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1:06

Hey everyone, it's Katie Couric, and I

1:08

wanna tell you about one of my

1:10

new favorite podcasts. It's called A Really

1:13

Good Cry with the amazing Roddy DeVlukia,

1:15

a plant-based chef, entrepreneur, and now a

1:17

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1:19

a journey of self-discovery one tear at

1:22

a time. Listen to A

1:24

Really Good Cry with Roddy DeVlukia

1:26

on the iHeartRadio app, Apple Podcasts,

1:28

or wherever you get your podcasts.

1:31

Hi, it's Katie. Welcome to Wellness

1:33

Check, our series of some of

1:35

our favorite Next Question episodes focused

1:38

on women's health and wellness. Enjoy.

1:48

Hi everyone, I'm Katie Couric, and this

1:50

is Next Question. You know,

1:52

I've known and admired Dr. Sanjay Gupta

1:54

for years. He's such a great guy.

1:56

He's also a neuroscientist. and the chief

1:59

medical correspondent for CNN, which, as you

2:01

can imagine, when COVID hit, put him

2:03

at the center of the pandemic storm.

2:05

This may be a new pathogen that

2:07

circulates around the world. You're running into

2:10

a situation where you just don't have

2:12

beds. If those numbers don't budge, it's

2:14

gonna be very hard to get to

2:16

herd immunity. I think this has added

2:19

a lot more urgency to an already

2:21

very urgent situation. There

2:23

has been so much to cover,

2:26

in fact. Sanjay also launched a

2:28

daily podcast on the subject. I'm

2:30

Dr. Sanjay Gupta, CNN's chief medical

2:32

correspondent. And this is

2:34

Coronavirus, Fact vs. Fiction. Throughout

2:38

this very long year, Sanjay has

2:40

really acted as our guide, helping

2:43

us understand this thorny virus and

2:45

what it means for our health,

2:47

our communities, and our country. And

2:50

he admits it's been as all-consuming as

2:52

you might think. All I

2:55

think about, Katie, has been COVID. You

2:57

know, viral transmission,

3:00

how people evaluate risk, social

3:03

behavior. But there is some

3:05

joy in getting so head down in something.

3:07

I feel like we live such distracted lives.

3:09

You get a little bit about a lot

3:11

of things. Like,

3:13

I really know so much about this virus. I

3:18

also wanted to talk to Sanjay because he's

3:20

got a new book out. Yeah, believe it

3:22

or not, he found time to write a

3:25

book during this crazy year. It's

3:27

called Keep Sharp, Building a Better

3:30

Brain at Any Age. And

3:32

it's fascinating. It's also a practical

3:34

guide for better brain health, something

3:36

I'm extremely interested in. And don't

3:38

worry, we do get into that.

3:41

But since I have the COVID

3:43

expert of experts, I couldn't help

3:45

but start our conversation there. You

3:49

must feel like you have a PhD

3:51

in virology at this point, right? Yeah,

3:53

I mean, totally. And the

3:55

irony is, Katie, is that this is

3:58

a novel virus, right? So,

4:00

I mean, novel actually means something, which

4:02

that didn't really strike me until a

4:04

few months into this either. Like I

4:07

think, because you said

4:09

the PhD in virology, the irony is that

4:11

I think people who had a

4:13

lot of knowledge about this in some ways, it got

4:17

in their way. Because it's very hard

4:19

to think about something as novel. You immediately

4:21

want to put it into a box. It's the box

4:23

of SARS. It's

4:26

the box of H1N1, whatever you

4:28

come up with. But this was novel,

4:31

which means that if you try to put it in a box,

4:34

you probably got it wrong. So

4:36

they had to cast aside their

4:38

preconceived notions completely. And

4:40

that's hard to do, right? For a

4:42

scientist. It's really hard to do. And

4:45

it goes against sort of how you think

4:47

about things. Let's get the best experts. And

4:49

by the way, I think there's really, really

4:51

great value and expertise. Don't

4:54

get me wrong. What

4:56

you would do is grab the coronavirus

4:58

experts, grab the pandemic experts. And that

5:00

was all important. But this virus

5:02

was just behaving in a totally novel way.

5:04

I mean, one of the best examples, as

5:07

you well know, was

5:09

everybody believed that respiratory viruses really

5:11

only spread when you were sick.

5:15

When you had symptoms, that's when you spread it. The

5:18

guidance was we'll screen people at airports. We'll tell

5:20

people to stay home if they're sick, which

5:22

people should do anyway, regardless of whether in a

5:24

pandemic. And we should

5:26

be able to quell this thing. No

5:29

one really believed initially that

5:31

this thing would spread most efficiently when

5:33

people didn't have symptoms. That's

5:37

never really happened before. As Dr. Fauci

5:39

has said, never in the history of

5:41

respiratory viruses has that happened before. That's

5:44

novel. I mean, you know, you remember the

5:46

story of typhoid Mary. She was

5:48

a silent carrier of typhoid. It

5:51

was so dramatic because she infected all these

5:53

people in this single residence

5:55

and this community and all that, and people

5:57

couldn't figure it out. millions

6:00

of typhoid marys in a way of

6:02

a brand new disease,

6:04

COVID. So it was quite

6:06

extraordinary to sort of see how that

6:09

all played out. Well,

6:11

before we talk about your new

6:13

book, Keep Sharp, because I'm really

6:15

interested as someone who's 64 in

6:18

maintaining my mental acuity

6:21

as I age, I

6:23

just want to ask you one last question about

6:25

COVID. And that is, are we

6:28

seeing the light at the end of the tunnel?

6:30

Every time I feel optimistic, Sanjay, I then

6:33

read something about variants or

6:35

increased cases. And it's

6:38

quite nerve wracking, I think, for

6:40

the average person who doesn't have

6:42

a medical degree or hasn't been

6:44

deeply, deeply entrenched in the science

6:46

of this. I mean, are we

6:48

screwed? Are we at the tail

6:50

end of this pandemic? I

6:53

do feel the light on my face and

6:55

your face. I mean, I do think that

6:57

the tunnel is the end of the tunnels

7:00

in sight. I mean, can

7:03

I just remind people, and I think this

7:05

is such an important reminder, that they were

7:08

having rave parties in Wuhan at the end

7:10

of last summer. And

7:12

I bring that up only to say that

7:14

we talk about the vaccines, we talk about

7:16

the fact that science is now rescuing us,

7:19

which is great, fantastic. But

7:21

so much of this didn't need to happen.

7:23

And I know that's not your question, Katie,

7:25

but I just feel like I can never

7:28

answer a question about the sort of future

7:30

or being optimistic

7:32

about this pandemic, because I'm so,

7:35

it's just so, I'm so angry in

7:37

so many ways. I mean, you know, 600,000 people

7:41

died, and some of them are my friends,

7:43

and I've seen families, I talk to families

7:45

still. I just, it just, this may not

7:47

have even been the Black Swan event, right?

7:49

We think of this Black Swan event, this

7:51

really contagious virus, which this was, but

7:54

something that has a 2 to 3% mortality, that

7:56

would be awful. That would be the Black Swan

7:58

event. This wasn't even that. There were countries around

8:00

the world that immediately quelled this and

8:03

measured their debts in the hundreds instead of the hundreds

8:05

of thousands. Having said

8:07

that, we are a society because

8:09

we focus on touchdowns

8:11

and home runs and knockouts. We

8:13

don't care much for singles and doubles because

8:16

we're that society. We waited for science to

8:18

rescue us. And the

8:20

vaccines, I think they're really extraordinary

8:22

and really effective. They

8:24

seem to be pretty effective against the variant

8:26

B.1.1.7, the UK variant, because there's

8:30

a lot of concern about that variant. But if

8:32

you have been vaccinated or if

8:34

you had the infection in the past, the

8:36

other, the circulating coronavirus,

8:39

that should also protect you. So I think it's

8:41

really good. And I think with the warmer weather

8:43

in the summer, viral transmission rates

8:45

will go down. That'll be great.

