Heart expert: dementia may start in your blood vessels — here’s how to prevent it. | Dr. William Li

Gut health and our brain health are connected through our heart health all working in tandem in order to be able to prevent those circulation and dementia problems when you actually have problems the pump the valve the Rhythm the electrical system it affects the workings of the brain how so depression bipolar disorder Alzheimer's Parkinson's and dementia of course Dr William Lee is a world-renowned physician heart health Specialist and New York 's bestselling author and in this episode we learn how you can protect your mind by caring for your heart when we're sleep sing the rest of

our body shut off but our brain is Recycling and rebooting it's cleaning itself when you don't get good quality sleep you feel kind of brain foggy it's because the brain didn't drain all the toxins weak heart weak circulation weak blood flow weak brain if I have D menure is it possible to slow down the Progression of symptoms absolutely and might even be able to reverse it the brain does regenerate so it's long been thought once your brain tissue dies that's it get a stroke you can't recover wrong we can actually generate parts of our brain

and because it's tied to diet and lifestyle not all hope is lost welcome to Zoe science and nutrition where World leading scientists explain how their research can improve Your health will thank you for joining me today thanks Jonathan always glad to be here so you may remember we have a tradition here at Zoe where we always start with a quick fire round of questions from our listeners with these very strict rules you can say yes or no or if you absolutely have to a one- sentence answer designed to be really hard for sort of professors

and scientists are you willing to give it a Go absolutely okay is dementia connected to blood vessel damage yes can I reverse blood vessel damage yes if I have dementia is it possible to slow down the progression of symptoms absolutely yes does my mental health impact my risk of cardiovascular disease yes too many yeses all right it's pretty good it's exciting can improving my diet help me combat memory loss yes and finally what's the most surprising thing about the connection between our brain And our heart that's not a yes question no you can give you

can give me give me a sentence I think the gut connects the brain and the heart that's one of the big surprises as someone running a company that does a lot of data science here's something that fascinates me YouTube has been telling me that 69.3% of you who watch this channel frequently haven't yet hit the Subscribe button so I want to ask you a quick favor you choosing to subscribe helps us A lot it helps us make the show better access World leading experts and ultimately make more progress on our mission to improve the health

of millions so if you enjoy this show all I ask is that you hit the Subscribe button and in return I promise we'll continue to make the show better and better each week you know the last conversation we had which was back in 2022 which was about blood vessels and heart health is Actually one of our biggest ever episodes with over two million listens so I'm very confident that today's episode is going to be really fascinating and this time around I wanted to talk about something different and that's the connection between our heart health and

our brain health and in particular dementia and I was completely surprised to hear that there was a link between like my heart and my risk of demension I think that's going to be True for most of all listeners and it's a topic that actually is very close to my heart because my grandmother had Alzheimer's and so I've seen firsthand how dementia affects not only the person who ends up living with it but everyone else in the family so I'm really excited because I think today we're going to talk about the way that there are things

you can do to change your risks I would love to believe that my parents will listen to this and change any aspect of Their lifestyle as a result I'm pretty sure it won't happen but I'm definitely going to share the episode so can we just start at the beginning we what is dementia and is it the same as Alzheimer's disease you've just asked a huge question because dementia is one word that represents the end result of many different um processes problems that impact our brain and so it's sort of a final result of different types

of disease states that can actually happen To us and people tend to underestimate how complicated and how different types of dementia actually exist so you asked about Alzheimer's disease well you can call it Alzheimer's dementia it's the type of dementia that we attribute to Alzheimer's disease and even Alzheimer's itself we're beginning to realize there different flavors or different types of Alzheimer's disease and it's not one size fits all so you know we've kind of moved from a table of contents on Dementia where we have SIMPLE chapters of understanding the brain to really beginning to understand

this is a dictionary and there's a lot of different definitions that need to be precisely understood in order for us to be able to better prevent better treat and indeed better reverse the condition okay so we're sort of describing as a lot more complex than maybe you know many of us listening had und understood in terms it's not like just one disease There's many different ways and underlying explanations for why this happens and if you were going to just sort of summarize I guess the symptoms that would distinguish someone with dementia from someone who's just

getting older what what are they you know I think all of us inherently can recognize the symptoms of dementia if you say it so memory loss cognitive problems you know you can't figure out is what what was I about to say maybe misplacing your Keys uh maybe not being able to solve a problem you know executive function decisionmaking these are the things that you know we associate as people get older and then ultimately have dementia uh we we say these are the symptoms of dementia now it can get even more serious there are you know

well-known figures like the Bruce Willis is the world who have lost the ability to speak that's Alasia that's another you know uh processed our ability to speak is driven By the brain and so when we actually have a misfire or derailing of those processes that allow our brain to normally function it could happen through our ability to speak uh and our ability to think but also by the way our ability to breathe and our ability to eat which is fundamental to life itself this is one of the reasons why dementia itself makes people feel apprehensive

you know you sort of lose everything is the impression but the good news is We're actually beginning to peel back the layers of the onion and as we do so yes things get more complicated but we're beginning to realize that there may be some solutions for prevention and treatment as well that we didn't appreciate before well I think that's a lovely sort of positive idea within something which you know is is pretty depressing and one of these things that um I think you know many of us sort of fear might Be happening in the future

you already mentioned in the quickfire round like the dementia is linked to our blood vessels could you explain okay well I'm an expert in blood vessels I study blood vessels and many people don't realize this but we have 60,000 mil worth of blood vessels packed inside our body adult body but 400 miles of those blood vessels are packed inside our skull around around and inside our brain 400 miles of blood vessels inside our brain And these blood vessels actually uh grow in uh it's kind of like a map like Google Maps and if you kind

of look at where are all the highways uh and byways uh of uh of the brain you will also see with the nerves the nerves of the brain track alongside the blood vessels blood vessels and nerves course side by side so when our blood vessels are healthy our brain has a chance to be healthy when our blood vessels are sick not a Chance your brain is going to be healthy and so that's one of the reasons why it's so important and so possible to actually tend to the Garden of our blood vessels those 400 miles

uh in our brain so important to take care of 400 miles firstly that's that's an awful lot of blood vessel crammed into my little brain so that's that is it's hard to get my uh head around I can understand obviously if you didn't have any blood vessels and your brain is obviously in Trouble so that that follows but how is that link to to dementia okay let's take it a little bit further back to how our blood vessels help normal healthy brains right like when we're children we're adults you know and we're in our Prime

what are our blood vessels doing well first of all our blood vessels are the channels the highways and byways to bring the oxygen that we breathe to every brain cell and also the nutrients that we're eating through our diet those Blood vessels are bringing those nutrients to our brain cells so the highways and byways of nutrition uh the the lifelines of oxygen like the scuba tanks uh of our brain this is what our circulation actually does and by the way that uh circulation those highways and byways have to be very very smooth and unimpeded there

