Neuroscientist: If You Don’t Have These 3 Things After 40, Your Brain Is at Risk For Dementia

0:00 You state that 45 to 70% of dementia cases may be preventable.

0:07 You also state that when you say that to people, there's often disbelief

0:13 and or resistance.

0:16 Yeah.

0:16 Where does that statistic come from?

0:17 And why do you think so many people push back at it?

0:22 That statistic comes from two separate studies.

0:26 45% comes from the Lancet uh commission on dementia prevention report.

0:32 There have been two now.

0:32 The first was in 2020.

0:34 Uh most recent one was in 2024.

0:36 They upgraded the uh the number from 40%

0:38 of dementias potentially being preventable to 45%.

0:42 The 70% number comes from a study using

0:45 UK bio bank data performed by Professor Yintai's group.

0:49 Um and they sort of looked at all the different modifiable uh factors and risk

0:54 factors for dementia to estimate you know if we removed all of these risk

0:58 factors from the population what proportion of dementias

1:01 would we expect to you know no longer happen and this is what essentially

1:05 what the Lancet Commission report does as well.

1:07 So they have these statistical ways of estimating how much a given

1:13 risk factor translates to a proportion of dementia in the population.

1:17 It is an artificial way of doing it because we know

1:21 that risk factors to any chronic disease are not a onetoone thing, right?

1:27 And people often have multiple risk factors

1:29 together and they compound and they interact.

1:32 But that's the best way to to truly estimate right now

1:36 how um different aspects of the environment and society impact dementia risk.

1:43 And so it's things like 7% of dementias are thought

1:46 to be preventable if everybody got access to high quality

1:50 education um and you know high levels of educational attainment

1:53 and then there are um uh risk factors related to smoking,

1:56 head trauma, obesity um hearing loss etc.

2:01 and the the 45% number from the Lancet uh commission report,

2:06 I think that could be conservative because

2:09 they didn't include things like poor sleep,

2:12 which we know is a risk factor.

2:13 They didn't include things like um late uh later life cognitive stimulation,

2:17 which we know is important as well.

2:19 So, that's why potentially this, you know,

2:21 70% could be the the upper limit perhaps um of dementias that are preventable.

2:28 But you're right that when you say something like that, first of all,

2:32 people are surprised.

2:34 I think this is this is new information.

2:37 Um, and then people,

2:42 especially those who have some kind of relationship with dementia,

2:47 they had a loved one or family member with dementia,

2:49 they have a family history of dementia.

2:52 If you say that dementias are potentially preventable,

2:56 they might interpret that as if there's

2:57 some blame on an individual who previously

2:59 suffered from dementia or is currently suffering

3:01 from dementia when that's absolutely not the case.

3:05 Right?

3:06 We've just said that we're only just starting to appreciate that dementia may

3:09 be preventable or you know a certain proportion of dementias may be preventable,

3:13 certain types of dementia may be preventable

3:16 and we know it's very complicated, right?

3:18 Multiple risk factors may come together in an individual.

3:20 uh genetic risk factors, environmental risk factors.

3:23 Um, and I truly believe that each person is doing the best with the information

3:29 that they have and the things that they can do at the time.

3:32 So, it's more an idea of hope, right?

3:35 Should we be able to modify our environment?

3:38 Should we be be able to make societal change to remove some

3:42 of these risk factors because some of them are related to socioeconomic factors?

3:46 there is um the possibility of dramatically

3:49 decreasing dementia burden in the population.

3:52 And yes, individually we can take

3:53 that on and and uh decrease our own risk of dementia.

3:57 But it's it's really um sort of an idea

4:01 of of what's possible rather than saying,

4:03 "Oh, because somebody got dementia, they did something wrong." Yeah.

4:08 It's that whole thing about blame.

4:10 It's something I think a lot about on the show because each week we're trying

4:13 to empower people with the things that you might be able to do in your own life.

4:19 It doesn't mean though that if you get something, you failed in some way.

4:25 Do you know what I mean?

4:26 It's a tricky one, isn't it?

4:27 It's also hard for us to to think about this as individuals because

4:34 we're talking about probabilities, right?

4:36 So it would be impossible to say

4:39 that any individual case of dementia is preventable.

4:43 It would be very possible to say were you to address certain risk factors,

4:47 you will decrease your risk of getting dementia.

4:50 But I could never say I can

4:52 guarantee that one individual won't experience dementia.

4:54 They may experience it later.

4:56 They may have, you know, less of a decline, fewer symptoms.

4:59 They may not experience it at all.

5:01 But it's sometimes hard to wrap our head

5:04 around the fact that when you're talking about statistics,

5:06 you're talking about probabilities rather than certainties.

5:09 And often in the health sphere,

5:11 we're sold certainties and black and white stories.

5:13 And it can be difficult to understand that there's some nuance in in what

5:16 we're trying to to get across and what we could potentially do.

5:19 I think those statistics firstly, they're very empowering,

5:23 but I think they're empowering on a couple of different levels.

5:26 I think firstly, it means oh wow, just cuz mom had it M

5:32 maybe it doesn't mean that that's my fate

5:35 and so oh let me learn more to see what I can introduce into my life.

5:39 So I think it's hopeful on that level but I think

5:43 deeper to that it it more broadly

5:47 to me speaks to our collective attitude towards aging.

5:54 Yeah.

5:53 Right.

5:53 Are we expecting our brains to get slower, weaker,

5:59 poorer, whatever that might be as we get older,

6:02 or do we actually think that that doesn't necessarily have to be the narrative?

6:05 And you know, in the new book, The Stimulating Mind,

6:08 you very clearly make the case that that does not need to be the case.

6:12 Let's talk a little bit about mindset and attitude

6:14 to aging because I I think that's quite key, isn't it?

6:17 Yeah, I think so.

6:19 And this is something that we've embodied as a society almost

6:24 that we expect a certain amount of decline as we get older.

6:29 And I uh I lay some of this blame at the feet of Sir William Oler.

6:35 If anybody's heard of him, he's a very famous physician.

6:38 Um he's a was a Canadian physician,

6:40 helped to found John's Hopkins Hospital in the US and then

6:43 he was a professor of medicine at the University of Oxford.

6:46 And in the early 20th century,

6:50 Osler helped to popularize the idea of retirement because before then,

6:55 other than sort of like military pensions,

6:57 it wasn't normal for people to to retire.

7:00 But he gave this famous address at Johns Hopkins

7:02 where he said that at the age of 60,

7:05 the uh average adult is useless and should be put out to pasture.

7:11 And this then is something that we have internalized

7:16 as a society and this is essentially what we expect.

7:18 I will give him a little grace by saying that at that time

7:24 average life expectancy in the US was in you know late 50s.

7:27 So maybe he was right that once you were

7:30 60 you know the average individuals wasn't in great health.

7:32 But that's no longer the case, right?

7:34 With the advancement of of medicine and every everything we've been able

7:38 to do to extend both lifespan and health span at the population level.

7:43 And despite that, I think we expect some level of decline and because

7:53 of that, we do things or stop doing things that then make that inevitable.

7:59 So uh there's this idea of stereotype embodiment theory um based on some

8:06 of the work include like Ellen Langers work you know you know her work well

8:09 she's great um and she talks about the fact that if

8:15 you expect decline then you embody this idea that you

8:21 will decline and therefore you stop doing the things

8:24 that prevent decline and therefore it becomes a self-fulfilling prophecy.

8:28 So if we expect to lose physical function, we expect to lose cognitive function,

8:32 then we stop doing the things that help us to maintain function.

8:36 Oh, I'm too old to learn a new language.

8:38 Oh, I'm too old to pick that up.

8:40 Oh, you know, I might get might get injured.

8:41 I don't want I don't want to do that.

8:42 Um and we stop doing those activities that challenge our physiology,

8:48 which are inherently the things that help us maintain function.

8:51 And as a result, um we we see decline.

8:54 So I think the most important thing to to realize and we could

8:58 certainly go into the uh into the evidence that decline doesn't have to be

9:02 inevitable but the first thing we have to realize is that there is

9:06 this huge possibility to enhance function physical

9:09 function cognitive function at essentially any age

9:13 as long as we engage in these processes and uh

9:18 skills and challenges that that help that to to happen.

9:24 Yeah.

9:23 When I think about how our attitude influences the reality of our lives,

9:30 I I think about two two cases or or two

9:33 sort of examples where there are some South American tribes uh

9:37 running tribes where you grow up from from what I understand

9:42 with the belief that as you get older you get faster.

9:46 Yeah.

9:47 Right.

9:47 And look, I haven't seen the physiological dates.

9:49 see the V2 maxes that they've measured or not measured,

9:53 but apparently in your 60s and your 70s they are the fastest runners, right?

9:58 And it and it, you know, we can look at the science go, yeah,

10:00 but we know you lose muscle mass from the age

10:02 of 30 and we know that this is going to decline, right?

10:06 Or whatever it might be.

10:08 And also, let's also not forget that if you grow up

10:11 in a culture where it's believed that you get faster as you get older,

10:15 how much of an impact does that have?

10:17 There's also some research I saw where if you live

10:21 in a culture where older women are looked up to,

10:27 right, and they're really valued, I think in some of those cultures,

10:31 they have uh less reporting of menopausal symptoms.

10:36 Now, I'm sure there's multiple complexities there.

10:38 You know, are they reporting them enough?

10:40 Are they are they doing them in the same way?

10:41 whatever it might be.

10:43 I just find this whole idea that our mindset and the influence it

10:46 has and of course Ellen Langanger's work

10:48 is hugely saying your mindset is massive.

10:51 It's kind of interesting, isn't it?

10:53 Yeah.

10:53 There's so many examples of how what we

10:57 think and what we expect drives our physiology

11:00 as well as driving our behavior and then essentially

11:03 creates the the reality that we that we expect.

11:06 And and you can measure this in many different ways

11:07 and and you know Ellen Langanger's work is critical to that.

11:12 Uh be that um you know manipulating how

11:14 people think about their sleep then affects how

11:16 they perform the next day day regardless

11:18 of how they actually slept or manipulating clock time

11:20 and um or how people think about uh the food that they ate which then affects

11:25 their blood sugar responses to it even if

11:27 you know it's a standardized meal under different conditions.

