Lactate and the Impact of Vigorous Training

    1. SBSteven Bartlett38:14

       is such a miracle drug, why can't I just drink it? Why can't I just get, get a shot of lactate versus-

    2. RPDr Rhonda Patrick38:22

       We-

    3. SBSteven Bartlett38:22

       ... having to go through vigorous interval training?

    4. RPDr Rhonda Patrick38:25

       It's a great question, Steven, because, um, there have been studies that have been done looking at, for example, traumatic brain injury patients, so people that have undergone some sort of head trauma, and they've infused sodium lactate through like an IV into their, you know, system and the lactate immediately gets consumed by the brain and it's been shown to improve their recovery. So it's called the Glasgow score, you may have heard of it, but it's kind of essentially this battery of tests that's done to sort of assess how someone's recovering from traumatic brain injury and the sodium lactate does improve that. So there are... you can find out there, you know, different types of lactate that you can consume.

    5. SBSteven Bartlett39:08

       Mm-hmm. (laughs)

    6. RPDr Rhonda Patrick39:08

       And theoretically it should help. But what happens is when you consume the lactate, lactate actually gets used by the gut. So a lot of it's going into the gut cells before it gets into your circulation.

    7. SBSteven Bartlett39:21

       There's always a trade-off with these bloody things. Whenever you try and tr- trick the system or shortcut the system by like drinking something, I feel like there's a trade-off which people don't talk about a lot.

    8. RPDr Rhonda Patrick39:31

       Well, the thing is, is that I... it is good for the gut. In fact, uh, former co- colleague of mine, Mark Shigenaga, has shown that lactate is really beneficial for, for, uh, the gut epithelial cells. In fact, if you think about it, all these sort of beneficial probiotic bacteria like bifidobacterium, for example, they're producing lactic acid and that lactic acid does get converted into lactate. It's sort of like this physiological homeostasis where you have, uh, the difference of just a hydrogen atom. So you're having lactic acid and lactate sort of in this equilibrium, so to speak. But, um, those, those bacteria in your gut are making lactate essentially. And the reason it's so good is because it is an very e- easily utilizable source of energy for the gut cells. So not to like go off on a tangent here. Yes, there is always a trade-off, (laughs) especially if we're doing something orally, but when it comes to exercise, there's so... like I mentioned when we first started talking about exercise, if you could pill up what exercise does, it sh- it, it... I mean, it's so many things, right? It's not just the lactate.

    9. SBSteven Bartlett40:35

       Yeah.

    10. RPDr Rhonda Patrick40:36

        So many different things, so many different adaptations that occur. I mean, it would be a miracle drug. So there's... you're not just getting the lactate, you're getting the, you know, the improvement in cardiorespiratory fitness. You're getting the muscular response, right? The adaptations to your muscle. Um, you're, you're increasing stress response genes like heat shock proteins that are important for preventing neurodegenerative disease. You're making antioxidants because the inflammation that you're generating while you're exercising. There's hundreds and hundreds of things that are happening all in concert from exercise, and you just can't... you can't pill it up.

12. 41:09 – 42:20

    Decline in Production of Lactate, Creatine, and Other Key Substances

    1. RPDr Rhonda Patrick41:09

    2. SBSteven Bartlett41:09

       I have another really silly question, which is, if lactate and these other things even like creatine and, you know, all these other things are so good for me, why doesn't my body just make more of it? (laughs)

    3. RPDr Rhonda Patrick41:19

       I mean, your body does make it. The, the problem is, is that, you know, as we're aging, everything becomes less efficient. Everything doesn't do what it used to do as well as it did when it was younger. Um, and it... and also in the, in the case of creatine, which we can talk about, you know, later if you're interested, then, um, you know, your body only makes so much of it, and-

    4. SBSteven Bartlett41:42

       Why doesn't it make more? (laughs)

    5. RPDr Rhonda Patrick41:44

       You, you know-

    6. SBSteven Bartlett41:45

       Maybe I'm not giving it the, the minerals or the environment it needs naturally to make more. I don't know.

    7. RPDr Rhonda Patrick41:51

       Y- you get it from your food too. Creatine is found in meat, in poultry and fish. So probably that's why your body doesn't make more of it, because it knows you're gonna be getting it from your diet as well.

    8. SBSteven Bartlett42:04

       Mm-hmm.

    9. RPDr Rhonda Patrick42:04

       And so that is another way to get creatine.

    10. SBSteven Bartlett42:07

        Okay.

    11. RPDr Rhonda Patrick42:08

        Of course, the vegans and the vegetarians, that's a whole other ballgame because they aren't eating meat and so they're really essentially only relying on what their body can make.

    12. SBSteven Bartlett42:17

        We'll definitely talk about that later. Um, on

13. 42:20 – 46:58

    How to Reduce Cognitive Decline

    1. SBSteven Bartlett42:20

       this point of the brain then, if, if I... I don't want to be an older person who can't remember things and stutters over my words and s- falls into cognitive decline, and I'm at... I'm 32 now, so I'm... I feel like I'm in a moment in time where I can really make decisions now that have a really big impact on my 90-year-old brain and my ability to think straight and clearly and remember things.Are there things that I can be doing now that will have a profound impact on my cognitive performance at 90?

    2. RPDr Rhonda Patrick42:48

       Yes.

    3. SBSteven Bartlett42:48

       And what are those things?

    4. RPDr Rhonda Patrick42:49

       Absolutely. Well, first of all, just to kind of wrap up the exercise story, because I think this study is so profound, and in fact, it wasn't done in 32-year-olds, it was done in older adults. So we're talking 60-year-olds or a little bit older, and these individuals were put on a aerobic exercise training program for one year that was more of like a 70 to 75% max heart rate. So it wasn't so vigorous, but it was pretty, pretty vigorous for them, right? And, um, the, the basis of this study was to look at brain aging. As we age, I mentioned our heart aging, right? It gets stiffer and shrinks with age. Our brain also shrinks with age. It's called atrophy. And as we age, especially starting in midlife, so around the age of 50, your, your brain and certain areas of the brain like the hippocampus, which is involved in learning and memory, starts to shrink by about one to two percent per year.

