Joe Rogan Experience #2170 - Max Lugavere

1. 0:00 – 1:46

   Max’s 10-year dementia-prevention documentary and his mom’s Lewy body dementia story

   1. JRJoe Rogan0:00

      (drumbeats) Joe Rogan podcast, check it out.

   2. MLMax Lugavere0:04

      The Joe Rogan Experience.

   3. JRJoe Rogan0:06

      Train by day, Joe Rogan podcast by night, all day. (instrumental music plays) What's up, Max? How are you? It's good to see you.

   4. MLMax Lugavere0:13

      So good to- I know.

   5. JRJoe Rogan0:14

      What's cracking?

   6. MLMax Lugavere0:16

      Oh, man. Just, uh, first of all, honored to be here.

   7. JRJoe Rogan0:19

      Thank you. Honored to have you.

   8. MLMax Lugavere0:19

      Love you and your work, and yeah, I mean, just a national treasure. So-

   9. JRJoe Rogan0:24

      Thank- that's very nice of you.

   10. MLMax Lugavere0:26

       ... go out on a limb and say it. But, um, no, I'm super, super excited because I've been working on this documentary for the last 10 years of my life, and, um, it's finally out today, which, uh, I'm super pumped for, and it's called Little Empty Boxes. And we talked about it the, the last time I was here.

   11. JRJoe Rogan0:40

       Mm-hmm.

   12. MLMax Lugavere0:41

       And, um, it's a project that means the world to me. I think it's the most important thing I've ever done, and it's the first-ever dementia prevention documentary about the science of dementia prevention, but it focuses... It's a very emotional and personal film for me because it follows my mom, who, for many years, suffered from a rare form of dementia called Lewy body dementia, which is akin to having both Parkinson's disease and Alzheimer's disease at the same time.

   13. JRJoe Rogan1:07

       That's what Robin Williams had.

   14. MLMax Lugavere1:09

       That's what Robin Williams had, yeah.

   15. JRJoe Rogan1:10

       Yeah.

   16. MLMax Lugavere1:11

       And it's a, it's a rare condition. It affects about one million people in the United States, but it's a, um, it's a dementia, and dementia is now a soaring public health problem. And there's a lot of controversy in- within the field. Um, the last time I was here, we talked about, you know, fraud in the, um, in the research space with regard to the prevailing hypothesis as to what causes Alzheimer's disease, which is the most common form of dementia. And actually, finally, over the past month, that paper was finally retracted. It took two years. But, um-

2. 1:46 – 4:14

   Alzheimer’s research scandal: the amyloid hypothesis and a retracted Nature paper

   1. JRJoe Rogan1:46

      Could you explain to everybody what the fraud was?

   2. MLMax Lugavere1:49

      Yeah, so basically, among the dementias, Alzheimer's disease is the most common form of it, and that affects about six million people in the United States. And since it was first named in 1906 by physician Alois Alzheimer, the prevailing hypothesis as to what causes Alzheimer's disease, dubbed the amyloid hypothesis, has been that this plaque formed by a precursor protein called amyloid-beta accumulates in the brain, and by finding a drug that can potentially remove, extract that, that, those plaques from the brain, from the extracellular space around neurons, that we could essentially cure the disease, that the, that the causal factor in the condition was this, was ultimately this amyloid-beta protein which forms the plaque. And trial after trial has been a, a dismal, had been a dismal failure, and it wasn't looking good until in, um, 2006, a paper was published in Nature, which for any scientist publishing in Nature, it's like winning an Academy Award. And that paper, essentially, what that did was it, it allegedly identified this variant of amyloid-beta that connected the plaque to the cognitive dysfunction. So the most important clinical feature of Alzheimer's disease. Because for a long time, it was known that cognitively healthy people accumulate plaque in their brains, and that plaque doesn't seem to correlate with cognitive impairment or anything like that. And so that was very deflating for researchers in the field until this 2006 paper came out, and what it did was it renewed faith in this, in this hypothesis, which was always a hypothesis, and continued to send billions and billions of dollars worth of funding down this path. And what turned out to be the case just two years ago was that that paper was essentially fraudulent, and it represented about 16 years worth of wasted time, wasted money, which was hugely deflating for not just the research community, but also for any patient who's ever suffered from Alzheimer's disease. And, you know, the way that the field is now slowly starting to turn, but this is a drum that I've been beating for the past 10 years, is that we really need to start talking about these conditions in terms of prevention. And that's what inspired me to set down this path of creating this documentary, Little Empty Boxes.

3. 4:14 – 8:30

   How the fraud worked: manipulated images, weak review checks, and minimal consequences

   1. JRJoe Rogan4:14

      What was the fraud? Like, what, what, how did they do it?

   2. MLMax Lugavere4:18

      So basically, the, in the paper, there were, they identified these proteins that they isolated in rat models of the condition, mouse models the con- of the condition, called Aß, A-beta*56. Again, amyloid is, amyloid is there at the scene of the crime, so to speak. So when you have Alzheimer's disease, somebody who's died of Alzheimer's disease, what they, what they find inevitably in the brains of cadavers who've died from Alzheimer's disease are two features. They see this aggregation of these plaques, amyloid-beta plaques, and tangled proteins called tau. And so it was a very seductive narrative that this plaque causes the condition, right? For years. The problem is they've succeeded at reducing the plaque in the brains of people with Alzheimer's disease, but that hasn't led to any improvement in the clinically meaningful features of the disease that we, that we aspire to improve for sufferers of Alzheimer's disease, right? The cognitive, the cognitive function. And in tandem with that, we see that amyloid is produced naturally in all brains, and people who are cognitively healthy have amyloid in their brains. There's a degree of amyloid burden that seems to be inevitable as a, as, um, a f- as a just general phenomena due to aging. And so it, it was very, it was becoming very clear that amyloid is not the causative feature here, that there is some other factor or factors at play which lead to cognitive degeneration, until 2006. And, and then i- in 2006, what happened, this paper basically found this subtype that when injected into a mouse caused profound cognitive dysfunction.And what they did was they illustrated these proteins on what are called we- a, a, w- in what's called a Western blot analysis, which is basi- basically a graphical depiction of proteins. And, um, the peer review process for papers, I mean, they, people go in and they crunch the numbers and stuff, but they don't look at, like, imagery and they don't, they don't look with a f- they don't go through the imagery with a fine-tooth comb to make sure that it hasn't been photoshopped, essentially. But one sleuth, who is a scientist himself, um, this researcher, uh, from Vanderbilt named Matthew Schrag, actually identified that a lot of these images had artifacts that made it very clear that they were faked.

   3. JRJoe Rogan6:40

      Wow.

   4. MLMax Lugavere6:41

      Yeah.

   5. JRJoe Rogan6:42

      So full-on fraud?

   6. MLMax Lugavere6:44

      Full-on. Full-on fraud. And by the wa- and it was a, it's o- it's been two years. It took two years for that paper finally to be retracted.

   7. JRJoe Rogan6:51

      Are there any consequences towards the people that published that paper?