11:30 And so we know that what we think drives physiology as well as behavior.

11:34 and then you sort of get the outcome that you expect uh

11:39 to a to a certain degree and therefore I think we need to understand

11:45 that this doesn't have to be the case when it comes to cognitive decline

11:48 in particular and there's a a few different ways that we can approach that.

11:51 the the the first thing if people think

11:56 about cognitive function you think about a graph

11:59 right so on one side you've got cognitive function like on the on the y-

12:02 axis on the left hand side and then along the bottom you've got age

12:05 and everybody might expect some they've seen

12:07 some curve where you know it peaks around

12:10 your 20s or early 30s this is like exactly the same with physical strength

12:13 or muscle mass and then sort of just

12:14 like declines from there and then eventually

12:17 at some point you'll lose enough function

12:19 that you might reach a threshold that we

12:20 call dementia When you're doing those kinds

12:24 of studies that result in those kinds of graphs,

12:26 what you tend to do is you just sample a whole bunch of people,

12:28 maybe thousands of people,

12:29 and you measure their cognitive function, and you see that on average,

12:31 yes, as you get older, the function is lower, right?

12:35 You add add up everybody's cognitive function

12:37 divided by the number of people, right?

12:38 You get the the the average.

12:41 And yes, some people as they get older do lose function.

12:43 So, there are people who are sort of dragging the average down.

12:46 But asking what the average function is or the change

12:49 in function in an average population over time

12:51 is not the same as saying what's my function going to be in 10 20 30 years time.

12:56 And so when studies have looked at that there's a a classic

13:00 study I think it was one of the first studies to do this.

13:01 It was called the Seattle longitudinal study run by Warner Shai

13:07 and he took individuals starting in the 50s um

13:11 and he measured their cognitive function every seven years

13:14 for multiple decades and every seven years he would

13:17 bring back the old participants and add new participants.

13:19 So in in the end he had data from people

13:20 in their 20s up to people more than 100 years old.

13:24 And what he saw was that the um the majority of people so like

13:31 more than half of people maintained cognitive

13:34 function into their 50s 60s and 70s.

13:36 So yes there were some people who lost function.

13:38 They dragged down the average but the the norm you know more than 50%

13:43 of people was to maintain function over time even into your 70s and 80s.

13:47 And those data were actually used to raise

13:49 the retirement age in the US because you

13:51 know he showed actually that we can expect

13:55 that most people will maintain function later into life.

13:58 But if we don't understand that as individuals then all

14:02 those things we just talked about come into play right

14:04 because we stop doing the things that help to maintain

14:07 function because we expect function to decline as we get older.

14:13 I think about that through the lens of public health messaging and you

14:19 know let's let's take what you do or what I do on this podcast.

14:22 You're trying to share information that people can then absorb

14:28 and then if they choose to take on in their life.

14:31 Yeah.

14:31 But there's a there's a fine balance, isn't there?

14:33 Because if you spend two hours talking about the problems of sleep deprivation

14:40 Yeah.

14:40 Right?

14:41 On one hand, you're being honest.

14:43 You're trying to educate people,

14:47 but also you're also probably infusing this idea that it's really, really bad.

14:54 And actually, as you beautifully write about in your book,

14:56 you know, we're pretty resilient.

14:58 You can deal with a couple of nights

15:00 where we don't sleep.

15:01 But I I I've changed my messaging around sleep over the years.

15:04 Let me put it, I've evolved it because I've realized

15:06 actually that when you do these deep dives, it's great.

15:10 And for many people, it's like, wow, I better start taking my sleep seriously.

15:14 Yeah.

15:14 Right.

15:14 But then you of course get new parents who then send me messages saying,

15:20 I'm really worried, you know, after that last podcast, you know,

15:22 I'm I haven't slept well for the last 3 months

15:24 cuz my young baby needs feeding through the night, etc., etc.

15:27 And then the unintended consequence is you're trying to help and empower people,

15:33 but sometimes that same message can

15:36 be very disempowering and frankly quite stressful.

15:39 Yeah, there's so that particular example I there's

15:44 a study that that I reference in the book that showed this is using UK bio bank

15:49 data again showed that the more children that parents

15:54 had both men and women the lower their risk

15:58 of dementia and I thought this was fascinating

16:01 because on the face of it having kids should

16:05 be devastating for your cognitive function right stress sleep,

16:09 you know, all the, you know, all these things that you don't get to do.

16:11 You don't get to look after yourself anymore because you're so, you know,

16:14 busy worrying about this this um this new

16:17 human that that now has to navigate the world.

16:20 Um, but this is what happens when we

16:25 focus on on the downside like downside of stress, downside of poor sleep,

16:29 downside of, you know, what are the, you know,

16:32 contaminants in seafood or is your food organic or not.

16:36 In general, so many of these things,

16:38 the benefits massively outweigh the downsides.

16:40 So when you think about kids, right, they come with opportunities for joy,

16:45 cognitive stimulation, social connection, pro-social behavior,

16:48 which is just such a critical component of um humans

16:52 and their evolution and what it takes to to you make them healthy.

16:57 Um you know, looking after other people and you know, building a community.

17:02 And so those benefits seem to massively

17:04 outweigh the the potent the potential downsides.

17:08 And like this is then I think the important thing for us to remember.

17:12 A we are incredibly resilient and adaptable

17:16 and b usually the things that we're doing

17:19 want to try and get the the the most benefit out of them as possible.

17:22 So when we're then worrying about

17:23 those minutia for like the potential downsides,

17:26 we're actually offsetting some of the benefits that we're

17:30 getting from all these amazing things that we're doing.

17:32 And I think a study that maybe we talked about previously,

17:34 but is worth bringing up again is um

17:38 a study where they looked at um physical activity,

17:42 both actual physical activity and perceived amounts of physical activity.

17:45 This was done by Alia Crumb,

17:47 who actually trained with Ellen Langer um and now she's a professor at Stanford.

17:52 And what they found was that people who um felt

17:57 like they were doing less exercise than people like them,

18:00 you you similar demographically, they had a higher risk of mortality.

18:04 And there was another study that found a similar thing for cognitive function.

18:06 So if you if you thought you weren't doing as much exercise as people like you,

18:11 they ended up having, you know, on average lower cognitive function.

18:15 Um, and this was after adjusting for how much exercise people

18:20 were actually doing as well as a whole bunch of, you know,

18:22 health related confounders.

18:24 So, what that says is if you spend all your time thinking, I'm not doing enough.

18:29 I should be doing more,

18:31 you are then essentially creating a situation

18:35 where you're not getting benefit from the things

18:36 that you are doing and creating this this chronic

18:39 stressor that's that's having negative health effects.

18:41 So I so I am much more in favor

18:44 of celebrating all the amazing things that we do do because

18:46 those are probably offsetting any of the sort of like

18:49 the minor things that we we would otherwise worry about.

18:52 Yeah.

18:52 And of course in the modern age now

18:55 we'll maybe talk about modern technology and social

18:57 media later but one of the things of course

19:00 that many of us have experienced is comparison.

19:05 Mhm.

19:05 Right.

19:05 And so, you know, maybe 100,000 years ago,

19:09 you're you're kind of comparing yourself to your tribe.

19:14 Yeah.

19:13 Maybe 150 people max, maybe less, who knows?

19:16 Now, we can compare ourselves to the best in the world at anything, right?

19:22 So, you go for your 30 minute walk around the block,

19:26 but then you go on Instagram and someone's just done an ultramarathon, right?

19:30 And so you you know your 30 minutes

19:33 around the block is fantastic for your mental wellbeing,

19:36 your physical wellbeing, emotional wellbeing, your stress levels, brilliant

19:40 but there is a risk that you think, oh gee, yeah man,

19:44 I did 30 minutes I've just done 30 hours or whatever it might be.

19:47 Yeah, there's um a really nice paper or set of papers

19:52 and essentially work done by uh George Slavich and Steve Cole there.

19:57 They're at uh UCLA and um myself and uh

20:03 Julian Ael who's a retired palative care physician.

20:06 We recently um curated and edited a set of scientific

20:10 papers on the importance of community and social connection in health.

20:15 And one paper was written by um Steve Cole and George Slavage

20:20 and they talk about social stress and the effect that has on our physiology.

20:25 And one thing that was like particularly impactful

20:27 to me was reading it and you you kind

20:29 of they talk about social social rank perceived social

20:34 rank right how we see ourselves compared to others.

20:37 And and it as you sort of like

20:39 read as you know I'm reading what they've written.

20:40 And I'm like, this is why social media is so bad for our health.

20:46 Because what happens is that you spend all

20:51 your time seeing people who are doing more than you,

20:53 more successful than you, richer than you, better than looking than you,

20:57 whatever, like however you would perceive that compared to yourself.

21:02 And what we do is then we rank ourselves like where are we in the in the world?

21:06 And we de demote ourselves internally because we see all these people

21:10 who we think are better than us or doing more than us.

21:13 And being demoted in your in your perceived social rank creates a social stress.

21:20 And so it creates the a phys

21:22 a physiological response similar to when we're socially isolated.

21:26 And we know that when we're socially isolated, we see shifts in our physiology.

21:29 It changes our immune function.

21:31 It changes baseline levels of inflammation.

21:33 This is a evolutionarily conserved response, right?

21:36 So, if you're isolated, then your immune system shifts away from being

21:40 better at dealing with things like viruses,

21:42 respiratory viruses, because you know,

21:44 you're not surrounded by anybody to give you a cold or a flu,

21:47 and it shifts more towards uh an acute

21:50 response that makes you better with like wound healing,

21:53 for example, which is survival.

21:55 That's important, right?

21:56 There's nobody to look after you if you get injured.

21:57 And these things are, you know, we can measure them in our physiology.

22:00 However, that comes with a baseline lower level of inflammation

22:04 because your body's like ready to respond to an injury.

22:07 If you continue that long term,

22:09 you then see an increased risk of many chronic diseases,

22:12 heart disease, dementia because of this immune system shift,

22:17 and that is driven by social isolation, but it's also uh driven by other social

22:22 stresses such as a lower perceived social rank.

