Joe Rogan Experience #1870 - Max Lugavere

Max Lugavere 0:00 (drumming) Joe Rogan podcast. Check it out. The Joe Rogan Experience. Train by day, Joe Rogan podcast by night. All day. (instrumental music) What's up, Max? How are you? What up? Thanks for having me. Nice to meet you. Same. I've enjoyed your content online, so it's exciting to meet you in person. Thank you. I'm glad to hear that. So, you were telling me, before we got rolling, I said save it, let's just talk about it. What, uh, this Alzheimer's- Yes. ... thing that you're doing? What are you doing? Yeah, so I've been deeply immersed in the, in the Alzheimer's dementia prevention world for the past almost, almost decade at this point. Um, I'm not a ... just to lay it out up front, I'm not a medical doctor. I didn't take the academic route. Um, I started college sort of on a, on a pre-med track, but what ended up happening was, uh, I ended up going into journalism straight out of college, and I ended up working for a TV network in the US, um, that was backed by Al Gore back in the day. And so I, I got to hone my storytelling chops there, but I'd always been really passionate about health, nutrition, medicine, things like that. But in 2011, my, my mother started to display the earliest symptoms of what would ultimately be diagnosed as a form of dementia called Lewy body dementia, which is like a rare- Mm-hmm. ... form of dementia. One in f- Robin Williams had that. Yeah. Yeah. Terrible condition. It's, uh, it's described as, as feeling like having, like you have both Alzheimer's disease and Parkinson's disease at the same time, and certainly that's what I, what I observed in, in my mom. And so, when she started to display those symptoms, um, it had taken me and my family completely off guard. I, I had no prior family history of any kind of neurodegenerative condition. Um, my mom certainly wasn't old at the time. She was 58. She was still, you know, a spirited, youthful woman in, in middle age. Um, she had all the pigment in her hair. And, um, for me, I was in between jobs and I, I really had the opportunity ... I was grateful to have had the opportunity to, to, to go with her to different doctor's appointments. And I grew up in New York City, so we had access to, you know, cathedrals, to medical, um, advice and, and, uh, and, and examination. And in every instance, we were met with what I've come to call diagnose and adios. Basically, a physician would run a battery of esoteric tests on my mom, scribble down a few notes on a prescription pad, and, and send us on our way. But we had to ultimately take a trip to the Cleveland Clinic in Ohio, which is known for taking on really complex medical cases. They build a team around the patient. And it was there that for the first time my mom was diagnosed with a neurodegenerative condition. She was prescribed drugs for both Alzheimer's disease and Parkinson's disease. It wasn't, um, until a few years later that she actually received the Lewy body dementia diagnosis. But at that point, um, I started to dive into the research, because I had been trained as a journalist, which, you know, you're not trained as rigorously as a, as a PhD scientist, but you're kind of taught similar- similarly to investigate things, to maintain skepticism, to, you know, ask questions. And I started to look into the literature and, and just generally get a sense of what it was that my mom had been diagnosed with, what, what this, what this,

Max Lugavere 3:01 you know, what this entailed. And I realized that in most cases, dementia begins in the brain decades before the first symptom. 10, 20, 30 years even, um, by some estimates. And so for me, this became something really important, uh, to explore as a potentially preventable condition, because I realized for the first time that I had a risk factor, that my mom, you know, was my risk factor essentially. I didn't ... I hadn't even yet looked into my genes at that point. But, um, but so I, uh, I started looking

Max Lugavere 3:31 into it and I came across all of these like fascinating insights which, which we can talk about, but I decided at that point, um, that I ... to, to sort of do what I could to help push the, you know, move the needle with this condition, um, that I would use my skills which at the time were, uh, filmmaking, 'cause I had just come off, you know, I was like producing content for TV and I was on camera. I was a communicator as well. And so I decided to do a documentary, um, on the topic of dementia prevention. The first ever, uh, documentary on dementia as a potentially preventable condition. We've all seen dementia documentaries on, you know, HBO and networks like that, and they're always, they always push this, this very like doom and gloom, um, mentality about the condition, which I, which I understand. It is a very difficult condition. It's America's most feared condition after all. Um, and this is a condition that, you know, 90% of what we know about Alzheimer's disease in particular, which is just one form of dementia, has been discovered only in the past 15 years. So it's a very rapidly evolving field of science. But I felt like if we know that this is a condition that begins in the brain decades before the presentation of symptoms, then to me what that is, that's a very empowering insight. That means that we have agency to change our cognitive destiny. So I started shooting with my mom, which was very hard to do, um, because, you know, I mean, my, the person who I love most in the world I was watching, um, decline right in front of the camera. But also, um, I decided to exploit my media credentials at the time to then talk to researchers and scientists around the world. Um, and I was doing my own research in the primary literature as well. But I decided to, um, to yeah, to go to these labs and clinics where they're really ushering in dementia as a potentially preventable condition, and I actually signed myself up to become a, a, a, a s- a study subject in one actually, at Weill Cornell in New York. Right. And, um, and I actually became, ultimately I became, um, a collaborator with the, uh, principal investigator there, who's become my mentor over the years, Richard Isaacson, um, and I got to, uh, co-author a paper in a clinician's textbook, uh, on the clinical practice of, of dementia prevention, 'cause, you know, uh, uh, after all this time, I've learned so much about, um, about the condition, the etiology and, and so forth. Uh, but this documentary, I'm super excited for it. It's, um, it's called Little Empty Boxes, and we have a trailer up at littleemptyboxes.com. Why Little Empty Boxes? Well, it's a, it's a nod to something that my mom says in the film, which is actually something that d- ... You know, w-... my mom's condition, it seemed like her cognition had just severely downshifted, almost, almost overnight. Um, and so my mom never, my mom never, like, forgot who I was or anything like that. The, the presentation of Lewy body dementia is different from Alzheimer's disease. And once you've seen one case of dementia, just generally speaking, you've seen one case of dementia. Every, every dementia is, is different. But in my mom's case, it led to her often losing her train of thought soon after, uh, beginning to express an idea. Um, and she would often say things that just, you know, didn't, didn't make logical sense. So it's sort of a nod to what, um, to something that she, you know, that she says in the film. But, uh, I'm super excited because we, we inked a partnership with a, uh, a wonderful foundation called the Alz- Alzheimer's Foundation of America. And, um, and, um, yeah, I'm just super excited to, uh ...

Joe Rogan 6:56 Is dementia purely genetic or is it caused by environmental factors or any other things that people consume?

Max Lugavere 7:05 Great question. Um, so though dementia ... Though Alzheimer's disease was coined in 1906 by a physician named Alois Alzheimer, the brain has long been thought of to sit in sort of the ivory tower of the brain, guarded from what happens down below by what's called the blood-brain barrier. But we now know that the brain is influenced by everything that happens down below. And the, the dogma, especially with regard to Alzheimer's disease fundraising over the past couple of decades, has really been that this is the on- this is a condition that you, you can't treat, prevent, or slow. But we now have really solid data to say that we actually, that it is a, it is a potentially preventable condition. So when it comes to, uh, our risk for developing Alzheimer's disease and other forms of dementia, there are basically two categories of risk. You have your non-modifiable risk factors, of which there are three. So you've got your age, your genes, and your gender. So your age: age is still the number one risk factor for developing Alzheimer's disease, right? You can't change your age, yet. You, um, you have your gender. If you're a woman, your risk is double that as compared to a male's. And you have your genes. Now, genes is something that we can actually talk about, because though you can't change your genes, making them therefore a non-modifiable risk factor, you can change y- the expression of your genes, how your genes express themselves moment to moment. So for example, if you live in the United States and you carry a copy or two of what's called the ApoE4 allele ... So it's basically a polymorph- polymorphism, meaning it's not a mutation. It's actually a very common g- gene variant. About one in four people carry the ApoE4 allele. In the United States, that increases your risk anywhere between two and four, fourteen-fold, depending on whether you carry one or two copies.

Joe Rogan 8:53 I think that's also the same genetic expression that makes you have CTE.

Max Lugavere 8:59 CTE, yeah.

Joe Rogan 9:00 Yeah.

Max Lugavere 9:00 It, it, it, it makes everything more ... It makes your brain more vulnerable, in general, to insult, whether that is from TBI, uh, exposure to pollutants, exposure to unhealthy ways of eating.

Joe Rogan 9:16 Do we know why it does that?

Max Lugavere 9:19 Well, it's interesting. Yeah, so the ApoE4 allele is thought to be the ancestral version. So it's the first version. All, all non-human primates are ApoE4. So they carry the ApoE4 allele, not just one copy but two copies, and yet they don't develop Alzheimer's disease. When you look to people, we've evolved, uh, these different isoforms of, um, the ApoE gene. So we have ApoE2, 3, and 4. And just to reiterate, ApoE4 is the ancestral allele. So cultures that have, um, longer exposure to modern agriculture, actually, there's lower frequency of the ApoE4 allele. The thinking is that, that agriculture, right, like when we became domesticated, when we started basing our diets around grains, when we became more sedentary, less, uh, generalized in terms of our, um, cognitive, the, the, the daily cognitive tasks that our ancestors would have undertaken, that it's selected against the ApoE4 allele. So it's possible that that allele, which again is very common, one in four people carry it, carry it, is sort of the canary in the coal mine for the, for the Western way of life. That if you adopt a Western way of life and you eat ... You know, today, 60% of calories that adults consume come from ultra-processed junk foods, right? We're more sedentary than ever before in human history. We've got more stress. We're exposed to more environmental pollutants. That that is what dramatically, is what pulls the trigger, right? Because genes load the gun. It's our diets and our lifestyles that pull the trigger. But if you were to take somebody with that same genotype, right, and move them to a less industrial, a less industrialized part of the world, like say, Ibadan, Nigeria, where the frequency of the ApoE4 allele is just as common, it has no assoc- it has little to no association with Alzheimer's disease. So just to put that another way, what that suggests is if you're genetically at risk for developing Alzheimer's disease in the United States, you might simply move to Ibadan, Nigeria or another less industrialized part of the world and see that risk abolished.

Joe Rogan 11:19 So with this consumption of, uh, processed foods that p- is responsible for a large percentage of the calories that people consume today, is the human body adapting to that? Is that why this ApoE4 is less prevalent than it is in other cultures?

