Tim FerrissHow to Future-Proof Your Brain from Dementia — Dr. Tommy Wood
EVERY SPOKEN WORD
105 min read · 21,142 words- 0:00 – 0:31
Preview
- TFTim Ferriss
Well, 45 to 70% of dementia is preventable through lifestyle. Is that a defensible statement?
- TWDr. Tommy Wood
45% comes from the most recent edition of The Lancet Commission report on dementia prevention, looking at different risk factors that have a consistent relationship with dementia risk. And there are other studies, like there was one big study done from the UK Biobank data by Professor Yuntao Yu, that estimated that up to 72% of dementias were preventable.
- 0:31 – 1:15
The cognition conversation commences.
- TFTim Ferriss
Tommy, Tommy, Tommy, nice to see you.
- TWDr. Tommy Wood
Nice to see you.
- TFTim Ferriss
Thanks for making the time. [laughs]
- TWDr. Tommy Wood
[laughs] Thanks for having me.
- TFTim Ferriss
Absolutely. And [laughs] as mentioned before we started recording, this is just gonna be like our last conversation—
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... because I wanted to reach out to you because cognition, cognition, cognition. Boy, oh, boy, is that on the mind, and pun intended-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... on one level, but we are gonna bounce all over the place, and I hope to give people, including myself, a lot of tactical, practical recommendations. Also being clear where the science is solid and where the science is maybe a little thinner ice, right?
- TWDr. Tommy Wood
Mm-hmm. Yeah.
- TFTim Ferriss
Or something is plausible, but not yet proven out. And
- 1:15 – 3:21
Why human babies are chubby little brain-fuel tanks.
- TFTim Ferriss
you've got me chewing xylitol gum.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
You've got me looking at air purifiers.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
But I'm skipping ahead. Let's go back to the beginning, and I want to give the good old Dr. Chatterjee a nod here because it came up in a conversation you had with him, and I was like, "Wow, I never would have thought of that." Why are human babies so plump? Why are they so fat compared to other species?
- TWDr. Tommy Wood
If you look at human babies compared to pretty much every other mammalian species, we are the only species that's born fat, even compared to other primates. And it's thought that the primary reason for this is that that fat-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... is a repository for things that the brain needs in order to develop. And the two that are probably most interesting to you and that seems to be particularly important are DHA, the omega-3 fatty acid-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... and fats as a source of ketones for the brain. When the brain is developing, in particular, and I think this is also very relevant to recovery from brain injuries and other states, the preferred synthetic precursor, as in the thing that the brain uses to make structure, like fats and cholesterol and that kind of stuff, which makes up a, a significant chunk of the brain, ketones are the preferred source, particularly in the developing brain, but I think also later on in, you know, various states as an adult. And so in order to support that very hungry brain, which it is particularly in humans, we're born fat so that we can generate a bunch of ketones to support that brain developing for the first, you know, especially for the first few weeks, but maybe even for months after that.
- TFTim Ferriss
Mm-hmm. Also have lots of, as I understand it, beautiful bat brown adipose tissue.
- TWDr. Tommy Wood
To keep them warm.
- TFTim Ferriss
To keep those little hairless monkeys warm. [laughs]
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
All right, so we're gonna talk about, because I think the, in a sense, the extremes inform the mean, but not the other way around.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
So we can talk about certain maybe edge cases, things that people might not view as immediately relevant to
- 3:21 – 7:22
Brain injury in newborns: Cooling, caffeine, and coming home.
- TFTim Ferriss
themselves. But since we're talking about newborns, I'm curious. You've looked at therapies, various types of research into brain injury in, in newborns.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
What do you do? What can you do? I mean, what's the state of the art when it comes to treating brain injury in newborns or in infants?
- TWDr. Tommy Wood
There's two main brain injuries of babies that I study, and they're probably also the two main brain injuries that are most broadly studied just because of their, their impact. And so the first is preterm brain injury. So that's a baby is born early. The earlier you're born, the greater the risk of neurodevelopmental impairment or, you know, some other kind of neurological disorder, cerebral palsy, other impairments later in life. And the other is something that we call hypoxic-ischaemic encephalopathy, which is essentially you get to normal full term, something happens.
- TFTim Ferriss
Mm. Not enough oxygen.
- TWDr. Tommy Wood
Exactly. Not enough blood flow, not enough oxygen get to the brain. Something happens usually during childbirth and people think about, you know, the cord is wrapped around the neck or you can get placental abruption, right? The, the placenta kind of tears off the inside of the uterus or like the uterus can completely rupture. But sometimes we don't know what happened. The baby just comes out and like something has happened. In that scenario, the second one, HIE as we call it, those babies are cooled down. So this is something that I studied a lot in my PhD. You take that baby and as long as you start within a few hours of birth, you cool them down to 33.5 degrees Celsius for 72 hours. And that significantly reduces death and disability.
- TFTim Ferriss
That's 92.3 degrees Fahrenheit for you Yankees-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... out there.
- TWDr. Tommy Wood
Although even in the US, many of the cooling machines are made in Europe, so they still run on Celsius.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
So those babies get cooled down and that's really the state of the art. Although now we're starting to figure out that there are still a whole bunch of injuries where that doesn't help, including preterm babies. So if you're born preterm, cooling doesn't help. Actually, it can be detrimental. And in that scenario, one of the things that they found recently, which is probably most beneficial, is caffeine.
- TFTim Ferriss
Really?
- TWDr. Tommy Wood
Yeah. Caffeine is not given for neuroprotection. It's given because babies who are born preterm don't breathe as well. They have this thing called apnea of prematurity. So they, they don't have like a normal respiratory drive.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So you give caffeine to stimulate that. But the trials that used caffeine to treat apnea of prematurity saw significant improvements in cognitive function.
- TFTim Ferriss
And those were durable improvements or just during treatment with caffeine?
- TWDr. Tommy Wood
When you do these kinds of trials, usually you follow those babies up to something like two or three years old. That's mainly because an NIH-funded trial or an NIH grant lasts five years.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So if you're gonna do a full trial in five years, then you have a year or two to enroll and treat, and then you, you have two or three years to follow them up. And so they see s- significant improvement at that age, but then also, you know, going into childhood, which is ideal. You really wanna look out as far, as far as you can. So then there's now a renewed interest in caffeine in other brain injuries in babies, and that's something that we've tested in my lab. There are some trials now starting in other brain injuries. But beyond that, in both groups, really the biggest impact on later outcomes is the home environment that kid goes back to. So yes, my colleagues who are the practicing neonatologists do a whole bunch of amazing stuff to keep these babies alive and keep their brains in good shape as much as they can when they're in the intensive care unit, but actually the home environment is where the biggest impact happens. And so then that means that even if you have an imperfect start to life, there's probably a lot that you can do as a parent to help that brain to develop and grow, you know, as normally as possible.
- 7:22 – 13:26
Adult concussion protocol: Fever management, ketones, and why you shouldn’t chug Powerade.
- TFTim Ferriss
All right, we're gonna continue to talk about brain injury for a little bit, and then we're gonna talk about a whole lot of [laughs] sort of multifactorial prisms around cognition and whether or not you can intervene with the fates to preserve or enhance cognition as an adult.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Right? So we're gonna get to that, but if we make the hop from infant to adult, right? If you slipped on the ice and hit the back of your head and suffered a severe concussion, what would you personally do after that?
