Brain Health with Dr. Steven Masley: Rational Wellness Podcast 039

Dr. Steven Masley explains how to improve your brain health with Dr. Ben Weitz. 

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Podcast Details

1:30 I asked Dr. Masley how he came to write a book about the brain? Dr. Masley just published The Better Brain Solutionhttps://www.barnesandnoble.com/w/the-better-brain-solution-steven-masley-md/1126646685#/    Dr. Masley explained that in his clinic he looks at 100 markers of aging. He looks at arterial plaque growth, cholesterol, lipids, sugar, etc. He also looks at brain function, brain processing speed, memory, attention span, reactivity, and executive brain function. He also looks at food intake, nutrient intake, fitness, stress management, and toxic exposure. He has an easy to follow five step plan that improves brain processing speed by 25-30%.

2:45 I answered that that is great because cognitive problems, neurodegenerative conditions like Alzheimer’s Disease, are really on the rise and are now the leading cause of death in women, exceeding even cardiac and breast cancer. Dr. Masley said that he agreed and the number one most expensive disease is memory loss at $215 million per year and that is supposed to double in the next 12-15 years. It’s because the number one cause of memory loss is elevated blood sugar. I mentioned that some practitioners are now calling Alzheimer’s Disease Type III Diabetes due to this relationship between blood sugar and insulin resistance.

3:58 I asked Dr. Masley to explain what does blood sugar have to do with the brain? Dr. Masley said that it has to do with insulin resistance. Insulin is the hormone that helps us to store energy. When we eat carbs, whether it’s a healthy carb like broccoli or blueberries or whether it’s a refined carb, which causes a much bigger blood sugar surge like sugar or flour, the insulin rises in order to push the sugar into the cell. That’s a normal function, just like muscle cells. We push glucose in, and we build glycogen. When we go for our next workout, that glycogen in that muscle cell is ready to burn as energy. The challenge is if we don’t have a healthy lifestyle …if we don’t work out enough; if we eat too many refined carbs … our cells become full. They no longer respond to insulin. In fact, they become insulin-resistant. Once they’re full of energy, they say, “No, we’re not listening any more. We can’t store any more energy.”

Dr. Masley continued to explain that when brain cells become full of glucose, they shut down and stop working. Insulin resistance makes brain cells unable to process and use energy, so if we do a PET scan on the brain of someone who’s super fit and healthy, it would likely light up like a Christmas tree. When we do a PET scan and we look at energy burn on brain cells in patients with insulin resistance, it’s pretty quiet.  The brain is unable to process glucose’s energy. It’s dysfunctional. They have brain fog. They’re forgetful. They walk into a room; they don’t know why they’re there. They read a passage in a book, and they have to keep rereading paragraphs and they can’t remember people’s names.  Their brain’s not functioning, and if that’s not just a day or so, but it’s ongoing, that insulin resistance state, the brain cells being unable to use energy, they become dysfunctional. Then they die, and if they die, then every time a brain cell dies, the brain shrinks a little bit. If you have millions of brain cells dying, your brain is shrinking a lot, so insulin resistance, this abnormal blood sugar regulation, literally makes us unable to use our brain, shuts our brain down, kills off our brain cells, and it’s shrinking our brain. Nobody should want a shrunken brain. That’s what’s happening with this whole process, and it’s just … Who would’ve thought, at a time when blood sugar levels are high, that our brain cells would be starving? That’s normal physiology. That’s how our body works.

6:41  I interjected that an easy answer is to just have 10 Diet Cokes a day. We see what that does to brain shrinkage. Dr. Masley answered, Yeah, just shrink your brain like a grape to a raisin as quickly as humanly possible. That would be an effective way to finish yourself off.

7:03 I asked what is the best way to test for cognitive decline in your office? Dr. Masley answered that while there are many labs we could look at, like thyroid and blood sugar and sodium and mercury and B12, but he does cognitive testing on the computer.  These tests measure how your brain functions, looking at memory, both word memory and visual memory, as well as at brain processing speed and the ability to focus.  By doing such computer cognitive testing on a computer he can detect that someone’s having gradual cognitive decline 20 years before they have real memory loss, which gives you plenty of time to try to prevent it.

8:04 I asked which test he likes the best? Dr. Masley said that he uses CNS Vital Signs, Central Nervous System Vital Signs.

8:19 I said that in your book, The Better Brain Solution, you mention you write about 12 foods that will promote brain health. Which are these brain-healthy foods?

