The New Frontier in Brain Health: How Lifestyle Changes Can Combat Dementia and Alzheimer’s

January 15, 2025 – Financial Sense Newshour's Jim Puplava explores the growing issue of dementia and Alzheimer's, which affects nearly 10 million people annually, with guests from the Center for Cognitive Resilience: Dr. Manna Semby, Dr. Erela Rappaport, and Michael Sanders. They delve into whether these conditions are hereditary, lifestyle-related, or a combination of both.

The discussion highlights the role of genetics and lifestyle in dementia, with a focus on how lifestyle factors contribute significantly to the rising cases. Dr. Rappaport connects oral health and sleep apnea to cognitive decline, explaining how poor oral hygiene and sleep disturbances can lead to inflammation, impacting the brain. They introduce the ReCODE 2.0 protocol by Dr. Dale Bredesen, which has shown promise in reversing cognitive decline in many patients through comprehensive lifestyle changes.

The guests address the higher incidence of dementia in women due to hormonal changes during menopause, and stress the importance of early detection through tests like the Montreal Cognitive Assessment (MOCA) and blood tests like BrainScan. Early signs of dementia include memory issues, mood changes, and getting lost in familiar places.

They advocate for preventive measures such as adopting a ketogenic diet, managing stress, optimizing sleep, engaging in brain-challenging activities, and using alternative therapies like oxygen therapy, red light therapy, and saunas to promote brain health. The role of ketones in providing neuroprotection and clean energy to the brain is also discussed.

The podcast concludes with a message of hope, emphasizing that with proactive action, individuals can prevent or slow the progression of dementia. The Center for Cognitive Resilience offers personalized plans to help manage and potentially reverse cognitive decline, underscoring the importance of early intervention and lifestyle modifications for a healthier cognitive future.

Website: Center for Cognitive Resilience – Functional Medicine for your brain health & longevity
Email: hello[at]centerforcognitiveresilience[dot]com
Brain health quiz (under construction): https://centerforcognitiveresilience.com/quiz

Labs and Tests Mentioned in today's show:

  • Blood labs - Markers of metabolic health such as fasting insulin, markers of inflammation such as homocysteine and hs-CRP, nutritional status such as Vit D, B12, hormone status such as estrogen, testosterone, genetic testing
  • Functional labs - this depends on each person's symptoms and results of blood labs but generally includes the following:
    • GI MAP with zonulin (stool test to check health of gut)
    • Food sensitivity testing (blood test)
    • Testing for chronic infections (blood test)
    • Testing for toxic burden (urine test) - mold, heavy metals, environmental chemicals
  • Other useful tests
    • Neuropsych evaluation - online via CNS Vital Signs
    • BrainScan - simple blood test that combines the Plasma Phosphorylated Tau 217 (p-Tau 217), Glial fibrillary acidic protein (GFAP), and Neurofilament Light Chain (NfL) to detect cognitive decline years before symptoms appear.
    • Genomic testing

Transcript

Jim Puplava:
Each year, the World Health Organization reports that nearly 10 million people are diagnosed with dementia or Alzheimer's. Is this hereditary or is it more to do with lifestyle? Maybe both. And that's the subject of today's podcast. And joining me on the program is Dr. Manna Semby, Dr. Erela Rappaport, and Michael Sanders. They're from the Center for Cognitive Resilience. Before we begin, tell us a little bit about the Center for Cognitive Resilience. How did it begin? The purpose and the things you're doing.

Dr. Manna Semby:
Thank you, Jim. We are so excited to be here today. So the Center for Cognitive Resilience is an organization that the three of us are very proud to have come together and formed. What we have been driven by is a drive to raise awareness that dementia is preventable in many cases. We like to say it's preventable in many cases. And that's why we have come together because we have expertise in helping people do the same. My specialty is in naturopathic and functional medicine and of course, Dr. Erela is a dentist who specializes in sleep medicine, and Michael Sanders as a health coach. We are all trained in ReCODE 2.0, which is a program created by neurologist Dr. Dale Bredesen. He came out with this protocol about 10 years ago, and it has been shown to reverse the symptoms of dementia in about 84% of cases. So we've been very proud and really excited to do this work with our patients, and we are very glad to be here today.

Jim Puplava:
Is this more hereditary or do you think it's more lifestyle that contributes to this disease?

Dr. Manna Semby:
Sure. So I think both play a role. When it is genetics, if it is only genetics, we would not have seen the increase that we are seeing, the rate that we are seeing in the cases every year. So there's certainly a strong genetic component. We hear about the genetic and genome-wide sequencing that tells us what parts of our genetics are leading to or causing dementia. And it's coming from a family history. For instance, APOE4, APOE3/4. This gene is more predisposing towards dementia. But there are other genes like the APP 12, the presenilin 12; those are more. If you inherit that gene from your family, it becomes much harder to prevent dementia. And most early-onset dementia cases are in that category. But the reason we see an increase at the rate we do in the incidence of dementia worldwide and in the US is because of lifestyle and the environment that we live in. So I'm sure we'll talk about that, but I think it's both to answer your question.

Jim Puplava:
You know, one of the things that really surprised me is the role that oral health and sleep apnea play in dementia. That was a real shock to me.