Max Lugavere 11:40 You know, it's possible, although with, with age being the primary risk factor, it's unlikely that, um, that that has put significant selection pressure. Um, so I'm not, I'm not act- I'm not sure. But we do know, you know, there are, I think, gene studies where they've looked at, um, expression of, uh, genes that produce enzymes that break down amylase, right, like starch and things like that, and those are increasing, I think, over time. It's a little, little out of my wheelhouse, but, um...... but generally, I mean, yeah, the standard American diet is completely aberrant from the diet, you know, that our ancestors consumed, the diet that, that, really, we attribute to the development of the human brain. 60% of the calories that we consume today come from ultra-processed, packaged convenience, convenience foods. Um, it's a massive problem. I mean, it's driving obesity, it's driving Type 2 diabetes. If you have Type 2 diabetes... So, going back to Alzheimer's disease and, and this, this gene expression. So, the APOE e4 allele is, you know, you have it, but it's not necessarily destiny. And 90% of Alzheimer's cases... I'm sorry, more. Nine, like 99% of Alzheimer's cases are attributable to some interplay between our genes and our environment. There's a very small proportion of patients with Alzheimer's disease that have a gene mutation that is a deterministic gene, um, and this is called the early-onset familial Alzheimer's gene, and that gene basically guarantees that you're gonna have Alzheimer's disease. But that makes up only 1 to 2% of cases. The vast majority of people who develop Alzheimer's disease, um, it's the interplay between their genes and their, and their environment.

Joe Rogan 13:18 So, excluding environmental factors like pollutants and plastics and all sorts of other things that affect people's bodies, what, what are the other things that a person can do to make sure that they, uh, at least are preventing the, the possibility of this happening?

Max Lugavere 13:38 Yeah.

Joe Rogan 13:38 Like, so, if you're saying that, like, if the, if the symptoms take, if it takes decades to, to exhibit symptoms, what are they seeing when they say that the, the people exhibit signs or exhibit some sort of a, a, a future of dementia? Like, how, how can you see that? What are you seeing?

Max Lugavere 13:59 Yeah, I mean, so there, there, you can't necessarily look inside the brain. Um, I mean, you can. There are, uh, studies that look at what's called brain glucose metabolism. So, something that you see in Alzheimer's disease is a redu- a reduced ability of the brain to generate energy from glucose. This is called glucose hypometabolism. This is a very, uh, this is a, a defining feature, actually, of Alzheimer's disease. And I say Alzheimer's disease... Again, my mom didn't have Alzheimer's disease, but it's the most common form of dementia, and so all the research on it really looks at j- m- mostly Alzheimer's disease. And then you get s- sort of, like, all-caused dementia in there, but, like, these, these more niche variants, like Lewy body, like frontotemporal, there's very little research on them. So, when I say, sometimes I use Alzheimer's disease and, and dementia interchangeably, but, um, but with Alzheimer's disease, one of the primary features is called glucose hypometabolism. So, the brain's inability to create, uh, energy from glucose.

Joe Rogan 14:54 So, you see that decades before you see symptoms of dementia?

Max Lugavere 14:58 Yeah, especially with people who are genetically at risk. About 10 p- a 10% reduction in the ability to generate energy with, out of glucose, which is the primary energy substrate for the brain under fed conditions.

Joe Rogan 15:10 S- so if people see this if they, uh, uh, get a test and they ru- they find out that they have this APOE e4-

Max Lugavere 15:17 Yeah.

Joe Rogan 15:18 ... and then they, um, get their glucose che- how are they checking that, their, their ability to process glucose?

Max Lugavere 15:25 Yeah. I mean, they do what are called FTG pet tests scans. Um, so they'll just look to see glucose uptake in the brain. But, um-

Joe Rogan 15:34 Where does one get... Like, if someone is saying, "Oh, my God, I have dementia in my family-"

Max Lugavere 15:38 Yeah.

Joe Rogan 15:38 ... and they're listening to this. What can, how can I find out?" What do they do?

Max Lugavere 15:41 You know, it's, that's not a test that you can easily get. Um, they'll use it for, uh, study purposes, like research purposes, but it's not a test being used clinically. Um, the, the, what correlates very closely with reduced glucose metabolism in the brain is your degree of insulin, uh, resistance in the body, or sensitivity. So, if you are insulin sensitive, you've talked many times on the podcast in the past about metabolic health, insulin sensitivity versus resistance. The sort of classic condition that we see here in the US characterized by insulin resistance is Type 2 diabetes. But what the studies have shown is that insulin resistance correlates very closely with reduced glucose metabolism in the brain. So, what you really wanna do to keep your brain healthy is to make sure that you're as insulin sensitive as possible. That's one thing that you can do that, um, you know you're checking off that box, 'cause when it comes to... So, we talked about the, the... And let me know if I should, like, you know, kind of double-click on any one of these, because, you know, I know we're covering a lot. But when it comes to the, the other, uh, risk factors, the, what are called the modifiable risk factors, you have 12 of them, and one of them is diabetes. So, insulin resistance, obviously the hallmark of Type 2 diabetes. We know that insulin resistance is strongly correlated to reduced glucose, um, utilization in the brain. Um, obesity is another modifiable risk factor. Studies show that as your waistline expands, your brain shrinks. Total brain volume is actually inversely-

Joe Rogan 17:21 That explains Bert Kreischer.

Max Lugavere 17:23 Yeah. (laughs)

Joe Rogan 17:23 Call Bert. He needs to know about this.

Max Lugavere 17:27 Um, so yeah, obesity is no bueno. It's not good. You know, I mean, there's like this push online now of like, the healthy-

Joe Rogan 17:33 Body positivity.

Max Lugavere 17:34 Body positivity, yeah. I think it's big problem.

Joe Rogan 17:36 So foolish.

Max Lugavere 17:36 Yeah.

Joe Rogan 17:37 I just, I, I can't imagine being so sensitive to people's feelings that you ignore a very clear warning sign that they're doing something that's insanely unhealthy and preventable, and it's something that should be broadcast to everybody. Everybody should know this is, this is a real factor in a host of different b- uh, problems that are gonna happen with your body.

Max Lugavere 18:04 100%. I mean, you can be more or less healthy at a given size, right? But to be not obese is healthier than being obese.

Joe Rogan 18:12 100%.

Max Lugavere 18:12 Yeah.

Joe Rogan 18:13 Yeah.

Max Lugavere 18:13 And by the year 2030, one in two Americans are gonna be not just overweight, but-... obese.

Joe Rogan 18:19 I thought it was already there.

Max Lugavere 18:20 We're close, we're 40%, but we're getting there. It's insane.

Joe Rogan 18:23 (laughs) Yeah. It's, and it's clearly connected to our diet.

Max Lugavere 18:26 Yeah.

Joe Rogan 18:26 And, you know, that's one of the things that I have enjoyed, uh, is a lot of your posts on diet and food, uh, but, n- we, we should, we'll get to that. But, let's, before we get into that, t- when you talk about preventative measures that someone can take, other than decreasing your waistline, losing weight, what do, what are the other factors? Does exercise have any factor on, uh, dementia?

Max Lugavere 18:50 Yeah. Exercise is medicine when it comes to the brain. So, and we can tackle this from a number of different angles. But, when you exercise, you're literally pushing fresh blood up to the brain, and blood carries oxygen, nutrients, antioxidants, things like that. Um, when you exercise, you are increasing the expression of a protein called brain-derived neurotrophic factor, or BDNF, which is sort of considered to be like a Miracle-Gro protein for the brain. Uh, you're increasing blood flow, you're increasing the expression of BDNF. You're changing the, the neuro-chemistry of the brain, essentially, with a workout. I mean, I'm a, I'm a different person when I leave the gym than I was walking into it. So you can subjectively, you can feel that, that it's doing something to your brain.

Joe Rogan 19:31 Yeah.

Max Lugavere 19:32 You're reducing inflammation, you're reducing blood pressure, you're normalizing healthy blood pressure. This is something that is, uh, this is, I mean, crucially important, but one of the seminal, uh, trials that I use in my argument, which is now, you know, finally being accepted by, you know, the, the, the medical establishment. But, um, the SPRINT MIND trial found that for people who were aggressively treated for their high blood pressure with pharmacologic drugs, but, um, but, you know, this ties into exercise because exercise is, uh, just as effective as blood pressure lowering medication, meta-analyses show. But, for these people who were put on aggressive blood pressure-normalizing therapy, they reduced their, um, the risk of developing mild cognitive impairment. And mild cognitive impairment is sort of a prodrome, it's, it's considered like pre-dementia. You'll often develop mild cognitive impairment before you're diagnosed with that.

Joe Rogan 20:26 That's also Bert Kreischer.

Max Lugavere 20:28 (laughs)

Joe Rogan 20:29 Send him a message.

Max Lugavere 20:31 (laughs)

Joe Rogan 20:31 This is, this one's for him.

Max Lugavere 20:31 Warning sign.

Joe Rogan 20:32 This one's for you, Bert.

Max Lugavere 20:33 (laughs) So, yeah. So, I mean, so exercise is like, it, it helps to normalize bl- blood pressure, it reduces insul- insulin sensitivity. It helps to, you know, the hormonal milieu, we talked about insulin resistance. Uh, physical exercise, right? Particularly resistance training, which is so important for people to do. It is one of the best ways of fostering insulin sensitivity.

Joe Rogan 20:52 Resistance training above cardio?

Max Lugavere 20:55 Well, car- they're both beneficial. They're both be- And actually, I, um, I like to remind myself this because I dislike doing cardio. Like, I don't like running on a treadmill. I love lifting weights, I've been doing that my whole life pretty much. But cardio is super important because we, we have a ton of evidence on cardio as it pertains to BDN- BDNF, which is this brain-derived neurotrophic factor. And we know this because it's very easy to get a mouse to run on a treadmill and then to sacrifice it and see what's going on in the brain. It's a lot harder to get a mouse to do squats and bench presses.

Joe Rogan 21:26 Mm.

Max Lugavere 21:26 You know? So from a, from like the basic scie- science standpoint, we have a lot of evidence on specifically what cardio does for the brain, right? But resistance training we know, in terms of bolstering whole body resilience, robustness, uh, y- we know that your muscles are a very important glucose disposal sink, right? So, I mean, we live in a time where your average American consumes 300 grams of carbohydrates every single day, right? Our bodies don't have, uh, a, a, a way to store carbohydrates beyond what, you know, the storage capacity of our muscles and our liver tissue, right? It's not like fat. You can store 3,000 calories of, of fat in a single pound of fat tissue, right? But, you know, your muscles, your liver combine only about f- four, 500 grams of, of glucose, you know, in a, in a given day. Or it's, or at a, at a time, rather. And so, um, so yeah, r- resistance training, you're building, you're, you're building up your musculature which is gonna allow you to continue to exercise and be mobile, which we know is really important for the brain. Um, for glucose disposal it's crucially important. So, I think, I think both are key. You can obviously tweak your resistance training regimen to have a more sort of cardio aspect to it, right?

Joe Rogan 22:35 Mm-hmm.

Max Lugavere 22:35 Like shortening the time between sets. But I do think that there's value in doing, in doing both, you know. Um, but yeah, exercise, it's just, uh, at this point, like, I think it was, uh, two or three years ago that the American Academ- Academy of Neurology finally made exercise a, uh, something that physicians could prescribe to treat somebody who's presenting with subjective cognitive, cognitive impairment in the, you know, as a, as a prophylactic so that they won't go on to develop mild cognitive impairment. So, it's really important.

Joe Rogan 23:05 Well, that's very progressive of them.