- TWDr. Tommy Wood
There are a few things that I think we can probably do, and we actually wrote a paper about this. It came out last year, that covered various nutritional strategies, and most of the strategies would be nutritional supplements I would probably lean on. And assuming that I didn't have any control over what happened beforehand, ideally I'd do lots of things to improve the health of myself.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Right? Because I think that's gonna affect how my brain and body then respond to the injury. But after that point, then there's a couple of things that I would do. One is I would manage fevers. This goes back to the hypothermia that we talked about in babies. Lots of trials have tried hypothermia for traumatic brain injury in older humans and adults, and they haven't really shown any benefit. What does seem to be beneficial is preventing hyperthermia. So if you have significant trauma, one of the things that happens as the immune system gets activated is you get a fever, and that fever increases this gap between the metabolic demand in the brain and the supply of energy because the mitochondria become damaged during the injury. So if you increase that gap because the, you know, higher metabolic rate because you're hotter-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... that seems to make that injury worse, and this has been found in some animal models, but also in some human data. So the most important thing to do is to prevent fevers.
- TFTim Ferriss
So get your flu shots, et cetera. Other things?
- TWDr. Tommy Wood
In this scenario, you know, if you need to take Tylenol to prevent a fever, you're right.
- TFTim Ferriss
I see. Take acetaminophen.
- TWDr. Tommy Wood
Yeah, acetaminophen, paracetamol, depending on where you are in the world.
- TFTim Ferriss
Yeah, where you are.
- TWDr. Tommy Wood
Maybe even there are some devices where you can do some neck cooling or head cooling. They probably don't have as much of an effect as some people think they do, but whatever you can do to maintain your body temperature. And so antipyretics, so things that help prevent fevers are, are gonna be helpful. I would then also manage blood sugar.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
The main thing being probably avoiding things that are gonna cause large glucose spikes, so avoiding refined carbohydrates.
- TFTim Ferriss
Why does that matter acutely after you whack your head?
- TWDr. Tommy Wood
You see, again, in multiple studies, and we have to do this experimentally, so some of this comes from animal models. But if you create diabetes or they're hypoglycemic during the injury or immediately afterwards, and some of it is driven by the injury. If you have an acute injury, you're gonna get higher blood sugar. So some is cause, some is effect. But it seems that these high glucose spikes are, again, stressful in that setting of an acute brain injury, so just minimizing that as much as possible. That doesn't mean that you shouldn't eat carbohydrates, but just, like, I would avoid refined carbohydrates.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
When I sort of worked with athletes at high risk of concussions, like, if you're being taken off the field, a low-risk thing is just to not chug Powerade as you're being, like, taken down the tunnel.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Other things that are gonna become important with varying degrees of evidence but still good enough that there's a high sort of positive asymmetry, right? High possibility of benefit with low risk. Creatine supplementation. Creatine is probably more beneficial if you have it on board beforehand.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
But there's at least one trial in pediatric TBI that showed creatine enhanced recovery. Omega-3 fatty acids are the same. We would certainly include those as well. And then the next thing I would do is I would take exogenous ketones.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
I have them, you know, at home. They are things I've played with. I don't use them regularly.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
But in this setting, again, I think there's enough promise-
- TFTim Ferriss
Right
- TWDr. Tommy Wood
... to suggest that they're worth taking. I didn't include that in this paper because we don't have good evidence for it, but if I was... if I had a brain injury, I would take exogenous ketones.
- 13:26 – 24:04
Washington’s 2nd Strongest Man talks omega-3s, methylation, and why your brain needs the whole orchestra.
- TWDr. Tommy Wood
worse.
- TFTim Ferriss
All right. So we're gonna take a moment, not for a commercial break, but just for a topical break to ask a very important question, which is, when you came in second at Washington's Strongest Man-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... in 2024, and then when you came in the top 20 in the world's first ever fully off-road Ironman Triathlon, what were your weights? What was your body weight in both of those cases?
- TWDr. Tommy Wood
Those two competitions were more than a decade apart, I will say so.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
In 2012 was when I did the world's first fully off-road Ironman. It was initially called XMAN, and then Marvel sued the company, [laughs] so it ended up being called Xtri 24. So when I did that, I think I was probably something like low 80 ki- 82, 83 kilos, so like, you know, 185 pounds, something like that.
- TFTim Ferriss
Mm-hmm. All right.
- TWDr. Tommy Wood
And then fast-forward a decade, when I was competing in Washington's Strongest Man, I was in the middleweight class, and to get into that class, I had to basically diet down and then do a water cut to get under 198 pounds.
- TFTim Ferriss
Okay.
- TWDr. Tommy Wood
So I was just under 90 kilos on the day, although, you know, normally I'd, I'd hang out like 15 pounds higher than that.
- TFTim Ferriss
Okay. Super interesting. We may come back to that.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
We're certainly gonna talk about your own personal routines and tricks of the trade that you apply. Before we do that, I wanna tie up a couple of loose ends. Specifically, infant baby, this thing you mentioned, DHA, and why that and/or omega-3s, more broadly speaking, are important, right? And I, for instance, I'd say one meal a day is probably right now two cans of sardines-
- TWDr. Tommy Wood
Uh-huh [laughs]
- TFTim Ferriss
... or [laughs] chub mackerel mixed with some type of oil, like olive oil or MCT oil with a splash of apple cider vinegar. It's shockingly good. It sounds like cat food. It's actually better-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... than it sounds with some salt. But could you explain why this DHA, et cetera, is important? You also mentioned the omega-3 in the context of recovery from brain injury. So why is it important, and what is the prescription, so to speak? Like, how can people translate that into something they actually do?
- TWDr. Tommy Wood
When you think about, again, sort of the structure of the brain-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... and you're trying to develop the brain in the first place.
- TFTim Ferriss
Big pile of fat.
- TWDr. Tommy Wood
Big pile of fat.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
And a lot of that fat is DHA. And actually brain, if you don't mind eating brain, brain is a great source of omega-3s.
- TFTim Ferriss
I tried it. I tried sheep brain in Turkey.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
I'm gonna tell you, the presentation could've used some work. It was just like straight out of the formaldehyde jar-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... plopped onto a plate. It was a bit much for me, to be honest, but yeah. [laughs] Continue.
- 24:04 – 34:09
Auguste Deter, Alzheimer’s mystery patient, and the 45-70% dementia prevention sweet spot.
- TFTim Ferriss
All right. So let's maybe return to, I'm gonna use a term that's a little dangerous to throw around, but kind of first principles or fundamentals maybe is a better way to phrase it. I'm terrified, as many people are, of this thing called Alzheimer's disease, and you could throw in dementia, cognitive decline in general, right?
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
And conversely, very interested in ... extending health span. I'm not totally convinced that, you know, we're gonna get to 150 years, 200 years-
- TWDr. Tommy Wood
Yeah, me either [laughs]
- TFTim Ferriss
... like all the tech billionaires might want to have us believe, but it does seem, certainly if I look at my own health span [laughs] kind of local maximum right now for myself, it's not really low s- there's just capacity right now compared to prior generations. I feel very good about it, so I feel like I can extend that runway.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
And cognition for me is just one of the most, maybe the most important pillars of that.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Because having seen multiple people disintegrate cognitively, they don't just lose their ability to remember. They basically lose their identity.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Right? They lose their ability to emote. It's a loss of the self. I mean, it's a death before death almost in a way. So really would love to do anything possible with the right risk-benefit ratio to avoid it.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
But fundamentals. Should we talk about, I'm gonna fuck this up.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Auguste Deter, Auguste Deter?