shouldn't be potholes in the road there shouldn't be blockages in the road no Boulders should being in a role blocking the blood flow now what Happens when you have potholes is that you know you wind up actually dinging your tire just like uh uh when you're on a highway and you have a pothole it's damaging to actually go down that Highway that where the road is damaged blood vessels can be damaged and so it's so important for us to maintain the healthy lining or the surface of the blood vessel and we absolutely need to avoid

getting blood clots in our brain a blood clot in the brain is kind of like A boulder from an avalanche that got set down into the middle of the highway and now the traffic piles up behind you and that's exactly what happens in a stroke if you actually wind up actually having a blood clot in your brain your blood backs up and guess what there's no you got this Blood make sure I follow youve got this blood vessel and suddenly there's basically this is your Boulder analogy it's just completely blocked and so no blood can

continue to flow through This no oxygen no nutrients and what's going to happen the brain's going to uh suffer including dying potentially now one other issue that can happen with blood vessels is you need to have the structure of the blood vessel to be really really solid so it's not leaking so think about a blood vessel as a tube like a garden hose maybe you know for your lawn in the summertime as long as it the water is flowing through the tube you're fine you can water your lawn but Imagine if you actually poked lots

of holes in the side of that garden hose and the water is spraying out everywhere okay when blood leaks out in your brain through your abnormal blood vessels the blood leaking out can also cause a different kind of stroke and there's one more thing about blood vessels in the brain which is probably very linked to dementia and and let's call it brain health before dementia because that's what we're look that's what we really Want to talk about is how do we keep a healthy brain and avoid dementia there is a grate a sewer grate a

filter between our brain and the rest of our body and it's made of blood vessels it's called The Blood brain barrier it's not really a barrier it's more of a filter it actually protects everything above our neck meaning our brain our eyes all those sensitive structure from everything else in our body so if we wind up having a raging infection in our Body that filter protects our brain from getting infected and similarly our blood it's that great is made out of our blood vessels so we need good healthy blood vessels to have an intact blood

brain barrier it's not really a barrier it's a protective shield it's a filter it's it's a Civ now here's the whole thing based on everything we just talked about 400 miles uh highways and byways that bring oxygen and nutrients and help to Uh guide nerves along the brain uh filters uh and protects our brain and and our eyes all dependent uh on good uh slick blood flow no leaking no bleeding no Boulders no potholes no sticking of anything along those that blood supply this is really the importance of the blood vessels as long as we

actually have good healthy blood vessels in our brain we have got uh brain health and I'll just repeat something I said earlier when your blood vessels are Healthy your brain has a chance to be optimal in terms of its Health when your blood vessels are unhealthy not a chance can you actually have optimal brain health you've got to have these really healthy blood vessels if you want the brain to be healthy and if things start to go wrong with these blood vessels then I think you gave some obviously sort of catastrophic examples with like a

stroke but it sounds like you're going to take us through the idea it's not Necessarily always like this instantaneous incident like that where you know you're healthy one minute and you're having a stroke the next minute I'm guessing you're saying that things can also deteriorate over time right I mean our blood vessels are uh carrying us through our everyday lives and decisions ordinary decisions we make uh can influence the health of our blood vessels how higher blood pressure is if you've got hypertension high blood Pressure continuously for years it put you at a higher risk

of having blood vessel problems in the brain including stroke if you have low blood pressure similarly it could actually uh interfere with the amount of blood that is going to nourish your brain if you've got clogs in your heart if you've got clogs in your legs you know atherosclerosis narrowing of the blood vessels that's also happening in the brain not enough blood flow to the brain it's going to Affect the performance of your brain and will is there anything because I guess you I need good blood vessels presumably in my little finger as well to

make those functions so I guess across my whole body this is important is there anything particular about the brain that makes it sort of more vulnerable to like the good functioning of this and I'm sort of curious you describe this sort of special barrier for my brain that I Don't have anywhere else so what's that about it suggests that somehow the brain is like different from the rest of our body the the brain is The Mastermind of health and of life it's self so you can lose an arm you can lose a leg you could

lose a kidney no problem okay you can have failure of an organ no problem as long as your brain is functioning you're going to be breathing you're going to be thinking you're going to be able to you know do the fundamental things that we Need to just survive and so over time Evolution has made it so that the most important thing that our body protects first and foremost is our brain it is it is the number one thing so for example you know people who wind up up being in a bitterly cold area let's say

you get lost in the North Pole all right your whole body shuts down okay uh except for your brain everything is preserved to the brain got it and hence um you're sort of set to try and protect this so Help me to understand a bit about then sort of the dementia link through to the heart because you've talked a bit about blood vessels but how are these two therefore link together okay we just talked about nourishing the brain maintaining the oxygen status maintaining the nutrient status and by the way once those oxygen and nutrients get

deposited in your brain the brain is very metabolically active meaning that it chews up a lot of energy uh because This you're thinking you're it's it's a it's a nuclear engine of mitochondria of power in the brain the even when I'm just sitting there watching Netflix even when you're I'm not sure I'm a depending on the show it might even be superpowered but you know the thing is that's interesting about the brain and I'm going to connect this to the heart but I want to make this a very important connection is that when you think

your brain is Least active it is super active and that is when you're sleeping okay most people say when I'm sleeping I'm not thinking about anything maybe I'm Dreaming but it's probably you know I used to think this must be a little little pocket in the corner of my brain this I don't know imagining something but not a big deal I'm not doing a math problem you know I'm not doing my taxes okay but here's the thing when we're sleeping the rest of our body shut off but our brain is Recycling and rebooting it's itself

it's cleaning itself and in fact the same system of blood vessels is collaborating with an entire hidden sewer system in our brain all right so blood vessels are our circulation there are is a whole other system that's related to blood vessels called lymphatic channels they're lymph channels right so you'd have lymph nose under the arm and around your groin they're also in the brain but the ones in the brain are like the sewer System of Paris now if you know anything about the sewer system of Paris you can't see the sewers of Paris from the

beautiful stones and the Beautiful You Know Housman buildings and the incredible statues that are above ground but there's this um amazing torrential cleaning system underneath the cobblestones of Paris that is continuously at work now in our brain we have a sewer system of Paris of our brain that's closed during the day okay Closed for for shop okay but at night when we're sleeping and especially when we get good quality REM sleep that's deep sleep the sewer system opens up and the sewer system drains out all the toxins that build up during the day the blood

during the day through those 400 miles brings in the oxygen and nutrients the brain is churning supercharging okay and at night when we think it's inactive it is recycling it is dumping all the toxins that accumulate during the brain Through these lymphatic channels and so this just to make sure this lymphatic channels I can think of as like another set of all of these vels vessels bit like the blood vessel but it's separate which is for draining out and it's connected to the blood vessels because the drain has to be connected to the spigot right

the blood vessels are bringing the fluid in the drain is connected to spig this is really happening at night in our brain because It can't happen while we're awake it does not work while we're awake and it only happens at night when we have good quality sleep and by the way when you don't get good quality sleep think about that old nighter you pulled maybe in college or maybe a party or maybe some event in your life where you just couldn't sleep well what happens the next day you feel kind of brain foggy right you