8:48

I do think we'll probably

8:50

get to herd immunity over the summer,

8:52

but it's worth reminding that herd immunity

8:54

isn't a sort of destination necessarily. You

8:57

can pop in and out of herd

8:59

immunity. So if not enough people

9:01

get vaccinated over the

9:03

next few months, then going

9:05

into the colder weather again in the fall,

9:07

we could see resurgences. It's

9:09

quite disturbing when you hear about the

9:11

people who are refusing to get

9:14

vaccinated. Many of them are white

9:16

men in this

9:18

country. I think you see the

9:20

impact of politics on that number,

9:23

not only in terms of the

9:25

response to the pandemic, but now

9:27

to the response to the vaccines.

9:31

That must be quite disturbing

9:33

for you, too. It is for me. Yeah.

9:37

I mean, there's been no, not

9:39

a single part of this entire pandemic

9:41

that hasn't been politicized in some way.

9:44

I guess now you say that in April

9:46

of 2021. It's

9:49

obvious, right? Everyone knows that, but start

9:51

starting off covering the story. All

9:55

the way now to the vaccines, even every

9:57

single component has been politicized in some So

10:00

it is it is disturbing the

10:02

anti-vax movement and you may not even remember this

10:04

Katie, but I actually did a segment on your

10:06

your show years ago about

10:10

Anti-vaccination movement at that time around

10:12

h1n1 But

10:14

it's been around for a long time

10:17

the anti-vaccination movement and it's sort of

10:19

you know, it simmers it we saw

10:21

measles outbreaks in Brooklyn and and Disneyland

10:24

and Minnesota this seems bigger though

10:26

Sanjay, you know That was a

10:28

particular group And

10:31

it really dealt primarily with

10:33

with childhood vaccinations. And

10:35

now this has expanded to

10:39

You know these adults who

10:42

I Don't

10:44

know for one reason or another I

10:46

think you can understand people of color

10:48

and the the terrible history of Tuskegee

10:50

and Some of the

10:52

ways that people of color have

10:54

been abused in scientific research in the

10:56

past and this kind of deeply ingrained

10:59

Mistrust of the medical community. So

11:01

I think you can appreciate that but this

11:03

is you know This is a

11:05

whole other ball of wax,

11:07

isn't it? Yes It really

11:10

is and you know, we're seeing some of

11:12

this for or really seeing it come

11:14

to light I should say, you know in

11:16

a in a pretty dramatic way now I think I

11:18

think I was reading the statistics this morning Katie Kaiser

11:20

Family Foundation 40 to 50

11:22

percent of those in rural areas

11:24

who say they Absolutely will not

11:26

take the vaccine. It's not a question of hey,

11:29

I want more information. I want to see how

11:31

this plays out They're just saying out of the

11:33

gate. They absolutely not take it. Yeah, what is

11:35

the explanation? That's the curious

11:38

thing like you said with some people

11:40

who are vaccine hesitance. It is concerns

11:42

about safety or mistrust or you know

11:45

My my grandfather was Experimented

11:48

on as part of Tuskegee, you know

11:50

things like that with this I think

11:52

it's almost an extension of this pandemic

11:55

isn't even real. It's not a hoax. Why would I take

11:57

a vaccine for something? That's

11:59

our the hoax. I'm not scared

12:02

for safety of it. I just don't. I think the whole

12:04

thing is sort of the scammedemic

12:06

sort of thing. So I

12:08

don't know if that's the case for it's a huge

12:10

percentage of people we're talking about here. So maybe there's

12:12

a some heterogeneity in some

12:14

variety of opinions there. But bottom

12:17

line, if the numbers stay

12:20

that high, we're not going to get

12:22

to herd immunity based on vaccinating adults

12:24

alone, which is really depressing. So

12:27

I mean, gosh, we wait for science to

12:29

rescue us. We don't do the basic public

12:31

health practices. And then when this truly extraordinary

12:34

scientific achievement occurs in the form

12:36

of this vaccine, people

12:38

don't take it. You're a Martian

12:40

coming to planet Earth and saying, so

12:42

let me get this straight. So

12:45

you didn't do anything about the virus. You

12:47

waited, created this amazing medicine and then you

12:49

don't take the medicine. It just

12:52

it doesn't make any sense. It's a

12:54

head scratcher for sure. Yeah. When do

12:56

you think Sanjay will be able to

12:58

go about our daily lives without masks?

13:02

I think it'll be this summer, Katie. I

13:04

really do. I mean, I know that there's people who are

13:06

painting a more dire prediction around

13:08

that. But, you know, we for no other

13:10

reason alone with the warmer weather and then

13:12

you're going to really see the blunting despite

13:15

the vaccine hesitancy that we're talking about, you are

13:17

going to see a significant blunting of people who

13:19

are getting very sick, people who are dying. And

13:22

we know that the vaccine does seem to

13:24

have good evidence that it stops or decreases

13:26

transmission. So I think we're really going to

13:28

get to a pretty good point. I think

13:31

you'll still see masks around, you know, in

13:33

Hong Kong after Hong Kong really wasn't

13:36

a mask wearing country until after SARS.

13:38

And then there was this huge psychological

13:40

impact. That's why they went to mass

13:42

so early in Hong Kong. But they

13:44

became a mask wearing culture. I think

13:47

you will see people who are just frightened, still

13:49

want to wear masks in public places. I think

13:51

in flu season, you know, the colder months, I

13:54

think you'll see more masks. I think that may

13:56

become a larger part

13:58

of our culture, not a dominant. but I think

14:00

a larger part of our culture. That's interesting

14:02

because I remember being in Tokyo, maybe

14:05

gosh, gosh, maybe 10 or 12 years

14:07

ago, and

14:10

going on the train to Kyoto

14:12

and seeing everyone wearing masks and

14:14

thinking, this is so weird, why

14:16

are they wearing masks? And now

14:18

of course I understand. And you're

14:20

right, I think when people are

14:22

on places like public transportation, if

14:24

they're in closed spaces with lots

14:27

of strangers, it

14:29

actually makes sense, doesn't it? I

14:31

mean, one thing we saw, as you may remember,

14:33

is that the flu numbers were

14:35

way down this past season. And

14:39

that wasn't because of any increase in

14:41

vaccination or anything, that was because of

14:43

just public health behavior. It's always worked.

14:46

I don't know, there's a metaphor for this, Katie,

14:48

right? I mean, I don't know, I guess it's

14:51

true in our lives, like we'd rather just take

14:53

a pill for weight loss rather than go exercise.

14:56

I mean, we always want the convenience. And

14:59

this is another example of that. I

15:03

was struck, and again, we could talk about COVID all

15:05

day long, but I'll

15:07

never forget these mask researchers from Harvard,

15:09

a guy named Abraar Karan, he

15:12

basically was doing all this modeling all along, we

15:14

were talking to him. He told me that if

15:16

for four weeks, and this is back October,

15:18

November of last year, if for four

15:20

weeks, everybody just

15:23

wore a high filtration mask when they went out

15:25

in public. That's it, for four

15:27

weeks, if everybody did that, it

15:29

would have ended the pandemic. Are

15:31

you kidding? That's incredible. The virus

15:34

would have nowhere to go. It couldn't find

15:36

a willing host. I mean,

15:38

that sort of concept is

15:42

something that's more than 100 years old. I

15:46

just don't quite, I don't know, maybe

15:48

I'm just being naive, but you hear that and

15:50

you think it's amazing, right? I think it's amazing,

15:53

and yet we also know, both of us,

15:55

that in the United States, that couldn't happen.

15:58

It just wouldn't happen. a

16:00

human being survived and thrived as

16:03

a species because we're reciprocally altruistic.

