Brain Health with Dr. Austin Perlmutter: Rational Wellness Podcast 420

Podcast: Play in new window | Download | Embed

Subscribe: RSS

Dr. Austin Perlmutter discusses Brain Health with Dr. Ben Weitz.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

 

Podcast Highlights

---

Dr. Austin Perlmutter is is a board certified internal medicine physician, New York Times bestselling author, educator, and consultant. He co-wrote Brainwash with Dr. David Perlmutter and he is the Chief Science Officer at Big Bold Health.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

_____________________________________________________________________________________________________________________

---

Podcast Transcript

Dr. Weitz:  Hello, rational Wellness podcasters. Today I am excited to be having a discussion with Dr. Austin Perlmutter. Dr. Perlmutter is a board certified internal medicine physician, New York Times bestselling author, educator, and consultant. He co-wrote Brainwash with Dr. David Perlmutter and he is the Chief Science Officer at Big Bold Health.  And today we’ll be having a discussion about brain longevity. Dr. Perlmutter, thank you so much for joining us.

Dr. Perlmutter: Thanks for having me.

Dr. Weitz: So, let’s start talking about brain and neurological health and immune health and the connections between all these and longevity.

Dr. Perlmutter: So to start with, the most important thing, I believe the brain health is the only thing that really matters.  And let me contextualize that a little bit. We worry about other problems. So heart disease is certainly the number one killer.  We know that metabolic diseases create all sorts of havoc throughout our bodies.  We know that arthritis, for example, that affects about 54% of people who live to the age of 75 is incredibly debilitating, but why does all of that stuff matter?

It matters because it takes away from your quality of life, the quality of enjoying your life and the ability to enjoy life. To show up each day, to be able to get outta bed and participate in this world and enjoy it for all of its worth is a direct manifestation of what is happening. In that two to three pound organ that we call the brain.

So I realized that if this was the case, then I needed to do a better job of teaching people what to do to keep their brains not only in good health, but in great health across their lifespan. And just for a little bit more background as to why I care about this. So my father is a neurologist. He’s been focused on brain health for his entire life.

His father was a neurosurgeon, was focused on brain health for his [00:02:00] entire life. But in my family, I had two grandfathers with Alzheimer’s disease a disease for which, at least at the time of this recording, there is no meaningful scaled out cure and a disease for which we know we can take amazing steps for prevention.

And that’s just one of the many things that can happen to our brains as we age. So my goal in this conversation is going to be to talk through what we’ve learned about. What causes our brains to age more rapidly and what we can do to help slow the rate of aging and perhaps even reverse certain aspects of that aging process so that we can keep our brains not only basically functional, but working exceptionally well over the course of our lifespan because there really is no value to lifespan without brains span.

I don’t think most people realize this, but there’s not a lot of value to living many years if your brain isn’t coming along with you on the ride in a way that it is healthy. So that’s why brain longevity matters so much, [00:03:00] and I’m excited to get into some of science.

Dr. Weitz: Yeah, I absolutely agree with that.

And I think a lot of people’s worst fears is losing their brain slipping into dementia. And I think that’s one of the reasons why people are so worried about that. And are willing to do whatever it can take to promote better brain health. And certainly when it comes to all these chronic degenerative diseases the treatments for any of ’em are really not that great, and prevention is a much better solution if we can get that started.

Dr. Perlmutter: Yeah, and I’m hopeful that five, 10 years from now, if people listen to this, they’ll say, wow, that was before that amazing cure for Alzheimer’s came out, or before that wonderful new drug came out. I hope that’s the case, but we also need to be truthful about the reality that in 2025, there is no meaningful pharmaceutical way to reverse Alzheimer’s disease or even to slow it too significantly.

So what that means is. For each of us. And Alzheimer’s is just one of the things that we need to be preventing. It’s maybe [00:04:00] the biggest age-related brain decline of any sort of condition, but all of us need to be taking steps right now. If you’re listening to this, if you’re watching this, there is no better time in your life to take steps to protect your brain than today.

I guess yesterday is slightly better, but we don’t really have that opportunity. So today is the day. The steps that we take today can either determine if we are at higher risk for developing Alzheimer’s disease and general brain decline as we age, or at a dramatically lower risk for developing Alzheimer’s disease.

And whether you have an A POE four allele or even two alleles, the reality is that lifestyle modification is the single most important thing we know of that is capable of modulating our risk for developing Alzheimer’s disease. And so this is not just kind of an integrative topic. This is not a functional medicine topic necessarily.

This is just a medicine topic that the best available literature. Is telling us that if our goal is to, and I want to take this one step, it’s not just Alzheimer’s, but if our goal is to [00:05:00] slow the rate of our brain aging so that we can protect our brains over our lifespan so that they are partners with us and not just us kind of being carried along to whatever our brains decide they’re going to be doing.

And they, the years after age 50 or so. These are amazing steps that we can take. What’s super interesting for me and for the research that I’ve been doing is the understanding that there are core systems that modulate the speed with which our brains age. And these systems just to go over a couple are able to influence to a significant degree our overall brain health right now and in years to come.

And the ones that I’ve been most focused on are metabolism. So our brain’s, metabolic health immunity, our brain’s immune health, and then neuroplasticity, which is a technical term for the fact that our brains are perpetually rewiring themselves. And the relative ease and value of those connections has a significant role to play.

In our overall brain health. So these are kind of the neurobiological systems that undergird things like [00:06:00] mental health and cognitive health and importantly, we are able to influence those systems, whether they’re going to be kind of bias towards brain health or bias towards brain disease through the decisions that we make each day, and specifically through our lifestyle choices.

Dr. Weitz: So what are some of the biggest levers we can push when it comes to making these lifestyle choices? I know I’ve heard you speak talking about the fact that one of the biggest things we can do is make sure we optimize our sleep.

Dr. Perlmutter: Yeah. Well, there are many things we can do, and maybe before we get into some of the specific levers, I just wanna make a general disclaimer here because I think that it’s important for people to understand that in this era of sensationalism, the best data that we have for the things that are going to significantly.

Decrease the rate at which our brains age and significantly increase our chances of having a healthy brain into our later years. Our basic lifestyle modification, it’s not extreme diets, it’s not extreme supplements, it’s not extreme biotech [00:07:00] companies that are gonna give you some sort of a device that solves everything.

It’s doing the basics well. That is, again, 2025, the single best data point that we have. So. There’s definitely some value in doing the extreme stuff, but the majority of the value that people will get in terms of protecting their brains is going to be basic stuff. For example, traumatic brain injury is a major preventable driver of brain dysfunction.

Not just mental health issues, but the development of dementia and overall worse brain health. So what can we do to prevent TBI? These are simple things. Wearing a helmet, if you’re on a bicycle, wearing a seatbelt, if you’re in a car being cautious, if you’re an elderly person to take steps to reduce your risk of having a fall.

