How to Be Smarter: quantitative EEG, neurofeedback, meditation, & nutrition with Andrew Hill, PhD

my name is andrew hill i have a phd in cognitive neuroscience from ucla and cognuro is sort of this intersection of mind and brain and a cognitive neuroscientist generally will try to figure out the the base science the core science how does the brain produce things about experience attention sleep stress learning i'm kind of an unusual cognitive neuroscientist because i took my training and flipped it back into the clinical world or the practical world before my phd i studied i worked a lot in human services in uh crisis work with acute psychiatric populations i'm not too far from you i worked at a autism center for a few years in providence i've done all kinds of work across addiction aging all you know pretty much every type of human suffering and i worked for a long time at the really serious edge cases of human suffering acute psychiatric multiple diagnoses i ran a group home for adults that had no language were multiple disabled physically disabled et cetera and just saw people at the edge of their you know peopleness so to speak when their cognition declined both acutely developmentally from drugs and alcohol and i had been working in human services for about 20 years when i got to work in this autism center in providence and suddenly was seeing things i didn't think were possible seeing adhd and autism and seizures and migraines and ocd and ptsd get alleviated like in a few weeks or a couple of months and this was sort of counter to what i experienced working historically in the health and human service field and so this provoked me to go back and get a phd studying this stuff this brain mind stuff but then instead of going to the academic route i decided to become an entrepreneur and i framed the work that i do kind of like personal training you know i'm a phd cognitive neuroscientist but my job is to be your educator your coach or scientist and to help you become your own neuroscientist so you can take control of this stuff up here i think a lot of times in interpersonal psychiatric work we're often trying to help the therapist or clinician develop the access and agency that the the or the perspective at least of your client that's part of the therapeutic process that's hard it's always been a achilles heel of neurofeedbackers to sort of have to understand what's happening in the head of the client they're working with especially between office visits and so instead of trying to close that loop as a really really good therapist i decided to close the loop by becoming um a sort of neuroscientist that transfers the appropriate neuroscience to you so if you have adhd or seizures or migraines or ptsd i can show it to your brain probably and then once you see that it's your brain the stigma can go away and for me this was such a powerful thing that i doubled down on it you know if i can show someone with ptsd that the back midline of their brain is stuck in a threat assessment mode it stops being something mysterious and out of their control and yeah ptsd is really uncomfortable and gets in the way all over the place but so does a low back that's spasmed up right those low back muscles are there to protect you and they spasm up when your spine is challenged the same thing happens to the posterior cingulate when the world isn't safe or predictable it clenches up in beta waves you see this little hot beta in the back midline and so if you can show someone in their brain and go hey it looks like you're a posterior cingulate kind of hot are you a little bit like ruminating threat assessing you're kind of like stuck in a high oh you are okay do you care about it oh you do all right you want to work you want to relax that resource pretty easy and the lovely thing that i found is if you take these sort of like extra active things that are potentially both good and bad like focus like threat assessment like attention switching gears like novelty seeking adhd stuff if you train people's brains you give them control over the stuff they like like the ocd person can put down the ocd when they feel like it or pick it up whenever they want to be a ceo and hyper focus and hold all the things in their mind at once but they don't have to anymore so i saw this stuff start to first impact people with severe brain issues major autism developmental issues seizures and then i moved out into more you know broad brains and these days um peak brain about a third of our clients are the sort of high level performers you know ben greenfield athletes executives people are trying to squeeze every little bit of performance out and we're just one more tool they're using and then about a third of that old classic population people with autism seizures migraines severe brain injuries et cetera et cetera and then there's all the rest of us who have some sleep some stress some attention maybe we drink too much maybe we smoked much weed you know maybe we're stressed out maybe some old trauma maybe we you know have some apnea and those things all take the brain's performance out like really quickly so half the people i look at i'm like oh hey look some slowed processing and you aren't getting good deep sleep and i could almost do that you know for everyone without looking at their brain because most westerners don't have good regulation of those things but this becomes a tool set to essentially steer the the direction of your brain your cognition does change your stress your sleep your mood your attention these things are regulatory resources and most of them are there to be relatively stable and to keep flexing as you stretch them and come back and support you but some of those resources especially when you get into mental health issues become less flexible less regulated you know like the posterior cingulate everyone has one probably or most people have one and you use it i bet you used it today when you were driving in you know wherever you were coming into uh well maybe aren't driving anywhere right now but in theory this is a very familiar experience you're driving you look at the floor for a second or your phone not that you would do this but if you did then you're like watch the road and you kind of have this orienting experience or someone says hey nick heads up and you like look up and catch the frisbee you know get smacked in the head that's your posterior cingulate it's orienting you to the safe behavior you have to engage in right now and what's changing we all need one if you didn't have one you wouldn't be very effective at keeping yourself safe or healthy but when it ramps up and gets stuck in a high gear then it becomes a little uncomfortable but we're so blind to these things in our head that i think people suffer from individual circuits you know visual system isn't shutting down with your eyes closed hyper vigilance posterior cingulate rumination anterior cingulate perseveration like a ocd ceo brain that gets hyper focused trust songs overhead eyes open slow brain waves inattention executive functions sluggish processing becomes things like speed of processing so you look young for this nick but probably in your 40s and 50s if your sleep isn't ideal you'll tank your speed of processing you'll suddenly think you're having memory issues because you can't find words it's not a memory thing actually it's a speed of processing but often when your sleep gets sub-optimal the first thing that goes is your slow of sleep slows down your speed of processing so again this i'm jumping around a little bit but all of this illustrates the idea that you can look at your brain just like you might want to look at your you know lipid panel or your c-reactive protein or your you know cholesterol levels or as you hit 40 50 60 years old your psa for guys like us to make sure they stay nice and low we don't develop any you know hyperplasias or anything these are all useful bits of information and i think we have an opportunity to uh you know not just an opportunity a responsibility to some extent to take care of it the same way you would probably not drink all the sugar and smoke all the weed and drink all the alcohol and you know give yourself a heart attack you have the same responsibility for your cognitive function your emotional function your learning your resilience these are resources