   8. MLMax Lugavere6:55

      I mean, it's obviously they have a lot of egg on their face, so to speak. I mean, it's very, it's, it's hugely humiliating. Um, but no, I don't think that there's-

   9. JRJoe Rogan7:05

      They're still employed?

   10. MLMax Lugavere7:07

       They're ... Yeah. The lead researcher, still employed. I mean, they're, they're investigating Sylvain Lesne, who's a University of, uh ... He is a, I wanna say Michigan? Not Michigan. Um, it'll come to me. But the, the, the, the primary researcher is being investigated, um, as far as I know.

   11. JRJoe Rogan7:27

       So the primary r- researcher, they're connecting to the photoshop? They're-

   12. MLMax Lugavere7:30

       Yeah.

   13. JRJoe Rogan7:31

       ... saying this person-

   14. MLMax Lugavere7:32

       Yeah.

   15. JRJoe Rogan7:32

       ... might've been the one that released it?

   16. MLMax Lugavere7:34

       Yeah. It was very clear. It was very clear. And that, you know, that's-

   17. JRJoe Rogan7:37

       God, it's so dirty.

   18. MLMax Lugavere7:38

       It's so dirty.

   19. JRJoe Rogan7:38

       And it's, it's so evil for all the people that are looking for some sort of relief.

   20. MLMax Lugavere7:42

       Yeah.

   21. JRJoe Rogan7:43

       And that, you know, you have this scientific paper you publish and you knowingly release these photoshopped images t- in order to validate your paper.

   22. MLMax Lugavere7:53

       There's a ton of fraud and-

   23. JRJoe Rogan7:55

       God.

   24. MLMax Lugavere7:55

       Yeah.

   25. JRJoe Rogan7:56

       It's so evil when you think about how many people suffer from this.

   26. MLMax Lugavere8:00

       So many people. I mean-

   27. JRJoe Rogan8:01

       And you're giving them this false hope just to boost up your academic career.

   28. MLMax Lugavere8:05

       Yeah. It's awful, the lost time. And by the way, that paper has been subsequently referenced thousands of times in the medical, medical literature. Basically, you know, r- negating a ton of research. I mean, like, count- countless papers that have been since published that have referenced that paper in 2006, that Nature paper that was finally retracted. I mean, think about the lost time. Think about the needless suffering.

   29. JRJoe Rogan8:30

       Yeah.

4. 8:30 – 10:05

   Why prevention matters: dementia starts decades before symptoms and diagnosis comes too late

   1. MLMax Lugavere8:30

      And it's my view that dementia ... Essentially, by the time you are diagnosed with dementia, we'll say Alzheimer's disease, you are in late-stage Alzheimer's disease, whether it's mild, whether you were just diagnosed yesterday. It's, it's ... This is a disease of midlife with symptoms that appear in late life. And so, that's why the field is now slowly, hopefully, I hope, pivoting more towards prevention. And where the money, I think, needs to go is i- in- into identifying that golden biomarker that's associated with the onset of the condition so that f- clinicians can intervene earlier. Because right now, when you catch it, it's sort of like pancreatic cancer, which incidentally, my mom passed from in 2018. But it's, you know, pancreatic cancer, most of the time it's diagnosed and it's too late. The can- the tumor's already metastasized. And so, this is kind of similar with Alzheimer's disease. By the time it's diagnosed, it's already, you're already very late in the game. There's widespread neuronal, uh, dysfunction. Glucose metabolism in the brain is diminished by 50%. So it's ... Again, you're, you're catching it in its latest stages, ultimately. And that's why I think Alzheimer's drug trials have a 99%, 99.6% fail rate. 'Cause by the time you catch it, I think reversing it is, you know, impossible. I think it can be slowed with exercise, with die- with a, with a multimodal dietary and lifestyle intervention. But, um, but yeah, it's really, it's really sad. And so that's why, 10 years ago when I saw this developing in my mom and I stumbled upon all this research and I began really diving in, it became very clear to me that this is something that, that anybody with a brain needs to be aware of and talking about.

5. 10:05 – 12:54

   Risk factors you can change: metabolic health, ‘type 3 diabetes,’ and insulin resistance in the brain

   1. JRJoe Rogan10:05

      And what, uh, what's the factors when it comes to someone e- eventually getting Alzheimer's? Is it purely genetic? Is it lifestyle? Is it diet? Are there environmental factors and toxins? Like, what is it?

   2. MLMax Lugavere10:19

      Yeah. So, there are what are called risk factors. So the, the heritability of Alzheimer's disease is very low. It's like 2 to 3%. And the variant that is hereditary is early-onset familial. But that affects, that, that makes up a very tiny proportion of overall Alzheimer's incidents. And similarly with Parkinson's disease, the heritability of Parkinson's disease is very low. I mean, this is a g- I, I ... And I definitely wanna talk about Parkinson's disease, because there's a lot of really interesting new research in that, in that field. But by and large, with regard to Alzheimer's disease, you have what are called your non-modifiable risk factors, which are your age ... You can't change your age, your gender, you can't change your gender, and your genes. You can't change your genes, although you can affect how your genes express themselves, which is known as epigenetics. But then, you have your modifiable risk factors, which I think is so exciting, 'cause these are the, the risk factors that you have agency over, you can, you can control. Obesity, hypertension, type two diabetes. I mean, these are all nutritionally mediated, obviously, which I love talking about nutrition and nutrition in so far as it can prevent or reverse obesity. I think that's incredibly empowering. Type two diabetes, if you have type two diabetes, your risk for developing Alzheimer's dis- disease increases between two and fourfold. There are actually now, um ... We interviewed in my documentary the researcher who coined the term type three diabetes. Have, have you heard that? Are you familiar with that concept?

   3. JRJoe Rogan11:39

      No. No, I haven't.

   4. MLMax Lugavere11:40

      So, it's looking a lot like Alzheimer's disease might, in fact, be a form of diabetes of the brain.

   5. JRJoe Rogan11:46

      Wow.

   6. MLMax Lugavere11:47

      Which is a mind-blowing way to think about this condition. Um, and in fact, we see that peripheral insulin resistance, so the i- the hallmark of type two di- type two diabetes is insulin resistance. And we see that the more insulin resistant a person is, the more difficulty their brains seem to have with regard to creating ATP, which is the primary energy currency of our cells.And the researcher who coined type three diabetes, her name is Suzanne Del Monte. She's a Brown University researcher, and she is in no way in the public sphere. She's a, you know, purely a bench researcher. She's actually in my documentary. It was, like, incredible to get to interview her and speak to her. But it seems that insulin resistance re- causes the brain to suffer in many ways. It damages the blood vessels. Ultimately, when you have type two diabetes, it damages the blood vessels that supply the brain with oxygen, nutrients, energy. But it also seems to impair... There also seems to be a- a- a- an aspect of insulin resistance that reduces the brain's ability to generate energy.