Max Lugavere 23:07 Yeah.

Joe Rogan 23:07 I'm glad they're doing that now.

Max Lugavere 23:09 Yeah. I mean, there's a lot of, um... And I, and I've seen this personally like in, in science. Like, I'm a, I'm a huge fan of science.I, my work relies on it. And, and the last thing that I would ever wanna do is sort of undermine confidence in science. But there's science and then there's the science.

Joe Rogan 23:23 Right.

Max Lugavere 23:23 You know? And, um, w- especially in the field of Alzheimer's disease, there was this huge revelation recently that the past 16 years of, um, Alzheimer's research, in many ways, was built on fraud.

Joe Rogan 23:35 Yeah, I read that. That w- is one of the things that I wanted to talk to you about, because it's so crazy. Please tell people about this, because it's so insane and it, it's so hard to believe that this could happen in modern medicine. And w- especially with something that affects so many people's Alzheimer's, but please, tell people about this study.

Max Lugavere 23:52 Yeah. So, basically the prevailing hypothesis as to what causes Alzheimer's disease over the past century, right, has been what's called the amyloid hypothesis. So ever since Alois Alzheimer discovered, or named, uh, Alzheimer's disease in 1906, and looked into the brain of a cadaver and saw these, um, plaques aggregating around neurons, right, in the extracellular space around neurons.... the plaques have come to be sort of the force, the, the, the focus of, um, Alzheimer's research, really. And the idea was that these plaques were the causative force in the, in the condition. Um, much like the plaque on your teeth, right? You see these plaques in the brain of an, of an, of a person with Alzheimer's disease. And so, that's really been the target of drug therapy. And the idea was that un- until we can find a drug that would, uh, reduce the plaque burden, reduce the plaque, get rid of the plaque in the brains of, uh, of, uh, a senior person, right? Somebody who's at risk for developing Alzheimer's disease, that it's a disease that you can't prevent. You can't, there's nothing to do to treat. Um, but the problem was that they could never actually tie the plaque to cognitive decline, right? Like the clinically meaningful symptom, the symptomatology of Alzheimer's disease, that it messes up your cognition, that it makes you, you know, that it makes you forget your loved ones. Ultimately forget who you are, ultimately forgetting how to eat, right? And that, and, and, and nourish yourself. They could never tie those symptoms to, to the plaque, right? Until a paper published in the journal Nature in 2006. So, what happened was this researcher named Sylve- Sylvain Lesne at the University of Minnesota basically was looking into these, the brains of, uh, mice who were bred to overexpress what's called, uh, amyloid precursor protein, which is the precursor to amyloid-beta, which is the protein that makes up sort of the skeleton of these plaques that we see aggregate, right? So, what he do- what he did was he isolated a subtype that he called A-beta*56 and injected it into a, uh, young and healthy mouse or rat mouse, and he saw the, that, that mouse's cognition rapidly declined. So, that was the missing link, right? That he found a subtype of this amyloid-beta protein that serves as the backbone of these plaques, which could never be pinned to the cognitive decline itself, right? The memory loss itself. But he claimed that he found it, and when injected into the, into the brain of, into the body of a healthy mouse, he saw rapid decline in terms of their, of their cognition, right? So, that was the missing link. And so at that point, um, faith in the so-called amyloid hypothesis was starting to wane because they couldn't find effective drugs. Um, Alzheimer's drug trials have a 99.6% fail rate, so worse than for cancer, worse than for any other, any other disease state, really. And, um, and the drugs that are currently FDA, FDA approved on the market, they're biochemical bandaids, they're minimally effective. I mean, they modulate various neurotransmitters, but you know, I've, I've heard it described like, uh, you know, trying, expecting to remove amyloid from the brain, uh, of a person with Alzheimer's disease and to see their cognition come back is sort of like thinking that if you remove all the headstones from a grave, you know, people will come back to life, right? Like, there's widespread neuronal dysfunction and death in the brain of somebody with Alzheimer's disease. And in tandem with that, uh, scanning technology has allowed us to look into the brains of healthy controls. And what we see is that there's amyloid plaque in the brains of healthy controls as well. So, there's no correlation between amyloid burden in the brain and one's cognitive abilities. But nonetheless, when this paper came out in 2006, it renewed fervor, um, in terms of this hypothesis, because he found the subtype of amyloid that could be injected into a young and healthy mouse that would then impair, seriously impair their cognition, right? And so that, that renewed interest in this, in this hypothesis, and it's what ultimately led to the fact that just a couple years ago, two years ago, um, there was a highly controversial drug that was approved by the FDA called Aducanumab or Aduhelm. And this is a drug that effectively reduced plaque burden in the brain. For the first time, they found a drug that could actually reduce plaque burden in the brain, but it didn't lead to any improvement in cognitive symptoms. Nonetheless, it was given the green light against, uh, against tons of opposition that the FDA received. They put together a panel of 11 people, neuroscientists, neurologists, right? Eight of them told the FDA not to approve this drug.

Joe Rogan 28:50 And what was the reason for that?

Max Lugavere 28:51 The reason for that was that the drug didn't, didn't move the needle on any clinically meaningful, uh, symptom, right?

Joe Rogan 28:58 Where there's significant side effects for the drug?

Max Lugavere 28:59 There were. So, 35% of the people in the trial had significant brain swelling, and half of them had, uh, bleeding associated with that brain swelling-

Joe Rogan 29:09 Ugh.

Max Lugavere 29:09 ... because it, these are antibodies. So Aducanumab is an antibody that basically targets, causes your own immune system to target the amyloid plaques, right? And so what that's doing is causing an inflammatory response in the brain, right? So, 35% of the patients in that, in the, in the phase two trials, I believe, had horrible side effects and no clinically meaningful, uh, effect on, um, on their cognition. But nonetheless, because it effectively did reduce the amyloid plaque burden, there was this intense pressure, right? To, uh, to get it green lit because that's like-

Joe Rogan 29:40 Right.

Max Lugavere 29:41 ... the amyloid hypothesis is right there, right?

Joe Rogan 29:42 Uh-huh.

Max Lugavere 29:43 So, huge problem. One of the big, uh, vocal sort of skeptics about this drug, Aducanumab, is a guy, a Vanderbilt researcher named Matthew Schrag. And so Matthew Schrag was like very vocal, vocally against the approval of this drug, which again, doesn't do anything, right? Like, horrible risk of side effects, no clinically meaningful effect on, on, on s- the, on the symptoms that we want to improve, right? Um, for a patient with Alzheimer's disease. And, um, and so he was vocally critical of that, and then he also was working on some other, some other drug, and he, uh, so, uh, what was revealed basically in the science paper that came out was that he was, um, dabbling in, uh, on a website called PubPeer, which is, um, a site where you can go-It's known for post-publication peer review. So, before a paper gets, uh, accepted for publication, it undergoes this peer review process, right? And so, he found that there were a lot of sort of red flags that were being brought up on this message board, essentially, about this Nature paper. This like seminal Nature paper that was published that found to, it was like the missing link, right? Between like, the amyloid hypothesis and like, the clinically meaningful, meaningful, um, symptoms, meaning memory loss. And he did a bit of like, image sleuthing, which is not generally part of the peer review process, right? And he looked at these, um ... the way data is illustrated in this, in this paper, as it is in- in research generally, it's called a Western blot, which is like a visual representation of, of data, the presence of proteins and so forth. And he found that they were all, for the most part, fabricated. In fact, this A beta star 56 wasn't found by any other team. Hasn't been found by any other team. It, it- it basically came to light that it was essentially faked. The whole thing was faked.

Joe Rogan 31:30 What was the motivation for this person to fake all this?

Max Lugavere 31:34 Because the thing, I mean, I think that we, we like to believe that science is this good faith endeavor towards human flourishing, right? But in the industry of science, there are flawed humans, just like there are in every other industry, right?

Joe Rogan 31:51 Yeah.

Max Lugavere 31:51 And scientists in general, I see this all the time in nutrition, online on social media, right? Social media is a great like, sort of, they say that sunlight is the best disinfectant. Like social media is a great way to kinda see how this plays out.

Joe Rogan 32:04 Right.

Max Lugavere 32:04 Because scientists are notoriously territorial, obstinate. They, you know, their, their-

Joe Rogan 32:12 Egotistical.

Max Lugavere 32:13 ... reputations. Egotistical, yeah.

Joe Rogan 32:13 Yeah.

Max Lugavere 32:13 Their reputations are everything, right?

Joe Rogan 32:14 Yeah.

Max Lugavere 32:16 And, um, I mean, it's just like, I see it, I see it every day. I see it-

Joe Rogan 32:20 They're humans.

Max Lugavere 32:21 Yeah, exactly.

Joe Rogan 32:22 Yeah.

Max Lugavere 32:22 So, yeah, so there's bad apples, right? Like-

Joe Rogan 32:25 Yeah.

Max Lugavere 32:25 I think a lot of people in science, um, like I'm, I'm, I live and breathe nutrition. I'm, it's the thing that I'm most passionate about, like in life, right? Like fitness, nutrition, sleep, disease prevention. My mom is what galvanized that, that passion for me, right? And what, what my mom, my mom went through and my desire to prevent it from happening to others that I care about, and ultimately people, you know, from all walks of life. But a lot, you know, a lot of people go into science, go into medicine because it's just a, it's a career path.

Joe Rogan 32:54 Right.

Max Lugavere 32:54 Right? It's a career path for somebody wanting validation. It comes with prestige, it comes with money, it comes with all the things that, that like, make sense that a person would want, right? But then ego gets in the way and it, and it becomes really problematic. I mean, you see it in nutrition all the time. You see it in nutrition like, all the freaking time.

Joe Rogan 33:10 So this person that fabricated this study and fabricated all this data, what consequences are there for that person?

Max Lugavere 33:17 I mean, I think that the, the Department of Justice is, is gonna be looking into it. But, but, um-

Joe Rogan 33:22 Gonna be looking into it. I mean, this is-

Max Lugavere 33:24 If they're not already. Yeah.

Joe Rogan 33:25 Yeah.

