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[Transcript] – Why A High-Fat, Ketogenic Diet Chock Full Of Saturated Fat, Coconut Oil & Butter Could Be Destroying Your Brain (& What To Do About It).
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Podcast from: https://bengreenfieldfitness.com/podcast/brain-podcasts/ketogenic-diet-destroying-brain/
[00:00] KION Products/Blue Apron Recipes
[03:31] About Max Lugavere
[10:22] How Max Started Out
[18:37] The Effects of MDMA Dosing
[23:38] Dopamine as an Abstinence from Hedonism
[26:39] What Happened to Max’s Mother?
[35:09] Harry’s Razors/Trusii Hydrogen-Rich Waters
[38:29] Regarding the APOE Allele & Alzheimer’s
[57:21] The Evolution of Oils
[1:09:41] Why High HDL Is Dangerous
[1:16:32] Tracking Your Blood Glucose
[1:25:30] Regarding Max’s Mother
[1:31:53] End of the Podcast
Ben: Wakey, wakey, I slipped out of my office to get up early this morning, which is why I’m drinking my coffee. I know people hate that when I consume things on the show. I think it just makes the show more intimate and fire cite, personally. I had to go in for a big blood draw this morning, my quarterly Wellness f(x) longevity panel, so I’m going to go in and give them 19 tubes of blood, but I figured I’d come down here and talk to you first. This is been Greenfield, you’re about to hear me talk to my friend Max, Max Lugavere, a really cool guy, and we have a chat about making yourself smarter with food. We talk about Alzheimer’s, dementia, take a dive into cholesterol. This one’s actually quite a thrill when it comes to cognitive stimulation with two bros talking like they’re smart, at least he’s smart. I try to play catch up.
This podcast, like all podcasts, is not brought to you by ketchup. See what I did there? It’s brought you by KION. KION is the playground where I create and discover unique formulations, supplements, foods, superfoods. I can no longer say foods without saying superfoods, and I collaborate? No, that’s not the right word. The right word is aggregate. I aggregate them all in one place for you. I’m working on some really cool new formulas. I’m going to be pulling back the curtains on soon, but in the meantime, may I suggest to you the brand-new clean energy bar. It’s essentially every single superfood that I used to sprinkle on my smoothies. Well now I just break this bar into chunks. I keep a few in the freezer. Let me tell you, this bar is amazing, cut into tiny little chunks and sprinkle on top of smoothies. It’s also really amazing, cut into little tiny chunks and sprinkled on top of hail a top ice cream, either one. It’s like cacao nibs and coconut flakes and chia seeds and almonds and all sorts of chocolaty, coconutty, salty goodness. Grab that, along with any of the fine supplements that we have over at getkion.com. That’s a getKION.com.
This podcast is also brought to you, as if your mouth weren’t watering enough yet, by a company that just this week, this week alone. This is hot off the presses, is delivering to your crispy chicken tenders with mashed potatoes, pasta with a creamy tomato sauce, a corn and goat cheese quiche, and finally beef and bok choy stir fry with cauliflower rice. As you can hear, there are all sorts of options, and these all come to you via Blue Apron. Blue Apron delivers farm fresh ingredients and step by step recipes right to your front door. I get these boxes, and my kids will open up the box, they’ll lay out all the ingredients, they open up these colorful recipe cards, and they make me this amazing meal, bursting with flavor, and you don’t have to know how to cook to do this. They just send everything to your house, the recipe, boom. The meals not done, you still cook the meal, but it’s fun because you get to cook the meal. It’s kind of a point, you learn how to cook too, so there’s a bonus. Anyways, you can check out this week’s menu and get your first three meals free over at blueapron.com/ben. That’s blueapron.com/ben to get your first three meals free. Blue Apron, better way to cook.
In this episode of The Ben Greenfield Fitness Show:
“I mean if I could give my mom a pill tomorrow or put on a diet tomorrow that would reverse her disease, I would do it, but I just don’t see that as happening. I think getting a normal healthy person to adhere to a ketogenic diet is hard enough, right? But getting somebody with dementia, and especially a person with dementia who’s cared for by caregivers who are completely uneducated to adhere to such a rigorous dietary protocol, when their brains are actually crying out for sugar and things that are anything but ketogenic, it’s a major, major stress.”
Ben: Hey folks, it’s Ben Greenfield, and I guess it was a couple months ago now that in a weekly roundup, I send out these weekly roundups on Fridays where I talk about stuff that I found interesting, and often those recommendations and takeaways include books. One of the books that I commented about was written by my friend and a guy who’s been on the podcast before to talk about a documentary that he made called Bread Head, but he wrote a book, and it was called “Genius Foods”. I figured it would probably be another eggs and walnut and fish make you smarter kind of book and thought I might get through in five minutes just flipping through, but it actually wound up pleasantly surprising. It takes this deep, deep dive into things like specific genes that affect intelligence and how to pair them with food, mouth-watering recipes for everything from liver to avocado, salmon bowls, and actually a lot of science that I hadn’t yet seen discussed particularly when it comes to either a) getting smarter, or b) taking care of your entire central nervous system intelligently, or c) even staving off your risk of something like Alzheimer’s or dementia, which I can legally say because I’m not a doctor.