you have them built in they're not as obvious as like you're belly fat but they're as risky maybe more so now the good news is you can get control of your executive function or your trauma or your sleep issue generally a whole lot faster than you can get abs so it's a it's a much more changeable system above your you know in your brain and the whole system is designed to change so it's once you can apply the right pressure you generally can get um in the sort of change you're looking for in these gross resources yeah i think it's really valuable what you spoke about particularly in you know being able to measure or being able to see you know different areas in our brain and understand uh where there may be changes in functioning and how that may relate to different symptoms that people are recognizing and how that can impact stigma um because it you know i think a lot of people growing up you hear about mental illnesses you hear about things like uh depression ptsd or ocd and you you you think that you know somebody is either overreacting or just sort of that's some sort of personal flaw but that by by having sort of greater understanding of the biological basis behind what we're experiencing we can you know attack it just like any other you know physical ailment of the body yeah i mean you would you wouldn't be guilty or you wouldn't be angry at your shoulder for hurting and then you went to the doctor and cut an x-ray oh well separated shoulder you probably wouldn't have been cursing it for the previous three weeks why is my damn shoulder hurting you might be angry at or frustrated but you wouldn't feel like guilty oh it's my fault my shoulder hurts oh my gosh i shouldn't i shouldn't talk about this i shouldn't you know no it's your shoulder go look at it oh here's the thing let's address it with some range of motion some you know cold whatever you can do the same thing for a lot of the things that we think of as cognitive or mental health thing a lot pretty much every category of anxiety is not a disease process it's a natural resource that gotten stuck every aspect of executive function unless it's like big injuries or you know uh sort of progressive illness most things for executive function um aging based things adhd uh being stressed and having your attention change those are regulatory feature features that switch just like your strength your you know your alertness and you can train them just like you can train your strength so i'm here to tell you that you don't have to suffer with your ptsd your ocd your adhd these things are largely tractable for most people i mean i do with adhd i do uh generally about 40 or 50 sessions of neurofeedback which takes about three to four months and when people come in with adhd on assessments they come up at like two to three standard deviations off the bell curve like the wrong side of the of the mean and i do about 40 sessions of training and they end up changing by four standard deviations on average and now they're above the mean by the same amount they were when they started ie you eliminate the problem and it's a permanent change right now not everything's permanent neurofeedback because the things that are permanent sort of the things you're doing every day once you tune them they stay tuned but if i was working schizophrenia or something and you stopped coming in it would probably just come back because you're you're working to slow it down more than really offset the core disease process there um but again you know you wouldn't be uh dismayed or you wouldn't just give up about your like bizarre knee pain that's making you limp you'd go get it checked out you know you go get it addressed and it would be really annoying and it would probably have some arthroscopic surgery and some healing time and some recovery but six months from now you're back on the field running or riding the bike or whatever i mean we have that capacity with our brains you don't have to get old in terms of mental stuff there's no decline that's necessary for the brain yes you lose some speed of processing yes you lose some brain tissue on average but it's not very much it's like a half a percent per year or something after age 62 and that's if you don't do things like meditate you know have other healthy habits that keep the brain tissue fat and happy and plastic like challenging yourself like fasting like having good muscle mass and doing resistance training you know getting good deep sleep stitched together these things all help the brain stay really quite fat and happy you definitely want a fat brain a thin brain is not a good thing it thins out throughout your life once you hit like 15 above it starts to thin out a little bit which is not ideal i think generally the average human in the west uh the the lateral side the tempo of the temporal frontal lobe called the insula um will thin out by about 15 or 20 percent the time you're in your mid-60s and that's the area of the brain involved with body awareness feeding self you know a bunch of other stuff is why elders aren't aware of their appetite and their balance and things because the insulin is uh atrophying essentially unless you're a meditator if you meditate um essentially 20 minutes 20 minutes a day the amount of years you've been meditating is completely correlated with how much spared tissue you have you can start at any age so 20 minutes of meditation will sort of sidestep natural cognitive decline that comes with aging you can also offset things that are you know problematic as well like injuries like adhd um so we have a lot of tools we just don't have a lot of understanding necessarily about where the levers are to pull to pull that you know system around right i would love to kind of stay down this path actually around cognitive decline in aging it's something that's really interesting to me myself uh so you've mentioned meditation as being something that can help to curb this uh and i've been reading a lot about sort of different dietary components different you know components of exercise for uh for um kind of staving off this natural decline in atrophy that can happen but i'd be curious you know what you think are some of the major levers that can be pulled to help to prevent cognitive decline in aging so there's a few um and i don't really have a good sense of which is like first like what's the most important i do think there's a few things that if you keep them maintained you're likely to sail through the rest of your life without too much trouble and if you don't take care of them you're only likely to survive if you're damn lucky gene wise the biggest one of those things is blood sugar almost all diseases of aging are essentially diseases of oxidation so diabetes cancer dementias parkinsonian cluster things including lead body dementias those are all driven by oxidation of tissue um i.e glycation or rusting of cellular tissue with oxidation of sugar and this is true of alzheimer's where the amyloid plaques are glycated and they rip to the brain faster lewy bodies become glycated parkinsonian processes can become you know rusted tissue that accelerate and even things like atherosclerosis you know not brain aging but body aging same process oxidation of tissue so you can work through this profoundly well even if you're already middle-aged old diabetic whatever you it looks like we can back this stuff out really effectively a lot of the information we're having to sort of watch to know if you're trending towards or away from better metabolic health will be around blood sugar and so we understand blood sugar pretty well i've been getting into measuring ketones because the ratio of blood glucose to ketones so having low-ish blood glucose is good high-ish blood glucose is bad theoretically but only chronically like you're supposed to have some high blood sugar and some low blood sugar and manage it pretty well but if it goes up and stays up that's when illness and death happens pretty much anything in the body that regulates when it stops regulating that's when you have big problems with cortisol supposed to oscillate if it goes up and stays up hippocampus dies or atrophies you end up depressed that's pretty much the process for depression increased stress shutting down hippocampal plasticity it's a the stress driven depression process um but we have essentially