Lifestyle Medicine A Foundation for Brain Health with Legendary Drs. Ayesha & Dean Sherzai

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Speaker 1: Welcome to the Reverse Mullet Healthcare 2 - > Podcast from BP2 Health. 3 - > We're in Orlando at the ACLM Conference 2024. 4 - > I'm your host, Justin Politti. 5 - >

Speaker 2: And I'm Ellen Brown here at the American College of 6 - > Lifestyle Medicine Conference and I'm totally fangirling right 7 - > now. 8 - > I'm just so excited at who we have on the show, so introduce 9 - > yourselves. 10 - >

Speaker 3: Thank you so much for having us. 11 - > We are Dean and Aisha Shirzai. 12 - > We're both neurologists and scientists, and we're so honored 13 - > to be here. 14 - > Our talk today was about the profound impact of lifestyle on 15 - > brain health, and that's what the focus of our work is too. 16 - >

Speaker 2: It's just beautiful, like I never thought in my 17 - > lifetime that I would get to combine my work in healthcare on 18 - > the payer provider kind of that side that a lot of people point 19 - > fingers at and say is awful with my passion for lifestyle 20 - > and health and food and trying to fix those things. 21 - > I never in my lifetime thought I would get to combine the two 22 - > and so to be sitting together with you guys it's just amazing 23 - > and it just shows me the power of what's happening in 24 - > healthcare. 25 - >

Speaker 1: Well, one other thing , too is we've had a couple of 26 - > guests on that brought up, in particular the speech that you 27 - > guys did earlier today, and how memories are formed, 28 - > associations are built. 29 - > It was fascinating. 30 - > People have walked out and they were like it's been very 31 - > compelling, so I just want you to know that. 32 - > Thank you so much. 33 - >

Speaker 3: Thank you so much for sharing that. 34 - > That means a lot. 35 - >

Speaker 2: Yeah, so talk about your work, stum, and I guess I 36 - > was thinking I was like, oh, I could just ask so many questions 37 - > and we have so little time. 38 - > But I guess one thing I would like is share your work please, 39 - > because a lot of people won't be familiar with it necessarily, 40 - > and it's just been such a powerful body of work for 41 - > cognitive disease and and something that I think is so 42 - > misunderstood and I think for me I mean I'll just tell you 43 - > personally is that when I heard you all you know you were I was 44 - > saying you were on the rich role podcast. 45 - > That was the episode that I listened to. 46 - > I you know you were. 47 - > I was saying you were on the rich role podcast. 48 - > That was the episode that I listened to. 49 - > I really learned about your work, but it I didn't understand 50 - > that cognitive function had anything to do with inflammation 51 - > and cardiometabolic syndrome. 52 - > I always thought it was this like did you, did you get the 53 - > short end of the genetic lottery ? 54 - > And if you did you were, it was over game, over right, and so 55 - > to hear from you and then fast forward. 56 - > Now I have a mom who has progressively whatever you're 57 - > going to definitely edit this, but progressive dementia rapidly 58 - > progressing. 59 - > There we go and now understanding that it was 60 - > because she was an unchecked diabetic for many years, and so 61 - > the work that you've done, and so, to have that all come full 62 - > circle, I'd like to hear the lifestyle medicine right, how 63 - > that sort of came into this for you all too as well. 64 - > Do you have something to add? 65 - > Sorry? 66 - >

Speaker 1: I also have a very I mean as many people do. 67 - > My grandfather passed away from Alzheimer's. 68 - > He was very, very healthy. 69 - > So I am like my grandfather passed away from Alzheimer's. 70 - > He was. 71 - > He was very, very healthy. 72 - > So I am like he was obsessed with the food and vitamins that 73 - > came into it Like no other, to a point where we were like, did 74 - > he take something that you know he was doing that might've 75 - > caused this? 76 - > Our family still, to this day, debates that. 77 - > But I'm super interested in your work, like from a personal 78 - > level, around you know, around all of this. 79 - > So yeah, yeah. 80 - >