Anyways, this book is in my opinion, a must-read, for anybody who wants a better brain, and as I usually do, I don’t like to get guys on the podcast and just talk about it. Guys or girls just talk about things that you could find if you were to just go freaking read the book. I like to take a little bit of a deeper dive and unpack, so to speak, some of the more cutting-edge concepts that I discover within the pages of wonderful books like this. So, I got Max on the show, he’s here with me. And like I mentioned, he was on a previous podcast episode called “The Surprising Facts About What Bread Does to Your Brain”, and he created this documentary called Bread Head, much to the chagrin of anyone who likes my wife’s slow-fermented, sourdough bread recipe, which I still have to get you to eat, Max. You may have also seen Max on the Dr. Oz Show, the Ray Show, the doctors. He’s also been on Vice and Fast Company and CNN and The Daily Beast. He’s all over the place, he even as a podcast now. He has a podcast called, of all things, “The Genius Life” just like his book “Genius Foods”. So, I will link to everything Max and I talk about if you go to bengreenfieldfitness.com/geniusfoods. That’s bengreenfieldfitness.com/geniusfoods, and you can just grab the book. Everything else that Max and I, talk about today. So Max, first of all, welcome to the show, and second of all, have you yet recovered from the severe beating that I gave you at the gym in Arizona a couple of months ago?
Max: Dude, thank you so much for having me. It is a pleasure and a privilege, there’s nobody better than you. You are simply the best and an inspiration.
Ben: Oh gosh.
Max: I just launched my podcast, and you are your master, and yeah, I’m still recovering. I’ve still got DOMS from that workout that we had three months ago.
Ben: Well that was my go-to. So, my go-to gym workouts subtracts anything that requires any amount of coordination or focus because I know when I travel, I have an incredible amount of decision making fatigue and lack of cognitive willpower from traveling. So, it’s a very simple workout. You simply choose five exercises, upper body push, upper body pull, lower body push, lower body pull and something for your core, and you just hammer all of those out for as many rounds as you can fit into the amount of time that you have, and after every round, you do two minutes of intense cardio. So, it’s like concurrent strength and cardio training, no, it’s not snatches or clean-and-jerks or anything remotely functional, but damn, for like you mentioned, Max. DOMS, it works doesn’t it?
Max: It works, I mean I consider myself to be in really good shape. I’m really interested in physical performance, body comp, stuff like that, but being around you and watching how you work out, I mean, definitely, it’s good motivation, so thanks for that.
Ben: You’re welcome, I’m also a masochist so that helps a little bit with the, would you call it a sesh?
Max: A sesh.
Ben: That’s what kids are calling it these days, huh? By the way, you’re incredibly well spoken, and I’ve seen you speak on stage a few times. You know your way around this science pretty well, how old are you?
Max: I’m 36, and so I’ve been interested in fitness and nutrition my entire life, began in high school. I wrote my high school senior thesis on creatine. So I was also kind of obsessed with the ketogenic diet, I read “The Ketogenic Diet” by Lyle McDonald back when I was seventeen, so I’m an early adopter, if you will, of many of these nutritional concepts which seem to be really entering the site guised lately, but for me, they’ve been a part of my life for as long as I can remember. So, if it seems like I know what I’m talking about, it’s just because I’ve been obsessed with nutrition science for the longest time, more than pretty much anything.
Ben: Why this book? Why don’t you write a book about, I know you got on the bread soapbox for a while, but what made you decide to write a book about food in your brain instead?