Dr. Masley said that he organizes these foods into groups. One group would be those with plant pigments, things like green, leafy vegetables; blueberries and cherries, those anthocyanins; dark chocolate. Those pigments literally protect our brain from oxidation and inflammation. They block it. One cup of green leafies a day, and your brain is literally 11 years younger than someone who doesn’t eat green, leafy vegetables. These plant foods are really pretty powerful, and we need more of them. Even coffee is beneficial, whether it’s decaf or not. It’s the pigment in coffe that protects our brain, rather than the caffeine.  Now with coffee, one or two cups of coffee has a benefit, maybe three. Four or more is actually harmful.  We call that a J-shaped curve. A little bit is good; excess is not better. That also applies to alcohol. Red wine in moderation also improves brain function and decreases cognitive decline, one or two servings with dinner.  Hard liquor and beer had no benefit, and if you drink more than two, three servings a day, no! It’s not good. All these are plant pigments, so those are all plant pigments that are good.

Another category is smart fats.  Our brain is mostly fat by weight. It’s 40 percent fish oil by weight, and 60 percent fat. We need healthy fats in our diet, and the idea of a low-fat diet to me is crazy. It’s now a closed case. They did the largest study probably ever with the low-fat diet versus a Mediterranean diet where they added more extra virgin olive oil or they add extra nuts, and by adding nuts or olive oil, brain function improved and cognitive decline slowed down. Those on the low-fat diet, their brains just kept shrinking, and they had increased dementia. Yes, we need healthy fats, like cooking with avocado oil and eating avocados and wild salmon and all the seafood that’s so good for us. Extra-virgin olive oil, nuts, dark chocolate, those are all great fats for our brain that we want more of.

Dr. Masley continued, that we need spices and herbs, because they’re anti-inflammatory. His favorite spices are Italian herbs, especially rosemary, and curry spices like tumeric. Those are very anti-inflammatory and they block oxidation,  He would also include a probiotic in the foods that have been shown to protect their brain.

11:29 I said that in your book, when you were talking about the healthy fats, I noticed that there was one healthy fat that’s really embraced by the functional medicine community today, and that’s coconut oil. It’s frequently mentioned as a fat that you should purposely take to promote brain health, but I get the impression that you’re not entirely convinced that coconut oil is a healthy fat.  Dr. Masley explained that he thinks of MCT oil (medium-chain triglycerides) from coconut oil as more of a supplement, which has been used in clinical studies and shown for people with mild cognitive impairment to improve their brain function.  But coconut oil only has 20 percent medium-chain triglycerides and it’s mostly other forms of fat.  Dr. Masley said that he uses coconut milk in his recipes in his Better Brain Solution book. But he doesn’t feel that we have the data for coconut that we do for MCT oil.

Also, there is one cardiac concern about coconut oil in people who have known cardiovascular disease, when we give them coconut oil versus olive oil, they showed endothelial dysfunction. Their arteries literally constricted, and they showed increased oxidation. Dr. Masley doesn’t recommend people with known heart disease or people who are being treated with cholesterol meds add coconut oil, because it can increase cholesterol 50 to 70 points.  For athletes, coconut oil is a great fuel source. If I’m on a two-, three-hour bike ride, I’m probably going to use coconut milk in my shake before I go to get those MCTs. I think of it as a healthy food source. I think it’s probably good for the brain but not proven. It’s great for athletes, but I’m still waiting to see. We don’t have the proof like for olive oil or for nuts or for seafood, which clearly have been shown to have brain help. We don’t have that yet for coconut oil, so I’m glad you asked.

14:01 I asked Dr. Masley if the worry is because of the saturated fat content, and what he thinks about the role of saturated fat in heart disease? Dr. Masley explained that he doesn’t think know that saturated fat is harmful and the bigger question: Is it clean? Does it have pesticides? If you’re eating meat and butter, is it organic? Is it from from a feed lot where they used Round-Up and all these chemicals? He’s much more concerned about, “Is it a clean fat?” than, “Is it saturated fat?”

There’s a caveat to that, which is that the 20% of people who have the APOE-4 genotype.  They tend to have more oxidation, more inflammation, have a higher risk for heart disease, for memory loss, and Alzheimer’s disease.  They tend to have very high cholesterol, so for them, saturated fat tends to increase their cholesterol even more, and there’s actually studies that show in the APOE-4 folks, that more saturated fat increases beta amyloid production.  Those with APOE-4 genotpye should keep saturated fat intake moderate, like no more than one or two servings per day.

16:12  I asked what is the best oil to use for cooking?  Depending upon which chart you look at, there’s a lot of controversy which temperature different oils burn at and which is the best oil to use depending upon what temperature you are cooking at.   Is it okay to use coconut oil at high heats? Dr. Masley said that if you use extra virgin olive oil, the smoke point’s 400, so he never goes above 375.  Coconut oil has an even lower smoke point–350, so it’s not a good oil for high heat cooking, but most people think that it is.  If the smoke point’s 350, he will only use low or medium-low heat. Rather than coconut oil, Dr. Masley prefers to use avocado oil, because it tolerates up to 520 degrees. If you use use coconut oil or coconut milk in a curry or a recipe like that, you should wait til you drop the heat to add it.  For high heat, the best oils are pecan or avocado.