22:24 Yeah, I remember reading that in I think this in the adapt chapter in the book,

22:28 which is one of my favorite chapters.

22:29 Um, that whole idea that the immune system shifts,

22:36 uh, I think is really interesting.

22:38 So, I just want to clarify something cuz I think

22:41 I don't know if you said lower inflammation or higher inflammation.

22:44 When it shifts because you're lonely,

22:48 the cost of that is a higher background level of inflammation.

22:52 So, it makes us inflamed basically being lonely.

22:55 Yeah.

22:55 Exactly.

22:55 Yeah.

22:56 And some of that being a perception is quite interesting.

22:58 I I once had a very successful author on the podcast uh Will store.

23:02 He's written some brilliant books.

23:04 We chat about status and I remember chatting to Will and it came up this idea

23:11 that Will is more successful than most authors in the whole scheme of things.

23:18 Yeah.

23:17 But he's not as successful as some in and let

23:20 me define success in terms of book sales.

23:22 Okay.

23:22 There's many ways to define success.

23:24 And so Will was, you know, quite honestly just saying, "Yeah,

23:28 but all I see is all the authors who are selling more than me and who

23:33 doing better than me." And it it just shows that it doesn't matter who you are,

23:37 no matter how successful you perceive yourself to be.

23:41 I agree with you.

23:42 I think that may be one of the darkest things

23:44 that happens to our subconscious when we're spending a lot

23:50 of time on social media cuz and this is one thing

23:52 I I I thought I thought about a few years ago.

23:54 We can talk about this stuff, right?

23:56 People can know it.

23:58 I go, "Yeah, when I'm on social media, um I don't take it seriously.

24:03 It's there.

24:04 It's just their highlights real, right?

24:06 I don't think it matters.

24:07 I think your subconscious is constantly being fed that you're not enough.

24:10 Yeah, that is better than you.

24:13 And I know in my own life,

24:14 so I've recently taken all my social media apps off my phone,

24:18 so I can go on, but I can't easily get onto them on my phone.

24:24 Um, and I just feel better.

24:28 Yeah.

24:27 Like that's subjective.

24:29 I can't give you a trial for that.

24:30 I just I just feel better.

24:32 There are Well, there are actually trials that that do look at that, right?

24:36 And it's interesting because the the the timeline matters, right?

24:43 If you if you ask somebody how they feel

24:44 about quitting social media after just a week or two,

24:48 they might not feel that good about it.

24:49 You still get, you know, FOMO and these other things because you're

24:52 you're not uh interacting in that world.

24:54 It's like asking how a how a smoker feels 2 days after they quit.

24:58 Um they don't feel great.

25:00 Um, but if you go out long enough, four weeks plus,

25:04 there seems to be an overall uh increase in in well-being.

25:07 And this is also driven by what people do instead, right?

25:11 And this is where a lot of the issue

25:13 uh with social media comes from, I think, because

25:16 it can be um a way to increase social

25:20 connection and social contact that you wouldn't have had otherwise.

25:23 And we see this in studies in older adults where

25:26 they're using Facebook for the first time.

25:27 and they can communicate with family members

25:29 that they would wouldn't have done otherwise,

25:30 you know, share photos, that kind of stuff, that is a net benefit.

25:34 But if you're using social media to consume content

25:37 instead of going and meeting people in real life, that's a net negative.

25:41 And we see that very clearly in terms of uh well-being.

25:44 So yes, you um there is maybe some benefit

25:49 from at least decreasing our exposure to social media,

25:52 but you can also curate the way that you

25:54 use it such that it becomes a net positive.

25:57 Plus, you need to think about what am I doing instead?

25:59 Um, and then there are multiple different ways to navigate that.

26:03 But just appreciating that these um these are potential issues

26:07 based on the fact that if you're you're constantly, you know,

26:11 uh being being exposed to to content from people

26:15 that makes you feel less than either consciously or or unconsciously.

26:19 Um it might be having a a net negative effect on your health.

26:23 Yeah, it's the tool, right?

26:25 And and like all tools, it depends how you use it.

26:28 I agree.

26:29 And at the same time,

26:31 I think something has happened recently which makes that even harder.

26:35 So a few years ago,

26:36 I thought, right, I'm going to cull everyone when it was still called Twitter,

26:39 I thought I'm going to unfollow everyone and just follow

26:43 the people who I think really are giving me value.

26:47 Yeah.

26:47 Right.

26:47 So some of these, you know,

26:49 there's a few endurance uh coaches who I really like following a lot

26:52 of they share research papers on exercise physiology and their experience coach,

26:57 you know, the things that I really enjoy looking at.

27:00 Yeah.

27:00 And I did that and for a while it worked and thought, okay,

27:02 cuz whenever I go on all I'm seeing is

27:04 stuff from people actually I want to see stuff

27:06 from, but I think algorithms have changed where you

27:08 don't only see stuff anymore from people you follow.

27:11 Yeah.

27:12 In fact, that's only a very small percentage of who you see.

27:14 So I do think it's getting harder and you do talk about this in the book, right?

27:18 You talk about the houseian days of social media and I I you know you were very

27:22 early cuz I think your uni was like

27:24 the third uni to get Facebook or something like that.

27:27 Yeah.

27:27 One of um one of the first unis to get uh

27:30 Facebook outside of the US in 2004 I think we got it.

27:34 Yeah.

27:34 Yeah.

27:35 But I remember back sort of I don't know 2007208 Facebook was great.

27:39 Yeah.

27:40 you you you it was way of staying in touch with mates,

27:42 you know, you'd share photos, you'd see what your mates are doing,

27:46 you might follow a few people and see their content.

27:48 And it was I think unless I'm looking at it

27:50 through rose tints and glasses, it seemed to be

27:54 connection like social connection.

27:57 Yeah.

27:57 I think for many reasons which you don't

27:59 necessarily have to go into on this show today,

28:01 but you're right about is it prime, but just explain what prime is.

28:05 Yeah.

28:05 So, this is information that we prioritize as humans.

28:09 um which um me so the prime stands for prestigious in-group moral and emotional

28:16 and this is because we prioritize information that tells

28:20 us something about our social environment because that's

28:22 going to help us survive right and we

28:25 are inherently social beings and so this then

28:29 is what's I I think leveraged by the algorithms to have us stay engaged or you

28:35 know continue scrolling and So they know

28:41 that information that you will respond to either

28:44 positively or negatively in a large way is

28:47 the kind of information that's going to keep

28:48 you keep you hooked in because your brain

28:51 thinks this is important information about my social

28:54 environment that I need to gather such

28:56 that I will then survive better in my environment.

28:59 And so that will include the things that you want to see, right?

29:02 But it might also include stuff that they know will elicit a negative emotional

29:06 reaction because you get these large swings

29:09 in dopamine that then drive learning, right?

29:11 That dopamine dopamine um is largely

29:14 um responsible for learning what's important.

29:16 Um and that's that's done on that's done on purpose.

29:21 And so like I think that social media takes advantage

29:26 of our need for social information whilst giving us social disconnection,

29:32 but we keep going back cuz we're like, well,

29:33 next time I'll learn something that will really help me.

29:36 Um, and that's how you get sort of like stuck in the loop.

29:40 Okay, Tommy.

29:41 So, so far we're basically up to the point where

29:46 we're saying that a lot of dementia cases are preventable,

29:48 which is very empowering message.

29:50 You've mentioned that the brain can adapt to any age.

29:54 Again, very empowering.

29:55 It doesn't matter how old you are when you're listening to this.

29:57 Um, I don't know if we'll get to your owl story or not today,

30:00 but you start the start the book with a beautiful story about owls,

30:02 which really highlights this point, right?

30:04 That that the brain can adapt to any age.

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33:13 We're talking a lot about social connection and I I want to really

33:18 talk about the 3S model that you you put forward in the stimulated mind.

33:22 Okay.

33:22 because well firstly I do have to tell you I think

33:25 this is one of the best health books I've ever read.

33:27 It's absolutely fantastic and it's it's so thorough.

33:31 It's what I'll tell you what I like about it the most.

33:35 Not only is it grounded in a lot of scientific research,

33:39 it's very clear that you've got a lot

33:40 of practical knowledge about the application of it as well.

33:46 And that's not always the case.

33:47 You know there are sometimes books from researchers which are great and you

33:52 see all the science but you know as someone who spent many years

33:56 practicing I'm like yeah but that doesn't that there is a different skill

33:59 I think to application of these things for real life people who are busy.

34:05 So it's a beautiful blend of that.

34:06 You also, and I know this whenever I talk to you,

34:08 you seem to know a study for absolutely every I can literally say anything.

34:13 And um you know a lot of studies, don't you?

34:17 Uh yeah, that's part of it's an occupational hazard at this point.

34:20 Um I think the the book has a reference list

34:23 of um it it'll be about 2,000 studies um 99.9%

34:28 of which are in humans um that people can have

34:30 access to if they're interested in in in digging in further.

34:33 It's it's very rigorous.

34:34 Um, which I think is great,

34:38 but I I really love this 3S model that you put forward

34:42 in the in the sort of the final third of the book as it were.

34:47 Yeah.

34:46 Stimulate, supply, and support.

34:48 And I'll just before you you sort of go, you know, outline it for us.

34:52 Something I read last night which I which I've been thinking about ever since is

34:55 this idea that nutrition of course is important

35:04 but I think it's only one of the assets.

35:07 Yeah.

35:06 And I think that's quite novel because we think

35:08 well what can I eat to support my brain?

35:11 You're making this case throughout the book that actually

35:13 stimulus to the brain is perhaps the most important thing.

35:19 So it made me think well hold on a minute.

35:21 If you think about physical health, right,

35:23 we can talk about eating protein for your muscles,

35:29 but if you're never stimulating your muscles

35:32 with movement or with lifting weights,

35:36 is that protein really going to translate to muscle growth?

35:41 And then I thought about through the lens of the brain,

35:42 we can have the right diet,

35:45 the right omega-3s, and you know, all the things you talk about, right?

35:48 We we we can we can have them in our diets, but that seems to be only one

35:53 of the S's if we're not also stimulating our brain.

35:57 We're perhaps not getting the the full benefit.

