Brain Optimization

By the way I just want to thank all the people who helped me on the video side it’s been really nice to see that. It’s something I wanted to do quite some time is actually sit in front of the room and I do enjoy capturing this stuff, so hopefully you’ve enjoyed seeing it at times, but this is an opportunity for me to tell the story about what I’ve been doing.

This story involves this year, but before we go into this year and we are going to go back in time to a year of 1982. 1982 was an important year. It was important, we all recognise that Rambo came out in 1982, E.T. also.

There is a lot of reasons why 1982 might be a important year, but for me it’s a little bit more related to QS and that around dementia. So for me, 1982, was unfortunately, the year that my grandmother started to really exhibit signs of dementia.

For her, what that meant was she was having paranoid fantasies that people were trying to kill her. She was confused quite frequently. It was painful for her undoubtedly and painful for the whole family really. For me it was just an personal exposure to something that is a growing problem.

So for those of you who don’t know dementia is quite a debilitating disease, and as I mentioned the experience that I had with our family is probably the experience who has had this experience, which there is an individual experience, which is quite painful. It can take on any of the symptoms, but there is also a familiar or helper experience, which is equally as damaging. So for the people around that the individual is affected, it’s quite a damaging thing. And that’s not just an emotional thing; it’s an economical thing as well.

The bad news is, as a disease it’s on the rise, so this chart tells us really two things. The little graph on the left says 44 million people, which is actually not a small number of people. But the bad news is that it’s growing and the expectation is right now that by 2050 that number would have tripled. So this is a growing problem.

One of the scariest stats that I saw was around the elderly population, and just a quick show of hands in the room, how many hope to be living through to your 80s? Okay, I was expecting that and a lot of you said yes. And if this was a sample population of people who were in their 80s, 85 I think it’s what it’s actually based on, 50% of you would have dementia.

It’s really a sizeable percentage when you start to get into that age group. The commercial costs are gigantic, and the estimated cost worldwide is something like $604 billion. Switzerland is no way at fault for this, but it is equivalent to their GDP.

Just to take it back to the UK, that’s $23 billion per annum, and I think the thing that’s interesting is that is actually bigger than cancer and heart risk combined. Cancer and heart risk. You know, the outcome is that people die. Dementia you couldn’t indirectly die, but I think cancer and heart disease deserve all the attention they get for the reasons that they are the number one and two killers out there. Dementia however has dramatic impacts and those can be measured from a commercial standpoint as well.

Personally, what is my response to that? No way, which means if there is any way that I can avoid having this thing that I’ve seen happen to people that I care about happens to me, I want to make sure that I do that.

What does that actually translate into, well, I don’t really know. I didn’t really know until December, December helped me a lot. Some of you may be familiar, this is quite a popular book these days and it made the New York Times bestsellers list. It’s by a neurosurgeon in the US, Dr. Perlmutter.

But the nice twist to it is that you know while a lot of books do focus on cardiovascular risk primarily also cancer risks, his ankle is on the brain and around brain related diseases. Interestingly, if you start to explore it, you realise that all of those risks all come back to some very similar things. So when reading a book like this, you end up finding out that some of the things that you can do. You can take action on to lower your risks, or taking action not only on brain-based risks, but also cardiovascular and cancer-based risks as well.

So I just want to quickly highlight a couple of the key messages that were the focus for my program this year, and these are directly out of the book. So glucose and insulin matter, I think you know with diabetes getting the attention that it has, people aren’t may be surprised of that. People have heard of type I and type 2 diabetes, just another quick show of hands, how many people have heard of type 3 diabetes?

So someone who just raised their hand want to just give us a quick introduction of what does type 3 diabetes mean?

That’s probably unfair isn’t it, okay, I’ll raise my hand. Type 2 diabetes is often referred to dementia risk. So dementia is not diabetes, and I don’t think anything official for someone to say. Dementia is type 3 diabetes. But the reason why it is categorized, similarly is that underlying is that the body is unable to regulate glucose in an effective manner.

Its effect is purely on the brain in the case of dimensional versus diabetes, which is more broadly across the body. But that point also points back to my earlier statement about some of the core risks that we are all facing, some of the actions that we can take at those core risks are similar.

Brain shrinkage, we all think about it. An interesting stat is that, year after year, your brain cells die and it’s a natural process, and you don’t have to worry about that. There is a big standard deviation, though. And a lot of that standard deviation is tied to what your glucose levels are.

The last point, which Perlmutter makes very effectively is that there is definitely a place for medication, exercise, and sleep, all of these things play a role and diet is one of the key instruments to helping yourself avoid some of these risks.