    5. SBSteven Bartlett43:45

       I don't want that to happen.

    6. RPDr Rhonda Patrick43:46

       Same. Same. The good news is, um, in this study, after a year of this sort of aerobic exercise training program, they were doing three times a week, about 30 minutes a day, really not even that intense. These individuals, and then there was a control group that was kind of the stretching, they like to use the stretching as the (laughs) control group. So that, let's talk about the, the control group, the stretching group. They did lose about one to two percent in terms of the size of their hippocampus. It shrunk one to two percent after that year, which is what you would expect normally. However, the group that was training, not only did they not have their hippocampus shrink by one to two percent, it actually grew by one to two percent, which comes down to that neurogenesis, that growth of new neurons, the brain-derived neurotrophic factor that's able to do that. You're actually able to grow new neurons even when you're in the age of 50, which is amazing. It's incredible. So that study I love because a couple of reasons. One, it shows that it's possible to s- not only stave off, you know, some of the components of brain aging, but to reverse it and increase it, right, through exercise. And number two, I love it because it's never too late. Like, you can start this, you know, in your 60s and still have a benefit, right? You're, you're talking about being in your 30s, but you know, some people watching this show, listening to this show may already be in their 50s or 60s, right?

    7. SBSteven Bartlett45:22

       Right.

    8. RPDr Rhonda Patrick45:22

       So it's never too late. Um, likewise, you know, we're talking about being cognitively sharp and not getting dementia. There's also studies showing that people, like women that were brought into the lab, they had their cardiorespiratory fitness measured. Those women with the highest cardiorespiratory fitness were 80% less likely to come down with dementia over the follow-up period of time. So it, again, I think exercise is one of the big ones when it comes to brain aging. But you asked an important question. You say, "What can I be doing now that's gonna affect the way my brain ages, you know, for the subsequent decades of my life?" And there are other things that can also be done that don't even require as much effort as exercise. Exercise is the gold standard because, I mean, being able to not only, you know, stave off atrophy of the, of the brain, but to like regrow some of it is incredible, right? I mean, that's just mind-blowing.

    9. SBSteven Bartlett46:19

       Have they ever taken people with dementia, Alzheimer's, and put them on an exercise program and monitored the decline of their cognitive abilities on an exercise program?

    10. RPDr Rhonda Patrick46:30

        Yes. I mean, it's, it's much harder when you already have someone who is in that pathological state because things just really snowball-

    11. SBSteven Bartlett46:39

        Yeah.

    12. RPDr Rhonda Patrick46:39

        ... and accelerate. And there are some benefits. I mean, but it's not, it's n- Prevention's always the best.

    13. SBSteven Bartlett46:46

        Yeah.

    14. RPDr Rhonda Patrick46:46

        Prevention's always the best. And so, you know, I, I think that if there's any sort of take home here, it's that like, let's, let's try to do what we can now so that we don't get to that point.

14. 46:58 – 52:56

    What Causes Dementia and Alzheimer’s

    1. RPDr Rhonda Patrick46:58

    2. SBSteven Bartlett46:58

       Before we get into the, the, the easier ways of staving off cognitive decline, d- do we know what causes dementia and Alzheimer's yet? Do we, do we have any ideas? 'Cause we can... When they do the brain imaging, they can kind of see these plaques on the brain, they say, but...

    3. RPDr Rhonda Patrick47:14

       I mean, there's a lot of different... It's multifactorial, which means there's a lot of different causes of dementia and Alzheimer's disease. So I would say, you mentioned plaques, amyloid-beta plaques. What happens is, you know, that's the aggregation of a protein in our brain called amyloid that typically is cleared from our brain, and, um, what happens is this abnormal, you know, thing happens where you're not clearing the amyloid, and so it starts to kind of form these clumps and aggregates with the amyloid proteins that are not being cleared. And that essentially is happening outside of your neurons, but it's happening where the synapses are formed between neurons, and so what happens is it kind of disrupts the synaptic connection between neurons, which is essentially forming a memory. And so when you start to disrupt that connection, you lose not only the... The memories start to go away, but... The whole purpose of the neuron is to kind of, I mean, one of the purposes is to, to form a memory, and so you start to like, neurons start to die, right? When they start to lose their purpose. Amyloid aggregation is linked to a lot of things. So for example, I mentioned it being cleared when we sleep, particularly when we're in our deep sleep stage, slow wave sleep. That is, um, something happens that's kind of incredible. It's called activation of the glymphatic system. So you've heard of the lymphatic system. Well, the glymphatic system is essentially this series of like networks and like almost like these like-... highways and es- essentially roads and stuff all, like, throughout the brain, where you're squirting the cerebral spinal fluid throughout the brain and it's clearing away all the garbage. Things like proteins that didn't get cleared, and it's sort of squirting them out and clearing them out through this glymphatic system. That glymphatic system is activated during sleep, and it's one of the reasons why people that don't get good sleep over the course of decades have a higher risk of Alzheimer's disease, is because they're getting these amyloid plaques built up in their brains. But there's other causes as well. So for example, glucose metabolism is disrupted in the brains of Alzheimer's disease. You need glucose, your neurons need glucose, and so th- you know, they're, essentially, um, your, your brain isn't able to make energy correctly without the glucose getting into your brain. And so that's another sort of metabolic underlying cause of Alzheimer's disease, where you're essentially ... I mean, it's thought to be where you're eating a lot of refined carbohydrates, refined sugars, and you're not exercising, and essentially you're, you're disrupting the glucose metabolism in the brain as well as the whole body, right? So the brain and body are connected. But, um, there's also genetic causes as well and, you know, some people have genes c- that can increase the risk of Alzheimer's disease because they're not able to clear amyloid as well, because they're not able to repair damage as well. So the, the blood-brain barrier, which is really important for filtering out toxic things from getting into the brain, it starts to break down and that's one of the, I would say, early, early signs of Alzheimer's disease, is that breakdown of the blood-brain barrier. And that happens in people that have a genetic risk factor called ApoE4. You may have heard of this, but this is probably one of the biggest w- genetic risk factors for Alzheimer's disease. About 25% of the population has one copy of this gene. That increases the risk of Alzheimer's disease by twofold. If you have two copies of it, it increases the risk of Alzheimer's disease by tenfold.

