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About Max Lugavere
Max Lugavere is a filmmaker, content creator and media personality. Though not a doctor, he talks about nutrition, the brain, and health tech. Max is the director of an upcoming documentary titled BREAD HEAD, which explores the impact of diet and lifestyle on brain health.
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Books Discussed in this Podcast
Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain – for Life by David Perlmutter
01:01 Grains and Brain Health: Being skinny does not mean that you are in perfect metabolic health. The absence of disease does not equal the presence of health. Many patients with Alzheimer’s are underweight. There could be metabolic dysfunction. Most of us over consume grains. Studies continue to show that one of the best ways to stay insulin sensitive is by eating low carb, high fiber, and high healthy fat. Over the past century, there has been a thousand-fold increase in omega 6 consumption. Our brains are downstream from many inflammatory processes.
04:39 Elevated Blood Sugar’s Impact upon the Brain: The amyloid hypothesis focuses on the plaque buildup in the brain as the cause of Alzheimer’s and this is the focus of pharmaceutical research for a cure. Decades of research is indicating that this is the wrong road. There is little correlation between amyloid load and cognitive ability. One of the earliest measureable features in the Alzheimer’s brain is impaired glucose metabolism. It is what characterizes type 2 diabetes. Insulin resistance is the inability of cells to let glucose enter for use by the mitochondria for fuel. Research shows that young people, carriers of the APOE-ε4 allele, the gene most associated with risk (not determination) for Alzheimer’s disease; decades before symptoms appear there is impaired glucose usage in their brains. People who have Alzheimer’s disease, regardless of whether they have the APOE-ε4 allele, 100% of them have insulin resistance in their brains. Research shows that insulin resistance in the body predicts amyloid buildup in the brain. Research also shows that ketones can provide an energetic back door to metabolically ailing brain cells.
08:28 Minimizing Risk for Diabetes and Alzheimer’s: Having type 2 diabetes doubles our risk for Alzheimer’s disease. The brain is fed blood by 400 miles of microvasculature. What is good for the heart and good for the metabolism is good for the brain. Changes begin decades before the first symptom, like many chronic diseases. Treatment options are so limited, that prevention is critical.
10:01 Diet and Minimizing Risk: The sugar, the refined carbohydrates, the chronic elevations of blood sugar, we are too sedentary and we are not eating enough vegetables. Carbohydrate consumption should be titrated according to our activities. Think of them as performance enhancing drugs. Have your carbohydrates after your workout. Recently published is a 6 month study of fish oil on executive function, where they measured insulin and total grey matter volume in the brain. Those who had lower levels of fasting insulin had greater volume of grey matter in their brains. Alzheimer’s is characterized by dramatic brain shrinkage. Higher insulin correlates to a smaller brain.
13:12 Metabolic Flexibility: In the morning, we are at our most insulin sensitive and cortisol is high. Insulin is the storage hormone and cortisol liberates fuels for the body to use. We have evolved to use sugar or fat for fuel. When you become insulin resistant, you lose that flexibility. When you burn sugar, you cannot go very long between meals. A higher fat diet allows you to go longer without feeling hungry. Intermittent fasting is another means to induce a state of acute physiologic stress. It does many of the same things that exercise does. It boosts BDNF in the brain that are depleted in Alzheimer’s disease and depression. It has an epigenetic effect, turning on certain genes that are involved in reparative and protective mechanisms. We would need to be healthy enough to do this. It is not advisable for insulin dependent diabetics. It turns on autophagy, the ability to clean up senescent cells that are emitting pro-inflammatory cytokines. Through gene editing in a recent study, enhanced the ability of mice to clear senescent cells. This corresponded with a dramatic increase in lifespan and health span in the mice. Max began intermittent fasting through a website called leangains.com. Max’s fasting practice is intermittent daily eating within a restricted window. We become more metabolically flexible by eating a diet low in carbohydrates, higher in healthy fats and fiber. Ninety percent of adults in the US do not eat enough vegetables. Focus on dark leafy greens. Consumption of dark leafy greens is inversely related to risk for dementia.