uh the ability to control a lot of this stuff if you keep your again your glucose down and your ketones up the gki the glucose to ketone index appears to be a lovely indicator of a bunch of things now if you're making some good ketones you're burning adipose you're you're burning your fat pretty good means you aren't burning sugar you know but the body can't do both at once so you have to kind of trick it to go back and forth and back and forth and get better and better at doing both and that's really a metabolically flexible state but as you're re-regulating this stuff you want to really try to get maximum ketones and low glucose and as that ratio goes up of um essentially higher ketones to glucose you will first get into a weight loss fat loss kind of stage of the ketones start to come up and then eventually you're into an autophagy stage where you're cleaning out dead cells and tissues and um then you're into like an anti-cancer stage which again it cancers a metabolic disorder that is sort of driven by glycation and aging a bunch of other stuff and there's many cancers of course but they're all kind of driven by metabolism being a little out of whack and you can back this out and pull the teeth of the big drivers of cancer i mean we all have some cancerous cells i mean it's kind of scary to think about but you and i are walking around with some proportion of pre-cancerous cells all the time and the trick here is to get the body to clean them up before they manage to edit out the p50 tumor suppressor gene and during the cancer and and other things they do to turn into cancer the body has all kinds of processes to help this including the autophagy stuff for cleaning up cells that are over proliferating and it doesn't do this if you're eating sugar three times a day or anything three times a day so you need time to clear the body out of this digest and and burn fuel mode and then it shifts over into what's called autophagy or clean up the garbage mode and you really i think can get a huge amount out of allowing your body to clean itself up there's lots of ways to do this and how you would do this in terms of fasting or minimizing food would be very much driven by your goals for fasting and for making changes here and for where you start you know if you're a 350 pound guy who's 40 body fat you basically don't need to eat and you just have salt and water and coffee for like forever pretty much until you want to be but if you're somebody who's got really unstable blood sugar hypoglycemic who's all up and down and you've never fasted before you're a standard westerner who eats every three hours and gets ravenously hungry two and a half hours in you've got problems with your insulin and you should probably start to you know be aware of that and the first thing i recommend is you can press the feeding window and just eat within like an eight hour or ten hour window and then i think that for aging for sugar there's a lot of this stuff will tap into circadian regulation and so i like to frame the rules around eating in ways that maximize circadian signaling so i have three big rules for keeping your circadian rhythm tight keeping your sleep good keeping your autophagy happening when you want to happen and allowing you enough other time frames we can layer in other things so this big three rules for circadian regulation are don't eat before bed you know fast for three to four hours before bed water is fine herbal tea is fine if you need a flavor or a ritual but i recommend against eating anything for three to four hours before bed let your insulin drop all the way um people often are like oh that's hard until i tell them the reason and then like oh okay i'll do that the reason is if you go to bed with insulin high at all you don't get any growth hormone released when you're asleep now i think all hormones in the human body are pulsatile meaning they're released all at once every so often and then the body uses it because if it was constant levels of hormones we would we would get tolerance we wouldn't actually have signaling so humans will have a giant pulse of growth hormone about two to a half hours after they fall asleep until you're about 35 or 40 years old and then it's a little tiny pulse a little tiny one and there's little like pulses throughout the day if you're younger but after you're 35 or 40 the only thing you're getting is one little tiny pulse of growth hormone in the middle of your night if you have low insulin and you can actually get into deep sleep if you don't have low insulin cortisol stays up insulin stays up and you don't get into that deep sleep mode so eating so the rule of thumb is go to bed hungry wake up refreshed and feeling full go to bed full wake up hungry and tired you know you're really messing with that those regulatory and counterregulatory hormones for energy throughout the night if you go to bed with food in your stomach so first roll fast before bed second rule get at the same time every day i don't care when you go to bed evening light is not that exciting for circadian screens are not that exciting for circadian blue light not that exciting i don't care about it at all unless you're not unless you're doing everything else and then you want to dial more things in but the morning light is is the light that matters there's a set of structures on top of the optic uh the place the optic nerves cross behind the eyes is called the optic chi or chiasm the x the glitter kai and the optic chiasm has a nucleus a little structure on top of it sits right on top of the x called the suprachiasmatic nucleus and the scn its job is to watch the temperature of light hitting your retina and say oh it's this time of day and the scn then synchronizes all of the other clocks in the brain the body in a cascade so you don't need the scn the suprachiasmatic nucleus to be pinged every morning to stay roughly in shape with time but you do need it sometimes or you will slide past the earth's daylight cycle and weird things happen then so that light the color of uh sunshine that's in the air even through clouds first thing in the morning is only there for the first hour or so and then the sun's higher in the sky and you get more of that color reflected back into space so i recommend people picking a time they can get up seven days a week that's the same roughly and that time should be no later than one hour after sunrise so of course today's daylight savings time we just you know pulled back an hour so right now uh i'm not sure where you are but where i am sunrise is about 6 15 in the morning which means i would recommend everyone get up by 7 a.m absolute latest this time of year seven days a week and you know i have parents being like my kids until three in the morning and playing video games it doesn't matter i don't care get them up at 6 30 every single day and after a few days the evening takes care of itself i mean it really does yeah and then the third rule exercise in the morning before you eat sometimes we're built to like leave the the cave in the jungle and hunt for jungle chickens and like you know expend energy before we receive it we're built that way so sometimes it doesn't be a big workout your big bodybuilder you probably want to you know work out fed instead of fasted but definitely do some stretching take the dog for a walk do some sun salutations just get your heart rate moving a little bit in those first few hours so when you put all these rules together what it looks like is you're not eating first thing in the morning you're riding your cortisol and your exercise not eating late at night you're letting your insulin clear in the middle of the day you're eating a couple meals and you're not snacking you don't want to keep your insulin pushed up the way that we thought in the 70s we had to have start every three hours it is it's it's really a big deal it's a problem for most westerners that's why we are the fattest country very much out there for a modern country have the most diabetes the most cancer the most alzheimer's you know they don't have alzheimer's in japan pretty much they have another form of dementia called uh vascular dementia because they have problems with too much sodium and salt and vascular pressure stuff in their diet but there's almost no alzheimer's relative to the population in japan because it's driven by