Max: Yeah, it’s a good question. So, I used to work for a TV network that was a news and information network, that reached one hundred million homes in the United States and was called Current TV. Some of your listeners might remember it, Al Gore was the co-founder of it, but it wasn’t a political platform for him. It was really just a news and information network meant to bring forth a new kind of journalism that was meant to ultimately make the world a better place, and I was one of the journalists for that network. I was handpicked out of college by this guy who gave many well-known journalists, journalists that are household names at this point, their first jobs, and I was one of them. So I got to do that for six years, cutting my teeth with some of the best of the best in the field, and I was very young, but nonetheless, I learned a lot, and when I left that job in my late 20s, I started spending more and more time with my mother in New York City, which is where I’m from, and I really seize the opportunity to catch up with my family, spend more time with my mom, I’m the oldest child. I’ve got two younger brothers, and I’m the first-born, so anyone who’s the oldest in the family listening can relate. You tend to have a special relationship with your mom, and there’s no question that I do. So, I began spending time with her, and you know, Ben? It was really strange. My mom was 58 at the time, and youthful, blonde-haired, had this vibrancy about her that my mom is really known for, and nonetheless, it had seemed as if her brain suddenly had downshifted and almost as if she had a transplant, a brain transplant with a much older person. It really came to a head when I would be cooking dinner with my mom, which is one of my favorite things to do, and I would ask her to pass a spice that was maybe in the overhead cabinet that she was standing by, and it would take her a few extra beats to register that command. I mean almost to a point where I was taken off guard and it left me with a knot in the pit of my stomach, but ultimately, I just wrote it off to aging, and in tandem with that, there was a change to my mom’s gate, which is the way that she walked. Now my mom is a New Yorker, I’m a third-generation New Yorker, and New Yorkers walk pretty fast, but what had previously been a very healthy stride suddenly had transitioned to more of a shuffle, and me and my brothers actually coldly would joke amongst ourselves, that it looked kind of like my mom had been bitten by a zombie ’cause of the way that she began to walk. We were completely ignorant of movement disorders, of neurological disease of any sort because dementia didn’t run in my family tree.
Ben: Yeah, and by the way, I should throw in there too, I don’t know if you’ve seen some of the some of the NIH studies that you can find. They go back as early as 2010 on PubMed about the pretty significant link between walking speed and survival or walking speed and risk of mortality. That’s one of the things to pay attention to if it’s declining dramatically with age. It’s like walking speed and grip strength are two of the main physical parameters to pay attention to.
Max: Yeah, 100%, as well as getting up off the floor or standing on one leg, balance is thought to correlate with brain health. I mean I’m not sure how many of these tests are being used clinically, but certainly walking is something that we’re literally engineered as a species to do. That’s the way that we’re able to move about the world and procure food, so any change to somebody’s walking pattern is going to raise eyebrows of any health care professional, but for me, I wasn’t healthcare professional. I was just a guy concerned about his mom, and I had the ability, thanks to my sort of a typical career, that at a certain point, I decided to step in and accompany my mom to doctor’s appointments, and we began in New York City which is where my mom lives, but ultimately, when we couldn’t find answers in any of the neighboring hospitals by my mom’s house, we cast a wider net, ultimately taking us to the Cleveland Clinic, and the Cleveland Clinic is known for taking on complex medical cases. What they do is they assemble a team around a patient, everybody from an endocrinologist to a neurologist, I mean, you name it. They’re like the place you go and all else fails, and on the other hand, it’s thought to be a cathedral to modern medicine. So, we went there and, Ben, there, for the first time, my mom was diagnosed with a neurodegenerative disease. She was prescribed drugs for both Parkinson’s disease and Alzheimer’s disease, and when I tell you that was one of the worst weeks of my life, I mean I’m a pretty chilled guy, but I had a panic attack when I began googling those drugs and realizing that not only are they of highly limited efficacy, but they have no disease modifying capacity.
Ben: What’s, by the way, an example for people who don’t know what type of drugs you get placed on with Alzheimer’s, and I guess one that I’m familiar with are ampakines that a lot of biohackers will use as a smart drug as well, but what were some of the drugs that were recommended to her?
Max: Yeah, so I mean the most common one is a drug called Aricept or Donepezil or Donepezil. I don’t know, I’ve heard doctors pronounce it a varied different ways, but essentially what it is it helps increase levels of acetylcholine, which is a neurotransmitter involved in learning and memory at the synapse. The problem in Alzheimer’s disease is that the neurons that produce acetylcholine begin to slowly die. There’s widespread neuronal dysfunction in Alzheimer’s disease, and so these drugs act like chemical Band-Aids to try to increase the availability of that neurotransmitter at the synapse in hopes of it improving cognitive function. So, some biohackers will take actually Aricept, but you know? I’m of the opinion and I know, I’m pretty sure that you are too, that there’s no such thing as a biological free lunch.
Ben: No, and a lot of people get a crash after they use something like that, just due to constant depletion of choline and acetylcholine levels, until you’re dumping in acetylcholine esterase inhibitor like that into your body. Yeah, you’re right there’s no biological free lunch, and I know that Donepezil has some other side effects that go along with it, but yeah, it’s a convenient Band-Aid, I guess, for the Cleveland Clinic.