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Data? How do you say this name?
- TWDr. Tommy Wood
Auguste Deter, I think.
- TFTim Ferriss
There we go.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
All right. Who is this person? Because I'm guessing most folks will not recognize the name.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Certainly I didn't recognize the name. Hadn't seen it until I got a couple of notes from you prior to hopping on.
- TWDr. Tommy Wood
So Auguste Deter, or if you read some of the original papers, Auguste D., was Alzheimer's index patient. So Alois Alzheimer, that Alzheimer's disease is named after, was a psychiatrist in the early 20th century, and he took a particular interest in individuals who had sort of rare or unusual cases of pre-senile dementia. So what we now call, or what now most of us call Alzheimer's disease, which is sort of a late onset dementia, or what was called a senile dementia, which just meant that it occurred after 65 years old, that was not what Alzheimer studied. He studied unusual dementias where people who were quite young, sort of in their, you know, 40s or 50s, experienced significant cognitive decline and dementia, and Auguste Deter was one of them. He then, after studying them as a psychiatrist or working with them as a psychiatrist, after they died, he then looked at their brains under a microscope. So he was the first person to see amyloid plaques, tau tangles that are now sort of pathognomonic. They're like what we consider to be sort of required as part of Alzheimer's disease. But it's just interesting that what we have now is not what he studied. So over time, people thought that the brains of individuals who had this sort of early onset Alzheimer's or these early onset dementias that Alzheimer studied and those who have this late onset dementia that we now call Alzheimer's disease, those brains looked very similar under microscope, so they were kind of lumped together. Although we do still have two kind of broad forms, the early onset Alzheimer's, which is usually a single genetic mutation in something like a presenilin gene or the amyloid precursor protein gene that then, you know, creates a picture that's much more like what Alzheimer studied, or the late onset Alzheimer's, which is what most people think about when they think about Alzheimer's disease, is probably somewhere between 95 and 99% of cases of Alzheimer's. And there is a genetic component to risk, but it seems to be much more tightly tied to lifestyle and the environment and other lifestyle factors that, that we have some control over, hopefully. And the reason why Auguste Deter is interesting to me is because I don't think she actually had Alzheimer's disease as we would now think of it. So there have been groups that have taken sections of her brain from like, you know, Alzheimer's old collections, and they've done genetic studies, and she didn't seem to have any of the genes that cause early onset Alzheimer's disease, or any of the mutations that cause early onset Alzheimer's disease. She wasn't an APOE4 carrier. I think she was 3.3, if I remember correctly. So she didn't have any of the genetic risk factors. What caused this and caused this so young, I think she was in her 50s, right, is still actually unknown. Some people think... There have been some like recent retellings of the story. Some people think that she may have had neurosyphilis.
- TFTim Ferriss
Hmm.
- TWDr. Tommy Wood
And neurosyphilis actually causes amyloid accumulation. It looks very similar to Alzheimer's disease.
- TFTim Ferriss
Neurosyphilis, meaning she had syphilis and-
- TWDr. Tommy Wood
It got into her brain.
- TFTim Ferriss
Got it.
- TWDr. Tommy Wood
Yeah.
- 34:09 – 48:06
From CGM monitoring to the “use it or lose it” glucose paradox.
- TFTim Ferriss
So part of the reason that I make this very self-interested is because I'm self-interested. [laughs]
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
The other part is that I think the personal is very easy for people to concretize, right, for themselves.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
So they can interrogate how they're behaving, what they might do differently, what they might add, what they might subtract.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
So let me tell you some of what I am observing and then some of what I'm doing, and I would love for you to identify or maybe speak to things that are low-hanging fruit or, like, reasonably accessible-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... that are missing.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Right? All right. So a few things. Lots of folks in my family currently caring for, in one way or another, deteriorating very quickly-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... with what has been called Alzheimer's. Again, kind of a tricky diagnosis. Not sure how, how much they're actually looking at.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Whether it's beta amyloid tau or anything else.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
But certainly in, in some cases, these blood relatives are APOE33. So I'm like, huh. Also raises the question of, is there an undiagnosed infection? Maybe it's an STI. Who knows, right? Like, I don't know what the answer is to that, and it's kind of another line of, of testing perhaps. And so I've been trying to do a few things for myself, recognizing that if someone starts to really show obvious symptoms that can't be easily explained away in their 70s, let's just say, the process probably started, what? Decades earlier?
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Right? I mean, things have started-- Like, the cars have started to pile up. The machinery has started to break a lot sooner.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
So it would seem like the earlier you intervene with better lifestyle changes, et cetera, the better off you'll be. So I've got the fasting and the ketogenic diet and all of that stuff, right, which I do regularly. I've got the exogenous ketones, which like you, I use sparingly. I don't use them all the time because particularly, like before this conversation, I took 11 milliliters of a ketone monoester. But I think once all is said and done, it's basically 51% 1,3-butanediol, and I have some concerns around-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... 1,3-butanediol specifically in chronic use.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Right? Or at sufficiently high doses, say 30 plus per day. I tend to use it for special occasions like this, you know? Toast, have a glass of champagne, have some exogenous ketones [chuckles] and off to the races.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
All right, so there's the ketone piece, which I think is non-trivial. There's the By, I would say, for the most part, avoiding crazy glucose spikes all the time.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Right? Occasionally I'll have... Like Christmas, sure, I had a bunch of cookies. Like, who cares? It's Christmas.
- TWDr. Tommy Wood
Yeah, yeah.
- 48:06 – 53:50
Open-skill and navigational exercise + VO2 max training as insurance against dementia.
- TWDr. Tommy Wood
When you look at the different physical activities or exercise and, and how they affect the brain, different types of exercise affect the brain differently, so you certainly need a smorgasbord of all of them to kind of get global support for the brain. But something that seems to be particularly beneficial is coordinates of exercise or open skill exercise, you know, plus or minus things that have a navigational component. And these are essentially sports or activities where you're constantly having to respond to the environment and adapt. That's what makes them open skill rather than closed skill or unimodal exercise like going for a jog or sitting on a bike or something like that.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So when they compare Sports or activities that have the same amount of physical challenge but different amounts of cognitive challenge because of the open-skill nature, you see greater benefits in terms of brain structure, improvements in cognitive function.
- TFTim Ferriss
And open skill just means high level of unanticipated variety or variety? What is that?
- TWDr. Tommy Wood
Both. It basically has a greater amount of complex motor skill required.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Some of it can be learned. So dancing is one example, right? So 'cause you, you learn the steps of a dance.
- TFTim Ferriss
Single strongest activity for dementia prevention. Am I overstepping there?
- TWDr. Tommy Wood
Yeah, probably.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
If you look at physical activity and the effect that it has on cognitive function and also mental health.
- TFTim Ferriss
Or one of the stronger.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
But in terms of both mental health, so studies in depression as well as studies looking at different activities that people do and their risk of dementia and studies where they randomize people to different types of activity including dance, dance seems to have the highest sort of effect size-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... compared to other types of physical activity. But there's multiple components to dance, right? So you have to learn the steps, but there's also a social component, there's a music component, right? All these things are probably like part of the magic sauce together. But open-skill sports also include, you know, board sports or ball sports or team sports where you're having to like react to the environment and other people around you.
- TFTim Ferriss
Do you say bull sports, like rodeo? What are we talking?
