#75: Team Sherzai MD - Your Brain's Destiny is in the Palm of Your Hands
Team Sherzai MD
If you want to know what service and passion look like, look no further than today’s guests - Drs. Dean and Ayesha Sherzai, affectionately known as ‘Team Sherzai.’ Dean and Ayesha make a return visit to the PLANTSTRONG Podcast to dig into their new book, “The 30-Day Alzheimers Solution - The Definitive Food and Lifestyle Guide to Preventing Cognitive Decline” which is being released March 23rd.
Undoubtedly, everyone has been affected or knows someone who has been affected by the devastating effects of dementia and Alzheimers. Whether you are at risk, or if a loved one is suffering from cognitive decline, Team Sherzai lay out actionable, research-based solutions to this rapidly growing issue in our society.
They recall their own personal galileo moment as physicians- when one public event influenced and changed the course of their area of study - to develop education and support around preventative neurology and brain health through behavior and lifestyle change. Today, these world-renowned neurologists are co-Directors of the Alzheimers Prevention Clinic at Loma Linda University and founders of the NEURO Plan.
What is the NEURO plan, and what are those factors that can drastically improve your brain health? That's what they dish in this beautiful conversation that will inspire you to build your cognitive connectivity, find purpose in every activity, and "rewire, don't retire" your brain.
Episode and PLANTSTRONG Resources:
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FULL TRANSCRIPT
Dr. Dean Sherzai:
Things that came back over and over again, that what prevented Alzheimer's, what prevented dementia in general, which is the umbrella category, what prevented strokes, what prevented cognitive diseases, we coined the term preventive neurology.
Dr. Dean Sherzai:
What prevented a lot of the cognitive and neurological diseases, not all, but a significant proportion, 80% and beyond, was lifestyle, was nutrition. And we said, "Oh my gosh. In a world where Alzheimer's costs nearly 500, actually more than $500 billion, why can't we focus even 10% of that funds towards lifestyle?"
Rip Esselstyn:
Season 3 of the PLANTSTRONG Podcast explorers those Galileo moments where you seek to understand the real truth around your health and dare to see the world through a different lens. This season we honor those courageous seekers who are paving the way for you and me, so grab your telescope, point it towards your future, and let's get plant-strong together.
Rip Esselstyn:
I'm Rip Esselstyn, welcome to the PLANTSTRONG Podcast. If you want to know what service and passion really look like, gaze no further than today's guests, Doctors Dean and Ayesha Sherzai, affectionately known as Team Sherzai.
Rip Esselstyn:
Dean and Ayesha make a return visit to the PLANTSTRONG Podcast to talk about their new book, The 30-Day Alzheimer's Solution: The Definitive Food and Lifestyle Guide to Preventing Cognitive Decline, which is being released March 23rd.
Rip Esselstyn:
Now, undoubtedly every single one of us has been affected in one way or another by the devastating effects of dementia and Alzheimer's. Whether you're at risk or if a loved one is suffering from cognitive decline, I want you to know I'm with you and want to provide you with research-based solutions to this rapidly growing issue in our society.
Rip Esselstyn:
It's exactly why I called upon the Sherzais; world-renowned neurologists who are co-directors of the Alzheimer's Prevention Clinic at Loma Linda University. In today's episode of the PLANTSTRONG Podcast, we discuss their own personal Galileo moment as physicians, when a public event influenced and changed the course of their area of study, to develop education and support around preventive neurology and brain health through behavior and lifestyle change.
Rip Esselstyn:
What are those factors that can drastically improve brain health? You'll find out as we dive into the content in their new book. Team Sherzai, welcome back to the PLANTSTRONG Podcast. God, the last time that I spoke with you two was at your home, pre-COVID, it was probably 2019. And you were on Season-
Dr. Ayesha Sherzai:
I believe it was, yes.
Rip Esselstyn:
Yep. And you were on Season 1 of the PLANTSTRONG Podcast when I was just a newbie. But your episode, if I remember correctly, we really focused in on sleep.
Dr. Ayesha Sherzai:
That's right.
Rip Esselstyn:
And we were talking about your first book, The Alzheimer's Solution, but since then, you guys have come out with a new book that I want to talk all about. It's called the 30-Day Alzheimer's Solution, and then the subtitle: The Definitive Food and Lifestyle Guide to Preventing Cognitive Decline.
Rip Esselstyn:
So I want to get into that, but before I do, here's my question for you both. So Season 3 is really... it's all about these Galileo moments where you guys looked through the telescope, you saw the truth, and it has kind of guided your journey to where you are now.
Rip Esselstyn:
And I think the fact that you two, husband and wife, right, MDs, co-directors of The Alzheimer's Prevention Program at Loma Linda, it's like this is so unusual, so unusual. And if you could just share with the audience how you got to where you are today and what was your Galileo moment that drove you guys to be this ambitious in doing everything to let people know that Alzheimer's is, well, preventable.
Dr. Dean Sherzai:
Yeah.
Dr. Ayesha Sherzai:
I love that, Galileo moment.
Dr. Dean Sherzai:
Wonderful. Yeah. It was kind of a Galileo moment. We both met in a conversation. In fact, our first conversation was about Alzheimer's and our grandparents, two on each side, dying from Alzheimer's. And that was the beginning.
Dr. Dean Sherzai:
Conversations, several dates and a year later, we were married. We came back and did the traditional, we went to UCSD, which was the number one neuroscience program in the country. Leon Thal, which was the preeminent neuroscientist in the country, he was my mentor.
Dr. Dean Sherzai:
Ayesha did some amazing work with FMRIs, with these machines that look at your brain while you're thinking. And we did all of that. We get our master's. Ayesha finished a residency in both preventive medicine and neurology, while I was the director of brain health at Loma Linda.
Dr. Dean Sherzai:
We studied the populations in Loma Linda, we took the path that was less traveled. We could have gone from UCSD to a lot of universities, but we picked Loma Linda because it's the healthiest place in the world. It's there where the Seventh-day Adventists are centered pretty much. And we decided to go there to study effect of lifestyle on brain health.
Dr. Dean Sherzai:
And the eureka moment was partly in my clinic, in our clinic, and partly in the community next to Loma Linda where we saw the healthiest people in the world in Loma Linda, the Seventh-Day Adventists that live in that area. In the gym and [inaudible 00:06:14] center, you saw people in their 80s, 90s, more active than you saw people in their 40s anywhere else, and cognitively sharp.
Dr. Dean Sherzai:
In my clinic, which was a dementia clinic, you would expect, given that the population is one third plant-based and one third Adventist, that you would see at least one third or one fifth of the population of the dementia patients being Adventist, it wasn't. It was a fraction of a percent. That was bewildering.
Dr. Dean Sherzai:
When we looked at the data over and over again, it was lifestyle that affected us. But what the eureka moment or the Galileo moment was when we went to the communities, and it wasn't just one moment, but I actually remember the one conversation that you and I said, "Oh my gosh."
Dr. Ayesha Sherzai:
Yeah. Yeah.
Dr. Dean Sherzai:
We were giving a talk in one of the churches, and afterwards all these people in their 60s would come to us. And every single one of them had significant cognitive decline or dementia.
Dr. Dean Sherzai:
And all of a sudden, that opened our... Wait a second, this is what we're seeing over and over again in San Bernardino, which is five miles away from Loma Linda. Get it? Loma Linda, you have people well into their 80s, 90s and beyond who are cognitively sharp, why the disparity?
Dr. Dean Sherzai:
It's not geographic. It's not even actually the things that people think it is, it's not genetic. It was access, it was information, it was lifestyle. The difference could not be more stark between what happened in Loma Linda and what was happening in San Bernardino five miles away.
Dr. Dean Sherzai:
And that just opened our eyes and we decided to go a different path from clinical trials to lifestyle and study that, do reviews, do research, go to the communities and do research. And the things that came back over and over again, that what prevented Alzheimer's, what prevented dementia in general, which is the umbrella category, what prevented strokes, what prevented cognitive diseases, we coined the term preventive neurology.
Dr. Dean Sherzai:
What prevented a lot of the cognitive and neurological diseases, not all, but a significant proportion, 80% and beyond was lifestyle, was nutrition. And we said, "Oh my gosh." In a world where Alzheimer's costs nearly 500... actually more than $500 billion, why can't we focus even 10% of that funds towards lifestyle?
Rip Esselstyn:
What year was this when you started to see these disparities?