36:00 So, I said a lot there.

36:01 I think it's interesting.

36:02 Can you walk us through the model,

36:04 then comment on anything I've just said that you feel is important.

36:07 Yeah.

36:07 Yes.

36:07 So, so what you say is exactly right.

36:10 And where the model comes from is all the different pockets

36:15 of neuroscience that I've worked in or coached in over the years.

36:19 So I'm thinking about the developing brain.

36:22 Um thinking about individuals who suffer some kind

36:25 of brain injury during life like a traumatic

36:27 brain injury or concussion or trying to help

36:30 um elite athletes perform at their absolute best.

36:32 Um and then also thinking about you know what are

36:35 the factors that contribute to long-term cognitive decline and dementia.

36:40 And you see the same things pop up again and again

36:42 and again which sort of makes me feel like there are these core

36:45 foundational inputs that the brain requires in order to perform at its

36:48 best both on a day-to-day basis but then also long term.

36:51 So things that you can do right now to improve how your brain functions

36:54 today or tomorrow then translate into uh

36:58 a longer term um lower likelihood of dementia

37:01 and you know much you're much more likely to maintain the function that you

37:05 do have or maybe even improve it right in your 60s7s 80s and beyond.

37:10 And there are a whole host of factors that we could talk about.

37:14 We've already talked about several of them, right?

37:17 But they for me they they coalesce around these three

37:21 common areas which is what which are the three S's.

37:24 So stimulus, supply and support like you said.

37:27 And I think that stimulus is something that we we inherently know is important.

37:33 Everybody said use it or lose it at some point, right?

37:35 But I don't think we've quite understood what

37:37 that what that truly means in order to give

37:40 our brains the stimulus that that or the stimuli

37:43 that they that they benefit from the most.

37:46 But I do relate it to this idea of physical performance

37:49 and physical health because people we kind of inherently understand that, right?

37:53 If I want to get uh if I want to get bigger and stronger, right?

37:57 I want bigger biceps,

37:59 the most important thing to do is to do bicep curls, right?

38:04 I can improve my response to my training with a higher

38:08 quality diet and making sure I attend to sleep and recovery,

38:11 but I can't just drink protein shakes

38:13 and nap and hope that my biceps get bigger.

38:16 Okay, this is great.

38:16 So, so in that physical health example, right,

38:23 you're making the case that the three S's are still important,

38:28 but the stimulus is the most important.

38:31 Yes.

38:31 Which I think makes intuitive sense if we step back and think about it.

38:35 Ex.

38:35 Exactly.

38:35 And and in reality, the function of any part

38:40 of your body is driven by how you use it.

38:44 Right.

38:44 And you can think about your bones when you do your weightlifting

38:48 or you can think about your heart when you go running, right?

38:51 The way that we use our body is the primary determinant of how it functions.

38:55 And the brain is exactly the same.

38:57 So I'm making the case that how you use

38:59 your brain is the primary driver of how it works.

39:03 Okay.

39:03 So we have this 3S model and I wonder if we

39:06 could just go through the three of them and you know stimulate,

39:09 how do we stimulate, supply, how do we supply, support, how do we support?

39:16 Yeah.

39:15 Um yeah, give us a sort of top line on that.

39:18 Sure.

39:18 So the the stim the stimulus that I think that we need

39:24 more of and I will acknowledge that I quite like the title

39:29 of the book the stimulated mind because it's provocative in a in a way

39:34 because right now we are at the same time under stimulated and overstimulated.

39:39 Yeah.

39:39 Everybody feels overstimulated, right?

39:41 So Tommy, how can you tell me that my brain isn't stimulated enough?

39:44 like I'm I'm constantly feeling stimulated.

39:47 And so it's the type of stimulus that really matters.

39:50 And I think we can talk about and you know social media

39:52 is one of those things we can talk about how you can decrease

39:54 these other stimuli that make us feel overstimulated or stressed because that's

39:59 an important part of it that that will end up in our support bucket.

40:03 But the the the kind of stimuli that drive

40:05 the development of the human brain are learning, knowledge acquisition,

40:11 skill acquisition, social interaction,

40:13 pro-social behavior are, you know, languages,

40:16 music, um complex uh movements in sports, uh social connection.

40:21 these things that require us to learn a skill and apply that skill um

40:27 in a way that involves processing information quickly

40:30 in a way that involves responding to the environment,

40:32 responding to other people.

40:34 Um and you know through multiple senses, right?

40:38 Our hearing and vision and touch, taste, smell,

40:43 like all of these things actually can

40:44 can be important stimuli for maintaining cognitive function.

40:48 And it's that kind of complex um skill

40:52 development and expression across all those domains you

40:57 including arts including computer games like like complex

41:00 computer games can even improve cognitive function because it's

41:02 the same thing you know multiensory complex cognitive

41:05 stimulus these are the things that I think we need more of and we need to spend

41:10 time really attending to them and focusing on them.

41:14 Is it the complexity of the stimulation?

41:16 Is is you know you you mentioned this kind

41:18 of the paradox of the time in which we live.

41:20 You know the book is called the stimulated mind.

41:23 As you say, many of us go, "Yeah,

41:24 but most people are over stimulated." But is it that it's almost like a

41:30 we've got too much of the wrong kind of stimulation,

41:33 like the the uni-dimensional perhaps like the the scrolling cuz you know,

41:39 let's say you wake up and you go onto your social

41:42 media platform of choice for an hour whilst drinking coffee.

41:46 Okay, you're getting stimulation, right?

41:50 You might in the hour see more information in the hour than

41:53 maybe your ancestors would see in a year or maybe even longer, right?

41:59 Okay, let's let's just work this 3S model.

42:01 Let's say for that one hour you got all of this stimulus in, right?

42:06 And then we go to the supply and go, yeah, and and you let's say you've got

42:09 an exceptional diet and you're moving your body regularly,

42:12 so you're getting supply and you're sleeping

42:15 well that night to allow that learning.

42:17 In theory, could that stimulation be beneficial for the brain to an extent?

42:24 So, if you're using Instagram and you're consuming educational

42:32 content such that you're you know learning important facts and thinking

42:35 and thinking.

42:36 Yeah, absolutely.

42:37 That can that can be an important stimulus.

42:40 Um, we know that education and the environment

42:45 are the primary drivers of brain development

42:47 and educational attainment is one of the best

42:49 predictors of long-term cognitive function and cognitive decline.

42:52 So that's literally just every day your job is learning, right?

42:57 You're learning and you're applying that knowledge.

42:58 That's why attainment is important, right?

43:00 You're actually remembering things,

43:03 applying that knowledge in exams or or however that that knowledge is is

43:06 so so okay.

43:07 So attainment that's so it's not just going to school and passively

43:12 uh consuming stuff you have to actively engage in some way.

43:16 Yeah.

43:17 So the to kind of like really simplify that it's it's

43:21 the difference between you know you spend 10 years at school

43:24 and you you know pass your A levels or you you

43:26 spend another few years and you get an undergraduate degree, right?

43:29 that those levels of attainment versus you spend 10 years retaking

43:33 the same year in school because you never pass an exam, right?

43:37 Those are two ve you spent the same time in education,

43:40 but those are two very different outcomes in terms

43:43 of applying your brain and making sure that you're,

43:46 you know, using the knowledge that that you've that you've gained.

43:48 And can the stimulation that we need like the primary

43:53 stimulus to the brain um we don't all need the same

43:58 cuz because you when you've been on the podcast you

44:00 you have spoken a lot about you know when do we

44:04 have peak cognitive status is it is it after university

44:08 or yeah in your late 20s maybe in in kind

44:10 of the modern western world in terms of how people who

44:12 go through education and then they might go and study beyond that.

44:16 But then it made me think about huntergatherer communities

44:18 and I and I thought well do we know

44:24 in these traditional societies whether they have high rates of cognitive

44:29 decline if they've not done the same type of education

44:31 but then then I think well but they would be

44:34 getting stimulated in other ways maybe not in the conventional

44:38 or the modern academic stimulus you know this stimulus

44:42 can come in a variety of different forms can't it?

44:44 Yeah.

44:44 So I think that's an important um clarification to make

44:48 because these studies are done in a typical west, you know, western environment.

44:53 We're doing specific tests of cognitive function, you know,

44:56 related to a whole bunch of different um

44:58 functions of the brain that could involve memory,

45:01 attention, um decision- making, um processing speed,

45:06 like how quickly you can process information.

45:09 But this is these are just the data that we have access to.

45:11 This is how we understand it, right?

45:13 And what that what those data show is that the cognitive

45:18 function peaks around the time that you leave formal education.

45:20 So the the later you the later you leave education, right?

45:24 So the longer you spend at school or you getting degrees,

45:27 the higher and later your peak of cognitive function because

45:30 I think you're just getting this stimulus on a day-to-day basis.

45:33 But that doesn't mean that that's the way that you have to do it, right?

45:36 This could happen outside of a formal educational setting.

45:39 You know, in those, you know, traditional huntergatherer groups,

45:42 they will actually constantly be learning and then

45:45 at some point they'll transition from learning to teaching.

45:47 Right?

45:48 This is this is a big this is a big part of,

45:50 you know, um later life where we know

45:54 that old adults in those communities in their 60s, 70s,

45:57 and 80s are just as active as their as their younger community members,

46:03 but they transition to being repositories of knowledge.

46:06 And that that is that's the expression

46:08 of these complex skill skills and information that they've learned,

46:12 you know, back to, you know, back to younger individuals who are now developing.

46:16 So they they're still constantly engaging their brains.

46:18 It's just then using the information that they've gathered.

46:21 So cognitive stimulus of of this type can come from anywhere.

46:27 um and you see very interesting studies looking at different um different types

46:32 of skills that have the same core effects on the function of the brain.

46:37 So there was this um one of my favorite

46:40 papers of all time was published very recently.

46:42 It was called um creative experiences and brain clocks and what

46:45 they did is they looked across multiple creative um experiences or skills.

46:50 So they had uh tango dancers, they had um musicians,

46:54 they had uh visual artists like painters and they

46:57 actually also included um a computer game group gamers

47:01 um including a randomized control trial where they had

47:03 people game and looked at the effect on their brains.