know why that is it's because the sewer system didn't drain all the Toxins we are going through the next day with toxins that have built up in our head and the Brain hasn't cleaned itself yet that is really helping us understand it's it's a window into dimensia so I want to back it up now because I I just explained to you how I think and researchers are thinking about the importance of circulation in drainage out of our brain and protecting it right okay so how does that connect to the heart well all of these functions

of Pumping in nutrients pumping in oxygen is tied directly to our heart our heart is the pump okay it is the pump that takes blood from the well if you have a well in your house and you want to actually put uh water in your sink or in your shower you want to take a shower you need that water pump to be working all right so that's the heart ldub ldb every single time your heart contracts it is jetting up those oxygen molecules and then nutrients to be able to feed Your brain weak heart weak

circulation weak blood flow weak brain that's one of the most powerful connections and so by the way when you talk about heart healthy foods or heart heart healthy lifestyle you know do your exercise you know lower your stress you're actually thinking about the heart but you're really talking about the brain because because by improving the heart you're directly going to improve sort of the health of your brain directly and by the Way not only is it a physical connection through circulation flowing blood but there's also hormones that connect the heart to the brain and the

Brain to the heart as well and this is sort of like you know we used to think of oh it's the heart is a circulatory organ no we actually realize the heart is also an endocrine organ it's sending hormones that go up into the brain as well so you know when you feel heartbroken yeah right it literally means something like When you feel pained you know that broken relationship or something that didn't succeed your brain is hurting and your heart is hurting this is an example of that hormonal link so heart and brain is connected

through lots of different channels and when we actually want to take care of our um mental state our cognitive State we have to think about taking care of our cardiac or heart State as well and will you mention about um this lymph system that I had never Heard of before has being sort of the the drainage out um and that was very important for like clearing out our brain how is that linked to the heart health and the blood vessel Health that you've been talking about well it's really interesting so first of all the lymph

channel in the brain has got a special name it's called the glyph ftic g y m pH glymphatic because the G part is related to Gia or brain cells we call them brain cells gleo cells nerve cells So lymphatic channels are not like any other drainage system lymph system in the body it specialized to the brain and what happens is that when you actually don't have good drainage overnight and you're not clearing the sink what happens in the kitchen when you're when you've got a clog in your drain or you got the stopper in and

you've got dirty dishes uh in the sink it drains it fills up and all the goo and gunks floats to the surface and you don't want to put Your hands in there definely right like that's brain fog of the sink but when it at when you don't drain your brain with good quality sleep that's now in your head now I mentioned that the brain sends signals neurotransmitters that power the heart okay and power breathing as well so when you actually have backup of the kitchen sink by not getting good sleep meaning that you're not getting

good drainage you've got toxins building up in your brain it interferes with the Signals that your brain is supposed to send to your heart and your lungs in terms of how you breathe and how your heartbeats eventually if you don't actually have enough good quality sleep and you build up these toxins I mean think about these extreme situations where people are not sleeping for days okay now look I I trained uh as a medical doctor uh during the training period we had to stay up for days at a time it did not feel good we

always had Brain fog and you know and some people W up having palpitations you know fast heart beats um our hearts weren't functioning normally either and we would take shallow breaths we weren't taking NE normal deep breaths because as we said earlier our brain is the engine that controls all the other healthy functions including our heart and so this is why I brought up the whole issue about the glymphatic system because if it's not draining properly then actually It's going to end up having this sort of negative impact back on your heart and then that

CES back around into your into your brain again exactly okay so you're basically saying these things are very you know sort of tightly linked I think anyone listening at this point is like okay so it's pretty clear I need to make sure that sort of all of these blood vessels are in good shape because otherwise I'm going to start to have all of these Negative effects maybe just before we go on to how we can improve them could you help us to understand I guess the final jigsaw which is like imagine you're seeing this deterioration

um in the blood flow in your brain you describe maybe the stroke which is obviously like this oneof effect but I think we were talking at the beginning more about dementia how how does this link through to sort of the symptoms that you were describing at At the beginning one of the most common forms of dementia is something that is not often mentioned and not well understood by the general public it's actually not Alzheimer's disease okay it's actually called vascular dementia vascular dementia vascular dementia is really just vascular meaning blood vess referring to blood vessels

is just narrowing of those blood vessels the 400 miles getting narrower and narrower uh and not feeding the brain adequately so If you cut down your blood flow to your brain by 5% cut it down by 1% you'll probably not be feeling quite as sharp you were you cut it down by 5% you're going to start definitely losing cognitive ability you cut it down by 10 or 15% which is what we're seeing in vascular dementia once you get a Beyond a certain level where you're just not getting a blood flow and by the way this

isn't only the big fat arteries that your heart pumps through your neck to Your brain we're talking about the capillaries we're talking about the pap the hair like thinness of the capillary the smallest blood vessels that are per culating in every tissue in your brain when those get narrowed guess what you're not getting enough blood flow so this whole idea of flow flow in flow out normal flow abnormal flow vascular dementia is really the most common form of dementia and actually it is uh it leads to those symptoms compromised Executive function memory problems difficulty in

remembering what you just said where you left your keys all of this starts with just you're talking about quite a small reduction in your blood flow right you're not saying it like hared or anything like that you're saying that even like a 10 per so that's like a pretty small you know if I was driving it's like going from 60 M an hour to 54 like these are very small differences you're saying this this can Actually lead to this form of Dimension that's right and that's because our brain is so reliant on having the fuel

in order to be able to function the oxygen the nutrients we need that fuel it also needs sugar and your brain is one of the most sugar consuming fuel consuming uh functions so you know we hear all this stuff in the public now about you know glucose spikes and watch out how much of sugar you eat and you shouldn't be that sugar is dangerous Look our our brain the most important organ in our body relies on sugar it is going to protect itself it's going to use that fuel it's going to generate its own fuel

if it needs to in order to be able to actually function and so um vascular dementia is the most common cause of dementia uh and by the way vascular dementia is the brain part of narrowing of the arteries that can happen in elsewhere in your body including your heart can I make sure I Just heard that you say that vascular dementia is the most common type of dementia you can get so correct like I don't think I've ever heard of it but actually that is now when you're describing at the beginning about the dictionary of

understanding the different sorts of Dimension this is actually the most common sort of cause that we We Now understand it's a root cause of compromised brain function as we get older and the reason is because Think about it narrowing of the blood vessels happens everywhere in the body right and we know that cardiovascular disease is the number one killer around the world and and what is it caused by narrowing of the blood vessels we used to think about it only in terms of the narrowing of the blood vessels on the heart or the limbs we

realize the same thing is happening in the brain as well and so again heart disease and brain disease I mean heart disease is a brain Disease which is the whole point of why you're asking this question heart and brain are go hand in hand brilliant and I think I should clarify because you were talking quite rightly about how we will die if there isn't any blood sugar in our blood and which I know from now being at zo for quite a long time is often called blood glucose just to clarify you're not saying that people