the type of starches and other things that are problematic in this country we have an epidemic of the alzheimer's style dimensions i.e the type 3 diabetes um which again is tractable there's some good work by dale uh yep um who the recode program um he i used to teach this stuff when i taught gerontology ucla it's about 37 factors in the brain sorry in the body metabolic factors that if a handful of them seem to get out of whack things like hormones c-reactor protein oxidation things you know methionine lithium imbalance when a handful of things can get out of whack it looks like the brain flips over into a mode where it's heavily immune uh sort of like angry and it's ready to fight anything in the in the brain because under these stressful conditions high starch and stressful conditions we evolve like in papua new guinea they all eat starch the historical papua new guineans ali tubers you know potatoes basically as their main source of fuel and they all have ap apoe44 status meaning they're easily oxidizing fats if they have any starch so if you were a western in the us you had apv4 for eating this much starch you get diabetes and or atherosclerosis and or alzheimer's period you just oxidize the tissue but nobody in papua new guinea has this problem the traditional diet people because they are exposed to microbially dirty environments the jungles are dangerous to the brain so all these microbes get in and the amyloid is an immune molecule and it fights out it fights the uh the microbes and keeps them healthy so in papua new guinea and jungle people will live longer than americans will with a high starch diet dramatically longer because they're actually using the amyloid as an innate immune function and um dr rosetten found that essentially he theorized that essentially amyloid's precursor app amoled precursor protein would cleave in a couple different directions of amyloid and one of those amyloids makes the brain synaptoblastic it builds more synapses like you have osteoblasts in your tissue that build more bone density your osteoclasts to consume it this is dynamic regulatory tissue in the bones same thing for synaptic density so it looks like alzheimer's type 2 diabetes metabolic damage etc produces this long slow metabolic adjustment trying to handle stress oxidation other dangerous things and the brain strips out synapses because of it we lose you know tissue we lose memories and in our 40s and 50s and 60s usually much later we actually have significant problems now evolutionarily it doesn't matter if it's up in our 60s who cares according to the brain that's not a caretaker role in the 60s and 70s doesn't matter nearly as much but for quality of life as a modern human matter is a big deal so literally most people are pre-diabetic in the u.s even if you're skinny if you're eating sugar if you're eating carbs three four times a day if you cannot go a full day without eating without feeling clear without feeling rested if you if you cannot deal without food you have a problem with your insulin basically and many people many people in the us will just eat every three hours for decades and just gradually put on more and more adipose gradually oxidized tissue never spend any time throughout the day or even year cleaning up all the crappy tissue that's been building up inefficiently all the oxidized stuff because you're never going into an autophagy state you're never letting things clear so all religions all spiritual practices have fasting built into them pretty much there's a reason for that you know most religions the rules they give you are because the world they lived in if you didn't follow the rules you died like all the rules for food preparation and judaism were about keeping the kitchens from having cross contaminants so you didn't get sick you know and fasting be it ramadan or be it lent there's a reason for it it helps your body be healthier dramatically healthier so we have the machinery to fast as well as we have the machinery to eat if you haven't fasted you might be leaving one whole set of tools off your um off your plate that will no pun intended here that will really actually make a huge difference in your performance i mean i'm i'm 97 years old look at me you know so yeah you know i think when i think about you know who's listening to the show i i think about people back home in my small town community in the midwest and then people that are my medical peers here on the east coast and i think when they hear about uh ketones or the key to the the ketone uh diet or ketogenic diet um you know they're thinking about just eating fat and that it's sort of this this fad diet where you're eating sort of fried balls of philadelphia cheese and bacon every day and you know and and so they have their medical questions about that um people in the midwest maybe you haven't heard about it so much or again they think it's some fad diet but then also uh thinking about fasting and uh intermittent fasting also sort of see seeming like it's this this fad diet and and you know in the hospital setting when we see people uh who aren't eating or who have ketones in their urine you know we're worried about things like diabetic ketoacidosis and like a type 1 diabetic where really the the risk that's posed that's posed to them is not from their ketones being elevated but rather from hypoglycemia in somebody with type one diabetes um you know which you can die from from low blood sugar but in a normal human being without type 1 diabetes or somebody who has signs of metabolic disease things like diabetes hypertension or cholesterol issues you know there there there are likely a lot of benefits to things like ketones and there's different ways to to arrive at getting into that ketotic state which you sort of started to mention um but i think you know thinking about sort of a a lay audience um just breaking this down a little bit more you know how do how do you think you know a lay audience can can begin to sort of understand uh uh ketones as a um as an energy source for the brain and how to approach this you know in a healthy and sustainable way sure so um you are a you know 30 to 40 year old guy relative good shape you're carrying around 125 to 150 000 calories in fat maybe you're really in shape i can't tell maybe it's only 100 000 calories you're carrying around with fat um we were built to go extended periods of time without food we did not have refrigerators we didn't have you know food we could get we had to hunt it we had to carry around we starved we fat we feasted we famined um keto acidosis high amounts of ketones because your body is freaking out and dumping all of your uh adipose into fuel basically is an extremely high level of ketones and you're right maybe not that dangerous in fact ketones uh nutritionally enhance ketosis creating ketones yourself out of your fat is profoundly good anti-cancer anti-aging it has it causes muscle oddly enough ketones cause muscle growth since the synthesis they actually turn on mtor and the muscles you know ketones uh prevent mtor which is a proliferation uh signal to it's a it's a fuel sensor based on the brain emptor senses protein or in the body android sensors protein insulin senses glucose or sugar basically so if eat protein mtor goes up if you eat carbohydrates you get insulin responses these things will go back and forth to create more protein based metabolism or sugar based metabolism if you will you literally can simply pull back a little bit on your eating window and drop the carbohydrates people think of keto diets as these fat heavy diets and they can be but they don't have to be i mean and the fact they shouldn't be if you're doing for weight loss you're doing it for like athletic performance then yeah if you're like a serious high level cyclist or weight lifter you should be eating a lot of fat because you need the damn fuel but if you're somebody who's like 30 40 50 100 pounds overweight your keto diet should not be a fat heavy diet it should be a moderate protein high leafy greens diet because you're carrying around plenty of fat you you're you're walking around with keto stores you don't need to supplement dietary fat if you've got plenty of excess fat so essentially the lipo um what's it called you burn your lip your lipids i forget you you release your thank you lipolysis you release your um