    4. SBSteven Bartlett50:53

       So twofold being 200%?

    5. RPDr Rhonda Patrick50:55

       Twofold being twice, twice as much. Yeah, 200%. And tenfold being 1,000%, right? You're, you're, you're basically almo- I mean, it's, it's pretty bad. And i- it's not like, um ... It's not your destiny to get the Alzheimer's disease if you have those genes. You can do things in your lifestyle that can sort of turn the table so you're not, you're not essentially gonna be getting that, that Alzheimer's disease and a lot of different lifestyle factors like getting good sleep, like exercising, avoiding alcohol, avoiding smoking, not being overweight and obese. Like, those affect your Alzheimer's disease risk. More importantly, if you have one of those genes, then you really have to be cognizant of those things because if you have one of those g- you know, ApoE4 genes, then, then essentially your lifestyle matters even more than people that don't.

    6. SBSteven Bartlett51:43

       And you can t- do a test to figure out if you have those genes?

    7. RPDr Rhonda Patrick51:46

       Yes, yes. There's a, a variety of genetic testing services that can be done. Pretty much all the ones that are out there on, on, on the market, you know, AncestryDNA. I mean, depending on where you live and what ... There's so many out there right now-

    8. SBSteven Bartlett51:58

       I would be-

    9. RPDr Rhonda Patrick51:59

       ... that will, that will test for that.

    10. SBSteven Bartlett52:00

        ... mortified if I found I had two of those genes.

    11. RPDr Rhonda Patrick52:03

        Two of 'em is less common. I, when I mentioned the 25% of the population having it, it's usually one allele. Alcohol essentially can really increase the risk of Alzheimer's disease if you have one of those genes, and I think that there's really no safe amount of alcohol that can be consumed for people that have ApoE4, if you're concerned about dementia and Alzheimer's disease. The other thing is contact sports and traumatic brain injury. People that have any of the, you know, any, one or two of the ApoE4 genes, if they have that, then if they get a TBI, like if they're playing American football or they're playing soccer or MMA or boxing, whatever-

    12. SBSteven Bartlett52:41

        Mm-hmm.

    13. RPDr Rhonda Patrick52:41

        ... then you talk about, like, going up to a tenfold risk for Alzheimer's disease when you get, like a, an injury because people with those genes don't repair damage as well, and so it affects their, their brain's ability to repair damage, and so that's also really important to consider.

15. 52:56 – 1:00:13

    Do Multivitamins Improve Cognitive Performance?

    1. RPDr Rhonda Patrick52:56

    2. SBSteven Bartlett52:56

       So moving back then to the s- the simple things that we can do to improve our cognitive performance as we age, the things that are simpler than doing the vigorous HIIT training.

    3. RPDr Rhonda Patrick53:04

       There's actually quite a few and first and foremost, the one I love the most is a simple multivitamin. And the reason I love this is because ... I don't know, it was about 10 years ago, there was a, a huge study that was published and it was published in the Annals of Internal Medicine and it was called Enough is Enough: Multivitamins are Not Only Useless, They're Harmful, and it was essentially looking at a variety of studies and arguing that multivitamins are expensive urine.

    4. SBSteven Bartlett53:35

       Hm. (laughs)

    5. RPDr Rhonda Patrick53:35

       You're just not really doing anything and, in fact, if you take a multivitamin, you might even be increasing the risk of disease. That study was terrible and I, 10 years ago, went and just broke it down and, you know, p- pulled it apart piece by piece. But here we are 10 years later, three large clinical trials have been done. These are randomized control trials where older adults were given either a multivitamin, and this was just your standard run-of-the-mill multivitamin, Centrum Silver, or they were given a placebo, and they were given this for a couple of years. And what three different studies showed was that a multivitamin improved cognition, improved processing speed, it improved what's called episodic memory, so the kind of memory where you're remembering experiences and you can recall events, things like that. And not only did it improve it, it improved it so much that it was equivalent to reducing the aging of the episodic memory by five years. So a simple multivitamin. And why is that important? Because, you know, multivitamins have a variety of these vitamins and minerals that we're not getting from our diet-... that are important for everything, for metabolism, for the way our neurotransmitters are firing, for reducing damage that's causing, you know, oxidative stress, right? So a simple multivitamin, how much easier can it be than taking a simple multivitamin? And the fact of the matter is that we're talking about a randomized controlled trial. This is showing cause, right? This isn't just an association. This is showing that you took a multivitamin for a couple of years and improved your cognition more than a placebo.

    6. SBSteven Bartlett55:21

       Mm-hmm.

    7. RPDr Rhonda Patrick55:22

       So I think that's pretty incredible and it's one of the examples that I like. But, um, diving deeper into, to some of the, the nutrients. This is, this is an area, you know, I started out as a scientist. I started out as a chemist actually. But when I first got into biology, I was working in an aging lab and studying aging. It was very interesting to me because I essentially, with my own experiments, with my own two hands, could, could manipulate these like tiny little worms. They're called C. elegans. And their whole genome was sequenced at the time, and this was like in the early 2000s. And, um, they have a lot of genes that are similar to humans. It's called homology. And one of the genes is the insulin signaling pathway and the IGF-1 pathway. So insulin signaling would be something that's activated with glucose. When you're eating a lot of sugar, right?And I could take these worms and I could genetically decrease their insulin signaling. So it kind of, if you think about a parallel to that, that would be, okay, we're not gonna be eating as much sugar, right? We're not gonna be activating that pathway so much.