need to eat sugar in order to have sugar in the blood you're saying that it is Completely normal to have um blood sugar and that actually your body is both able to create it as well as being able to take it from all sorts of you know complex foods that we eat not not just sugar here's the whole thing our uh brain and our whole body is engineered to be able to function uh blood glue glucose is normal healthy in the bloodstream H at normal levels and what we don't want is extra added sugar which

is what we see in these Ultra processed Foods and then sodas and things that are that we know aren't good for us so we don't want to be piling it on we want to optimize and work it in sort of that perfect you know like our body is a race car you want to actually just make sure it's running on the perfect amount of fuel not too much and not too little let's talk now cuz I think you've now sort of put together slightly scary story about how even a very small sort of reduction in

the way that my um blood Vessels work can you know lead to dementia what is going to cause that blood flow to start to get worse and these blood vessels to cease to be these sort of um beautiful highways that you're describing well you know I'm going to turn my answer inside out to your question which is how does our body normally prevent this from actually happening cuz that's the amazing thing like why don't we get demension when we're younger so you know as a scientist I like to ask the questions that haven't don't have

the answers yet right so the the thing that's interesting is we're beginning to figure out that when we are young and when we are in our Prime our body's Health defenses these are systems in our body that are hardwired protect our brain and so our bodies are normally geared when we're healthy to be able to do everything possible to protect our brain our body protects our blood vessels we got good circulation we can Grow more when we need them you don't want to actually have them bleeding or leaking or having any kinds of problems they

are they are absolutely slippery smooth we actually are able to control inflammation and so you know we talked about if you don't clear the brain and the toxins build up that's very inflammatory guess what our body's Health defense lowers inflammation it's connected to our gut it's connected to our immune system lower inflammation Protects the brain you don't want your brain to be cooking with inflammation and that's also regulatory um our gut health is one of the most important aspects that we're beginning to discover we only look at the tip of the iceberg gut health and

heart health super connected gut health and brain health absolutely connected gut heart brain also a new connection that we didn't realize existed before and so the the fact of the matter is our healthy Systems are all working in tandem uh get you know at the same time uh and and together over the sequence of our life in order to be able to prevent those circulation and dementia problems that can actually occur how we live our lives what we eat what we're exposed to the amount of stress that we actually have uh how we self soothe

all these things actually can influence our health defenses and therefore influence our brain so when you ask the question like You know what actually happens when we start to get dementia the overly simple explanation that we used to rely on look I went to medical school in the 1980s and 90s we used to have simple and incorrect explanation yeah when you get old you know your brain just stops working operating some people have it worse than others that is just totally the wrong way to think about it I think that's how I was brought up

as well like when you get old you slow down In general you can't walk upstairs and you lose your memory and like that's just part of aging well the wonderful thing about uh the research that's being done the wonderful thing about science is we're beginning to understand how the body normally protects the brain and if we can do that better we can do that longer we can do that more more effectively not only are we able to prevent dementia and this is really where I think the research is going We're standing on the precipice of

getting enough understanding to figure out how to turn that train away from the brick wall so can we actually Veer people away from developing Dementia by protecting blood flow by having better drainage systems by preventing leakages and blood clots look that is so important and hopeful for people and because it's tied to diet and lifestyle and Stress Management by the way um you know that's emotional our emotional Health is absolutely important in terms of brain health this means that we stand a chance to be a within our lifetimes to be able to actually avoid that

brick wall of dementia and I and I you know as somebody who is like everyone else getting older I actually feel optimistic that by boosting our body's defenses protecting our circulation lowering inflammation finding ways to actually get better sleep for better drainage better Mental Health all right all these Things will contribute to having longer more vital brain health what is starting to happen within and I think we often hear about things when we go and see the doctor about maybe like cholesterol what's that we hear that actually diabetes for example also is something is is

a risk could you help us just to understand hopefully in a level that we can follow like how that is affecting this sort of flow in you know these 400 miles of um highways and byways as you Put it in in our brain I told you that uh blood vessels are like a garden hose to water your lawn all right that's a great way to think about it but we get much more insight by looking at how blood vessels form to begin with okay so let me set it up for you uh Jonathan your dad's

sperm met your mom's egg and we were you and we all were once just a ball of cells that were forming we haven't yet formed a face we haven't yet had arms and legs we were just starting To become something not quite sure what is going to look like yet well one of the first organs that forms you know within a couple of weeks of fertilization in the womb in your mom's womb is our circulation it's one of the first tissues that form you know why because every organ is going to need a blood supply

okay right and so what happens is that the circulation the blood vessels start forming ultimately 60,000 miles worth 400 in the brain but They all start forming by these little channels and these channels are tubes right so now let's think about the garden hose for a second have you ever had a garden hose and maybe maybe most people haven't done this yet I've done it take up a pair of garden sheares and chop that garden hose in half and look H look at its cross-section all right you got the hole in the middle that's where

the water flows through but there's a wall in the garden hose and that's why It's thick and that's why it's strong that's why you can drag it through the through the brambles okay and you still it just not going to rip open and so just like uh your garden hose are blood vessels everywhere in our body from our heart to our brain okay uh have a thick wall okay and that wall is really important because that wall is lined on the inside with what I would call seemingly like Saran Wrap you know the saram plastic

wrap yeah uh you know Sandwiches are wrapped on it and all that kind of stuff probably shedding microplastics not good not good for the body but in the case of blood vessels really good for the body that that saran WP lining presumbly not made of plastic I'm guessing it's not made of plastic it's the actually it's one of the most important cells in your body they're called endothelial cells e n d o thelial t h l i a l endothelial cells are the lining of our blood vessels and they are Responsible for allowing our blood

to flow smoothly without interruption from our heart where they to get pumped from the blood cells get plumped from all the way to our brain also to our fingertips you mentioned to every organ in our body so when the endothelial lining is slippery and smooth it's a wonderful thing now lining that's got to be smooth a wall that's got to be solid and thick right so if you actually perforate the wall it's going to start leaking and Bleeding so you need to have good structural strength and the reason I'm explaining the healthy part of it

is because our diet and lifestyle affects the Integrity of this lining the endothelial lining as well as the walls uh of the blood vessels I want to say one more thing about the lining have you ever gone ice skating I have gone ice skating okay may not be very pretty to see but I have been ice skating that's okay I'm not talking about a winter Olympics but most of us have had at least um a chance to lace up uh the skates and get on the ice so you know that the first time you get

on uh you go to a rink uh if you go to a freshly paved rink they have this machine called a Zamboni machine you know it drives out if you ever see the hockey games um there's this truck that drives out and what this thing is doing is really kind of buffing the ice and heating it so it's putting some uh water on it some Warm water and polishing it right now that's clean fresh ice on a rink if you were to actually stand at the side of the rink uh after it's been cleaned all