6. 12:54 – 16:57

   Max’s first warning signs and ‘diagnose and adios’: navigating a broken care pathway

   1. JRJoe Rogan12:54

      Mm. Okay. So, when you first started, uh, becoming aware of this, when your mother, uh, develops this condition, you s- first start being aware of it, what were the first things that you noticed that started to get you to question whether or not the conventional, uh, uh, applications of drugs and things were, were on the right path?

   2. MLMax Lugavere13:16

      Yeah, I mean, you know, I grew up in New York City and when my mom first started to show these symptoms-

   3. JRJoe Rogan13:22

      And how did you notice it? Like, what- what- what were the symptoms?

   4. MLMax Lugavere13:25

      She would, I mean, we would have... I was living in LA at the time, and so we would, we would touch base every other day via phone, and she started to complain to me about brain fog. And, uh, there was some aspect of what she was sharing with me that I thought was just a natural part of getting older. But ultimately, she revealed to me and the rest of my family that she had sought the help of a neurologist, and that seemed odd. You know, why would my mom... I- I hadn't had any prior family i- incidents of dementia, anything like that. Why would my, why was my mom suddenly going to see a neurologist? And... But, you know, like, I was still in LA living my, my life. I was in my late 20s at the time. But it wasn't until a trip to Miami, my family went down to Miami to hang out with my dad, 'cause my parents had been separated, and my mom was in the kitchen and she confessed to the family that she'd been having memory problems. At this point, so it had been described as brain fog, but she revealed that she had sought the help of a neurologist and, you know, me and my, and my brothers and my dad, we were in total disbelief that my mom was having anything outside of the r- could- could- could possibly be having anything outside of the realm of ordinary. And so we were kind of mocking her in a way, um, and we said, "Well, if you're really having such- such profound problems, what month is it?" Or I think it was like, "What year is it?" Or something like that. And she couldn't recall. She couldn't recall what the month was and she started to cry. And at that point, for me, that's when I knew that something was really wrong and that I needed to step in. 'Cause you know when you're sick, it is a really... That's a really scary place to be. It could be frustrating, it could be confusing, and you know, when you're in these doctor's offices and they're, you know... Oftentimes they don't have the best bedside manner and they run a battery of esoteric tests. It can be incredibly overwhelming and it becomes really hard to advocate for yourself, I've learned, as somebody with a chronic illness, not least of which a chronic illness that's affecting your cognition. And so I decided at that point, um, essentially that I had to pack up my LA life. I moved back to New York and I started going with my mom from doctor's visit to doctor's visit. And again, you know, I'm pretty privileged, grew up in New York City. My mom had health insurance resources. We started going, you know, to all of these different cathedrals to Western medicine, academic medical insight. And in every instance I experienced what I've come to call over time, adios- diagnose and adios. And so the physician would, you know, run these tests, titrate up the dose of a medication that she was already on. One physician actually thought that all of her symptoms were due to depression, right? There's this, like, idea of the hysterical woman. Today one in four women over the age of 40 are on an antidepressant drug, you know? So one-

   5. JRJoe Rogan16:18

      One in four?

   6. MLMax Lugavere16:19

      Yeah. Over the age of 40.

   7. JRJoe Rogan16:21

      Jesus Christ.

   8. MLMax Lugavere16:22

      Yeah. They're... I mean, I'm not saying there's no use for them, those kinds of drugs-

   9. JRJoe Rogan16:26

      Right.

   10. MLMax Lugavere16:26

       ... but they're very over- overprescribed. Um, that's not, that's not... I don't think that's controversial. And so my mom was given one of these drugs without full informed consent, I don't think. I mean, ultimately we tried to get her off of them, which we found out was incredibly difficult to do. Titrating off one of these SSRIs is really, really hard actually. And it turned out obviously to be, to be the case that my mom... That these symptoms were not due to depression. They were due to degeneration in her brain. And we went from

7. 16:57 – 22:00

   Polypharmacy, lack of deprescribing, and the search for real prevention levers

   1. MLMax Lugavere16:57

      doctor's office to doctor's office, ultimately culminating in a trip to the Cleveland Clinic. So just imagine, like, we're in New York City, right? We have like multiple hospitals at our, at our disposal. We had to book a trip to the Cleveland Clinic and it was there that for the first time my mom was diagnosed with a neurodegenerative condition. So she was prescribed drugs for both Alzheimer's disease and Parkinson's disease at that time. And that to me was... I'd never... I've always been a pretty chill guy but that was the first time in my life I'd ever, I've- I've ever had a panic attack just googling the drugs. You know, like a scared... Like any scared kid would do when their mom receives a li- a life changing diagnosis. And um, and that was the moment for me that I realized that my life had to pivot and I, I had no choice but to dedicate myself to learning all that I could about these conditions.

   2. JRJoe Rogan17:44

      And so you find out about the fraud, and how long into your research did you find out that most of what people understood about the condition was based on this fraudulent study?

   3. MLMax Lugavere17:59

      Well, it's not even just the study. It's the fact that these conditions begin decades before the emergence of symptoms. So, you know, again, it's a, it's a disease of, of midlife essentially. The- the- the Alzheimer's disease begins 20 to 30 years, if not more before the- the first symptom. And so to me it became very clear that we were approaching these conditions in the wrong way, you know, trying to-... acting in a, in a reactionary way to something that had taken decades to manifest, to me, just seemed wrong. And I stumbled upon the work of a neurologist at Weill Cornell New York-Presbyterian who was talking about Alzheimer's disease as a preventable condition, which is not something that I'd heard prior to coming across his work. And I realized at that time that this was, like, considered, 10 years ago, a fringe idea. Dementia prevention was, like, a fringe idea, except for through the lens of this neurologist who was working within the confines of, you know, rigorous randomized research and, you know, and checking all the boxes for scientific credibility. And, um, and so to me it became really, it became really clear that, that this is a topic that I needed to help amplify using my skillset as a non-medical doctor, as a non-academic scientist. And I also learned really early on that it's not a genetic condition, that we have genetic risk factors, but that, um, that we have a say when it comes to our cognitive destiny, that this is not a natural part of aging. I mean, uh, you know, everything in the body as you get older tends to falter in its functionality. You know, like, our joints don't work as well. And, you know, there is a degree of forgetfulness that I think is in a, in a way a natural aspect of getting older, but cognitive impairment, that's not natural. Degeneration of our, of our neurons of, you know, of, for example, the portion of the brain that cr- that drives movement, the substantia nigra, which is, which occurs in Parkinson's disease, that's not normal. And so it began this investigation for me, trying to understand, because I was seeing the person who meant the most to me of anybody in life, you know, degenerating every day in front of my face, getting worse and worse and worse. It- it instilled this- this burning desire in me to understand all that I could and to share, to pro- ch- in the hopes that it might prevent it from happening to others. And, um, and yeah, it was also very odd because my, um, my maternal grandmother did not have dementia. So, it was really sad and, and surreal, in fact, that my mom was increasingly requiring around-the-clock care while her mother, who lived in the same home and was 30 years older, was cognitively totally healthy. It was just the, it was just the oddest thing. My, my, my grandmother, my mom's mom, was in her 90s and totally cognitively healthy, able to ha- form cogent sentences. And my mom was struggling to express an idea, to get out of a bathroom. And it just, to me, it was, it was so shocking that I, you know, it was like, it was traumatic. I mean, I still have PTSD, I think, from, from those days, but it, it's, yeah, it's motivated me to, to do what I can to help. And I saw all in, in every ... You know, by the end of my mom's life, she was on 14 different pharmaceuticals. And I'm not, I'm not anti-pharma. Like, if, if there was a drug that would have actually helped my mom, I would have been first in line at the pharmacy to, to fill that prescription for her. But the drugs don't work at all, and physicians are very quick to, you know, to write a prescription, to, like, add a new drug to the arsenal. They're, they're very, um, reluctant to deprescribe. I've, I, uh, have never seen a prescription deprescribed to my mom. And by the end of her life, she was on 14 different pharmaceuticals. And there's nobody on earth that, that understands how all of those different drugs are interacting in an i- you know, in a, in a system that's going, growing increasingly