    8. SBSteven Bartlett56:31

       Mm-hmm.

    9. RPDr Rhonda Patrick56:32

       And I could do that in this worm that has a life expectancy of about 15 days. And I could extend its life expectancy to 30 days, right? So you're increasing its life expectancy by pretty much, you know, 100%, right? Well, not only did they, you know, live longer, they were healthier and youthful and you could see that visually. They're moving around and they were just youthful worms. And so I was very excited about this, you know, in my 20s, because I was like, "Wow, this is very relevant." We have this gene and we know lifestyle factors that affect it, right? Sugar. So the take home for me was lifestyle matters. You know, yeah, genetics, maybe that'll be something one day where we're decreasing the insulin signaling, but I was looking for the now, not the future technology. And so the now to me was, wow, like, I don't wanna be constantly activating my, you know, insulin signaling pathway. Like, look what happens to these worms if you reduce it. I mean, it's amazing. They're youthful and they live longer. And so I started to kind of get into diet and lifestyle, sort of just out of curiosity and sort of reading in the literature. And I came across some studies from my mentor, Dr. Bruce Ames, where he was showing that not getting enough nutrients, like for example, folate. Folate is found in dark leafy greens like kale. You know, folate, if you, if you de- if you decrease folate and make someone deficient in it, it essentially causes double-stranded breaks in your DNA that essentially is like being under ionizing radiation. And that experiment was done. Like, you could take a mouse, make it like, put low folate in the, in, you know, the mouse's food and then take another mouse and put it under an ionizing radiation machine. And the amount of double-stranded breaks in their DNA which cause cancer, which accelerate aging, which affect every, every, you know, how, how your, your cells are functioning, it was this, the same. So it was like, wow, th- not having a certain nutrient in your diet was like standing under a, an irradiating machine. Ionizing radiation, no one's gonna wanna stand under an ionizing radiation machine, but no one's thinking about how your diet can do the same thing. Um, and that was kind of, I got into a lot of Bruce's, Bruce's research at the time. So Bruce, he, anyone in the, in the science field knows Dr. Bruce Ames. He actually came up with the Ames carcinogen test. And that essentially was a way of cheaply looking at and identifying whether something's a carcinogen. And he got into sort of nutrition as he started to figure things like folate basically being, lack of folate being a carcinogen essentially, right? Like ionizing radiation is a carcinogen. And then he started to go on to other nutrients as well, like magnesium and B vitamins. But I think for me, the aha moment was micronutrients and these vitamins and minerals are affecting the way we age, are affecting our health on a similar level as these toxic things that we're worried about-

    10. SBSteven Bartlett59:35

        Mm-hmm.

    11. RPDr Rhonda Patrick59:35

        ... like ionizing radiation. And nobody's thinking about it like that. So I'll give you an example. Vitamin D, you talked about dementia, what's gonna help prevent dementia. Vitamin D is, it's actually more than a vitamin. Vitamin D gets converted into a steroid hormone. So a steroid hormone, essentially what it does is it goes into the nucleus of a cell where all your DNA is and it, it's activating genes and deactivating them. It's affecting your genome. And it's actually over 5% of your, your, your genome is being affected by vitamin

16. 1:00:13 – 1:02:59

    70% of the U.S. Population Is Vitamin D Deficient

    1. RPDr Rhonda Patrick1:00:13

       D. Why is that important? Because 70% of the US population has insufficient levels of vitamin D. The reason for that is because vitamin D3 is actually made in the skin from UVB radiation from the sun. And so if you're not outside, then you're not really making a lot of vitamin D3 in your skin. And vitamin D3 then gets converted into this steroid hormone that regulates everything, right? And so, um, you know, modern day society, you know, we're inside all the time. We're working, we're not outside. And even if you were outside, there's so many other factors that affect it. So anything that blocks out UVB radiation blocks out the availability of your body to make vitamin D3. So sunscreen-Right? That's a big one. Melanin, the, the darker pigmentation that acts as a natural sunscreen. And then latitude, depending on where you live also. So, you know, a good number of months out of the year, if you're in a more northern latitude, like England, like Wales, like Chicago, or Sweden, you're not e- UVB radiation's not even hitting the atmosphere, you know, for several months out of the year. Combine that with sunscreen or melanin, and you got, like this disaster, right? In fact, there was a study out of the University of Chicago that looked at African Americans and Caucasians, and their ability-

    2. SBSteven Bartlett1:01:41

       Black people and white people.

    3. RPDr Rhonda Patrick1:01:42

       Yeah, exactly, their ability to make vitamin D3 from UVB radiation from the sun.

    4. SBSteven Bartlett1:01:47

       From the sun, yeah.

    5. RPDr Rhonda Patrick1:01:48

       And as I mentioned, you know, melanin is a natural sunscreen. And, you know, people that are, you know, either, you know, from African origin, or South American, or Southeast Asian, right? People that are closer to the equator usually have more melanin. It's an, it's an adaptation to prevent you from burning from the UV rays of the sun. Well, um, this University of Chicago study found that, um, you know, people that are African American had to stay in the sun 6 to 10 times longer than people with fair skin, the Caucasians, to make the same amount of vitamin D3. And so as a consequence, if you take someone who, like yourself ... Well, you're, you're, you've got a little bit more mel- melanin.

    6. SBSteven Bartlett1:02:27

       I'm like mixed.