47:06 And across all those different um these are very different skill

47:10 types but across all of them they had this as you

47:14 gained expertise in these complex skills they saw the same

47:19 effects on different networks and and functions within the brain.

47:22 So there you the the brain has all these different regions and each region has

47:27 a specific function although but what we're now

47:29 learning is that really functions are distributed across

47:32 the entire brain into these complex networks

47:36 and how well these networks are connected and how

47:39 efficient they are is uh a primary determinant

47:43 of how our brains function as we get older.

47:45 So as we get older, these networks tend

47:47 to become a little fuzzier and a little less efficient.

47:49 Um that makes it harder to um say

47:52 pay attention or maybe slightly harder to remember something.

47:55 But as people gained expertise in a complex skill,

48:00 those networks strengthened regardless of what that skill was.

48:04 Um this is networks like the front of priority network.

48:06 It's really important for attention and memory.

48:08 So what that says to me is that when we're doing these inherently human,

48:14 creative, multiensory um things that requires us to pay attention.

48:20 It requires us to focus.

48:22 It requires us, you know, it drives neuroplasticity through learning.

48:26 And then this is what's important for maintaining brain function,

48:29 the function of these networks for processing uh

48:31 information and you know uh language and you

48:35 know the social aspects of of the things we want to do with our brains.

48:39 And that also then means depending on what you find interesting to do, right?

48:44 I just listed four or five things that are very

48:46 different but they all have similar effects on the brain.

48:48 So that just mean that just means pick the one that you enjoy

48:51 and you know start by not being good at it and get better.

48:57 And it's in the getting better it's in the you know the learning

48:59 and the failing that's what drives the improvement of connections in the brain.

49:03 That's what drives um the you know the improvement in the in the function

49:08 of these networks that then ultimately translates

49:11 to improved cognitive function over long periods of time.

49:14 That whole interconnected nature of the brain but also more widely the body

49:21 is also another theme that that underpins

49:23 the whole book which I absolutely love.

49:25 It's how I've always seen health and wellbeing and I think when people

49:31 think about I guess the typical you

49:33 know inverted commas lifestyle factors like nutrition,

49:36 exercise, sleep, stress management, whatever it might be.

49:40 I love that section at the end when and you there's you know

49:43 you quote quite a few people there about the interconnected nature of health.

49:46 You change one thing, you change everything.

49:50 Yeah.

49:49 And I think that's really empowering for people especially

49:52 when they get bogged down with well that expert said

49:55 these are the benefits of yoga and that expert

49:57 said that you know this is the benefit of running.

50:01 Yeah.

50:01 And that expert said these are the benefits of meditation

50:03 and and yes yes and you don't have to do them all.

50:07 Yeah.

50:07 you do the stuff that you want to and you'll probably

50:10 find that that starts to change other things in the body.

50:14 Yeah.

50:14 So, so that's and I think to to to fully unpack that we can

50:18 like flesh out the model a bit more because then you kind of understand how

50:21 how this how this works which then gives us a lot more agency and it's

50:25 a lot simpler um in terms to start applying this stuff and benefiting from it.

50:29 So we have stimulus, right?

50:30 You've stimulated your brain doing doing something, right?

50:33 Starting to learn a new language.

50:36 When the areas of the brain that are

50:38 related to that skill that you're learning are activated,

50:43 they ask for more blood flow.

50:45 There's this thing called neurovvascular coupling where

50:47 the the neurons and the astrotes in that area

50:49 stimulate the local blood vessels to bring in uh they need more oxygen, right?

50:53 They need more glucose or whatever fuel you're fueling your brain with.

50:58 Um, and so those blood vessels dilate, you know,

51:01 they widen, they bring in more blood flow.

51:03 This is then, so now we're in our supply bucket.

51:06 And so that's where like cardiovascular health becomes important.

51:10 We know that um things like high blood pressure,

51:12 high blood sugar are important risk factors for long-term dementia.

51:15 And that's at least partly because they

51:18 um affect the health of those blood vessels.

51:20 if you want your brain to be able to react and adapt and do a whole

51:24 range of different things that our blood

51:26 vessels need to be healthy and respond accordingly.

51:28 So, so you've stimulated your brain and now we're going to the second S supply.

51:33 When you have chronically high blood sugar or you have poor metabolic health,

51:39 you are negatively affecting the supply and the supply is important

51:44 to get the most out of the stimulation that you just gave your brain.

51:48 Exactly.

51:49 And is this why perhaps we read things where let's say we've

51:53 done a 90-minute bout of work um and you know because my son's

51:57 in his GCSE year I'm talking a lot to him about how he

52:00 revises and how important it is to move his body and you know

52:04 um so you know you do the stimulus let's say you've revi

52:09 your whatever whether it's a child or an adult you let's say you

52:11 work for 60 minutes on something

52:13 quite cognitively challenging is it overly simplistic

52:17 to say that if You then go for a walk or a run.

52:20 You've done the stimulation with a 1-hour work.

52:23 The run and the walk has basically got your blood flowing.

52:27 So your you know your supply from nutrients from oxygen everything is increased.

52:33 Is that's correct?

52:35 Right.

52:35 Yeah.

52:35 So one of the reasons why um movement is so beneficial for the brain

52:40 in the in the very short term is

52:42 because it improves blood blood flow to the brain.

52:44 Um so the supply the second improve improve supply exactly and then

52:48 that also translates longterm right longterm

52:50 the more you if you're more physically active you may maintain better physical

52:54 fitness then and physical health metabolic health then you maintain good good

52:59 blood flow to the bl brain because your blood vessels are are healthier.

53:03 Um the the other part of that is that and uh we may get to this more

53:08 later is that you inc if you increase uh arousal uh which exercise does you

53:13 increase some of the neurotransmitters that are related

53:16 to learning and focus and attention and that then

53:20 afterwards once you've taken a chance to recover

53:22 and adapt you you remember things better.

53:25 So we know that if you do exercise before or after learning something,

53:29 partly due to blood flow, partly due to um arousal and neurotransmitter release,

53:34 you will then remember those things better.

53:37 So that's why um movement around learning can be really important.

53:41 Plus, if you've been learning because you've been you

53:44 you've been sat in a chair the whole time,

53:46 we know that if you if you sit um very still for long periods of time,

53:50 blood flow to the brain starts to decrease

53:51 and that can decrease mood and attention a little bit.

53:54 So it's another way to just kind of reactivate

53:57 uh everything you know related to that learning process.

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55:20 Okay.

55:20 So, let's go back to the three S's.

55:22 We've stimulated the brain and now you're talking about supply.

55:26 Yes.

55:26 So, you've stimulated an area of the brain or the networks in the brain.

55:30 We're now bringing in more blood flow.

55:31 Um, right.

55:32 So we've talked about why uh physical health

55:34 becomes really important there to maintain healthy blood vessels,

55:37 maintain good uh uh glucose supply to the brain and we

55:41 know that in individuals with Alzheimer's disease in particular um

55:45 there's a there's a a decrease in in glucose getting

55:48 into the brain that that may be there's two parts to that.

55:51 One may be due to decreased stimulus, right?

55:53 If you're not using your brain in the same way,

55:56 the brain is going to ask for less glucose,

55:57 but there may be also an issue with the glucose

55:59 getting in if we have poor physical health, metabolic health.

56:02 So then the final part of supply is nutrients.

56:05 The the critical nutrients that we know are important

56:07 um both for cognitive function on a day-to-day basis,

56:10 but also in terms of long-term dementia risk.

56:12 So, the ones that we have the best evidence for, uh, vitamin D, iron,

56:16 uh, omega-3 fatty acids, uh, B vitamins,

56:19 especially the B vitamins related to methylation,

56:23 like, uh, B12, folate, uh, B6 and rioflavin.

56:26 Um, other things that we see are important

56:29 for long-term cognitive function are like the antioxidant um,

56:34 vitamins like vitamin C and vitamin E.

56:36 Um, antioxidant polyphenols.

56:38 There's very cool things that you could get from, you know,

56:40 that make berries purple and red or that make um,

56:44 you know, fruits and veggie veggies orange and red.

56:46 So like lutein um zeazanthin, aanthin,

56:50 that's what makes uh shrimp um uh and salmon pink.

56:54 These antioxidant polyphenols um seem to have really uh interesting benefits

56:58 for the brain both in the short term and the long term.

57:01 Um and then some other minerals like uh

57:04 magnesium and zinc things like that become important too.

57:07 So those are the critical nutrients that we're hopefully getting from the diet

57:10 that then get directed to the parts

57:12 of the brain that are building new connections,

57:14 building new signapses as it sort

57:16 of cements the things that you're learning, right?

57:18 And so that's that's that's the final part of supply.

57:21 And then you've stimulated a part of the brain,

57:23 you've brought in all the resources it needs

57:25 to do the thing that you've asked it to do.

57:27 Then we know that for a tissue including the brain to adapt to a stimulus,

57:34 it needs uh a period of time to do that.

57:37 And that's usually during rest, right?

57:41 So um it's the same if we uh if we

57:44 if we're going training for something like a marathon, right?

57:47 You don't get faster while you're running.

57:48 You get faster while you recover after the training run that you did.

57:52 And so the brain is the same.

57:53 This is where sleep is really critical.

57:55 So now we're in the support the third S.

57:58 Um so sleep is a big part of support

58:00 that that's when all those connections that we've made are cemented.

58:03 That's when um you know we're building that function in the brain

58:07 based on the based on the stimulus that we've applied.

58:10 Um but we can also further support

58:12 that adaptation through a variety of different things.

58:15 So that's where hormonal status can become important.

58:17 That's where other factors that get released uh by the body

58:21 can support um the neuro neuroplasticity and development in the brain.

58:25 Things like brain derived neurotrphic factor

58:27 which is released during during exercise.

58:30 These can kind of help to support the direction

58:32 and and creation of new connections in the brain.

58:35 Um and then uh sort of the other side

58:38 of support is want to avoid things that inhibit that process.

58:40 So um smoking, excessive alcohol, um air pollution,

58:46 uh other things that can cause um chronic increases in inflammation.