16:05

There's a reason that it feels good to do

16:07

good. Why should it feel good when I do

16:10

something nice for you? I mean, what purpose does

16:12

that serve my evolutionary tree? I don't know. But

16:14

the reality is that it does feel good to

16:17

do good. We encoded that in some way in

16:19

our DNA, and then people can't be bothered to

16:21

wear a mask to save tens of thousands of

16:23

lives. I just... That

16:26

may be one of the greatest mysteries of all out of

16:28

this whole thing. Well, I

16:30

just want to say on behalf of

16:32

the American public, thank you for your

16:34

coverage of this. I

16:37

think you're so measured and so

16:41

eloquent and honestly

16:44

calming in a way. And

16:46

I just really appreciate all

16:48

the fantastic reporting you've done

16:50

throughout this pandemic. So on

16:54

behalf of a grateful America, I would

16:56

like to say thank you, Sanjay Gupta.

16:59

Katie, thank you. Thank you. And

17:01

that obviously means a great deal

17:04

in particular coming from you. So I

17:06

appreciate that. You know, you get it.

17:08

You know, I mean, you are

17:10

the standard, obviously by whom we all

17:12

measure ourselves. But also, you know,

17:14

we're all in these black holes, right? I mean,

17:16

I don't know where you are right now, as

17:18

I said, I'm in this tiny little closet. You

17:21

don't get any feedback. Sometimes it's

17:23

been really dispiriting because you think, okay,

17:25

I'm a medical reporter in the middle

17:27

of a pandemic. That is my, you

17:29

know, that's a job. And

17:32

at the same time, the country in which I'm

17:34

reporting arguably did the worst in the world. I

17:37

mean, I know I keep taking this in that

17:39

direction, but it's just so dispiriting. Did

17:41

anyone listen to me? I mean,

17:44

if you're the medical reporter and presumably

17:46

people are counting on you to provide

17:48

knowledge hopefully that will inform how they

17:50

behave and then we do the worst

17:53

in the world. That's

17:55

you know, I'm going to need to reflect on

17:57

that. I think, you know, in the

18:00

years. to come. Like what is the real

18:02

impact here? One could argue that maybe it

18:04

would have been worse. Who knows, you know,

18:06

but it's pretty bad. Well, don't

18:08

get too dispirited because I think a

18:10

lot of people listened, relied on you

18:13

and actually acted. So

18:15

even though the track record was bad, your

18:18

information was good and important. So

18:20

thank you. I appreciate that.

18:30

Let's talk about Keep Sharp

18:32

because moving forward, I think

18:35

many people like me really

18:37

are interested in how to

18:39

keep our cognitive and mental

18:42

health at

18:44

the top. And I think, you

18:46

know, certainly one big change

18:48

in medicine is that we

18:52

as patients are not

18:54

passive. It turns out

18:56

Sanjay that there is a lot of

18:58

things that we can do to keep

19:01

our brains in shape, just like we

19:03

can do to keep our bodies and

19:05

our organs and other things in shape.

19:08

And that's why you wrote Keep Sharp. But you

19:10

have a very, very personal

19:12

connection to this, I

19:15

guess, well, obviously, because

19:17

of your specialty, but

19:19

particularly about Alzheimer's dementia

19:22

and our

19:24

failing brain power that happens as

19:26

we age. Tell me about that.

19:29

Well, when I was 12 or 13 years old,

19:31

my grandfather, my

19:35

mother's dad, who I was very close

19:37

to, developed,

19:39

you know, signs of dementia.

19:43

He had had a stroke earlier in

19:45

his life that had recovered and

19:47

was now developing, you know, just these

19:52

periods of time where he really wasn't aware

19:54

of what was going on. He would sometimes

19:58

make a joke that no one else was in. on, you

20:00

know, and it was all these things that I remember

20:02

really being struck by as a kid because you look

20:04

at adults and you're not used to seeing brain

20:07

power start to diminish and it was the

20:09

first time I saw really specific things like

20:11

he could he could still write but he

20:14

couldn't really read. It was it was all

20:16

these things that became really fascinating in a

20:18

way for me in terms of just how

20:20

does the brain work like that but

20:23

also to see it in a loved one to wonder is

20:26

that how genetic is that? Is that gonna is

20:28

my mom going to develop those symptoms will I

20:30

one day all of that and

20:32

then you know fast forward you know 30

20:34

40 years later and and we're

20:36

still worrying about the exact same things and

20:40

and haven't really made a lot of progress

20:42

in terms of being able to deal with

20:44

that so that was that was a large

20:46

part of what I think inspired me to

20:48

to write the book what has

20:50

happened over the last 40 years both

20:52

from a you know a pharmaceutical standpoint

20:54

but also more importantly I think from

20:56

a from a lifestyle behavioral standpoint in

20:59

terms of what we know. And how

21:01

does that influence you to go into

21:04

neurology? No you know it's funny

21:07

it didn't I actually when I started medical

21:09

school I thought I was gonna go into pediatrics

21:11

and then I did a neurosurgery rotation

21:15

during my third year of med school and I just sort of fell

21:17

in love so I came to it quite late but

21:19

I was always interested

21:21

in the brain because of my grandfather

21:23

and so it felt like a very

21:25

natural fit. Let's talk about the numbers

21:28

because 47 million

21:30

Americans have some evidence of

21:32

preclinical Alzheimer's disease and by

21:34

2060 one new case

21:37

of dementia will be diagnosed every

21:39

four seconds. Sanjay

21:41

what the heck is going on here?