Max Lugavere 33:25 If they're not already. But I personally ... So, one of the worst things about this, right? Is it's not just like the lost time and all the money that went to continue looking down this sort of path of the amyloid hypothesis, right? Looking in the wrong place, really. 'Cause amyloid is there, but it's sort of like what you see in cholest- in like, atherosclerosis, right? Like cholesterol. It's like everybody like has pointed at cholesterol as being the bad guy, 'cause cholesterol's clearly there in atherosclerotic plaques, right? But what's causing it to be there? That's the question that these researchers should've been asking all along. And some have, right? Like there, there have been other like, my mentor, as I mentioned, you know, at Cornell, who I've been lucky to, lucky enough to work with over the years on certain projects, um, you know, knew that, that there was another way. It's this glucose hypometabolism, right? It's like, but there's no money in that. There's no money in saying like, "Make your, keep yourself as insulin-sensitive as possible. You know, reduce your exposure to environmental pollutants. Don't hit your head too hard." You know, all these different modifiable risk factors, it's not as, it's not, you, it's not druggable the way that this like amyloid beta pla- protein, um, is, is druggable. And so, I think the worst thing about it is that anybody who would advance an alternate viewpoint over the past couple of decades would be ridiculed and silenced by the, quote, "amyloid mafia." And I was the, I, I, this happened to me. When I first started doing my documentary, um, Little Empty Boxes, which when I first started doing it, uh, it had a different name. I called it, it was called Bread Head. And I could talk about why I named it that, but that was always a, sort of a working title, uh, for the project. But somebody at one of these foundations, right? Like, um, there's all these like big like Alzheimer's foundations. Uh, I'm lucky to be working on this project with one who really believes in me and the project, the Alzheimer's Foundation of America, but there are these other nonprofits that really what they are is just like a front for, you know, perpetuating the status quo and, and keeping the sort of the funding pipeline open for drug discovery. And so when I first got started doing, working on this, on my film, I did a Kickstarter campaign for it. And one of these nonprof- quote unquote "nonprofits," right? Deeply invested in the amyloid hypothesis, came out and wrote an, uh, an op-ed in the Wall Street Journal disparaging me and my project and any other alternate sort of viewpoint, and talking glowingly about that Aducanumab drug, which at the time had yet to be approved, right? And it was so like painful to me at the time, because I was like working on this project out of the love and passion that I had for my mom and my desire to get the science out, to catalyze, you know, interest in this science. It takes 17 years on average for what's discovered in science to be put into day-to-day clinical practice. So I was like, that's, that's time we don't have to lose when the brains of our loved ones are at stake. And so, yeah, I was like directly sort of in the crosshairs at the time for this like, this amyloid mafia. I was like directly affected by it.

Joe Rogan 36:19 Because this medication is profitable.

Max Lugavere 36:22 Yeah, because the medication's profitable and that the whole avenue was thought to, you know, if you could find a drug that would reduce amyloid burden in the brain, I mean that makes, that's gonna make shareholders-

Joe Rogan 36:31 Sure.

Max Lugavere 36:31 ... really happy.

Joe Rogan 36:33 And this drug, is it still being prescribed?

Max Lugavere 36:35 Yeah. It's, uh, it's, uh, it's approved. It's approved.

Joe Rogan 36:39 And so, there's no real way of telling how many people have died from this drug because most of the people that are taking this drug already are experiencing this neurodegenerative disease, and you could easily chalk it off to that being the cause of death.

Max Lugavere 36:52 (smacks lips) Yeah. I mean, I, I can't speak to, like, you know, people's experiences on it currently. But I do know that, um, that the trials were, you know ... I mean, if I had a loved one, based on what I know about this drug and those trials, I would, my, my loved one currently would not be on that drug. They would be perhaps experimenting with, uh ... You know, and this is a very difficult sort of road to go down. I guess th- it's easier to say if I had dementia, right? (smacks lips) If I myself had dementia, I would be experimenting with

Max Lugavere 37:22 a ketogenic diet on myself and other ketogenic therapies, because ketogenic diets, what they do ... So, as I mentioned, in the Alzheimer's brain, the ability to generate energy from glucose is reduced by about 50%, 45, 50%. Its ability to generate energy from ketone bodies is unperturbed. So, the idea is that a ketogenic diet can essentially keep the lights on in the Alzheimer's brain. It's not a cure, but, um, but there has been, uh, research, um, on patients with Alzheimer's disease, mild to moderate Alzheimer's disease, that ketogenic, uh, ketogenic diet intervention can actually improve functional capacity in those patients, which is everything, right?

Joe Rogan 38:03 Yeah.

Max Lugavere 38:04 Um, so that's what I would do for myself. Uh, for other people, you know, when my mom, um, was starting to show these symptoms, I, I attempted to put her on some kind of like ketogenic-style diet. But actually, as you, uh ... What's very interesting is that people that develop Alzheimer's disease, they, they start to develop a sweet tooth. And it's thought that that's sort of like the brain crying out for sugar-

Joe Rogan 38:24 Mm.

Max Lugavere 38:24 ... essentially, because it's just, it's struggling to generate energy.

Joe Rogan 38:27 Right.

Max Lugavere 38:27 You know? And dietary change is difficult for anybody, let alone somebody with dementia, so I can only ... Yeah, I can only speak for myself.

Joe Rogan 38:33 So, even though this study has been shown to be fraudulent, and even though that medication has shown to have some pretty severe side effects, and even though the amyloid plaque hypothesis has kind of been disproven now as being the cause of it, why are they still prescribing that drug?

Max Lugavere 38:54 (smacks lips) Yeah. It's, uh ... You know? It's, uh ... (laughs) Because it takes 17 years.

Joe Rogan 39:01 Right. But once they have access to the fact that that study was flawed, not just-

Max Lugavere 39:07 Yeah.

Joe Rogan 39:07 ... flawed, but fraudulent. I mean, that's, it's pretty significant, the impact that that's had.

Max Lugavere 39:11 They should pull it off the market.

Joe Rogan 39:13 I mean, think about the num- the, the, sheer numbers of people that have dementia and Alzheimer's and s- these significant, horrific problems, and they're basing the treatment of it on fraud.

Max Lugavere 39:27 Yeah.

Joe Rogan 39:28 And the fact that they still do it without, like, having this immediate cease, like what could be, other than generating more revenue ... Other than generating more revenue, like what-

Max Lugavere 39:39 Yeah.

Joe Rogan 39:39 ... what else could possibly be the reason for continuing to prescribe that drug other than ignorance?

Max Lugavere 39:45 Yeah. Well, I think that it's not that this paper came out and suddenly the amyloid hypothesis is, uh, you know, has been debunked or whatever, you know? Like, there, there is still a ton of money invested in this hypothesis, and there are still a lot of researchers who think whether or not this drug is, is the, is the ... You know, this is like version one.

Joe Rogan 40:06 Right.

Max Lugavere 40:06 So, there are still many researchers who think that this is like still the target, still the appropriate target.

Joe Rogan 40:11 But once they realized that the study was fraudulent-

Max Lugavere 40:15 Yeah.

Joe Rogan 40:15 ... and that when injected into these mice and it's causes significant de- degeneration that this is not really accurate-

Max Lugavere 40:22 Yeah.

Joe Rogan 40:22 ... that this is all fake-

Max Lugavere 40:24 Yeah. Well, this-

Joe Rogan 40:25 ... so then they don't have a mechanism.

Max Lugavere 40:26 Right.

Joe Rogan 40:27 Right? So, why are they still prescribing a disease to combat the mechanism that's proven to be fraudulent?

Max Lugavere 40:32 (smacks lips) Yeah. I think it's just because that's where all this, you know, their, th- it's just, there's ... What is the term? It's like a sunk-cost fallacy. You know? I think people in, in many ways are just so ... The w- you know, whether it's like academia or pharma, they're, we're just so deeply invested in this hypothesis, and it hasn't been debunked. And this fraudulent paper didn't test aducanumab, the drug. So, you know, (smacks lips) I think that-

Joe Rogan 41:02 But the fraudulent paper is the reason why-

Max Lugavere 41:04 Yeah.

Joe Rogan 41:04 ... that drug was approved.

Max Lugavere 41:06 Yeah. Yeah. It's a, it's a-

Joe Rogan 41:08 That is fucking wild. If you're a person right now-

Max Lugavere 41:11 It's all a scam.

Joe Rogan 41:11 ... who's listening to this, and they're dealing with ... You know, my friend Jessie May, uh, her, her dad had-

Max Lugavere 41:17 I know her.

Joe Rogan 41:17 ... Alzheimer's.

Max Lugavere 41:18 Yeah. It's-

Joe Rogan 41:20 And it was, uh, so hard for her. I mean, it was, it s- it was so terrible to watch her suffer while her, her, her father, who she loved dearly, was just deteriorating.

Max Lugavere 41:30 (smacks lips) Oh, it's super hard. And you get drugs that, you know, one of them, Namenda, it's like an NMDA receptor, uh, modulator. And then you get another one, donepezil, which works to boost, you know, acetylcholine. They're just bi- they're biochemical Band-Aids. They do no- nothing to address the underlying pathology. And, um ... And yeah, I mean, (laughs) it was literally until it, I believe, 2020 was the year, um, or twen- 2017, I think, was the first time that The Lancet Neurology acknowledged that, um, a significant proportion of dementia cases were attributable to modifiable risk factors. So, that's sort of their way of saying that, "Look, you can, uh, put ... There's a significant proportion of these cases that are potentially preventable," right?

Joe Rogan 42:14 Obesity, type 2 diabetes.

Max Lugavere 42:16 Yeah.

Joe Rogan 42:17 Diet.

Max Lugavere 42:17 Smoking.

Joe Rogan 42:18 Smoking.

Max Lugavere 42:18 Excessive alcohol consumption, air pollution, hearing impairment.

Joe Rogan 42:21 Alcohol, uh, air pollution?

Max Lugavere 42:22 Air pollution.

Joe Rogan 42:23 Really?

Max Lugavere 42:23 Yeah. As of 2020, that has now been acknowledged to be a major contributor, you know. Exposure to fine particulate matter like PM2.5 has been shown to pierce the blood–brain barrier and, and-

Joe Rogan 42:34 Mm.

Max Lugavere 42:34 Amyloid-I mean, the thing about amyloid is that it's like, our body, our brains produce it. It's not necessarily bad, the same way that, like, cholesterol, you know, we, m- when you hear the term cholesterol, like, you know, we think of it as this, as this bad, pathologic thing that we wanna get out of our bodies, right? But cholesterol's vital to life, right? Like, we need it. Same with amyloid. Amyloid-

Joe Rogan 42:55 It helps you formulate hormones.

Max Lugavere 42:56 Hormones. Yeah.

Joe Rogan 42:57 Yeah.

Max Lugavere 42:57 I mean, it's at, at, every cell membrane, like, requires cholesterol-

Joe Rogan 43:01 Yeah.

Max Lugavere 43:01 ... to stay supple and fluid, right?

Joe Rogan 43:02 Which is, vegans don't wanna hear that, ever.

Max Lugavere 43:04 They don't wanna hear that.

Joe Rogan 43:05 Th- they panic.

Max Lugavere 43:06 Well, I, yeah, I butt heads with them all the time.

Joe Rogan 43:08 (laughs) Of course.

Max Lugavere 43:09 Yeah.