stored adipose into triglycerides and or you take dietary fat triglycerides i.e fats in solution the bloodstream and triglycerides are three uh essentially fat molecules fatty acids with a glycerol a little glycerin backbone and the body will take triglycerides out of fat and or out of the diet and it will cleave the backbone off of it and i have three free fatty acids floating around the bloodstream and these guys can be burned as fuel which is awesome body the brain can now make fuel out of your stored fuel or your body can um however the brain really prefers glucose and while you can burn ketones it doesn't like to do so very well so the body's really cool it takes that triglyceride and it takes three of those glycerol backbones and turns it into glucose the liver gluconeogenesis takes fat turns it into glucose or protein if you're eating it and turns it into glucose just enough not very much but enough to provide the brain with a sort of uninterrupted very very low key stream of glucose and so you can have a steady stream of blood glucose to your brain sufficient to provide no you know no hypoglycemia once you've adapted keto adapted and there's a difference between producing ketones through nutritional means either through eating lots of fat and not much carb or lots of protein and much carb you'll eventually produce good ketones out of the food and or nutritional keto sorry i'm fasting ketosis essentially where you get better at producing them so in the absence of food you're pumping them out all the time from your fat stores um the body's really good at this and it will partition some of this fuel into the liver and then into up into the brain as glucose to make sure that you don't have any hypoglycemia but that process of getting better at burning the triglycerides being dumped out of adipose turning some of those into glucose for the brain that whole liver sort of pathway up into the brain that takes time it's enzymatic if you've been eating sugar every day pizza's an ice cream every day and then you suddenly stop and eat bacon and butter all the time your body's like wait what i have no idea how to do this and it takes weeks to drop your dependence on insulin to bring up your ability to metabolize fats better it can take weeks for people especially if you're overweight especially if you've been keeping blood sugar up you know exogenously putting things in your body so i really do think the best way to handle ketones is endogenous production i think keto diets are really useful but i don't think that you should be you can eat lots of fat um dr jason fung basically suggested a pure fat diet would work well but that's only for like that type of population that's trying to lose weight it's adipose driven it's health driven in terms of uh you know dropping fat ie people that are diabetic people kidney disease you want to lose fat you want to lose body weight um but for you like you probably don't need to carve off 10 pounds of body fat and maybe your you know your partner would like that or something but like you don't care about it probably but if it was 5 10 15 20 years from now and you get a little cancer or something whoa okay now you want to really tap into autophagy or maybe you want to do it off and on fast once a week between now and the time you hit 60 so that you have a nice clean sharp processing and never actually develop those oxidative states in your brain so the point is that you can start doing this stuff really easily just don't eat it's not that hard or eat things that are no carbs the average person will get into ketosis pretty well you know produce ketones pretty well within three days eating no more than 50 total grams of carbohydrates a day and if you break that into two meals start snacking 25 grams max carbs 20 net 25 ma total in a meal two meals a day you'll be in ketosis in a few days you'll be pumping out ketones if you've been poor metabolically you won't be burning those ketones you're just gonna pee them all out mostly and breathe them out acetone and bohb in your urine and things your blood just pee all those things out but after another week of that you'll start burning them so if you start measuring like blood blood ketone what you'll see is it go up up and up and up and up and up and after a couple of weeks it goes down not because you're not making less but because you have less of a reservoir in your blood because you're burning it faster so you have to kind of think about your current nutritional status i mean and metabolic health because if you're carrying around a little extra body fat and you eat a carbohydrate-rich diet or you know sugar-rich diet um you're probably carrying around in gluca glycogen um for you and i you know relatively uh medium to big size guys 400 500 grams of carbohydrates roughly you know um and that's a fair amount i mean we don't usually eat that per day even in a carbohydrate rich world so nice to think about oh wait i'm carrying around about 50 grams maybe 100 grams my liver if i'm really good at you know fill my liver up with glycogen if i'm really muscular maybe another three to four hundred maybe 450 in all my muscles you know cool but now you have to think about ways to deplete that system to kick yourself up into burning the other fuel source so you can almost kind of go oh i'm not going to eat i'm going to work out for half an hour it's about 300 calories my intense workout oh i've just actually brought my glycogen down dramatically i'm going to fast for a little bit have some fat have some protein i'm guessing my body's not gonna be able to grab the residual glucose and starch everywhere it's gonna start trying to burn fat and then i have tools i use like this i'll show you this is my favorite tool these days called the biosense it's a breath acetone meter so i can check my my ketone levels two hours um and and finger sticks aren't all that accurate because the system oscillates you have to finger stick every two to three hours to get valid readings especially if you have a diabetic or blood sugar issue so i'm a huge fan of using breath acetone which is not directly measuring bohb a butyrate in the blood not numbing ketone in the blood but it's a waste product in some ways it's being exhaled but it's highly correlated with um producing blood ketones so you can sort of figure out well for you what is ketosis you know can you have 100 grams of carbohydrates or not most people can't some people can can you have 50 can you have 20 how often can you eat does too much protein kill your uh your ketone production because it will for some people some people get up above you know like i've been doing one meal a day for a while and discovered that if i ate more than about 2 000 calories in that one meal even if it was like a rotisserie chicken an avocado you know like mostly fat and protein i would still blunt my acetone production over the next 24 hours if i exceeded the amount of protein by if i was 150 grams of protein above that i was suddenly my body's like oh there's plenty of protein let's make some of that into into sugar all right essentially so while there are rules i can give people and i do coach people on how to do this stuff and take control of the insulin sensitivity basically the best way to do it is to get some data get a glucose ketone monitor stuck to the back of your arm your doctor will let your prescription for one these days no problem or get a breath ketone meter or get a finger step device uh keto mojo or the for a care six i have one of those i'm using four qr6 is great um but i don't i don't use it because i'm diabetic i use it because i'm concerned about my brain health my long-term aging i i wanted to you know i'm 50 i was joking i'm actually not 97 i turned 50 in about a month and a half and i'm like oh by the time i hit 50. i want abs so for the past uh seven and a half weeks i've been doing this insulin reset protocol insulin sensitivity reset protocol but i stack fasts 22 44 and 66 66 hour fasts i just cycle them and i go back and forth and then i refeed with high carbs and i drop the carbs and i watch my body's you know handling it and i sort of walk that edge of keeping myself both maximally fat burning but also then shutting it down and the meters i have don't go above i get basically 40 um parts per million breath acetone equates to about three and a