Speaker 4: Yeah, we met 20 years ago around this topic. 81 - > We were in Afghanistan of all places. 82 - > I had gone back from NIH, I was doing wonky work on stem cells 83 - > into the brains of Parkinson's patients and I was in medical 84 - > school. 85 - > We had both independently gone back. 86 - > We always did service. 87 - > I did cleft palate surgery with Operation Smile In China and 88 - > other places. 89 - > We went back to Afghanistan and in an expat party we met. 90 - > The first conversation was about her grandfather dying from 91 - > Alzheimer's and my grandfather dying from Alzheimer's and after 92 - > that we dated and then a year later we were married and then, 93 - > coming back, we went to the number one neuroscience program 94 - > in the country at the time, ucsd , dr leon thal. 95 - > We did work I should did fmri work, looking at brains, that 96 - > they're active, and I was doing pathology and patient care and 97 - > after a couple of years we became a little disillusioned, 98 - > uh, with the studies that were coming, failure after failure 99 - > after failure and and, by the way, I'm not putting down 100 - > studies or pharmaceutical and all that All that is incredibly 101 - > valuable. 102 - > But there was nothing being done on prevention. 103 - > So we looked around and, lo and behold, we found out that 60 104 - > miles northeast is a city called Loma Linda, where people are 105 - > living 14 years longer and healthier than everybody else. 106 - > Specific men versus and we're a little proactive. 107 - > People picked up the phone, called the president of 108 - > university. 109 - > I said we have these resumes. 110 - > We want to build a brain center there. 111 - > Would you have us? 112 - > He said of course, come back, come here. 113 - > We went there. 114 - > We. 115 - > I said I mean immediately. 116 - > We said we want three days off for community work. 117 - > They said you're not going to get paid for that. 118 - > I said that's okay. 119 - > So we started a clinic. 120 - > We saw patients and did the community work, figuring out 121 - > what's going on and I should did a dual residency family of 122 - > preventive medicine and neurology yeah. 123 - >

Speaker 3: So, as you can see, it didn't come. 124 - > You know it wasn't offered on a plane Like here it is. 125 - > Here's a lifestyle program I want you guys to do prevention 126 - > and neurological diseases. 127 - > It was a lot of sacrifice and a lot of strategy. 128 - > Talking to a lot of people reading papers on our own 129 - > speaking. 130 - > Remember Dr Elizabeth Barrett-Connor Like she was this 131 - > amazing scientist. 132 - > She ran the Rancho Bernardo study looking at the impact of 133 - > lifestyle on heart health and we said there's got to be some 134 - > research on brain health as well . 135 - >

Speaker 2: We have to be able to look at that. 136 - > So was it the Loma Linda? 137 - > Was it just the fact that there was such a difference in that 138 - > population? 139 - > They were like I have to go there and research it and 140 - > there's got to be something here . 141 - > Yeah, Okay. 142 - >