    7. RPDr Rhonda Patrick1:02:27

       A little bit, yeah. You've got a little bit more melanin. But let's say you take someone who, you know, has uh ...

    8. SBSteven Bartlett1:02:32

       Like my mom.

    9. RPDr Rhonda Patrick1:02:33

       Like-

    10. SBSteven Bartlett1:02:33

        She's Nigerian.

    11. RPDr Rhonda Patrick1:02:34

        Okay, your mom. From, yeah, Nigerian. And let's say your mom moves to Chicago, right?

    12. SBSteven Bartlett1:02:38

        Yeah. Or she's moved to bloody England or the southwest.

    13. RPDr Rhonda Patrick1:02:40

        Or if she moved to England, right, exactly. Then you're talking about a recipe for disaster in terms of vitamin D, because you're not only not making it several months out of the year. I forgot how many months out of the year, maybe four or five or something like that, where the UVB radiation's not even hitting the atmosphere, but you have this natural sunscreen.

17. 1:02:59 – 1:06:49

    Vitamin D Deficiency and Increased Risk of Dementia

    1. RPDr Rhonda Patrick1:02:59

    2. SBSteven Bartlett1:02:59

       What's the consequences of that in terms of symptoms?

    3. RPDr Rhonda Patrick1:03:02

       Well, it's, it's ki- it's not like an acute thing, where you kind of just look in the mirror and you're like, "Ugh."

    4. SBSteven Bartlett1:03:08

       What is the causation then, in terms of?

    5. RPDr Rhonda Patrick1:03:09

       Right, right, yeah. So the reason I say this is because people always think of like, "Well, I'm not getting enough vitamin C, and I have scurvy," and you can look in the mirror and your gums are falling apart, right? It's easy to identify this. Vitamin D deficiency or insufficiency is more insidious. It's kind of this damage that accumulates over time. It's something that isn't, you know, quite noticeable, or maybe, maybe you're feeling, you know, may- maybe you're feeling like lethargic or you don't have enough energy, things like that, but you don't re- really know quite why. So vitamin D insufficiency and deficiency, there are acute effects, where like if it's severe it can cause rickets and like bone malformations and stuff, especially if it's happening early in life. But, um, what we now know is that being deficient or insufficient in vitamin D can increase dementia risk by 80%, and that's been shown in multiple studies. The converse is also true. So people that supplement with vitamin D3, and this is where a simple solution comes in, right? So you're not making it from your skin, but you can take a supplement. People that supplement with vitamin D3 have a 40% reduced risk of dementia. So in other words, they're avoiding deficiency, which is very common, and avoiding that deficiency then is reducing their dementia risk. And there's actually even been studies in people with dementia, in people with Alzheimer's disease, that were given a vitamin D supplement or a placebo control, and those individuals given the vitamin D supplement had improved cognition. They had, um, lower markers of amyloid plaques, so those were, those were a- those were also measured as well. So vitamin D is doing a lot of things. It's, it's regulating 5% of your protein coding human genome.

    6. SBSteven Bartlett1:04:51

       If I were to increase my probability of getting dementia then, I've gotta stay out of the sun, I've gotta avoid, um, vitamin D, I've gotta drink alcohol, smoke, be sedentary, and I've gotta sleep really badly.

    7. RPDr Rhonda Patrick1:05:03

       Yes, and eat a lot of ref- refined sugar. (laughs)

    8. SBSteven Bartlett1:05:06

       Yeah.

    9. RPDr Rhonda Patrick1:05:07

       Yes, yes, exactly.

    10. SBSteven Bartlett1:05:08

        Okay.

    11. RPDr Rhonda Patrick1:05:08

        Exactly. Now, you might go, "Well, how much vitamin D," right? I'm talking about deficiency and insufficiency, and you really wanna get a blood test to know what your levels are. There have been, I don't know, 30 plus studies that have looked at vitamin D levels and all cause mortality. So that would be, again, you know, how ... You, you know, dying from a variety of different diseases. Cardiovascular disease, respiratory disease, cancer. And people that have blood levels of vitamin D between 40, 60, maybe 80 nanograms per milliliter have the lowest all cause mortality. So these people are not deficient, not insufficient. Insufficiency happens at about 30 nanograms per milliliter below that. Deficiency is 20 nanograms per li- milliliter and below. And so, um, there have been a variety of studies that have looked at, for example, the brain and the aging brain in vitamin D levels, and it's been shown that for every, you know, 10 nanomol per liter decrease in vitamin D blood levels, there's an increase in brain damage. It's called white matter hyperintensities. It's basically damage to the white matter in your brain, and the white matter in your brain is myelin. That's how your brain's communicating and, and like how, you know, it's, electrical impulses are being, you know, moved so that you can think and talk and all that, exactly. (laughs)

    12. SBSteven Bartlett1:06:27

        Yeah, I hadn't had one today, so I feel like (gulps) (laughs) you've, you've persuaded me.

    13. RPDr Rhonda Patrick1:06:31

        Most people that are deficient can increase their blood levels to a normal sufficient level by about 4,000 IUs of vitamin D per day. So not ... And that's been done, that's been shown in multiple studies. Not, it's not, it's not that hard to take. In fact, vitamin D supplements are probably the cheapest supplement out there. It's like 10 cents per pill.

18. 1:06:49 – 1:09:39

    Views on the Ketogenic Diet

    1. RPDr Rhonda Patrick1:06:49

    2. SBSteven Bartlett1:06:49

       When you talked about these-

    3. RPDr Rhonda Patrick1:06:50

       Mm-hmm.