Dr. Erela Rappaport:
First of all, in terms of oral health, we know that inflammation will take its toll on many areas of the body, particularly the heart and the brain. So we know that patients who have poor oral hygiene are one and a half times more likely to have dementia. If you have poor oral hygiene practices, you're going to have a lot more inflammation of the gum tissue. And studies have shown that there are some bacteria that appear in the ones that are responsible for gum diseases, particularly P. Gingivalis, and that has been discovered in patients who have dementia. So we have these bacteria, along with the inflammatory markers that occur in gum disease, they have been found in the brain. So we know that there's a direct link between oral health and cognitive decline. In terms of sleep, look, we all know what it feels like when we don't get even one good night of sleep, how we're really not very with it that day. We're just not as quick. So imagine if night after night you're not getting a good quality of sleep, and b, good quantity of sleep. So sleep apnea, for those who don't know it, is when we have a full or partial obstruction of the airway. In a healthy sleep cycle, breathing is smooth. It's uninterrupted; air flows through our airways and allows us to breathe without effort. But with obstructive sleep apnea, when the muscles at the back of the throat relax during sleep, the tongue either will completely or partially block the airway that blocks the flow of air and oxygen and disrupts sleep. So the constant disruption of sleep and especially the deep, restful sleep can. It doesn't allow our brain to kind of cleanse itself in the middle of the night, and it won't cleanse itself of these beta-amyloid plaques, which we know is a hallmark of dementia.

Jim Puplava:
You know, it was really amazing. I have a dear friend who recently took a test and was diagnosed with sleep apnea. Never knew that she had it, and what a difference it makes. She does. One of the CPAP machines you use something that is somewhat unique. It's kind of like a mouth guard. Explain that. Because most people think of a CPAP machine. You know, you got the distilled water, all the things that you have to use. This is so simple. You put it in your mouth and boom, you don't have to deal with the machines.

Dr. Erela Rappaport:
Correct. A lot of people who are using CPAPs. I mean, some people are great with it. They use it every night. They don't have any problems with it. But a lot of people, even if they say they're using it, they're only using it about half the night, which is really not quite enough, especially early in the morning when you're having those sessions of long REM sleep. If you're not getting oxygen during that, that's when heart attacks happen, that's when sudden death happens. So for people who have mild to moderate sleep apnea, we have a really simple solution. Instead of a CPAP, we can make an appliance for you. It's something that fits over your upper and lower teeth. They fit together in a certain way, and that will keep your lower jaw in a slightly forward position. And when the lower jaw comes forward, so does the tongue, so that when you lay down and go to sleep, that tongue can't fall back and won't block the airway. Sometimes we have patients who have severe sleep apnea and just can't tolerate a CPAP. And even though it's not the treatment of choice, we still, if they can't use a CPAP, we need to do something for them. And this appliance will at least help them decrease the number of apneic events through the night. Sometimes we even need to do a combination of a CPAP and an appliance.

Jim Puplava:
Another question I have, is there any difference between men and women in terms of getting dementia or Alzheimer's? We know that women outlive men, but when it comes to dementia or Alzheimer's, what are the statistics showing?

Dr. Manna Semby:
So we know that women are diagnosed with dementia at twice the rate of men. Yes, and so what happens is more and more research is showing us that until women go through, until the age of menopause, generally women are healthier. You know, they don't have heart problems, they don't have cholesterol problems, no blood pressure, no autoimmune issues for the most part. Once they go through menopause and they lose their hormones, once they lose their estrogen, progesterone, and testosterone goes down significantly, their global systems take a hit. And what ends up happening is women go through menopause around the age of 50, 51, let's say about 20 years after, is when we begin to see a lot of women getting diagnosed with mild cognitive impairment and full-blown dementia. And now is when researchers are putting it together that perhaps it actually begins at midlife with the loss of hormones for women, and it's even more of a concern for women that go through a hysterectomy for various reasons. Sometimes women go through a hysterectomy in their late 30s, early 40s, and they may or may not have been put on hormone replacement therapy. And that can make a big difference to women's cognition. So if you're a woman listener, I would say it is even more imperative that you take stock of your cognitive health today.

Jim Puplava:
So would you suggest, if you are a woman and you're going through menopause, maybe. Would you wait a year before you get these tests, or would you do it going through menopause?

Dr. Manna Semby:
So I wouldn't say that you need to do these tests as you're going through menopause, but just know that menopause in itself brings such a huge range of symptoms, and brain fog and mood changes are one of the common ones. Difficulty sleeping through the night. Women can have this in the absence of sleep apnea, and perhaps sometimes with sleep apnea, that can go on for years. So all of these things can combine together to create a real risk for dementia. So what I would say is when women are perimenopausal, which is just before menopause, and menopausal, do not do nothing about it. Work with your doctor to see how you can address any symptoms that you have, whether it's brain fog or fatigue or joint pains or hot flashes. Many of these symptoms are neurological symptoms, and women don't know that they are coming from the brain that's telling you your hormone levels are too low. So, and if you leave that unaddressed for a period of time, eventually that can lead to cognitive decline.

Jim Puplava:
I wonder if any of you would address this, for years, in fact, it's practiced in medicine extensively, the treatment of Alzheimer's and dementia. You take a pill, and that's the standard answer. It really doesn't do much. I lost my mother to Alzheimer's, and I can remember three years, we started to change her diet. She was given six months. She lived three years, just with some simple changes like that. But contrast what you guys are doing compared to traditional medicine. And is this starting to catch on? Because I know what you're doing is working. Dr. Dean Ornish has come up with a program that is addressing dementia as well. But it seems like we're moving from Medicine 1.0 to what Peter Attia calls Medicine 2.0, where lifestyle choices and other therapies are much more effective, in my opinion.