Max: Yeah, and the other drug was essentially a replacement for dopamine because my mom had those movement symptoms that I was talking about. The change to her gait, which was indicative of some kind of Parkinsonian complex, and so in Parkinson’s disease, a group of neurons in a region of the brain called the substantia nigra begin to die off, and by the time you show your first symptom of Parkinson’s disease half of the dopaminergic neurons in that part of the brain are already dead. So again, talking about a biochemical Band-Aid, you’re basically trying to replace dopamine by these neurons that are slowly dying but have already significantly perished, at the point of being prescribed a drug like this, and also what I think these doctors neglect to mention is that if the drugs don’t work, a patient really shouldn’t be on them because they’re pro-oxidants. There’s these double-edged swords that are present everywhere in biology, like the fact that oxygen, we simultaneously need it for life, right? We need to breathe, but oxygen is an oxidant, and it ages things. It makes things go bad, like a sliced apple that you leave out on the counter, right? Well the same thing with these neurotransmitters like seratonin and dopamine and acetylcholine. We need them for the proper functioning of our brain cells, right? But having too much lingering at the synapse actually acts like a pro-oxidant, and it’s one of the reasons why the drug MDMA, otherwise known as ecstasy, is so dangerous to your brain cells, because it causes a flood of serotonin into the synapse, which literally burns away the dendrites, which serve as physical correlates of memory.
Ben: Wait, can you say that again because a lot of people are super interested in MDMA, even as a frequent microdose right now. By the way, ecstasy, for those who aren’t familiar with it.
Max: Yeah, so MDMA, it’s a street drug, but it’s actually also got some medical merit. It’s being studied as a potential therapeutic for post-traumatic stress syndrome, and look, for people with clinical problems like PTSD, when all else fails, I would not deprive them of the potential of seeing some kind of therapeutic benefit from these drugs, but I’m talking about most people using them recreationally. Again, there’s no such thing as a biological free lunch, and when you break the regulatory dam that governs serotonin release at the synaptic cleft, well you’re basically causing a hole or leaving the door open for a whole host of problems. That’s why many people feel depressed the day after using a drug like MDMA, but over the long term, it literally can cause brain damage. I’ve actually become, and not to go on too much of a tangent, but I’ve become somewhat interested in the research on psilocybin mushrooms because, unlike MDMA, which again, breaks the regulatory dam and floods the synapse with your own serotonin, so psilocybin actually acts like a serotonin agonist, activating the same receptors but not really tinkering too much with your body’s own serotonin release. So that’s how I understand the difference in those two compounds.
Ben: That’s interesting, especially when you consider that MDMA was synthesized, psilocybin as you can get some DMT analogs and synthetic psilocybin derivatives off of laboratory chemical websites, and they work pretty similarly to psilocybin although the effects. I’ve toyed around with a few of these, the effects seem to last much longer which probably means that they are indeed affecting seratonin receptors even more than say a naturally based psilocybin from a mushroom growing out of a cow patty, but MDMA, it’s chemically synthesized, and I would be interested to see if some of the same risks are inherent with something like microdosing with LSD, for example, but when it comes to exhaustion of some of the neurotransmitters, what you’re saying is that similar to some of these Alzheimer’s drugs, you risk some of the same issues, like a desensitized sensitivity to serotonin or to dopamine, for example?
Max: Yeah, so that’s one of the problems is that you can cause a down regulation of the receptors that literally bob up to the surface of the receiving neuron. Those receptors can actually become down-regulated when you force too much neurotransmitter into that cleft. It’s one of the reasons why dopamine-stimulating drugs can be so addictive, because you essentially create a dependency, a tolerance to dopamine. The same thing happens with the dopamine-replacement drug in Parkinson’s disease. Actually, it’s very interesting, so when you flood the brain with synthetic dopamine, which comes in the form of a drug for Parkinson’s patients called Sinemet, there’s a down-regulation of the dopamine receptor. It’s sort of like insulin resistance, you become tolerant to dopamine. So, this leads to less receptors on the surface of the receiving neuron, and you need to take more of the drug to have the same effect. What happens over time, actually this is a very strange side effect of Parkinson’s drugs, some Parkinson’s patients actually start to display risky behavior, like they begin to gamble maybe a little bit more or engage in you know more risky sexual activity which is very strange to think about a Parkinson’s patient, becoming a sex fiend, but nonetheless, it’s super interesting, and one of the things I talk about in the book is the absence of these neurotransmitters, making the receptor become more up regulated as a means of desensitizing your brain to various things. I know you talk about coffee and getting off coffee for a week here and there to desensitize your brain, maybe to adenosine receptors?
Ben: Right.
Max: So, it’s really the same mechanism throughout biology that’s really elegantly and beautifully re-appropriated. The same thing occurs to insulin. You repeatedly pound insulin receptors with insulin, you’re going to become insulin-resistant or tolerant to insulin, so the same thing happens in the brain with our various neurotransmitters, especially when we pharmacologically tinker with them.
Ben: Now you actually get into this a little bit in the book, and by the way we’re completely ruining the Burning Man experience for a lot of listeners right now. Anyways though, you get into a very interesting perspective that you have, and I want to return to your mom here in a second, but you talk about dopamine, and I believe you refer to it as like abstinence from hedonism in the book. Can you describe a little bit more what you mean by absence from hedonism, and if there is a way for someone to weave together an intelligent use of something like plant-based medicines or any of these other things that would cause potential exhaustion of dopamine or serotonin?