Joe Rogan 43:09 Well, it's an ideology, you know, unfortunately. It's an ideology based on a really good premise. The premise is you wanna do less, uh, less harm. You wanna be a, a more ethical, moral, kinder person. And I, I respect their motivation. The problem is in practice, both in monocrop agriculture, which is horrific for the environment, and then also in the effects on the human body. If you, i- it's very difficult to do correctly, you know, and we've had conversations before, and unfortunately, you know, there's a lot of documentaries and a lot of people that are propagandizing this ideology. They're doing it like it's a religion, and that's how they treat it. They, they ignore any evidence to the contrary. They, they won't even look at eggs-

Max Lugavere 43:57 (laughs)

Joe Rogan 43:57 ... which are really kind of ... I mean, if you have chickens, or if you know someone has chickens, or if you can get eggs from a, a place that has, uh, free range chickens, it's like zero ethical dilemma. It's, they lay eggs every day.

Max Lugavere 44:13 Yeah.

Joe Rogan 44:14 They're not going to be chickens. It's just free protein. If you let these chickens roam around and eat grass and bugs and do the stuff they're supposed to do, you have literally one of the most healthy sources of food that's available to the human body. And it's ethically free. Like, if you're a person that's a vegan and you're doing it for moral purposes, but you recognize the fact that you're not getting the appropriate amount of nutrition, get chickens. If you have a backyard, get some chickens. They lay an egg almost every day.

Max Lugavere 44:42 (laughs)

Joe Rogan 44:43 And they're better for you than any egg that you're gonna buy in a store from grain-fed chickens.

Max Lugavere 44:47 100%.

Joe Rogan 44:48 And you don't have to worry about them ch- being treated horrifically. They just w- I mean, I used to have chickens before the fucking coyotes got them all.

Max Lugavere 44:54 (laughs)

Joe Rogan 44:55 But, uh, this was back when I lived in California. It's a long story. But, um, it, it w- wasn't just the coyotes got them all. It was like, the fire burnt the chicken coop down. Our ... We almost lost the house. The fire burnt the chicken coop down. Then we had a smaller chicken coop, and then that one wasn't as robust. I had, like, a real serious one built by a carpenter.

Max Lugavere 45:12 Wow.

Joe Rogan 45:12 And then we bought a store-bought one, 'cause we had to get a chicken coop quickly and the coyotes figured out a way to get into it.

Max Lugavere 45:19 Hmm.

Joe Rogan 45:19 And it was a fucking bloodbath. It was horrible.

Max Lugavere 45:21 Damn.

Joe Rogan 45:21 Nine chickens destroyed overnight.

Max Lugavere 45:23 Oh my god. Wow.

Joe Rogan 45:24 Yeah, it was, it was fucking horrific. Um, but those little fucks, they had been-

Max Lugavere 45:28 (laughs)

Joe Rogan 45:28 ... targeting my chickens for quite a while.

Max Lugavere 45:30 Wow.

Joe Rogan 45:30 But the-

Max Lugavere 45:31 Good eating.

Joe Rogan 45:32 But the, the eggs themselves are so good for you. And again, they're not going to become chickens. These are non-fertilized eggs, and people need to understand that. I didn't know that until I was 40, by the way.

Max Lugavere 45:44 (laughs)

Joe Rogan 45:45 How s- how fucking dumb I am. I thought that, like, if you just, like, let the, the egg go, it would become a chicken. And then, and then someone goes, "No. You, they don't even need a rooster-"

Max Lugavere 45:53 (laughs)

Joe Rogan 45:54 "... to lay that egg." I was like, "Oh, yeah. Oh, yeah."

Max Lugavere 45:59 (laughs)

Joe Rogan 45:59 How could it? Yeah, duh. (laughs)

Max Lugavere 46:01 Fascinating.

Joe Rogan 46:02 But that was before I had chickens.

Max Lugavere 46:03 You're making me wanna get chickens.

Joe Rogan 46:04 Well, listen, it's a great way to have protein, and it's really a great relationship. You know, you, uh, I would feed them worms. Uh, I would buy these mealworms. The, you know, that you would, uh, s- the e- they, they come, come dried. And I would, like, shake the box of mealworms and the chickens would just run towards me, full clip.

Max Lugavere 46:22 Oh my god.

Joe Rogan 46:22 And I would dump them out on the ground. They would go crazy and eat them all.

Max Lugavere 46:25 That's so awesome.

Joe Rogan 46:25 Yeah, I mean, they, i- d- you've never seen, um, savagery like a chicken eating a mouse, though. They would occasionally catch a mouse. Holy shit. You think cats are vicious? Cats have nothing on chickens.

Max Lugavere 46:39 Wow.

Joe Rogan 46:39 Have you ever seen a chicken kill a mouse?

Max Lugavere 46:40 I've never thought of chickens as, like, predators, but ...

Joe Rogan 46:42 Oh, boy. I'm in-

Max Lugavere 46:43 (laughs)

Joe Rogan 46:43 Well, I'm gonna show you something. Jamie, uh, pull up a video of a, a chicken killing a mouse. There's a, there's a bunch of great videos online. But I found this out by accident, and this is how I found out. My, my, um ... We had a house when I lived in California that had a glass, uh, wall. And it used to be, like, a fence, and then my wife was like, "Wouldn't it be better if it was, like, a glass wall?" Then you can see the view. I was like, "Yeah, that'd be better." So we put this glass wall in, and unfortunately, the hawks couldn't recognize that it was a glass wall. So they would fucking dive bomb it. Bang.

Max Lugavere 47:18 (laughs) Oh my god.

Joe Rogan 47:18 So it was kind of like karmic justice for whatever mouse they were trying to kill. So they would dive bomb and slam into this glass fence and get knocked out, or die. And a couple of them died in my yard and we were like, "Fuck." So one of them died ... Before, before you do this. So one of them died, um, and then one of them survived, and my family ... I was out of town for the weekend, doing standup, and my family went to a local pet store and got what are called pinkies. And pinkies are these little infant mice that they serve to snakes and reptiles and things like that. So they got a few of them and fed them to this hawk. You know, they looked online what do hawks eat. And so the hawk ate all these pinkies and, uh, we had to wait until Monday to get the hawk to this, uh, wildlife rescue center that takes care-

Max Lugavere 48:10 Wow.

Joe Rogan 48:10 ... and rehabilitates hawks. So one pinky was still alive and my kids were like, "We're gonna raise it."

Max Lugavere 48:16 (laughs)

Joe Rogan 48:16 I go, "Listen, you just fed them to this fucking horrible raptor."

Max Lugavere 48:19 (laughs)

Joe Rogan 48:19 "And now all of a sudden it's your con- this one is gonna be your friend? And how traumatized is it gonna be but all his siblings got murdered by this fucking giant dinosaur?"

Max Lugavere 48:27 Damn.

Joe Rogan 48:28 And, uh, I said, "It's not gonna survive." It, it's, it hasn't been weaned by its mother. You know, we, we k- we can't. It's not gonna live. And it hasn't eaten in days. I'm like, "This thing, it's not gonna live." I go-... I think I'm gonna feed it to the chickens. They're like, "Don't, don't feed it to the chickens."

Max Lugavere 48:43 (laughs)

Joe Rogan 48:43 Anyway, long story short. I go out into the chicken coop and I put that pinky down, and they dive on that thing like nothing I've ever seen in my life.

Max Lugavere 48:52 Oh, my God.

Joe Rogan 48:53 One chicken grabs it. The other chicken is attacking that chicken-

Max Lugavere 48:56 (laughs)

Joe Rogan 48:56 ... trying to pull it out of their mouth. Like, they instinctively recognize that that's a food source.

Max Lugavere 49:01 Wow.

Joe Rogan 49:02 So watch this. So this is what happens when chickens see a mouse. Like, immediately.

Max Lugavere 49:09 Oh, my God.

Joe Rogan 49:09 Look, they try to steal it from each other.

Max Lugavere 49:11 Savages.

Joe Rogan 49:12 Oh, my God. I mean, it's like their favorite food. Mice are their favorite food.

Max Lugavere 49:16 Holy cow.

Joe Rogan 49:16 If you have mice and chickens, the chickens will fuck those mice up. Chickens are, they're creepy little domestic dinosaurs.

Max Lugavere 49:24 You're right. I mean, yeah, when you say that, I'm like ...

Joe Rogan 49:26 I mean, that's what they are. Look.

Max Lugavere 49:27 Yeah.

Joe Rogan 49:27 They're still trying to steal from her. And, uh, there's another one where a cat is playing with a mouse, and the chicken's like, "Let me show you how it's done, bitch."

Max Lugavere 49:37 (laughs)

Joe Rogan 49:37 And the chicken comes running over and, like, steals the mouse from the cat.

Max Lugavere 49:41 Damn.

Joe Rogan 49:42 Yeah.

Max Lugavere 49:43 Did you see, uh, there's this amazing dinosaur miniseries on Apple TV?

Joe Rogan 49:47 No.

Max Lugavere 49:48 It's, um, it's so good, and they actually portray raptors as dinosaurs with feathers.

Joe Rogan 49:52 Yeah, they think that now.

Max Lugavere 49:54 Yeah.

Joe Rogan 49:54 There's a museum in Montana, in Bozeman, and they show you two options of this raptor. They show you one option, like the Jurassic Park version, and then they show you on the other side of this raptor, they have it completely covered in, like, beautiful colored feathers-

Max Lugavere 50:10 Wow.

Joe Rogan 50:10 ... just like a chicken. Which is most likely-

Max Lugavere 50:12 Fascinating.

Joe Rogan 50:12 ... the case.

Max Lugavere 50:13 Yeah.

Joe Rogan 50:13 They think that dinosaurs had feathers. Which makes sense.

Max Lugavere 50:17 Fascinating.

Joe Rogan 50:18 I mean, the, the things we see now, I mean, if you look at an eagle, that's a goddamn dinosaur.

Max Lugavere 50:22 Yeah.

Joe Rogan 50:22 That's it right there.

Max Lugavere 50:23 Oh, my God.

Joe Rogan 50:23 Which is really cool-looking.

Max Lugavere 50:24 Wow.

Joe Rogan 50:26 I mean, that's most likely... So Jurassic Park and all those films, they're probably incorrect. This is probably what it looked like. 'Cause they've actually found-

Max Lugavere 50:35 Still terrifying.

Joe Rogan 50:35 ... fossilized imprints of feathers with, with the fossils of dinosaurs.

Max Lugavere 50:40 Whoa.

Joe Rogan 50:40 So they've had the, these, these clear indications that feathers existed on these creatures.

Max Lugavere 50:46 Hm.

Joe Rogan 50:47 Yeah.

Max Lugavere 50:47 Wow, fascinating.

Joe Rogan 50:48 So if anybody wants ethical, like, uh, guil-free, karma-free protein that's as good as your body's ever gonna get, eggs. (slaps table)

Max Lugavere 50:59 Yeah. I actually-

Joe Rogan 51:00 From a chicken that you raise.

Max Lugavere 51:01 Totally. I consider eggs to be a cognitive multivitamin, actually, because if you consider the fact that when an embryo's developing, the, the central nervous system, and the nervous system in general, is the first structure to coalesce, right? So an egg yolk literally has everything in it that nature has deemed important to grow a brain.

Joe Rogan 51:17 Which is so frustrating when people wanna eat egg white omelets.