half or four million molars for for blood ketones yeah the meat the breath meter stops there um when i was first doing this i was a little concerned because i was easily pegging the meter i was easily above its maximum reference range frequently and i pulled out the four care device to make sure that i was below eight millimoles for ketones because that's about where keto acidosis can kick in right so i wasn't concerned because i know that high ketones isn't really a big deal but if i was like a you know diabetic doctor oh my gosh your ketones are so high i'd be very concerned about that kind of thing getting disease happening whenever else but if you know your own levels you know your own numbers you know if you're able to handle things and you track this stuff i mean what's the business guy drucker say you know what is measured as managed you have the ability to manage your blood pressure your lipids your oxidative stress your c-reactive protein your beta brain waves your alpha your speed of processing you know there's the great democratization of science and health care is continuing and you have the kind of decision criteria education and access information that doctors didn't have in the 50s so i feel this is just another place where you should be taking control of it and gosh fasting and time-rested feeding and working out appropriately to cause autophagy that doesn't cost anything it's just you know as a biohacker as a performance coach my first port of call is fix the stuff you're doing every day someone's like hey do i need some blue blocker glasses not really but you probably shouldn't eat at night oh okay you know like pick the big things you're doing every day i mean you're always eating theoretically you're always sleeping you know those are the things that really make big impact small incremental changes modifiable behaviors um will take the individual and like our populations up in health and performance over time simple i i think that you know for somebody listening to this who hasn't uh thought very much about their diet and their approach to uh staving off cognitive decline with aging they think about diets we talk about diets as if they're all sort of uh you know comparing apples to apples like there's a mediterranean diet and then there's a ketogenic diet and there's there's different components to different diets so really you should almost call them lifestyles because it's one component is uh what you're eating another component is when you're eating another component would maybe be like what um micro or macronutrients sort of balance your eating so uh you know talking about something like a mediterranean diet it's talking mostly about what you're eating and maybe some of the evidence about um you know the benefits of a mediterranean diet even though it's it's really a poorly defined diet uh but but it does in in general it it's uh it has a lot of you know leafy greens or vegetables and things like that which are maybe you know you're getting some benefit from the from the micronutrients and definitely from a macronutrient perspective there's less simple uh refined carbohydrates in a diet like a mediterranean diet but that doesn't mean that it's a perfect diet and an important issue about that diet is that it does not talk about when you eat uh and you know so uh something that matters i mean there is something about med training lifestyle where they do eat in a certain way or the french paradise the french in the 70s and 80s smoked all you know chain smoke like it was their country pastime their diets are full of carbohydrates and saturated fat and yet they have a heart disease risk that is on the lowest of any developed nation i think a lot of it is they have two hour lunches and go for a walk all right i really do think that's about as simple and you know i've traveled a lot in europe and if you have dinner with some europeans you're not like sitting down at 5 p.m and you're done at 6. you're like oh hey come on over let's oh it's 8 p.m the sun's still up we're sitting there until 11 p.m you're chatting food's even slowly i really do think that makes a difference i mean there's a lot of good research showing you can hack the same thing you can eat lunch and go for a walk and the the postprandial the the insulin response after you eat is dramatically reduced if you just go for a walk after you eat and the french you know parisians certainly would walk would have the little cafes with you know offset the potential problems of course there might be something there about the glyphosate you know in our wheat as well in the western world but um they're also probably not waking up and having a bowl of cereal and a glass of orange juice you know right when they wake up as well that's right they're having a coffee you know and then like a couple hours later they have a croissant and they walk down to the place to see their friend with the paper you know they're not like shoving captain crunch in their face yeah right right yeah well uh i think there was a lot of really interesting conversation about diet and and its impacts on brain health one thing that i really wanted for us to talk about was about cognitive performance and about the work that you're doing at the peak brain institute um so you touched in the beginning on some of the different domains of cognition and i would really appreciate if you could kind of reorient uh me and the listeners to uh you know what sort of different domains you consider as part of cognition and and your approach to those different domains great question um you know again as a cognitive neuroscientist i'm a little bit of a reductionist um i mean i really am i i have a hard time understanding things like consciousness in fact the more i get into the brain the less i believe in the mind uh i have sort of a it's funny as i get more and more heavily into the neuroscience i sort of come to come to a buddhist perspective that the self isn't really there that we have an illusion that stitches us together you know over many days and we kind of have this sense of self that is not all that interesting but the individual resources while historically somewhat hard to define these days not so much so i think about the core resources that are sort of one level below our experience i mean our experience is very subtle and i'm not a psychologist i have a you know it's it's it's a psych or a cognitive neuroscience degree but i'm really focused on the machinery and so i think about i really focus on the the underpinnings the resource underpinnings of human resources that are measurable like executive function or attention control has several things built into it like orienting to space being vigilant to things changing resolving response conflict having to step out into the street when the car comes around and it says walk at the same time speed of processing as i mentioned earlier it's really tied to memory access and how we can pull things into your mind working memory can you hold things in your mind how fast can you think can you can you come up with new ideas um and then you know for for individuals i often look at their brains and what i'm seeing are the unusual things that stick up and because i do population level analysis i don't know for any one person if this thing's in the way but i can say oh hey look here's a resource on attention stress sleep mood that for some people this pattern of way it's acting might get in the way what do you think oh that's relevant well then great so again it's very bespoke it's very individualized and so i might have somebody who's you know a self-stimming screaming no eye contact autistic kid having three seizures you know every five minutes or i might have a ceo who's like a little anxious and on edge when they get home at night you know and they want to work on different things but the process of going after your resources is somewhat the same we do something called brain mapping or quantitative eeg qeg and so uh we put a cap on your head scored a flow gel um you sit still for about 10 minutes we measure your brain at rest eyes open eyes closed we also measure your executive function your performance on an attention test and those three sets of baselines are compared to a database of people your age and we end up with somewhat arbitrary you know population level means the goal