20:05 Olive Oil and the Brain: Olive oil is polyphenol rich. There is a compound in olive oil called DMB, which suppresses the microbial fermentation of carnitine into an atherogenic compound called TMAO. Meat contains many brain building compounds. In a diet rich in olive oil, meat is totally healthy. Resveratrol, in a recent mouse study had a similar effect. Eating high amounts of saturated fat, as in the standard American diet, is inflammatory. Animal proteins need to be balanced with lots of phytonutrients. Our diets should be mostly plants.
25:00 Ketosis: Ketosis mirrors the metabolic effect of fasting. Coconut oil is a great thing to integrate into your diet. Medium chain triglycerides convert into ketones. Ketogenic diets have been used for centuries to treat epilepsy, in part because they reduce inflammation in the brain. In brains that display impaired glucose metabolism, providing ketones to them can reverse neurodegenerative disease. The brain will use ketones in proportion to what is in plasma. Much more research needs to be done. There is an FDA approved MCT-based medical food prescribed for patients with Alzheimer’s disease called Axona.
28:25 APOE-ε4 SNP: This genotype lends an increased risk of Alzheimer’s. Some think that APOE-ε4s over-respond to saturated fats and may have an exaggerated LDL response. The best way to reduce LDLs is to reduce inflammation in the body and eat a lower carb diet. In some of the MCT studies, those with APOE-ε4 did not respond as well to ketone treatment. Perhaps the level of ketones was not high enough. A recent large study found that eating cholesterol in unrestricted amounts did not affect cardiovascular risk markers even in patients with the APOE-ε4 SNPs.
34:32 Optimizing Brain Health and Brain Function: It is challenging to make a huge shift in someone’s nutrition and exercise after decades of disinterest. Exercise is medicine for the brain. Max is focused on the idea of prevention. Alzheimer’s and other neurodegenerative diseases, like vascular dementia or Parkinson’s, progress over decades. It is important to modify diet and lifestyle now. Keeping the mind active with novelty is helpful. Life begins at the end of your comfort zone and Max believes that health begins at the end of your comfort zone.
38:05 The Oral Microbiome: We have gram negative bacteria in our mouths. It is one of the reasons why poor oral health is linked with cognitive decline. For decades it has been linked to cardiac health. If you have poor oral health, just chewing can cause the release of bacterial endotoxin into the bloodstream.
42:40 Dairy and Neurologic Issues: The data on dairy and cognitive decline is mixed. Bovine dairy slows transit through the gut. Casomorphins in dairy stimulate mucus production. It is a special variety of mucus that is only secreted by the gut epithelium in response to inflammation. Casomorphins are comparable to opiates.
45:26 Meditation and Cognition: Meditation helps to rebuild grey matter in the brain. It reduces stress and tunes the parasympathetic nervous system. It lengthens telomeres and reduces inflammation.
48:38 Bread Head Documentary: Join the email list to track Max’s progress on the movie.
50:21 Max’s Favorite Nutrient: Omega 3 fatty acids from fish oil are his favorite. DHA is a brain building block. EPA is a super anti-inflammatory. Max is doing research on how fish oil can improve executive function in the brain.
51:28 Max’s Morning Routine: After drinking water, Max meditates for 20 minutes. About an hour after he awakens, and his cortisol has subsided, he makes coffee, maybe with MCT oil, turmeric, and black pepper. Piperine in black pepper helps with the absorption of turmeric. He likes to focus, respond to emails and do left brain things. After this, he tries to do his workout. Later in the day, he transitions to creative activities. He often works late into the night.
54:54 One Health Tip for America: Recently, an expose revealed that a leading soft drink manufacturer channeled funds to a non-profit to shift the obesity focus away from diet to exercise. Two hundred thousand people world-wide die every year purely due to sugar sweetened beverages. People are confused enough about nutrition. A large part of why people are so sick in this country is from a lapse of education.
Dr. Kharrazian is one of the most sought-after educators and clinicians in natural medicine, laboratory analysis, and nutrition. His seminar schedule is booked years in advance. He lectures both nationally and internationally at major medical and scientific conferences worldwide.
He conducts several professional and scientific presentations a year in addition to giving radio and television interviews. Dr. Kharrazian has personally trained a group of more than a dozen exceptional doctors to lecture nationally to meet the demands by health care providers on how he clinically manages complex cases.