Dr. Dean Sherzai:
So Ayesha and I went to Loma Linda in 2008, and around 2010 is when the eureka moments happened. We started talking about this in 2010. We remember going to conferences and saying this.
Dr. Ayesha Sherzai:
Oh. Yeah. And I think people who are in the realm of health, and we've talked about this with [Esse 00:09:07] extensively. When you go to these medical conferences, I mean there are a lot of great things happening, but it's so focused on molecular research or pharmaceutical research or zapping amyloid protein in the brain with lasers. I'm kidding, but high-tech things like that.
Dr. Ayesha Sherzai:
And year after year, year after year, we would go to these conferences and there would be conversations about molecular models of Alzheimer's, mouse models of Alzheimer's. 400 different clinical trials that worked on mice but when they pointed that out or when they applied that into humans, it never worked.
Dr. Ayesha Sherzai:
Not having a single medicine that treats this devastating disease after years and years and billions of dollars spent on clinical trials. And yet we have these population models and we have these prospective studies that show when people live in a particular way, they're able to withhold the disease, they're able to prevent this devastating disease and they live very long, very cognitively vibrant lives well into their 80s, 90s and beyond.
Dr. Ayesha Sherzai:
And so that was a pattern. But then in 2019, not during the pandemic but a year ahead of that, the first time, when we went to the Alzheimer's Association International Conference, their plenary session, it's a session where all of the scientists and all of the doctors get together to talk about the biggest reveal.
Dr. Dean Sherzai:
5,000 people.
Dr. Ayesha Sherzai:
5,000 people. And the first conversation was about prevention. And I think I got a little teary-eyed when I saw on the PowerPoint presentation one statement saying, "Prevention is the new treatment." Which, after decades of just dwelling into the minutiae, the first time they understood and they accepted that prevention was very, very important.
Rip Esselstyn:
And that, to me, is the perfect transition to your new book, which is really the future of health, I think we all can agree. So what inspired the new book? Because you wrote The Alzheimer's Solution [inaudible 00:11:17], was it 2016?
Dr. Ayesha Sherzai:
17. Yes.
Dr. Dean Sherzai:
17.
Rip Esselstyn:
2017?
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
And then, as far as writing books are concerned, this is hot on the heels of The Alzheimer's Solution, right?
Dr. Ayesha Sherzai:
It is.
Rip Esselstyn:
And I can't imagine... In looking through this book, it is so drop-dead gorgeous, it is packed with so much information. That must have taken you a year and a half, two years to put this all together [inaudible 00:11:43].
Dr. Ayesha Sherzai:
Yes.
Dr. Dean Sherzai:
Yeah.
Dr. Ayesha Sherzai:
I think we just started working on it right after we wrote the second one, and it's a culmination of our clinical work and our community work.
Dr. Dean Sherzai:
Yeah. The first book has a lot of the how, but it's mostly the why. The second book is the how. There's a lot of science in it as well, but there are 75 recipes. Ayesha is a cook as well, as you know.
Dr. Dean Sherzai:
She did her fellowship at Columbia University, and in the morning she would be in the ICUs, at night she would be in the cooking classes. Because if we can't help with the transition, if we can't give them healthy, tasty foods, if we can't create that sense of belonging and culture and taste, it's going to fail, it's going to be a didactic professorial talk.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
So this book has 75 recipes, but more important than that... Not more important, food is extremely important. That was a ridiculous statement.
Dr. Ayesha Sherzai:
As important.
Dr. Dean Sherzai:
As important as that is that we're behavioral neurologists, so we really focus on how to translate goals and visions into behavior.
Dr. Ayesha Sherzai:
And I think that's the key. I think there's this disparity between the information that we have about health and wellness and how it's applied and translated into homes, families, and communities. And so we just focused on the how, specifically in this book, and we're very proud of it.
Rip Esselstyn:
Yeah. Yeah. Well, it's broken up into three parts. We've got the proven plan, which is part one. Part two is what to eat, what not to eat, and why. And then, of course, number three is it's actually the NEURO plan, the 30 days for brain boosting.
Rip Esselstyn:
So I'd love to, at a high level, let's just jump in and let's start with the NEURO plan. NEURO is an acronym. What in the world does NEURO stand for and why should we care about it?
Dr. Ayesha Sherzai:
Thanks, Rip. NEURO is an acronym that we came up with, self-serving because we're neurologists. But I think it was a good representation of the proven lifestyle factors that work, whether it's prevention of Alzheimer's, stroke, dementia, other kind of dementia, etc.
Dr. Ayesha Sherzai:
And it stands for; N is for nutrition, E is for exercise, U is for unwind or stress management, and we can go into the details of that. R is restorative sleep, not the type of sleep where you take a sleeping pill and go to bed, but the kind that allows you to go through the different stages of sleep because that's important for brain health.
Dr. Ayesha Sherzai:
And O is optimizing cognitive activity. Now, this one is really interesting because it comes from the concept of building redundancy and cognitive reserve, and it's doing things that you're passionate about that keeps your mind challenged with complex activities. So that's what NEURO stands for.
Rip Esselstyn:
Got it. So can we just dive a little bit deeper into each one? And let me just start by saying, so under N for nutrition, you guys say in your book; with every meal you eat, you either make or break your brain.
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
That's a pretty powerful statement.
Dr. Ayesha Sherzai:
It really is, isn't it? And I think more than this being a scare tactic, I think it's a very empowering message because it means that with every action, you can build your brain, you have total and complete control.
Dr. Ayesha Sherzai:
And this brain of ours, it's a three-pound organ. And for those who haven't been to a chemistry or a biology lab, I don't know if you guys have actually seen... Rip, have you seen a brain in a jar in labs? It basically is like a squishy organ, it's like hard jello.
Rip Esselstyn:
Yeah.
Dr. Ayesha Sherzai:
And this incredible squishy organ is consuming 25% of our body's energy at any moment. It's an energy hog, it just sucks up everything. So everything you do, everything you eat, every action that you participate in affects this brain tremendously.
Dr. Dean Sherzai:
The genes that have been associated with Alzheimer's, the genes that have been associated with a lot of the chronic diseases, have to do with that energy metabolism. They are the genes that have to do with lipid or fat metabolism, APOE4.
Dr. Dean Sherzai:
They are the genes that have to do with glucose metabolism, your genes that have to do with inflammation as a result of your relationship with food, and the genes that have to do with you getting rid of waste.
Dr. Dean Sherzai:
I mean, this highly active organ that doesn't even sleep, isn't that the funny part? When it sleeps, it actually does some of its best work. It has to get rid of waste. In fact, it does most of its waste elimination during sleep, that's why sleep is so important.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
So the food that you gave it, if it's productive, constructive, and nutritionally dense yet not by-product dense food, it will build your brain, at any age. But every meal that you give, you know that food coma that you develop? There's a reason that that's a coma. That excess sugar, or sugar in general, or excess fat, or fat in general, or inflammatory foods.
Dr. Dean Sherzai:
The meal that you just took is not going to be compensated by a handful of blueberries. Well, that was a little disempowering, but it's okay.
Dr. Ayesha Sherzai:
It is. Blueberries are great.
Dr. Dean Sherzai:
Blueberries are fantastic. But what I'm trying to say is, eating the good foods are important, and we talk about that. We talk about the Neuro Nine, the nine foods that are good. But we're not reductionists, so we're not going to even talk about those here.
Dr. Dean Sherzai:
It's about not eating the bad foods, the fats, the sugars, the processed, and eating a variety of beautiful, colorful, nutrient-dense foods which, on a day-to-day, basis at age 60, at age 70, at age 80 will build the brain.
Dr. Dean Sherzai:
But for the young people who think they're immortal, here's the thing, you can actually build a level of focus and concentration and memory with good food and with the optimized component, that you have never experienced without going to these biohacking seminars or anything. You can do it in your kitchen and in your living space. That's the whole point of this book.
Rip Esselstyn:
Yep. Yep. And I want to do a little deeper dive obviously into the food side of it with the Neuro Nine and some of the seven rules that you guys have, but not yet. So E is for exercise, is exercise really that good? I mean, is it really that important?
Dr. Ayesha Sherzai:
Oh my goodness. Yes, absolutely. It's funny that nobody argues about that, nobody argues about exercise but everybody's arguing about nutrition. And I think this-
Rip Esselstyn:
I want to let you know, I have some people that I have worked with and they tell me that just the thought of getting up off the couch and exercising makes them want to go take a nap.