here isn't to say why aren't you average let's make you average the goal is to say oh hey look here's some ways that you're unusual for some people those things are relevant let's talk about them and try to figure out if you care about those things so the brain is mysterious and i don't necessarily know what a particular brain pattern or resource means for you but i can sort of say hey look this thing means this for many people and provide the educational sort of you know close that gap and then you end up making the meaning so people are often a little surprised what i can see in a brain map when i look and anything that shows up obviously is usually very very tractable meaning just change it if you want to and those include things like for all pretty much all forms of adhd show up in the brain reliably the brain mapping most forms of anxiety most forms of like sleep issues um you might see evidence of slowed brain waves that could be from concussions or mold or lyme or chemotherapy you don't know why it's there but you can tell there's some issue in the brain's being sluggish metabolically and so you can give people some perspective on the core resources that might be pinching their cognitive resources and then correlate that with the attention performance and you can help people understand the machinery they're carrying around for impulsivity or trauma or oc you know perseverative stuff for selection attention falling asleep staying asleep you know these are all things all brains do every day theoretically so if you can measure the core resources about the stuff you care about you can then use neurofeedback to lean on those resources and change them pretty rapidly as i was saying earlier and so you know some of these different components being focus attention creativity uh mood uh hyperactivity rumination impulsivity uh so the the approach that you take is by quantity quantitative eeg and by you know kind of seeing where people are abnormal in those realms and then uh you have sort of different prescribed approaches for each of those yeah let me give you an example um uh let me know if there's a specific cognitive or mental you know thing you'd care about i'll give you an example that's specific to that but the easiest one is probably adhd because i see so much of it it's so common it's also not a disorder right it's a natural brain thing tuned one direction so in the case of adhd in kids below 18 years old the data is 94 accurate for spotting adhd in the absence of a sleep issue at least um and what you see is someone's theta brain waves are very high with their eyes open usually beta brain waves are also low so like the theta beta ratio the slow brain waves are up the fast brains are down in the average person with adhd and again kids who are below 18 you can measure on the top of the head with one electrode the vertex and it's 94 specific for blindly sorting kids into buckets of adhd and non-adhd the inattentive features which is alpha being stuck in neutral add that's eyes open alpha waves and that marker if you will you know if i saw lots of eyes up in alpha for you um about 80 accurate i mean i wouldn't know if it's true or not but i might guess about it i would also of course measure your attention so i would see the performance go up these two things line up you want to probably work on your attention so let's say you had some impulsivity you don't obviously but if you did my guess is your theta be high and probably in the part of this the brain the right hand side involved with supervisory attention there's a circuit that stitches together the whole brain's attention system on the right about there and if i stuck a wire there and a couple of ear clips on your head and then measured your theta and measured your beta on its own moment to moment every so often your theta would dip and your beta would climb when you focused or felt focused or resource shifted just on its own and so what we would do is we'd have you sit and watch a computer screen and put a pacman on it or a spaceship or a dragon flying across a lake or something silly and whenever your brain happened on its own to move in the right direction for half a second we go yeah good job brain and make the game run better so the pac-man starts to move dots and the music gets louder the next moment your brain moves in the wrong direction the theta surges the beta dips and the pac-man slows down and stalls or the car you know hits the edge of the track or the dragon starts to miss her targets and you're like your brain's like hey i was watching that information why did it go away and the brain happens to move back in a couple seconds and this offer goes yo good job so obviously as as a as a brain professional you're already uh sort of picking up that this is operant conditioning you know skinner's pigeon's not pavlov's dog i've not made anyone drool i promise with my ring a bell um we're taking things right uh you're already making alpha beta certain speeds or brain waves amount of brain waves we're taking that we're shaping it we're applauding the trends that already exist and so if i applaud your theta dropping for 10 15 minutes as it drops here and there your brain goes well that was pretty cool i got some input i kind of like input so tomorrow your brain reaches for that state and it drops its theta lifts its beta and you're like oh i focus that was cool or maybe ask your kid take the trash out and he does being asked the first time and you're like that was weird you know because the organizational stuff starts to shift so neurofeedback becomes this i mean it's not it's not a metaphor it very much is iterative personal training you know where you come up with some goals off of a fitness assessment do some workouts see how they land and reassess so you know the the end point for success is sort of open-ended i mean yeah you get some autism some trauma there's obvious goals some seizures obvious goals but i have a lot of people to start off with a mix of attention anxiety and adhd sorry attention anxiety and sleep issues and you know six eight weeks in those things are gone and they're working on like deep creativity and laser-like focus and being a better listener to their wife or whatever else you can really start to work on second level resources once the basics stress sleep and attention which i do think all brains have that that cluster of resources that need to be worked out so it ends up becoming simply do you want to work on your theta waves are distractible or maybe those cingulates maybe a little bit better back there and you tend to be threat sensitive or the front maybe you're obsessive now again here's the good thing about neurofeedback let's say you're obsessive and the anterior single gets really stuck in beta songs play in your head you bite your nails wash your hands whatever it is perseverative the mind gets stuck on things that's a superpower it's also kryptonite i mean it's stuck that's why it's kryptonite but it's really a superpower i wouldn't know looking at your anterior cingulate if you had ocd features or if you were just that guy who's hyper focused when he wants to be but if you're like oh yeah that kind of gets in the way sometimes i would say great let's train that down a touch and clench it and after you train it down whenever you want to be obsessive or hyper focused you just reach for it and it's there whenever you don't want to be you put it down again so we don't rob the adhd person the person that's hyper focused the person that's you know a little unusual the anxiety person often has a very fast brain that can think incredibly well when they aren't overwhelmed you you sort of retain access to these resources and then tune them just like you might work out your you know physical body and then feel like you're using it better later on so we have this iterative process of exercising the waves about three to five sessions in you start feeling it about 20 sessions then we map the brain again and we typically do a couple rounds of that 20 sessions i mean two or three of those rounds adhd and anxiety take about two rounds um concussions take three to four you know peak performance people often continue autism to continue because you can make change just gradually slowly you know over time but we generally re-regulate a lot of the really acute stuff i mean i