And I don’t mean this as something that, you know. People are gonna get excited about. This isn’t some sort of an amazing hack, but what I am trying to say is these are the types of steps that the science is clear on. That we can take small steps each day to mitigate in a major way our [00:08:00] risk for developing brain health issues down the line.

Now there are some really exciting aspects of what the science is telling us we can do to act upon these key pathways. And as I’ve alluded to. One of the key pathways that is absolutely vital in determining our brain health right now and in the future is immunity. So, you know, I learned in medical school that the brain is made up of a whole bunch of different cells, but we primarily focused on cells called neurons.

That’s the brain cell that most people are aware of, and it’s a great cell. Don’t get me wrong, you have 80 billion or so neurons in your brain, but there are roughly 80 billion or so other cells called glial cells, which comes from the word for glue. Because initially it was just thought these cells served to hold things together.

It turns out that glial cells play a massive role in mental health and cognitive health and decision making. Even in personality, and one of the most important of the glial cells is a cell called the microglial cell. Microglial cell. Somewhere between 10 [00:09:00] to 15% of all the cells in your brain, something like 20 billion cells in your brain.

What makes it so interesting is that it is an immune cell that lives inside of your brain that changes its function, that changes its physical shape depending on the data that it receives, and based on the way that the microglial cell changes its form and function, it actually influences the way that your neurons work.

So what we’re saying here is your brain has an immune system. It has these microglial cells. These microglial cells are listening to what you do each day, whether you exercise, if you eat a healthy meal, if you had good sleep, if you’re breathing in air pollution, what is the quality of the things that you’re consuming?

And based on that input, they dramatically transform their function. And this has now been determined to be a principle driver of everything from the rate of brain aging to depression to PTSD, as well as to risk for developing dementia and specifically [00:10:00] Alzheimer’s disease. So this brings this concept of immunity, which is generally something people think about, is happening only as a defense system.

You know, you get a cold, you get a flu, you need your immune system to rev up, you wanna make sure you’re topped off on vitamin C. So your immune system works well. Actually, that is such a small part of what the immune system does because the immune system is a principle force translating the outside world into the inside world.

And because your brain, as amazing as it is, doesn’t really have access to the outside world, it relies on signals in part through the immune system. To know how to change itself in order to guide us towards ideally survival, not necessarily thriving, but survival. So immune system in the brain, significantly directing how we think, how we act, how we feel, and being directed by our lifestyle choices, what we consume each day.

Programs, the brain’s immune system. And by doing so, programs, our brain health.

Dr. Weitz: And this is a [00:11:00] new concept because we used to think that there was this impermeable blood brain barrier. So there were no pathogens in the brain, there were no toxins in the brain, and there was no need for it to have a brain immune system.

But we’ve learned that’s not really true.

Dr. Perlmutter: That’s absolutely right, and I think this is still a common misconception. You know, it, it kind of stems from another really popular misconception, which is that the brain and the body don’t communicate that you have what happens in the brain and you have what happens in the body.

And you know, maybe they occasionally exchange a letter, but by and large they’re not talking. And what we now know is. That there is constant bidirectional communication between the brain and the body. And the best example may just be this gut brain axis. And we know that what happens in our GI tract, especially our microbiome, but also in our gut immune system, is able to influence what happens in the brain through a variety of different channels, the vagus nerve, the bloodstream.

And so we’ve kind of gotten [00:12:00] rid of, at least in the scientific world, this idea that the brain and the body. Exist in isolated chambers, but I think most people kind of fail to understand the gravity of that science because what it says is that your brain doesn’t exist away from your body. That your decisions that you make in terms of the food that you eat, in terms of even what you put on your skin, what you breathe, how they direct influence on your brain health.

And I mean, I can give so many examples of how this happens, but maybe the one people are most familiar with is hunger. So what is hunger? Hunger is a response to sure a low energy state, but it’s programmed by hormones that are produced, for example, in your stomach, one called ghrelin, that actually increases your level.

Of hunger. Another called leptin that’s produced in part in the gut, but also in your fat cells that helps you to feel full. It’s a satiety hormone. So what that means is signals from your gut, signals from your body, signals [00:13:00] from your fat cells are telling your brain how to behave and telling you how to change your decision making.

So if you follow this line of reasoning to its natural extension, what I’m saying here is even though we like to operate as though. We’re in control. We’re up here. We’re directing all of the things around us that our brains are responsive in real time to the things that we are consuming to our environment.

And this is one of the reasons why I would say that your best opportunity for making healthy decisions and having a healthy life is not to rely on willpower and forcing yourself to make healthier choices, but it is to program your brain to make it more likely that you make those healthy choices to make it easier.

This is kind of the whole idea of developing healthier habits. Your brain, as much as we see it, as part of us as our identity is constantly changing, and we have the opportunity to rewire our brains for health. Or let our brains be rewired by what happens [00:14:00] around us, which by and large, when you look at the consumed data points in the American world and largely around the world, what we’re consuming is programming our brains for disease and poor health.

So it is incredible opportunity for us to change the narrative and build brains that not only serve us today, but for decades to come.

Dr. Weitz: So how do we reprogram our brains that way? You’re talking about having a eating schedule, an exercise schedule, a sleep schedule. Is that what we’re talking about?

Dr. Perlmutter: Sure.

There are many things you can do, any person can do to help bring their brains back to a state of relative balance. I do think it’s important for everyone out there to know. That your brain changes every day, every moment across your lifespan. So it isn’t as though you’ve missed your opportunity If you’re 70 and saying, oh, I’m not thinking as clearly as I used to.

You always have the ability to direct your brain function for the better. And one quick point that I wanna make before we jump into some of the [00:15:00] tangibles here is that some recent research came out and it in essence showed that midlife so kind of. The middle period of our lives is a key window in terms of what directs our rate of brain aging.

There’s a publication called The Middle Aging Brain that came out in trends in neurosciences, and what they said is that between the age of 40 and 65, this is a key window that directs your future for brain health, and the key pathway seems to be the immune system. So let’s talk here specifically about what you can do to help program your brain’s immune system towards a better state, a state of relative balance towards a state that helps to hopefully prevent your risk of developing a host of brain related disorders, because as I’ve said, it isn’t just your risk for developing dementia that’s associated with a brain immune state activation.

It’s also very strongly a risk factor for depression, which is one of the reasons why I wrote a paper back in 2021 looking [00:16:00] at COVID and the pandemic and the correlations between infection with COVID, but also. People’s lifestyles as a function of lockdown. So this was kind of an interesting thing because back then, as of now, as now, there’s a lot of polarization around what happened, what went wrong, what should we or shouldn’t we have done?