Max Lugavere 51:19 Yeah.

Joe Rogan 51:19 When I go to a store or a restaurant and I see egg white omelet, I'm like, "Where's the fucking whole egg?"

Max Lugavere 51:24 Oh, yeah.

Joe Rogan 51:25 Why are you serving egg whites?

Max Lugavere 51:26 It's insane. It's, I mean, the, the yolk ha- it's, like, again, cau- a cognitive multivitamin, and it, it's, it's no surprise that, uh, egg yolk, people, you know, like vegans are, they, they just see red, right, whenever you say cholesterol. Whenever they see that, like, there's cholesterol in a food.

Joe Rogan 51:40 Right.

Max Lugavere 51:40 But, but it's, it, it should be no surprise that an egg yolk is rich in cholesterol, because the brain is rich in cholesterol.

Joe Rogan 51:46 Mm.

Max Lugavere 51:47 Right? Like, despite accounting for only 2% of your body's mass, 25% of the cholesterol in your body is located in your brain. That doesn't mean that you have to, you don't need to eat cholesterol to support brain health. Your brain produces all the cholesterol it needs. It's called de novo cholesterol synthesis. But an egg yolk has a little bit of vitamin B12. It's got choline. Choline is one of these, like, crucially important micronutrients that 90% ... Actually, the adequate intake for choline is probably less than, than what it should be for, when you account for our brains' needs. But 90 per- percent of adults don't consume adequate choline.

Joe Rogan 52:18 And acetylcholine is, uh, a primary ingredient of many nootropics, which, uh-

Max Lugavere 52:22 There you go.

Joe Rogan 52:22 ... have been shown to improve brain function.

Max Lugavere 52:24 Yeah, it's a super important, um, neurotransmitter involved in learning and memory. And in fact, one of the drugs that's prescribed for Alzheimer's disease modulates that, uh, that cholinergic sort of pathway. Um, but yeah, choline is crucially important. It's found in, in egg yolks. I think egg yolks maybe is, uh, second place to, like, beef liver, which is a, which is the top source for dietary choline. But again, something that we under consume. And studies show that people who consume more choline have reduced risk for, um, dementia. And choline is, like, one of these foods alm- a, one of these nutrients could almost be considered a surrogate marker for animal protein intake, because you find it in both plants and animals, but it's much more concentrated in animal protein.

Joe Rogan 53:03 But speaking of which, what do you think about these, uh, desiccated supplements of heart and liver and testicles-

Max Lugavere 53:12 (laughs)

Joe Rogan 53:12 ... and all these things that you see being sold now? I, I have a friend of mine who is in the medical field, and he's very concerned about this, 'cause he's like, "I don't know what, whether or not these things could contain prions, whether they, like, how are they taking these? Like, you're eating beef liver. How is this processed? What, what is the source? Like, how do you know what's in these things?"

Max Lugavere 53:37 Yeah, it's a good question. I mean, I think we likely consu- our ancestors probably consumed brain early on as a good source of DHA fat, which is one of the most important structural building blocks of the brain, right? Docosahexaenoic acid, DHA fat. And the brain is rich in that. But, um, but yeah, I mean, I think, I think it's a, it's a valid concern, although, you know, I haven't, to be honest, I haven't, like, looked, looked into it too deeply. I do think the liver is a great food. It's one of the most nutrient-dense foods there is. Um, and I do think that there is a little bit of truth, at least in the case of liver, where like supports like. Like, we know that beef liver is a top source of choline, right? And we know that choline directly supports liver health, um, because it helps to export fat. So choline is actually a good treatment for non-alcoholic fatty liver disease-

Joe Rogan 54:23 Hm.

Max Lugavere 54:24 ... 'cause it helps to get fat out of the liver. So in that way, I think eating liver can support liver health, and the liver is, like, a crucially, I mean, it's a vital organ, obviously, but it pl- it plays hundreds of roles in the body.

Joe Rogan 54:35 It tastes good too. You just have to eat and cook it right.

Max Lugavere 54:38 Yeah.

Joe Rogan 54:38 You know, a lot of people don't like the texture. They feel weird about eating it. But once you realize the nutritional value of liver, you know, liver and onions is delicious.

Max Lugavere 54:46 Yeah, super tasty. I think, like, cooking it kinda rare-

Joe Rogan 54:50 Mm-hmm.

Max Lugavere 54:50 ... getting a nice sear on the outside.

Joe Rogan 54:51 Yeah. Yeah.

Max Lugavere 54:52 I like cooking it in ghee.

Joe Rogan 54:54 Oh, okay.

Max Lugavere 54:54 Yeah. I have, uh-

Joe Rogan 54:56 I usually use beef tallow.

Max Lugavere 54:57 Oh, beef tallow. That's a good option. I actually, um ... My thoughts on dairy have evolved kinda recently.

Joe Rogan 55:03 Yeah?

Max Lugavere 55:03 And, um ... Yeah, you know, I get like on social media especially, like on Instagram, I get a lot of shit from pretty much everybody. Like, the vegans don't like me, right, 'cause I promote animal products. The carnivores don't like me because I'm a big believer in the value of dietary fiber and plant, you know, phytochemicals and the like. Uh, the evidence-based, like, credentialist community doesn't like me 'cause I'm not a, you know, I don't have any- any credentials after my name. Um, but, uh ... But yeah, and then the paleo community, because I- I recently have sort of come out sort of not being a huge fan of, like, butter and- and ghee. You know, I'm a huge fan of dairy and dairy fat in general, which ... Dairy fat ... So all natural fat-containing foods contain some proportion of saturated fat, polyunsaturated fat, monounsaturated fat, right? So like, any natural fat-containing food is gonna contain some saturated fat. So, demonizing any type of fat, I think, doesn't make any sense, right?

Joe Rogan 55:56 Including avocados.

Max Lugavere 55:57 Yeah. Avocados are great. Like, avocados are mostly monounsaturated fat. I think people should steer clear from, as best they can, the grain and seed oils like the canola-

Joe Rogan 56:07 Yeah.

Max Lugavere 56:07 ... corn, soybean.

Joe Rogan 56:08 I definitely wanted to talk to you about that because-

Max Lugavere 56:10 Controversial.

Joe Rogan 56:11 This is, uh ... I've been trying to have this conversation with my family 'cause they'll buy salad dressing and say it's healthy. I'm like, "Do you ever read what's in this shit?" I'm like, "Unless it has olive oil in it, it's probably not good for you." Like these shitty seed oils that they put in these salad dressings, I eat salad with the salad dressing on it, I feel like shit.

Max Lugavere 56:30 Yeah.

Joe Rogan 56:30 I feel, like, bloated. I feel gross. Whereas I eat salad and I just put balsamic vinaigrette and olive oil on it, and I feel great. It feels like, okay, my body likes this. And isn't, f- like ... Just consuming, like, vegetables by themselves is not as effective as consuming them with some fat.

Max Lugavere 56:50 Yeah. You're absolutely right. So I mean, a lot of the compounds that we want in- in veggies are fat-soluble. So I talk a lot about the value of carotenoids. So carotenoids are like plant pigments. They're responsible ... Generally in the produce section you'll see, uh, yellow produce and orange produce, rich in these compounds. And two in particular, um, plant-based carotenoids I've become a big fan of called lutein and zeaxanthin. And they've shown that people, higher consumers of lutein and zeaxanthin have ... They- they seem to be protected against, uh, cognitive decline.

Joe Rogan 57:24 Vision loss.

Max Lugavere 57:24 Vision loss, certainly. Yeah.

Joe Rogan 57:25 Yeah.

Max Lugavere 57:25 If you look at any eye supplement, they usually will have, um, those two in them because they can help prevent age-related macular degeneration.

Joe Rogan 57:32 Yeah. Now, um, what are the criticisms, uh, against seed oils, uh, specifically? Like, I- I've seen you speak about grape seed oil, which is a really fascinating one, 'cause it really wasn't something that was in the human diet until y- w- as you were saying, that wine makers realized, "Hey, like, we could ... We're leaving money on the table."

Max Lugavere 57:51 Yeah. (laughs)

Joe Rogan 57:51 "Grow all this grape seed, turn this shit into oil."

Max Lugavere 57:54 Yeah. So again, some industrious, uh, entrepreneur saw that as a byproduct of wine-making, you're losing out on all these grape seeds, right? And grape seeds are rich in oil, like- like all seeds are, right? And so if you can extract the oil and get rid of the noxious, like, aromas and- and flavors, then you've got something that you can sell, right? For- for ... I think it's like a $500 or $600 million a year business, if not more, these days. Um, so grape seed oil, like any of these grain and seed oils like corn oil, uh, canola oil, which comes from the rapeseed plant, soybean oil, they're referred to sometimes within the food industry as RBD oils. Refined, bleached and deodorized oils.

Joe Rogan 58:36 Blegh.

Max Lugavere 58:36 Yeah. Um, because they're- they have like these like, again, these harsh bitter flavors, right?

Joe Rogan 58:42 Mm-hmm.

Max Lugavere 58:42 Some of them, like, uh, like the rapeseed, contain toxins like erucic acid.

Joe Rogan 58:46 They might wanna change the name of that seed.

Max Lugavere 58:48 Yeah, right?

Joe Rogan 58:49 Doesn't it seem like a rude way ...

Max Lugavere 58:50 Yeah. (laughs)

Joe Rogan 58:50 You know, you want a murder fruit? No.

Max Lugavere 58:52 (laughs)

Joe Rogan 58:53 You know what I'm saying?

Max Lugavere 58:54 Yeah.

Joe Rogan 58:54 Like, why is it rapeseed?

Max Lugavere 58:55 Exactly.

Joe Rogan 58:57 Okay. So, um, what do ... What's the negative effect of things like, like ... I would imagine that in the human diet, consuming, uh, an exord- exorbitant amount of this kind of grape seed oil is really not even possible. Like, the ... How many grapes would you have to eat to get ... With the seeds, to get the kind of, uh, the amount that you would get from a tablespoon of, like, grape seed oil?

Max Lugavere 59:24 Yeah. I mean, humans, we don't even, like, generally ... We would ... We- we're averse to seeds for a reason. I mean, if you've ever tried to chew into a grape seed, it's bitter, right? You spit it out.

Joe Rogan 59:33 Yeah.

Max Lugavere 59:33 So, that's why these oils didn't ... They didn't exist in the human food supply before 100 years ago. We hadn't had the chemistry labs, the erector sets required to extract these oils and then run them through all these myriad processes to- to make them, to some degree, palatable and- and- and able to be utilized by the food industry. They used to be used as engine, you know-

Joe Rogan 59:53 Yeah.

Max Lugavere 59:53 ... lubricants and things like that.

Joe Rogan 59:54 That- that's in industrialized, uh ... Seed oils have always been used as lubricants for engines.

Max Lugavere 59:59 Yeah.

Joe Rogan 1:00:00 So when did they start using them ... What is this, Jamie? What'd you pull up there? Okay.