Dr. Ayesha Sherzai:
Oh.
Rip Esselstyn:
They are so [crosstalk 00:18:51].
Dr. Ayesha Sherzai:
That's true.
Rip Esselstyn:
But anyway-
Dr. Dean Sherzai:
Yeah.
Dr. Ayesha Sherzai:
That's true.
Rip Esselstyn:
We all love exercise.
Dr. Ayesha Sherzai:
We love exercise.
Dr. Dean Sherzai:
Oh, yeah. Yeah.
Dr. Ayesha Sherzai:
Yeah. So exercise is important because it creates the juices that creates the connections between brain cells. The number of brain cells doesn't really matter in our brain. I know that's the wonderful question, because a lot of people are worried that they lose brain cells as they grow older. We all do.
Dr. Ayesha Sherzai:
After age 20, there's a rapid decline in the number of brain cells, but we continue to make connections between brain cells. And these connections, they reflect our capacity to think, to be creative, to be bright and sharp, to withstand diseases like Alzheimer's and stroke. And exercise essentially creates these connections.
Dr. Ayesha Sherzai:
And people who exercise on a regular basis, in a regimented way where they do it, say for example, four or five times a week, they have better blood flow to their brain, they have these growth hormones, a specific one called brain-derived neurotrophic factor or BDNF that increases rapidly when you do lunges or squats or when you go for a run, and it lingers in your system.
Dr. Ayesha Sherzai:
So a combination of good blood flow to the brain, these growth hormones secreted and so many other different factors, they create connections. And guess what? These connections are like your bank account, like the money you put in your bank account.
Dr. Ayesha Sherzai:
So say, for example, down the road you hit your head or you have a car accident, or say, for example, your blood pressure goes up really high and it disconnects some of these connections, you have enough to withstand trauma later on in life. As much as exercising is important, it's also important not to be sedentary.
Dr. Ayesha Sherzai:
Unfortunately, a lot of Americans have become sedentary. We have desk jobs, we exercise for 20 minutes but then we sit behind our desk for, say, two to three hours. All of that exercise that one does can be negated by the sedentary activity. So standing up, opting for standing desks, walking, moving naturally, having an environment that pushes you to just get up and go do something every once in a while is incredibly helpful for the brain.
Rip Esselstyn:
Yeah. Yeah. Dean, didn't you guys go to Cleveland and attend one of Jane's conferences recently?
Dr. Ayesha Sherzai:
Yeah.
Dr. Dean Sherzai:
We did. We did. It was an amazing experience.
Dr. Ayesha Sherzai:
It was amazing how we actually all stood up and we would walk and Jane would make everybody dance and stretch after one hour. And Esse was involved in it too.
Dr. Dean Sherzai:
Esse. One of the stories that I always bring up, which gives me so much respect for Esse; the thing that makes me hopeful about humanity is ability to communicate, ability to learn, ability to change. Communicate, learn, change.
Dr. Dean Sherzai:
If that's not happening at any stage of life, I think that's the basis of our problems we're having as a society, in healthcare and beyond. Beautiful story was that when we came back from the conference, I was sitting in front with Esse and we were talking. And for 45 minutes he kept asking questions, more and more questions, one after the other.
Dr. Dean Sherzai:
And after about 45 minutes, we got to their home, we sat, everybody got together, we were having dinner, and he disappeared. And we're wondering where did he disappear to. And an hour later he came back and he said, "You know, I had a conversation with Dean in the car and I've always known that exercise is important, but the importance of exercise for the brain, oh my God."
Dr. Dean Sherzai:
He actually worked out 45 minutes on the bike. This is a human being that is continually improving himself, continually learning.
Dr. Ayesha Sherzai:
Constant learning.
Dr. Dean Sherzai:
And that ability to change, that ability to incorporate into life, and the fact that I think the bike is in their bedroom-
Dr. Ayesha Sherzai:
I think it was in the bedroom upstairs.
Dr. Dean Sherzai:
Yeah. Yeah. Yeah.
Dr. Ayesha Sherzai:
He just disappeared for 45 minutes.
Dr. Dean Sherzai:
But the key is that we can all do it. We can always bring it to our home. We believe in everything in your living space at your work and your community and your home. So one of the things we bring up is if you can't do anything else, what you can do is while watching TV, stand up and do steps.
Rip Esselstyn:
Mm-hmm (affirmative).
Dr. Dean Sherzai:
Or make a rule for yourself, "I'm not going to watch TV unless I'm standing up and doing X number of steps." Or the other thing is a recumbent bike, because it gets rid of balance issues, it gets rid of falls issues. The rule is: I'm going to watch TV only if I'm moving the bike.
Dr. Dean Sherzai:
That kind of activity level where it's constant, it's part of your life, it becomes empowering, it really truly grows the brain better than any pill will do in the near-future.
Dr. Ayesha Sherzai:
Absolutely.
Rip Esselstyn:
Yeah. Yep. So I take it my father was late for dinner.
Dr. Dean Sherzai:
He was late for dinner. Yes. Yes. Yes, of course.
Rip Esselstyn:
But he had a good excuse.
Dr. Dean Sherzai:
He did.
Dr. Ayesha Sherzai:
Definitely.
Rip Esselstyn:
All right, unwind. Help me out with unpack, unwind, and then let's hit restore.
Dr. Dean Sherzai:
I'll do the unwind and you can do restore.
Dr. Ayesha Sherzai:
Sure.
Dr. Dean Sherzai:
Unwind is about stress management. It's not a small matter. We talk very little about it because people think that we have no control over it. "It's stress, what can I do about it?" No, no, no, stress is about stress management, it's about good stress and bad stress.
Dr. Dean Sherzai:
It's really important to write down the good stresses and the bad stresses, specifically, measurably, and in a way that you can affect it. So "I don't like my job" is not specific, it's not measurable. "I don't like doing the morning reports, but I like the conferences" is a very important way of specifically...
Dr. Dean Sherzai:
So you identify all your, or as many of the bad stresses specifically and measurably and the good stresses. What is good stress? Good stress is the kind of thing that pushes you, that makes you learn, that makes you grow, that has... Again, specific and measurable. Your podcast, when you started it three seasons ago-
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
How many parts was to this? Lots of parts. That's mental activity.
Dr. Ayesha Sherzai:
Yeah. Absolutely.
Dr. Dean Sherzai:
To me, mental activity, to Ayesha and I, it's not about Sudoku or crossword puzzle, it's complex activities that engage multiple parts of your brain.
Dr. Dean Sherzai:
We did a meta-analysis two years ago, it was published in 2018, that looked at cognitive activity and brain health. And what we found was purpose, which doesn't sound like a science word, but it is. It looked at complexity and challenge.
Dr. Dean Sherzai:
Complexity means activities that are multi-domain. When you're learning a musical instrument, you're actually engaging multiple parts of your brain and you're pushing yourself. And challenge means don't just stick to the same song. I know that I'm stuck at the same song, but that's okay. But keep moving to the next level, and the next level. And who knows better than you where the next level is? And keep pushing, and why is that important?
Dr. Dean Sherzai:
Whereas nutrition, stress management, and sleep create the environment for growth and reverse the damaging environment that happens through aging, that's important-
Rip Esselstyn:
Yep.
Dr. Dean Sherzai:
... Exercise and mental activity make the connections. And how many connections? We have 87 billion neurons.
Dr. Ayesha Sherzai:
Yeah.
Dr. Dean Sherzai:
Each of them can make a couple of connections or as many as 30,000 connections.
Dr. Ayesha Sherzai:
It's amazing.
Dr. Dean Sherzai:
That's a 15,000 times power. I mean, that's what the power we have. So stress management is about identifying the good stress and building, increasing, empowering and tooling the good stress in a systematic way, and reducing, eliminating and delegating the bad stress in a systematic way.
Dr. Dean Sherzai:
And then where you can't do either one, you create the positive language, like we have for our travel to Loma Linda. We live in Redondo Beach. We're about an hour and a half to two hours [crosstalk 00:26:38] each way.
Dr. Ayesha Sherzai:
Yeah. The drive is just a killer.
Dr. Dean Sherzai:
Two days a week.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
And we say, during that two hours, which is stressful, we've created our work routine where when I drive, she does some of the stuff. We've actually created the language where we have music and we have podcasts we listen to. So you alternate.