21:44

Well this is this will

21:46

become the the most dominant neurodegenerative

21:48

disease of our time I think

21:51

that that part I think is is pretty

21:54

well established at this point but

21:56

there was two things about the statement that you

21:58

just made that I thought were really important

22:01

in terms of what we could potentially do about

22:03

it. As you point out, there's probably about

22:05

47 million people who if you were to look at

22:07

their brains, they would have

22:09

objective evidence of plaques and tangles and

22:11

things like that, but also

22:13

have no symptoms. That's the

22:16

preclinical time, right? So

22:18

you hear that. Okay, you're breaking me out a little. Well,

22:20

it's, you know, but I think this is

22:22

ultimately good news and I'll tell you why. If

22:25

you look at patients with Alzheimer's disease

22:27

and able to retrospectively

22:29

look at their lives and their scans and

22:31

their brains, you find, we now

22:33

know that Alzheimer's starts in

22:36

the brain decades before people

22:38

develop symptoms, decades. So you're

22:40

starting to see the kindling and then even

22:43

plaques and tangles. But the

22:45

fundamental point that neuroscientists really started to

22:47

focus on was almost the

22:50

analog of that, meaning, okay, so now

22:52

you've established that you can have a

22:54

brain that has plaques and tangles, but

22:56

still functions normally. So

22:59

why don't we focus on that side of

23:01

things instead of saying, hey, look, let's get

23:03

rid of the plaques and tangles. And we

23:05

have spent billions of dollars testing drugs to

23:07

do that that haven't really worked. What

23:10

if we say instead, we have established that

23:12

a brain with plaques and tangles can function

23:14

normally? Let's figure out why and see

23:16

if we can basically make

23:19

that an aspiration. Do

23:21

you still have objective evidence

23:23

of Alzheimer's in your brain? Yes. Is

23:26

it consequential? No, because you

23:29

are able to still have normal

23:31

cognitive function, memory, judgment, all the things

23:33

that you associate with a healthy functioning

23:35

brain. The metaphor in some

23:37

ways, Katie, would kind of be like a heart

23:39

bypass surgery. You got a blocked

23:41

blood vessel. Now you

23:44

go in there and you bypass that area of

23:46

the blockage with a new blood vessel. Do you

23:48

still have heart disease? Yes. Is

23:53

it causing you some dysfunction? No, because you're getting

23:55

enough blood flow now to the heart. If

23:57

you can think about that same metaphor

23:59

for for the brain, yes, you

24:01

have plaques, but there's so many ways

24:04

to build all these new pathways in

24:06

the brain to your destination that little

24:08

blockages due to the plaques

24:11

becoming consequential. So is there

24:13

a tipping point? You know, you talk about

24:15

these tangles and plaques in your brain. Is

24:19

it just a slow growth

24:22

of plaque or slow accumulation

24:24

of plaque and increased kind

24:26

of tangles that then

24:28

lead you from being perfectly

24:31

functioning, you know, maybe some

24:33

memory issues, right? That once in a while,

24:35

you know, you're not quite as sharp as

24:37

you were when you were

24:39

younger, but where you kind of fall

24:41

off or it's just gradual buildup of

24:43

this gunk in your brain. Well,

24:47

it does seem to be a pretty

24:49

gradual buildup and you can tolerate a

24:51

significant amount of buildup before

24:53

you, I guess, as you say, fall

24:56

off, you know? So what exactly then

24:59

pushes people over? It's not all of a sudden you

25:01

have an exponentially more plaque and

25:03

that leads to the problem, maybe for

25:05

different people, it's a different inflection point,

25:07

but the brain is actually quite resilient. I mean,

25:10

that's the thing that came out of this. Even

25:12

with a lot of plaque and tangle, you

25:14

could actually be doing fairly well. I mean,

25:17

the occasional memory lapse, like you say, which

25:19

is probably due more to inattention than even

25:21

anything organic in the brain, but

25:24

other than that, doing pretty well. And you see

25:26

societies around the world where

25:28

arguably brain function, not

25:32

only is it good, it may be improving

25:34

as you get older. Which is

25:36

so incredible. And that I think is one

25:38

of the hopeful things about this book, that

25:41

our brains can get sharper and

25:43

better as we age and dementia

25:46

is not necessarily an inevitable, you

25:49

know, concept's not necessarily an

25:51

inevitable, you know, consequence

25:53

of old age. So, you

25:55

know, I remember reading Sanjay, how

25:58

your brain like... By

26:00

the time you're 23 or

26:02

24 and then your prefrontal lobe and all

26:05

this stuff that has to

26:07

do with judgment, after

26:09

that, your brain really stops

26:11

absorbing and growing

26:13

and changing. That was

26:15

sort of what I always thought. And then

26:17

it was downhill from there. But

26:20

this book is really

26:22

cause for celebration in some

26:25

ways, right? Right. Absolutely.

26:28

And I was told the same thing, right? You got a

26:30

certain number of neurons in your brain and

26:32

then you're going to drain the cash as you go

26:35

through life. Certain things like drinking alcohol and things like

26:37

that are going to kill more brain cells. You're never

26:39

going to get them back. I think that's what our

26:41

parents told us to keep us from drinking. It

26:44

works well to some extent. But that

26:46

part of it is not true. And

26:51

that may be one of the most fundamental new

26:54

things that we learned. And by the way,

26:56

you'll appreciate this, Katie. I'm

26:58

in some ways this book, I'm

27:00

acting as translator. I

27:02

go to these neuroscience meetings because I

27:04

live this bifurcated life between medicine and

27:07

media. But I'm still going to

27:09

these neuroscience meetings. And they're talking about these

27:11

fascinating developments. And yet that hasn't

27:13

really gotten to the lay public yet. So

27:16

it's about a 10 year gap. In some

27:18

ways, Keep Sharp was to just accelerate that

27:20

knowledge tree. But one of

27:22

the things that they've been talking about is

27:24

exactly what you mentioned, which is neurogenesis. One

27:28

sort of neuroplasticity, which basically means you

27:30

can recruit neurons, brain cells

27:32

from other areas of the brain to do new

27:34

functions. This is actually

27:36

growing new brain cells. And

27:38

we were told throughout our lives that it basically

27:40

happened twice. When you were a

27:43

baby and your brain was still forming, and

27:45

maybe after an injury, like a stroke or

27:47

a traumatic brain injury, there may be a

27:49

process of neurogenesis that occurs. But

27:52

what these neuroscientists have

27:54

really been writing about and

27:56

focused on for some time is that at any

27:58

age, a healthy brain. can

28:00

continue to grow new understand

28:24

the difference neurogenesis.

28:27

Um, explain a

28:30

fifth grade. Okay. So of

28:33

neuroplasticity, it's brain is like

28:35

plastic. It So

28:38

let's say there's been brain where someone

28:41

had a stroke or something, you

28:44

another part of the brain compensate,

28:47

compensate. Y don't

28:49

take. So if it was for

28:52

example, on the right that was affected cells,

28:57

don't do motor function. motor

28:59

function could be r sort

29:02

of work or a sense. Y lose

29:04

a sense. Other senses heightened

29:07

or even create that

29:09

with blind people, y of

29:12

a heightened sense

29:14

of of

29:16

senses, right? That co that you

29:19

can't see. Exac that

29:21

is a, it's an amaze sort

29:24

of gives real birth cognitive

29:27

therapy. We're y therapies

29:30

to basically re parts

29:32

of your brain to do can't do right now.

29:34

The h amazing,

29:37

isn't it? It

29:39

cont delight me

29:41

every day. And about

29:43

this for 40 years. Y um

29:47

neurogenesis is the gr cells.

29:51

So this, this, thi of

29:53

what we were all told that you only have

29:56

a cert that's it. This

29:58

is basica new brain

30:00

cells at any age. The metaphor I think

30:02

that may make it more, more accessible is

30:06

is right now our

30:08

COVID life is kind of like how our

30:10

brain operates. And what I mean is that

30:12

you probably are at home, you may drive

30:14

to the grocery store, maybe you drive to

30:16

a couple of different places. And

30:19

you but you're not you're mostly in just

30:21

a small, small square sort

30:23

of area of place. You

30:25

know how to get to all those places really well, you

30:27

could drive there with your eyes closed, no problem. But

30:30

but you you're not traveling around the rest of

30:32

the world, you're not even traveling around the rest

30:34

of the state right now. That's kind of how

30:36

our brains are, we use our whole brain. But

30:38

90% of the time we're

30:41

using 10% of our brains. That's

30:44

the thing. If you start to

30:46

actually do things to inspire neurogenesis in your

30:48

brain, it's kind of like building new cities

30:50

and visiting those new cities in your brain.