Max: Well what I say in the book is that absence makes the dopamine receptor grow fonder, and really what I’m talking about is the fact that we all, as human beings, experience something called hedonic adaptation. This is very easily illustrated, if you’ve ever sort of desired something and then gotten what you’ve desired, whether it’s a girl that you have a crush on or a guy that you have a crush on or a car that you really want, the fantasy is always a lot more powerful than actually having and spending continuous time around the object that you desire.
Ben: Almost like a chemical version of a familiarity breeds contempt?
Max: Exactly, you know a car that you’ve always wanted, for example? Once a car has been sitting your driveway for six months, I mean you don’t have the same level of reward, the same sensation of reward that you had, maybe the first couple of weeks that you had that car, and driving it was full of novelty. So, what I advocate in the book of taking a moment every once in a while, to step off that hedonic treadmill and to allow your brain really to desensitize the things that make you happy because we can become tolerant of the stuff. I mean a lot of people experience with hyper-palatable foods that I talk a lot about, the fact that our food supply has become rife with foods that push our brains to a bliss point beyond which self-control is completely impossible. It’s sort of the call an area equivalent of pornography. Pornography, actual pornography does the same thing. It’s so extreme, it’s like not something that could ever be replicated with, on average, in a typical sense, with normal human relationship, and so what it does is a kind of short circuits our brain’s reward system.
Ben: Right, when from an ancestral standpoint would we have been surrounded by dozens or hundreds or even thousands of beautiful women who we could basically, for lack of a better word, fuck, and do so over and over again. Yeah, there’s a definite, definite effect on dopamine. There’s a great website, by the way. Have you been to yourbrainonporn.com?
Max: I have not.
Ben: Dude, it lays all this out wonderfully. I would say that any person who wants to know more about what porn does to your brain is pretty dramatic, pretty shocking really. Anyways though, so we got from your mom into porn and dopamine, but let’s go back to what happened. So, she left the Cleveland Clinic, she got prescribed these medications for Parkinson’s and Alzheimer’s, you started to dig deep into these drugs and figure out they probably weren’t really the best thing for your mom to be taking, based on some of the stuff we just mentioned, so what’d you do?
Max: Yeah, I began to wonder why, and one of the most shocking things that I learned when I began my investigation is that changes begin in the brain decades before the first symptom, when talking about the most common form of dementia, which is Alzheimer’s disease, and so I realize that this is a decades long process that was probably simmering in my mom’s brain before the emergence of symptoms, and it became really clear to me that this was something that there might be some kind of lifestyle intervention that I could use to help my mom, but it became simultaneously a mission for me to try to understand as best I could what I could do to help prevent this from ever happening to my own brain, because I had this newly discovered risk factor, the fact that my mom had dementia. So when you have a family member with a condition, I mean that’s essentially a risk factor for you to develop the same condition, and having a lifelong passion, as I mentioned, for health and nutrition, that’s where I began, but also, Ben, at the same time as my mom was succumbing to the ravages of this condition, there was a strange overlap where my mom’s mom, my grandmother was alive at the same time, and she was 96 when she died, but up until her death, she was cognitively sharp.
My grandma did not have dementia, so I intuitively had the sense that there had to have been something that shifted in between my grandmother’s generation and my mom’s generation that pulled the trigger, so to speak, on my mom developing this condition and my grandmother being relatively safe-guarded against it. And if you look at our environment, I mean obviously a lot has changed, right? We have iPhones, we have cars, our lifestyles are dramatically different, but I would say the most profound change has occurred to our food supply, and so I began looking there. I began looking at the foods and how they contribute to a person’s overall metabolic health and how that might contribute to conditions like Alzheimer’s disease and Parkinson’s disease, and I did this despite the fact that my mom was not formerly formally diagnosed with Alzheimer’s disease. She was diagnosed with a much more rare form of dementia, but nonetheless, I assumed that what’s good for the brain is good for the brain.
Ben: What do you mean a much more rare form of dementia?
Max: So, she has something that feels like having Alzheimer’s disease and Parkinson’s disease at the same time.
Ben: Is there a name for that?
Max: Yeah, it’s called Lewy body dementia, and it’s like one percent of dementia cases.
Ben: Wow, I’ve never heard of this.