Speaker 4: Yeah. 143 - > So the Adventist health study is one of the largest and 144 - > longest run well done studies and IH supported, and they had 145 - > already found that a significant less risk of diabetes. 146 - > Significant less risk of the dementia I'm sorry, not dementia 147 - > . 148 - > One study on dementia that showed that, um, and significant 149 - > less risk of dementia Sorry, not dementia. 150 - > One study on dementia that showed that. 151 - > Significant less risk of heart disease, and on and on and on 152 - > and on. 153 - > And cancers. 154 - > We said it's got to be that relation with brain as well, but 155 - > nobody had studied it and there aren't that many populations 156 - > that are that well studied and well defined. 157 - > It's not Loma Linda, it's the seven-day Adventists that live 158 - > there and they're unique because their religion is very 159 - > health-centered, not just plant-based food. 160 - > Everybody focuses on that. 161 - > But it's more than that, it's environment, it's walking, it's 162 - > community, all these things. 163 - > We had a half-a-day clinic in San Bernardino. 164 - > If anybody's been in Los Angeles they know this. 165 - > San Bernardino is basically a highway separating Loma Linda 166 - > and San Bernardino, so not an environmental difference. 167 - > In San Bernardino we would see patients in their 40s and 50s 168 - > having vascular disease of the brain. 169 - > In Loma Linda it was bewildering no-transcript. 170 - > Over five years, 3,000 patients , and of these 3,000 patients 171 - > you expect one-third, because the majority of the seven-day 172 - > Adventists live there. 173 - > One-third of the population is seven-day, one-third of them are 174 - > plant-based and they're more likely to go to their own 175 - > hospital. 176 - > Why would they go all the way to USC or somewhere? 177 - > So you expect, of the 3,000 dementia patients, at least 178 - > one-third to be plant-based and normal 7-day amphetis. 179 - > Nope, 19. 180 - > 19 people, 19 people out of 3,000. 181 - > I was thrown off and we said this is unbelievable. 182 - > Yet in San Bernardino, 40-year-olds with vascular 183 - > disease. 184 - > And then we did more research, shopping at the same grocery 185 - > stores almost yeah but then buying different things, 186 - > absolutely yeah so it's, and and we knew that lifestyle it's 187 - > more than just food, but it's lifestyle has. 188 - > And so we then we went to cedar sinai and studied, and what we 189 - > found was that uh, lifestyle basically can, can affect 90, 80 190 - > to 90 of brain disease it's crazy and it it. 191 - >

Speaker 2: It's so fascinating to me because I did. 192 - > I was convinced until I listened to your research. 193 - > I was like, well, you're either going to get it or you're not 194 - > right. 195 - > And if you get it, it's game over. 196 - > And it was such an epiphany. 197 - > It was like, wait a minute, this is all related. 198 - > And it did really put that light bulb off of like. 199 - > We got to figure this out in healthcare. 200 - > You know, it was like when the wheels started first turning for 201 - > me, where I was like, wait a minute, I'm running around the 202 - > country doing all the wrong things with lifestyle in terms 203 - > of stress and sleep, trying to implement outcomes-based 204 - > healthcare models, but yet we're not actually delivering a care 205 - > model that's capable of supporting those models. 206 - >

Speaker 3: So, something's wrong . 207 - >

Speaker 4: It is. 208 - >

Speaker 3: That's true. 209 - > I think there's a lag of what we know, and you know, when 210 - > scientists and doctors do a lot of studies and research, it 211 - > takes a very long time for that information to come and be 212 - > applied in public health, like you were saying, ellen, earlier. 213 - > For a long time we thought, you know, the brain is a completely 214 - > black box. 215 - > It's separate from the rest of the body and you might have to 216 - > take some supplements or some medication for it. 217 - > But we now know that what is good for our body is good for 218 - > our brain too. 219 - > The kind of foods that we eat for our body affects our brain 220 - > too. 221 - > And so this information, you know it took some time, but now 222 - > we actually know. 223 - > And it was back then when we started, when we initially 224 - > thought about the concept of preventive neurology what can 225 - > people do to prevent neurological diseases? 226 - > And lo and behold, you see a huge overlap with the same risk 227 - > factors that affect the heart, the kidneys, the rest of the 228 - > body, affecting in the brain as well. 229 - > So I suppose in many ways the medical community and the 230 - > scientific community has failed to disperse information about 231 - > health into our communities, and we need to be that bridge, and 232 - > I'm so glad that ACLM is doing all of that. 233 - > We all need to be that bridge of dispersing the information 234 - > and the message of health. 235 - > Justin had an idea, which is we should all be wearing T-shirts 236 - > with results on it. 237 - >

Speaker 1: Honestly and walking billboards. 238 - >

Speaker 2: Gebra needs to be having a T-shirt that says I had 239 - > 230 patients drop their A1C by three points and I saved $5 240 - > million. 241 - >