58:50 So we already talked about the social side,

58:52 but that could include like uh uh dental dental

58:56 health and oral health is is a an increasingly

58:58 recognized risk factor for dementia because uh either

59:01 because of the direct effect of the bacteria,

59:03 but also maybe the inflammation that they create.

59:06 Um, and then chronic stress uh plays a role here too because we know

59:09 that if you never get a chance

59:11 to fully switch off um because you're chronically stressed,

59:15 then that that can sort of like impair our ability to to to adapt.

59:19 So then you you realize that all

59:22 these different buckets are interconnected, right?

59:25 So um stimulus drives supply and stimulus also drives support.

59:29 So when somebody um does a cognitively challenging task,

59:34 they then have a greater need for sleep that evening.

59:36 So they actually they they may sleep better

59:39 because they have a greater uh drive for it.

59:41 So So just sorry to push you there.

59:44 But that could mean

59:46 if someone's listening to this and they sometimes struggle to sleep

59:50 and there's many reasons for that.

59:52 One of the reasons might be that you're not stimulating your brain enough.

59:56 Yes.

59:57 So uh one of the ways that we know know that um

1:00:01 one of the ways we understand it the best is through exercise.

1:00:03 We know that exercise improves sleep uh can

1:00:07 improve sleep onset as well as sleep quality.

1:00:10 But there are really interesting studies in older adults where they

1:00:13 have them do a brain training program uh for a few weeks.

1:00:17 And what they see is that compared to a control group who

1:00:20 are just um doing much less cognitively stimulating stuff on a computer,

1:00:23 they were using like um paint to just like you know make some things.

1:00:28 But it's not the same as like really challenging

1:00:30 your your cognitive function with some of these brain training programs.

1:00:34 Those who are cognitively stimulated,

1:00:35 they ended up sleeping better because they're creating greater sleep drive.

1:00:39 And so I often wonder if part of the reason why as we get

1:00:45 older we sleep less is because we're not using our brains in the same way.

1:00:48 We're not stimulating them.

1:00:49 We're not asking as much of them.

1:00:51 So we're not creating that that pressure,

1:00:52 that sleep pressure, that drive to sleep.

1:00:55 And so because all these things are connected,

1:00:59 that then means exactly what you said earlier,

1:01:01 which is when you change one thing, you change everything.

1:01:04 So, we know that if you start to sleep a bit better,

1:01:07 then your blood pressure improves and your blood sugar improves.

1:01:10 Um, and the next day you feel more sociable,

1:01:13 so you're more likely to engage with other

1:01:15 people in like some kind of social interaction.

1:01:16 We also know that if you're less fatigued because you've slept better,

1:01:20 you're more likely to engage in a cognitively stimulating

1:01:22 task because we avoid cognitively challenging things when we're tired.

1:01:25 Um, and the the same is true, right?

1:01:28 If you stop smoking, right, blood pressure improves,

1:01:31 uh inflammation improves, you're more likely to exercise,

1:01:33 you're more likely to make um a more like nourishing meal choice.

1:01:37 If you start to um exercise,

1:01:39 then you sleep better and all those other things um kind of come off that.

1:01:44 So if we understand that these are these are

1:01:47 not a long list of things that or all

1:01:50 these things we have to do but instead even

1:01:53 just within one bucket you would identify something where

1:01:56 you're like oh yeah I could start to make

1:01:58 a small change there we know that benefits tend

1:02:01 to be linear right a little bit more is

1:02:05 going to have is going to have some benefit

1:02:07 right you don't have to do four hours

1:02:08 of exercise in order to see benefit right anything is

1:02:11 going to start to be beneficial but you pick

1:02:14 the thing that you feel like you can make

1:02:15 some change in, you're you would enjoy doing

1:02:18 or you know you're able to do the whole network

1:02:21 starts to shift in your favor and then you

1:02:23 can start to come in from other places as well.

1:02:25 But understand that it's not a a long to-do list that's overwhelming.

1:02:29 It's a network that allows you to come in pretty much

1:02:32 anywhere and start to see big benefits that has huge practical application.

1:02:38 I think back to earlier on in my career and I very quickly learned that if

1:02:45 I was to tell a patient or give them loads of things that they could do,

1:02:51 you know, say, "Hey," and and I give them the research,

1:02:53 say, "Hey, you know what?

1:02:54 If you do this, it's going to do that.

1:02:55 If you do that, it's going to do that." And they come back four weeks later,

1:02:58 they haven't done anything.

1:03:01 Yeah.

1:03:00 Right.

1:03:00 I was like, "Oh, I've actually just overwhelmed them." Have you found that to be

1:03:04 true yourself in in your own sort of coaching in your own in your own life?

1:03:09 Absolutely.

1:03:10 I think that right now it's very common on social media

1:03:16 to see here's a list of things to do for your brain health.

1:03:19 And they can all be very evidence-based, right?

1:03:20 It could be all the things we've talked about today.

1:03:23 But I've seen time and time again,

1:03:24 you give somebody a list of 37 things, they will do zero things, right?

1:03:27 For those exact reasons.

1:03:29 And my my favorite personal experience is the first time I worked in Formula 1.

1:03:34 I um you know had sort of interacted with the team a little bit before.

1:03:39 This is I do all of my Formula

1:03:40 1 work through a company called Hinsa Performance.

1:03:42 Um and I was invited to go to the the US Grand Prix

1:03:47 in Austin and I was going to be in the paddock, you know,

1:03:49 meeting with coaches and drivers and team principles and all this, you know,

1:03:52 all these amazing people and like I was a big Formula 1 fan.

1:03:54 So this was like a this was a big deal for me.

1:03:56 You nervous?

1:03:57 are very nervous.

1:03:58 And then I did what any good nerd would do and I massively overprepared.

1:04:04 I was like I went in armed with a hundred

1:04:07 things and 200 studies to be like I'm ready.

1:04:11 I've got all these things that people could do right

1:04:13 to to improve performance and health and all this kind of stuff.

1:04:16 And I I remember having a conversation with a coach

1:04:21 um and so the the way that um Hinsa works is the majority of the drivers

1:04:26 that we work with, they have a hint coach.

1:04:27 This is usually somebody they have like a master's

1:04:29 degree in strength and conditioning or they're a physio

1:04:32 or a you some of them are have

1:04:34 a psychology background just depending on what the driver needs.

1:04:37 But they're there like inserted into the into the life and world of the driver.

1:04:40 They're there every day.

1:04:41 They hold the helmet next to the car, hold the umbrella.

1:04:44 They're doing all the warm-up drills.

1:04:45 They're doing all the training and they're looking after diet,

1:04:48 all this kind of stuff.

1:04:49 They're sort of like organizing their lives.

1:04:52 And these are these are the individuals that I spend most of my time

1:04:54 interfacing with like how can I help the coach do their job better?

1:04:58 And so I'm meeting with this coach for the first time

1:05:00 and I think I'll probably start throwing out all these different ideas.

1:05:04 And he he's like, "We've got time for maybe one thing maybe." Right?

1:05:10 What you don't realize or maybe don't think about is that first of all,

1:05:15 your drivers are essentially jetlagged nine months of the year

1:05:17 because they're constantly flying from place to place.

1:05:20 Plus, you have to do all the um well,

1:05:22 there's the races, but then there's all the preparation in between.

1:05:25 There's media days.

1:05:26 There's you got to go and smoo the sponsors, right?

1:05:28 Cuz everybody wants their piece.

1:05:30 Plus, you've got a million people like me showing up and be like,

1:05:33 "Hey, try this thing.

1:05:34 Do this thing.

1:05:34 Hey, right." And so so then it it it come he's like right we've got time for one

1:05:41 thing what's the one thing that you think would

1:05:42 have the biggest impact and so like ever since

1:05:44 then that's the mindset that I've had to take

1:05:47 in like if we we can start with a big

1:05:50 net but first of all like where's the biggest

1:05:53 potential anchor or issue that's affecting this one individual?

1:05:57 What's the highest return thing that that person could do

1:06:01 with the time and resources and things they have available?

1:06:04 And that's that's where you start.

1:06:06 Um, and yeah, sometimes you get it wrong.

1:06:08 Um, and that's true for all of us, right?

1:06:10 We we experiment.

1:06:11 Yeah.

1:06:11 And like, of course, like some of some of this requires some trial and error,

1:06:16 but starting with the one thing that you think

1:06:18 is most likely to have an effect is always going

1:06:20 to be much more likely to actually start to move

1:06:23 the needle because you'll actually start to do it rather than thinking about

1:06:27 a hundred things that I've suddenly thrown at you like, well,

1:06:29 I just don't know where to start, so I won't do any of it.

1:06:31 Yeah.

1:06:31 You mentioned Formula 1 and I know we've I've always wanted

1:06:34 to delve deep with you about

1:06:35 your experience there because it's super fascinating.

1:06:38 Um, as you were describing the drivers there and the pressures on them,

1:06:43 the pressures to compete, to perform at high level, to deal with jet lag,

1:06:47 sponsors, everyone wanting a piece of their time.

1:06:51 I thought, "Wow, that must be quite

1:06:53 stressful." And perhaps some of these extra commitments

1:06:57 that they have potentially are going to get

1:07:00 in the way of their ability to perform,

1:07:02 which is ultimately what they're paid to do.

1:07:03 But of course, they have to appease the sponsors

1:07:06 and all that kind of stuff as well.

1:07:09 From all your time in Formula 1 and having worked with several drivers,

1:07:16 would you say there is something that's common to all of them?

1:07:21 like an a an a a skill or an attribute that actually you

1:07:25 know what they all seem to have that something that I I see

1:07:32 across you know all the successful

1:07:35 athletes I've either worked with or interacted

1:07:37 with is in a way that's relevant to them focusing on process above results

1:07:50 because and I think this is This is also relevant to to everybody.

1:07:52 Yeah, for sure.

1:07:56 Because you will never achieve the result

1:07:58 or and you can never guarantee the result.

1:07:59 Yeah.

1:08:00 Right.

1:08:01 Um but you can enjoy the process and figure out what works best for me.

1:08:06 How can I make this better?

1:08:07 How can I continue engaging with that?

1:08:09 Um how can I be more targeted in the things that I

1:08:12 do and don't do so that I have better better overall balance.