30:52

That's it's a it's a little bit of a

30:55

simplistic metaphor, but it makes me really happy to

30:57

think about because visiting other

30:59

places in your brain is an incredibly

31:01

joyous thing. You start to see patterns

31:03

that you would have otherwise missed, you

31:05

connect dots, your thinking is is

31:07

clear. And that's

31:10

the whole concept of what neurogenesis can

31:12

do for you. When

31:14

we come back Sanjay's advice on

31:17

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31:19

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O'Wahi. Well,

34:33

take me on a trip. What

34:38

do I do and how can

34:40

I visit these new places in

34:43

my brain? Because this is really

34:45

exciting and I know

34:47

your book has a lot of

34:49

recommendations for ways that we

34:52

can encourage neurochemists. So

34:54

what do I do Sanjay? Yeah, so I'll

34:57

tell you, the way that I wrote

34:59

the book was I took all

35:01

these neuroscience concepts and tried to make them

35:03

accessible and also help you set up a

35:05

substrate for your brain in terms of how

35:08

you nourish yourself, how you rest your brain, things

35:10

like that. So the basics are there, but

35:13

your question is more about taking the trip and

35:15

building the new brain cells. So

35:17

after you sort of make sure, and

35:19

it's not challenging to get to the right

35:21

sort of place in terms of your diet

35:24

and the amount of rest that you need, that's

35:26

important. But

35:28

the biggest, I think, difference with growing

35:30

new brain cells versus how we typically

35:33

think about strengthening our brain is

35:36

that you don't necessarily want to just

35:38

keep doing the same things over and

35:40

over again. The whole practice makes perfect

35:42

sort of teaching, the kill and

35:44

drill sort of teaching that a lot of

35:46

schools focus on. It's important

35:49

to understand and be able to

35:51

learn concepts, but

35:53

that's kind of like those roads I was talking

35:55

about that you travel so well. That's like getting

35:57

even better at traveling those same roads. can

36:00

really do with your eyes closed. Now you

36:02

know it's totally second nature to you. But

36:06

if you were to do different things,

36:10

totally different things, things that get you out of your comfort

36:12

zone a little bit, a totally

36:14

different sort of hobby, that's when you're

36:16

starting to actually build

36:19

some of these new brain cells, create some of these new

36:21

cities, create some of the new roads,

36:24

whatever metaphor you want to apply to it, that's

36:28

a much better way to sort of do

36:30

that versus the practice

36:32

makes perfect. So if practice makes perfect,

36:35

change is what's going to build the

36:37

neurogenesis, it's going to build the resilience

36:39

and redundancy in your brain. So

36:42

I played the piano, should I not

36:45

focus as much on the piano, because I

36:47

thought about taking lessons, even though

36:49

I took for 10 years and I played

36:51

by ear, but I enjoyed the piano and

36:53

we actually have a beautiful piano, that

36:56

Jay and I bought each other for our

36:58

birthday back in the day. Yeah. And but

37:00

but should I learn how to play the

37:02

guitar or the violin or the violin sounds

37:04

just horrible if you're not good at it.

37:06

But what I mean, should I try a

37:09

new instrument? Yeah, you know, so I asked

37:11

a lot of neuroscientists about this, because one thing

37:13

about writing a book like this is that it

37:15

affects everybody, right? So even the guys and

37:17

gals who are doing all this

37:20

research, they're thinking about what to incorporate into

37:22

their own lives. And there are

37:24

a couple of things that sort of jumped out

37:26

at me. One is that something new is, I

37:28

think, really important. That's that's that that is a

37:30

key. But something that you can also use your

37:32

hands with that you're actually activating

37:35

your motor motor cortex as you're doing seems

37:37

to be even more beneficial. So so an

37:40

instrument is great. Painting

37:42

should I have and should I try a new one?

37:45

Because I a new one. Yes. I mean, I mean,

37:47

the piano, again, I want

37:49

to be careful here. I did this. Bill

37:51

Clinton, I was talking to him about brain health the

37:54

other day, and he got on my case because he

37:56

said he loves crossword puzzles. And he's like, so you

37:58

tell me crossword puzzles are not good. for... No,

38:01

no, I'm not saying don't do those

38:03

things, but understand what you're accomplishing. You're

38:06

paving those roads really, really well in your

38:08

brain, and that is great. There's great value

38:10

in that. But if it is

38:12

true that you can build all these new roads,

38:15

and the question you're asking me is how to

38:17

do that, then it would mean doing something different.

38:20

So I'm not saying stop playing the piano, keep

38:23

driving those roads, but if you

38:25

want to start going on these trips

38:27

around your brain, doing something different, and

38:29

preferably doing it in a way that

38:32

may be even a little uncomfortable. So

38:35

if you're painting, and I just bring up painting because this is

38:37

the one that came up

38:39

several times among these neuroscientists, learn

38:42

how to paint. I'm a terrible artist, learn how to

38:44

paint, do whatever you can, and do it with your

38:46

non-dominant hand. Do it with

38:48

your non-dominant hand. Really? Yes. In fact, they

38:50

went so far as to say that tonight

38:53

at dinner, when you're eating your dinner, try

38:55

eating your meal with your non-dominant hand, and

38:58

just see what happens. And it's really

39:00

interesting, Katie, because we think of building

39:02

the brain means reading books and gaining

39:04

new knowledge, and that's true. But

39:07

in terms of actually creating neurogenesis, it's more

39:09

like you think about a physical workout. I'm

39:11

going to do something different, and

39:13

I'm going to actually now focus

39:16

the left side of my brain, which

39:18

normally isn't doing motor function that's delicate

39:20

or fine, on actually doing

39:22

that sort of stuff. It has real relevance,

39:24

because again, you're actually building these

39:26

roads and these cities in your brain, and that's

39:28

fun. Try it. It's fun. But on

39:32

a more practical level, to your original question,

39:34

let's say one day the

39:36

road that you drive so

39:38

well becomes blocked by

39:40

one of these amyloid plaques that we're talking about,

39:42

some of these tangles. Now, you

39:44

know that road really well, but you know what? You

39:47

don't really have other roads to get from point A

39:49

to point B. If you've been

39:51

building all these roads by painting

39:53

with your left hand and spilling your food

39:56

by eating with your non-dominant hand, whatever it

39:58

might be, you're actually building roads. This

40:01

gets back to the bypass analogy. Do you

40:03

still have a claxon tangles in your brain?

40:05

Yes. So are these

40:07

the cognitive reserves that you're talking

40:09

about? Yes, the cognitive reserves, the

40:12

cognitive resiliency, which is

40:14

often, they often use these terms interchangeably. But

40:17

that's exactly it. We have

40:19

the capacity to have significant cognitive

40:21

reserve. We're barely tapping into that.

40:24

If you look at societies around the world where people are

40:26

living into their 90s and hundreds and have hardly any dementia,

40:31

the presumption now is that if you were to image their brains,

40:34

they might have plaques and tangles. If

40:37

you were doing an autopsy, they may be diagnosed

40:39

with Alzheimer's because that's how Alzheimer's was diagnosed, was

40:41

that autopsy. But the truth

40:43

of the matter is that during their lives, they

40:45

had perfectly normal cognitive function. Before

40:48

we talk about your 12-week program,

40:50

I'm just curious in terms of

40:52

diagnostic advances and

40:54

therapeutic advances. Will

40:57

we get to a point where

40:59

someone can have a brain scan

41:01

and say, okay, here's the status

41:03

of your tangles and plaques, and

41:05

here's what you need to do?

41:07

Because brain imagery, I always found it

41:10

so interesting, even when you talk

41:12

about antidepressants and serotonin

41:14

reuptake inhibitors or whatever they're

41:16

called. SSRIs. Yes.

41:20

I think that there was never

41:22

a way until recently to measure

41:24

how the brain was reacting. It

41:27

would be very anecdotal. You throw it

41:29

against the wall to see what sticks.

41:32

Now we have so much better

41:34

brain imagery. Will

41:36

that translate into dementia and

41:38

Alzheimer's and preventative

41:40

strategies that we could follow? I think

41:43

so. We're making a

41:45

lot of progress on brain imaging. You're

41:47

absolutely right. The brain has long been

41:49

considered this black box, only

41:51

measured by its inputs and its outputs. You

41:54

really couldn't get a good idea

41:56

of its internal machinery. But now we can.

42:00

I mean, I don't know that we're

42:02

at the point yet where we can determine degree of

42:04

severity of dementia based on a

42:06

scan. And as I said. You think we will,

42:08

you think we'll get to that point, though, Sorrente? I

42:11

think we'll get to the point where

42:13

we can very quantifiably measure the burden

42:16

of plaques and tangos and other things in the

42:18

brain. But

42:21

again, what I think is so extraordinary,

42:23

Katie, is that you could have two

42:25

people with the exact same scan, essentially,

42:27

and very different clinical pictures.

42:29

One person may be completely debilitated,

42:31

obviously having dementia, and the other

42:33

person may be functionally cognitively

42:36

normal. Right. And I, again,

42:38

I look, do I

42:41

I don't want to I don't want to have

42:43

plaques and tangles in my brain. But mostly what

42:45

I don't want to have is the cognitive dysfunction

42:47

that comes with that. It's a

42:49

different way of thinking. It really is like

42:51

I think, again, we focus so much on

42:54

making someone's images look better or whatever. And

42:56

what the person really wants is them to

42:58

be better. And there are ways

43:00

to do that, you know, with lifestyle changes. I

43:02

mean, I'm a neurosurgeon saying this, by the way,

43:05

just remember that because I'm a specialist. That's that's

43:07

what I was trained to do. And yet I'm

43:09

now becoming increasingly convinced that

43:11

these types of changes that

43:14

we talk about in this book really can

43:16

can prevent you from developing the symptoms of.