Speaker 4: Yes. 242 - > I love that. 243 - > I love that idea. 244 - >

Speaker 3: You came up with that idea. 245 - > That's a brilliant one. 246 - > That's trademarkable, right? 247 - > Yes, I love that. 248 - > I love that idea. 249 - > Somebody, you came up with that idea. 250 - > That's a brilliant one. 251 - >

Speaker 4: I mean that's trademarkable, that's right 252 - > there. 253 - > No, but it has to be. 254 - > I mean on the brain side, just to get people excited. 255 - > Of course it's going to be affected by lifestyle. 256 - > We're talking about a three-pound organ. 257 - > It's a jello. 258 - > It's a little hard jello three pounds but it's 2% of your 259 - > body's weight but consumes 25% of your body's energy. 260 - > It has one quadrillion connections. 261 - > It does 60 trillion operations per minute. 262 - > 60 trillion, that's one of those numbers that you can't 263 - > even. 264 - > No, yeah. 265 - > And so all that work, all that activity, all that energy 266 - > utilization, all that oxygen utilization, of course if you 267 - > don't give it the right energy, it's going to be affected more 268 - > than any other body part. 269 - > Of course, if you give it toxins, it's going to be 270 - > affected more than anybody. 271 - > Of course, if you do something that affects its vasculature 272 - > vasculature it is the most vascular organ. 273 - > In fact, if, if you connect they did that math on this 274 - > connect all the arteries in the brain, end to end, it's 400 275 - > miles of vasculature Of course it's going to be affected by 276 - > vascular factors. 277 - > So lifestyle is going to have more of an effect on this 278 - > incredible organ than any other. 279 - > And on the positive side is it's also the most resilient 280 - > organ. 281 - > So if you give it a chance, it will actually persist and grow. 282 - > We actually say something very controversial in basically our 283 - > next book your brain will get better as you get older If you 284 - > do the right things. 285 - >

Speaker 3: It makes sense. 286 - > It's the only organ that gets better with age. 287 - > I love it. 288 - >

Speaker 4: Yes, yes, I mean. 289 - > Think of yourself as a teenager , or myself as a teenager. 290 - > My God, you don't want. 291 - > I don't want to even think of myself as a teenager. 292 - > What was going on in that brain ? 293 - >

Speaker 1: Nobody wants to know, nobody wants to know I have a 294 - > pinball image going, that's right, it's like ding, ding, 295 - > ding. 296 - >

Speaker 4: Yeah, it was chaos and I was smart. 297 - > You know, I played soccer, I played football. 298 - > That wasn't that smart. 299 - > I broke. 300 - > I broke my back. 301 - > Oh yeah, I played tennis. 302 - >

Speaker 1: I played football without a helmet. 303 - > That was, you know, back in the backyard back then in the 304 - > eighties. 305 - >

Speaker 4: Yeah, yeah, oklahoma's without a helmet. 306 - > Yeah, that's right. 307 - > So it's it's. 308 - > It's terrible, but now I'm older, I have shoulder. 309 - > You know, I did some pushups because I wanted to break some 310 - > record and I tore my shoulder and pain here, pain there and 311 - > all that. 312 - > But I am so much more secure, calmer, I'm able to organize 313 - > thoughts better, I have more things to build on, we are much 314 - > better and we can get much better, but we have to do 315 - > certain things to make sure that the infrastructure is. 316 - > So how do you? 317 - >

Speaker 1: exercise your brain. 318 - >

Speaker 2: I'm sorry so what are those things right? 319 - >

Speaker 1: What are the exercises? 320 - >

Speaker 3: Yes, so, if you know, we came up with this acronym 321 - > just based on all of the data out there. 322 - > You know what are the things that are good for brain health 323 - > and it? 324 - > You know, essentially it's the. 325 - > It's the, a variation of this theme that I'm about to say. 326 - > Five factors nutrition, exercise, stress management, 327 - > sleep and cognitive activities. 328 - > And we came up with this acronym called NEURO N is for 329 - > nutrition, e is for exercise, u is for unwind or stress 330 - > management, r is for restorative sleep and O is for optimizing 331 - > cognitive activity. 332 - > And we know that when people adhere to these lifestyle 333 - > factors it doesn't have to be all or none. 334 - > Even small, little incremental changes in any one of them 335 - > benefit the brain. 336 - > People actually do better. 337 - > They have lower risk of Alzheimer's, other types of 338 - > dementia, stroke and mentally, as far as mental health is 339 - > concerned, they do better as well. 340 - >