Some of these topics are covered there as well, and other things that I’ve researched. Here is just another couple of other things that were going through my head when I was doing this exercise. The first one is underlying all of the risks that we’ve talked about, inflammation and we will talk about it later about CRP that measures inflammation in a general sense is at the root cause of a lot of these diseases, or at least plays a significant role.

I’m consistently amazed by the human reliance on simple metaphors, you know, you are what you eat. Who doesn’t love that expression; it’s just not very true. It may be closer to see you are what you digest, but it has led us to believe that certain things just aren’t true and it leads us to believe that you know eating high cholesterol food results in are having high blood serum cholesterol, it’s not true, except for a very small percentage of the population.

It leads us to believe that eating fatty food makes us fat. Also not true. So it’s looking at some of these common sense pearls of wisdom that are really misleading and saying let’s stop believing them. You know, it’s so easy even if you kind of intellectualize and say, well I don’t believe that. You still fall in the trap. You know, that’s so fatty but I can’t eat that. But wait a second, didn’t I just say - you know, so it takes a long time, and we’ve been telling ourselves as a society for 30 years of some things that just aren’t actually true. So to get around that it takes a little while.

So here is what my plan was, this was me plotting my plan in December and executing my plan come January 1. It centers around a low carb, high-fat diet and a lot of you have probably heard of LCHF. Also one of the really centre points of Grain Brain is around no gluten as well, so I excluded gluten, dairy, alcohol, pretty much anything that sounded like fun. The idea was I’ll do this for a month, but my God, that’s going to be one long month. So that will be it. I actually extended by a month, and not because I just enjoyed the pain. It was more that I actually wanted to – especially on some of the blood tests, I just wanted to get more out of them and see more distance between the two sets of markers.

Also, I had every intention and Timmy and experiment is always about figuring out something that can be sustainable and I don’t get any enjoyment that is brutal, hard effective for a month and then I just fall back to my old ways. So the second month was really more about trying to ease into something that I could do.

Again, this timeframe you will see in some of the metrics is January 1 and February 26, and that’s related to the formal blood measurements that I did and there was a lot of measurements that took place in between. And the goals I was looking at was addressing – you know the long term is really what I’ve been talking about, it’s just I don’t want to have any sort of mental disorder, whether that be Alzheimer’s or whatever it doesn’t matter. It’s the fine markers that help me lower that risk, and then track those markers.

But really to make it work I need something in the short term, whether hat is pure vanity. You know things like, hey, I look thinner isn’t that great or something that’s a feel good factor mixed in with it’s not brutally hard. You know I have to be able to feel that I’m not missing out in life while I’m doing this.

So here are the markers that I looked at. I will go into all the details here, because I have a suspicion I might go over. Glucose, body composition, cholesterol, and if anybody wants to go into more details we can do that later. Then there is the other categories, and the other category in this case actually has one really quite important one which I mentioned which is CRP. That’s an information marker, and then a homocysteine which is an amino acid that is used to measure, traditionally cardiovascular but I think that’s been getting less legitimacy. It definitely still is being seen as a legitimate marker for mental risks. Then gluten intolerance I crossed out, not because I didn’t want to, but it’s awfully expensive. I mean I can’t remember exactly what it is in the UK, I think it’s around £600, so just felt like I’ll pass, you know I should be able to judge for myself whether or not long and gluten insensitive. I don’t need a test. That was the theory. I still want to do it.

Okay, outcomes, so qualitatively I have to say it was awesome. You know, at the end of January. This brutal, I can’t do anything diet I was so excited about what I was doing. I mean the cognitive focus on function that I had was it felt like I haven’t felt I don’t know if it was feeling younger and it was a feeling different, so just the level of energy and the lack of brain fog, awesome.

I was losing weight, even although it wasn’t an intentional one and just feeling light and feeling good. Then sleep. I put into smaller circles, because if you had asked me in December, I would have told you that I was a good sleeper. But it turns out I can be a better sleeper. I think what I was doing when I was sleeping historically probably more closely resembled passing out then going to sleep. And what I mean is you know it took me all about 10 seconds to be you know to bed from being asleep, and that meant the book that I really wanted to read never got red. Now I can go to sleep relatively quickly, but if I choose to read a book I can read a book and I’m in control, whereas I wasn’t before.

It’s a big change, and some of you may remember me, blabbing on about magnesium and if you’re still interested, I’ll do it afterwards for you. I love magnesium, and magnesium in a real way for me helps. This helped in that same sort of category, but I would actually put this above magnesium in terms of the impact that it’s had for me. It was a substantial impact. So what I’m going to do over the next couple of slides is going to some of the actual metrics, so you can see what I was tracking and what that meant.