8. 22:00 – 26:06

   Environmental contributors: air pollution, PFAS, microplastics, and pesticide links to Parkinson’s

   1. MLMax Lugavere22:00

      frail. It was just really sad. And, you know, so I started to investigate these modifiable risk factors, you know, whether it's diet, dietary, diet related, which it, you know, in my mom's case, it may have had something to do with her diet over the years. It might have had nothing to do with her diet over the years. I'll never know. But also now, we're starting to see that air pollution is a major, um, contributor to neurodegeneration. We're starting to see now that, well, as of 2020, it was acknowledged that, um, exposure to air pollution is actually one of these newly identified model- modifiable risk factors for Alzheimer's disease. So, exposure to fine particulate matter, PM2.5, actually might cause Alzheimer's disease for some patients. And then most interestingly, and this is one of the things that I wanna talk about with you, which I came across the work of a, of a neurologist named Dr. Ray Dorsey, who's over at, um, University of Rochester, who's done a lot of work publishing on the link between environmental toxicants and Parkinson's disease. But Parkinson's disease is now the fastest growing brain disease. And my mom's condition actually had more in common with Parkinson's disease than it did Alzheimer's disease. She had Lewy body dementia, which is, has more in common with Parkinson's, even though they're, they're both dementia, um, Lewy body and, and, and, and Alzheimer's. But there's data now linking exposure to certain herbicides and pesticides to Parkinson's disease, dramatically increased risk, anywhere between three, two and a half to sixfold, um, increased risk.

   2. JRJoe Rogan23:35

      Which herbicides and pesticides?

   3. MLMax Lugavere23:37

      So, there's a pesticide called paraquat that there was a great article written in The Guardian by, um, a journalist named Carey Gillam, and I got to speak, uh, on a panel with her recently at a, at a scientific conference in DC called Brain and Environment. And paraquat is this compound that it's a, it's an herbicide that's produced in China, but its use is banned in China. We import it here.

   4. JRJoe Rogan24:02

      (laughs)

   5. MLMax Lugavere24:04

      Yeah. It's crazy.

   6. JRJoe Rogan24:05

      Uh.

   7. MLMax Lugavere24:06

      We use it here and exposure, occupational exposure to this compound is associated with between two and a half to three times the risk for the development of Parkinson's disease. Related compounds are literally used in mouse models to create Parkinson's disease. And-... the company that has ... that creates it is ... has been under investigation for years. And what has now come to light is that they knew about the fact that these, that these, that th- these chemicals accumulate in the brain, in brain tissue, and they seem to selectively target the region of the brain associated with Parkinson's disease, the substantia nigra.

   8. JRJoe Rogan24:50

      Wow.

   9. MLMax Lugavere24:51

      It's very scary. And, um, you know-

   10. JRJoe Rogan24:54

       What, um, crops are these used on? Is it specific crops? Is it specific foods to avoid or how do you know if those pesticides or herbicides are being used?

   11. MLMax Lugavere25:04

       Well, it's, it's the, the residues and the, the exposures that you get from eating them is very low. But we don't know what long-term exposure to those low levels is doing to us. I mean, my, my mo- my mother is somebody who never believed in organic produce, right? And organic is not perfect and natural compounds, some of them are the most dangerous compounds on earth. So I know, you know, some people listening might say, "Oh, you know, here we go with the appeal to nature fallacy." But it's very clear that occupational exposure is very hazardous. You have to be licensed, you have to use this stuff very carefully, but it ... some people actually use it to, to, to off themselves. I mean, it's like a, it's a really toxic compound. And we're now, we, we now have data suggesting that it creates this condition, that it s- selectively targets and, and destroys dopamine-producing neurons that, that, that mediate movement. And, um, and it's used, yeah, it's used in, in cereal grains, things like that. Um ...

9. 26:06 – 38:25

   Nicotine and Parkinsonism: the paradox of smoking, neuroprotection hypotheses, and cotinine

   1. JRJoe Rogan26:06

      Why does, uh, cannabis oil have a profound effect on Parkinson's patients?

   2. MLMax Lugavere26:12

      You know, I don't, I don't know about cannabis oil, but I can tell you about nicotine. And nicotine is a very interesting compound from the vantage point of Parkinsonism. And I know, I mean, a lot of people, you know, love nicotine obviously for its, its cognitive boosting effects. Um, I'm not gonna say that it's a, it's a healthy compound. I mean, I think that it has cardiovascular repercussions, um, and the like, but there seems to be a ... and it, uh, and of course smoking is terrible for you, but-

   3. JRJoe Rogan26:43

      Cardiovascular, um, with the delivery method or just across the board?

   4. MLMax Lugavere26:48

      Nicotine by itself raises heart rate and it raises blood pressure acutely. Not by much, but, um, presumably, uh, pr- and it's vasoconstrictive as well, so it, you know, there's some evidence suggesting it, it impedes wound healing.

   5. JRJoe Rogan27:05

      Mm-hmm.

   6. MLMax Lugavere27:06

      Um, I will occasionally use nicotine as a, as a cognitive enhancer, but I also have ... I have chronic low back issues and, um, I think that, you know, for people with disc issues ... this is just a speculation, but I think that it's probably not a good idea to chronically use nicotine if you have disc issues which are already ... your discs and your back are already poorly vascularized and nicotine is a vasoconstrictor, vasoconstrictor. Um, and smoking, you know, increases your risk for Alzheimer's disease. Um, I'm not s- I don't think that there's a, uh, a ... that we've identified a relationship between pure nicotine and, well, pretty much anything. The, the, the research on pure nicotine by itself is pretty sparse. Most of the na- most of the research on, on the health effects of nicotine is confounded by smoking, which is obviously, obviously not good for you. But interestingly, there does seem to be an inverse relationship between nicotine use, even via smoking, and Parkinsonism. So people who smoke cigarettes seem to be protected, to some degree, against Parkinson's disease-

   7. JRJoe Rogan28:08

      Hmm.