- TWDr. Tommy Wood
Ball sports. B-A-L-L.
- TFTim Ferriss
Oh, okay. [laughs] I was like, it's not gonna be good for the TBI to get people on top of bulls, but okay, got it.
- TWDr. Tommy Wood
Although I think bull sports would probably be good if you could avoid the TBI.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
Actually probably right up there. Similarly, martial arts also good as long as you don't get punched in the head a bunch or kicked in the head a bunch.
- TFTim Ferriss
Or choked out too much. Yep.
- TWDr. Tommy Wood
Or choked out too much.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
Beyond the physical strain that these exercises have, they seem to have an additional aspect of, you know, requiring reaction speed-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... challenging processing speed, learned complex motor skills. They seem to have an outsized effect in terms of cognitive function.
- TFTim Ferriss
Yep.
- 53:50 – 55:55
Jiu-jitsu, sleds, and the Norwegian torture method (4×4 intervals).
- TFTim Ferriss
I'm still completely stuck on the three times a week.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Basically VO2 max training, right?
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
For a few months. Is a few months like three or four months, or how many months was it?
- TWDr. Tommy Wood
The study was either 6 or 12 months. I can't remember the, the intervention period.
- TFTim Ferriss
Okay. All right.
- TWDr. Tommy Wood
It was one or the other.
- TFTim Ferriss
And with durable effects over a follow-up period of-
- TWDr. Tommy Wood
Five years
- TFTim Ferriss
... five years or something like that. Like that is a great investment.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
That makes it a much more compelling sales pitch-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... for me. And like I've done plenty of VO2 max training in the past, but like it's not necessarily fun, right?
- TWDr. Tommy Wood
No.
- TFTim Ferriss
I mean [laughs] I will say if you can av- again, avoid getting your arm snapped, exhibit A right here with my elbow surgery, but if you can avoid the breaking limbs and getting choked out too frequently.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Something like jujitsu, right, is, is actually fantastic because you might have three to five minute rounds, and then you take a break for a round, and then you go back in. And chances are, depending on who you're rolling with, it's gonna be pretty intense.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Obviously depends on how competitive the gym is, but the durability is just remarkable. That is really, really, really, really interesting. Now, is the threshold for sufficient intensity, I imagine it varies tremendously from person to person depending on lactate threshold, right?
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
But like for you Do you need to do something approaching the Norwegian 4x4 to cross the threshold sufficiently in your mind, or does something less suffice?
- TWDr. Tommy Wood
The problem with having just one, I mean, it's one very good study, but just having one study-
- TFTim Ferriss
Yeah, right
- TWDr. Tommy Wood
... on this is that we get really focused on the protocol.
- TFTim Ferriss
[laughs] Yeah.
- TWDr. Tommy Wood
But I think that anything that is regularly producing, you're getting above your lactate threshold, you're generating significant, you know, several millimoles of lactate.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
I don't think people need to measure it. But, you know, if you're getting six, seven plus, something like that, right, you're, you're definitely gonna be in that
- 55:55 – 58:51
Lactate training: Forget the finger prick, embrace the misery.
- TWDr. Tommy Wood
range.
- TFTim Ferriss
Is there something like a, people use a talk test, for instance, Peter Attia talks about this for zone two training, where you can kind of have a conversation in belabored short sentences, but you don't really feel like it, as an indicator that you may be roughly sort of in zone two. Is there an equivalent for that range of lactate?
- TWDr. Tommy Wood
Not that I know of.
- TFTim Ferriss
10% from puking into a bucket. [laughs]
- TWDr. Tommy Wood
[laughs] Yeah, it's definitely gonna be misery related.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
So if I think about a lot of the training that I did as a student, I was a rower.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Right?
- TFTim Ferriss
Oh, brutal.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
You love misery.
- TWDr. Tommy Wood
I don't love misery enough, which is why, probably why I wasn't as good a rower as I could have been.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
But there are lots of protocols where you're doing relatively short sprints with relatively long rest periods that still generate large amounts of lactate.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And so in studies where they've done this, you know, you're talking about, like, 30 seconds flat out on a bike or a rowing machine with several minutes of rest times six, eight, 10 rounds. By the end, right, you can generate a lot of lactate without having to do something continuously for, you know, several minutes at a time. I think I was just reading that one of the favorite training protocols for one of the, like, world champion rowers was 45 seconds, I mean, flat out, like completely flat out on the rowing machine within six minutes of recovery, but doing that, you know, several times. And then at the end, right, you're generating several millimolar of lactate.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So I think anything like that that's gonna get you in that zone, it just requires, you know, maximum effort for even just, like, 20 to 40 something seconds, even with several minutes break in between, you're gonna be hitting that.
- TFTim Ferriss
So imagine the gold standard, do you have some guy in a lab coat and with a clipboard who pricks your finger or something and does these blood draws to determine the millimolar concentration of lactate? Is there a breathable option as there is with ketones, right? Where you can measure acetone through something that looks like a breathalyzer as opposed to a finger prick for BHB. Does anything like that exist?
- TWDr. Tommy Wood
No. They're working on continuous lactate monitors.
- TFTim Ferriss
Yeah.
- TWDr. Tommy Wood
Some people do sort of have those. They're near being commercially available, so some people do have access to those already.
- TFTim Ferriss
Ooh. All right.
- TWDr. Tommy Wood
But equally, I would argue that it doesn't matter that much. Just, like, go and do something really, really hard for a short period of time and do that a few times over, and do that relatively regularly. Like, that's probably enough majoring in the minors that you need to do-
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
... to kind of get, get that benefit.
- TFTim Ferriss
Sounds like my sled assignment. I do love my sled pushing and pulling. You can definitely wipe yourself out with that stuff. Okay.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
All right. Without necessarily the impact of me trying to run from wolves on a treadmill or something.
- 58:51 – 59:50
Announcing The Stimulated Mind: Tommy’s brain-saving book.
- TFTim Ferriss
Okay, I do wanna take a brief commercial break, but it's not for any sponsor. It's just to mention that, and then we're gonna kind of dive straight back into the programming and discussion, but you have a book that is coming out shortly called The Stimulated Mind. It goes through all the stuff we're talking about and a lot more. People should pick it up. That's Dr. Tommy Wood, obviously, but The Stimulated Mind. There's so much horseshit and charlatanism floating around out there in the world of anything related to cognition and memory. It's part of the reason, [laughs] this kind of segue is a little awkward, but I was like, that's part of the reason I wanted to have you on, was not to highlight necessarily that, but the antithesis of it, which is someone with real clinical expertise, research credentials, who is also a practitioner, right? It's like you walk the walk. And I wanted to ask you,
- 59:50 – 1:01:09
Foundation supplements: Omega-3s, B vitamins, vitamin D, iron, and magnesium.
- TFTim Ferriss
you mentioned supplements earlier, and of course everybody loves to hear about supplements, but what are some that may not be on the usual list of [laughs] suspects, so to speak? I mean, one I- I would love to hear you speak to is CDP-choline.
- TWDr. Tommy Wood
Mm.
- TFTim Ferriss
People might not think of xylitol as a supplement, but certainly you could argue that maybe there's a place for it. Do you wanna add anything to that and just expand on those?