Dr. Manna Semby:
Yeah, I mean, I could start, and sure, I'm sure Michael would love to jump in on this as well. It's so true. I mean, for Alzheimer's dementia as well, we have drugs, but we also know that all they do is reduce the rate of decline by a small percentage, like maybe 10 to 15% or so. So they don't really make a big difference. And it's really heartening that more and more awareness is coming into the whole lifestyle, diet, exercise, and everything that Dr. Attia calls the Medicine 2.0 approach. And more and more people and organizations are beginning to realize that this is indeed the case, even the Alzheimer's Association. Until recently, you know, on their website, we would not read about like, you know, that you can do these, follow these strategies to prevent dementia. And now they are beginning to talk about it. And only recently, and this is a real turnaround for them, is only recently they've started to talk about air pollution as a risk factor. This is all new stuff. We are very heartened that there is more awareness about lifestyle, about modifiable factors that are leading to a diagnosis of dementia, and also understanding that these are risk factors. What can we do now in our day-to-day life to change the trajectory so that our later decades are as healthy and we can be independent?

Jim Puplava:
Several Dr. Bredesen and Sandison are talking about six components of brain health. They talk about toxins, nutrients, stress, structure, infections, and I wonder if you could address each of those and how they play into it. Because, you know, we think, well, maybe there's one cause, it's hereditary. But in many cases, like as Dr. Rapoport talked about, it could be things like oral health, it could be apnea, there's a number of things. Address these if you would.

Michael Sanders:
Yeah, I can jump in on some of those. In fact, Jim, as you were explaining about your mom, you know, some simple changes in diet enhanced her lifespan by, you know, almost three years, which is incredible. So we have many, many more levers to pull than just the medical model of, you know, a pill, which is wonderful. And Dr. Bredesen calls it the Bredesen Seven, in fact, and he talks about nutrition and exercise, stress reduction, sleep optimization, detoxification, brain stimulation, and supplementation. And you know, we're working with our patients with all of these levers so that it's not just one thing, but it's a comprehensive approach. And that way, it's. We're not, we're not depending on just one way. There are so many ways. And I think the body also is enhanced when you're looking at more than just one thing. So like for instance, nutrition, he calls it the KetoFLEX 12/3. And so it's a ketogenic-based diet, which is a lower carb, higher fat, moderate protein approach. So, you know, that practically could look like a piece of wild Alaskan salmon on your plate with some steamed broccoli and cauliflower and one other of your favorite vegetables, whatever that could be. So it's a very practical and easy way to structure the plate to get a ketogenic diet. And just coming back to the 12/3 component, 12 is just focused on the fasting window of, let's say, that you're finished eating by 7 p.m. so you don't want to eat anything until at least 7 a.m., and we talked about the APOE4 gene. So if you have one or two copies of that, you'll probably increase that fasting window to 14 to 16 hours. And the 3 in the 12/3 just stands for if you stop eating by 7 p.m., that means you're going to go to sleep somewhere around 10 p.m., and you don't want to eat for at least three hours before bedtime.

Dr. Manna Semby:
Sorry Jim, if I could jump in and also address your previous question on the components of brain health, like you mentioned, the toxins, the nutrients, stress, structure, infections, and signaling. It's a really good question, and kind of understanding what does that mean? So starting with toxins, right? We just mentioned about air pollution. So what are the different toxins we need to keep in mind? We need to be concerned about mold toxins, heavy metals, chemicals, glyphosate. These things are everywhere in our society, and they cause; they are neurotoxic and they also have other harmful effects on the body like causing cancer and different kinds of chronic diseases. So understanding what kind of toxic load we might be carrying, it's super important. In terms of nutrients, not only food and nutrition is important, but also in terms of do you have any nutritional deficiency? How are you on vitamin D, vitamin B12, how are you on omegas? You know these things, do you have enough of that? Do you have enough of the hormones? For women especially, do you have enough estrogen and progesterone? And for men and women, do you have testosterone and pregnenolone and DHEA? This is very important to understand. Then we go to stress. If somebody has chronic depression, that has been correlated with a higher incidence of dementia. Chronic stress has been correlated with higher incidence of dementia. Structure, what is structure? When it comes to dementia, it's things like traumatic brain injuries, it's things like concussions. It could also be things like hydrocephalus, which is a condition of the brain which is completely treatable. But if your doctor doesn't know to look for it, then you might end up staying untreated for a very long period of time and just go through immense suffering because of that. Then infections, there are things like Lyme, Babesia, Bartonella, tick-borne diseases or other infections like HIV, even P. Gingivalis in the mouth, sinus infections. There's a small distance between the sinuses and the brain, and the bugs can go very easily into the brain. So understanding and testing for the different infections that you might have in your body is important. And finally, signaling is all about what's happening in the brain, right? Like how is your brain signaling between the neurons and the synapses, and how is the signaling being carried out through the brain? So all of these things are very important to understand that these have a direct connection to leading to a diagnosis. If we don't address and understand these components of brain health, let me ask.

Jim Puplava:
You this, what test in, because you take your standard physical, they don't test for these kinds of things. So what are some of the tests that you would recommend if, let's say, you know, we all know as we get older and age and get older, memory isn't as sharp. You know, you forget where you put your car keys or your sunglasses. What tests should people start taking or request of their doctor to take, and when should you do it? Should you do it in your late 50s, early 60s?