1:08:16 I think it's people who who love that process and really focus on improving

1:08:21 the process itself then end up

1:08:23 consistently uh achieving high levels of anything.

1:08:26 And this is this works in academia and sports and you

1:08:29 know any kind of um area that that you might think about.

1:08:33 The other thing that I see very consistently and I don't just

1:08:37 say I like we as as a team the team that I

1:08:40 am part of I'm head scientist for motorsport for hensa but you

1:08:43 know we have doctors we have coaches we have a bunch

1:08:45 of performance experts psychologists right that we all and we all

1:08:48 work together the thing that I see most consistently then is is

1:08:54 this need for down regulation and recovery right so if we're thinking

1:08:58 about our 3s's unlikely that we can come in and somebody's already,

1:09:06 you know, performing at that level and say, "Do you know what?

1:09:08 You need more stimulus." Right.

1:09:10 Right.

1:09:10 Right.

1:09:10 Because they've spent their entire lives learning how

1:09:14 to drive those cars and dedicated to that craft.

1:09:16 They Right.

1:09:17 You're driving around a track at 200 miles an hour.

1:09:19 You're getting you're getting plenty of stimulus, right?

1:09:22 Um and you know, we spend a lot of we spend a lot of time,

1:09:25 you know, looking at blood work,

1:09:26 looking at diets, you tweaking those things just to kind of make

1:09:29 sure that they have all the bases in in in place.

1:09:33 But really recovery is is where a lot of a lot

1:09:37 of the the benefit is going to be seen.

1:09:38 Like how can we get the allow these guys to rest, recover, downregulate,

1:09:43 adapt so that they can get the benefits

1:09:46 from the the stimuli they're receiving that, you know,

1:09:48 physical um in their training, you know, in the car, you know,

1:09:51 everything they have to do around engineering

1:09:53 and and working with the teams there.

1:09:55 So, so the third S,

1:09:57 the third S becomes really critical um for them and that's probably where we

1:10:00 spend a lot of our time focusing because in driver development and this is

1:10:05 something we we we do a lot of now as as a company and we're

1:10:08 we're doing more and more over time and and trying to improve these processes.

1:10:11 You know, if you have a a young driver wants

1:10:14 to be in Formula 1 in 5 10 years time, yes, we might focus on stimulus.

1:10:18 how can we build skills and and and fitness and performance

1:10:23 um cognitive physical um and so like that's maybe where we focus.

1:10:28 But once you get up to that tip, it's it's thinking about how can we make

1:10:33 sure they're getting the most out of what

1:10:35 they're doing and you know so that they

1:10:38 can sustain performance for long periods of time.

1:10:40 Yeah.

1:10:41 It reminds me a little bit of um I think a case

1:10:44 you write about in your book when you first started coaching perhaps.

1:10:48 Was it a was it a a runner who was Well, you can tell the story because it's it

1:10:56 it it really now I'm looking at that fresh

1:10:58 through the lens of the 3S's going you can

1:11:00 stimulate all you want and supply all you want but

1:11:04 if you ain't got the capacity for the support for the rest the sleep for you

1:11:08 to absorb the stress and adapt to it you ain't going to get any faster.

1:11:13 Yeah.

1:11:13 And and so this is this is something that's very common in amateur athletes.

1:11:17 So like this this this uh individual

1:11:19 wasn't they were they were a high performer.

1:11:22 They comp they competed at a high level but they were they were an amateur

1:11:26 um as in you know they weren't paid to take part in their sport.

1:11:29 And so this was a runner who who came to us several

1:11:32 years ago and did felt like his um performance was going backwards.

1:11:38 So like he wasn't getting the race times that he wanted and was also

1:11:41 sort of like slipping back in the field

1:11:43 whenever you compared compared to others.

1:11:45 But he was training wasn't he?

1:11:46 He was training.

1:11:46 Yeah.

1:11:47 So he and was training very very hard.

1:11:50 Plus you layer on top of that um the a travel schedule that was that was

1:11:56 quite brutal because every two or three

1:11:57 months he would travel internationally to to compete.

1:12:00 Um and so the reason why I tell this story in the book is because

1:12:03 it was the first time that I you know because as a coach previously um

1:12:08 I would focus on stimulus right what's

1:12:10 the training program like how can we improve

1:12:11 that but it was the first time when I looked back well I looked you

1:12:15 know across everything that I had

1:12:16 from this individual and thought all these other pieces

1:12:19 are the are the most important pieces and so like I think the first thing

1:12:22 I said to him was if you continue this the only thing I can guarantee

1:12:26 is that you'll get a divorce right And um it was a bit tongue and cheek,

1:12:31 but basically you're seeing somebody who's overtrained, not eating,

1:12:35 not able to eat enough calories to to um

1:12:38 or not able to have the the cognitive bandwidth

1:12:42 to focus on getting enough calories in because they're

1:12:45 so focused on their training plus a brutal travel schedule.

1:12:49 Plus, right, they're a they're a husband, they're a father, right?

1:12:52 they have a family to to to that they should spend time with that they're not

1:12:57 that they're not focusing on because they're just

1:12:58 like so focused in on on their training.

1:13:01 Um, and this then essentially made me realize

1:13:07 that it's all these all these other things

1:13:09 are going to affect our capacity to a get

1:13:11 the benefit of the stimulus that we're applying.

1:13:14 Um but you know be like the the overall picture of of what it even means

1:13:20 to be an athlete or be an individual in the world that that we want to be right.

1:13:26 He presumably and I think this was the case and you know he

1:13:30 he made changes to his training program and his and his his race schedule

1:13:33 to kind of uh take take account for these things right having

1:13:37 a a family and being a husband and father was was more important than racing.

1:13:40 But like once you're so deep into this and you're

1:13:44 um you know so stressed and um overworked,

1:13:48 you become very focused on singular things

1:13:50 like what's the thing that I can control?

1:13:51 And what he felt he could control was I'll just train more.

1:13:54 I'll just do more, right?

1:13:55 That's the thing that I I I that's the needle I can move.

1:13:58 when actually that was the thing he he needed

1:14:00 to pull back on so that he could then benefit

1:14:03 from that and actually think about like who is actually who

1:14:06 is the person who who is the person I want to be

1:14:09 that yes is an athlete and performs well

1:14:11 but also does all these other things and so then

1:14:14 by focusing on the recovery aspects by focusing

1:14:16 on these other areas maybe even training a little bit

1:14:20 less making sure that he was eating enough right

1:14:22 enough supply to kind of support this the adaptation

1:14:25 then he ended up doing less but performing better

1:14:28 because he was taking care of these other areas.

1:14:31 I imagine a lot of people listening are probably thinking,

1:14:36 well, yeah, I could probably get more stimulation, you know,

1:14:39 I could probably learn new things or get

1:14:41 more social connection or whatever it might be,

1:14:43 learn new skills, all that kind of stuff.

1:14:48 Regular listeners to this podcast will of course

1:14:51 know about the importance of regular movement,

1:14:53 good nutrition, the the stuff that you'd put in that second bucket of supply.

1:14:57 Yeah, but I think this third S of support is something

1:15:00 that a lot of people need help with these days.

1:15:03 So many people struggle to downregulate

1:15:06 and switch off and maybe they're not getting

1:15:08 the right kind of stimulation in the day

1:15:10 or when they're scrolling in the evening.

1:15:13 But it is so common now for people to feel wired but tired, right?

1:15:17 They are knackered but they can't switch off and fall asleep.

1:15:20 Yeah.

1:15:21 So I know you sort of there's a whole chapter on this in the book but have

1:15:24 you got some sort of practical guidance for people

1:15:26 who might be experiencing that at the moment?

1:15:32 I think one of the thing things that ends up being

1:15:36 very common is because of the way we structure our workday.

1:15:44 We get to the end of the workday and we're

1:15:48 still sort of stressed about what we have and haven't done.

1:15:54 Plus, we're sort of desperate for some kind of way to to switch

1:16:00 off that that we end up um spending a lot of time on screens,

1:16:05 social media, right?

1:16:07 And and those things can be beneficial if we if we or you know they they

1:16:10 they don't have to be that detrimental if

1:16:11 we we if we craft our experience with them.

1:16:14 But a lot of what happens when people

1:16:15 can't sleep you know this sort of like tired

1:16:17 and wired thing I think is downstream of our um

1:16:25 lack of structuring how we spend our days.

1:16:30 So in um you one of the one of the first people that I met when

1:16:36 I was working when I started working

1:16:38 with Hensson is a guy called uh James Hwitt.

1:16:41 um he's uh he he used to be a professional cyclist and now he's a sort

1:16:46 of a a cognitive performance specialist and he wrote

1:16:52 a book with Akiha who founded Hinsa called exponential where they

1:16:56 they outline this idea of cognitive gears and it

1:16:59 sort of again relates to sort of like the physical

1:17:01 side and physical training and but basically we have

1:17:04 three gears in which we can use our brains.

1:17:07 Um, high gear is sort of really deep focused work.

1:17:12 Like this is when we're paying attention to one thing at a time.

1:17:15 We're doing something complex.

1:17:16 We're learning.

1:17:17 We're problem solving.

1:17:18 Um, you know, these big tasks that we have to get done in our days.

1:17:22 Um, low gear at the other end is, you know, when we're fully,

1:17:26 you know, switched off, relaxed, you know, our brains free associate, right?

1:17:31 you know, this is why we have uh moments of inspiration in the shower because

1:17:35 we're not sort of constantly having to deal with other other inputs or this is,

1:17:38 you know, often happens when I'm in the gym.

1:17:40 Like that's when I'm not thinking about anything

1:17:41 else and sort of like ideas kind of appear.

1:17:43 Same when you go for a walk, right?

1:17:46 And ideally your brain spends a lot of time in this kind of mode because you

1:17:51 need that mode to recover from this like

1:17:54 complex cognitive work that that you've been doing

1:17:57 even during the day like in addition to sleep

1:18:00 where we spend most of our time if not all of our time is in the middle gear.

1:18:03 So think about high gear is like sprinting,

1:18:07 low gear is like walking and middle gear is kind of like jogging or running.