    4. SBSteven Bartlett1:06:50

       ... I was really surprised to hear that they have cancer preventing chemicals in them. And then, um, I was looking at some of the research. It does say, exactly as you said, things like kale, broccoli, Brussels sprouts link to a reduction in breast cancer risk, prostate, lung, and-... colorectal cancers, according to the World Cancer Research Fund and PubMed. Most of us don't eat enough of this stuff 'cause it's not the tastiest stuff. And you talked about sugar as well. It- it- it makes me think about the diet that I'm currently on, which is the ketogenic diet, and whether that is an optimal diet in terms of all of the things we've discussed earlier, dementia, longevity, aging. What is your views on the ketogenic diet?

    5. RPDr Rhonda Patrick1:07:32

       I think there's... uh, there's the extreme ketogenic diet, like the classical ketogenic diet, and then there's modified, sort of low carb ketogenic diets that do allow for... I mean, there's, yes, these are leafy greens that are carbohydrate, but they're high in fiber and they're low glycemic index. And so you can actually eat leafy greens on a ketogenic diet and still be in ketosis. So I, uh, the ketogenic diet is very, I'm very interested in it because I do think that beta-hydroxybutyrate, which is the key- major circulating ketone body that's produced when you're in ketosis, is highly beneficial, much like lactate. It can actually do a lot of what lactate can do. It gets into the brain and it's an ea- easily utilizable source of energy by neurons.

    6. SBSteven Bartlett1:08:21

       These are ketones?

    7. RPDr Rhonda Patrick1:08:22

       Yes.

    8. SBSteven Bartlett1:08:22

       Which is what your body makes when you ab- abstain from carbohydrates and sugars.

    9. RPDr Rhonda Patrick1:08:27

       Yes.

    10. SBSteven Bartlett1:08:27

        It eventually shifts into ketosis, where you're running on keto- ke- ke- you're in ketosis and you're running on ketones.

    11. RPDr Rhonda Patrick1:08:33

        Yes. It's what you're measuring when you're doing your, when you're measuring-

    12. SBSteven Bartlett1:08:36

        Finger prick.

    13. RPDr Rhonda Patrick1:08:37

        ... your finger prick. Uh, it's beta-hydroxybutyrate. That's the major circulating one that you're measuring and that's actually a signaling molecule. It's activating brain-derived neurotrophic factor in the brain. And so it's very interesting because it's- it's almost like having lactate in your body, but having it constantly. So I'm super interested in a ketogenic diet, particularly for people that respond well. I mean, some people, their triglycerides go really high, their cholesterol goes really high, and there's sort of an, I would say, individual variation in terms of how you respond. And so it's good to always measure everything, right? To make sure that you're responding well to ketogenic diet or to maybe cycle it. I've been very interested in cycling it for brain benefits as well because of the beta-hydroxybutyrate, where it's, I- it's just so beneficial for the brain. You know, it's been shown that, you know, beta-hydroxybutyrate... So what happens is when you have this ketone, like beta-hydroxybutyrate, get into the brain, it's able to be used as energy instead of glucose.

19. 1:09:39 – 1:14:28

    What Is Ketosis?

    1. RPDr Rhonda Patrick1:09:39

    2. SBSteven Bartlett1:09:39

       I feel like we should take a step back and explain what k- keto is for- for the- for the listener who maybe has never really heard or understood it before. And I know that there's a large proportion of people that don't know what it, what it is, because I spend a lot of time at dinner parties trying to talk about it, and it's s- super surprising to me that the average person actually doesn't really know what- what keto or ketosis is.

    3. RPDr Rhonda Patrick1:10:02

       So y- I think that's great. Yeah, we can talk about ketosis. Um, essentially, if we- if we kind of take a thousand mile high view of it without getting so technical-

    4. SBSteven Bartlett1:10:12

       Yeah.

    5. RPDr Rhonda Patrick1:10:12

       ... I would say the best way to think about being in ketosis is your body is using fatty acids as energy and not much glucose. You'll still use a little bit of glucose. You need to use glucose because your red blood cells, for example, don't have any mitochondria. They need glucose. But you're mostly using fatty acids as energy that are being produced from, they're being released from fat stored in adipose tissue.

    6. SBSteven Bartlett1:10:41

       Which is like my belly.

    7. RPDr Rhonda Patrick1:10:43

       Which is like your belly, visceral fat, um, subcutaneous fat, for example.

    8. SBSteven Bartlett1:10:46

       So this sounds great. My body's gonna use, burn the fat instead of burn, you know, burning glucose, which I've got from eating bread or something, so I'm gonna get skinny.

    9. RPDr Rhonda Patrick1:10:55

       People do lose weight on a ketogenic diet, and-

    10. SBSteven Bartlett1:10:57

        My dad has lost so much weight, it's ridiculous. It's, like, shocking.

    11. RPDr Rhonda Patrick1:11:00

        On a ketogenic diet?

    12. SBSteven Bartlett1:11:01

        Yeah, it's crazy. He was quite a big man, if I say so myself. Very big belly. And he sent me this screenshot the other day after a couple of months on the ketogenic diet, and he's, like, 13... He's just g- for the first time ever been 13 stones. Since- since he was in his teens, he's now 13 stone. So he's lost, what, the equivalent of about four st- four or five stone in weight in a couple of months, and he just looks completely different. Now, I'm not, uh, you know, I'm not necessarily saying to stay on that diet forever, but the- the speed in which one can lose weight on a ketogenic diet is remarkable.