43:19

Yeah, I was going to say, so you're saying the

43:21

brain scans are just part of the story. Yes. Sort

43:23

of like it's half of

43:26

the story, because even with them,

43:28

you could have these cognitive reserves

43:31

developed and be very asymptomatic.

43:33

Well, let's talk about this

43:36

12 week program. Sharp,

43:38

take us through the steps because I'm

43:40

all ears. It's it's

43:42

12 weeks where I basically based

43:45

on how I think your brain is going to

43:47

change and react to

43:49

things that you're now doing that are different or new.

43:53

It all sort of builds on itself. I

43:55

start off by really making sure you get

43:57

the basics right. And I'll tell you, it's.

44:00

It's not that complicated. There are a

44:02

few big messages in terms of the

44:04

overall getting the substrate right.

44:06

And as you might guess, diet

44:08

nourishment is one of them. But

44:11

the big takeaway here is I think generally people

44:13

know what a healthy diet is.

44:16

And for those who don't, there's some information

44:18

there about what's specifically healthy for the brain.

44:20

There are some distinctions between the brain and

44:22

the body in this regard. One

44:24

is sugar. You

44:26

know, we talk a lot about sugar and people

44:28

know that they shouldn't eat too much sugar. We

44:31

used to get sugar, you know, twice a year

44:33

when fruit fell from the trees. Even

44:35

honey was protected by the bees. And

44:37

now we're eating 130 pounds a year on average of sugar. But

44:41

what was a learning point for me

44:43

was that the brain is exquisitely sensitive

44:45

to sugar. So typically you eat

44:48

a lot of sugar and you think, well, that's being

44:50

absorbed into cells, I have a lot of energy, whatever

44:52

it might be. These are a

44:54

lot of calories that are now providing me energy. The

44:56

brain, as soon as sugar levels get beyond a

44:59

certain point and it's a pretty narrow range, the

45:01

receptors basically shut down. So

45:04

you could run into a situation where you're

45:06

taking in a lot of calories, a lot

45:08

of energy, and starving your

45:10

brain at the same time. And

45:12

that is a situation that leads to

45:14

a whole cascade of

45:17

events that you can pretty easily avoid.

45:20

So that's, you know, as much as I talk

45:22

about in the first few weeks of what to do,

45:25

there are several things that you're

45:28

told not to do, just to avoid.

45:30

And that's more than half the battle,

45:32

and they're not that hard to do. I

45:34

also try to make the case for things like

45:36

sleep, which you've read a lot about, I've read

45:38

a lot about, but reminding people

45:41

just how metabolically active the brain is during

45:43

sleep. And this wonderful conversation that I'm having

45:45

with you right now will be encoded into

45:47

my hippocampus if I get good sleep tonight,

45:50

so that 20 years from now I can

45:52

recall this and remember it. A

45:54

lot of times people say that they can't remember

45:56

something. It's not that they forgot it. It's

46:00

that they never actually stored it in their memory

46:02

centers in the first place. So

46:05

these are strategies to help that.

46:07

But then, you know, sort of the midpoint of the

46:10

book is really about the

46:12

evidence-based things that we know improve brain

46:14

health. Starts off by asking

46:16

you to define what you think a healthy brain is. What

46:19

is a healthy brain? We know what a

46:21

healthy heart is. It pumps a certain amount of blood out

46:23

with each beat. What is a healthy brain? I

46:27

spend a little bit of time talking

46:29

through, talking to the

46:31

reader through how they define that because it is

46:33

different for different people. Robert

46:35

Sapolsky, who is this evolutionary

46:37

biologist, I was interviewing him and he

46:39

said to me that

46:41

a healthy brain is a brain that

46:44

has a bigger circle of you, is

46:46

what he said, which basically means you

46:48

let more people into your circle. Now

46:50

why is that relevant? Well,

46:52

it's relevant in ancient times

46:54

because you were more likely to be protected by

46:56

the group. But now it's this

46:58

idea of what true

47:00

connection does for protection

47:03

of the brain. And now,

47:05

to your earlier point, measurable.

47:08

A lot of what we talk about is based

47:10

on objective data that we couldn't collect some

47:13

time ago. But I will tell

47:15

you something fascinating because I find this

47:17

topic really interesting. There's this loneliness researcher

47:20

named Stephanie Cacciopa. She's an Oregon. I

47:22

know, I know. She's in Chicago.

47:25

Her husband was one of the

47:27

preeminent scientists about memory and

47:29

then he died. I know. And now she's

47:31

in Oregon and I talk to her from

47:33

time to time. It's been

47:35

tough, as you might imagine, and she's by herself

47:38

in Oregon, which as a loneliness research you have,

47:40

it's about the quality. But what does that mean,

47:42

quality? One thing Stephanie said to

47:44

me was a sort

47:47

of shortcut to building the

47:49

quality and the high intensity connection

47:52

is to be vulnerable, to

47:54

ask for help, to share your problems,

47:57

which is totally counterintuitive to how I think

47:59

about things. I would rather not burden somebody

48:01

with things. But I took

48:03

it to heart and I was talking to my parents

48:06

who were in their late 70s in Florida through this

48:08

pandemic and we were having those conversations, how you doing,

48:10

how the girls, that was the conversation for months. And

48:12

I said to them, I asked

48:14

them a question about a problem I

48:16

was having with one of my cars. My wife's

48:19

car had some smoke coming from the hood. They're

48:21

both engineers. And for

48:23

days, Katie, we started to have these

48:25

really interesting conversations about cars, about their

48:28

history of being interested in engineering and

48:30

all this stuff, figure

48:32

out the way to build the

48:34

meaningful connection. That

48:36

is probably one of the most critical points

48:39

and there are pretty easy ways to

48:41

do it. I think the

48:44

point is connection, deep connection is

48:46

good for your brain. Yes. And

48:48

good for you and I think it's good

48:51

for you in general. So the

48:53

last part of the 12-week program, I'll just

48:55

tell you quickly, is more about what we

48:57

started talking about initially, which is then how

49:00

do you create, now that I've primed your

49:02

brain for neurogenesis, giving you all

49:04

the right amounts of the right hormones,

49:06

not too much epinephrine, but enough oxytocin

49:09

and all that sort of is happening by going through

49:11

the first few weeks of the program. Now, how do

49:13

you build the new brain cells? And

49:15

that gets to a lot of what we were talking about

49:17

in terms of that cognitive reserve, actually

49:21

doing these different types of activities, doing

49:24

similar activities in a totally different

49:26

way, doing things with different

49:28

people, doing them in at different times, eliminating

49:31

certain things completely from your regimen

49:33

for a while, adding in something

49:35

totally unrelated. It

49:37

was fascinating to me. I tried it.

49:39

I based this entire thing on my

49:41

conversations with these neuroscientists who all tried

49:43

it and written about it and

49:45

published it in journals. It's fun.

49:48

It's a fun ride. I was gonna

49:50

say, so give me some ideas real

49:52

quickly before we go about things I

49:54

could do. Should I take a pottery

49:56

class? Should I learn Italian? Should I

49:58

pick up the guitar? What should I

50:00

do? I think that, you know, I

50:03

think the two big ingredients are it's got to

50:05

be something you really haven't done before. This isn't

50:07

about trying to, again, build a two lane highway

50:09

where you're used to driving one. This

50:12

is about getting to, you know, to

50:15

Italy instead of staying in New

50:17

York or going somewhere even different,

50:19

Argentina, you know, totally different.