Rip Esselstyn:
I love the example.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
That is so wonderful. Yeah. A two-hour commute twice a week, four hours round trip.
Dr. Dean Sherzai:
Four hours round trip.
Dr. Ayesha Sherzai:
Yeah. Four hours round trip. Yeah. Yeah.
Rip Esselstyn:
[inaudible 00:27:09]
Dr. Dean Sherzai:
Yeah. Yes. Yes.
Rip Esselstyn:
Okay.
Dr. Ayesha Sherzai:
Yeah. They're usually planned.
Rip Esselstyn:
Yeah. All right. Ayesha, can you hit us with restore?
Dr. Ayesha Sherzai:
Yes. And I think we've talked about that in the past, Rip.
Rip Esselstyn:
Yep.
Dr. Ayesha Sherzai:
People really underestimate how important sleep is. But I'm so glad that we decided to make it a tenet of health. Because we believe that, based on different studies and all of the science behind it, thankfully we now know that the duration of sleep, the time when we sleep is probably the most important time for the brain.
Dr. Ayesha Sherzai:
I know it sounds ironic. We're not awake, we're completely knocked out, but it is the most important time for the brain to cleanse itself, to restore itself. And it is a very, very important determinant of cognitive health.
Dr. Ayesha Sherzai:
We now know that people who have disrupted sleep or if they don't get enough sleep, they actually build amyloid protein, which is the bad protein associated with Alzheimer's disease. And there have been studies where even one night of bad sleep, let's say you stayed up because the movie was just so exciting and you didn't sleep and you had to wake up really early the next day for a meeting, even one night of bad sleep increases the level of amyloid protein.
Rip Esselstyn:
Wait, wait, wait. So you mean to tell me that if I binge watched three episodes of The Queen's Gambit, I'm in trouble?
Dr. Dean Sherzai:
No, because...
Rip Esselstyn:
My chess game will suffer.
Dr. Dean Sherzai:
No, no, no. Because it was The Queen's Gambit, which was so good, probably not. It was so good.
Dr. Ayesha Sherzai:
Yeah. I love that show, by the way.
Dr. Dean Sherzai:
But the reality is it's not... We do all kinds of those little micro damages. It's the cumulative direction that matters.
Dr. Ayesha Sherzai:
Right.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
So the cumulative direction if you are building a beautiful sleep hygiene, sleep environment, that's what's important.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
Because the two most important things happen at night: memory consolidation and eliminating waste.
Dr. Ayesha Sherzai:
Exactly. And that's so important. It's almost like when everybody leaves a building, the janitorial team comes in and they start cleaning the building, that's almost exactly what happens in the brain.
Dr. Ayesha Sherzai:
There are these specialized cells called the microglia and there's a specialized system called a glymphatic system, they get activated when you're sleeping. Only when you go through the deeper stages of sleep, they get activated. And what they do is they get all the vacuum cleaners and all the cleaning products and they get rid of all of the by-products that have accumulated during the day. And our brain is so active.
Rip Esselstyn:
Yeah. So for people that are doing the Ambiens and these other sleeping pills, does that allow them to then get into that level of sleep and clear out? Do we know?
Dr. Ayesha Sherzai:
I'm glad that you brought that statement there, another question. So different medications have different effect on the sleep architecture. And a lot of them actually disrupt the architecture of the brain, so it doesn't really allow you to go through the different cycles of sleep.
Dr. Ayesha Sherzai:
So we go through stage one, stage two, stage three, and then REM, and then go back to stage one, two, three, REM. And we go through about four or five cycles of these sleep every night. And we have to go through each and every stage because each and every one of them have a specialized mechanism of taking care of the brain.
Dr. Ayesha Sherzai:
And sometimes these medications disrupt this flow in the sleep architecture. So as a quick measure, if somebody's really suffering or if they have some trouble sleeping, one or two or three nights of taking medications to help you re-establish that cycle is okay, but long-term they can be damaging.
Rip Esselstyn:
Yeah. Yeah.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
Well, I know in Season 1 we talked pretty extensively about sleep. So if anybody wants the deeper dive, go listen to that podcast. I think it was episode 3.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
Okay. If you could touch upon optimize. And then I want to jump into some of the foods that you recommend we eat.
Dr. Ayesha Sherzai:
Sure, of course.
Dr. Dean Sherzai:
So optimize is about that good stress, it's about purpose, it's about challenge. If you think that you're going to retire and then spend time on the beach, well, first two weeks is great, but you better start challenging that brain.
Dr. Dean Sherzai:
Because at that age, for that matter, at any age, but especially as we get older, this brain is using a lot of energy. And then you're not using the energy properly, which is its purpose is capturing data, right? And it's telling the brain, "Well, he doesn't need all the neurons." It actually starts pulling back and starts shrinking rapidly.
Dr. Dean Sherzai:
So it's critical, we say, "Don't retire, rewire." A friend of ours high-ranking says this. Rewire, reconnect, find a purpose, find activities that challenge your brain, that forces the brain to make those connections. It's better if it's multiple domains, it's not just one thing like mathematics or one thing like language.
Dr. Dean Sherzai:
Or if you can't find one thing that has all of them, several activities. It could be visual spatial things like building models or building things or musical instruments or, as I said, book clubs, but it should be multiple activities that really push you.
Dr. Dean Sherzai:
And there's very little that's more effective for building brain connection, connectivity, and resilience than that. Multiple studies have shown this, that even later in life, the London taxi driver study, the nun study, huge studies showing that, at any age, people who took on an activity that challenged their brains, not only did they not go down the path of normal shrinkage of the brain, they actually reversed it. They actually grew that part of the brain.
Dr. Dean Sherzai:
So I say to people, find purpose-driven complex activity, and that will make your life for multiple reasons, but especially for your brain health.
Rip Esselstyn:
Yeah. Yeah. Thank you for doing that review of NEURO. It's a brilliant acronym, it really is. It's so easy to remember.
Rip Esselstyn:
We're about to open our Rescue 10x Mindset Mastery Program to those who are on the wait-list. This program only is offered a few times a year and gives people who need it 10 weeks of group coaching, accountability and support. If you've tried absolutely everything but can't stay on track with a plant-strong lifestyle, this program is for you.
Rip Esselstyn:
If you want to finally jump off the cycle of yo-yo dieting and get yourself in the mindset for success, I want to invite you to check out the program. Go to rescue10x.com, that's the number 10 followed by the letter X, and enter your phone number.
Rip Esselstyn:
We'll then text you a VIP discount code as soon as the program opens. Don't miss out. Visit rescue10x.com or click the link in the show notes today, thanks.
Rip Esselstyn:
I want to jump into food right now.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
Why don't we do this; so in your book, you have the seven rules for eating for optimal brain health, and you also have the Neuro Nine foods. Why don't we tie that into rule number one, which is why you love plants, right?
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
And so any way you guys want to talk about that, but yeah. So, rule number one.
Dr. Ayesha Sherzai:
Amazing.
Rip Esselstyn:
Yeah.
Dr. Ayesha Sherzai:
Yeah. So, eat a plant-based diet. And I think that has been the core message of our work in the first book, Rip. And you and I, the three of us have talked about that a lot.
Dr. Ayesha Sherzai:
And the reason is, I know that it's a very straightforward, very direct message, but it comes from a lot of thought and a lot of background work from our clinic, from our research, and also years and years and years of research from other individuals, scientists, researchers, Dr. Esselstyn's work, your work.
Dr. Ayesha Sherzai:
Knowing that whatever dietary pattern it is, whether it's the Mediterranean diet or the mind diet or the DASH diet or the dietary pattern that have been studied in multiple populations; when you do factor analysis, when you look at the foods that stand out to be the best foods for health and especially for brain health, it's on processed plants.
Dr. Ayesha Sherzai:
I feel privileged that I've had the opportunity to look at dietary patterns in specific populations. I work with a California teachers study. And when you go into the nitty-gritty science of it, there is a term that is called the anti-inflammatory index, which basically means how much of an anti-inflammatory effect does a particular food have?
Dr. Ayesha Sherzai:
And when you put all kinds of foods in there that people eat, the things that stand out are the greens, the beans, the whole-grains, the fruits, the nuts and seeds. And what seems to be on the bottom of the list and on the harmful side is sources of saturated fats, whether it's meat, chicken, dairy, cheese and processed food.