right fresh ice and you were to throw a sweater on the ice that thing would be so smooth it would Glide all the way to the other end of the rink now go have a a skating session with 200 people on the ice you know including the little kids and the older people and the people who really know what they're doing you know The beautiful skaters out there carving up the ice and you know you see the little spray of the ice going around okay for do that for an hour or two all right now

now everyone's taking a break or lunch break now take your sweater and throw it on the rink what happens okay that sweater will not move it it gets jammed up on the scraped up ice amazing right okay so when this happens in the blood vessels the lining of the blood vessels the endothelium is nice and Smooth which is what it should be in health it's like the Zamboni actually prepared our blood vessels to have perfectly smooth circulation from heart to brain to every organ now if we have worn down scuffed up scraped up lining of

the blood vessels okay which can happen with smoking which can happen with toxic exposures which can which can actually happen with uh eating Ultra processed foods and having all kinds of things that can injure this lining Damage this lining that damaged lining is like an ice skating rink after a big hockey game or after a big crowd is skated on it it's rough it's scuffed up and when blood flows on it it tends to stick like that sweater it's not going to sail all the way through and when blood cells stick to the lining of

the blood vessels like a sweater on the ice skating rink that's when blood clots can actually form so you asked me to talk about like okay so what actually happens That would set up for a stroke or set up for a problem well it's a scuffing up that scuffing up can not only set up for a stroke but it sets up for the accumulation of lipids cholesterol fatty streaks uh inside the wall of the blood vessel right now this is where the cholesterol that our doctors all get worried about har cholesterol starts to clog up

the blood vessels because the aligning isn't smooth anymore it's not going to kind of Glide by it's going to Stick to the side and a little more sticks a little more sticks it's going to get narrow oh what happens when you have narrow blood vessels you're not delivering the blood flow and when that happens to the brain Jonathan vascular dementia so what I just showed you is you know with the analogy the of the ice skating rink okay is what happens between Health perfectly smooth ready to ready to skate rink for the first time super

smooth sweater across the rink to Actually damage blood vessels during aging from a lifetime of wear and tear of your blood vessel where you are not taking good care of that lining all right and now blood clots can form and now narrowing blood flow and now Dementia in 2022 we took a huge risk we put our reputation on the line to prove that Zoe membership could improve the health of millions our team commissioned a randomize control trial it's the most rigorous tests that science has to offer Which means you commit to sharing your findings good

or bad the results of this study have just been published in nature medicine which is basically the Oscars of the Science World and these results show Zoe to be more effective in improving Health than government advice participants doing Zoey saw larger reductions in blood fat body weight and waist size they had better blood sugar control and saw an increase in their good Bacteria crucially those doing Zoe also felt better they were twice as likely to report improved mood and feeling less hungry and four times more likely to report better sleep and more energy compared with

a control group results like these are why more than a 100,000 members trust Zoe to help them make smarter food choices each day to achieve their health goals so will you give Zoe a try the first step is easy take our free quiz to find out what Zoe Membership could do for you simply go to zoe.com podcast okay back to the show well before we move on to like what can you do about this which I know all the listeners are like no let's talk about what we can do but just before we do that

in your book Eat to beat disease you discuss something called epcs and you say they're really important I have never come across these before but you have this thing you called them like Cellular seamstresses I just wanted to say that CU it sounded great what are they and they are they important in this story from your perspective I'm so glad that you brought that up okay an EPC these are initials E is for endothelial and I just told you this was the that's what you call the lining of the blood vessels p is pro is

for progenitor meaning it's a stem cell so EPC is a stem cell of the lining of the blood vessels which means what's a stem Cell which means that it's a cell that is held in reserve to help repair and regenerate Dam damage scuffed up lining of the blood vessels when we're born we've got about 70 million of these that are left over from basically they are the original cells they're the OG stem cells that help us form our whole circulation in the womb but by the time we're born at 9 months you know we still

have some leftover about 70 million left over those are all packed away stored Away into our B into our bone marrow so we go through our our childhood our adult life uh into uh our uh older ages with stem cells packed in our bone marrow and when our blood vessels need to be repaired the injured lining that scuffed up lining sends a signal to our bone marrow to say hey you know what I need a little regeneration here please a little loving I need to be fixed here and what happens is that that Zamboni the

EPC Comes out there to repave that scuff ice so we once again have good blood flow so super important for maintaining good blood flow between heart and brain every other organ in the body but here's something that is uh stunningly important these progenitor cells or stum cells endothel progenitor cells epcs also have the ability to turn into other cells as well epcs can turn into other cells that's one of the Hallmarks of stem cells by the way I wanted to make a Clarification here I'm not talking about a stem cell that you can go to

the corner strip mall to get injected into your knee or your shoulder that to me is a commercial Venture that's not quite ready for prime time and I've been involved by the way with the uh Biotech Industry to try to develop real Bonafide cellular therapy with stem cells it works we're not but we're not ready to actually get it uh mainstream yet it's it's still working its way through the Development process but our body does it already and the thing about we know about stem cells is that if a stem cell wants to turn into

a blood vessel done deal if a stem cell wants to turn liver it can do that too and guess what epcs as stem cells can also turn into brain cells so the amazing thing is that we didn't realize until maybe a decade ago just starting to have the inkling we can actually regenerate our brain so it's long been thought that you know once Your brain tissue dies that's it you get a stroke you can't recover wrong we can actually regenerate parts of our brain does not happen very quickly and gosh if we could actually figure

out how to do it better and faster more efficiently that would actually completely turn the tide on dementia so this is an area of research that I work on it's really really exciting it not only repaves the blood vessels the zambon of the good circulation which we need for brain Health and other organ Health but it is also the Wellspring for regenerating actual brain tissue we've teased the listeners for too long I'd love to talk to okay so what can you do and maybe we could take this in in two parts actually maybe we could

start with is there anything you can do if you're diagnosed with Dementia or maybe someone you love you know at that point is there anything that you can do to sort of slow down the progress of you know this awful disease And then maybe we could talk about you know um afterwards you know people thinking about this you know much earlier yeah well look let me let me bring it really personal to me uh my mother has early stage vascular dementia and so but but she's quite functional and she's very pleasant and I'm doing as

a doctor and using my knowledge as a science stist do everything for her so I you know have been walking the walk on this so first you have to assess the Brain to make sure you understand to the best of all possible options like what's actually going on right so if you if you're having trouble with memory and other people are noticing There's issues you know you do want to see a doctor ideally a neurologist to get a a checkup of the brain a checkup of the brain is very specialized one of the things even

though we still don't know a lot about the brain we don't know everything about the brain uh scanning and imaging of the Brain can really help because Alzheimer's dementia looks different than frontal temporal dementia which looks different than vascular dementia okay uh a radiologist a neuro radiologist somebody who actually looks at an MRI scan can actually see the differences there is stuff because I think I was under this impression there was like nothing that anyone could do to even understand what sort of Dimension that's no longer true no longer true we Can actually look at