Dr. Manna Semby:
Yes, this is an excellent question, and we could devote a lot of time to really getting into the nitty-gritty of this. So what you have to ask is, especially for somebody who has a family history of dementia or there's any family history of neurological disease, it's really important to be as proactive about your health as possible. Dr. Bredesen actually talks about something called a cognoscopy, just like we now know to get a colonoscopy at a certain age. He talks about assessing your cognition, starting, let's say, certainly by the age of 40. Start to do this screening test so that you are staying ahead of any pathology in the brain. It's important to understand that a diagnosis comes many, many, many years, decades after your brain begins to change. It can be 20 to 30 years before you get a diagnosis. And more and more research is now suggesting that dementia is actually a disease of midlife. Except that the diagnosis comes way late. The diagnosis may come in your late 60s or 70s, but the brain has been changing for a long time. So the most important test that has come out only in the last year, it is called a BrainScan test. And what it is looking for is inflammation in the brain. It's looking for a direct specific marker for Alzheimer's, dementia, and generalized inflammation in the brain. So this is a simple blood test. And through the blood test, you can find evidence of plaque that is already building in the brain. So this is the most cutting-edge kind of testing that has come out recently. Then, of course, there are all other kinds of testing. Right? You can test your APOE gene to see do you have a higher risk than the general population. You can do a neuropsychological evaluation to kind of see how do you do on those neuropsych evaluations. And that can tell you, are you above average as compared to your age group, or are you in the average range? And if you're in the average range, what percentile are you at? 40th percentile, 50th percentile, 60th percentile? And then can you kind of take stock of where have you been all your life? And is the percentile lower than it has been previously? If you've ever done testing like this before? And then there are plenty of blood tests, urine tests, stool tests, different kinds of testing for antibodies to various toxins that are available. So it really depends on how deep one wants to go and how proactive they want to be.

Jim Puplava:
What about somebody that's 65 and older and they're on Medicare? How do you get a doctor? Because Medicare, you know, doesn't like to do a lot of testing. How do you get this if you're on Medicare? Do you have to request, and is there one specific that you would start with?

Dr. Manna Semby:
So most of the tests that we are talking about are actually not covered by insurance. You know, maybe one or two here or there might be, but most of these tests are what are called functional medicine labs or precision medicine labs. And conventional medicine has yet to catch up with any of that. Right. Most of medicine and Medicare is still at Medicine 1.0. We have not gone to 2.0, and 3.0 is far way off in the distance. So what you certainly can request from your doctor, which they should definitely cover, is something called a MOCA assessment. It's a Montreal Cognitive Assessment. And this is a questionnaire, it's a one-page oral questionnaire that your doctor can administer to you. And it's a validated test that has been around for decades. So depending on your score on that test, then that might become an instigating factor for your doctor to perhaps order other tests. But really, in the space of dementia and Alzheimer's, conventional medicine really doesn't have any diagnostics that catch things early because our medical model basically is you wait to get a diagnosis and then we treat. The focus really isn't on prevention. So we have a ways to go before we get there. And so what one has to do is pay out of pocket. But I think what is important to keep in mind here is see what is at stake, find out how much these labs cost and compare that to the cost of not taking action.

Jim Puplava:
Since we're talking about this, what are the early signs of dementia and Alzheimer's?

Dr. Manna Semby:
So the earliest thing that we see is this. You know, we have this trouble with word recall. It's on the tip of our tongue, and we can't think of it. This is common. So I wouldn't advise, like, people get alarmed because of this. But I think if you have, if you're having difficulty following a conversation or processing complex information that you were able to follow with ease earlier, that is an important sign. Then a change in anxiety, like emotional and mood changes, increased anxiety, irritability, or mood swings, becoming more emotional, heightened emotional sensitivity or mild depressive symptoms with no clear cause. Other things to keep in mind is like if you become easily overwhelmed with complex tasks, difficulty planning, sleep disturbances, you know, if you are waking up during the night or if you have fragmented sleep, that can make a difference. Other things are like if you have a reduction in sense of smell, this can be if you have an increased sensitivity to noise or light. Again, this is something to bring up with your doctor. Then if you have pre-diabetes, it's important to keep in mind unexplained weight gain, checking some of your inflammation markers like C-reactive protein, this could be helpful. So these are non-specific things. But the thing that Dr. Bredesen likes to say is when something is happening with an individual, with their brain, with their thinking process, often that person knows something is up. It's just a feeling like something is up. I'm not able to think or process information the same way at this time. Nobody else in their vicinity, maybe not even close family, would be able to tell that something is wrong. So it is that feeling which is the first red flag, and it's really important to take action right then.

Michael Sanders:
Yeah, I would just add, I think Manna covered it quite extensively. I think I would just add some of the obvious things, like you're driving home, and you know, you've done this drive lots of times. Maybe it's from work or the grocery store, and you find yourself confused and getting lost. You know, if you're not depending upon your GPS certainly is. Is a strong sign that something is possibly up. And then the other thing, you know, you hear about people losing their keys all the time, is placing them, which we all do. But, you know, when you find them in the refrigerator or the freezer or someplace, you know that you certainly wouldn't be putting them for any other reason. And if that's a pattern, then I think it's time to do some serious, you know, consideration of what can be going on here with my health, cognitively. Yes.

Jim Puplava:
It's amazing that you say that, because that's how we found out my mother had dementia. She went to visit her daughter, and going home, she pulled over on the side, she got lost. She didn't know how to get home. So this very thing you talk about, Dr. Rapoport.

Dr. Erela Rappaport:
So Michael brought up the keys. I mean, a lot of people will walk around, you know, where did I leave my keys? And it's not so much where did you put the keys? As when you find the keys, do you know what they're for? That's a big difference.