1:18:12 And we basically spend our entire day running.

1:18:14 And if you imagine like how exhausting is it to run all day?

1:18:17 You couldn't do it, right?

1:18:18 But you just like keep trying to keep keep going.

1:18:21 Um, and this is essentially what we're doing

1:18:23 to our brains in the modern work environment.

1:18:24 And it's uh the middle gear is, meetings, uh, emails,

1:18:31 dealing with Slack and Teams and all these different inputs,

1:18:34 multitasking or task switching across multiple like trying

1:18:36 to deal with multiple things at the same time.

1:18:37 like you're trying to do some work and then an email comes in or a message comes

1:18:41 in or we you know we get to the point

1:18:43 where we're so used to distractions that we distract ourselves.

1:18:46 There's some really nice work from from Gloria Mark,

1:18:49 fantastic book called Attention Span if any if anybody's interested in this.

1:18:52 But basically, if we're distracted a lot,

1:18:55 our brains get used to distractions and then we go looking for distractions,

1:18:58 you know, like when you go to pick up your phone,

1:19:00 even though it hasn't gone off and there's no I mean,

1:19:02 you you I mean, you have your your framework like why now?

1:19:06 Why am I doing this?

1:19:07 Like what what what is it for?

1:19:08 But we basically get to the point where our brain

1:19:10 gets used to distraction and goes goes looking for it.

1:19:13 And so we know that when we're forced to multitask or, you know,

1:19:19 we're interrupted in our work,

1:19:20 which is essentially everything we're doing in the modern work environment,

1:19:24 it's inherently stressful.

1:19:25 It it creates this low level of stress.

1:19:28 And then you layer on top the fact that you never get a chance

1:19:31 to do the really high quality work that makes you feel useful, right?

1:19:35 This this is what I'm good at.

1:19:37 Like this is this is a job that I'm here to do.

1:19:39 Um, and it could be, right, researching or writing a book.

1:19:43 It could be uh you know preparing presentations for a a board.

1:19:47 It could be you know luckily um you know if you're like

1:19:51 a a surgeon right they get to remove all the distractions and actually

1:19:55 do their their their work but that's the kind of thing that we

1:19:57 want to be doing like focused this one thing that we're doing.

1:20:00 This is the thing that we're good at really applying ourselves.

1:20:02 But we'll do that with a surgeon because

1:20:03 we know that someone's life depends on it.

1:20:07 But without being flippant,

1:20:09 you could kind of make the case that all of our lives depend on it, right?

1:20:14 Like if yes, we're not surgeons or many

1:20:16 of us who are listening are not surgeons.

1:20:17 I'm sure there are a few surgeons listening, but

1:20:20 you know, the quality of your life probably does

1:20:25 depend a lot on how you're spending each day.

1:20:29 Yeah.

1:20:28 Right.

1:20:29 So, yeah, a surgeon has a reason

1:20:31 to do that, but we kind of need to give ourselves that reason as well, I think.

1:20:35 Exactly.

1:20:35 And so we want to feel we want to feel useful and productive, right?

1:20:38 We're no longer, you know, as as a species, our history was largely,

1:20:43 you know, our productivity was largely due to physical work, right?

1:20:46 Hunting, gathering, farming,

1:20:48 but now the product of our work is due to our brains, right?

1:20:51 We're knowledge workers.

1:20:52 Um, I'd like to call us all cognitive athletes, right?

1:20:55 And so like that's important because the best

1:20:58 athletes like I was saying earlier they know

1:21:01 they have very targeted training they have very

1:21:03 targeted stimulus and then they focus on recovery

1:21:07 adaptation how getting the most out of their training

1:21:10 whereas we just spend all day jogging

1:21:13 and never think about the recovery that our brains

1:21:16 need in order to perform at our best.

1:21:17 So well then what happens is at the end of the day you've felt

1:21:22 very busy and very stressed because you're

1:21:23 constantly bouncing around between all these different things.

1:21:25 You know you're in in Zoom while you're also writing an email

1:21:29 but you're like not paying proper attention to either of them.

1:21:32 Um and so that is that process is inherently stressful.

1:21:36 Um and we know that people make more more mistakes and errors

1:21:39 and feel more stressed when they're interrupted or they have to multitask.

1:21:42 And then you're stressed about the fact that you

1:21:43 didn't actually do that really high quality focused

1:21:45 piece of work that you needed to do

1:21:47 because you were so busy in meetings and multitasking.

1:21:50 Um, and so then when you get to the end of your day,

1:21:52 you're like you're stressed about the fact that you didn't do do those things.

1:21:56 Um, and then you have to try and somehow wind down and go to sleep.

1:21:59 So you then may rely on other things that could that you

1:22:03 feel like are allowing you to relax but could could compound that.

1:22:06 So it could be social media or it could be,

1:22:08 you know, a glass of wine which then, you know,

1:22:10 impairs your impairs your sleep and then or you two glasses of wine

1:22:14 and then the right then the next day the whole kind of cycle starts again.

1:22:17 So I kind of start by thinking about how can I structure the how can

1:22:21 I structure the workday so that even if it's just for 30 minutes I can just

1:22:25 get the get the thing that I need to get done today done and you do

1:22:29 that by if if you can structuring your day so that whenever you feel best like

1:22:35 each of us feels most focused mo most

1:22:37 alert most you know attentive at one specific

1:22:40 time of day and it could be in the morning it could be in the evening

1:22:42 right depending on chronoype and other things during

1:22:45 that period of the day like just get

1:22:47 just set aside half an hour to like do the thing that you need to do.

1:22:50 And then you can also set aside time to do

1:22:53 the the do the meetings and other things, right?

1:22:55 And the emails.

1:22:56 We we all have to do that.

1:22:58 But in between those things, allow yourself time to get to to have a break.

1:23:03 Can you go for a 5-minute walk, right?

1:23:04 Can you just like look outside at something green?

1:23:06 Right?

1:23:06 There are studies that show that we can um become reinvigorated and less

1:23:11 cognitively fatigued just by looking out a window at greenery for 90 seconds.

1:23:15 Right?

1:23:15 So it doesn't necessarily take that much.

1:23:17 There are also some nice studies where uh people feel

1:23:20 reinvigorated after 5 minutes of watching comedy clips on YouTube, right?

1:23:24 Just something to completely disengage from the work that you're doing.

1:23:27 So can you build some structure in that allows

1:23:29 you to do high quality focused work?

1:23:31 Can you build in breaks during the day that um so that you

1:23:35 can you know recover just like in between bouts of sprinting, right?

1:23:40 You can't sprint forever.

1:23:41 You have to like take a break and then you go back and do it again.

1:23:43 And then at the end of the day,

1:23:46 if there's anything that's still on your mind, you know,

1:23:49 that you need to get done or your to-do list,

1:23:50 like we know things that like mental offloading can really help with sleep.

1:23:53 So, like you write down your to-do list

1:23:55 or you write down the things you're worried about.

1:23:57 Um, and then that um helps people fall asleep helps get it out of your mind.

1:24:02 Get it out of your brain.

1:24:03 Yeah.

1:24:03 Exactly.

1:24:03 And and then maybe you can also think

1:24:05 about those other things that you might be doing

1:24:06 in the evening that that could impair your ability

1:24:08 to sort of wind down and and recover.

1:24:11 But I kind of think about it in that way that your sort

1:24:14 of like tired and wired thing starts at the beginning of the day.

1:24:18 Um, and then there's also like the cycle of alcohol and caffeine which

1:24:20 is very which is very common that can then also impair that process.

1:24:24 Um, but just thinking about how we structure how again how we use our brains

1:24:28 I think sets us up for the ability to wind down in the evening.

1:24:32 Yeah, I love the idea that if you're feeling tired and wired in the evening,

1:24:39 think about how you started your day.

1:24:42 Yeah, it's not just about what's happening in the evening, right?

1:24:44 The whole day plays into that.

1:24:47 One thing I've often spoken to patients about is this idea of a stress threshold

1:24:52 and that you accumulate all these stress doses in the day.

1:24:57 And when you get to your personal stress threshold,

1:25:00 and we all have one, and you know,

1:25:02 each one of ours can be different depending on our resilience,

1:25:05 depending on what we've got going on in our life,

1:25:07 but it's when you hit that threshold that the problems

1:25:11 often start or when you get close to it,

1:25:13 your back goes, your neck goes, you react to an email,

1:25:17 you said something about you shouldn't have done or whatever it might be.

1:25:20 And I have seen over the years if

1:25:23 once people understand that stress threshold concept and go

1:25:26 yeah so I' I've been working for a couple of hours I'm I'm getting closer to it

1:25:30 can I take a five minute break just move myself away from it

1:25:33 in the day you just keep you never let it accumulate to the point where you

1:25:36 hit because once you've hit it it's hard

1:25:39 you can downregulate with you know there's breathing sections

1:25:41 in your book that you you know different

1:25:43 exercises people can do and there's all kinds

1:25:45 of things but if you can and if you do have a degree of autonomy over your Okay.

1:25:50 Building in those like regular sort of micro breaks.

1:25:55 Yeah.

1:25:55 It has an outsized effect in my experience.

1:25:57 Absolutely.

1:25:58 Um especially if you can so so like um like

1:26:02 I said any any kind of hard cognitive work right you

1:26:05 need you need a break from just like with just like

1:26:07 with physical work and it doesn't have to be that long.

1:26:10 It just has to be something that completely

1:26:12 dis you know allows you to to disconnect.

1:26:14 And you know even better if you can pair it with just like

1:26:17 a very brief exercise snack or period of movement because like I was mentioning

1:26:22 earlier if if we if we spend long periods of time sitting mood

1:26:27 starts to drop right maybe that's where you know maybe like our stress threshold

1:26:30 decreases right uh blood flow to the brain decreases a little bit you

1:26:34 know we don't have quite the same sort of level of cognitive um function

1:26:39 so just like breaking up sitting and using that as a as a cognitive

1:26:42 break if you can go outside or you and just like do anything.

1:26:45 You can just like step back.

1:26:46 There's multiple things that then happen at that that moment

1:26:48 in time that allow you to then go back into it,

1:26:51 you know, just a few minutes later.

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