   8. MLMax Lugavere28:09

      ... which is very odd. And they've shown in mouse models that nicotine actually, when they use some of these mitochondrial toxins, some of these poisons like paraquat, right, or another one called MPTP, which is, has been used as a, as a street party drug, but it's actually profoundly neurotoxic. It, it's been shown to create chronic Parkinsonism with just acute use. Nicotine actually prevents that in those models. So it's been shown to somehow protect the brain from i- in some, in some regards, um, against Parkin- Parkinson's disease. So I wouldn't recommend using nicotine unless somebody ... and this is, again, a speculation, but my, my hypothesis is that if you were, if you were exposed occupationally to some of these compounds like paraquat or rosinone or, um ... there are, there are other compounds that are being directly connected to Parkinson's disease too, like trichloroethylene, I would say maybe nicotine is a, is a potentially disease-modifying intervention in those contexts.

   9. JRJoe Rogan29:10

      So in these, uh, w- when they've studied patients, th- d- was there a small, like a noticeably smaller instance of people who developed Parkinson's who were smokers, or was it non-existent? Like ...

   10. MLMax Lugavere29:24

       They're, they're just ... I'm not sure the, the relative risk, um, decreased, but it's one of these odd things that seems pretty consistent in the literature that smokers are less likely to develop Parkinson's disease. There-

   11. JRJoe Rogan29:39

       By what factor?

   12. MLMax Lugavere29:40

       I'm not sure. I'm not sure of the factor, but it's significant. It's significant.

   13. JRJoe Rogan29:44

       Hmm.

   14. MLMax Lugavere29:44

       But smo- but smokers are more likely to develop a whole host of other-

   15. JRJoe Rogan29:48

       Oh, yeah. It's terrible for you.

   16. MLMax Lugavere29:49

       Yeah, yeah. But that's the interesting thing is that nicotine ... it's thought that nicotine protects this one region of the brain in a, in a-

   17. JRJoe Rogan29:56

       Have they looked-

   18. MLMax Lugavere29:57

       ... significant way.

   19. JRJoe Rogan29:58

       I'm sorry. Have they looked at people that are in- taking nicotine in different ways like cigars, uh, ch- gum, patches, things along those lines?

   20. MLMax Lugavere30:08

       Not p- a lot of the, a lot of the research on nicotine is in animal models unfortunately, um, but it is ... I mean, it does seem to do ... if you set the vascular effects aside, which might play a role, um, in neurodegeneration because, you know, the brain relies on its vascular network. The brain, you know, is a, is a very hungry organ and vascular dementia is the second most common form of dementia actually, but nicotine does seem to have some really protective effects on the brain. It seems to reduce neuron inflammation, um, it-... might act in a way as an antioxidant in the brain. I'm not recommending it 'cause th- there are risks, of course. But, um, but they've shown that it seems to be protective in these animal models against con- a- against these poisons that would otherwise cause Parkinsonism. And some other cool facts about nicotine actually, 'cause I did do a little bit of a deep dive recently into it 'cause, 'cause I do notice a, a cognitive benefit when I, when I use it. Nicotine-

   21. JRJoe Rogan31:12

       How do you use it?

   22. MLMax Lugavere31:13

       I just use it, I, uh, I use it, like, before-

   23. JRJoe Rogan31:16

       But what, in what form?

   24. MLMax Lugavere31:18

       A lozenge, like a little, like, you know, lozenge. Um, and, uh, and I don't have an addictive personality, so for me, I'm not, like, you know, it's not something that I feel compelled to do every day. But I do it, uh, before, like, I have to go on, like, a TV show or do a big podcast or something. And, um, and I do see, you know, I do definitely see, like, a, a cognitive be-, like a st- you know, it's a stimulant.

   25. JRJoe Rogan31:41

       Mm-hmm.

   26. MLMax Lugavere31:41

       That's, um, that's pretty well-known. But, um, but yeah, nicotine also, it has a very short half-life, so its half-life is only about two hours. I mean, you compare that to coffee, coffee's is, like, eight hours. So it's, it's relatively transient in your system. But then, I think the more interesting compound is, uh, is its primary metabolite, which is called cotinine, which, its, cotinine's half-life is 20 hours long. And it seems to also boost cognitive function, mental health, uh, insofar as animal models can show us that these compounds boost mental health. Um, might even enhance what's called fear extinction, so for people with PTSD, it might play a role. So it's a, it's a really interesting compound, but, you know, again, it's, it's highly addictive, and, um ...

   27. JRJoe Rogan32:27

       What is cotinine?

   28. MLMax Lugavere32:29

       It's nicotine's primary metabolite in the body. So when you ingest nicotine, nicotine lasts in the body only about, the half-life is two hours, so it lasts presumably about four hours. Um, but it converts to this compound called, called cotinine in the body, and the half-life of that compound is about 20 hours, so it's in your system for a long time.

   29. JRJoe Rogan32:50

       And d-

   30. MLMax Lugavere32:50

       And it-
10. 38:25 – 45:45

    Food system realities: ultra-processed foods, conflicts of interest, and how misinformation spreads

    1. MLMax Lugavere38:25

       I mean, we see it all the t- I mean, even within our own, you know, within our own government, the USDA, the, the dietary guidelines for Americans, 95% of people on that committee have had ... have or have had conflicts of interest with the pharmaceutical industry and the food industry.

    2. JRJoe Rogan38:42

       Yeah.

    3. MLMax Lugavere38:43

       At least 50% that I'm aware of today, you know, working on the 2020, 2020, 2025 issue, um, we see all the time there's been a number of, uh, great, um, journalism done by, done in the Washington Post, um, exposing how the food industry pays dieticians to promote, you know, certain, a certain ideology around food-

    4. JRJoe Rogan39:06

       Mm-hmm.

    5. MLMax Lugavere39:06

       ... that all foods are cool, you know? You just have to eat less and move more. All foods fit. There are no good or bad foods, which-

    6. JRJoe Rogan39:13

       Yeah, it's hilarious.

    7. MLMax Lugavere39:14

       It's hilarious. It's crazy.

    8. JRJoe Rogan39:15

       Yeah. I mean, these companies, they, they pay these people that are body positive influencers as well, you know? So they're, they're basically paying people that are ill because of eating these things to tell other people it's okay to eat these things and that it's somehow or another phobic-

    9. MLMax Lugavere39:32

       Mm-hmm.

    10. JRJoe Rogan39:32

        ... whether it's fat phobic or whatever it is, to not encourage body positivity. And it's stupid. It's just stupid. It's stupid for the people that are getting it. It's sti- it's stupid for the people that are promoting it. It's stupid for our culture to be inundated with this nonsense and misinformation where we have to sort through it and try to do deeper research and condult, condu- you know, consult people who actually understand what's going on. It's so disheartening that we live in this world that's so compromised by money, that information about key things like your own health is so distorted that it's hard. Like, you know, you talk to people, and so many people have like a basic misunderstanding of what is good and not good for you. And i- all of it is because of this kind of thing, that it's just so prevalent and it's so confusing. And you're getting expert advice from people, which is one of the wildest ones for me when you look at-

    11. MLMax Lugavere40:33

        Oh, thank you.

    12. JRJoe Rogan40:34

        Get some coffee in your system there, fella.