Jim Puplava:
You know, in dealing with dementia, it's. It's by Bresnan Sanderson. They're talking about modify behavior that contributes to the disease. I wonder if either one of you would address the kind of behavior that should be addressed in reversing.

Michael Sanders:
Yeah, I can jump in on that. So we think about lifestyle factors as the key modifiable behaviors. And diet, obviously, we're feeding ourselves two to three times a day, and sometimes more. And snacks. And what's the quality of these foods that we're ingesting and drinks. We talked about alcohol a little bit, I think, before we started recording here. And we all know that alcohol, there's nothing that's going to be helpful for your brain with alcohol. So. But coming back to what we're eating, it could be that somebody's having, you know, pancakes with syrup, and maybe it's margarine for breakfast. And then they're having some kind of, maybe a muffin, a high carb, high sugar, unhealthy fat. Maybe it's made with canola oil, some other unhealthy oil between breakfast and lunch. And maybe lunch looks like fast food. I'm at McDonald's, getting my Big Mac and fries and Coke. And then there's another snack, etc. So food is one modifier, highly modifiable way that you can improve your brain health. And certainly when we're talking about detoxification as well, we're taking in a lot of things that we may not think of as toxins, but these are toxic for our body, for our organs, our heart, our brain. So, you know, I think you talked also, Jim, about your own lifestyle changes and how you've been following more of a ketogenic approach. So it's, it's, it's obviously, you know, helpful. Again, your example with your mom, we could look at stress. You know, are we walking around getting not enough sleep? So we're stressed out from that? Maybe we dislike our job, maybe we're in a relationship that's not serving us. So there's so many factors, again, that can add to our burden of stress. Toxins. We've talked about whether that's food, the air, heavy metals. Again, that can come from things like tuna, but it can come from the air we breathe and lots of other sources. Even people like to burn candles in their houses. And these things are highly toxic. There are paraffins if they're not, you know, pure beeswax or even soy. Be careful with the candles that you're burning in your house. And cosmetics, you know, there's so many cosmetic products that, you know, we all use, and what's in those. Do we know what our skin is absorbing and how that's causing us to be even more toxic? And then finally, I'll talk about inactivity, and, you know, are we couch surfers or are we out there getting into the water and surfing? Are we hiking, are we walking? Are we taking just a walk around the block and getting out in the morning sun, as lots of podcasters like to talk about, you know, just getting out for a five-minute walk even before 10 a.m. can be a big difference in the sleep we get that night.

Dr. Erela Rappaport:
And in terms of the toxins that Michael was talking about, we have to remember that a lot of people still have the silver amalgams in their mouth, and they are a good long-term restoration. But once those start breaking down in the mouth, they will start releasing toxins such as mercury. And we want to get those out of the mouth, out of the system.

Jim Puplava:
We've talked about Dr. Bredesen, I wonder if you could boil it down, the key components to his protocol, which you are practicing at the Center.

Dr. Manna Semby:
Yes, absolutely. So the first thing is, of course, proactive action. And we start with an assessment which is looking at their global health. And we are looking at inflammation markers, we are looking at heart health, we are looking at nutritional status, hormone status, and then we are. What Dr. Bredesen likes to do is he will categorize the different kinds of Alzheimer's. He has come up with these categories that not only help us define the etiology, like the risk, where it's coming from, but also a clue as to how we must treat it. Right. So he has gone ahead and created these types like type 1, 2, 3, 4, 5, and for instance, type 1, he calls it the inflammatory. Right. It's caused by generally by chronic inflammation. You know, it could be due to infections, it could be poor diet, but generally inflammation is the etiology. And so how are we going to treat that? Right? And then. Or then there's a second type, which is glycotoxic, which is coming from sugar associated with insulin resistance. And how are we going to treat that? And then, you know, type three is the toxic type, which is coming from different kinds of toxins. So first we do the testing, you know, extensive blood testing. Then based on the findings from that, then we will dig into a second level of work, which is where we dig down into doing some urine testing to find out what is your body's toxic load of mold, heavy metals, chemicals, glyphosate, et cetera. We will look into your gut health by doing a stool test to see do you have a leaky gut? If you have a leaky gut, you probably have a leaky brain. Are you able to absorb nutrients? What kind of bacterial overgrowth is there? So we look at that. Then we will look at, do you have any food sensitivities? Do you have any chronic infectious burden in your body? Are there antibodies to different kinds of infections? Infections like herpes virus or Lyme, as we mentioned before, or P. Gingivalis. So we will look at that, we will look at your heart health, cardiovascular markers. So getting all this information then helps us prioritize what needs to be worked on first, right? What is it that we need to work on first? And then as we go along and we start to make improvements on one thing at a time, we build on the success of each individual stage. And through this time, through the whole time, what we are doing is we are encouraging each participant to do brain exercises regularly to assess their neuropsych abilities every month. So we can see, we can correlate whether the work that we are doing with them is actually translating into improvement, improvement on cognitive assessments. So our work with each individual is over a period of time. It takes about a year of working with us. About eight or nine months into the work with us, when you begin to see sustained improvements and beginning to reverse some of that decline. So it's a pretty intensive work, starting with blood work and then the different kinds of functional lab testing, figuring out where is it that the problem is originating in each person's case, and it may be a combination. And then we start to work on all of these things to reverse the decline.