The first one was rather disappointing for me actually, because I just told you was awesome and there was this great impact. I went from 5.5 to 5.4, and I don’t care what we’re talking about, which is not important, and that doesn’t sound exciting.

What I was talking about was the hemoglobin measurement, which was a 90 day average effectively of your blood sugar level. It went down, so that’s good and the direction is right, but it wasn’t very impressive and it was quite small.

Fasting glucose, also the right direction, but I just couldn’t understand. For me, experientially this didn’t make sense, so I happen to have more data. I track my fasting glucose myself at home, not every day, but a lot of days.

This is data from 2013/2014 in the January/February timeframes. So the same time of year, and it’s isolated as is scientifically as I could make it. You know, and what you see here is a dramatic difference. In both cases, my blood sugar level is not high, 5.2 in 2013 no doctor is going to get worried about my health, based on that number. But 4.4 is substantially lower and 4.4 feels different to me. I started to get the sense of doing a regular testing I can guess morning for my glucose is going to be and I’m not bad at it. I can kind of feel when my blood sugar is, it’s something that I never had a sense for prior to doing the testing, and it definitely changed as a result of this diet.

Insulin response just a kind of partner in crime with glucose, it was also kind of a healthy status when I went into this exercise and gotten better. Not much more for me to say there.

The body composition, what we are looking at here is the red line was my weight, the other stuff is my body fat and I use three different techniques to measure body fat. There are all going in the same direction and they are all pointing to the same conclusion.

It was that I was losing weight and I was losing body fat. The body fat percentage was I was reliant on are - the blue line is hand scale which is better than a foot scale, it’s just less convenient. Then this is the kind of gold standard over here, and I like it because it’s a really low number and it makes me feel better.

But I had no intention of losing weight and as I said it happened, but I went from about 17½ %, 12½%. Probably the reasonable comparisons down to 15% so that was a substantial change and that was within a month and a half.

And then a graft this out and this is basically be on girth, and a lot of people look to the chest to waste ratios as a key health indicator, and obviously wanting the chest to be more than the waste. And I had a New Year’s resolution I guess and I don’t even remember doing this, but I had data from January 1 of 2012 - 14, so I just use that and put in what happened in December.

And I realised actually this graph is crap, because each of these measurements are being at the same distance apart. So this is actually what it looks like, and it’s pretty dramatic actually.

You know, you see a slow define in both chest and waist measurements, and you know that this is the year. I run my first marathon, and the year I run my first triathlon, and that’s not triathlon but ultra-marathon, and then that’s the month I decided to eat differently. You know, look at the ratio is clearly moving in the right direction and I ran a less in January, even had a cool new watch that I was really excited to use. I really wasn’t running that much and I was thinking I should really be out there running, but it didn’t seem to matter in terms of losing weight and changing the shape of my body.

So cholesterol, is one of these classics and I used to worry about cholesterol because it was in terms of the classic numbers to her late, and I have worked on that and my numbers are okay in a traditional sense. But actually, here are the four things that you get when you do a cholesterol test; total cholesterol, HDL, LDL, triglycerides. Let me just tell you right now, forget about total cholesterol it’s a complete waste of time. HDL is not completely worthless, but like you know it is in a kind of a realm of normal in numbers, and you can probably ignored. It doesn’t really matter as much, and that’s the way I look at it. This is all my opinion, by the way, and I’m not a doctor, and nor have I played one on television.

LDL is LDLC, unless you ask for LDLP and paid a lot of money, you got LDLC. C is calculated and it means that they didn’t measure it, but they did kind of calculate it. And what they didn’t calculate is the particle size and that is turning out to be the thing that really matters.

LDLC is questionable, it’s a dubious measurement, but it’s the bad cholesterol and it gets a lot of the attention and it’s what statins are really good at dropping, so that means it’s important.

Then, triglycerides actually that’s a good marker. It has shown time and time again that it does have important relationships to health and risk factors. It is also very susceptible to diet, so if you are changing your diet. That’s a marker you can move. This is what I use is triglycerides, and that’s my primary thing.

Another thing to keep in mind to and this is a very rough proxy, but if your triglycerides are low, probably your particle size is low to for your LDLs. What that means is that you are not to worry about the number and it doesn’t matter. Triglycerides are low forget about LDL. However, there is a better approximation and that’s APOB.

APOB tells you in a better way how to think about the particle size of your LDL and I guess I couldn’t completely give up on and it should say HDL over total cholesterol, and some people find that’s a better measurement.

So that’s what I used, here is what I got. Cholesterol, I was already in a good place from a triglycerides standpoint, but it got better.