50:21

If you can do something that involves your

50:25

hands like pottery or painting, even better. That

50:27

was something that came up over and over

50:29

again. And then the second

50:31

ingredient, I guess, and this is a little bit

50:33

more vague, is that it's good

50:35

if it makes you a little uncomfortable. And

50:38

I know that sounds almost euphemistic or too

50:40

easy or too simple, but the

50:43

whole point is that when you start

50:45

to release certain hormones

50:47

in the body like some

50:49

stress hormone, stress can be good, it

50:52

really helps that process of neurogenesis. So

50:54

a little bit of discomfort with something

50:56

totally new, preferably using your hands. That's

50:59

a pretty good prescription. Before

51:01

we go, can you tell me

51:03

about foods that are healthy brain

51:05

foods? I know that you hear about

51:08

fish, you hear about nuts, you

51:10

hear about extra virgin olive oil. Are

51:13

all those things sort of good brain food?

51:15

And what else should I be eating other

51:17

than staying away from the cupcakes? Yeah, no,

51:19

I, right. Yes, definitely do. The

51:22

sugar thing I mentioned already, so I mean, that's just,

51:24

that's just a, I think you could

51:26

accomplish 70% of all the

51:28

other things by basically just

51:31

eliminating added sugar from your diet. But

51:33

I think the adage, what

51:36

is good for the heart is good for the

51:38

brain remains true. But I think with

51:40

the brain, there are a few, few

51:42

distinctions. One is if

51:45

an apple a day keeps a doctor away, then berries

51:47

are what's good for the brain. These

51:50

really good data around berries really start to add

51:52

berries into your diet. I think that's one

51:54

of the big ones. And while most

51:57

of the neuroscientists did not advocate a caloric

51:59

restriction diet, diet necessarily, a calorie

52:01

reduced diet overall to the extent that you

52:03

can do it. We create

52:06

a lot of metabolic byproducts from

52:08

overeating and a lot of those

52:10

metabolic byproducts get accumulated in the

52:12

brain. So if you

52:15

can cut down on the amount of energy

52:18

that has to be metabolized in that way, you can

52:20

make a lot of progress. Even

52:22

though berries may be good for your brain,

52:24

you don't believe in this whole idea of

52:27

supplements or super foods, do you? No,

52:30

I think super food, first of all, is

52:32

a really vaguely defined term as

52:34

part of this book. I asked a lot of

52:36

people, and I even talked to your friend Mark Hyman about this as well. It

52:40

doesn't have a really objective meaning. There

52:42

are some foods that are maybe better

52:44

than others. But I think

52:46

the thing about supplements that struck me was the

52:49

idea that for certain people who

52:51

have deficiencies, then supplementing

52:53

that part of their diet is

52:55

important. But Katie, in

52:57

this country, and I'm not advocating this, but

53:00

in this country, even the standard American diet,

53:02

like if you go to a McDonald's even,

53:04

the food is

53:06

largely fortified with all these

53:09

different vitamins and micronutrients and things

53:11

like that. That is a decision

53:13

that our USDA made decades ago

53:15

to fortify food so that people

53:18

wouldn't develop basic nutritional deficiencies. So

53:20

oftentimes we're supplementing something that doesn't need to

53:23

be supplemented. A lot

53:25

of the approaches more in

53:27

terms of what you're not eating versus what

53:29

you are eating, and that holds up to

53:31

be true. So berries, I

53:34

sing aloud because they are one

53:36

of these foods whose active ingredients

53:38

are particularly good at crossing the

53:40

blood-brain barrier, particularly good at creating

53:43

these scaffoldings for the neurogenesis that

53:45

we talked about earlier. So

53:48

I put that high on the list. But

53:50

what about, I see this stuff in the drugstore and

53:52

I'm like, oh, should I be taking like previgen

53:55

or should I be taking, what

53:57

is it like almost, isn't it

53:59

like jellyfish? derivatives and stuff. And

54:01

I'm like, should I be doing

54:03

that? Well, you know,

54:05

the Prevegen one is interesting because,

54:08

you know, Eric Kandel is very

54:10

involved with this. And he's a

54:12

very prominent neuroscientist, did a lot

54:14

of the original jellyfish research, basically

54:16

trying to figure out where the

54:18

memory stores were in jellyfish, how

54:20

jellyfish remembered and isolating those stores

54:22

and basically creating a supplement. It's

54:24

a fascinating idea. I

54:27

don't know that it really works. I mean, it's

54:29

very hard to study this sort of thing. You

54:31

know, it takes decades long studies to prove that

54:33

something like that's improving memory. What

54:35

we do have is decades long data

54:37

on societies around the world where

54:40

dementia is essentially so rare that it's reportable.

54:42

You know, if somebody developed dementia, you'd report

54:44

that in the medical journal. But

54:46

my point is though that with these,

54:49

we don't need to have the supplements.

54:51

We know it's possible to be done

54:53

because we see it having already transpired

54:56

real time in large societies across the

54:58

world. And in those

55:00

societies, you know, I took the neuroscientific

55:02

data that we had and

55:05

tried to see are they in

55:07

some ways applying that unwittingly? I mean,

55:09

they didn't read these papers obviously, but

55:12

were they sort of just by

55:14

default essentially, following that right

55:16

diet, following that right amount of movement,

55:19

following the right amount of rest. So movement, for example,

55:21

I'll just tell you, this was an interesting one. If

55:24

you look at movement, it's probably the

55:27

only thing that has the

55:29

longest amount of evidence behind it in

55:32

terms of actually creating neurogenesis. All of

55:34

this is new research, but that's sort

55:36

of the oldest new research. But

55:39

what was fascinating to me was that what

55:42

does movement mean to people, right? I

55:44

use the word movement instead of exercise

55:47

because what they found was

55:49

that moderate movement, brisk walking,

55:52

that tended to be a lot better for

55:54

neurogenesis than intense exercise. Now,

55:57

why would that be? Well, it turns out that

55:59

when you... you briskly

56:01

exercise, you're releasing a

56:03

lot of what is known as brain-derived neurotrophic

56:06

factor. That's kind of like the miracle grow

56:08

for your brain, as was described. If

56:10

you are intensely exercising, you also tend to

56:13

release a lot of epinephrine,

56:15

and epinephrine is actually a blocker.

56:17

It's a cascade blocker of what

56:20

BDNF, this neurotrophic factor, does. I know I'm

56:22

throwing a lot of language at you, but

56:25

no. No, that's okay. I'm following. Intense

56:27

exercise may be great for your heart and

56:31

maybe even weight loss, whatever your

56:33

goals may be. But for your

56:35

brain, intense exercise actually is not

56:37

good, and you find that

56:40

can actually be a little bit destructive

56:42

by releasing these stress hormones that block

56:44

the beneficial effects that exercise should have

56:46

on your brain. I never knew that.

56:48

I think I

56:51

go for a walk as often as I

56:53

can with Rebecca now. That wasn't something I did.

56:55

I was out there thinking, I got 40 minutes.

56:57

I'm going to go hard. That was my approach.

56:59

Sometimes I still

57:01

feel the need to do that, but walking

57:04

is great. Here's

57:06

the best way to do it if you want to just make

57:08

it for your brain. Take a brisk

57:10

walk with a close friend

57:12

or family member and talk about your

57:14

problems. That brings all these

57:16

things together in some ways that we've

57:18

been talking about. Take your berry

57:21

smoothie with you, and you've pretty much nailed it.

57:24

I'm curious about social media and

57:26

the way we live our lives.

57:29

We're constantly distracted. We have constant

57:31

incoming information. Our attention

57:33

spans have shortened. I read

57:36

a fascinating study a while ago that said

57:38

the part of your brain, I think it's

57:40

a hippocampus. You can correct me if I'm

57:43

wrong, responsible for creativity.

57:46

It only fires up when you're bored,

57:48

and that's why you have so many

57:51

great ideas when you're in the shower,

57:53

when you're not distracted, or when you're

57:55

taking a long walk and you don't

57:57

have your phone with you. I'm curious.