Dr. Ayesha Sherzai:
And it's a spectrum of different things. But we say that the optimal diet if you want to live the best life and if you want to provide your brain and your body the best kind of fuel, it's a whole food, plant-based diet.
Rip Esselstyn:
Yeah. Yeah. Now, you said in there to limit or avoid saturated fat.
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
It seems like half of this country is just insanely enamored with paleo, keto, the new kid on the block, the carnivore; where the lifeblood of these diets is saturated fat. Do you think that this is, long-term, going to have some really consequential effects on their brain health?
Dr. Dean Sherzai:
Yes. Let's look at mechanistically. There are four pathways that lead to brain health diseases and others that we've defined; inflammation, oxidation, glucose dysregulation and lipid dysregulation.
Dr. Dean Sherzai:
I don't think there's any serious scientist that would argue that saturated fat affects all of them. I mean, for them, it would mean that they're closing their eye to a thousand studies and finding the one-off study.
Rip Esselstyn:
Yeah. Yeah.
Dr. Dean Sherzai:
And by the way, if you're going to look for one-off study, you will find anything out there, even in PubMed and the-
Dr. Ayesha Sherzai:
Legitimate sources.
Dr. Dean Sherzai:
Legitimate source. Because somebody's written something in an obscure journal and it's going to get published. You're going to find somebody who says eating aluminum is going to save you from Alzheimer's.
Dr. Dean Sherzai:
So the one-off studies, or even one-off randomized clinical trial doesn't mean anything. In fact, recently, a paper from a legitimate database, the British Biobank, came and they hid the source of the funding very well, but we know, we found out what source it was, University... In any case.
Dr. Ayesha Sherzai:
No names. No names.
Dr. Dean Sherzai:
[crosstalk 00:38:42]. No names. But they found that drinking as much as even a bottle of wine, cheese, and lamb is better for your brain than eating vegetables. In fact, eating vegetables were found to be harmful.
Dr. Ayesha Sherzai:
It's just crazy.
Dr. Dean Sherzai:
I mean, I don't think anybody would believe that, but we're in a world where data can be manipulated. But the breadth and the ocean of data from population-based studies, from clinical trials and others, have shown the things that reduce inflammation, oxidation, glucose dysregulation and lipid dysregulation is: foods that are low in saturated fat, foods that are less processed, less sugar in processed foods. They significantly reduce those. That's actually the data on the mechanism side.
Dr. Dean Sherzai:
On the population body side, show me a population that has lived with keto diet long-term.
Dr. Ayesha Sherzai:
There is no long-term [crosstalk 00:39:36].
Dr. Dean Sherzai:
There is no long-term population. The population that came to us are our patients.
Rip Esselstyn:
Eskimos. Eskimos, I don't know.
Dr. Dean Sherzai:
Not really actually, no. And by the way, the data from Eskimos from that population was misstated because when they looked at the data, they had significant cardiovascular disease.
Dr. Ayesha Sherzai:
Right.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
Yeah. So we're not going to get into that.
Rip Esselstyn:
No.
Dr. Dean Sherzai:
But keto diet, there is no long-term. Every study that comes to us is six months. Six months studies mean nothing. In fact, we have people doing six months studies on dementia now and keto and other diets.
Dr. Dean Sherzai:
I can smile at somebody for six months. Well, Ayesha smiling at somebody six months will give them better outcomes. Me, probably would give them dementia.
Dr. Ayesha Sherzai:
No.
Dr. Dean Sherzai:
But six months means nothing. Whenever you see a study like that, they're trying to quickly get famous.
Rip Esselstyn:
Yeah.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
That doesn't work. The long-term study, Ayesha studies 133,000 people over 20 years.
Dr. Ayesha Sherzai:
The California Teachers Study. Yeah.
Rip Esselstyn:
Wow.
Dr. Dean Sherzai:
California Teachers Study. The Adventist Health Study is 97,000 people over 50 years.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
They might say that, "Oh, but that's a population." No, we can see huge confounds and get rid of it and study it, we can see patterns, and the pattern after pattern after pattern.
Dr. Dean Sherzai:
And in my own clinic, my gosh, in the center of where you expect this population, to actually have one third of them be dementia, we saw 19 patients out of 2,500.
Rip Esselstyn:
Wow.
Dr. Ayesha Sherzai:
Yeah. People say that nutrition is complicated. I don't think nutrition is complicated. I think we have enough information of what works and what doesn't work. And I think we should, obviously it's important to keep an eye open for new studies and new science coming in. But so far, like Dean said, the majority or the maximum, the breadth of the information supports a whole food plant-based diet.
Rip Esselstyn:
Yeah. So are there any pharmaceutical drugs that are doing anything that can touch a whole food plant-based diet [crosstalk 00:41:36]?
Dr. Ayesha Sherzai:
Not even close.
Dr. Dean Sherzai:
Zero.
Dr. Ayesha Sherzai:
Nothing. Nothing.
Dr. Dean Sherzai:
Even on the vitamin side, we just did a review, a huge review. We just submitted two of them; one for omega-3 and the developing brain and omega-3 at the aging brain. We're looking at data on vitamin stuff.
Dr. Dean Sherzai:
And for none of these, there's absolute data, so we look at patterns and trends and that's good enough in science. Believe it or not, the plane that you flew in with 300 people was created not with absolutes, with incremental increases and directions, even in physics.
Dr. Dean Sherzai:
Nonetheless, it appears that, even with vitamins, if you are deficient, yes, take supplements. And by the way, a lot of these deficiencies by those who were trying to say that plant-based diet has this deficiency, we call it the deficiency syndrome of the day. And none of them are true.
Dr. Ayesha Sherzai:
Yeah.
Dr. Dean Sherzai:
B12 deficiency, yes, there's a lot of it in plant-based but it's actually ubiquitous.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
You just have to be aware of it, make sure that you eat a complex diet. I mean, if you eat potatoes all day, all night, you're going to have problems. But if you have a complex diet, you should be fine and be aware of your levels.
Dr. Dean Sherzai:
Omega-3, be aware of it, eat foods that are rich in omega-3s like chia and flax seeds, which are amazing, which is one of the Neuro Nine, and you should be fine. But even then, if you're worried, especially in certain times of life like developing brain, children, like pregnancy, or aging brain, take a supplement, algae-based.
Dr. Dean Sherzai:
But for majority, if you're aware, you're fine. The one thing we found was turmeric, from our study in Cedars-Sinai where we looked at the retina, which is a continuation of the brain, when we gave them cumin in high doses, it actually bound to amyloid. And we know that cumin with pepper is actually anti-inflammatory, significantly, and it binds to amyloid. Again, not causal data, but pretty strong data. So we add cumin as part of our food.
Dr. Ayesha Sherzai:
Right.
Rip Esselstyn:
So it binds to the amyloid, you're saying that's a good thing.
Dr. Ayesha Sherzai:
Yeah.
Dr. Dean Sherzai:
It removes it. The body removes it.
Dr. Ayesha Sherzai:
Yeah, actually it removes it.
Rip Esselstyn:
Okay.
Dr. Dean Sherzai:
Yeah. Yeah.
Rip Esselstyn:
Got it. Yeah. So what do you guys, do you guys supplement with anything besides B12?
Dr. Ayesha Sherzai:
No. There was a time when I was pregnant and when I was having my kids, I supplemented with omega-3 fatty acids, but right now we're taking vitamin B12 and just trying to eat a very, very healthy diet.
Dr. Ayesha Sherzai:
Flax and chia seeds are a very important component of our foods, we add hemp seeds on our oatmeal in the morning and just being cognizant of the amount of omega-3 fatty acids we consume, because that's very important for brain health.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
DHA is one of the only omega-3s or one of the only fats that the brain need. The statement that the brain is mostly fat therefore it needs fat is ridiculous.
Dr. Ayesha Sherzai:
Oh, God. How many times do you hear that?
Rip Esselstyn:
All the time. Yeah. Can you just dive a little bit deeper into that? Because I think that's a really cool [inaudible 00:44:23].
Dr. Ayesha Sherzai:
Yeah, absolutely. So the notion that the brain is made out of fat so we have to eat a lot of fats is important is so false, because neither saturated fat or cholesterol in our diet or the cholesterol that is made in our body passes through the blood-brain barrier into the brain.