And the point that I made was whether you’re worried about a virus or worried about the lockdown procedures, depression was rampant. And it’s because in part, we’re programming our brain’s immune system towards inflammation. So our goal here is to try to go against that chronic neuroinflammation brain inflammation in order to preserve brain function, enhanced brain function, and protect against what happens in the future.

What can we do about it? I would say. You want to be thinking about the ideas of what you’re consuming each day. So what we consume becomes our biology, and that’s across the entire spectrum. So for example, if you were to be [00:17:00] exposed to a bunch of radiation changes our biology, but more practically for most people, you want to think about what you’re breathing.

You want to think about what you’re eating, you want to think about what you’re putting on your skin. And if you cover those bases, you’re actually getting the majority of the major lifestyle variables. I’d say exercise and sleep slightly outside of that, but we can talk about that in a second. So when we think about the nutritional or yes, let’s start with nutritional.

When we think about the nutritional variables that are most associated with inflammation in the body and in the brain, what I would say is on the one hand, you have the things that you don’t want to consume because at high levels especially, they’re correlated with higher levels of inflammation.

There’s two major things that I would like to address there. One is the Western pattern diet, the standard American diet, the ultra process diet. We can talk all sorts of nuance around individual nutrients and keto and paleo, but the bottom line is if you consume ultra processed food, [00:18:00] most of the time you’re putting your brain and body at risk of chronic inflammation.

So what is an ultra processed food? There are different scales that you can use to determine whether it’s ultra process or not, but one really easy way to determine if it’s an ultra processed food is if you read the ingredient list on the back of a food, and there are things there that you don’t have in your kitchen that is most likely an ultra processed food.

Now, are all ultra processed foods equally concerning for brain health? No. There’s one in particular that I would say is at the top of the list that I would highly recommend most people. I would say everyone should dramatically cut back on or try to avoid completely. And that is an ultra processed food that has almost zero value in terms of what it provides for health.

And almost everything slated towards what it takes away from your health. And that is sugary beverages, sugar sweetened beverages. There is no nutritional value in these beverages, aside from the calories that come from the sugar. So if you were absolutely [00:19:00] starving or if you were incredibly dehydrated, sure.

But for most people, and most of the time, they’re getting absolutely no value from consuming sugary beverages. And sugary beverage consumption is correlated with worse brain health, higher risk for dementia, higher risk for depression. And why is this the case? Well, all that sugar appears to rev up the immune system and promote neuroinflammation.

So very briefly, ultra processed foods eat less of them, but specifically try to avoid the sugar sweetened beverages. And as long as we’re on the topic of beverages, I think it’s notable that. Large doses of alcohol seem to activate microglial cells, increase brain inflammation, so there’s still a lot of debate as to moderate, mild high levels of alcohol, but at high levels and specifically in alcoholism and other people who have had specific brain damage related to alcohol, one of the key mechanisms appears to be neuroinflammation.

So if you’re worried about brain inflammation, high levels of alcohol. [00:20:00] Not a good idea. So those are kind of from a nutritional perspective, the things that I would recommend against in order to decrease your exposure to neuroinflammation and all the things that come with it. On the flip side, if we’re talking about what to do more of, well the opposite of an ultra processed diet is a minimally processed diet.

It’s foods that humans have messed with the least. And what’s kind of nice about brain research is there’s conclusive data, at least as of now, 2025, that there is one diet that is kind of the best overall diet for most people to prevent brain issues and to in particular, help to slow brain aging by targeting these key pathways.

And that’s the Mediterranean pattern Diet. Many people have heard of it before. Different people have different ways of kind of describing the Mediterranean pattern diet, but the key to it is made up of a lot of minimally processed foods. You have fruits, you have vegetables, olive oil, nuts and seeds.

It tends to deprioritize red meat. [00:21:00] It tends to have you consume more fish Omega-3 rich foods. And in particular it is a diet rich in molecules called polyphenols, which are these plant-based nutrients that have been associated with better brain health. So a minimally processed Mediterranean pattern diet is the diet that is best studied to help slow rated brain aging, prevent dementia, and even to improve neurological function in the context of things like.

Depression and mental health issues. We can get into a lot of the specifics of it, but kind of the core constituents that I’ve been most involved in studying, again, polyphenols, Omega-3 fatty acids. These are nutrients, polyunsaturated fat, linked to better brain health, and then fiber, which is something that most people just are not consuming even half of what they need each day.

So I’ll pause there. That’s a lot specifically on the nutrients that can help to offset some aspects of the brain aging process. The good news to all of this is even though there’s no magic bullet, that every [00:22:00] day there’s a chance to do slightly better when it comes to the food that we’re eating.

Dr. Weitz: Right. And it turns out that the Mediterranean diet, even though it’s always a little bay, does it include dairy? Does it include bread? Does it include this? But we have a general sense of what it is. It’s also seems to be the most effective diet for reducing cardiovascular disease and most of the other chronic diseases.

So I think that all sort of goes hand in hand.

Dr. Perlmutter: Yeah, there, there’s no huge liability here. I mean, I think for certain people, you know, there’s a lot more to be said about maybe saturated fat intake and the forms of fat intake. But by and large, what’s great about the Mediterranean diet is that population-based analysis and even interventional data support, that it is a good diet for basically every condition.

So it is a general longevity promoting diet and it also happens to be good for brain health. So it’s nice that you don’t have to say, well, actually this diet is the worst diet for your heart, [00:23:00] but it’s really good for your brain. You don’t have to choose, in this case, which always makes it a little bit easier to be talking about,

Dr. Weitz: you think that somebody who’s starting to have the beginnings of symptoms of decreased brain health.

Should consider more of a ketogenic yeah. Focused diet where maybe they’re gonna be getting their energy more from fats and from carbohydrates.

Dr. Perlmutter: It’s, so there’s an interesting correlate here, which is this question of brain metabolic function and something called cerebral hypometabolism, which is a complicated way of saying as the brain gets older, it seems to have more trouble extracting glucose and using glucose this doesn’t mean there’s less glucose around.

It just seems like the brain metabolizes glucose worse. And this change in metabolism, which some people call type three diabetes is correlated with. Overall brain atrophy and risk for mild cognitive impairment and risk [00:24:00] for Alzheimer’s disease. So what you’re bringing up here is mechanistically. It seems that as we age, our brains become less able to use glucose as a fuel.

I should say this. Glucose is the brain’s primary fuel source. We mostly run on glucose. So this isn’t saying sugar is bad, we need the sugar to run on a brain. So that’s very different from saying added sugar is good, added sugar not good, but we do need to have stable levels of glucose. So a diet that is low in carbohydrate, or I should say just fasting not eating anything whatsoever.

Would increase levels of what are called ketone bodies. And what makes these ketone bodies interesting is that they actually are a more I shouldn’t say bioavailable, but the brain actually will use those in place of glucose. And so that’s interesting. It’s not just the brain, the heart, other tissues can use ketone bodies.