Max: Yeah, there’s virtually no research on it, but it’s a form of Parkinsonism, so it’s actually got a lot in common with Parkinson’s disease. It’s known as a synucleinopathy, which means that in Alzheimer’s disease, Alzheimer’s disease is characterized in part by an aggregation of a form of plaque in the brain called amyloid beta. In Parkinson’s disease, there is also an accumulation of amyloid beta, but the central plaque in Parkinson’s disease is a bit different. It’s called alpha synuclein, and alpha synuclein, it’s thought actually that what causes that protein to clump and aggregate in the brains of these patients might actually begin in the gut. It’s very interesting research, but Lewy body dementia. So, these plaques with alpha synuclein, the plaques that they form are called Lewy bodies, so Lewy bodies are present in Parkinson’s disease, but Lewy body dementia is different than Parkinson’s disease because Parkinson’s disease is usually, at least not until the later stages, a dementia. It’s a movement disorder, so Lewy body dementia is different because at the onset, my mom displayed both symptoms of a movement disorder and cognitive decline, which is usually a typical. You can look at the most well-known patient or public figure with Parkinson’s disease as Michael J. Fox, and he clearly doesn’t have dementia. He goes on talk shows, he has movement symptoms, but Parkinson’s disease usually is not to mention the later stages, at which point it becomes Parkinson’s disease dementia. Lewy body dementia is a variant where you get the dementia and you get the Parkinson’s at the same time, and it’s very tragic.
Ben: So, at that point, what did you do?
Max: Well I began looking at all of the risk factors at play when it comes to Alzheimer’s disease and Parkinson’s disease, but you know the fact that Alzheimer’s disease is the most common form of dementia by far means that there’s going to be a lot more research about it on PubMed, and so when looking for dietary interventions that relate to Parkinson’s disease now and Lewy body dementia, you’re grasping at straws. So, for better or worse, I went for Alzheimer’s disease, and I just became fixated on understanding the risk factors, both the non-modifiable risk factors like gene. We can talk about the APOE 4 allele. I’m very interested in the APOE 4 allele, and the Nutrigenomics surrounding that, but also, I started looking at the modifiable risk factors. Everything from diet to metabolic health to education, you name it, and I learned that if you have Type-II Diabetes, your risk for developing Alzheimer’s disease increases anywhere between two and four fold, and if you look to parts of the world where their food supply has not been industrialized but the genetic risk factor for developing Alzheimer’s disease is present, like in Ibadan in Nigeria, you see that the most well-defined Alzheimer’s risk gene there has a little to no association with actually developing Alzheimer’s disease. So, I was like the food supply really is probably playing a very significant role in terms of our overall increased risk of developing this condition here in the US, and so I began looking at our food supply, and I realize that you know we’re eating 60% by calories, ultra-processed, packaged foods.
When I was growing up, my mom was terrified of healthy natural fats. She was brought about in a time where saturated fats were demonized, and I grew up consuming foods like margarine and corn oil. My mom was always afraid of eating eggs, I never saw her eat any red meat. The only kinds of protein that she ate were chicken breasts and turkey breasts because they were full of protein, but actually, as a food, chicken breast is pretty nutrient poor other than the fact that it’s got a lot of protein in it. That’s pretty much all it has in it.
Ben: That’s where I drench my chicken in olive oil and eat the skin and chew the ends off the bones, like a whole Rotisserie chicken. That’s how I eat chicken if I’m going to eat it.
Max: That’s exactly what I do, that’s exactly what I do. I believe we have a biological imperative to not be wasteful in the whole animal consumption. I think it benefits our health as much as it benefits the earth.
Ben: I agree, and even organ meat and, awful aside, kidney and heart and liver, if I have guests over to my home and we’re having either my bone-in rib-eye or Rotisserie chicken or a beer can chicken off the grill, I am well known for basically going, this might sound offensive, but I’ll say it anyways, going Helen Keller style and walking around the table, grabbing people’s bones that they haven’t eaten and just basically drenching them in olive oil and salt on my plate and finishing people’s bones, chewing the ends off and digging my teeth into the end of the bone of the rib-eye because I’m such a believer in the fact that lean meat is pretty low down on the totem pole when it comes to getting all the nutrients out of an animal-based source of protein.
Max: You are a beast, Ben Greenfield. Yeah, I completely agree. I mean when we’re eating connective tissue and ligaments and organ meats and we’re getting that collagen, collagen is really high, and an amino acid called glycine which actually helps our bodies. Some animal models show better metabolize methionine, which is more abundant in muscle meats. I mean it’s all about balance, and by sticking only to muscle meat, I think we’re doing our bodies a disservice.