scans and get a better sense of what actually going on this is new and this is why any friend listening you have to realize that medical research in this area dementia is such and brain health is such a problem for our society that there's been enormous research poured into this and some really important forward progress being made so scanning to get an idea of what we're dealing with number one number two what I think as an Internal medicine doctor you need to do is go right for the heart okay and you you brought this up

earlier we talked about this you need to make sure the heart is doing its job as best it can to pump blood into the brain so are you having Rhythm problems do you have narrowing of the heart blood vessels is your heart not functioning properly are you getting enough blood with every single squeeze of the heart enough to Jet up to the brain and get into those 400 miles because if you're not tending to that you're not going to actually be able to service the brain and so there are things that we can do for

the heart and by the way the neurologist the brain doctor is not going to know the tools to use so now you want to see a card olist and that a simple test that can be do done to assess the pump function of the heart is called an echocardiogram it's basically taking a microphone and putting it right up to your heart you Know uh for pregnancy they put on the ultrasound for the baby okay uh you hear that noise well you can do that for the heart as well and it gives you a sense of

how good your pump is actually working that's the second thing you need to do first Brain image what's going on second heart make sure that pump is working right it just follows right in line with everything else we're saying now the other thing that you want to be able to do is to see what other Conditions health conditions might be going on we talked a little bit about um diabetes and sugar spikes and Insulin problems we just touched on a little bit look diabetes is a disease that the whole body okay it's not just a

pancreas issues it's a disease of every muscle every cell every tissue and so you need to be able to fix that right to be able to optimize it it's like a mechanic of the body right when you're actually diagnosed with dementia you realize it's Time to take the body to the shop to really get a close look at everything that you can have there now it still doesn't answer how do you fix it but if you don't have a handle on what's going on you don't have a chance of fixing you're just throwing darts at

the board all right and what I believe the progress in dementia is getting is the name of the game is to get as specific as possible because if your heart isn't punction pumping strongly there are ways That we can actually get our H part to pump more effectively more efficiently might be a Val you might need to valve problem you might need to actually um fix your valve all right that could actually help pump more blood to your brain it could be narrowing the arteries well maybe we need to actually make sure those arteries are

less clogged and there's a lot of those changes could potentially sort of slow down the rate of this dementia and might even be able To reverse it the brain does regenerate so look not all hope is lost you need to actually get it this root cause of understanding the symptoms and not just get the diagnosis and and throw your hands up and say you know All Is Lost no we need to actually get specific now the other thing that's really interesting uh and this actually Bridges medicine to food as medicine all right from the Health

Care system to the health care we do at home is what can we Do to help our circulation uh the androgenesis the blood flow to our brain get a little bit better incrementally all right remember I told you 5 10% narrowing that's going to make a difference right so what can we do to actually open up the blood vessels widen them a little bit to get a little bit better blood flow every little bit helps a remarkable research is showing that if we can actually uh lower blood pressure we're decreasing the damage the scuffing Up

of the blood vessels the lining of the blood vessels that sets up for stroke but if we also allow the blood vessels to widen okay so that so let's say it's blocked let's say there's a narrowing you widen it now you've actually regained your previous opening size of opening you got to widen them how do you widen is that possible it yes it is okay and we can do it with medicines and we can do it with food and will I think one part I'm taking from This very clearly is that if this is happening

to you or someone you love you should absolutely be going to doctors and really pushing for what's possible because the te you know sort of the understanding has gone on so far um and you're sharing you know your own experience with your mother which is really powerful what about the nonmedical side of this so the things that you could you know be doing at home yourself or that you're probably Discussing with your mother I'm imagining right right right so basically you know we go to the doctor uh for our quote health care it's really sick

care when we go to the doctor generally but healthc care is what we do at home and so one of the things that we're able to do is to use food as medicine to help heal and maintain the health of our blood vessels that's something that's well established all these things are sensitive to our diet we can keep our Blood vessels healthy what are some of the things that do that well eating plant-based Foods you know the polyphenols that come in our colorful vegetables eat the rainbow guess what that rainbow helps to heal the blood

vessels and keep that lining nice and smooth so blood can flow as well as possible Omega-3s you know we know that Marine Omega-3s which you can actually get from you know oily fish and even not so oily fish and even shellfish can Actually um help to preserve reserve and maintain that slippery smooth normal lining of the blood vessels okay very very important for our brain health not just for heart health right omega-3 good for heart health turns out omega-3 great for brain health all right flavanols you know the polyphenols flavonol guess what there's been studies

looking at flavonols coming from plant-based foods like cacao Cacao is the plant source for the material that's used to make Chocolate dark chocolate has more flavonols and ultra high flavanol chocolate has been studied and it protects not only heart health but lowers the risk of Dementia by improving brain health at the circulation level as well so food is medicine is a no kidding thing and by the way the food that we eat also uh is supportive of our gut health here at zoa you guys have spent so much energy helping to connect to gut health

with other parts of our health And so I want to make another one which is our gut health and our brain Health are connected through our heart health right gut brain is now becoming uh accepted as you know yeah I always knew that but now we're talking about the heart as a wayist station between the gut and the brain so it's interesting so it's gut heart brain now how does a gut actually um work well you know good healthy gut microbiome you want to feed it fiber you want to feed it prebiotics With polyphenols from

your food you want to have it the chlorogenic acid from your coffee the cakin from your tea all right you want to keep it away from uh all the harmful Ultra processed foods and preservatives and chemicals that you know are going to harm your gut microbiome do more good for that neighborhood of your gut microbiome it pays us back how does it pay us back well it lowers inflammation for one thing and by the way lowering Inflammation isn't just good for lowering the risk of cancer and improving the symptoms of autoimmune disease but remember I

told you inflammation in the brain actually pickles your brain as well so when you have got good gut health that lowering of inflammation the butyrate the acetate the proprionate that you may have talked about another podcast actually also helps to lower inflammation in your brain gut health brain health and you Think that is related to uh another part of what can lead to dementia the the sort of higher inflammation bra absolutely because most people with dementia have been found to have high levels of inflammatory markers like CRP C reactive protein and other inflammatory markers tnf