And so the hypothesis here is that if a brain has more trouble using glucose for a number of [00:25:00] reasons, you could bypass that fuel source and provide ketone bodies either through a diet that is very low in carbohydrate, or through fasting or through exogenous ketones. So you can now consume ketones in little, you know, shots or beverages.

What we know so far is that mechanistically, it should work. There have not been any large scale studies proving that a ketogenic diet is, powerful in terms of reversing aspects of Alzheimer’s disease or even significantly mitigating the cognitive issues. There’s some data for improvement in symptomatology, so kind of activities of daily living.

I’m optimistic that metabolic therapies will actually prove to be efficacious for Alzheimer’s disease, and I’m not in any way opposed to ketogenic diets for people who have metabolic dysfunction because not only may it be beneficial for the brain, but cutting back on carbs I think can actually be quite advantageous, specifically in reversing aspects of type two [00:26:00] diabetes.

And so there’s some really powerful data showing that you can reverse type two diabetes with a low carbohydrate diet. My concern around this would be if you are a person who is looking at decades of of age ahead of you, and you’re trying to do the best you can to protect yourself against Alzheimer’s and other brain related issues.

And you start a very restrictive diet like the ketogenic diet. Not only could it put your body under metabolic stress long term, and that’s some of the data that we’ve actually seen in fasting and other more restrictive diets, but you’re missing out often on things like fiber and polyphenols that have also been correlated with better brain function.

So I think I would be opposed to a wide scale recommendation that people should adopt a ketogenic diet for long periods of time for brain health, because I don’t think the data substantiates it. I would be in favor of trying a ketogenic diet. If a person has underlying metabolic dysfunction, which to be fair is about 90% of Americans, but in the context of doing it [00:27:00] alongside a practitioner where you’re actually monitoring and creating a plan for.

What is the sustainable version of this look like? Because I don’t think, just like I wouldn’t recommend long-term fasting for people, I don’t think it is reasonable to bypass the whole question of, is this sustainable when we make dietary recommendations? So I’m interested in the ketogenic diet. I’ve been following the literature.

There’s some preliminary data suggesting some potential value, but as of now, I think it’s still too early to make a broad recommendation specifically for brain health that a ketogenic diet outweighs something like a Mediterranean pattern diet.

Dr. Weitz: And when we talk about metabolic health for brain health, I recently read Chris Palmer’s book, brain Energy, and he talks about the importance of brain getting enough energy through the mitochondria.

And so therefore, what we’re using for energy, whether it be carbohydrates or fats or a combination thereof, is very important for overall brain health.

Dr. Perlmutter: That’s [00:28:00] right. I mean, the brain, two to three pounds uses up 20 to 30% of your glucose at rest uses up a ton of energy. And so if for example, you were to cut off blood supply to the brain and you didn’t have access to glucose and oxygen, you’d die within minutes.

Right? This is not kind of a a long-term process that the brain is able to work without energy. It has tons of mitochondria. You have thousands of mitochondria, potentially more per neuron. They’re clustered around areas that require lots of energy specifically to reset after depolarization. And what does seem to be pretty strong data is that as our systemic metabolism is compromised, and again, depending on the study you look at, it’s somewhere between 88 and 92% of Americans now with some aspect of metabolic or cardiometabolic dysfunction.

But as our body becomes resistant to insulin, as our blood sugar levels start to go up, as we start to develop dyslipidemia the other things that accompany metabolic syndrome. And a fat [00:29:00] that is more programmed towards inflammation. Our brains are not immune to this. And so while there may be a kind of a slight buffer in between developing systemic metabolic dysfunction and brain metabolic dysfunction, there’s no clear line to say, okay, your body’s metabolically unhealthy, and your brain is fine.

It doesn’t seem like that’s the case. So there’s a lot to be said for, you know, the pathways involved, what we can do around that. I do think you know, Dr. Palmer and others have really called excellent attention to the fact that your brain’s energy function is critical for. For general health, but also to mental health.

And I think that’s something we’re learning. I wouldn’t say the data is nearly as strong for metabolism and depression as it is for inflammation and depression, but we’re starting to get more and more of an understanding as to how these pathways interface. So certainly metabolic function, something we all need to pay attention to.

I just think as it stands right now, it’s a little bit more towards immune [00:30:00] activation for the mental health, cognitive health continuum and the metabolic health is a little bit more towards long-term cognition in terms of the risk profile.

Dr. Weitz: What are some of the other important dietary factors? You mentioned Omega-3 fats, which we get from eating fatty fish taking fish oil supplements, and potentially also some alpha linoleic acid that we can get from nuts and seeds.

Dr. Perlmutter: Yeah, so, so I think you know, at Big Bold Health we’re focused on three pillars of kind of nutrition. So one is the omega threes, as you’ve mentioned. Omega threes are interesting in that they’re highly kind of conserved and prioritized in our brains. So our brains are mostly fat by weight, but they’re also incredibly rich in one specific Omega-3 called DHA or docosahexaenoic acid.

And so we want to make sure our brains get enough of that to be able to maintain membrane fluidity, to be able to maintain general immune balance with more EPA or [00:31:00] cosent acid. So the or sorry, cagno acid. So the the basic idea here would be that we want to make sure that we’re prioritizing omega threes.

And by and large, most people don’t consume enough omega threes. I don’t think that’s highly debated. You can get it from diet, so it’d be great if you’re able to get access to, ah. Salmon seafood, eat that each day. The reality for most people is that’s not sustainable. So then you get to kind of supplementation.

I think many people are kind of fixated on this idea of getting two to three grams of EPA plus DHAA day. I’d say most of the quality recommendations from various groups would say closer to 500 milligrams is kind of the sweet spot for maintenance. Now, there are certain conditions, for example, depression where about two grams of, again, EPA predominantly, but also DHA seems to be most effective.

But most of us benefit from just shooting for that 500 milligrams a day. Again, D-H-A-E-P-A, there’s some data for [00:32:00] alpha-linolenic acid, as you said, a LA, this precursor to EPA and DHA. But what seems to be key to understand is that most people cannot convert the a LA to the EPA and subsequently the DHA at high enough levels to where they’re actually getting access to that.

If they’re only consuming plant-based sources. So if you’re a vegan, if you’re somebody who primarily eats plant-based food and you’re not consuming any seafood, I think you’re probably going to wanna look at supplementing with something like an algae-based Omega-3 supplement. Beyond the omegas. The real kind of concentration of my research with big, bold health has been on polyphenols.

And so polyphenols are a group of molecules, 8,000 plus molecules found in plants that have been historically thought about as kind of throwaway molecules, meaning they don’t do that much. We’re now understanding that they’re actually one of the key sets of nutrients that signal between the soil and the plant and the human meaning.