58:00

the impact of all this mental

58:02

stimulus or stimuli has

58:05

on neurogenesis and keeping

58:07

our brains healthy. Yeah,

58:10

okay. That's a great topic and I approach it

58:12

as a person who wrote this book, but frankly,

58:14

also as a dad of three

58:17

teenage girls, because this is conversation topic number

58:19

one in our household all the time. And

58:22

I'll tell you two things that actually

58:24

came out of a dinnertime conversation I

58:26

recently had. And I try not to be

58:29

too preachy with my girls, although sometimes I can

58:31

say, I don't use this line often, but I

58:33

can say I did write a book about that.

58:36

The girls hate it when I do that, but it's true.

58:38

And I can use that as a wild card to actually

58:40

get them to listen to what I'm saying about

58:43

the fact that when

58:45

you are distracted like that and

58:47

you think maybe even you are

58:49

multitasking, the brain is actually not

58:51

that good at multitasking. It actually

58:53

requires a lot of energy to

58:55

shift back and forth between things,

58:58

between scrolling through your social media

59:00

feed, trying to have a conversation, trying to

59:02

look your dad in the eye when he's

59:04

talking to you, whatever it might be, it's

59:06

hard to transition back and forth between all

59:08

these things. We think we're being efficient and

59:11

we're not because the amount of energy it takes

59:13

to actually make the switch is a

59:15

lot higher than we realize. That's kind of novel

59:17

thinking because it's always been about multitasking. How many

59:19

things can I do at the same time? But

59:22

the second thing, which I think is I

59:24

worry about the most and I think is what you're

59:26

saying as well, is that leaving aside

59:28

just the content on social media for

59:31

a second and just the fact that

59:33

it's so incessant, like you're saying, when

59:36

we talk about stress on the

59:39

brain and on the body, stress

59:41

in and of itself is not the enemy. In

59:44

fact, we need stress. I was a little nervous

59:46

to do this podcast with you today because I

59:48

have so much respect for you, but it makes

59:50

me a little stressed because I have that nervousness.

59:52

But it's good. I need that because I prepared

59:54

for this. But the

59:57

problem is that we can't get a break from

59:59

the stress. Social media screens,

1:00:01

the incessant nature of it, make it

1:00:03

very difficult for us to ever turn

1:00:05

the stress off. We don't want

1:00:08

to turn it off completely or never have it. That

1:00:10

would not be a worthy or

1:00:12

possible goal. But

1:00:15

we don't get breaks from it. And

1:00:17

that's what I worry about the most with my

1:00:20

girls, myself, to some extent, although I'm much more aware

1:00:22

of it. But that's what I

1:00:24

worry about, Katie. So you're saying that

1:00:26

it's really important to put the phones

1:00:28

down, put them away, even

1:00:30

studies that show if it's on a table,

1:00:33

it's distracting by

1:00:35

its very presence, because you can't

1:00:37

have a deep, focused conversation with

1:00:40

that thing in your line of

1:00:42

sight. Right. The

1:00:45

distraction, just the presence of it, whatever it

1:00:47

may be, it takes you away from being

1:00:49

in the moment. And again, I

1:00:51

know some of this sounds so euphemistic, and

1:00:54

maybe you've heard it all before, but now the

1:00:56

data is there. I mean, smartphone

1:00:59

has only really been around since 2005, Katie.

1:01:02

I mean, think about that, 15 years. And

1:01:05

it's not that long. And we

1:01:07

had some of the biggest behavioral shifts

1:01:10

ever recorded in human history during that

1:01:12

time. You talk about

1:01:14

kind of constant stress, and you

1:01:16

need stress and then recovery. I

1:01:18

guess that's because your brain is

1:01:20

producing too much cortisol, right? I

1:01:22

mean, the stress hormone? Or is

1:01:24

it doing a lot of other

1:01:27

stuff physiologically? I

1:01:29

think the thing that is becoming

1:01:31

clearer is that the absolute amount

1:01:34

may not be as important as

1:01:36

how long your cells are sort

1:01:38

of exposed to the stress hormone.

1:01:40

You can have these amazingly high

1:01:42

spikes. And they saw this in

1:01:45

people, fighter pilots, people who

1:01:47

are in these incredible situations for periods of

1:01:50

time, really high spikes. So high, in

1:01:52

fact, that the blood vessels in the back of their

1:01:54

eyes would change. They would have to account for blurriness

1:01:57

of vision because their epinephrine spikes.

1:02:00

so high, but when

1:02:02

they weren't in that situation,

1:02:05

they had incredibly low levels of

1:02:07

stress, really high heart rate variability.

1:02:10

Heart rate variability is a really interesting

1:02:12

measure of this because if you have

1:02:14

high heart rate variability, that's good. That

1:02:18

means your blood vessels aren't clamped

1:02:20

down by all the stress hormones.

1:02:22

They're kind of loose and the

1:02:24

variability is good. And

1:02:26

so it wasn't the spikes in

1:02:29

cortisol, epinephrine, other stress hormones

1:02:31

as much as it was

1:02:33

them staying plateauing at an

1:02:35

unreasonably high level. Interesting.

1:02:37

When it comes to stress in closing,

1:02:39

because I've kept you far too long,

1:02:41

Sanjay, but I could talk to you

1:02:43

all day, is what

1:02:45

is the impact of this

1:02:48

year plus of really

1:02:50

for many people this constant

1:02:52

stress? And how

1:02:55

is that going to, in

1:02:57

your view, affect us in

1:03:00

terms of collective trauma? We

1:03:03

have pretty good data on what these

1:03:06

stress hormones in prolonged periods of time

1:03:08

do to the brain. That's

1:03:12

been documented now in all

1:03:15

sorts of different studies. Nothing quite like this, obviously,

1:03:17

because this is so unique and that's

1:03:19

why I still preface by saying I

1:03:21

don't know for sure with great humility. I try

1:03:23

and answer some of these questions. But

1:03:26

I think there

1:03:28

will be an impact, but I think that

1:03:30

we've also learned that we can grow

1:03:33

new brain cells though. We can recover from

1:03:35

that. We can create

1:03:37

situations where it doesn't become such

1:03:39

an incessant memory that it

1:03:42

basically leads to post-traumatic stress, which

1:03:44

is a real concern as well.

1:03:47

There will be people that have significant

1:03:49

amounts of post-traumatic stress, but our ability

1:03:51

to treat that, to recognize it, is

1:03:53

better than before. And our ability to

1:03:56

build new brain cells to help compensate is

1:03:59

better than before. So impact

1:04:01

significant, but solutions emerging

1:04:04

as well. So it

1:04:06

is possible to heal, I hear

1:04:08

you say. It is

1:04:10

possible to heal. And we've

1:04:12

seen it before with even

1:04:15

other pandemics. A huge

1:04:17

thank you to my friend, Dr.

1:04:20

Sanjay Gupta, who

1:04:24

you can watch on CNN

1:04:26

or listen to on his

1:04:28

daily podcast, Coronavirus, Fact or

1:04:31

Fiction. His new book,

1:04:33

by the way, is called Keep Sharp, How

1:04:35

to Build a Better Brain at Any Age.

1:04:37

And I want you all to know, I

1:04:39

just ate breakfast using my

1:04:41

left hand. Next

1:04:49

question with Katie Couric is

1:04:51

a production of iHeartMedia and

1:04:53

Katie Couric Media. The executive

1:04:56

producers are me, Katie Couric,

1:04:58

and Courtney Litz. The supervising

1:05:00

producer is Lauren Hanson, associate

1:05:02

producers, Derek Clements, Adriana Fazio

1:05:04

and Emily Pinto. The

1:05:06

show is edited and mixed by Derek

1:05:08

Clements. For more information about today's episode

1:05:11

or to sign up for my morning

1:05:13

newsletter wake up call, go to katikuric.com.

1:05:16

You can also find me at katikuric

1:05:18

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1:05:20

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from iHeartRadio, visit the iHeartRadio

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