- TWDr. Tommy Wood
Sure, I can expand on those. I think that the supplements that we have the best evidence for, they start with those core nutrients that we could get from the diet, but if we don't, then we definitely should supplement. So we've mentioned omega-3s, the B vitamins, especially those involved in methylation, so that's vitamin B12, folate, which is B9, riboflavin, which is B2, and then B6.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Vitamin D, obviously critical. Iron supplementation, particularly if people are anemic.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So that requires a whole assessment for, like, why are you anemic in the first place, but often particularly more common in women, and many of the symptoms that women may experience around perimenopause are associated with inadequate iron status. So getting your iron status checked and addressed is really important. Magnesium, certainly critical as well.
- 1:01:09 – 1:02:58
Polyphenols, choline, and the case for eating more liver.
- TWDr. Tommy Wood
If we're thinking about other things that do seem to have both an acute and long-term benefit in terms of cognitive function, then All the kind of antioxidant polyphenols are very interesting, particularly those that come from berries, but related ones in coffee, tea, on the skins of roasted nuts and seeds.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
They have similar effects. And then, so you mentioned choline, and right at the beginning when we were talking about omega-3s, I think choline is critical because of its importance as a head group for fats to be attached to in membranes.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
That's maybe one of the reasons why it's important for the brain, and various estimates suggest that we're becoming increasingly choline deficient as, you know, we stop eating things like eggs and liver, which are our richest sources of dietary choline. But there are randomized controlled trials in two different settings that we've talked about already. So one in older adults already experiencing some degree of cognitive decline, where supplementing with CDP-choline, which is also called citicoline, seems to improve certain aspects of cognitive function. And then again, after traumatic brain injury, there are meta-analyses that show that supplementing with CDP-choline can improve some neuropsychological outcomes, in particular after TBI. So I think most of us can probably get choline from the diet, but in some of these cognitively degraded states, we might call them, you know, something like 500 to 1,000 milligrams a day of-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... choline seems to be beneficial.
- TFTim Ferriss
Do you take it or do you just get it from eggs and so on?
- TWDr. Tommy Wood
No, I get it from eggs and liver and some seafood. Sardines have some choline in, as do some whole grains, like oats have some, quinoa has some.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So all of it kind of adds
- 1:02:58 – 1:04:10
Creatine: Tommy’s 10-gram cognitive stimulant ritual.
- TWDr. Tommy Wood
up. I don't supplement with choline. I do supplement with creatine. I don't have the perfect trial that creatine is gonna prevent dementia, but I think we've seen enough interesting data across depression, again, sleep deprivation.
- TFTim Ferriss
Sleep deprivation. How many grams do you take daily? What's your standard daily dose?
- TWDr. Tommy Wood
I take 10 grams every day.
- TFTim Ferriss
Single dose or divided? Doesn't matter?
- TWDr. Tommy Wood
So I take it all in one go in the morning. There's some evidence that suggests that once you get above five grams, you probably start to saturate creatine up to your transporters, so maybe you don't take all of it up. But the reason why I take it all in one go is because I remember to take all of it in one go. Another reason is that I find creatine to be quite stimulating, quite cognitively stimulating for me.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
So w- you took your ketones, I took my creatine before-
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
... I got on this call.
- TFTim Ferriss
I took five grams of creatine too. [laughs]
- TWDr. Tommy Wood
[laughs] And so if I take creatine later in the day, I don't sleep as well. It's very noticeable for me, but it's not... that's not the case for everybody.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Some people take creatine and they don't notice a cognitive effect. They, doesn't affect their sleep. So it's very different from person to person. And so those are the reasons why I just take it all in one go in the morning. But
- 1:04:10 – 1:06:35
Cheap creatine temptation leads to lavatory lamentation.
- TWDr. Tommy Wood
especially if you're gonna take over 10 grams, 20, 30 grams, you're probably best splitting it up into several doses so that you absorb more of it.
- TFTim Ferriss
Yeah. [laughs] Or 30 grams at one go also is tempting the gods to-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... smite you with [laughs] a really bad bathroom situation. [laughs] Yeah.
- TWDr. Tommy Wood
So yeah, and a lot of people do mention GI side effects from creatine. I think some of that is due to the quality of the supplement that you're taking.
- TFTim Ferriss
Yep. I agree.
- TWDr. Tommy Wood
So if you're taking Creapure creatine monohydrate, that's what most studies that have tested creatine have used, and there was actually a systematic review meta-analysis that just came out that found that across all the studies they could find compared to placebo, creatine didn't have any additional GI side effects.
- TFTim Ferriss
Mm.
- TWDr. Tommy Wood
But also, those studies use high quality creatine. Also, not all of those studies use 30 grams. So you could certainly get to a point where you're gonna start to have GI effects based on dose.
- TFTim Ferriss
I think it also has to do with the fact that my, like, polypharm in the morning when I'm just getting booted up, it's like I might be having the coffee plus the creatine plus, you know. [laughs]
- TWDr. Tommy Wood
The MCT oil. Yeah.
- TFTim Ferriss
Like sardines with MCT oil.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Yeah. I mean, there's a lot going into the cocktail of potential disaster, which you do acclimate to. Quick question before I forget. On lactate-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... is there any argument to be made for anything that you would ingest or otherwise put into your body, not to avoid doing the intense exercise, but to increase the amount of lactate that you uptake into the brain? Or is, is that something that people have looked at or is that just risky business and to be avoided 'cause you'll end up in like, I don't know, some type of acidosis or some other problem?
- TWDr. Tommy Wood
People have looked at exogenous lactate itself, right? Usually as lactate salts, just like people have looked at ketone salts.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
You can bump up blood lactate a little bit, but similar to ketone salts, they, you don't get nearly the, the increase as you do with other compounds. You don't need to do anything to increase brain uptake of endogenous lactate because the brain will generally just take up as much as you've got, similar to ketones, right?
- TFTim Ferriss
Yeah. I, I think I misspoke when I was asking the question.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
I guess it was just increasing the amount of circulating lactate so your brain just sucks it up like a vacuum.
- 1:06:35 – 1:13:55
Blood flow restriction training: High lactate, low load, maximum travel convenience.
- TWDr. Tommy Wood
I think you can make plenty of lactate yourself.
- TFTim Ferriss
Mm.
- TWDr. Tommy Wood
So, you know, another way to do it, blood flow restriction is another great way to produce lactate with low load, and there are some studies where that, well, they have them do leg presses, but, like, sets of 20 leg presses wearing blood flow restriction cuffs.
- TFTim Ferriss
[laughs] Oh, man.
- TWDr. Tommy Wood
That will get you up there as well. Again, several millimolar of lactate. Like, it's not fun. [laughs]
- TFTim Ferriss
I think I'd rather do the Norwegian's 4×4. Uh, yeah. Oh, wow. That's intense.
- TWDr. Tommy Wood
That's another way to do it.
- TFTim Ferriss
Yeah.
- TWDr. Tommy Wood
If you, for whatever reason, don't want to do sprints on a rowing machine or... Like, you can, you can probably get up there with some blood flow restriction under low load-
- TFTim Ferriss
Mm
- TWDr. Tommy Wood
... and high rep. But no, I, I don't think there's anything that I would take to increase lactate.
- TFTim Ferriss
Okay. Got it.
- TWDr. Tommy Wood
Just because you can make it so easily yourself.
- TFTim Ferriss
All right. I wanna hop on the blood flow restriction. What- Make and model do you use? What's your kind of tool of choice for the BFR stuff?
- TWDr. Tommy Wood
I use the B Strongs.
- TFTim Ferriss
Excuse me? [laughs]
- TWDr. Tommy Wood
The company is called B Strong.