That polyphenols change the microbiome of [00:33:00] the soil, that plants actually send out polyphenols to attract various microbes. And they communicate in this way to promote a healthier plant that polyphenols then can translate those polyphenols to us when we consume them. And that when we eat polyphenols, they have names like quercetin and rootin, that these molecules can have effects on our microbiome, our immune system, and by extension may influence our brains.

Some of these may actually penetrate the blood brain barrier and influence brain immunity. And so we’ve been focused on polyphenols from a certain plant called Himalayan Tery buckwheat, which is an interesting plant because unlike most things that people tend to consume, it’s incredibly high in polyphenols.

And so, if you think about, you know what people typically eat in a grain-based form, wheat rice, these tend to be. Basically stripped of the hu, which is the most strong source of polyphenols. So they’re low in polyphenols. They basically convert to sugar quickly. They’re low in fiber. Buckwheat [00:34:00] has higher levels of polyphenols, but there’s a variant of buckwheat called tart buckwheat that is a little bit bitter.

And the reason for that is because it’s so concentrated in these polyphenols, in particular rootin. I think it is the single most concentrated form of rootin, of any plant that exists. And so we’ve been looking at this subset of polyphenols as to how it relates to immunity. And we studied this in a trial that we published last year in Frontiers and Nutrition, showing that the polyphenol compliment in this Himalayan artery, Bucky.

Significantly impact metabolic, immune and longevity related pathways, which from my understanding at least at this point, is pretty much the first study to ever look at tery, buckwheat and show that it can impact these immune and longevity pathways. So polyphenols, I think, really important to consider I for overall health, for longevity, and we’re starting to look at this more as it relates to brain function.

Other nutrients to consider here. I mean, there are many, so magnesium something that a substantial percentage [00:35:00] of Americans are really not consuming enough magnesium. There’s a debate over the right form of magnesium that has the most kind of brain availability. But the bottom line is you want to be getting several hundred grams or a hundred milligrams of magnesium each day to support good brain function.

And there is data showing that when people do not consume adequate magnesium, that their brain function declines. Similarly, there’s data now for creatine monohydrate, specifically at around the five to 10 gram a day range in terms of supporting overall brain health and promoting brain energy, which I think is super cool.

There’s data around vitamin B, there’s data around vitamin D, but I think the cornerstone to this is really diet. It’s not the supplementation. So trying to build a diet, again, the Mediterranean diet. Which is high in all these things, naturally is a great place to start. And I think that if you’re concerned about this, especially if you’re concerned about cognitive decline, you know that’s where a healthcare practitioner is really best situated to help you because it’s [00:36:00] not as helpful to just assume that you should take vitamin D.

Some people may have a very low vitamin D despite thinking that they’re high, and other people may not need supplementation. I will tell you from getting my own levels tested, I never know exactly what I’m gonna get back until I’ve seen those labs, and then you can change your levels of intake. Maybe you just need 5,000 IUs.

Maybe you need a whole lot more. Maybe you need a whole lot less, but you won’t know unless you actually test. So bottom line to this, lots of nutrients that influence the brain. I think Omegas, polyphenols, creatine, magnesium, those are some of the top ones on my list and things that I try to prioritize each day.

I think the creatine is one that you really can’t get enough from diet for most people because we’re talking about five to 10 grams magnesium. Some people get enough through diet Omegas, maybe some do, but probably not. And then polyphenols, you gotta be prioritizing a lot of plant-based foods, a lot of spices, a lot of herbs.

And if you’re not doing it through that mode, you may not be getting kind of the one to two grams of [00:37:00] polyphenols a day that are probably best situated to be supporting overall health.

Dr. Weitz: Yeah. Definitely inflammation is a big factor and omega threes help to reduce inflammation And I even like using the, the the resolve ins from fish oil to help reduce inflammation. When it comes to testing, I think that’s super important. There’s no way you know how much you need of various new. Nutrients unless you test. There’s so many different factors. You don’t really know what the content of food is.

You can look at a chart and see that eating a carrot has this much vitamin A, but each particular carrot has a huge variance. We have different receptors, we have different metabolisms, we have different abilities to absorb nutrients. So if you don’t test, you’re guessing. And so I think it’s super important that all of us get our important nutrients tested.

You mentioned vitamin D and Omega-3 [00:38:00] and magnesium, but I think if you can get all these nutrients tested and do that periodically, I think that’s the best, most scientific way to know you’re getting optimal levels. That’s what we need. We want to get optimal levels of all these nutrients and not just what’s considered the normal level.

Dr. Perlmutter: Yeah I totally agree with you and I think you know, I think sometimes people say, oh, I’m just going to tweak my diet a little bit and should be fine. And that’s the great thing about labs because unless you know, the lab company messes up, which does happen on occasion, you’re actually getting a good snapshot as to what is happening in your physiology.

And I think there’s a risk to over supplementing just as there’s a risk to not getting any additional nutrition if you need it. So I think that is a good call. I will just mention a couple of other nutrients. Choline lutein, xanthin. These are all nutrients that have been studied to potentially help with certain brain aging pathways, including inflammation.

And so, you know, these are things that you can take in supplement form. Egg yolks tend to be very rich in [00:39:00] them. Leafy greens. I feel like I’d be remiss if I didn’t mention it’s a great source of a lot of these nutrients that we’ve been talking about. Can

Dr. Weitz: we talk about choline for a second? Yeah, go for it.

So choline a, there’s a bit of controversy about it because for sure there’s tm, there’s a particular Yeah, exactly. TMAO. So we have this researcher from Cleveland Clinic, Stanley Hazen, who’s done some research showing that TMAO levels increase your risk of heart disease and consuming choline, a carnitine increases your risk of TMAO.

In fact, FISH is the greatest natural source of TMAO directly. And yet we know these foods like choline and fish are so beneficial for our overall health, for brain health, for cardiovascular health. So I have a tough time with that TMAO concept.

Dr. Perlmutter: It’s interesting, right? So the TMAO is one of the most consistent kind of data points that vegans or plant-based people will point to in terms of saying that, you know, eggs are [00:40:00] bad, seafood’s bad generally speaking based products are bad.

You know,

Dr. Weitz: unfortunately in this set of diet wars we have people lining up in different political parties and sometimes they’re looking for, you know, a weapon that they can use and there’s the TMAO weapon to show why the vegan diet’s best.

Dr. Perlmutter: Yeah. So, I’ll just say, and as somebody who, you know, doesn’t have a huge bone to pick in this, other than I think it’s really unhelpful when we keep going back and forth on what people should be eating.

So, TMAO has actually been linked to this is trim triethylamine an oxide, right? Trimethylamine an oxide, which is a metabolic byproduct of choline. So. Is linked to specifically cardiovascular disease specifically atherosclerosis and death from cardiovascular disease. So the idea then is if you eat a bunch of choline, you make a bunch of TMAO and therefore higher risk of cardiovascular [00:41:00] disease.