    13. MLMax Lugavere40:36

        Thanks, brother.

    14. JRJoe Rogan40:37

        Cheers, sir.

    15. MLMax Lugavere40:38

        Cheers. (glass clinking)

    16. JRJoe Rogan40:38

        Good to see you.

    17. MLMax Lugavere40:39

        Same.

    18. JRJoe Rogan40:40

        Um, one of the things that's crazy to me is that we get expert advice from people that are clearly sick. How many times have you had nutrition or dietary advice from someone who is obese?

    19. MLMax Lugavere40:52

        Yeah.

    20. JRJoe Rogan40:52

        You're fat. You're, you have no muscle. Your body looks like it's just in decay, and you're the person giving advice.

    21. MLMax Lugavere41:00

        Uh, yeah. I mean, mo- most of the social media, you know, personas that I've observed that purport to be experts or that, you know, that, that seem to have, I don't know whether it's through cre- cred- credentialism, uh, a degree of authority, I mean, I wouldn't send a loved one to.

    22. JRJoe Rogan41:18

        Yeah.

    23. MLMax Lugavere41:19

        You know? Uh, it's just gaslighting on a, on a mass scale 'cause, you know, your, your average person today comes across this ideology that all foods are fine, it's all good. And they try to reduce their consumption of the crap that they're already eating, and they end up failing at that because it's really hard to moderate your consumption of these foods which have been engineered to be consumed quickly and regularly. And then they feel as though they're, you know, they feel, they feel moral failure, and, and then it just creates this vicious cycle of, of yo-yo dieting. We're not being honest about the way that these foods impact behavior. And today, 60% of the calories that your average person consumes comes from ultra-processed foods, which are foods that are highly calorie dense. They are nutrient poor. They are minimally satiating. They're uber delicious. I mean, they push your brain to a bliss point beyond which self-control is, is seemingly impossible. And by the way, it's these ultra-processed foods that are a major route of ingestion for these kinds of chemicals that we're talking about, these industrial chemicals, forever chemicals. You know, ultra-processed foods are, you know, if you want more phthalates in your body, consume more ultra-processed foods. There was a study that recently was published that found that for every 10% increment in ultra-processed food consumption, pregnant women were ingesting about 14% higher levels of, of these phthalates, right? I mean, you had ... You did such an amazing episode with Shawna Swan a couple years ago talking about the fact that our exposure to these chemicals are reducing the anogenital distance in boys, right? Which is a, which is a, a very easy ... Well, I don't know about if easy is the right term, but it's a very, it's- it's a very simple, uh-... proxy to use to identify how these compounds might be affecting us, right? But that's only what you can observe. Like, how are these c- chemicals affecting us in other ways?

    24. JRJoe Rogan43:11

        Right.

    25. MLMax Lugavere43:11

        You know? And, um, and so it's crazy, and, and these are the kinds of, these are the kinds of foods that we're just eating en masse, day in and day out. And 60% is the average. Children consume about 70% ultra-processed foods today. On average, Black Americans unfortunately consume 80% ultra-processed foods, and there's obviously, it's, this is not all choice. There are systemic issues. Many people today still live in food deserts. Accessibility is an issue. Cost is an issue. I know all that. But the messaging that we're getting from our most trusted sources is essentially that everything's fine. Just eat less, move more.

    26. JRJoe Rogan43:47

        (sighs) Yeah. And it's so difficult for the average American to access information from people that they can trust, or to figure out who to trust. You know, you get experts that tell you, "Oh, you don't need to take supplements. You just need a well-balanced diet." And you go, "Oh, bi- vitamins are bullshit." And you have people expressing that. Like-

    27. MLMax Lugavere44:05

        Yeah.

    28. JRJoe Rogan44:06

        ... w- it's just, how could someone say that when there's so much data on the efficacy of vitamins and the benefit of vitamin supplementation?

    29. MLMax Lugavere44:14

        Of course, and vitamins, I mean, we, we need vitamins. Supplements can be really helpful. And I get asked this a lot, like, "Who do you know, who to trust on social media?" I think a really good heuristic is, you know, s- somebody ... Actually I was giving a talk recently and somebody, somebody, uh, um, h- uh, highlighted that i- uh, o- one good indicator of somebody who is, is likely trustworthy is somebody who pre- uh, is willing to present the opposing viewpoint. And not strawman the opposing viewpoint, but actually steelman the opposing viewpoint. Like, to actually make clear what the opposing viewpoint is.

    30. JRJoe Rogan44:49

        Right.
11. 45:45 – 59:04

    Unexpected detour: fixing chronic back pain with decompression, Reverse Hyper, and training modifications

    1. JRJoe Rogan45:45

       What have you been doing for your back?

    2. MLMax Lugavere45:48

       Um, well, I try-

    3. JRJoe Rogan45:50

       You have, uh, bulging discs? What do you have?

    4. MLMax Lugavere45:53

       Oh man, I have, um, like mild ... Or it's probably progressed, but it's like disc desiccation between L5 and S1, and then, um, so it's like basically a dehydrated disc. And uh, which I got from just squatting improperly 10 years ago, and my back's like never been the same since.

    5. JRJoe Rogan46:11

       Mm.

    6. MLMax Lugavere46:13

       Um ...

    7. JRJoe Rogan46:13

       Have you ever used a Reverse Hyper?

    8. MLMax Lugavere46:15

       No.

    9. JRJoe Rogan46:16

       You don't know about that?

    10. MLMax Lugavere46:17

        No.

    11. JRJoe Rogan46:17

        Uh, it was, uh, a piece of machinery that was, uh, designed by, um, uh, W- Westside Barbell, Louie-

    12. NANarrator46:28

        Simmons.

    13. JRJoe Rogan46:28

        Roberts.

    14. MLMax Lugavere46:29

        Hmm.

    15. JRJoe Rogan46:29

        Wasn't it?

    16. NANarrator46:30

        Simmons.

    17. JRJoe Rogan46:31

        Simmons. Louie Simmons, sorry. Louie Simmons from Westside Barbell developed this machine that strengthens the back and actively decompresses the back. And, uh, what it is is your body weight with your chest down sits on this bench, and underneath it you hook your legs to this thing that's like a leg curl, and you lift up, which strengthens your back. And on the decel, when it brings it down, it's actively pulling your back.

    18. MLMax Lugavere46:57

        Hmm.

    19. JRJoe Rogan46:57

        And it's phenomenal.

    20. MLMax Lugavere46:59

        Whoa.

    21. JRJoe Rogan46:59

        It's really good. It's really good at decompressing your back. It's really good at strengthening all the muscles around your back to keep your back stable. This is the machine right here. We have one-

    22. MLMax Lugavere47:07

        Damn.

    23. JRJoe Rogan47:07

        Yeah, we have the rogue version of it out there in the studio. I could show it to you after we're done here, but I love it.

    24. MLMax Lugavere47:12

        Wow.