Dr. Ayesha Sherzai:
The kind of fat that we have in our brain is structural fat. It's just a part and parcel of the infrastructure of your brain. The only kind of fats that pass through the blood-brain barrier, which is a very tight junction between the cells of your endothelium, of the small little blood vessels that supply oxygen and nutrition to the brain, the only kind of fat that passes through these junctions are omega-3 fatty acids.
Dr. Ayesha Sherzai:
And omega-3 fatty acids are needed on a daily basis for normal brain function. People who are not really cognizant about their consumption of omega-3, whether they're omnivores or plant-based diet, they tend to have difficulties with their cognition if they get older. So it's important for us to be aware of it.
Dr. Ayesha Sherzai:
The rest of the fat, saturated fats and cholesterol, which is the rhetoric that you hear all the time, no, our body creates enough cholesterol to replace those fatty infrastructures in the brain and we don't need it in our diet at all.
Rip Esselstyn:
What about, you always hear this for kids under 2, they need a lot higher fat, more fat for the brain, what are your thoughts on that?
Dr. Ayesha Sherzai:
If you eat a variety of different plant foods, which includes nuts and seeds and avocados, I think that should be enough. Of course, I think it's important for us to be aware of the different quality and quantity of foods that we give to children, but the amount of fat that we actually need is not too much and it should be covered with just including some high fatty plant-based foods.
Dr. Dean Sherzai:
On the paper that we looked at, we actually said that there's trends that say that maybe supplementation would be helpful for developing brains. The human brain, at some point, actually doubles within a year in size, and it's growing massively.
Dr. Dean Sherzai:
So as a precautionary measure, given that there's some evidence, and we looked at the review paper, all the data, there appears to be that we might need some type of supplementation. But as important as that supplementation is this fact: because the path of translation of ALA to DHA is actually a rate-limiting step, if you're getting a lot of saturated fat or omega-6 in your diet, that actually blocks the other pathways.
Dr. Dean Sherzai:
So it's great to focus on supplementation and all that, but the bigger focus should be, look at the amount of omega-6 and saturated fat and processed foods that the children are getting in their diet.
Dr. Dean Sherzai:
In one paper, actually a couple of papers, it showed that, forget about ADHD and ADD for children, some of the children in the Western world who are having a lot of fat in their diet and are a little bit on the obese side or have the pathology associated with it, which is pre-diabetes and diabetes, have white matter disease at age 12.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
We're talking about the kind of white matter that you shouldn't be seeing until you're... Well, you shouldn't be seeing ever, but the average person, she sees it in their 60s. We're seeing it in children.
Dr. Dean Sherzai:
So it's better to focus on a clean plant-based diet. Don't worry about deprivation. There's no evidence of [inaudible 00:47:59] deprivation. If you're worried, take some B12 and omega-3. But also get rid of the saturated fat, which blocks all the pathways that are beneficial in the brain.
Rip Esselstyn:
Yep. That is fascinating.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
That is really fascinating. Let's talk about, so the seven rules. We talked about plans. We talked about avoiding saturated fat. You also have in there, avoid refined carbohydrates.
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
Do you want to talk for a sec about that?
Dr. Ayesha Sherzai:
Of course. I think when you look at the dietary pattern of most Americans, it's just saturated with refined carbohydrates, whether it's the white bread or the white pasta or the white rice-
Dr. Dean Sherzai:
Or sugar.
Dr. Ayesha Sherzai:
... Or sugar, added in everything, even pasta sauces and ketchup and everything is just jam-packed with sugar.
Rip Esselstyn:
[inaudible 00:48:54]
Dr. Ayesha Sherzai:
Yeah. And what happens is, our body is just not used, biologically it's not used to so much refined sugar. It passes through the arteries and it increases the amount of glucose in our circulation rapidly.
Dr. Ayesha Sherzai:
And so the body goes into a frenzy. Our liver, our pancreas, our brain, that goes into a frenzy to try to use as much as they can but then mostly focus on getting rid of it. That's how insulin resistance develops, when you are completely overwhelmed with too much refined sugar.
Dr. Ayesha Sherzai:
I mean, sugar in itself, or the simplest form is glucose, is the best fuel source for our body and for our brain. It's not ketone bodies, it's glucose. That is the best fuel for us. But our brain is very prissy. It's like it doesn't want food right away, it needs to sit down on a beautiful table with a four-course meal and with a silver spoon brought up to it. So in small, little, minute quantities, right?
Dr. Ayesha Sherzai:
And when we eat an unprocessed diet, the unprocessed part of it, the fiber that is in our vegetables and fruits and whole grains, it doesn't allow glucose to be introduced into our body right away. So the body doesn't go into a frenzy.
Dr. Ayesha Sherzai:
It gets its normal amount of glucose, it doesn't lose its mind over so much, and it doesn't go from thrive mode into damage control mode. And that's how you survive and you actually grow instead of get damaged.
Rip Esselstyn:
[inaudible 00:50:31]. I like to say it's like, the whole unprocessed plant-based foods are like the big logs you put in the fire. And then the processed ones, it's like the hay that goes up really quickly.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
Yeah.
Dr. Ayesha Sherzai:
I love that analogy.
Dr. Dean Sherzai:
Yes. Yes.
Dr. Ayesha Sherzai:
I might steal it, Rip.
Rip Esselstyn:
Oh, please do.
Dr. Ayesha Sherzai:
I'll give you credit for it.
Rip Esselstyn:
Please do.
Dr. Ayesha Sherzai:
I'll give you credit. That's awesome.
Rip Esselstyn:
All right. Let's talk about reducing sodium, salt. Why is that important for our brain?
Dr. Ayesha Sherzai:
Oh.
Dr. Dean Sherzai:
Yeah. One of the poisons of the 20th century has been excess salt. Your body needs salt. Sodium is a major part of every cellular function. I mean, sodium and potassium and chloride and magnesium and calcium. Those are the main micronutrients that are important for body function, cellular function, whether it's neuronal cells, muscle cells or any cells.
Dr. Dean Sherzai:
How we create energy in many ways is the sodium-potassium pump that creates this process, so it's important. But when we get too much, it actually creates an entire cascade that, at the one level, raises blood pressure, at the other level also damages the cells.
Dr. Dean Sherzai:
So what we have done is we have increased the amount of sodium so much in our diet for two reasons. Evolutionarily... Let me just step back.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
We are actually trying to cheat evolution. Evolution didn't care about us living past the age of 25, 30. It cared about us reproducing, running away from the tiger, and then dying.
Dr. Dean Sherzai:
What you did in your 40s and 50s was of no concern, so we're cheating the system. And living up to 30, the body could withstand anything, right? You could eat a ton of sugar, a ton of... Well, first of all, you never got access to a ton of sugar.
Dr. Ayesha Sherzai:
Back then, yeah.
Dr. Dean Sherzai:
Where would you get sugar a thousand years ago? So sugar is an external massive source of energy which the body craves, addicted to for survival, not for thriving. Fat is an excess source of energy that the body needs for survival, not thriving. Long-term, they're incredibly damaging.
Dr. Dean Sherzai:
Having that in mind should actually kind of help out, that when you take salt, which is another survival thing, to quickly get salt so that you retain water. I worked at public health in Afghanistan and other countries, and we knew that the one thing that made people survive during these massive infections and diarrhea's was salt and water. It's a survival tool, not a thriving tool.
Dr. Dean Sherzai:
And if we separate that, we realize that salt, the excess amount that we have in our diet, damages the cells, damages the kidneys, increases the blood pressure, which is a major factor for disease long-term.
Dr. Ayesha Sherzai:
Absolutely.
Dr. Dean Sherzai:
So we have to be aware that if you eat natural foods, you don't have to have added salt. In our book we did say, just for taste, which means minimal. But the amount of salt we're getting in our food right now, especially processed food, is going to kill us.
Dr. Ayesha Sherzai:
Enormous.
Rip Esselstyn:
Yeah. I think it's important for people to know that... I think that the minimum we were supposed to get is right around 500 milligrams daily.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
And just by eating potatoes and broccoli and beans, you're going to get between 500 and 750, right?
Dr. Dean Sherzai:
Yes.
Dr. Ayesha Sherzai:
Absolutely.
Dr. Dean Sherzai:
Absolutely.
Dr. Ayesha Sherzai:
We get plenty of sodium by eating just unprocessed foods. And on the contrary, the average American gets about 2,300 milligrams of sodium every day, or actually, it's more than that. And now they're saying that we should reduce it to about 1,500. But you're right, it's actually even less than that, a requirement.