But then the question is that the actual pathway? Or is it measuring something else? And so my understanding of the data right now, and I’m sure that you’ll have guests on, or maybe you know this better than I do, is that there is no direct study showing that choline intake correlates with worse cardiovascular outcomes.

There’s this surrogate where there’s an assumption, which is because choline increases, TMAO and TMAO is linked to higher levels of cardiovascular disease. Therefore choline is bad. But in terms of what I can tell right now, there may be a confounder or another variable, but I’m not seeing the data showing that specifically.

Consumption of choline translates into worse cardiovascular disease. And you would think if that was the case too, just as you said then higher consumption of things that are rich in choline would correlate with higher levels of cardiovascular disease. But that’s not really what the research is telling us, so, right.

I think, yeah,

Dr. Weitz: I think that, I think the key factor is the microbiome. And I think that people who produce [00:42:00] TMAO, it’s not because they’re consuming choline, it’s because they have a a dysfunctional or less than optimal microbiome. And I think if they change their microbiome, they won’t have a problem with TM ao.

Dr. Perlmutter: Yeah, I think it’s certainly an interesting thing. I mean, there’s a lot of mechanisms at play to talk through, but we know choline is an essential nutrient for brain health. And so personally, I have not modified my diet based on the TMAO component in terms of decreasing choline intake.

And I think I would be super interested to keep following this research, but I think this may be a scenario where you know it’s part of the story but not the complete story. So. Right. A little tangent there on Colline, but certainly Interesting.

Dr. Weitz: Yeah. So polyphenols, these are part of the phytonutrients that we find in plant foods.

And we know the importance of all these different phytonutrients, including polyphenols. And the way we can get [00:43:00] ’em is by eating lots of colorful plants, fruits and vegetables and and then there specific seeds and grains like the Himalayan Tart buckwheat.

Dr. Perlmutter: Yeah, that’s right. So the richest source of polyphenols in the diet is going to be, I think, as lasso, right?

I think it’s cloves of all things, but it’s spices and herbs are gonna be the most concentrated source of polyphenols. But any minimally processed plant food is going to be a good source of polyphenols. The more food has been processed, typically the more the polyphenols are removed. So again, going back to the example I gave before, if you’re eating a bleach white flour, if you’re eating a bleach white piece of rice, that’s gonna be.

Probably much lower in polyphenols than eating a colorful piece of fruit. And what’s interesting about polyphenols is that they have this they can actually create some bitterness when you eat certain foods. That’s why coffee is bitter. It’s why dark chocolate is bitter. And so we can offset that by adding sugar, which is what most people do, or fat, [00:44:00] which is a popular thing.

So there’s a reason why the top form of chocolate is milk chocolate and why most people like a latte and don’t drink, you know, a black coffee first thing in the morning. And usually add sugar to both of those things as well. But the fundamental kind of idea behind this is that. When we consume bitter foods, we’re actually programming our immune system through these polyphenols.

So bitter isn’t bad. Bitter is actually a signal that we’re getting good levels of these nutrients. And so that’s what we found with tartar buckwheat compared to even conventional buckwheat, it is a little bit more bitter, and that’s because of the polyphenols, but what we’ve been doing is sprouting it.

And what’s interesting about the sprouting is that you actually produce a new molecule, a new polyphenol that helps to dampen down the bitterness. So it’s kind of a polyphenol metabolite that has an anti bittering effect. It’s homo aol of all names, right? It’s a kind of a random one, but this is a nutrient that helps to decrease bitterness to the point where companies will actually put this in their foods as a way of [00:45:00] offsetting bitterness.

And what happens with this tar bucket is when you sprout it, you produce an anti bittering agent, which is just a cool little bit of biology. As we’re looking at what poly what polyphenols do to our physiology, what is known is that polyphenols are actually a form of prebiotic. So they influence the microbiome, they change the makeup of the microbes in our gut.

Polyphenols also appear to influence the immune system, both indirectly, for example, by influencing the microbiome. And they seem to bind to immune cells and change their programming. And so, polyphenols are now thought to be kind of messengers that alter. Immuno metabolic pathways. And so this is just kind of taking this story and making it more and more complicated.

But metabolic health and immune health are not separate, right? So our immune cells are powered by metabolism, and our metabolism is influenced by our immune system. And so polyphenols act on both sides of that pathway. So polyphenols. Are thought to [00:46:00] be immuno metabolic agents that can actually change our risk for chronic diseases and impart influence brain health.

So it’s kind of just a really cool area of science because we’re taking this idea of food is medicine and we’re expanding it beyond just the idea of, oh, well, polyphenols are antioxidants. Antioxidants are good because oxidative stress is bad. And now transitioning to saying, actually no, polyphenols are changing the signals within our body, influencing our immune system, influencing our metabolism, and this may be one of the reasons why people who live in these blue zones that Dan Butner has described tend to live longer and healthier lives, is because they consume large quantities of these polyphenols that can help to program their immune system and their metabolic system, both of which are some of the biggest predictors of how long we live in the quality of our lives to a more balanced state.

So. Eating colorful fruits and vegetables, eating more spices and herbs isn’t just for the flavor, isn’t just for the look. It’s actually a wonderful [00:47:00] way to bring in more of these nutrients, which most people do not consume enough of, because most people eat mostly processed food. So what’s been taken out of those foods tends to be maybe as much of a risk from what we consume as the things that have been put into those ultra processed foods.

Dr. Weitz: It’s kind of interesting for a number of years, Dr. Bland was focused on another bitter of food hops and did a lot of research on with hops and developed a number of products from hops and it’s kind of interesting how he’s transitioned to Himalayan Tart Buckley. He,

Dr. Perlmutter: like, he likes bitter, but I think more importantly, he just, he likes the polyphenols, right?

Yeah. He’s kind of obsessed with how. Food is able to program our body, and our physiology and certain foods, and you brought it up, this great example, hops. So beer is bitter, but if you look at all of these different groups of foods that have somehow become popular, despite their bitterness, they tend to be accompanied by something else.

So in the case of coffee, it comes [00:48:00] with caffeine. In the case of bitter. For, or I should say hops that bitterness comes with alcohol. So people are, you know, they make these associations in their brains. What I will say is what’s interesting now we have these non-alcoholic beverages like hop water for example, or non-alcoholic beer that still gives you the bitterness without the alcohol, and they’re growing in popularity dramatically.

So. Oh, interesting. It makes me. It makes me think that maybe we are transitioning to where it doesn’t have to be accompanied by the, you know, potent brain, I should say neurotoxin, right? In the case of alcohol. Yeah. Or the added sugar that maybe we are able to just enjoy the the beverage without it having to be bad for us, which is exciting.