Jim Puplava:
I'd like to talk about some alternative therapies too, that are out there. Something like EWOT. I train on my treadmill with oxygen, red light therapy. I have a red light helmet that I use each morning, things like PEMF mats. And the other thing that really surprised me was sauna, infrared sauna. I read that if you do 20 minutes of infrared sauna four times a week, it reduces stroke, heart attack, and dementia. Anyone want to address that?

Dr. Manna Semby:
Yes. Sauna is one of those therapies that has so many benefits, and there's a few different reasons for it. One is, of course, you're sweating, right? And your skin is your largest organ. You are able to sweat some of these toxins out. So it's important when you sweat out, make sure, of course, that you're replenishing your electrolytes and staying hydrated. But also to make sure that you wash off the sweat with tepid water and a good quality soap, that you're not absorbing any of that back into your body. But also what that is doing is it's increasing the rate of blood flow and the flow of lymphatics. So the lymphatics help to detox your body. So you are increasing the rate of circulation of the lymphatic system. So you are making that more efficient. But also you're perfusing areas of the body by increasing the rate of blood flow throughout all the smaller capillaries. So then your brain is getting perfused in a way that it normally might not. Right. So there is a common element in all the therapies that you're speaking about, whether it is EWOT or whether it's sauna, right? What is happening, what is common in both of these, is that you're perfusing the cerebral perfusion in the brain. You're increasing the rate how much blood is getting to different parts of the brain. So, yes, for those reasons, these therapies are extremely beneficial.

Jim Puplava:
And another thing, Bredesen talks about nutrition. What are brain nourishment nutrient type foods that are helpful in a diet?

Michael Sanders:
Right. So again, the ketogenic approach, it's a higher fat. So when we're talking about higher fat, there's polyunsaturated fats which are more the plant-based, you know, like olive oil, avocados, even nuts and seeds have a fair amount of the polyunsaturated fats as opposed to saturated fats. And you know, it's really important to make that distinction between the two fats because the saturated fats, while they are healthy, we have to be careful with those who do have one or two copies of the APOE4 gene because they could be more sensitive on the cholesterol side, and it can drive up their LDL particles and things of that sort. So we have to be careful. That said, it is really important to be having these high-quality fats because our brain thrives on those. You know, it used to be thought that we had to be low fat and high carb. And we've just come to see, looking at our society where that's brought us. So that's one of the components. And again, so I was coming back to olive oil, the avocados, the nuts and seeds. You know, when you're thinking about high-quality fats in terms of animal fats, we're talking about wild-caught salmon, we're talking about grass-fed beef, lamb, things of that sort, pasture-raised eggs. So those, those are all very good quality nutrition that we could be having. And then we combine that with carbohydrates, the carb, it's not a no carbohydrate, it's just a healthy carbohydrate focus. So we're talking about all of the lower glycemic vegetables such as broccoli and cauliflower, you know, cabbage, you can include even carrots even though they're a little bit higher. And most of us don't have to worry about that unless we are maybe type 2 or type 1 diabetics. But you can look at your leafy greens, and there's just a, you know, whole smorgasbord of beets and, and just, it's, it's really important to eat all the colors of the rainbow when you think of all the different colored vegetables. So to bring those into a meal is really important. And then, of course, the way that we look at it, it is there is a, a little pyramid, a food pyramid, or a ketogenic 12/3 pyramid. And at the very top, there are permitted some, you know, snacks which are like, you know, your dark chocolates, things like that. So we're not saying you can't have anything that you find tasty and delicious, but the things that are the higher carb that we would, you know, look at is the ice creams and the cakes and the cookies, and those things that are going to drive up our blood sugar and insulin levels. We try to avoid those.

Jim Puplava:
Basically go to the grocery store and shop the outer aisles.

Michael Sanders:
Well put. And when you are shopping those inner aisles, you need to look at those ingredients because even when you're in Trader Joe's or Whole Foods or any other health food store, they can sneak in a lot of the bad ingredients. So be careful.

Jim Puplava:
Yeah. One of the things that really surprised me in my research is these seed oils that are just about in everything, your salad dressings, foods. I was even looking at a bean, a can of beans from a health food store. And they were using canola oil.

Michael Sanders:
Yes, yes, they do. They, it's so much cheaper than using a higher quality oil like an olive oil. And while there are products now on the market, they are a little bit more costly. So if you're going to pay, you can pay more now and buy those higher quality foods, or you can pay later. And as we know, it's not just later, it's. It's putting you on the way to later with each, you know, poor quality ingredient food that we're eating.

Jim Puplava:
Since we've been talking about a ketogenic diet, I wonder either one of you talk about the importance of ketones with the brain.

Michael Sanders:
So the brain could be fed on. It can. It gets energy through insulin. It gets energy through glucose or ketones. And ketones are generated both by the body, which we call endogenous ketones, which, you know what? For me, for instance, I do measure my ketones, and I know that I'm going to be running very low ketones when either I'm eating around the clock or I'm not eating substantial enough healthy fats or my carbs are super high, as opposed to if I'm having that nice window of fasting of at least 12 hours and maybe longer if I'm having some. What I do is I put some MCT oil, which is medium-chain triglyceride oil that comes from coconut oil. If I put that into my coffee, you may have heard of bulletproof coffee. I blend it. There it is. So yeah, that's very helpful and good for the brain. So when we're doing some of these things, we're enhancing the function of the brain, and you know, when it's running on glucose, we know it can run on glucose just fine. However, that may be spiking the blood sugar, and it is driving down our ketone levels. So our brain just doesn't function as well. And Manna, you may want to add some more.