- TFTim Ferriss
B-E Strong.
- TWDr. Tommy Wood
No, no, capital B Strong.
- TFTim Ferriss
Oh, okay. Got it.
- TWDr. Tommy Wood
I have no real-
- TFTim Ferriss
Affiliation?
- TWDr. Tommy Wood
I have no affiliation with them other than, like, I know some of the guys who work there, but I paid for my device myself.
- TFTim Ferriss
Mm.
- TWDr. Tommy Wood
So it has leg and arm cuffs, but it comes with, like, a sphygmomanometer, right? L- one of those blood pressure things to kind of pump it up to get the pressure. Those are the ones I use.
- TFTim Ferriss
Yeah, nice and simple. I'm testing a few different ones right now. So when you travel, right, people think of exercise as this thing that involves, potentially, right, all sorts of machines and you need your kit. There can be a lot of excuses or things that people imagine as obstacles that are not, in fact, obstacles.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
So talk to me about your exercise when traveling with blood flow restriction. What does it look like?
- TWDr. Tommy Wood
As my wife calls it, I have my gym in a bag, which I take-
- TFTim Ferriss
Yeah
- 1:13:55 – 1:30:24
Language learning, music, StarCraft, and why your brain needs to fail.
- TFTim Ferriss
feel free to chime in. I wanted to talk about cognitive stimulation, right? So we spoke about dancing earlier. Could you speak to language learning and music? 'Cause I'm realizing, I think accidentally, I might have really helped my brain a lot early, which is great as a surprise. But also have next to me an Ohana ukulele, which was gifted to me, that has basically just been gathering dust. And after doing prep for this and then looking into it, I'm like, you know what? I should spend a couple of minutes a day just screwing around with this.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
It seems like a great use of time. But could you speak to music and language learning?
- TWDr. Tommy Wood
So this actually, if we include dance, this comes back to something that, that we kind of started talking about earlier, which is, you know, what are these experiences or what are these activities that you can do with the brain that kind of maximally activate it or increase glucose uptake?
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And there was a really interesting study that came out recently called Creative Experiences and Brain Clocks.
- TFTim Ferriss
Creative Experiences and Brain Clocks?
- TWDr. Tommy Wood
Brain Clocks, yeah.
- TFTim Ferriss
[laughs] Okay.
- TWDr. Tommy Wood
I'll break that down into... There's different components. Kind of like when you did an MRI scan for your brain-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... and all those other tests you did. There are various different ways that people can sort of like estimate how old the brain looks.
- TFTim Ferriss
Right. And I don't know if that's hugely BS or not. I don't know.
- TWDr. Tommy Wood
It's a bit of both.
- TFTim Ferriss
Yeah. [laughs]
- TWDr. Tommy Wood
But in this context, I think it's, it's kind of useful because when you think about what happens to the brain as it ages, there are a few things that happen, right? The structure changes, different parts of it gets smaller, right? You lose volume. But then functionally, it also changes. The different networks that we have in the brain that have different functions and activities, they become less discreet and they become more distributed, right? So you get less of these kind of very functions specific, you know, tightly knit networks and connections, and then everything just like, just becomes a little bit more sort of like loose and different areas of the brain get connected together and it's, it's sort of like a bit more of a mishmash. You get this increase in entropy. Initially, what we call this brain entropy, right? It's not as discreet. Entropy then decreases again as we get towards the end stage of dementia, just because there's not much going on in there unfortunately anymore.
- TFTim Ferriss
[laughs] Sorry.
- TWDr. Tommy Wood
Sorry. That's the best way I can put it.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
And so when you look at different ways to quantify how old this brain looks, one way is to look at the structure and the connectivity of the networks.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And how like discreet they are. Things like the fronto-parietal network, the salience network, right, the attention network. Like these parts that are really important for like executive function, focus, attention, all this kind of stuff.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And they tend to lose function as we get older. And the easiest way to do this is with EEG, so electroencephalogram, where you measure the electrical activity in the brain. And so in this study, what they did is they took a whole bunch of different studies and they looked at these different creative experiences. So one was tango dancing, one was language learning, then there was musicians, they had artists, and they also had video gamers. And they had an interventional study where they had people learn the video game. And it was StarCraft was the game that they used, just in case anybody was wondering.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
Although if we're talking about video games as a cognitive stimulus, the one that has the best evidence is Super Mario 3D World, just in case you were interested.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
Lots of studies for that actually. And what they did is they compared amateurs to experts, and then they also looked at the effect of an intervention where people actually, you know, were trained in this thing. And as you increase in expertise in these different creative like complex arts, you see improved structure and discreetness of these like really critical networks that are susceptible to aging as we get older. But the effect was similar in tango dancers versus those who are bilingual versus those who are artists versus video gamers, right? So there's some core effect-
- TFTim Ferriss
Mm
- TWDr. Tommy Wood
... of these like complex, like multi-sensory stimuli that require us to gain significant expertise and skill in order to perform them that seem to have this, this broad effect.
- 1:30:24 – 1:37:38
Sleep anxiety, air pollution, and gum disease: the overlooked dementia risk factors.
- TWDr. Tommy Wood
plasticity.
- TFTim Ferriss
So w- what else do you have in your personal regimen of kind of non-negotiables, right? You got... Obviously you're lifting weights.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
You're doing your blood flow restriction torture-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... every once in a while. I don't know if you're much of a ballroom dancer. [laughs]
- TWDr. Tommy Wood
[laughs] I was a, a field raver in my youth-
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
... but I was never much of a ballroom dancer.
- TFTim Ferriss
Get that man some glow sticks.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
So a big part of the reason I got elbow surgery was to get back into rock climbing-
- TWDr. Tommy Wood
Mm
- TFTim Ferriss
... which I think is just a phenomenal, phenomenal sport for mental and physical development.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
I mean, it's just a kinesthetic puzzle on a wall. I mean, and was really inspired over the last two years seeing people in places like Colorado, you know, Idaho, Utah, where I'd go into these gyms and you see people in their 60s and 70s who are doing stuff that I can't even imagine doing physically.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
And they meet a couple times a week, and I was like, wow, okay, if you can have that kind of longevity in this sport, like, that seems like a great investment.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Plus, I just really, really enjoy doing it.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
But what are some other non-negotiables, right? If you look at all the possible things you could do, all the things you do, and you're like, "All right, these are the things that are meaningful and that I stick with consistently," what falls in that bucket, right? Because a lot of people will get these, like, 27 things, 47 things you can do to improve your brain health lists or whatever.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Even if they want to do all of those things, there's no way they're going to.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Right? So there's a question of sustainability or, or adherence as well, right? So yeah, what are some of the other non-negotiables for you?
- TWDr. Tommy Wood
The one that we haven't talked about that, that really is non-negotiable is sleep.
- TFTim Ferriss
Yeah, let's talk about it.
- TWDr. Tommy Wood
I think this is the major thing that's missing from these studies looking at dementia prevention, like, as a, as a risk factor. And I think inadequate sleep, you know, really seen in, like, so many studies now is associated with increased risk of dementia. So that's something that I very consistently make sure that I get enough of. That's, like, the one thing that really is non-negotiable. Like, I don't mind if my diet gets a bit crappy for a few days, or I don't mind if I can't get to the gym for a few days. Like, this stuff integrates over months and years.
- TFTim Ferriss
Mm-hmm.
- 1:37:38 – 1:44:15
Air purifiers, CO2 levels, and sleep optimization hacks.