Dr. Weitz: Yeah. I love using herbal bitters. I use ’em with a lot of my patients to stimulate digestive enzymes and bile flow and hydrochloric acid. And I love taking some herbal bitters prior to eating to get those things going. So I think [00:49:00] more bitter foods are gonna be better for our health for sure.

Dr. Perlmutter: Bitter is better.

Just have to get over the hurdle. Bitter is better,

Dr. Weitz: you know,

Dr. Perlmutter: get over the hurdle and stop. Being only willing to eat the foods that people have processed to the point where they’re not really food anymore.

Dr. Weitz: And of course, exercise is super beneficial for brain health and brain energy and brain inflammation.

Dr. Perlmutter: Yeah, I mean, that’s an entirely separate, but I guess related topic I’ll just kind of do the main takeaways here, which are that there’s no single intervention that has been most more shown to improve brain function and even reverse aspects of cognitive decline than exercise. Kirk Erickson and others have kind of shown that the hippocampus grows in people when they do exercise regularly, which is a super cool thing to do because the hippocampus is the part of the brain that tends to shrink most along with aspects of the cortex and people with Alzheimer’s disease.

So exercise promotes [00:50:00] neuroplasticity, grows new neurons, exercise suppresses inflammation. It improves metabolic function. And these are things that most people already kind of know. So what I’ve been talking about more recently is that there’s cardiovascular exercise what we would typically think of as aerobic exercise, where we’re doing repeated motion.

So jogging is probably the best example. You know, brisk walk things where we’re just kind of doing these repeated motions that get our heart rate up but don’t completely exhaust us. And then there’s anaerobic exercises, so things that take away all of our oxygen. And that could be something like sprinting or high intensity interval training, but it could also include or does include resistance training, weight training.

What makes that super interesting to me? Is that we now understand that one of the key pathways by which exercise improves our brain health is the production of these molecules called mykines. Myokines are produced by our muscles. They actually can go to our brains and influence brain immune and metabolic pathways.

[00:51:00] And they have names like irisin and brain derive neurotrophic factor cathepsin b kind of esoteric names. But the key of it is to understand myokines molecules move that are moved to our brain through our muscles are activated by things that activate our muscles, the things that activate are skeletal muscles.

To the most significant extent are actually going to be weight training. So if you lift weight, if you do resistance training with your biggest muscle groups, which are found in your legs, you are going to have the biggest increase in some of these myokines that are linked to better brain function and potentially that can help to prevent or at least significantly mitigate risk for developing brain issues like dementia.

So all of this is to say, yes, exercise is essential, but don’t skip leg day at the gym. You’ve gotta do weight training, and you’ve gotta do leg exercises, and it doesn’t have to be giant weights on the squat rack or on the, you know, the [00:52:00] deadlifts. You can do body weight squats, you can do lunges, you can use bands.

The key though is to actually do resistance training with your muscles and in particular, your leg muscles, because those are going to produce the most of these positive signals, these myokines that may help to boost our brain function.

Dr. Weitz: Not to mention, no. Decrease your risk of falling. And they’ll increase not only muscle mass, but bone density.

So those are all important for longevity.

Dr. Perlmutter: Yeah, it’s, you know, it’s just like the Mediterranean diet. It’s not just going to benefit your brain, but it’s definitely going to benefit your brain along with other aspects of your health.

Dr. Weitz: That’s great. So, I guess, we can wrap this discussion. Any final thoughts you wanna leave us with and then tell us how we our listeners can learn more about you and the work you’re doing at Big Bold Health.

Sure.

Dr. Perlmutter: Yeah. Well, I mean, I’m hopeful that as people have listened or watched, that they’ve been able to pick up a couple of tools in terms of things that they may be able to do to help decrease their risk for developing [00:53:00] brain aging or at least slowing their rate. Of brain aging. One thing that we didn’t talk about, which I would be remiss if I didn’t bring up, is that what we inhale has a major role to play in our brain health.

And so I’ve been for the last couple of years educating on and writing about air quality as a risk factor for dementia. For depression. What we’re seeing in journals like Gemma and other top tier journals around the world is that air quality is a massive risk factor for brain health and unfortunately.

Even though in the United States overall air quality outdoors has gotten better in the last couple of decades, there are two things that have happened that can put our brain health at risk because of poor quality air. One is we’ve actually seen a relative plateau and a decrease in some places in air quality as a function of wildfires.

So that has been in spec specifically in the on the west coast of the United States. A big issue because we are being exposed to more and more days with very high levels of air pollution that are [00:54:00] linked to risk for dementia, depression, violent crime, metabolic dysfunction, cardiovascular disease, early death, all the things.

The other thing which we have much more agency over is what air pollution we bring into our homes. And so what I would say here is, this is probably the most important hidden risk factor for brain dysfunction, is what you are inhaling in your home. There’s lots I can say as to the specifics, but just recognize that if you’re creating smoke in your home, whether that’s, you know, because you’re a smoker or living with a smoker, that’s a pretty obvious one, but it’s a huge risk factor.

Or because you’re cooking things on the stove top and generating a lot of smoke, or because you’re burning candles or incense, all of these are massive risk factors for worse overall health, lung health, immune health, cardiovascular. But in my case, what I’m concerned about is. Brain health. And the other component of this is it’s not just the smoke, it is all of these chemicals that we introduce into our homes, perhaps unwittingly in terms of volatile organic [00:55:00] compounds.

So that could be air fresheners, that could be cleaning supplies that could even be cleaning out your vacuum cleaner or creating dust in your house because you’re sweeping. These are all sources of air pollution. Again, lots more to say on that. I actually started a company called Lichen Air, L-I-C-H-E-N.

A i r.com and you can learn about that on the blogs there. But the main thing to understand is to appreciate that what we inhale is a major risk factor for our brains. We won’t get into today, obviously what we put on our skin. Another big consideration, right? So our skin is a massive organ. It absorbs what we put on it.

It actually has a microbiome that we can throw off, but I think that’s probably sufficient in terms of some of the things that people can do. And then la that last piece, just to understand that if you are using incense scented candles in your home, I would say to be cautious about that because even though it’s associated with wellness, it’s having the exact opposite effect on your brain health.

Dr. Weitz: Are there any kind of candles that are safe, you think? [00:56:00]

Dr. Perlmutter: I think in order it’s scented candles are the worst paraffin, specifically soy candles, and then b wax unscented candles. So the reason for that is most candles are made out of petroleum derivatives, so that’s not ideal. Scented candles produce a bunch of volatile organic compounds that are poorly regulated and may actually introduce new molecules into your environment like formaldehyde, which you don’t want.

And beeswax tends to produce lower levels of all of those molecules, especially if it’s unscented. But the key thing to understand is if you are seeing smoke in your home, that is particulate matter and particulate matter exposure, there’s no, you know, good level, there’s no hormesis, there’s no benefit.