Dr. Manna Semby:
Yeah, I do want to add something. I like to think about ketones as brain food. Whenever I am on the ketogenic diet, I feel like the energy is cleaner, and it's, you know, the energy lasts longer, and there is more clarity in the brain. So I like to think of it as brain food. There are neuroprotective benefits. It enhances the mitochondria in the brain. It's anti-inflammatory, you know, it increases this connection, the neurogenesis, and helps to clear the amyloid that accumulates in the brain. And not only that, because you're not getting the spikes from insulin from the sugar, then it helps to stabilize the blood-brain barrier. So for many different reasons, ketones are very helpful for the brain. As long as overall your health is such that you are able to derive benefit from them. I think they are ketogenic diet and ketones are a really important part of taking care of your brain.

Jim Puplava:
Let's talk about two, the number of devices out there that can help you. Like for example, I was on Dexcom for a couple of months just monitoring and seeing the impact that certain foods had. And it was amazing when we had pasta, and my glucose levels just spiked. Looked like a NASA space launch. We have the Oura ring which tracks your sleep, your oxygen levels. But we have a lot of stuff that's come out today that can help people monitor this so you can see your progress in terms of your treatment and what you're doing. I want to talk about challenging your brain. I used to be fluent in Spanish. When I was in graduate school, we had to take a language. One of my goals this year is I'm going to retake Spanish. So, you know, taking up music, taking up a foreign language, taking up dancing, playing bridge. There's a program out there called Lumosity that I've done in the past. Right. Things that challenge your brain and create new brain paths. Let's talk about that.

Dr. Manna Semby:
Yeah. Whenever you put the brain in a position to have to learn something new, what you're doing is increasing the adaptability of the brain. So you're promoting neuroplasticity, and that forms new connections between brain cells. It also enhances your cognitive reserve. When you learn a new skill at a later stage in life, you are actively encouraging new memory formation. This is helpful in we have to keep in mind what happens with dementia. One of the things is your recent memory is where you have the problem. You don't have problem with long like memories that you've had for a long period of time. So your recent memory is what you have trouble with. So when you're actively working to take in new information and consolidate in the brain, you're actually increasing neuroplasticity and training the brain to create a reserve. So I think this is a great thing, whether it is learning a new language. Ballroom dancing is recommended a lot because not only are you learning to move your body in space in a way that you may not have done before, and you're incorporating music and movement, but you're doing it with a partner. So there's that connection piece and the music and the dancing that gets my vote every time. Learn any kind of new skill, whether it's a language or a dance. But yes, really, really helpful for new brain cell growth.

Michael Sanders:
I just want to jump in though, Jim. You've just inspired me to take on learning chess because I've never learned how to play chess, and I've always wanted to. So that's going to be my goal for this year in terms of just brain stimulation. I'm going there. So thanks for that.

Jim Puplava:
Yeah, there's a unit that you can buy. It's a computer. So you can play chess against the computer and learn moves. And it's a great way to learn chess. As we get to a close here, one of the things I'm going to ask, and I'll ask this of you, Dr. Semby, if you could put the one, that one test, the questionnaire on that somebody would take. But some of the other tests, if you could send that to us, and we're going to post this with the link to this interview because I'm sure a lot of people listening to this program never heard of any of these tests. And once again, they're not covered by Medicare. But you know, you pay now or pay later, and I think that's important. And then if you were to summarize in the work that you're doing with your organization, if you could boil it down to three or four, maybe five key things that somebody should do if they think they have it running in the family, or maybe one spouse suspects of the other spouse. They're starting to see signs of, you know, mental acuity dropping. What would that be?

Dr. Manna Semby:
I think the biggest bang for the buck would be a neuropsych evaluation, like cognitive assessment, and a blood test, which is the BrainScan. If you can do those two things, that'll give you a lot of information and a lot of motivation as well to start taking action today.

Jim Puplava:
Let's say you do that, and they're showing some of the beginning signs. What's the next step?

Dr. Manna Semby:
The next step is then to work with a provider. You could work with our center or another doctor if you find who has experience working with people to prevent and reverse early stages of dementia. You want to find a practitioner who has worked with people to prevent and reverse early stages of dementia and knows how to follow this ReCODE protocol. Right. Knows how to do this, how to order the blood tests that are needed, that tell us where are your particular risk factors coming from? Where is the problem in your particular case coming from? From. We do a lot of testing, and all of that is so that we can create a profile for each person. You know, perhaps you don't have heavy metals, perhaps you don't have chronic infections, but perhaps you're carrying such a high load of mold toxins that it's leading to symptoms of dementia. Right. Or perhaps it's a woman in her 60s, had a hysterectomy in, in her 40s, was never put on hormone replacement, and now is feeling her brain not functioning as well. Well, find a person who can help you with hormones, who can help you reduce inflammation. So it's really finding the practitioner who can do this work with you and getting started with all the testing to figure out what are the few things that you need to focus on for the next year so.

Jim Puplava:
And Dr. Rapoport, I wonder if you would address this because it happened to me going to you. I took a sleep apnea test, and I was shocked. I had a mild case of apnea. And most people don't think of this unless, you know, your spouse says, hey, you're snoring at night, or something like that. But address that because I was shocked.