    13. RPDr Rhonda Patrick1:11:35

        Right. And so you're- you're basically, the food that you're eating is predominantly fat, right? So you're- you're basically not only using the fat that your body already has stored, but you're also fueling yourself. You're feeding yourself more fat, right? So you're basically using the fat as energy and through a whole bunch of biochemical reactions, you produce ketone bodies as a byproduct of- of that. It doesn't necessarily have to be just ketogenic diet. Like, you can, when you're fasting, you go into ketosis, right? Because if you think about it, you're- you're not giving yourself food. Instead, you're relying on what your body already has as a source of energy, and you only have so much glucose stored as glycogen, right? In your liver. And that, I would say about after, there's individual variation, but after about 12 hours of not giving your body food, you sort of deplete all your glycogen stores and then so you start to sh- shift to lipolysis, which means the breakdown of fat. So fasting is another way to go, to get into ketosis. Another way would be intense exercise. So like, you know, these endurance athletes that are doing long duration types of exercise also can go into ketosis, right? Because they're depleting their glycogen stores much quicker and they're also using all this energy that they've- they've fueled themselves with because it's- it's- it's so intense, right? Long duration type of exercise. And so, and you can combine these things as well, right? You can do endurance exercise with a ketogenic diet and you really kind of can get into ketosis quicker.

    14. SBSteven Bartlett1:13:06

        Is it like a switch?

    15. RPDr Rhonda Patrick1:13:08

        So there is something called metabolic flexibility, which essentially means that your body is able to switch between burning glucose and using glucose as energy, but also using fatty acids as making, you know, as energy and then producing ketones as well. And the more, I would say, the more, um, if you've done ketosis or if you exercise a lot, like frequently, or you do any form of fasting or what's called time-restricted eating, so let's say you eat all your food within an eight-hour window and then for 16 hours you're not eating food, your body is used to switching to fatty acid metabolism, to, to using fatty acids as energy. So you're really f- metabolically flexible. And, um, not everyone's able to do that because most people actually, they think they eat within a 12-hour period, but they, there's been studies (laughs) that have been done that have shown that actually they eat more like within a 15 to 16-hour period, not, not even a 12-hour period. Certainly not a 10 or 8-hour period. So there's, as I mentioned, it takes about 12 hours on average to deplete all your glycogen levels. Now you can accelerate that if you're doing a lot of physical activity. But once you deplete that liver glycogen, that is when you s- shift into burning fatty acids and then eventually ketosis, right?

    16. SBSteven Bartlett1:14:26

        In terms of longevity, have they ever

20. 1:14:28 – 1:19:30

    How the Keto Diet Affects Life Expectancy

    1. SBSteven Bartlett1:14:28

       done any studies where they've put someone on the ketogenic diet or like a mouse or a route on a ketogenic diet versus the n- the average diet and then monitored how long they live?

    2. RPDr Rhonda Patrick1:14:38

       There have been studies by, uh, Dr. Eric Verdin out of the, uh, Buck Institute for Aging in Novato, California, and, I mean, this was several years ago. He's done these studies probably almost 10 years ago, maybe about 2018 or 2017 these s- studies were published. But, um, he, he did do some of these studies with a ketogenic diet in rodents, and it did seem to extend life expectancy, but more importantly, the health span, so particularly in the brain. So it's like their brain had aged much, much better. They had less of the, all of the pathological features of Alzheimer's disease.

    3. SBSteven Bartlett1:15:15

       Mm-hmm.

    4. RPDr Rhonda Patrick1:15:15

       And again, I do think, like I mentioned, I th- I'm, I'm super interested in beta-hydroxybutyrate in particular. I mean, there's m- it's multifactorial because on the one hand you're not eating as much glucose, right? And that in, in and of itself is important because glucose can be so damaging, particularly if you're not physically active, because it's n- if you, if you're physically active and you're eating some amount of glucose, it's going in your muscle.

    5. SBSteven Bartlett1:15:40

       Yeah.

    6. RPDr Rhonda Patrick1:15:40

       It's not damaging the vascular system. The vasc- the cardio, the vascular system is very much related to the brain, right? So when you start to stiffen your blood vessels and stiffen everything, I mean, that's, that's affecting blood flow to the brain. It's ef- you know, it's causing hypertension. That all affects brain aging as well. So I think just, you know, and then the, the, the damage that the glucose does in and of itself, like, I mean, there's studies, it's really interesting. There's studies showing that people even on the high end of normal in terms of their blood glucose levels, so they're normal, but they're kind of on the high end of normal, they had more brain atrophy than people on the low end of normal.

    7. SBSteven Bartlett1:16:20

       By brain atrophy, you mean their brain was-

    8. RPDr Rhonda Patrick1:16:23

       Shrinking.

    9. SBSteven Bartlett1:16:24

       ... shrinking?

    10. RPDr Rhonda Patrick1:16:24

        Shrinking. And it was the hippocampus, by the way, again, that-

    11. SBSteven Bartlett1:16:26

        Hmm.

    12. RPDr Rhonda Patrick1:16:27

        ... that part of the brain that's involved in learning and memory. So the glucose itself has this effect on causing damage and accelerating the aging process. But then there's this other very interesting effect of these chemicals that are made as a byproduct of being in ketosis, and that is the beta-hydroxybutyrate, that ketone body, gets into the brain, it's transported across the brain through an MCT transporter. And when it gets into the brain, it can be used as energy and you, your neurons don't need to use glucose, and it can do that... So your b- your neurons can use glucose as energy, but it takes energy to use that glucose to make energy. When you use the ketone, the beta-hydroxybutyrate, it takes less energy to u- to make that energy. So it's energetically favorable to actually use that ketone, that beta-hydroxybutyrate. On top of that, this is what's so interesting, it frees up glucose. So the neurons aren't using the glucose. Where does the glucose go, right? Because it's there. It's, it, it sort of shunts it into this other pathway that's called the pentose phosphate pathway. I don't want to, you know, burden people with all those technical details. But let's get to the important part of that is that it shunts glucose into this pathway that m- makes... Essentially it's precursors that make what's called glutathione, the major antioxidant in the brain. And so you're making more glutathione day after day after day. That is huge because oxidation in the brain, inflammation, this is a huge cause of brain aging and Alzheimer's disease, dementia. We now know neuroinflammation is one of the major causes of it. And so if you have more glutathione in your brain, you are going to basically sequester that damage that's causing, you know, that's ca- that's aging the brain essentially. And so the glucose now is not being used for energy. It's being used to make an antioxidant in the brain. Okay? That's also really cool. And there's more. There's more. Okay, so then the beta-hydroxybutyrate itself is a signaling molecule like lactate.