Speaker 2: Is there a disproportionate like? 341 - > Is one more important than the other? 342 - >

Speaker 3: It depends on an individual's factor, right? 343 - > So it just depends on what your strengths are, what your 344 - > limitations are, what your resources are. 345 - > Some people do very well when they manage their, say, ldl 346 - > cholesterol significantly. 347 - > Some people do really well by starting exercising. 348 - > So it just varies from person to person and it's really 349 - > important for the person and their healthcare providers to 350 - > kind of draw a picture of what their risk factors are Like. 351 - > For example, a lot of our patients and our community 352 - > members who come to us and they talk about brain health, we 353 - > don't start by telling them go ahead and eat green leafy 354 - > vegetables or kale. 355 - > We try to speak with them, we try to understand where they are 356 - > , and a lot of patients tend to have depression and anxiety, 357 - > which is such a huge risk factor for cognitive impairment. 358 - > That's the first thing that we address, and so it just varies 359 - > from person to person. 360 - > Or they have sleep apnea. 361 - >

Speaker 4: Oh yeah, if they have sleep apnea and it's not being 362 - > treated. 363 - > Several studies show as much as 70% increased risk and that's 364 - > easily treatable. 365 - >

Speaker 2: No, I know, when I prioritize sleep, I like I 366 - > always. 367 - > I came up with a new term. 368 - > We were in Las Vegas last week at health and they always give 369 - > me a hard time because they're like we must put her to bed Like 370 - > she's-. 371 - >

Speaker 1: Turns into a pumpkin. 372 - > Right, I turn into a pumpkin and Vegas-. 373 - > Not at midnight, it's seven o'clock. 374 - >

Speaker 2: No, but it's really brutal in Vegas because it's 375 - > three hours early, you know it's that whole thing and you want 376 - > to go out. 377 - > So I came up with a new term, which is slangry. 378 - > You know how everybody says I'm hangry. 379 - >

Speaker 1: Yes. 380 - >

Speaker 2: Slangry, oh, sleep angry, that's my new term. 381 - > I love that. 382 - >

Speaker 1: I might steal that. 383 - > Yes, slangry. 384 - >

Speaker 2: It's a new term. 385 - > Yeah, okay, it's a new term. 386 - > Yeah, ok, back to you, justin, sorry. 387 - >

Speaker 1: No, the question I had was, you know, going back to 388 - > my grandfather. 389 - > He retired. 390 - > He was a, he was an engineer for Sikorsky and helped develop 391 - > the Black Hawk helicopters. 392 - > He was dealing with very complicated implementations and 393 - > then all of a sudden he retired and he wasn't like he didn't 394 - > have that to do anymore. 395 - > Like he, he did not have those extra. 396 - > I guess that. 397 - > And so the question is like does that contribute to? 398 - >

Speaker 4: 100. 399 - > So what a beautiful uh. 400 - > So thank you, thank you. 401 - > So mental activity is critical, but the old part, neuro. 402 - > So they've said they've seen that people who have been very 403 - > mentally active, extremely, and then they stop doing the same 404 - > things and for two years, even two years, they didn't do much 405 - > of that mental activity. 406 - > Guess what? 407 - > They had the steepest decline. 408 - > See, that's my mom. 409 - > Yeah, you know why? 410 - > Because this brain is now used to being challenged. 411 - >

Speaker 3: Yeah, you're here, you're used to this level, and 412 - > then you drop to a lower level and the brain, just you know 413 - > starts shrinking faster than average. 414 - > Literally and figuratively. 415 - >