work with veterans uh with ptsd i get free services away and 20 sessions and they're like hey doc let's keep coming i feel great and i'm like yeah you're you know as long as you feel fine it's fine and they aren't done from my perspective but they're so much better than they used to be and they're taking two buses to my office and they're you know it's fine but what i want people to take away from this is it doesn't matter what particular thing you might want to work on the brain is a tractable set of resources just like your abs your pecs your your lower back if these things are not operating the way you don't want them to you actually can change them just like you can get stronger shoulders or you know sleep better because you worked out differently you can go after the core resource here really reliably for the things that brains do commonly that's the basic resource stuff so so what i heard you mention is you know you do the brain mapping and then you do this neural feedback approach uh that sounds like a component of it is the video games to uh sort of you know retrain uh your your brain in areas of brain perhaps that are weak or that are overactive um but i've also seen that that you have part of the approach being mindfulness meditation and i'm curious what uh what sort of deficiency that's going after or what role you see it playing yeah so i sort of view the combination of neural feedback and mindfulness to be very multiplicative in some ways i used to run a the brain side of an addiction center that did a lot of work around moderation a lot of work around mindfulness and what i saw both in addiction clients and then just regular brain clients i saw i saw that people that did both neurofeedback and mindfulness had accelerated changes compared to those that did either i mean neurofeedback is very rapid anyways but when they added mindfulness to it it like the effects people were getting were taking off they were they were just dramatic i mean i have this still happens to this day i have clients yesterday someone called me he's been meditating for six months he's been in norfolk for a year he's just started experiencing something called the jaundice these absorptive experiences you know feeling light suffuce you and warmth cover your body these are things that happen 10 20 years into meditation of classic meditators i'm getting ceos to do it routinely six months in because their meditation skills are like more powerful than they realize and they're hey doc i'm this is weird what's happening here oh actually interesting like you're very absorbed cool um so i view these two things kind of like the neurofeedback is the strength and conditioning coach in the gym making me bang out the rep and build the resource and mindfulness the coach in the field helping you lift your shoulder more or your elbow or not release weirdly it's a voluntary set of experiences mindfulness it's pure mind but it helps shape the brain i mean i mentioned the uh insula is built up um or at least you're spared the loss with age but also when you meditate the cingulates change their activity so the anterior cingulate when you first meditating has a hot spot right in the top middle of it which is like a self-centered kind of perspective what am i focusing on what am i thinking about and when you meditate over the years the activation goes to the top side to the underside of the cingulate which can't experience self so you literally move from a self-centered awareness of your mind into a measurably self-less measurement of your mind with you know decades of meditation so it does change shapes the individual um but you can do a lot of that simply with whatever tool you feel like i mean i have clients that don't meditate i have clients that don't fast i have clients that don't know any tropics my clients do all of those things and i'm not so concerned about which tools you take to take control of your performance as long as you have some goals and you want to take control of your performance and you know incidental things happen even if you don't want to take control of a specific symptom i joke that if you walk into equinox you know all the staff has their abs hanging out but at peak brain everyone has like kindness and good listening skills hanging out because i have always 20 and 30 something you know year old staff that are like 80 year old tibetan monk vibes like super love low-key very kind because they start training their brains in the off hours and after a few months they're like the best possible you know even keel resilient well-rested attentive individuals so and most of them don't have anything wrong they don't have like big problems but since they have access to the gear they hang out they ask me for protocols we train them and they all get uh optimized before they go to grad school basically so yeah wow well it's all really fascinating and i think uh both an approach from uh you know a cognition in the um sphere of sort of cognitive decline in aging as well as just for people who are maybe not quite in that stage of life and that want to work more on their attention or on their uh hyperactivity or or their mood seems like there's you know a lot of different approaches that people can take um and i appreciate your exploration of all of that right so yeah so uh so just to finish off here uh for people that are more interested in you and your work uh where could i send them to learn more about you yeah so we have um peak brain la or peak brain institute.com same website i'm the main brain training centers um i'm at andrew hill php everywhere on socials i think i'm andrea phd on you know youtube facebook instagram plus my websites andrewpatch.com um and you know peak brain is our main website uh for brain training but we have offices for peak brain in st louis we have one in la one in orange county one in london a new one opening up in copenhagen shortly and then we have um this point you know in a peripandemic world uh 75 percent of our clients train from home wow even 2019 it was 55 so we already do a lot of virtual remote support we give you a private chat basically and work with you live when you're doing training and teach how to do it and then provide support but these days you don't have to come into a center you could say hey peak brain send me stuff i want to get my brain short up for you or your family and we do it all virtually so it may be worth knowing that people that are listening to your podcast get a discount so if you come into one of the centers the brain map is cut in half our brain map pricing is pretty good anyway it's only 500 bucks list and we can do free repeats which no one does for like ongoing education when they sell when they tell us they come from your podcast we'll cut that in half so it's 249 for a brain map one-time fee and they have free access to the centers thereafter or they can have the same discount off of a training program and those are a few grand but it's a pretty competitive price wise because we're not therapists we don't have to charge therapy rates so we end up doing personal trainer kind of stuff but um peak brain la is the main website please come check us out please ask me on instagram on facebook on youtube give me your brain questions i'm i'm uh i'm getting all kinds of content out there and i'm starting to develop articles and as i move more you know out of just pure neurofeedback into more of the peak performance coaching for a community i still do a lot of this individually i have a private coaching roster that are you know ceos and athletes and things but i'm trying to make this content more accessible to everyone and so like the discussion we just had about fasting i mean i have about 15 things i would want to educate an individual around and we covered a bunch of them but i have this conversation with my clients again and again and again as you might expect some people out there please let me know what you want to know and i'll make sure that i coalesce that particular set of biohacking in ways you guys can go and dig into without having to just listen to me you know chat some morning so yeah all right well andrew hill thank you very much for your time uh it's fascinating uh i look forward to keeping in touch this is clearly an area of interest for me and and i look forward to seeing the things that you're up to