Ben: Hey, I want to interrupt today’s show. Is that annoying when I interrupt like that? Hey. Well I’m going to keep doing it ’cause it’s the only way I know how to how to interrupt conversations. Harry’s Razors is what I’ve been shaving with these days, why? Because of the closeness of the shave, ’cause they have like eight billion blades on these things, actually that five blades, but looks like eight billion, lubricating strip, trimmer blade. This stuff just wipes away hair like that old nares I used to use, and I was a bodybuilder? They’d smear on your skin like a chemical? This doesn’t do that, it’s just this wonderful, weighted ergonomic handle and a five-blade razor that I mentioned the lubricating strip and the trimmer blade. They give these to you at about two dollars per blade compared to four dollars or more with all the competing brands. You get this rich lathering shave gel and a travel blade cover if you get their trial set which is everything you need for a close and comfortable shave from these wonderful folks over at Harry’s. Thirteen-dollar value that trial set. Well here’s the deal, you can get it for free, easy peasey. Here’s how to get your Harry’s trial set. You just redeem your trial set at harrys.com/greenfield. That’s harrys.com/greenfield. So, you go over there, that’ll redeem the offer, that’ll let them know I sent you to help support the show, so Harry’s. HARRYS.com/greenfield. If you don’t love your shave, let Harry’s know within thirty days, and they’ll give you a full refund.
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Ben: Now your mom didn’t do that obviously, as you’ve alluded to, but before we turn back to that, I don’t want to neglect this population you’re talking about that carries these alleles that would increase the risk for Alzheimer’s. I assume you’re talking about the APOE. The Apolipoprotein E gene. Can you describe a little bit more about why it is that someone with that particular genetic factor would have an increased risk of Alzheimer’s, and in addition, what they found or what has been noted in these populations who carry that genotype but don’t show Alzheimer’s progression?
Max: Yeah, so I mean I looked at studies with Nigerians that live in a certain part of Nigeria called Ibadan where they’ve done some really interesting about epidemiology. They’re looking at the 8.4 allele frequency, and they see that it mirrors pretty much that of here in the United States, and what they found was here in the US, it’s well known that carrying one copy of the allele increases your risk for developing Alzheimer’s disease between two and four-fold and having two copies increases your risk anywhere between ten and fourteen-fold, and this is relative risk. Again, this is not a determining gene, it’s not like having early onset familial Alzheimer’s disease, which is a very rare and niche variant of it. It’s sort of a mutation that determines whether or not you’re going to develop Alzheimer’s, but most people, when we talk about Alzheimer’s disease, the vast majority of people are going to develop what’s called late onset or sporadic Alzheimer’s disease, and that’s a gene that’s not baked into your genome. It’s more influenced by genes, probably a multitude of genes, genes that we have yet to even identify, but the most well defined of them is called the APOE 4 allele, and just to sort of illustrate that for you, if you have genes that put you at higher risk for cardiovascular disease, that’s also going to increase your risk for developing Alzheimer’s disease.
Ben: Yeah, I carry both, by the way, so this is a topic near and dear to my heart. I’m POE 3, 4 and also carry out some of those cardiovascular risk disease genes. As a matter of fact I have a doctor who I think my podcast interview with him is probably going to come out after this podcast interview, but I’ve been working with him on my genes, the genes of both myself and my boys and making some pretty dramatic shifts in everything from saturated fat consumption to the type of nutrients that I’m consuming and even a little bit more robust management of some of the things we’re going to talk about on today’s show, based on the fact that I am APOE 3, 4, and so I have to go out of my way to learn a lot more about this stuff, and frankly, so do a lot of other people.
Max: Is that a new finding for you, being 3, 4? Is that something you’ve known now for a while?
Ben: It’s something that I had noted on my 23andMe results, but it’s one of those things where you need a medical practitioner to highlight the importance of potential risk of that for you before it really drives the point home. So, while I was aware of it, having a doctor say, Ben, you really need to pay attention to, for example, coconut oil and butter consumption versus your mono-unsaturated fat consumption a lot more dramatically, and I know that we’ll talk more about saturated fats in a little bit and how to know how many. I don’t want to shove moll under the bus, but yeah, I mean I’ve, for example, stepped back dramatically on my intake of saturated fats.
Max: Yeah, I mean look. We’re at the very tip of the iceberg in terms of understanding personalized nutrition to a T, but I’ve, at this point, spent a lot of time with all of the leading researchers in the dementia prevention space, and not one of them is recommending to me to consume more saturated fat. I’ll just put it to you that way, and I’m a big believer in the fact that everybody is different. There’s no such thing as a one-size-fits-all diet, and while certain people I’m sure can better metabolize an excessive amount of saturated fat, when it comes to making a widespread recommendation, there is no evidence to say for anybody that butter is going to dramatically, or even in any significant way, improve brain function or brain health, whereas one thing that I talk about all the time in my book, on my Instagram, wherever is that the only oil for which there exists a strong supportive body of evidence to say it’s going to improve your health is really extra virgin olive oil. I mean, irrespective of what genes you have, we can look to population studies which are imperfect, but we know that extra virgin olive oil is a staple of the Mediterranean dietary pattern, and research out of Russia University led by Martha Claire Morris has shown that adherence to a Mediterranean-style diet which uses extra virgin olive oil exclusively, I’m not talking about coconut oil or butter or even avocado oil. If you adhere to that diet strongly, you can achieve a 65% risk reduction for developing Alzheimer’s disease and dementia.