Dr. Erela Rappaport:
Sure. A lot of people don't think that they have sleep apnea. I mean, they might hear that their spouse, their bed partner is telling them that they snore, they're getting elbowed at night, or even the spouse or themselves are banished to another bedroom to sleep at night. Going through the sleep divorce. What I do is whenever a patient comes into the office for their dental treatment. Besides screening them for all the normal things that we look at, cavities, gum disease, jaw relations, oral cancer, we also look for the signs and symptoms of sleep apnea, which we can see in the mouth. I look at their airway, how wide open is their airway, how large is their tongue, are they grinding or clenching their teeth, so things like that. And once I see some of those signs and symptoms, I could look at other things. For example, are they overweight? Do they have a large neck size? Sleep apnea is much more common in men over 50 and postmenopausal women. So there is a checklist that I go through, and if I see that they have a few of those signs and symptoms, I will recommend a home sleep test, either through us or through their physician. It doesn't matter as long as they get tested, and then we can find out do they have sleep apnea and if they do, what severity of sleep apnea. Most people, you know, it used to be that, oh, it was overweight men over 50. But, you know, we will find sleep apnea in young, slender women. So there is not one, you know, one size fits all to who has sleep apnea.

Michael Sanders:
So about two, maybe three years ago or longer. Four years ago, I was tested. I did show mild to moderate sleep apnea. I was, you know, diagnosed to use a Pap machine sleep ap device. And I couldn't stand it and didn't use it, therefore, and just went a couple of years and then saw Dr. Rappaport, got another sleep study done again, it showed mild to moderate sleep apnea. And she did make a device for me. And this device is so convenient. I actually will not even go to a hotel without it. I will not even go camping without it. It's just, you know, and it's so practical and so easy. I mean, it's in the little carrying case, and it just makes me sleep so much better. I wake up so much more well-rested. So this is, you know, totally unbiased. I'm just saying my truth. And it's. It's wonderful. It's wonderful.

Jim Puplava:
So I'm using mine, and my wife. You started with my wife? She had it because I was always elbowing her at night. And then she got the mouth guard and sleep soundly. And then she said, you know, you might want to try this and get tested. And lo and behold, I had a mild case. You know, as we close here, I think one of the messages that the three of you can give our listeners and viewers is there's hope. It can be prevented, it can be reversed. So you're not on this. I'm. Once again, my. My own mother was given three, four months to live. And just by making some modifications and things, we took her out of a retirement home. She moved in with one of my brothers and familiar territory around family, and she lived three years instead of three months.

Dr. Manna Semby:
That's an amazing story. That's wonderful. You know, that's what happens when people take action, when they have the right information and they take action, and your loved ones and you can live much longer, healthier lives. And so I agree that we have a message of hope that, you know, despite the fact that the cases are rising, you can take your health in your own hands and take action today to understand your risk factors and do what is necessary to prevent it.

Jim Puplava:
So as we close, why don't you address and tell our viewers and listeners about your center and how they could work with you, the best way to contact you. And at the end, I'd like you to give out your website. We want to post some of those key tests that you talked about. We're going to put them along with our podcast and our YouTube video so that people can get these tests.

Dr. Manna Semby:
Yes, sure. So our center, the Center for Cognitive Resilience, we, the three of us work very closely together on each individual's case because we know how important it is to have your sleep optimized and your oral health taken care of, and for you to have a health coach that can help you every step of the way. Because making these changes, doing all these testing, and getting this so much information can be overwhelming. So we make sure that we work with you together as a team over a period of a year to take you from where you are today to feeling confident and hopeful that you have already begun to see changes in your cognitive health, and that you are now set up to follow some of those recommendations for the rest of your life, whether it's in what you eat and how you exercise and optimizing your sleep and using some of these devices, whether it's a Dexcom or an Oura ring or different kinds of devices, to give you information on how best to help yourself. So what we recommend is our website is simply CenterForCognitiveResilience.com and find us online. And we are going to. We are working on putting on a quiz on our website, which will be called Find Your Brain Health Score. Right? This is something that people. This is a quiz, a questionnaire that people can take and evaluate themselves. And if they are telling us some risk factors that they have, if it is just a very few risk factors, we will tell them, yes, there is something, and perhaps you could take so and so action on your own. But if it is even a little bit high on this assessment, then we will recommend making an appointment with us and coming to for a, for a whole one-hour complimentary visit where we talk about the protocol, we will talk about how we help you in detail, and that would be a way to go forward.

Jim Puplava:
And a final question. You know, let's say you don't have Alzheimer's, you don't have dementia. I have a dear friend who is very forgetful. So even if you don't have these two diseases, following some of these protocols can help that memory loss. You know, you go out, you walk into the bedroom, you get into the bed, why did I come here? Or where did I put my keys? So you can help those things as well. You don't have to have the disease.

Dr. Manna Semby:
Correct. You can just train your brains to make newer memories and consolidate, and just kind of like just train yourself to how to be better about day-to-day life even when you don't have dementia or Alzheimer's or if you don't have a family history of that.

Jim Puplava:
Well, I think the concluding message here, if you're listening or viewing this, is that there's hope here. You're not going to end up your life in the way most people do. You can reverse it, you can prevent it, and even if you even slow down the progression of the disease, like I said, my mother lived three years instead of three months. Well, listen, I'd like to thank all three of you, and once again, I mean, the exciting thing about Medicine 2.0, and who knows what 3.0 is going to look like, is we're finally looking at disease rather than treating it once you get it, talking about prevention and reversing it. And that is a message of hope I want to leave you all with. Thank you so much, all of you for joining me on the program.

Dr. Manna Semby:
Thank you for inviting us.

Michael Sanders:
Thank you, Jim. Wonderful.

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