It’s basically a graded exposure risk. The more you inhale, the higher your risk of having health problems. Doesn’t mean, you know, you can’t light a candle, it doesn’t mean you can’t use some incense, but you also have to put that into the context of. If I’m not ventilating this room, if I’m not [00:57:00] doing this for a short amount of time you know, it’s like eating junk food.

It’s, maybe it’s enjoyable, but recognize, I think in this case it’s actually worse than junk food, but recognize that what you’re doing is actually not good for your health, as opposed to, I think, some common mythology, which is you burn some Palo Santo and you know, you do some smudging and you’re doing something good for yourself.

The exact opposite is true.

Dr. Weitz: Interesting. Even if you’re burning an herb or something like that.

Dr. Perlmutter: If there’s smoke, it’s bad for your brain.

Dr. Weitz: Okay. What about breathing in essential oils?

Dr. Perlmutter: Yeah, so there’s a bit more debate on essential oils. Certain essential oils have actually been associated with better brain function.

So lavender, for example, may be calming. Cedar oil, for example, may be able to activate the parasympathetic nervous system. The thing about essential oils is when you diffuse an essential oil, you’re actually aerosolizing a lot of molecules, volatile organic compounds. So not just the ones that you can smell, but a lot of additional [00:58:00] molecules that are found in the vehicle for that essential oil.

If any essential oil diffuser is going to decrease the air quality in your room pretty dramatically. Some of that is just the water vapor, but there’s actually this potential where if you’re using tap water, you could actually be introducing heavy metals into your local atmosphere. So the recommendation there would be if you’re going to use an essential oil diffuser to use filtered water, that can help in some ways and to buy essential oils from brands that you know are only using a pure essential oil.

I think that. Like most things in wellness, you know, there’s differing degrees of quality, but beyond just purchasing from a reputable source, Johns Hopkins recommends, and I would agree with this, using it locally as opposed to diffusing it. So if you want to have a little bit of essential oil, put it on your skin again a diluted version that’s very different from saying, I’m just gonna run this diffuser in this room for the next three hours and just completely saturate this environment with these molecules, [00:59:00] because it’s not just about what’s in the essential oil.

These molecules can react in the environment to create new molecules. Some of which we definitely don’t want to be inhaling. So I don’t want to burst everybody’s bubble when it comes to this. I think, you know, some essential oils seem like they’re fine, but I think localized use as opposed to just saying.

We’re gonna run this thing in the background for the next 10 hours. And one last thing I’ll say there is, but when

Dr. Weitz: you say localized use, you’re talking about putting little on your skin or

Dr. Perlmutter: skin. Okay. Getting a couple of spritzes, you know, in your bedroom as opposed to just running the diffuser.

Dr. Weitz: Okay.

Dr. Perlmutter: The other thing I’ll just say here real quick because it’s close to this, so air fresheners, which many people use them for the same reason as essential oil diffusers. I won’t name any brands, but the plugins, the Wix, we know those

Dr. Weitz: are really toxic for sure. Yeah.

Dr. Perlmutter: So don’t do those. I think that’s just, that would be my recommendation.

There’s no, oh, just a little bit. They’re not good. And to be honest, like I’m trying to build up [01:00:00] to have a protocol around you know, Uber drivers, taxi drivers, because you get into those cars and the little dangly tree, it’s the same thing. And so it’s. It’s challenging sometimes some of these things you can’t do anything about, you know, I understand that.

But if you are staying if you, it is in your home and you have the little plugin thing that’s pumping out this unregulated air pollution every five seconds, I would just toss it. And the same with the sprays. If you’re looking for a way to improve your air quality, if you simmer some spices on the stove top, I’d say that’s a much better option.

Dr. Weitz: What about some of the natural sprays you’ll see at you know, at the health food store? Yeah. Like vanilla spray, you know, that you spray in the air a little bit.

Dr. Perlmutter: Well, I guess I, I’ll be cautious here because I don’t know exactly the one you’re referring to.

Dr. Weitz: Okay.

Dr. Perlmutter: If it’s an air freshener, if it’s an air freshener, I would just say, generally speaking, I would’ve try to avoid it.

If it is a cleaning spray, that’s a slightly different [01:01:00] scenario. And I think one way to go there is the environmental working group. Just kind of look at their individual products and they can give you a sense as to their perceived risk with the product. But I’d say anything in the air fresheners aisle, I would just avoid.

Dr. Weitz: Great hints. I think some people are gonna be disappointed to hear that their favorite way to freshen up a room is not good anymore.

Dr. Perlmutter: You know, I’m not telling people what they have to do, but I will say there’s a lot of natural

Dr. Weitz: health people with with diffusers. Listen I

Dr. Perlmutter: totally get it right.

It’s, it feels like a nice thing. But, you know, drinking a sugary beverage also tastes like a nice thing. It just. I would just say in terms of prioritization here, an essential oil diffuser is much lower on my list of concerns than is incense. Than is, you know, anything that smokes. There’s good data showing that incense produces insanely high levels of pm 2.5.

[01:02:00] Actually, if you were to burn one gram of incense, it produces five times more air particulates than a cigarette would. So it’s not some sort of an esoteric thing. Incense is designed to smoke and so it is designed to produce air pollution in a really big way. Candles, you can mitigate a little bit, trim your wick, make sure that it’s not super high so you’re not getting the sputtering and producing a bunch of smoke and some candles can be nice.

I don’t think having a candle on occasion in the house is the issue, but go with an unscented candle. I think essential oils, you know, some pros and cons, there’s actually some literature showing that they can be beneficial. But you wind up in the same scenario, which is you gotta ask yourself, if you’re gonna be inhaling these molecules for the next four hours, how much do you trust the quality of this company, this multi-level marketing company that is really incentivized just to sell this product?

You know? So there, there are sometimes unpleasant questions to ask about the things that we use, but I think they’re necessary. [01:03:00]

Dr. Weitz: Right. Alright, great. Give up the diffuser if you so choose. Thank you Austin. So how can people find out more about you and what you’re up to? For sure.

Dr. Perlmutter: So my, best ways to get ahold of me would be My website is austin perter.com.

That’s where I have my brain health newsletter. It goes out to 170,000 people a week. For people who are interested to learn more about the Himalayan Tar Artery buckwheat research, big bold health.com, and then for people who want to, I guess learn more from me and the big bold Health team in any way, shape or form, you can find us on YouTube.

You can find us on social media. I’m on social media at Dr. Austin Protter. And Big, bold Health is there at Big Bold Health. And otherwise, I guess if you ever go to conferences, I’m at a lot of conferences speaking on these topics. So if you happen to listen to this podcast and you see me at a conference, let me know.

Dr. Weitz: Sounds good. Thanks, Austin.