Max Lugavere 1:00:05 (laughs)

Joe Rogan 1:00:05 To produce 237 milliliters, eight-ounce fluid bottle of grape seed oil, one ton of grapes is required. So, 2,000 pounds of grapes to get eight ounces of grape seed oil. The finished oil is light yellowish-green in color. Holy shit.

Max Lugavere 1:00:24 That's insane.

Joe Rogan 1:00:25 Well that ... There you go.

Max Lugavere 1:00:26 Yeah.

Joe Rogan 1:00:26 So if you're cooking in grape seed oil, you're- you're essentially ... It's a crime against nature. (laughs)

Max Lugavere 1:00:33 Yeah.... it's, it's just, yeah. It's the most unnatural thing. And, uh, you know, people listening to this might, might say, "Oh, you know, appeal to nature fallacy. What's natural isn't always..." Like arsenic is-

Joe Rogan 1:00:45 Right, true.

Max Lugavere 1:00:46 ... but I think that, that, like a platitude like that, isn't very helpful, right? In the modern world.

Joe Rogan 1:00:50 So, what are the negative effects of things like industrialized seed oils?

Max Lugavere 1:00:54 Yeah. So, um, I mean, for one, they all undergo that step called the deodorization step, which is the step that removes the noxious odors and aromas from these oils, makes them palatable, gives the oil... It's basically the food industry's equivalent of a witness protection program, right? 'Cause it takes an oil and it makes it so bland and, and free of any kind of character, right, that it can be used to roast nuts in, it can be used to make granola bars, it can be used to sauté food in in a restaurant. It c- c- c- can be used to fry food in, for example. And the problem is... One, one of the problems with these seed oils is that that deodorization step creates a small but significant amount of trans fats. And we know that there's no safe level of trans fat, artificially m- you know, man-made trans fat consumption. Their most, uh, recognizable form was in, uh, poly, uh, partially hydrogenated vegetable oils, which were outlawed, right? Five, six years ago. Something like that. Um, but you can still find man-made trans fats on the market in the form of these grain and seed oils. Now, the dose likely makes the poison, as it does with most things, but your average, um, American today is over-consuming these oils. I mean, they didn't exist, again, in the few- human food supply prior to a century ago, and their use has increased anywhere between, uh, 250 and 1,000%. 1,000% for soybean oil, in particular, which is the most commonly used, um, grain and seed oil. And so, we're over-consuming these fats. They harbor these trans fats. When we cook with them, in particular, when we expose them to high heat, especially for prolonged periods of time, they generate poisons called aldehydes. And some of these aldehydes are really toxic. I mean, they're neurotoxic, they're mutagenic, meaning they're cancer causing. Um, you know, one such aldehyde is acrolein. Acrolein is found in cina- in, uh, cigarette smoke, um, it's found in all kinds of industrial pollutants, and we can see it in the brains of people with, with Alzheimer's disease. Like it actually accumulates-

Joe Rogan 1:02:55 How is it produced in cigarettes? Sorry to interrupt, but how is, how does cigarette smoke produce acrolein?

Max Lugavere 1:03:01 Well, I'm not 100% sure as to how it's produced in cigarette smoke, but it is a byproduct of like the burning of garbage, and you know, it's created in, in myriad industrial processes. Um, likely-

Joe Rogan 1:03:13 So it has something to do with the heat?

Max Lugavere 1:03:15 Probably the heat.

Joe Rogan 1:03:15 And-

Max Lugavere 1:03:16 Yeah.

Joe Rogan 1:03:16 ... whatever the plant compound.

Max Lugavere 1:03:18 Heat and oxygen.

Joe Rogan 1:03:19 Mm-hmm.

Max Lugavere 1:03:19 Yeah. The coalesce, you know, the, the coalescing of heat, oxygen, light.

Joe Rogan 1:03:25 So what about if it's not being heated up? Like, what about seed oils as they exist in salad dressings and the like?

Max Lugavere 1:03:32 Well, I think one of the big fears, um, another big fear with regard to these oils is that they might not be acutely inflammatory, so I think a lot of people, um, and this get, this is what tends to get pushback among the evidenced-based crowd on social media, you'll hear claims that these oils are inflammatory. And I think this is more an issue of semantics. They're not acutely inflammatory, but they may be chronically inflammatory because they provide the precursors to our body's inflammation pathways, particularly the omega-6 fats. Omega-3 fats are, generally speaking, anti-inflammatory, right? They're able to convert to compounds called resolvins, which quite literally resolve the inflammatory cascade. But omega-6 fats provide the backbone to these pro-inflammatory signaling molecules in the body, which are responsible for heat, pain, redness, swelling, things like that. And inflammation underlie, you know, it's a process that is not bad, but when it's chronic and low-grade, it's associated with, um, you know, all of these chronic conditions that we're talking about. Certainly Alzheimer's disease, other forms of dementia, but also cardiovascular disease, type 2 diabetes, and the like. Now, are they gonna actually stimulate an inflammatory response? You know, I don't think so, unless maybe the oil is, is highly damaged. But if it's, we'll just say like it's a fresh oil, which none of these oils are fresh, 'cause they've all undergone-

Joe Rogan 1:04:52 Right, they've been sitting on the self- shelf forever too.

Max Lugavere 1:04:54 Yeah, in plastic.

Joe Rogan 1:04:56 Yeah.

Max Lugavere 1:04:56 Right?

Joe Rogan 1:04:56 Right.

Max Lugavere 1:04:56 Which is like... I mean, if you look at extra virgin olive oil, you'll, you'll seldom find a good extra virgin olive oil in plastic-

Joe Rogan 1:05:02 Right.

Max Lugavere 1:05:02 ... because producers know what they've got. This is like liquid gold, right?

Joe Rogan 1:05:05 Yeah.

Max Lugavere 1:05:06 But these grain and seed oils, you know, they're sitting on a shelf in plastic, they're sitting, uh, you know... With extra virgin olive oil, for example, one of the tips that I offer people when buying extra virgin olive oil, which I think is medicine in many ways to the brain, is you wanna buy it in small bottles, right? Small glass, opaque bottles. Because extra virgin olive oil, unlike wine, only degrades over time. So there's no like appreciation that occurs with time. The same thing is true for these grain and seed oils. But they sell them in these big tubs, right? We leave them in our warm kitchen environments, and these oils are very prone to a process called oxidation, which, um, is like essentially a damaged oil, right? Like you wouldn't, you wouldn't see a piece of rotting food on the counter and intuitively think to yourself, "That looks good," right? You can't necessarily see it happening in these oils, but nonetheless, we're told over and over again to integrate them into our diets and our, and our lifestyle. So, they're easily oxidized, they, um, they provide the raw materials in abundance to our body's inf- inf- inflammation pathways, right? And we likely consumed them in a ratio that was, you know, maybe around four to one, omega-6 to omega-3s, uh, you know, f- for most of our evolution, and today we're consuming them, you know, way, in a, in a way higher ratio, 25 to 40 to 1, omega-6s to omega-3s. So I just don't think that this is, like...I like to take the precautionary principle approach, right? These oils, again, they didn't exist in the human food supply, right? I don't have all the data to, to convince the most ardent evidence-based practitioner. I like to say that my approach is evidence-based, but not evidence-bound. I think that we need to be highly skeptical of foods, especially foods, and supplements, and products that haven't been around all that long, right? It's just a, a mass sort of experiment being laid out on a vast stage, and I don't think that we have the ... We don't have good data to say what they are or aren't doing, right? To us, necessarily. But I do think that because these oils are so easily oxidized and they're of particular relevance to the brain, right? I think that matters. We don't yet know what they're doing to our brains. Lipid peroxidation is a major feature in the Alzheimer's riddled brain, right? We know that as we consume more of these polyunsaturated fats, which again, are what predominate these grain and seed oils, these highly, easily oxidizable types of fatty acids, right? We know that, um, in nature where you see a higher proportion of polyunsaturated fats, you see a higher proportion of vitamin E. Vitamin E literally exists in, exists in nature to protect PUFAs, to protect polyunsaturated fats. We know that your average American is under-consuming vitamin E. Like 10% of, uh, of Americans consume adequate vitamin E. So, as our, uh, intake of these polyunsaturated grain and seed oils increases, our need for vitamin C increases. We're not consuming adequate vitamin E.

Joe Rogan 1:07:50 You mean vitamin E?

Max Lugavere 1:07:51 Vitamin E, yeah.

Joe Rogan 1:07:51 Yeah. You said C.

Max Lugavere 1:07:53 Um, sorry, vitamin E. And so, we're, we're under-consuming vitamin E. Um, that's gonna have consequences, right? 'Cause vitamin E, literally its role in the body, um, is to pro- protect lipids, right? From oxidizing. And, um, and you can look to parts of the world, like in Israel ... Are you familiar with the Israeli paradox?

Joe Rogan 1:08:10 No.

Max Lugavere 1:08:11 So, the Israeli paradox, Israelis do everything right in accordance with what the nutritional and the medical orthodoxy would say to do about nutrition, right? They consume more of these omega-6 dominant grain and seed oils than anywhere, anyone on the planet. You think that we consume a lot of grain and seed oils here in the United States? They consume 10% more. And they have-

Joe Rogan 1:08:30 Why is that?

Max Lugavere 1:08:32 You know, I don't know. It could just be that they're, they're more health-conscious.

Joe Rogan 1:08:35 Hm.

Max Lugavere 1:08:35 So, like, healthy user bias-

Joe Rogan 1:08:36 Right.

Max Lugavere 1:08:37 ... infuses all of these, which, which we could talk about, but like, this is a big confounding aspect of, of, uh, nutritional epidemiology. But in Israel, they consume about 10% more of these types of oils than we do here in the US, and their, their health is horrible. They have the same amount of heart disease. They have skyrocketing rates of cancer, right? Um, type two diabetes, and the like. But nonetheless, you look at their diets, and they're the picture of like, they, they would be like, the prize client of any, you know, of these like, more orthodox dieticians.

Joe Rogan 1:09:07 So, when, if someone does have some sort of salad dressing, should that salad dressing always be stored in the cold?

Max Lugavere 1:09:17 Yeah. So, extra virgin olive oil is, I like to say that it's, extra virgin olive oil is like, the primary oil that I use. I generally, you know, I use avocado oil when I'm cooking at very high temperatures. But for the most part, extra virgin olive oil is an oil where you can look at the entirety of the hierarchy of evidence, and we see that it's beneficial. It's also the oil used in the Mediterranean dietary pattern, which is, to suggest that we use any other oil is not an evidence-based recommendation when the Mediterranean dietary pattern is the, is the, the dietary pattern that the medical and nutritional orthodoxy is seemingly in love with for every other reason, right?

Joe Rogan 1:09:57 Mm-hmm.