    25. JRJoe Rogan47:12

        It's phenomenal. And it's, it's great for developing leg strength and hamstring strength and glute strength, but really I use it for lower back, for decompression. Show a video, Jamie, if you would, so you could, we could see how it worked. This is Louie. Uh, he was on the podcast back in the day. He was an amazing guy and very innovative. So he was a power lifter and developed some back problems himself. But you see how on the downswing it's, it's actually pulling your back, and you can feel it pull your back. So you can feel it like separate everything.

    26. MLMax Lugavere47:46

        Wow.

    27. JRJoe Rogan47:46

        You feel like little things pop in there and it, it provides relief. And for him, they were telling them that he had to get his disc fused-

    28. MLMax Lugavere47:53

        Hmm.

    29. JRJoe Rogan47:53

        ... because he had too much compression. He said, "Well, what about decompression?" And they were reluctant to consider that. And so he's a genius, a, a fitness genius, and so he designed a machine that would actively decompress the spine while strengthening the muscles around it.

    30. MLMax Lugavere48:09

        Whoa. That sounds awesome.
12. 59:04 – 1:07:32

    Fiber, ‘detox,’ and gut health: bile acid binding, microbiome diversity, and carnivore debates

    1. MLMax Lugavere59:04

       Yeah, and I, you know, to, to, to, to, quote unquote, "detoxify," which has become one of these contentious words now on social media, granted maybe possibly for good reason because it's used to sell detox supplements and things like that. But, I mean, our bodies can detox. We just have to make sure that we're giving our bodies the right, the right raw materials to, to do that. And that's actually one reason why I think... You know, I'm not a carnivore dieter. I'm, I'm, I'm a big advocate of consuming grass-fed, grass-finished meat. I'm a, you know, huge protein guy. But I do think dietary fiber plays an important role in terms of helping us, you know, detoxify, release some of these compounds when we go to the bathroom.

    2. JRJoe Rogan59:40

       How does dietary fiber play a role in detoxifying?

    3. MLMax Lugavere59:44

       So the three primary means in which a body detoxifies is via peeing, pooping, and sweating. And when you release bile acids into the lumen of the gut, with those bile acids com- compounds that the liver has, has essentially deemed, has, has marked for removal from the body. And fiber, dietary fiber, soluble fiber, um, specifically sequesters these bile acids and they, they're, because they're absorbed by the soluble fiber, they disallow reabsorption. And so you poop them out.

    4. JRJoe Rogan1:00:19

       Hmm.

    5. MLMax Lugavere1:00:19

       That's one of the reasons, that's, that's actually the mechanism by which soluble fiber reduces, can reduce LDL cholesterol, ApoB, because it sequesters bile acids, which your liver creates using cholesterol. And, um, so you e- you essentially like poop out lipids, toxins. I mean, if you're not pooping on a regular basis, you're harboring, you know, toxins. That's why I think that-

    6. JRJoe Rogan1:00:42

       (laughs)

    7. MLMax Lugavere1:00:42

       ... that's probably one of the mechanisms by which fiber seems to be so consistently associated with healthspan, lifespan. Um, you know, and those observations are not necessarily causal. Like there's healthy user bias there. I think, you know, obviously people who eat more fruits and vegetables today, they likely have other healthy dietary and lifestyle habits. Like that's o- that's clear, right? But I do think there's a mechanism for fiber to help, um, remove some of these toxins and, and the like.

    8. JRJoe Rogan1:01:12

       And is the idea behind that mechanism that fiber encourages defecation?

    9. MLMax Lugavere1:01:18

       ... fiber, the soluble fiber like traps. It basically, bile acids get released into the lumen of the gut-

    10. JRJoe Rogan1:01:24

        Mm-hmm.

    11. MLMax Lugavere1:01:24

        ... which help break down fats, right? You need these, you need these compounds to break down an obs- an, an assimilate fats from your diet, right? But there's a very small, I believe it's at the end of the small intestine where these acids essentially would otherwise get reabsorbed, but because they're trapped by this soluble gel-forming fiber, they get passed.

    12. JRJoe Rogan1:01:42

        And so how is that different than what would happen if you just ate meat and you have these compounds?

    13. MLMax Lugavere1:01:50

        That's a big question mark, but I think that that's, uh, something that is not often discussed and should be discussed. One of the potential benefits of fiber is the fact that it helps trap toxins in the gut.

    14. JRJoe Rogan1:02:01

        And meat does not?

    15. MLMax Lugavere1:02:02

        No. Meat is, meat is a low residue food, food. Meat is largely absorbed in the small intestine. I mean, when people, you know, the bulk of stool is made up of fiber, and dead bacteria, and cells that have been sloughed off the, you know, epithelial layer of the, um, large intestine, small intestine. Um, but yeah, fiber is generally what makes up, you know, the majority of, uh, of stool.

    16. JRJoe Rogan1:02:28

        And if you just eat meat, then what is your stool?

    17. MLMax Lugavere1:02:32

        Well, I've never personally done a carnivore diet and I'm not a gastroenterologist, but, um, you know, carnivore dieters say that they poop fine. But, um, but I think it's a missed opportunity to not be getting fiber in your diet. I, I, I don't think that the carnivore diet long term is, is optimal. Short term ... And a- and also I will-

    18. JRJoe Rogan1:02:52

        And-

    19. MLMax Lugavere1:02:52

        ... say that people that, that see reprieve from awful conditions like, you know, Crohn's or I- you know, IBS or whatever these autoimmune conditions are that people who adopt carnivore diets, like I would never, I would never say stop doing this diet that seems to be helping you.

    20. JRJoe Rogan1:03:04

        Mm-hmm.

    21. MLMax Lugavere1:03:05

        Like I would never say that.

    22. JRJoe Rogan1:03:06

        So the primary function of fiber that you think is beneficial, uh, versus having a carnivore diet is the fact that it can absorb these compounds inside the gut, whereas if you're just eating meat, it's, that's not going to happen.

    23. MLMax Lugavere1:03:20

        Correct. I d- I think that's one of the benefits of fiber. I think fiber, fiber has a few bene- benefits. So for one, fiber is satiating. It's not as satiating as protein, but it does mechanically stretch out the stomach, which, you know, turns off the hunger hormone ghrelin. So fiber is, is, fiber containing foods are satiating because it's, you know, f- s- are beneficial because they're satiating. Two, for this lipid regulation, hormone regulation, toxin removal function that fiber plays. Um, but then three, fiber seems to promote, um, gut bacterial diversity. Um, there are some studies that suggest otherwise, that it's not necessarily the fiber, it's fermented foods that play a, a larger role in promoting gut bacterial diversity. Um, but we know that fiber feeds gut bacteria, and as a result we get beneficial postbiotic compounds like sodium butyrate, which is anti-inflammatory, feeds cells in the gut, um, that use it as a, as a fuel source. So I think there, I think there are a few benefits to fiber consumption. Um, you know, I, I, I'm not like one of these like, you know, I don't think that fiber is the primary thing that we should be looking for in the diet necessarily. I'm, I'm, I prioritize protein. I think eating, you know, a protein rich diet, there seems to be many benefits of that. Um, and fiber is not a, it's not an essential nutrient, um, but it does seem, it does seem to do good things in the body. So I mean, I'm, I'm not anti-fiber.