Ben: I remember that in your book, there was a specific molecule that you talked about in the book that’s present in olive oil. Was it oleocanthal, something like that? Like a phenol in olive oil?
Max: Yes, it’s a powerful anti-inflammatory. In fact, I call extra virgin olive oil, nature’s Advil. It’s very powerful, they’ve shown it to be as anti-inflammatory’s low dose ibuprofen, which is Advil.
Ben: No kidding, I didn’t know they’d compared it to Advil in clinical research.
Max: Yeah, I mean not branded Advil, but the generic chemical which Advil is at its core is ibuprofen.
Ben: I was going to say don’t cost me my ibuprofen sponsorship for this episode, please.
Max: Yeah, so I mean that population level. We can look to randomized control trials. There was the pretty neat trial that was recently reanalyzed. I’m sure you talked about that, but the results were the same.
Ben: I should note, by the way, you mentioned olive oil. I’ve seen a little bit of research on fish oil, seeming to appear to help a little bit with APOE 4 carriers. The other thing would be when we talk about coconut oil and MCT oil, I know some people might point out the fact that you see in a lot of books, and I think there are some studies that look at Alzheimer’s and oral dosing of medium chain triglycerides, MCT oil or MCT from coconuts and show those to be effective, but even those in those studies, the participants seem to be deriving the benefits from the ketone body, beta hydroxybutyrate, meaning that you could probably get some of those same benefits with ketone esters, ketone salts or, shocker, fasting, like an intermittent fasting protocol. So even high dose MCT oil is something that might not be necessary, in my opinion at least, for management of Alzheimer’s.
Max: Yeah, although I’m a little bit more, I guess the term, it’s a stock market term, bullish. I’m a little more bullish on MCT oil. You know, you’re right. I mean I think it’s probably better to produce ketones as nature intended for free, in your liver as a result of consuming a low-carb diet or occasionally fasting or even intermittent fasting. Most people wake up in a mild state of ketosis, but ketones are not just an alternate fuel that the brain will happily use, and by the way, this is important because one of the potential suspects in why APOE 4s have a higher risk of developing Alzheimer’s disease is that evident in their brains, from a very young age, sort of a reduced ability to create ATP from glucose, right? And this occurs typically in most people, regardless of the gene, as they get older, and it’s accelerated by things like Type-II Diabetes and obesity, but the brain’s ability to use ketones as a fuel source is undeterred by these things, so it’s believed that ketones serve as an energetic a life raft for a brain that maybe isn’t doing as well on glucose. But aside from that, aside from the fact that ketones are a powerful fuel for the brain, I think what’s most interesting and what’s come to light recently in the research is the fact that ketones also serve as a signaling molecule in the brain, that more than just allowing the brain to keep the lights on. The brain upregulates production of certain endogenous antioxidants like glutathione when ketones become available.
So, this is super cool, and this is one of the reasons why I think if you’re staying within your calories and it’s not affecting your body composition and you can potentially have a supply of ketones going up to the brain, over the course of the day, even if you’re in a non-ketonic state, meaning you’re in a fed state, I think it’s probably not going to be a bad thing. That’s my hypothesis, and we actually don’t know because typically, throughout our evolutionary history, the body would never have ketones available when glucose was also available, right? Ketones would only start to become produced once food would cease to be available, right? So now only, as of the past, I don’t know, two years, are we able to, as humans, have an elevated level of blood sugar as well as ketones, right? Because we have these incredible supplements, so nobody knows what the long-term effects of having both elevated at the same time are, but as a potential signal molecule, I think, I don’t know. I’m cautiously optimistic.
Ben: Yeah, I think that the argument that our ancestors would never have experienced high blood levels of glucose and ketones is actually a little bit flawed, for two reasons. The first is that organ meats, particularly liver, and I was talking with Dominic D’Agostino about this, contains naturally high levels of beta hydroxybutyrate. So, if you are returning back to organ meats, eating organ meats, technically you are assuming that you’re getting some amount of gluconeogenesis from the protein or maybe consuming something else along with the liver. You are actually elevating ketones from just oral consumption of them along with glucose simultaneously.
Max: That’s interesting.
Ben: The other factor, it happened to me just this morning. I had a cup of coffee, which we know mobilizes liver glycogen and steps up blood glucose, even if you’re in a fasted state, and then I did a workout which is also a notorious way to increase blood glucose, again because you mobilize muscle glycogen and liver glycogen, even in the absence of consuming glucose, and so this morning, I’m wearing a continuous blood glucose monitor right now. I had a blood glucose of 117, and then I went downstairs, and I have this little device called a level that measures your ketone]]>
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