- TFTim Ferriss
That's part of the reason not to keep banging on this drum because I know it's not the shoe that fits everyone, but that's another reason for my fascination with ketones.
- TWDr. Tommy Wood
Mm-hmm.
- TFTim Ferriss
Just remarkably anti-inflammatory on a couple of different levels. So for folks who might be wondering, and we'll put these in the show notes as well, air purifiers. Do you mind if I just read from this email that you sent to me?
- TWDr. Tommy Wood
Sure.
- TFTim Ferriss
'Cause of course I'm such a stickler. I'm like, what exactly make and model?
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
I'll just read from this. The blood pressure study I mentioned, this is I equals Tommy-
- TWDr. Tommy Wood
Yeah
- TFTim Ferriss
... used the HealthMate, that's one word. Jaspr is good, that's J-A-S-P-R, as are most of the Blueair, one word, Blueair models tailored to the size of the room. The Coway, C-O-W-A-Y, AirMega is a good budget option.
- TWDr. Tommy Wood
Mm.
- TFTim Ferriss
So we'll link to all these in the show notes. This is one, God, with travel, such a pain in the ass, although I think it was James Nestor who wrote the book Breath-
- TWDr. Tommy Wood
Yeah
- TFTim Ferriss
... who was giving me just some horrifying quantified self data related to looking at, like, CO2 concentration in various hotels-
- TWDr. Tommy Wood
Mm
- TFTim Ferriss
... [laughs] and airplanes and so on. I don't think he'll stay in a hotel that has sealed windows.
- TWDr. Tommy Wood
Mm.
- TFTim Ferriss
I think it's kind of part of his policy these days.
- TWDr. Tommy Wood
Yeah, high CO2 really negatively impacts sleep.
- TFTim Ferriss
Yeah.
- TWDr. Tommy Wood
So, like, lots of people in a small room that's not ventilated, that can definitely negatively impact sleep, so we always have a window open or something-
- TFTim Ferriss
Yeah
- TWDr. Tommy Wood
... for that reason.
- TFTim Ferriss
Anything else that you do for sleep, besides not becoming too orthorexic about it and, like, freaking out on the wearables and stuff, which is a real thing for sure?
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
Besides recognizing that you're gonna be fine, humans have been dealing with this for a long time, what else would you say, right? I would imagine, you know, there are things people have probably heard, like keeping the temperature sort of whatever it might be, right, 65 to 70 degrees Fahrenheit-
- TWDr. Tommy Wood
Mm-hmm
- TFTim Ferriss
... et cetera. Other things that you find particularly helpful?
- TWDr. Tommy Wood
Things that have helped me a lot, I stop work before dinner. I don't do work after dinner unless I really, really have to, and that helps a lot because I find I ruminate a lot more if I, if I do work late into the evening. A basic shutdown routine, I put on the blue light blocking glasses. They're probably just placebo at this point, but, like, I put them on and, like, my brain is like, "Oh, it's bedtime."
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And then, you know, I read fiction before I go to sleep. I have a... quite a recent purchase was an Eight Sleep, which has been amazing because I tend to-
- 1:44:15 – 1:47:22
DORAs for sleep quality: when cognitive stimulation isn’t enough.
- TFTim Ferriss
Uh, all right, so sleep. Do you have a position on DORAs?
- TWDr. Tommy Wood
Hmm.
- TFTim Ferriss
On dual orexin receptor antagonists. 'Cause I've chatted with folks, including Matt Walker, who's, you know, very credible in the space with respect to sleep research, that the potential that DORAs could help with the clearance of beta amyloid, what is it, P-tau 217, et cetera, and possibly be of some help in preventing the accumulation of things that later contribute to Alzheimer's. I mean, it's, it's not like the vote is in and it's 100%.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
But there seems to be a couple of interesting publications around it, including in humans. Do you have a position or any thoughts on it?
- TWDr. Tommy Wood
So, like very quickly, we know that sleep quality and quantity affect amyloid accumulation in the brain. That can be seen over short periods and long periods.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And some of that work is from, from Matt Walker's lab.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And he's even done studies that show that later in life, if you can improve the amount of sleep that you get, then that's associated with a lower overall amyloid burden.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
I think that some of this, like we get very focused on amyloid, it's a part of the picture of Alzheimer's dementia, just like you said, it's not the full picture. But I think we, we look at it and it's kind of, it's a marker for all the things that you should be clearing out of the brain when you sleep that you aren't, right? Amyloid is one of those things. There are probably many other things as well.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
So the DORAs have now several studies in different states, you know, with in insomnia, in sleep apnea, you know, these states where we know people are getting lower quality sleep, and they certainly seem to improve that. I think that in individuals who have some kind of sleep issue, be that insomnia, something else that's going to prevent high quality sleep, then improving that is certainly gonna be beneficial. Right now the DORAs are now the best option. Previously, you know, people recommended trazodone, which is like-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... you know, we talked previously like the least worst option because it doesn't negatively affect sleep architecture unlike many of the other sedatives that people might use to help sleep. But if you're sleeping fine or you manage to maintain high quality sleep as you get older, I don't think we need to start taking DORAs to prevent Alzheimer's because I think your sleep is probably already doing the job that it's doing. And there are studies that show that increased cognitive stimulation in older adults improves sleep quality-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... or that engaging in cognitively stimulating activities helps to offset some of the potential increased risk that we would have with poor or less good deep sleep, which is when a lot of this clearance happens. So I think a lot of the other things that we mentioned already, physical activity we know improves sleep quality. So I wouldn't jump straight to DORAs, but in somebody who, who does have insomnia and say CBT-I, so CBT for insomnia doesn't help them, or some of these other things that we can do to improve sleep and those don't work-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... and you've ruled out anything sinister, then, you know, I think they are now, they're now our best option to help support sleep.
- 1:47:22 – 1:49:03
The thesis behind The Stimulated Mind: Practical, referenced, and sustainable.
- TFTim Ferriss
All right. We have covered a lot. I want to know why you decided to do something very difficult, which is write a book, The Stimulated Mind. What was the driver behind this and who is the book for?
- TWDr. Tommy Wood
I like to joke that the book is for anybody with a brain.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
The subtitle is about preventing dementia, but really a ton of it is just about cognitive function and cognitive performance in general, so even people who are younger and aren't thinking about dementia yet. Although, like you said, it's worth thinking about it earlier than you think. So I, I think for most people who think about how their brains work or want their brains to perform better and/or want to prevent or decrease their, minimize their risk of dementia long term, it's got what I think the big rocks and the tactics for how to address those that we know substantially increase dementia risk. All those things we talked about earlier that kind of contribute to those dementias that are potentially preventable. And the reason I wrote it is because I didn't think that book really existed. Like, people might focus on one particular area or they might focus on everything, right? There are books on dementia prevention that are just like endless tables of blood tests and supplements and this stuff that just like most people are never gonna do, right? It's not gonna be sustainable.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
I didn't really see a middle ground. But equally, I wanted it to be very heavily referenced. So if people want to get into the references, I have a reference list, it's gonna be 2,000 papers all in humans like, and it's cited in the text, right? I have like little superscript citations in the
- 1:49:03 – 1:50:14
Kelly and Juliet Starrett’s stamp of approval.
- TWDr. Tommy Wood
text.
- TFTim Ferriss
You teased the subtitle a little bit. It's a good subtitle. I so want to give it some real estate here.