    13. SBSteven Bartlett1:18:28

        The ketone.

    14. RPDr Rhonda Patrick1:18:29

        The ketone itself is a signaling molecule where it's basically, you know, it's a little bit of a stressed state, right? So when you're in ketosis, it's, you're, you're stressing the body. It's either exercise or you're fasting, or you're on this ketogenic diet. And so your body, again, is responding to that stress by making like a bunch of awesome resilient stress response things that are basically gonna improve the way you age. And so the ketone, beta-hydroxybutyrate, then activates brain-derived neurotrophic factor, this miracle growth for your brain, right? It's involved in growing new neurons. It's involved in increasing the connection between neurons, it's involved in neuroplasticity, all those things. And so you get this multi-level benefit.Not getting, not having the gl- glucose causing the damage. You have, um, basically, the glucose now being used, not only is it not going, causing damage, it's being used to make an antioxidant. And then you have the whole ketone es-, you know, aspect where you're, you're essentially, um, making and activating all these beneficial pathways in the brain that reduces aging.

21. 1:19:30 – 1:23:53

    Exogenous Ketones and Cognitive Repair

    1. RPDr Rhonda Patrick1:19:30

    2. SBSteven Bartlett1:19:30

       And what's going on when we take exogenous ketones, external ketones via a drink or something like that?

    3. RPDr Rhonda Patrick1:19:37

       Yeah, so what's happening is you're essentially giving your body the beta-hydroxybutyrate ketone that it would make normally if you were undergoing ketosis and using fatty acids only as energy. You're giving your body a big boost of it. So you're kind of bypassing the, the way that your body would make it itself and giving it to your body. And it's great for people that have a hard time with doing a ketogenic diet, for example. Maybe they just can't stick with it or maybe they don't respond very well to it in terms of other biomarkers. They're gonna get a lot of the benefit but it's only gonna last, you know, one to three hours, right?

    4. SBSteven Bartlett1:20:16

       Yeah, until it flushes out, right?

    5. RPDr Rhonda Patrick1:20:17

       Until, until, until you use it up. Yeah, and so it's in addition to just people that wanna get that focus and attention, which is what both you and I have experienced when we've taken these, you know, supplements, this exogenous ketone, there's also some potential therapeutic effects. So people that have mild cognitive decline, maybe like the first stages of dementia or Alzheimer's disease, can kind of perk up and, um, perform better when they have, when they're given an exogenous ketone, this supplemental ketone beta-hydroxybutyrate. There's not a lot of studies on it, but there's like a few case studies where, case studies being like a single person-

    6. SBSteven Bartlett1:20:59

       Mm-hmm.

    7. RPDr Rhonda Patrick1:21:00

       ... is given it and they're followed and looked at, you know?

    8. SBSteven Bartlett1:21:03

       I-

    9. RPDr Rhonda Patrick1:21:03

       And it's very interesting.

    10. SBSteven Bartlett1:21:05

        I actually know that they're doing studies on exactly that at the moment, um, because I've spoken to a few of these companies and a few scientists that are, are in this field over the last couple of, over the last couple of weeks, in fact. And they were saying that we're currently in the process of doing studies to see that if exogenous ketones, which are these ketone drinks or ketone shots, can repair your cognitive faculty- faculties. And is that via the process that you described where glucose is pushed into this other pathway?

    11. RPDr Rhonda Patrick1:21:32

        Yes. So, um, I think I'm aware of the same study because I've, I've looked it up in the clinical trial and what's, what's being looked at after giving this exogenous beta-hydroxybutyrate, this supplemental ketone, in people with Alzheimer's disease, you can repair damage because again, you are activating brain-derived neurotrophic factor, which can, it can repair damage. It can grow new neurons, it can help with brain atrophy, it can strengthen connection between neurons. And then the glucose now is being shunted into that repair pathway, that glutathione's being activated and, and that's able to, you know, repair damage as well. So I, I'm excited to see the publi- like, the, that study published.

    12. SBSteven Bartlett1:22:17

        Mm-hmm.

    13. RPDr Rhonda Patrick1:22:18

        I would hypothesize that there's gonna be beneficial effects and it's gonna be pretty exciting, particularly because it is hard for older adults, some older adults to do a ketogenic diet. It's not the easiest thing to follow. I mean, you do have to be pretty disciplined. So this alternative to being able to supplement with something that can sort of, at least for the course of a couple of hours, do what being on a ketogenic diet can do is very exciting, right?

    14. SBSteven Bartlett1:22:46

        When you took the keto shot that you had at home, what did you experience? You said it was potent, it was powerful.

    15. RPDr Rhonda Patrick1:22:54

        Yeah, it was like a nootropic effect where, when I mean nootropic effect, it's, it's the kind of effect where you, you feel focused, your attention, your alertness is enhanced. You're sort of filtering out all the background noise in your brain that sort of, those little thoughts that pop in and distract you and so, uh, you're more productive. And, um, that was very noticeable. In fact, there was a time when I was like, before any podcast, I would take a shot of it. (laughs) I wanna do it. And, um, it's kind- kind of expensive, but it is, I- I- there's a lot of people that're, that're using it now and I think it's, I think it's a better alternative to some other nootropics that are common right now, like nicotine for example, which can really have a negative trade-off, but can do something similar. Whereas this is like, not only gives you that sort of cognitive enhancement, that brain pump, it also has, like, benefits for brain aging, right?

22. 1:23:53 – 1:26:33

    Recommended Superfoods

    1. RPDr Rhonda Patrick1:23:54

Episode duration: 2:58:48