Alpha tumor necrosis Factor Alpha in lucans you know this this is the stuff of scientists not of science fictionist anymore this is the stuff that we're actually able to me Measure and actually some doctors are able to measure that um as well I don't know in your Zoe system you're actually able to capture all those inflammatory markers surely some of them we definitely measure some of them um but we we haven't had this focus on dementia so it's really interesting you're saying this link it's going it's going to be connected 100% And so better gut

health lower inflammation better heart health better brain health gut heart brain it's Starting to be one integrated system you've talked a lot about food within um lifestyle that can affect dementia um I feel like the other thing I've heard people talk about is exercise and I'm guessing that somehow this links in again through like these hearts these blood vessels do do we understand how right firstly how important is it so you're thinking about this um whether it's for your mother or for for you or me and then how it We we know that exercise is

helpful but when we think about exercise a lot of people get put off there saying you know what I I can't afford a gym or I can't I don't have time to go work out two or three times a week and they just kind of put it off and they're like well that's for somebody else well listen exercise means staying in motion all right and our body is designed to stay in motion it's one of the laws of physics right a body that stays in motion is in motion Stays in motion so it's one of

the things that we actually need to do working out being deliberate about our exercise is is good cardio is great if you want to actually you know go for a spinning or you want to go jump rope or you want to actually go swimming or you want to go ballroom dancing those are all things that actually are good cardio all right and what happens when you're actually getting a really good workout okay for those of you who might be Jogging or running or training for a marathon um you're actually getting your heart working to pump

blood we just talked about this PP the heart pumping blood through that 400 miles into your brain is going to be better at delivering oxygen and nutrients to that engine that that Mastermind that's inside your skull so exercise is good for the brain but there's more to it than that exercise also uh winds up triggering stem cells you want to get Stem cells to actually help repair your organs and you want to get a jump on that you want to actually get a little more juice out of your stemach cells you want to exercise exercising

helps your bone marrow release these stem cells regenerative cells into your bloodstream and guess where they go they go wherever there's something that needs to be fixed stem cells are very smart your brain needs to be repaired it's going to go to the brain your liver needs to be Repaired it's going to get uh it's going to go to the liver you want to get a little more juice out of the system that's already set up in order to fix you from the inside out exercise is really important that's really so we had another guest

on the podcast talking about he believes the the reason why Exercise Works in a sense is the exercise directly might cause some damage in your body but it triggers all of these healing mechanisms and it Sounds like you're now sharing like a particular way in which we might be starting to understand how that's happening that is exactly it so let me demystify exercise for people right so if you and let's think about it from a young person's perspective you want to actually be in really good shape you want to look really good in the mirror

okay uh you want to have sound just like my son now the the the six-pack the cut pcks the biceps right the definition Right so think about it you got to work at that you're lifting you're doing your cardio let me tell you what happens when you're exercising you are straining your muscles and in order for your muscles to get bigger they have to regenerate so you're you're straining them they're breaking down a little bit that's okay that's what they're there for you're breaking them down and then it's triggering the repair system which includes stem

cells To build more muscle so when a young person wants to build bulk and get more muscular they're breaking down their muscles so your their own body can build it back up including using stem cells and better circulation by the way so you get better blood flow and more stem cells into your system now look what's good for the biceps is good for the brain and so as we get older you know not everybody is going to be of the mindset of actually going to the gym and Working out but this is where even a

moderate amount of exercise can help even going for a walk for 30 minutes after dinner actually can be really useful and if as you're old getting older if you wind up actually having knee problems hip problems back problems where you're not quite as mobile this is where actually getting physical therapy to uh help you out you right you know ask your insurance company ask your doctor to help you out to get a physical Therapist and maybe you have a neighbor or you know somebody who is a who's already trained as a physical therapist to help

you stay in motion get out of that chair even if you need a walker or a cane stay in motion it's going to help your body you know you you use the word breaking itself down you know I like to I like to be kinder and gentler to say that you know you're you're you're putting it through its paces and then afterwards it's going to build itself Back up and repair itself because that's how we're hardwired so much of this Jonathan we're talking about is the body's own hard wirring that actually does what it wants

to do we just need to allow our body to do what it's designed to do uh and not impede it it feels as though what you're describing is sort of the same that you might be saying to me or you about what you should be doing is there anything sort of different for someone who is wanting to try and avoid This happening from somebody who you know um knows that this is starting to happen but wants to try and delay or even maybe it sounds like potentially sort of prevent the progression yeah that's a that's

a deep question uh Jonathan because you know all of us want to avoid dementia of all the things I mean you know maybe cancer is number one but dementia would be the the other thing that everybody would sort of dreads fears and is probably willing to Do anything at least to consider how they can avoid it themselves let me recap some of the high points of what we've talked about uh you know in this conversation because these are all the things that can actually protect us let's talk about exercise stay in act Physically Active even

30 minutes of walking a day uh is use get good sleep you don't want those toxins to build up all right get good quality sleep very important right so What do you need to do to get good quality sleep besides you know um being comfortable don't eat too close to bedtime don't drink too much alcohol don't drink coffee at the very end of the evening all these things interfere with um good sleep good sleep is required for the lymphatic system to drain to Su drain the toxins out of your brain that's what's needed to be

done all right now what about having good blood flow well look Something very simple it's never too late to stop smoking if you're smoking it's never too late to stop drinking heavily which can affect your blood vessels and your circulation as well as well as directly pickle your brain alcohol is a toxin for the brain okay alcoholic dementia is a real thing so cutting down or cutting out your drinking could be very very uh important part of uh lifestyle and then we talked about the gut gut health pays off Throughout our lives for so many

things things against autoimmunity against cancer against cardiovascular disease look it's never too late to start thinking about your gut to protect your brain for the reasons we talked about and I love that and I guess we you know some of the data that um some of which is not even yet yet published about the way in which you can really change your gut health it's one of the things I find quite exciting because I think again Coming back to the sort of story that I was brought up with which was you sort of fixed with

your genes there's nothing you can do about it that's really what's going to determine your life you're going to get old and incapable and I think um what's really exciting I think whether it's talking to you or many other sort of people doing Cutting Edge research is the sense that there's so much more control so there's not total control things can still happen but You're not just on this pathway that was sort of set by you know you told that story at the beginning about like my my mom dad setting me off on a path

that you're not just stuck on these tracks with nothing you can do that actually you know you can be 70 listening to this and you can make changes to your diet which will really change your microbiome health and you know can give you even then many more years of healthy life I find that very exciting and it is so Empowering to know like for let's just talk about gut health for just a little bit longer because every uh neurogenerative disease known from Alzheimer's to Parkinson's to ALS Huntington's disease autism you know all of these brain

conditions have been tied to abnormalities of the gut or disposes meaning going away from a healthy neighborhood of gut healthy bacteria now we don't know the exact cause and effect we don't understand exact mechanisms but What we are really clear on is that there is a clearcut connection between the gut and the Brain uh in in terms of these terrible uh diseases that everybody wants to avoid so you know and by the way that's then tied to Lifestyle and diet eat plant-based Foods eat dietary fiber prebiotics probiotics eat fermented foods don't eat too much by

the way optimizes your metabolism don't add added sugar that overwhelm your metabolism you want to lower Inflammation you want to stay Physically Active you want to get good sleep the old adage of Live Well to be well is so true and what's I mean it's it's always been true but what's different now Jonathan is that we now have the power of Science and Zoe's doing some of it I mean I I'm amazed when I read the papers that are coming out of Zoe publishing nature nature medicine I mean these are the hard hitting journals that