- TWDr. Tommy Wood
Uh-huh.
- TFTim Ferriss
So The Stimulated Mind, subtitle, Future-proof Your Brain from Dementia and Stay Sharp at Any Age. I'm looking at the Amazon page for the first time. I hadn't looked at it.
- TWDr. Tommy Wood
Mm.
- TFTim Ferriss
I had no idea that you know Kelly and Juliet Starrett. Those are two very close friends of mine.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
And you got a very nice quote from Dr. Kelly and Juliet for the book. That's fantastic.
- TWDr. Tommy Wood
I only really connected with them about a year ago, but they've been-
- TFTim Ferriss
Mm-hmm
- TWDr. Tommy Wood
... some of the most... Like, I just have... Like, they've been so, so helpful. Like, "What do you do when you wrote a book, and how do you get it out there, and how do you get people to read it?"
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
Like, they've given me so much of their time and help. They've just been, they've been amazing.
- TFTim Ferriss
They're fantastic. All right, so Dr. Wood, that's you, explains that a brain that improves with age is the result not of expensive pills, far-off discoveries, or strict lifestyle optimizations, but rather of actions within our control: diet, sleep, physical activity, social connection, stress tolerance. And obviously, it goes on and on. But clearly, you have a lot of very practical, specific advice that people can implement. And
- 1:50:14 – 1:51:30
The beautiful compounding effect of fixing just one thing.
- TFTim Ferriss
what else makes this book different?
- TWDr. Tommy Wood
Those things that I mentioned make it different. I think it's, it's very practical and approachable, but very science driven. And if people wanna like, dig into the references, th- those are available. And then I think, like towards the end, right, after I've given you... Like, there's all these different areas where we talked about nutrition, sleep, physical ex- exercise. I give like, how you would approach each of those things in terms of supporting cognitive function and minimizing dementia risk. But then I kind of bring them together in a model of how I think people can implement this in their daily lives. Like, how do I just pick one thing? And actually, does picking just one thing help to support, like, the overall function of the brain? And, and the answer is yes, it does. Because when you sleep better, so say if you focus on improving sleep, right, you're more sociable. You're more likely to engage in cognitively challenging tasks. Your blood sugar improves, your blood pressure improves, right? So just changing one area, suddenly the whole network shifts in your favor, and that's the case from almost anywhere you, where you kind of approach it. And I think that means that people are much more likely to actually start doing this stuff and realize that it doesn't require a ton of work to start moving the needle. And then these things, you know, sort of compound over
- 1:51:30 – 1:53:37
Who is Dr. Ragnar, and does he make housecalls to Valhalla?
- TWDr. Tommy Wood
time.
- TFTim Ferriss
All right. The Stimulated Mind, folks. Go grab a copy. Obviously... You know I hate when people say obviously, but I'm gonna say it.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Obviously, Dr. Tommy Wood has the credentials, has the expertise, has the bonafides with respect to research in humans, and has provided a lot that you can use in this conversation, and a lot more is in The Stimulated Mind, so check it out. Why on earth is your X account called Dr. Ragnar?
- TWDr. Tommy Wood
Oh. [laughs]
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
I first started blogging around the time you first started podcasting.
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
I remember listening to your, like, first interviews with Dom D'Agostino back in the day when I was, like-
- TFTim Ferriss
Way back, yeah
- TWDr. Tommy Wood
... in my PhD, check, writing blog posts. But my middle name is Ragnar.
- TFTim Ferriss
Oh. [laughs]
- TWDr. Tommy Wood
So, like, I created a website. It was Dr. Ragnar. That was, that was initially where I did my stuff.
- TFTim Ferriss
So let me think about this for a second. I'm gonna make myself probably regret asking this question.
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
But what does Ragnar... Does Ragnar mean anything? 'Cause now I'm thinking of Ragnarok and if those two have any connection. Is, does it mean anything in particular?
- TWDr. Tommy Wood
No. So you're right, like Ragnarok is like the final battle of, for Valhalla, right?
- TFTim Ferriss
Mm-hmm.
- TWDr. Tommy Wood
And actually, there are, like, some online gaming accounts where I use the name Ragnarok.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
But I think what it means, the translation for the Old Norse is like wise counselor. I think that was another reason why I picked it, because it was ve- I'm very self-important as a, as a 30-year-old-
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
... health blogger. But it was my grandfather's name, and-
- TFTim Ferriss
Mm
- TWDr. Tommy Wood
... then these names sort of get passed down in the family. Technically, it should have, 'cause I was the firstborn grandson, it should have been my first name, but my dad was English, and he was like, "People are just gonna make fun of him at school. He's gonna get bullied-
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
... if he's called Ragnar." It's very cool now, right, because of Vikings and, like all these other, all these other TV shows where Ragnar now appears.
- TFTim Ferriss
[laughs] I mean, you could make it work, but Dr. Ragnar Wood also is a little s- [laughs] has kind of a strange combo.
- TWDr. Tommy Wood
Yeah. Yeah, yeah.
- TFTim Ferriss
One, two to it.
- 1:53:37 – 1:54:53
Tommy’s open invitation for complaints and scientific debates.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
To be honest, I don't use X.
- TFTim Ferriss
[laughs]
- TWDr. Tommy Wood
So you can follow me on X, but you won't see anything.
- TFTim Ferriss
But people can find, presumably there's something at drtommywood.com. D-R-
- TWDr. Tommy Wood
Yeah
- TFTim Ferriss
... tommywood.com.
- TWDr. Tommy Wood
Yeah.
- TFTim Ferriss
So that is the home base online. And then?
- TWDr. Tommy Wood
Instagram.
- TFTim Ferriss
Instagram.
- TWDr. Tommy Wood
@drtommywood. Again, drtommywood.
- TFTim Ferriss
@drtommywood. All right, folks. So you got it. Check out The Stimulated Mind. I'm a huge fan of what you do. I am going to try to improve my chesticle and arm situation-
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
... with more use of BFR [laughs] and bands. And is there anything else you would like to say before we wind this to a close? Anything you'd like to ask of the audience, point them to, requests, complaints?
- TWDr. Tommy Wood
[laughs]
- TFTim Ferriss
Anything that comes to mind?
- TWDr. Tommy Wood
No. Other than, you know, if you do happen to pick up a copy of the book and you do have any complaints, do send them to me. One of the reasons why I wanted to make it so that, like, every statement that I have in the book has a citation, you can go, you can read that paper. If you disagree with my interpretation of it, I want to know. Like, I can't promise that I have all the answers.
- TFTim Ferriss
Mm.
- TWDr. Tommy Wood
So that will help me learn more. So yeah, if you have a complaint, just, uh, tell me about it.
- 1:54:53 – 1:55:28
Parting thoughts.
- TFTim Ferriss
All right, Tommy. I really appreciate all the time, man. This was great. Took tons of notes for myself, which is always a good sign, so thanks for carving out a bit of time to be on the show. Really appreciate it.
- TWDr. Tommy Wood
Thanks so much for having me. This was so much fun.
- TFTim Ferriss
Yeah. And for everybody listening, as per usual, we'll, uh, provide copious links and show notes at tim.blog/podcast, tim.blog/podcast. And until next time, be just a bit kinder than is necessary to others and also to yourself. As Jack Kornfield says, "If your compassion does not include yourself, it is incomplete." Thanks for tuning in.
Episode duration: 1:55:39
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Transcript of episode tTLLfUoOFLU