Rip Esselstyn:
Yeah. What about water? How important is water for our brain? Should we be drinking water during the day?
Dr. Dean Sherzai:
So important.
Dr. Ayesha Sherzai:
For multiple reasons. Yeah.
Dr. Dean Sherzai:
For multiple reasons.
Dr. Ayesha Sherzai:
Absolutely.
Dr. Dean Sherzai:
Let's take the cushiony factor, although this has not been studied a great deal. If you hold the brain in your hand, as Ayesha said, it's a gelatinous organ. I mean, just watch, what's the movie? Silence of the Lambs. Well, that has a different...
Dr. Ayesha Sherzai:
No.
Dr. Dean Sherzai:
That took a dark side.
Dr. Ayesha Sherzai:
I would refer people to National Geographic [inaudible 00:54:39].
Dr. Dean Sherzai:
National Geographic. Okay, forget it. Forget it.
Rip Esselstyn:
You like the fava beans. You like the fava beans.
Dr. Dean Sherzai:
Yeah. Fava beans.
Rip Esselstyn:
[inaudible 00:54:43]
Dr. Dean Sherzai:
But it's gelatinous, it's gelatinous, and it's in a bony case which has sharp edges.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
So it's moving all the time. And the fluid covering it as a buffer is not viscous, it's like water, so when it moves, it moves. So realize that and realize the head trauma and all these things, what it can do.
Dr. Dean Sherzai:
Water actually goes up and down, and your cerebrospinal fluid, by how much you drink. So if you are dehydrated, actually the cerebrospinal fluid levels go down as well. So it's important for that.
Dr. Dean Sherzai:
The other thing is, every single molecular process in your body is affected by water as a co-factor. Water is involved in every system of the body as a co-factor, either directly because it's using water in there or as an indirect measure. And as we get older, the amount of water in our body goes lower and lower.
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
So drink water and drink it consciously and be aware of it. By the way, Coke and sodas and things of that nature don't replace water, even coffee and tea don't replace water because they have a diuretic effect.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
And so you pee and urinate more. So be aware to have water by itself as clean, beautiful H2O.
Rip Esselstyn:
Yeah. As we age, why is it reduced? The water.
Dr. Dean Sherzai:
Multiple reasons, one is that our aging cells actually shrink a little bit, they require less water, and our system of diuresis or the kidney and everything else also get rid of water a little bit on the side of elimination. So again, that thing that I said earlier, which is you have to cheat the system.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
The system didn't care about you surviving long-term, and I do, so I'm going to cheat the system.
Rip Esselstyn:
Yes. Yeah.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
And it truly is fascinating how, what... I mean 110, 120 years ago, what was the average lifespan? [crosstalk 00:56:51]
Dr. Ayesha Sherzai:
Oh my gosh. Forties? Yeah.
Dr. Dean Sherzai:
Forties.
Dr. Ayesha Sherzai:
Yeah. Forties for women actually.
Dr. Dean Sherzai:
Yeah. You don't even have to-
Dr. Ayesha Sherzai:
It's like, between thirties and forties for women.
Dr. Dean Sherzai:
Yeah. I worked in Somalia and Afghanistan. In 2002, the average lifespan there was 48. So when people here in Los Angeles say, "Oh, forget about vaccines, forget about this," I'm like, "As a public health person, please come with me and see what infections do."
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
Washing your hands, eating healthy, eating a plant-based diet. Ironically, in a lot of countries, the one saving grace besides the infections that kills people [inaudible 00:57:25], is the fact that it's a plant-based diet.
Dr. Ayesha Sherzai:
Yeah.
Dr. Dean Sherzai:
And you see the beauty of that.
Dr. Ayesha Sherzai:
You do. Yeah. And certain villages when you go, especially in India, all their lives they've probably just ate beans and whole grain bread and rice and they don't have diabetes, they don't have high cholesterol, they don't have high blood pressure, and they live a long, long life.
Dr. Ayesha Sherzai:
And usually in those countries, the environmental diseases are related to accidents and things of that nature, it's nothing like what we see here where cardiovascular disease, diabetes, high blood pressure, high cholesterol is the leading cause of death.
Rip Esselstyn:
Yeah. Yeah. Yeah, but now you look at it, you look now and what's the average life expectancy? Somewhere in the 80s? 78, 80, something [inaudible 00:58:10].
Dr. Ayesha Sherzai:
Right.
Dr. Dean Sherzai:
Yeah. Yeah.
Rip Esselstyn:
It's almost double. And I'm wondering, are we going to double again over the next 30, 40, 50 years due to technology, whatever.
Dr. Ayesha Sherzai:
Yeah. I hope so. I hope so. I'm looking forward... I'd like to live a long life.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
Well, okay. I want to have a whole nother conversation with you about that.
Dr. Dean Sherzai:
Yes.
Rip Esselstyn:
So the last rule you have is to eat homemade meals.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
Which, to me, dovetails perfectly into the whole beautiful [inaudible 00:58:40] section. That is incredible, truly.
Dr. Ayesha Sherzai:
Thank you.
Rip Esselstyn:
I went through there and I highlighted some sweet potato, oat pancake; zucchini, chickpea savory pancakes.
Dr. Ayesha Sherzai:
Oof.
Rip Esselstyn:
The Totally Possible burger. [inaudible 00:58:56]
Dr. Ayesha Sherzai:
It was a spin. Yeah. Yeah.
Rip Esselstyn:
That was a great spin. The spicy cauli-tofu bowl, I love tofu and cauliflower. Thai tempeh green curry, I love curry. Farro, what an amazing whole grain that most people haven't used is farro.
Dr. Ayesha Sherzai:
Isn't it? Yeah.
Rip Esselstyn:
It's like a wonderful hefty rice. Tempeh bowl, I love tempeh. Plantastic neuroplastic meatballs. I mean, who thought of that title?
Dr. Ayesha Sherzai:
That was Dean and I after a cup of coffee. We were on fire.
Dr. Dean Sherzai:
We have these whiteboards everywhere. As you know, our house is a whiteboard.
Rip Esselstyn:
Yeah.
Dr. Dean Sherzai:
It was one of those whiteboard sessions. Yeah.
Rip Esselstyn:
Nice. And cortical cauliflower with walnuts. I had to look up what cortical was.
Dr. Ayesha Sherzai:
Yeah. Well, we wanted to...
Rip Esselstyn:
Part of the brain.
Dr. Dean Sherzai:
Yes.
Dr. Ayesha Sherzai:
Yeah. Yeah.
Dr. Dean Sherzai:
Yes, yes, yes.
Dr. Ayesha Sherzai:
We wanted to make it fun.
Rip Esselstyn:
Yeah. And then south of the border salad and your berry nice cream cake, that is the cover of the book. I only have a PDF version.
Dr. Ayesha Sherzai:
Yes.
Rip Esselstyn:
Do you guys have it there? Can you show it?
Dr. Ayesha Sherzai:
Actually, we don't. It's on its way, and we're going to send you-
Dr. Dean Sherzai:
This week.
Rip Esselstyn:
Oh, really? Okay.
Dr. Ayesha Sherzai:
... A copy of it, the beautiful final version of it. Pandemic has slowed down some of the things, but now we're really excited about that. And the reason we put that on the cover, Rip, we had a lot of back and forth and they said, "I think it's important for people to kind of get that shock factor, to see that a plant-based diet can be so beautiful and it can be so scrumptious."
Dr. Ayesha Sherzai:
So instead of choosing something that we eat on a daily basis, we just put that cake on the cover to say that-
Rip Esselstyn:
I know.
Dr. Ayesha Sherzai:
... "This cake is good for your brain."
Dr. Dean Sherzai:
Yeah. And the communities that we deal with, we work in the communities, our studies are in the communities, and we see dementia and stroke in people in their 40s and 50s. If they feel a sense of deprivation, no amount of fear is going to change people if there is not a sense of gain.
Dr. Dean Sherzai:
We wanted to make sure that people get the sense out of this book that you're not going to be deprived. And there was a lot of pushback to us and people saying, "Oh, look, you're promoting cakes." I said, "No, no, I want to make sure people realize that you can have tasty, healthy foods."
Dr. Ayesha Sherzai:
Yeah. And that cake, by the way, is made of whole foods. It's berries, it's bananas, it's walnuts.
Rip Esselstyn:
Yeah.