    24. JRJoe Rogan1:04:56

        Yeah, it's one of the weird arguments from the carnivore diet side is that fiber is not necessary. And you know, when you see these people that have been eating nothing but meat for five, 10 years and show an alleviation of all sorts of symptoms, of different autoimmune conditions and different issues that they've had, it's, it's interesting.

    25. MLMax Lugavere1:05:16

        Totally. Well, m- first of all, there's no such thing as a one size fits all diet. And plants, people have different, um, tolerances to different plants. You know, it's, red meat, for example, is much more well tolerated by the vast, vast majority of people. I mean, there's a complication of Lyme disease known as alpha-gal syndrome where people develop a sensitivity to red meat. But by and large, red meat, like you, provided you're producing enough stomach acid, you should be able to-

    26. JRJoe Rogan1:05:43

        Is that officially a Lyme disease? Or I thought it's from the lone star tick, it's a different-

    27. MLMax Lugavere1:05:49

        That, yes.

    28. JRJoe Rogan1:05:49

        Yeah.

    29. MLMax Lugavere1:05:50

        Yeah. I believe you're right. I believe you're right. Um, I'm not 100% sure, but it's, uh, it's associated, it's one of these tick-borne-

    30. JRJoe Rogan1:05:58

        I had a buddy of mine got it. Yeah, my friend Evan had it for a year and it actually went away and then came back again.
13. 1:07:32 – 1:28:45

    Antibiotics and gut fallout: probiotics vs fermented foods, low-FODMAP, and elimination approaches

    1. JRJoe Rogan1:07:32

       I'm glad you brought up the, uh, overuse of antibiotics because there's a very interesting case. Uh, that belt on the wall up there, the- the- the- Abu Dhabi Combat Club, that's, uh, the most prestigious grappling, um, competition in the world. And the guy who won that is the greatest grappler of all time, his name is Gordon Ryan.

    2. MLMax Lugavere1:07:51

       Whoa.

    3. JRJoe Rogan1:07:51

       And he's a guy who's- he's only 28 years old, which is really wild, and he's- hasn't been beaten in, like, forever.

    4. MLMax Lugavere1:07:57

       Whoa.

    5. JRJoe Rogan1:07:58

       And it's not whether or not he beats people, it's how he beats them. It's- he's that good. He's that- he's one of the most dominant athletes of any sport of all time. But, he had staph infection, which is very common amongst grapplers, it's very common. People get a lot of staph infections. Well, he was getting it so often that he was essentially on antibiotics for a whole year, and his gut is fucked up-

    6. MLMax Lugavere1:08:21

       Hmm.

    7. JRJoe Rogan1:08:22

       ... like real bad, to the point where he's, like, constantly nauseous. He's seen a bunch of different doctors and they've tried to fix it in a bunch of different ways and no one can really figure it out. Like, when someone has developed a really destroyed gut biome because of antibiotics and long-term, like, really irresponsible use of antibiotics, what could someone do to try to come back from that?

    8. MLMax Lugavere1:08:49

       Yeah, I mean, most- most people would reach for a- a probiotic, but there was actually a study that came out a couple years ago that found that probiotics after a course of antibiotics, I believe the antibiotic was Cipro, um, actually delayed recolonization of the gut by healthy bacteria.

    9. JRJoe Rogan1:09:04

       How so?

    10. MLMax Lugavere1:09:05

        You know, I don't know, but it's just a- the- the microbiome is a big buzz term and there are still so many more unanswered questions than there are answers. I think based on- based on my assessment of the literature, and I've- I've written about it in my- in my books, I think that the best thing to do would probably be just to, you know, to- to- to slowly get back to a diet that contains, it's- you know, that pro- that contains fermented foods. I think fermented foods have been shown to be really supportive of gut bacterial diversity.

    11. JRJoe Rogan1:09:33

        Like kimchi and things like that?

    12. MLMax Lugavere1:09:34

        Yeah.

    13. JRJoe Rogan1:09:34

        That's what I like.

    14. MLMax Lugavere1:09:35

        Yeah.

    15. JRJoe Rogan1:09:35

        I like kimchi.

    16. MLMax Lugavere1:09:35

        More so than- than probiotic supplements, I think fermented foods are really what's up.

    17. JRJoe Rogan1:09:40

        Hmm.

    18. MLMax Lugavere1:09:40

        Um, kimchi, I'm a huge fan of nattoo, raw sauerkraut, raw pickles. You have to make sure that they're raw, you know, not pasteurized. Um, but yeah, that- that seems to be really helpful. And then essentially just feeding- eating- because what you feed, you breed, you know? So eating, um-

    19. JRJoe Rogan1:09:56

        Well, he has a hard time even keeping food down.

    20. MLMax Lugavere1:09:59

        Yeah, that's-

    21. JRJoe Rogan1:09:59

        Like, he- he's in this position where he's, like, constantly nauseous and he tries to train, but he gets nauseous while he's training sometimes.

    22. MLMax Lugavere1:10:06

        Hmm. That's rough.

    23. JRJoe Rogan1:10:08

        What would you recommend to someone like that?

    24. MLMax Lugavere1:10:12

        Yeah, I would say, I mean, it depends. You know, some people do really well on low FODMAP diets, so like, you know, these fermentable carbohydrates that are- that include fiber but also include other specific carbohydrates that are- that are easily fermented.

    25. JRJoe Rogan1:10:27

        What- what are those?

    26. MLMax Lugavere1:10:28

        You know, like, there's- there's certain prebiotic carbohydrates that are found just across the, um, you know, like throughout the- the- the produce section of the supermarket that are, uh, usually eliminated when attacking SIBO, bacterial overgrowth in the small intestine. Um, there's a- people can Google, like, there's a whole list of, like- it's the- it's a low FODMAP diet. Um...

    27. JRJoe Rogan1:10:56

        'Cause Gordon has been doing this- trying to deal with this for, like, a couple years now. Here it is, low FODMAP diet, so vegetables, fruits, uh, dairy, alternates- These are all high. ... high FODMAP groups. These are low down here. And the low stuff is vegetables like eggplants, green beans, bok choy, bell peppers, fruits, cantaloupe, capes. Okay. So all sorts of different things that you can eat that can potentially help you, but-

    28. MLMax Lugavere1:11:24

        Yeah, so I would- I would-

    29. JRJoe Rogan1:11:25

        ... he's on a bunch of medications, it's like nothing's helping.

    30. MLMax Lugavere1:11:28

        I mean, I would- I would probably adopt a low FODMAP diet, and at a certain point- You know, again, this- I'm just speculating. But, um, so I mean, this could be the- the worst advice, so don't- take- take with a grain of salt, but I would probably adopt one of those diets and then- You know, first, maybe even like an elimination diet, like a really aggressive one, um, 'cause people with- with- with serious gut issues, I mean, again, I'm not like a carnivore advocate, but seem to do really well.

Episode duration: 2:35:24