I publish in for example I know how difficult it Is to get it published in this is like Relentless rigorous scientific data uh I pay attention to it and the connections that are being seen between gut health and brain health are incontrovertible could I just maybe finish with that last point because we could go on phas I wonder if this is almost a tea up maybe for our next conversation but I did ask a quickfire question right at the beginning about a link between mental health and cardiovascular disease and You said yes and we haven't

touched on this and I I feel like a lot of listeners will be like well hang on a minute that sounded really surprising and Powerful could you maybe just give us the the little teaser around that to explain that and then I think that might be a whole whole topic perhaps if I can tempt you back in the future absolutely the heart is a pump but a lot of things can go wrong with the pump you can have a difficulty with the pump itself you Can have rhythm problems you know AR rhythmia I might have

heard of atrial fibrillation uh you can have heart failure where your heart becomes really baggy uh you can have all kinds of electrical disturbances you can have valve problems so what I'm trying to paint this picture of is that there's the heart is a very strong organ that withth from the beginning of Life until the end of life right that's the that's the final call when your heart actually Stops and so all these things in the heart are important for getting that blood flow to the brain now blood is only one of the components the

other components are these neurotransmitters that realizing that the heart releases hormones that influence our brain as well and our bra come out of the heart comes out of the heart I didn't know that I had no idea I thought the part just pumped blood around n we used to I feel like every time I speak to Scientists they like and I've now discovered that in my thing there's all this new stuff so your heart is a your heart is an endocrine organ that releases hormones that affect your brain and your brain also releases hormones that

affect your heart amazing these two things are so interconnected that when you actually have problems in any way shape or form the pump the valve the Rhythm the electrical system very easily it affects The workings of the brain how so depression bipolar disorder schizophrenia and the dementia of course we're starting to see the um nature of this interconnectivity much more clearly now we don't have all the answers but is clearly this uh you know we we mentioned this earlier today if you think about the fact a broken heart feels like you have got a broken

brain if you've ever had AO breakup in your relationships and you just feel terrible about it you feel Depressed afterwards that sends a signal of how connected these two organs are I love it well I know I could keep going for ages but I'm I know we're past time so let me just try and summarize we covered a lot of a lot of things so I'll try and make sure that I've caught the heart so we start off talking a bit about actually what the brain is and you describe the fact there's these 400 miles

of blood vessels in our brain they're next to every single nerve Because you need to get this oxygen and nutrients in and you also said that we have these lymph channels which I had no idea about that sort of clean everything out of the brain they can only work at night sort of when we we fall asleep and that is a big part of why the healthy heart is so necessary for the healthy brain because you need to be able to make sure all those blood vessels are working really well but also this drainage can

come out um really well um And then you said that we sort of evolved to protect that blood flow to our brain more than anything else in our body so basically you know we will shut down every other part of our body but keep that blood into our brain because even a very small drop in that blood flow has this massive impact so you said like even with 1% less blood flow I'm going to feel less sharp like with 5% I'm going to lose my sort of some of my thinking ability and you said at

10 to 15% I'm going to develop this vascular Dimension and these are sort of small differences that show you sort of how perfectly this machine has to work and then you helped us to understand like what's going on Within These blood vessels why there would be this problem so you said let's see if I got this right the blood vessels have sort of strong wall on the outside but they're lined with these epithelial cells which basically make this Endo endothelial Thank you endothelial cells that let it flow really smoothly like the ice and so you

had this Vision that like it's like the ice after it's just had the was it the zamboo zambon machine Zamboni machine all smooth but actually then our lifestyle ends up scuffing this this up and so you start to accumulate all of these um scuffs and suddenly the blood doesn't flow very well and you're describing particularly in like these small blood vessels and things in our Brain you can see if it stopped flowing very well you can end up having this this vascular um dementia and you also shared this this brand new thing i' never heard

of these epcs that I've got I think you said 70 million of them left over from when I was a fetus stored in my bone marrow ready to come out and fix some of these scuffed up blood vessels is a brand new area of research but there's only so much you can do and so if we overwhelm it with all the damage From our lives it can't cope and I think in the second half um you Shar this very personal um story about um how you're dealing with Dementia with your mother and actually how you

would approach and I think there were sort of two halves is what I took one half is you want to really understand the root cause of this and that these days doctors can do a lot more than maybe I than I thought and I think many people thought to assess what's going on and that's both like Going and trying to understand what's going on in the brain to understand where it's coming from but you would absolutely then go to the heart and make sure the heart is doing the best job it can to pump this

blood in and then really understand what are the other diseases that might be affecting this because if you could treat this you could potentially you know really slow down the progression I got the sense from you you felt you some cases maybe Even stop it yeah you can actually temper it and and and in some cases uh you can reverse dementia I mean so many of these irreversible diseases like heart disease we know we know you can reverse heart disease now it we can't do it every single time but we know it's reversible uh cancer

thought to be runaway disease you know uh we now know we can reverse cancer we can take stage four cancer and Stage zero cancer I never thought I would see That in my career and I think the mentions the same way I think that it's not a runaway train I think that the more we understand the more we're beginning to realize we can not only slow it down but we can even reverse it in some cases it's like vision loss you know we never thought you could actually reverse blindness but actually in some cases we

can actually give people back partial Vision that they had lost it's very exciting and I can see why you like Research science as well because you've got this edge of how you can transform and I think that almost brings us on to the final part which isn't it which is sort of the lifestyle ways in which um you can either help to prevent this or slow it down or or or maybe even reverse as you said so you started with really sort of food as medicine is like your number one thing um you talked about

very much a sort of whole plantbased diet fiber polyphenols which are all the Sort of colorful Foods so they sort of eat the the rainbow you mentioned sort of the marina omega-3 and oily fish is all things that can really help to improve your dementia and that a lot of that is coming you think because of the role of the gut microbiome which is sort of sitting between it but a lot of this is also how this can affect your heart health and the health of your blood vessels as the way to help to explain

how that then links through to the heart Um you also mentioned though that there's probably this direct link to the way the gut microbiome could lower your inflammation in your body that can also lower the inflammation in your brain and increasingly it seems like information is another very important part of what affects Alzheimer's and then we talked about the other things you could do so exercise really important and a big part of that again is it's helping your heart because if you're having to do exercise It's s like exercise for your heart that has to

therefore get stronger and I think part of your message was you know even if you're not maybe really fit like you know my son might be or whatever then actually just staying in motion will make a big difference so if you can do 30 minutes of walking versus just being static that's going to make a huge difference not just to your General Health but to your dementia risks um and then I think some key things that maybe You know not all of I guess talk about but are sort of like sort of obviously core pillars

of this like good sleep don't smoke you know don't drink heavily all of those things will also impact your risk wonderfully summarized it that's exactly what we talked about well thank you so much I really enjoyed that I think that as always it's a brilliant um job of sort of making this stuff quite easy to understand while also seeing how much the is is you know Changing quite fast and um I hope I can tempt you back in the future well thank you Jonathan it's a real pleasure and I would love to come back I

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