So I don’t know if this is even fair, but on a percentage basis, I got 20%, and that’s pretty impressive, but it’s almost in that I don’t care category because it was pretty darn good.

HDL, also pretty good. You know, I spent many years worrying about this, but I put myself in the opposite category than I was before.

Here is where I didn’t make the optimal category, and actually the markers are a little bit messed up on the screen, but I will tell you what they are. There are two markers and they follow exactly on the same path. One is LDLC which I said, maybe who cares. And this is me getting the feeling for that, so I again, I’m not claiming to be an expert, but APOB is the cost-effective way to get to your particle size, and it was in the risk category.

So that worried me, and I asked a number of quite well-known doctors in this space in whether I should be worried about it. Their general feeling was like person they shouldn’t be with all the metrics they were seeing, but I wanted to get it lower and through the course of diet. I got it into a normal category, but it’s still not where I want it to be. So as we look at the next steps, that’s where I’m going to focus in and that’s the one thing I want to see get better and get into the optimal category.

CRP, the direction is going the wrong way, and again it’s sort of all very good numbers for me and they say get below one and that’s where you should be. But I think if you order your test the lab will say less than five and I was way less than five, but I went in the wrong direction. I’m not sure why, and I don’t really know if that matters and I measured it twice. So on a day-to-day basis. Does it fluctuate by 0.5, 0.8, I have no idea. And I don’t actually even know a good way of doing research on figuring out what is that kind of normal variants. If someone has insights into that I would be hugely interested, because the only way in which I’ve been able to do it is just test it out myself.

He is homocysteine which I had never heard of before I read Grain Brain, and dammit, it’s not good. So the good news this year is actually homocysteine for most people. You can take a lot of folic acid and vitamin B and get that right down into the happy zone.

For me, I had bought some vitamin B , and as any good student of the arts will do, but I bought the super maximum strength one, which made my urine orange and frightened me, so I stopped that, and I have now bought a more moderate strength of vitamin B, but I haven’t had a chance to test, so I’m hoping that will come down.

So who doesn’t love blood pressure, so I put that in there and it’s actually partly my results and partly a question out to the audience. There are three things for people measuring blood pressure. They get the systolic and diastolic, and there is a clear tramline here to and again the same timeframe January, and I think we went to March here, so I cheated for a week, but it is clearly going in the right direction. But the thing that is not showing up here is my resting heart rate, my pulse and that is often measured in the same sort of sentence.

That actually went out and I talked to a number of people who had been on this kind of diet and they have had a same sort of experience. Now for me, my resting heart rate was really good and it went from really good good to just good, so I didn’t care. But I would be interested if anyone has any ideas on why would it go up and is there any reason for some people to be concerned. Especially people who have gone through this and it didn’t start out in the place that it started.

So summaries of the overall test, I would say that when I looked at the metrics outside of that kind of early one that I assured it kind of felt the feeling of how things have gone and the numbers seemed to match up there is always a risk of that you’re being self-filling prophecy I understand. But, the numbers and the way I felt about it were all very good. I’m extremely positive about what came out of this. I’m probably annoying at dinner parties now, I’m pretty certain because I can’t stop talking about it.

I’m definitely planning on continuing this. You know the February was probably loosening up, and March was even more loosening up and I need to be careful about not loosening up too much. But I’m determined to find a way to make this sustainable and get the results that I have gotten out of it to be sustainable.

What I’m thinking on doing next. As I mentioned earlier, the homocysteine and the APB are the two markers that aren’t in the right place for me, so I’m going to push them into the optimal category. Asked me two months from now, three months from now and hopefully the answer will be that’s where they are at.

One of the first things I struggled with when I first came through coming to the end of January and I started to get back into my running was I felt like I was missing a a half a gear. I wasn’t quite there, and I thought maybe this is just an outcome of the diet and that would be really disappointing. But then of course I realise that especially endurance athletes are using the ketogenic system as an optimizer because it’s a much bigger field because you use ketogens rather than a carbohydrate-based energy system.

So I debated for a long time and in this kind of intellectual exercise with myself, I eventually got to a place where I think I was just more keyto adapted and some of the performance problems that I had been having were going away. So now I can run 10, 12 miles very easily again and I don’t think about that any more. But I still think that from a performance standpoint, there is more that can be done. So I’m looking at super starch more than anything else as a mechanism to tap into the carbohydrate based energy system alongside the ketogenic energy system. And resistant starch is something I am looking at for my gut health and my digestive system, which took a very small hit for me during the course of this period. My wife had exactly the opposite experience, but both of those I’ll be looking into.