Speaker 1: Yeah, yeah. 416 - > So there's brain like have you guys done that, like measured? 417 - > Oh yes, yeah. 418 - > So we say, brain is actually shrinking. 419 - >

Speaker 4: Yeah, no, no. 420 - > We said don't retire, Rewire, yeah, Find new things that push 421 - > you as much. 422 - > But around your passions. 423 - > One of our patients in our first book it was this. 424 - > He was a VA guy. 425 - > He came to me depressed, cognitive decline, significant 426 - > decline, but not dementia but pre-dementia. 427 - > But by the way I'm going to say this a couple of times there 428 - > are going to be people that said that they've reversed dementia, 429 - > They've reversed Alzheimer's. 430 - > Nobody reverses Alzheimer's and I'm going to stand by that 431 - > because that's a way to pick on people's hopes and sell them 432 - > things. 433 - > If not now, tomorrow they'll sell them things. 434 - > And we were told when we were ready to get our first book out 435 - > just hint at the fact that you can reverse Alzheimer's and 436 - > nobody checks anymore. 437 - > You know nobody, nobody. 438 - > What can they do to you? 439 - > And you will sell 2 million extra. 440 - > We can, we can't, because we know what happens when that at 441 - > that stage, Good for you. 442 - >

Speaker 2: Thank you. 443 - >

Speaker 4: No, and, and nobody should be saying that, because 444 - > when we've had two grandparents dying from Alzheimer's, you want 445 - > , hope you have hope. 446 - > You want hope, but you don't want charlatans to take that 447 - > hope. 448 - > Yeah, and sometimes when a person has Alzheimer's, they let 449 - > them go through their journey of decline with dignity, with 450 - > honor, with not always desperate for the next person that's 451 - > selling them the next thing. 452 - > No amount of kale is going to cure Alzheimer's and I'm going 453 - > to lose friends here. 454 - > I'm going to lose friends. 455 - > I don't care. 456 - > It's about those people, those individuals. 457 - > But prior to dementia there's so much you can do to prevent 458 - > and that's important enough. 459 - > And cognitive activity is critical. 460 - > Cognitive activity is the good stress. 461 - > I made a joke there. 462 - > It's like you have 87 billion neurons, one quadrillion 463 - > connections. 464 - > Do you think all of that was just to mate and find food? 465 - > No, it took that much for me to get her, but that's a separate 466 - > issue. 467 - > But for most people it's less five, six neurons, but the most 468 - > successful reproducers are bacteria. 469 - > That's funny. 470 - > Yeah, you want to win. 471 - >

Speaker 2: Justin's like this is great. 472 - >

Speaker 4: The most successful reproducers are bacteria One 473 - > cell. 474 - > The most successful food gatherers are viruses. 475 - > No, you know, it's not about that. 476 - > The brain wants to be challenged, the brain wants to 477 - > be pushed, but around your passion. 478 - > So this guy was a veteran. 479 - > The first question I asked him wasn't what's your blood 480 - > cholesterol level? 481 - > I said what did you used to do? 482 - > He said before military, I used to rebuild cars in my garage. 483 - > I said what do you do now? 484 - > He said I retired and I went to work for a car shop and all I 485 - > do is change mufflers over and over again. 486 - > I was like that's what's killing you. 487 - > I said go retire, have fun, enjoy. 488 - > He came back six months later, completely different. 489 - > No pills, not that I'm against pills, but he didn't need it. 490 - > He's so happy. 491 - > I said what are you doing? 492 - > Oh, I'm building cars in my garage, but in my own terms. 493 - > So building and pushing your brain around your passions in a 494 - > way that really satisfies you and pushes you is what connects 495 - > those neurons. 496 - >

Speaker 2: That's me right now, like these guys know, like I 497 - > can't stop. 498 - > No, I just once I started finding how to connect all these 499 - > different folks, all these different solutions, all this 500 - > knowledge together to say we have sick care, we need 501 - > healthcare, and to me, lifestyle medicine as a board 502 - > certification is that bridge that can help us create that. 503 - >