Dr. Ayesha Sherzai:
It's just a good testament of how beautiful a whole food plant-based diet can be.
Rip Esselstyn:
Well, and it's obvious to me in flipping through the book that this was such a family affair, and how you guys, you walk, you run. I mean, you guys embody this lifestyle, right? Every member; Alex, Sophie, who you've dedicated the book to in such a beautiful, beautiful way.
Dr. Ayesha Sherzai:
Thank you.
Rip Esselstyn:
But it is outstanding. I'm going to actually take a break right now.
Dr. Dean Sherzai:
Yeah, of course.
Rip Esselstyn:
Because we're at 55 minutes.
Dr. Ayesha Sherzai:
Yeah.
Rip Esselstyn:
The information is so insane that I realized, okay, we got to go over, we got to go over. I'm trying to think of the best way to pack this out right now. Why don't I just say, what's exciting for you guys?
Dr. Dean Sherzai:
Yeah.
Rip Esselstyn:
And then you guys will talk about the nonprofit and whatever else you want to.
Dr. Ayesha Sherzai:
Sure.
Rip Esselstyn:
And then we'll wind it down.
Dr. Ayesha Sherzai:
Sounds great.
Rip Esselstyn:
Okay. All right. So Dean and Ayesha, I can't recommend the book enough. I think it truly is a masterpiece. It is a life plan, it is the future of health, and I want you to know how proud I am of what you guys have done here. And I can't imagine how you're doing it with everything else you have going on in your lives, crazy.
Dr. Ayesha Sherzai:
Thank you.
Rip Esselstyn:
So speaking of that, what are some of the exciting things that you guys have going on right now that you'd like to share with the PLANTSTRONG audience?
Dr. Ayesha Sherzai:
Thank you so much, Rip. Yeah.
Dr. Dean Sherzai:
Yeah. Thank you so much. We are excited and we're working hard because it's not work, it's that optimize that we were talking about. I think we've engineered our life to serve our purpose, and our purpose is service, and our purpose is to help people that we see suffering around us, our purpose is to help the planet, our purpose is to connect to like-minded people like you and others who want to change the world, because it is a beautiful place.
Dr. Dean Sherzai:
We live in a gorgeous place on the beach, and every day we walk by the beach and we say how blessed we all are as human beings yet we forget that moment that we can do so much. So with that, our purpose is to make a difference. And one of the things we do is around our life, which is the science of the brain, lifestyle and nutrition.
Dr. Dean Sherzai:
And we realized that what we were doing in the clinic, and we still do; in a way, the clinic work is selfish because we love that personal connection, but it's not as effective as what we do in the communities.
Dr. Dean Sherzai:
We were the first people to actually, that clinical research in brain at the community level. In fact, even now there are studies out there that are still doing the... They give people some food and then they bring them to the lab and so on and so forth.
Dr. Dean Sherzai:
We actually are changing communities one community at a time, measuring the cognitive state before and after, following their lifestyle changes, bringing in coaches and making a difference. And it's been absolutely remarkable. We have a not-for-profit called healthymindsinitiative.org. And its entire purpose, in fact, even beyond that, everything we make, the book is dedicated to this, the profits from the book, our life, our work at Loma Linda is dedicated to building this very innovative model of brain health in all the communities, not just in the U.S. but abroad.
Dr. Dean Sherzai:
With a lifestyle orientation, where people can bring it, not in an artificial way, but into their life. And if we have changed people's lives by 10%, that's more effective than most public health systems in the countries. So we're privileged to do this, Ayesha and I, with you, your father, others are out there.
Dr. Dean Sherzai:
There is no controversy. We're all doing the same thing. There is no controversy. The little nicks and nacks here and there is not a controversy. It's the fact that massive movements are trying to make people healthier is at the core what we are about.
Dr. Dean Sherzai:
And that's why we love you, we love your dad, we love everybody in this world that are trying to move us toward a more plant-based orientation, toward a more community-based orientation. Not that we don't like the clinics, but it's time to move a little more towards the community.
Rip Esselstyn:
Yeah. Where can people find you guys on Instagram and stuff like that?
Dr. Ayesha Sherzai:
We are Sherzai MD on Instagram, Twitter, and Facebook.
Rip Esselstyn:
Will you spell Sherzai for people who don't know how to spell it?
Dr. Ayesha Sherzai:
Sure. It's S-H-E-R-Z-A-I M-D on social media. And our website is teamsherzai.com, so T-E-A-M and then our last name Sherzai, S-H-E-R-Z-A-I dot com. And we'd be happy to connect with anyone. And if people want to learn more about our efforts in the community, the website is healthymindsinitiative.org.
Dr. Dean Sherzai:
And with the book, one amazing thing that we've added to it is because we want to take a group of people for a month forward, those people who sign up get the book early. Although it's actually on our system, so you really don't have to get the book, but we would like for you to get it.
Dr. Dean Sherzai:
They actually get brought into a closed group where on a daily basis we take them through this process. We have amazing nutritionists there. We have a Harvard-trained sleep doctor that helps with sleep. We have an Oxford-trained stress management doctor that helps with stress.
Dr. Dean Sherzai:
So they're going to go through a month, and hopefully at the end of this month they're going to be left with the tools necessary, not the end product, to take that journey forward themselves.
Rip Esselstyn:
That's beautiful. Wow. You guys are giving back in such a beautiful, strong way. Thank you for that. I'm going to put you guys on the spot here before we close up shop, all right, and that is this. I'm going to start with you Dean and then you Ayesha. So what do you love most about your wife?
Dr. Dean Sherzai:
Very easy. What I love most about her is, it's not like we don't fight, we don't argue, but it's such an important thing. What I love most about her is her purpose-driven life. That's the first conversation we had. And it's the conversation we have every day.
Dr. Dean Sherzai:
And it's that fact that her entire life is to help reduce suffering and my entire life is about helping reduce suffering, and our children's life is about helping reduce suffering. There is no question that that's the... Well, she's beautiful, she's talented. I don't know how the hell she picked me.
Rip Esselstyn:
And amazing brain.
Dr. Dean Sherzai:
Everything.
Dr. Ayesha Sherzai:
Exactly.
Dr. Dean Sherzai:
Singing, you name it.
Dr. Ayesha Sherzai:
[inaudible 01:08:22]
Dr. Dean Sherzai:
But it's purpose, our purpose and her purpose when we had the first conversation, to help reduce suffering.
Dr. Ayesha Sherzai:
Did you mean to make us cry at the end? Is that what you do to your guests?
Rip Esselstyn:
No, no, no, but you had me crying now too. What about you Ayesha?
Dr. Ayesha Sherzai:
Oh my goodness. Dean is the true north for me, from day one when we first met. And we've lived a very unusual, fearless life. I met him at a party where he was sitting around with men and I was with Doctors Without Borders in a refugee camp working as a volunteer and he was there as well.
Dr. Ayesha Sherzai:
And this was back in the early 2000s when things were kind of unstable. And he's standing there and I hear this loud man, I'm like, "Who is that? Who is yelling at the top of his voice?" And I go in there and Dean is standing there in front of all these men and he's arguing for women's right. And he's trying to push a project that was meant to train women to become community leaders and healthcare providers in their communities.
Dr. Ayesha Sherzai:
And he's been like that all his life, always fighting for what is right, even when he was all by himself, and I think that's the most beautiful thing about this man. And I'm so privileged to be with him.
Rip Esselstyn:
We are lucky. We are lucky to have you two on the planet. Wow. Wow.
Dr. Ayesha Sherzai:
The privilege is mine.
Rip Esselstyn:
Thank you so much for being a part of Season 3 of the PLANTSTRONG Podcast. Thank you for your service and thank you for your commitment to preventing Alzheimer's.
Dr. Ayesha Sherzai:
We love you so much, Rip.
Dr. Dean Sherzai:
We love you.
Dr. Ayesha Sherzai:
We've always loved you, we've loved Esse and Anne and Jane and your entire family. Thank you for all the fantastic things you're doing for the world.
Rip Esselstyn:
Love you guys too, thank you.
Dr. Dean Sherzai:
Thank you.
Rip Esselstyn:
Okay. My goal was not to bring Dean and Ayesha to tears, but I think it's clear the depth of their service is as deep as their love and shared purpose as a couple. Team Sherzai are a beacon of light in the world of medicine and brain health. And they have devoted their careers to exploring the prevention of Alzheimer's and other neurodegenerative diseases.
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