Max Lugavere 1:09:58 So, they exclusively will use extra virgin olive oil. And, um, and we know that extra virgin olive oil, it's very heat-stable, so it's, it's, uh, about 15% saturated fat. The rest is monounsaturated fat. You get a tiny proportion of polyunsaturated fat. But the fats in extra virgin olive oil are, they're already chemically stable and, you know, the, the small amount of PUFAs in extra virgin olive oil are protected by the, the vast array of antioxidants that extra virgin olive oil contains. Extra virgin olive oil actually has a compound in it called oleocanthal, which is as anti-inflammatory as low-dose ibuprofen.

Joe Rogan 1:10:33 Whoa.

Max Lugavere 1:10:34 Yeah, which is a non-steroidal anti-inflammatory drug that chronic use of that drug is associated with cardiovascular events and the like. You get all the benefit of like, regularly taking an anti-inflammatory drug if you just routinely use extra virgin olive oil.

Joe Rogan 1:10:47 One of my wife's friends told her that olive oil's bad for your vision.

Max Lugavere 1:10:52 That-

Joe Rogan 1:10:52 Does that make any sense?

Max Lugavere 1:10:53 Doesn't make any sense to me.

Joe Rogan 1:10:54 No.

Max Lugavere 1:10:54 Zero.

Joe Rogan 1:10:55 I, I was like, "What?"

Max Lugavere 1:10:56 Yeah.

Joe Rogan 1:10:57 "How, where'd you hear that?" She's like, "That's just what she told me."

Max Lugavere 1:11:00 No.

Joe Rogan 1:11:00 I'm like, "Okay. I'll find out. I'll talk to Matt today."

Max Lugavere 1:11:03 (laughs) Yeah. It's, um, it's pretty good. I mean, it's like, from a cardiovascular standpoint, it's a great source of monounsaturated fat, which is-

Joe Rogan 1:11:10 How could it be possibly bad for your vision? Is there any-

Max Lugavere 1:11:13 I don't-

Joe Rogan 1:11:13 ... pathway that makes any sense to you?

Max Lugavere 1:11:16 I think maybe she misread something that was saying that these, the grain and seed oils are bad for your vision. I mean, they're, you know, highly oxidizable and we know that your eyes are neural tissue essentially, so it's, what's not good for the brain is gonna be not good for the eyes and vice versa.

Joe Rogan 1:11:30 So, as far as oils that should be put on, say, like salad dressing. Like, what oils do you feel like are acceptable?

Max Lugavere 1:11:38 I think extra-

Joe Rogan 1:11:39 Other than ... Extra virgin olive oil is primary.

Max Lugavere 1:11:41 Yeah. I think, like, avocado oil is good, but it's, you're missing out on the opportunity to get some of those phytochemicals in olive oil, extra virgin olive oil particularly. That-

Joe Rogan 1:11:52 What is the difference between extra virgin and other olive oils?

Max Lugavere 1:11:55 So, extra virgin olive oil is just like, you crush olives. That's how you get extra virgin olive oil. And then you protect that oil. The, uh, the other types are, um, well, there's filtered and unfiltered extra virgin olive oil. But you generally wanna buy filtered. I know some people might see filtered, uh, unfiltered and think that that's the one to buy-

Joe Rogan 1:12:13 Right.

Max Lugavere 1:12:13 ... because it's more pure, but actually, what you end up getting with filtered, uh, with, sorry, unfiltered oil, is little olive microparticles and water which can accelerate the degradation process of the oil. So, you want it to be filtered.

Joe Rogan 1:12:27 Hm. Okay. And should you store that in the cold or can it be stored in a-... closet-

Max Lugavere 1:12:32 You don't have to.

Joe Rogan 1:12:32 ... or, or pantry? No?

Max Lugavere 1:12:34 I think just in a, you know, you wanna keep it away from the stove. But in general, you wanna keep it in a, you know, it doesn't have to be refrigerated. But you do wanna make sure that you're buying it in glass, darkly colored bottle. And the best extra virgin olive oils are gonna have a harvest by, or a-

Joe Rogan 1:12:47 Mm-hmm.

Max Lugavere 1:12:47 ... sorry, a harvest date on the bottle. Because again, extra virgin olive oil, it's a fresh fruit juice, right?

Joe Rogan 1:12:54 Mm-hmm.

Max Lugavere 1:12:54 So, it only gets worse over time. So, you wanna buy the freshest extra virgin olive oil, extra virgin olive oil that you can find.

Joe Rogan 1:13:01 And how long should you keep it for?

Max Lugavere 1:13:03 You wanna consume it, like, as quickly as you can. So, I like to buy, if you're, like, a single person like me, you wanna just buy, like, a small, like, as small of a bottle as, as you can find, and then use that. And then just keep buying those small bottles, right?

Joe Rogan 1:13:15 Mm-hmm.

Max Lugavere 1:13:16 If you're a big family and you're using it all the time, like, a bigger liter bottle, I think, will suffice. But we can look to, like, you know, randomized control trials, like, the PREDIMED study, which is one of these, like, seminal nutrition studies 'cause it's a huge population, multi-center trial. Um, RCT that found that when people used a liter of extra virgin olive oil a week in their families, they had profoundly improved cardiovascular health, metabolic health, brain health, and even, like, uh, I believe, anthropometric features, like their, like, their waist. Um-

Joe Rogan 1:13:44 Wow.

Max Lugavere 1:13:45 Yeah.

Joe Rogan 1:13:45 So, if you're consuming-

Max Lugavere 1:13:46 That's nice.

Joe Rogan 1:13:46 ... salad dressing, it should just be virgin olive oil?

Max Lugavere 1:13:50 Yeah. That's my take.

Joe Rogan 1:13:51 Extra virgin olive oil.

Max Lugavere 1:13:52 That's my hot take.

Joe Rogan 1:13:53 And is there anything negative about balsamic vinaigrette?

Max Lugavere 1:13:57 No, balsamic vinaigrette, I think, is great. Um, first of all, balsamic vinegar, vinegar in general is, uh, acetic acid is the, is the primary, uh, ingredient that you'll see across all vinegar variants. And it can help to reduce, um, there's a s- uh, it can induce satiety. So, actually vinegar is a good, like, one of these, like, foods that's, like, oddly satiating.

Joe Rogan 1:14:18 Mm-hmm.

Max Lugavere 1:14:19 Um, it can reduce, uh, postprandial glycemia, so, like, the blood sugar spike after a meal.

Joe Rogan 1:14:24 Really?

Max Lugavere 1:14:24 Um, so vinegar's a great, great food. The balsamic vinegar does have a little bit of sugar in it, but I don't mind. Like, I'm not, you know ... Like, I think that the benefits outweigh the risks. And also, vinegar, balsamic vinegar has a compound in it. I forget what the acronym stands for, but the acronym is DMB, so y- people can usually find it. Um, it's one of these, like, long, complex chemical, chemical designations. But, uh, that's been shown to actually support gut health, like, support the microbiome, particularly for people who consume a lot of red meat.

Joe Rogan 1:14:53 Mm-hmm.

Max Lugavere 1:14:53 Which is awesome, which I do. I consume, like, I'm a big advocate for, you know, the consumption of grass-fed beef and things like that.

Joe Rogan 1:14:59 So, um, as far as salad goes, um, just extra virgin olive oil, uh, either balsamic vinaigrette or regular vinegar? Is, is there a benefit to having regular vinegar over balsamic vinaigrette?

Max Lugavere 1:15:15 I think only if you're, like, really counting, like, counting calories, which I don't endorse. Like, that's not, you know ... I, I, I think balsamic vinegar is great. You also get a little bit of resveratrol-

Joe Rogan 1:15:25 Mm-hmm.

Max Lugavere 1:15:26 ... in balsamic vinegar because of the-

Joe Rogan 1:15:28 Okay.

Max Lugavere 1:15:28 Yeah. So, I think that the, the, I think balsamic vinegar is great. I happen to love it. And also, people that eat a salad every day, so this is a really cool research from Rush University. Found that people who eat a big bowl of dark leafy greens every day have brains that perform up to 11 years younger.

Joe Rogan 1:15:43 Wow.

Max Lugavere 1:15:44 Yeah. So, this could be, like, healthy user bias. Like, n- again, nutrition, even my own, the o- recommendations that I make, like, you know, a lot of ... Healthy user bias confounds many, um, of these kinds of studies in the world of nutrition because we just don't have many long-term randomized, you know-

Joe Rogan 1:15:59 Right.

Max Lugavere 1:15:59 ... large population, multi-center randomized control trials, right? But the research shows that, that, that regular consumers of dark leafy greens, so I like to say, like, a salad a day, that's what this research found, that, um, they have more youthful brains by up to 11 years. And when you actually look at what dark leafy greens have in them, first of all, they're one of the most nutrient dense foods that we have. I mean, most mo- the most nutrient dense foods that we have access to are gonna be animal products, right? But dark leafy greens are up there because they're so calorie sparse, and they are a good source of folate and vitamin C. And we also know that they're one of the best ways to get those carotenoids, like lutein and zeaxanthin, which is not just associated with, um, better cognitive aging and lower risk for cognitive decline. But, um, in young and healthy college students, they've actually shown that when you give people who are already thought to be at their peak of cognitive prowess supplemental lutein and zeaxanthin, that you see a, a, an improvement by about 25% in visual processing speed.

Joe Rogan 1:16:56 Wow.

Max Lugavere 1:16:57 Yeah. It was a University of Georgia study.

Joe Rogan 1:16:58 25%? That's incredible.

Max Lugavere 1:17:00 Yeah. And-

Joe Rogan 1:17:01 Now, is there any concern about oxalates?

Max Lugavere 1:17:05 I think only if you know that you're sensitive to them. I'm not a-

Joe Rogan 1:17:09 How would one find out?

Max Lugavere 1:17:11 I think if you have, like, you know, kidney stones, like, in your family, things like that. Like, if you are ... Generally, you would know, you know, I think there are genes that play a role in this, or if you know somebody in your family, or if you yourself have had them before. You know, calcium oxalate is what you wanna be careful with, but I don't think that, like, eating a salad a day is gonna put you at risk.

Joe Rogan 1:17:31 Is there any benefit of cooking leafy greens versus eating them raw, or vice versa?

Max Lugavere 1:17:38 Certain leafy greens can definitely be made more digestible when, um, when you cook them. Uh, but, but, you know, there's always, like, a give or take when you cook or store vegetables. Some micronutrients become more viole- bioavailable, some become less. So, um, I tend to recommend, uh, you know, sort of a mix, like, a, like a, like, variety, you know? Some cooked, some raw. But in general, with the salad recommendation, you know, with dark leafy greens like arugula, kale, spinach, things like that, I, I don't think that ... Spinach is probably the highest with regard to oxalates. So, you know, if you're sensitive to oxalates, um, you know, you might wanna cut down on your raw spinach consumption.

Joe Rogan 1:18:18 I used to drink, uh-

Max Lugavere 1:18:19 But-

Joe Rogan 1:18:19 ... kale shakes all the time, and, uh, I would