Speaker 1: and and once I that got in my belly, it's like I 504 - > just I can't stop because it's like we can do this I am going 505 - > to say one thing though do you guys have any secrets on 506 - > shutting it off so she can go to sleep? 507 - >

Speaker 4: Yes, yes, I don't know if it's secret there's a. 508 - > I'm a big proponent, I'm a psychology background and a big 509 - > proponent of cognitive behavioral therapy. 510 - > I think that should be taught in schools. 511 - > It's basically, it's very simple. 512 - > It's about how to know your own thoughts and how to manage your 513 - > own thoughts. 514 - >

Speaker 2: You can't manage emotions, own thoughts you can't 515 - > manage emotions. 516 - >

Speaker 4: Oh yeah, you can't manage emotions. 517 - > Emotions are like amoeba. 518 - > How do you put your hand around emotion? 519 - > I'm going to be more happy. 520 - > That's not going to work. 521 - > But what you can do the thoughts and behaviors that lead 522 - > to unhappiness, you can address those. 523 - > The thoughts and emotions that continually run in your head, 524 - > you can start managing them. 525 - >

Speaker 2: Well, somebody said to me last week I loved the 526 - > analogy. 527 - > He said it's like I can't stop thinking, I have all these ideas 528 - > and it's so great, you know. 529 - > And he said yeah. 530 - > And I said, but sometimes I just want to turn it off. 531 - > And he said, yeah, it's like you went into the Matrix and you 532 - > took the blue pill. 533 - >

Speaker 3: Yes. 534 - >

Speaker 2: That's exactly it so, um, well, I really I know you 535 - > guys have places to be. 536 - > It's a this is a short event and but a short period that we 537 - > have you, but, um, we would love to try and do a full episode 538 - > and I'd love to talk with you more about really how this whole 539 - > cognitive science and its link with lifestyle medicine, how we 540 - > can look at it from the lens of healthcare, how we look at it 541 - > now, how we could look at it in the future. 542 - > You know we've had a lot of conversations on some of things, 543 - > like, you know, full body scans and different type of 544 - > diagnostic tools up front, and just how do we move the system 545 - > right? 546 - > How do we take all of this knowledge that you all have been 547 - > amazing at creating and actually change the way we 548 - > deliver healthcare as a society right? 549 - > Like, how do we leverage that? 550 - >

Speaker 1: And I'd love to jump into, like you mentioned, a 551 - > couple of different examples of like people who, like you know, 552 - > they stopped, they did something a little bit different, like 553 - > what's the window of time where you can actually act on this and 554 - > really influence it before it gets too far? 555 - > And it's not, you know, you're not able to reverse it, and 556 - > always, anytime, except when Alzheimer's is in place. 557 - >

Speaker 3: Okay, obviously it's better if it's as soon as 558 - > possible, as early as possible, but we've seen, and you know, 559 - > there's evidence for protection of the brain and growth of the 560 - > brain and reconnecting between neurons even as late as 99 years 561 - > of age. 562 - > So it's never too late either and there's a lot of hope. 563 - > And as far as implementation is concerned, I think essentially 564 - > being ambassadors of lifestyle and brain health, each and every 565 - > one of us and you know, even though it takes a long time to 566 - > move a large ship, but these little tugboats of you know, 567 - > individuals, communities, coming together, speaking about it, 568 - > groundless level of communication and really truly 569 - > involving the community. 570 - > We've underestimated the community leaders, the 571 - > faith-based communities, individual social workers 572 - > spreading this message. 573 - > I think it takes a whole entire team of people spreading this 574 - > message, instead of us waiting for the top-down model. 575 - >

Speaker 1: So we'll get the t-shirts printed for you all, 576 - > and then we'll. 577 - > We've got the messages ready, to go Ready. 578 - >

Speaker 3: I'm going to be a billboard. 579 - > I'd be happy to be a billboard. 580 - > Yeah, thank you guys. 581 - > I'm so excited. 582 - > It's our pleasure. 583 - > Thank you so much for having us .