18:07 I asked what constitutes high heat?  Dr. Masley answered that high heat is more than 475 degrees. Medium-high, like when we saute vegetables and protein is about 450-475, so you could use almond or macadamia nut oil. Or you could use pecan or avocado oil. Another alternative would be ghee, clarified butter, which tolerates up to 475 degrees. Regular butter only has a smoke point of 350 degrees and it starts to be damaged and turns brown as with medium to medium-high heat. When you purify it and you cook it at low heat and the foam comes up and you scoop off all those bubbles and you’re just getting it down to an oil that is very stable. Ghee is basically clarified butter and can be heated up to about 475. Also most people who are dairy intolerant can tolerate ghee because almost all of the proteins are gone. 

19:48 I then asked what are the most important supplements for brain health? Dr. Masley talked about the benefits of vitamin D, mixed folates, extra B12 in the methylcobalamin form rather than cyanacobalamin, chromium, and magnesium, which you could get in a two pill multivitamin/mineral. Dr. Masley also recommends fish oil, a probiotic, and curcumin, which comes from the spice turmeric. Rather than test patients for MTHFR, Dr. Masley prefers to just give all of his patients the active form of B vitamins, since it is so safe. 

24:55 I asked Dr. Masley to explain how exercise is important for brain health. Dr. Masley explained that his clinic data demonstrates that the number one factor that improves brain processing speed … literally to make your brain quicker, sharper, more productive … is fitness. It’s not about how many minutes spent per week.  All the relationship is with how aerobically fit you are and your muscle mass and strength. Independently, aerobic fitness clearly helps brain processing speed and even increases the size of your brain and helps improve insulin resistance, which is the number one cause for memory loss. Strength training does, too. Independent to aerobic activity, adding more strength training, adding more strength, muscle mass, improves insulin resistance. It helps enlarge the brain. You get brain derived neurotropic factor BDNF that goes up.  80-year olds have been shown to increase the size of their brain when they add strength training, so we really want both aerobic work and we want strength training on a regular basis. 

26:44 I asked about the dosage–How long do people need to exercise for? How much should be strength versus cardiovascular training, and how many times a week should they exercise?  Dr. Masley answered that he does  fitness testing in his office, so all his patients are required to come in and do push-ups and sit-ups and sit and reach and VO2 Max Stress testing. They show up in gym attire, and that’s what my patients expect. Other doctors’ offices, they get a blood pressure. With Dr. Masley, they’re doing push-ups and running up a hill. He goes through their nutrient intake and harasses them over their food.  Dr. Masley explained that when he measures fitness, he compares his patients to their age group and he’d like them to be in the top third for someone 10 years younger than their age. Dr. Masley feels that 20 minutes of intense interval training three days per week can give you the same benefit 30 minutes of moderate activity five days per week.  An ideal routine would be do intervals three times a week, strength training twice a week and then add yoga once a week and then do a moderate, long thing on the weekend, like a 23-mile bike ride or like a two-hour bike.

28:57 I asked Dr. Masley about the software program Heart Math, which he talks about in his book?  Dr. Masley explained that with Heart Math the patient is hooked up to a monitor to measure their heart rate variability and they are asked to do a meditation exercise and see how calm and relaxed they can get in two minutes. Most patients are so stressed out that they are not very good at relaxing. Heart Math tells patients whether they are calm, semi-calm, or agitated. Dr. Masley works with them with different verbal cues to get them to practice relaxing, such as “Think of going to the beach.” It’s a really fabulous feedback tool to help people get calm.

32:17 I asked Dr. Masley about the role of toxins such as tobacco, mercury, pesticides, etc. in affecting brain health.  Dr. Masley answered that the brain’s the most sensitive part of your whole body to toxins. If you have elevated pesticide levels, you’re 350 percent more likely to get Alzheimer’s, so we really do need to worry about pesticides. Tobacco drops brain processing speed and overall cognitive function. Alcohol at more than one or two glasses of wine is also a toxin. BPA lined cans are also a problem and two cans per week increases your risk of diabetes and insulin resistance by 20%. Dr. Masley also said that people should stop cooking with plastic and putting plastic containers in the microwave. He also talked about the danger of eating deli meats, hot dogs, and bacon with nitrosamines, which have been shown to be neurotoxic and to kill brain cells. We can actually kill off and make rodents have Alzheimer’s just from eating the amount of bacon people would get from going to the restaurant every day. 


Dr. Steven Masley can be contacted through his web site https://drmasley.com/ where you can get a free Better Brain Shopping Guide or by calling his office 844-300-2973.  I highly recommend his book, The Better Brain Solution, which is available from Amazon and Barnes and Noble, https://www.barnesandnoble.com/w/the-better-brain-solution-steven-masley-md/1126646685#/

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure by calling the office 310-395-3111.


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