Oh our frazzled brains. Help clearing that fog, curbing that anxiety, finding your focus – and that elusive word – in this fascinating episode with neuroscientist Dr Andrew Hill. He’s one of the world’s leading practitioners of neurofeedback. Dr Hill age-stages his best bio-hacks to nourish and rewire our brains for peak performance. He says when you eat is critical. As is getting enough deep sleep. And he tells us intermittent fasters we’d be better off shifting our eating windows to earlier in the day. He explains why kids shouldn’t be allowed to play contact sports until their brains are finished developing: “Half of all brain injuries are silent and have no symptoms. They show up years later as slowed processing, degraded quality of sleep and word-finding”. He also tells us why loves the meditative power of Ashtanga yoga and performing West African drumming in crowds on mountaintops. Dr Hill is the founder of Peak Brain Institute, a global chain of “brain gyms” headquartered in Los Angeles. He holds a PhD in Cognitive Neuroscience from UCLA’s Department of Psychology, where he lectures in psychology, neuroscience and gerontology and researches attention and cognition. He’s been practising neurofeedback since 2003. Notes How neurofeedback works to tune the brain to reduce stress, improve sleep and attention Types of brainwaves: “Delta is the heartbeat of the brain” “Alpha waves are the idle speed” Age-matched data sets are used to interpret brain maps How our brains change over the decades; consequences of the shifts that happen – attention, focus, speed of processing “You don’t want to diagnose off of this stuff, you want to come up with ideas and if they ring true, then you’re on to something” “If you find things that are real, you can change them almost always. Understanding brains is hard but changing brains is not that hard” His academic and professional background in mental health that led to him setting up the Peak Brain Institute “We spent a year teaching someone to use a fork” How own struggle with ADHD (Attention Deficit Hyperactivity Disorder): “I was moving 9,000 times faster than everyone around me, chewing through books..I dug into everything” Was astonished by positive outcomes when he started working at a centre using neurofeedback What’s happening to the brain when sex hormones decline at perimenopause and menopause The reason you’re having brain fog and word-finding issues His take on the significance of estrogen decline, referencing the work of Dr Lisa Mosconi “Women have autoimmune stuff and most forms of classic dementia are not infectious diseases but metabolic diseases” The importance of deep sleep to banish brain fog and optimise brain health Why he says we’re doing Intermittent Fasting or Time-Restricted Eating wrong “The strongest cue for circadian rhythm is not light, it’s not when you sleep, it’s when you eat” “If you go to bed with any insulin that’s high, any blood sugar that’s high at all, you suppress growth hormone completely” How to properly measure ketones The benefit of movement before food every morning to burn off the cortisol – “it squeezes your liver and feeds you breakfast” – and glycogen that woke you up not call for more (by eating and flooding your system with sugar) Do low-key workouts in the morning and high-energy exercise in the afternoon when your cardiac output is best and your cortisol is lowest Impact of social media on brain health, especially for children “There’s definitely an epidemic of childhood anxiety and sleep issues but there’s no more ADHD than there was 50 years ago” Advice to parents of athletic kids who want to play rugby or football? “You shouldn’t let your kids play contact sports.. non-contact is ideal until your brain finishes developing” The ecstasy of West African drumming on mountaintops and the meditative value of Ashtanga yoga Links Dr Hill’s Peak Brain Institute - https://peakbraininstitute.com From Andrew’s blog: How to prioritise sleep for peak brain performance - https://peakbraininstitute.com/the-1-thing-you-need-to-do-to-get-better-sleep-plus-4-bonus-tips/ Andrew on Twitter - https://twitter.com/AndrewHillPhD ***** LISTEN 🎧 SUBSCRIBE ✅ REVIEW🥰 Apple podcasts: https://podcasts.apple.com/gb/podcast/the-big-middle/id1435522193 Spotify: https://open.spotify.com/show/0eLtffWrIsPauWwlojQmV2 FOLLOW ► Website: https://www.susanflory.com Twitter: https://twitter.com/thebigmiddlepod Linkedin: https: //www.linkedin.com/in/susan-flory-9b903b1a/ Instagram: https://www.instagram.com/thebigmiddlepod/?hl=en Hit like and subscribe here so you don't miss an episode. Big thanks 💕 for letting me know in the comments below what you learned and loved most about this episode of The Big Middle. Cheers!
Episode Summary
I sat down with Susan Flory on her podcast for a long conversation about how the brain works, how it changes across the decades, and what you can actually do to keep it sharp. You can watch the original conversation. What follows is drawn from that discussion, in my own words.
What is neurofeedback, and how does it change the brain?
Neurofeedback is a way of exercising the brain by shaping either brain waves (measured with EEG, the electricity) or blood flow (measured with HEG, hemoencephalography). You measure an aspect of brain activity moment to moment and reward the brain when it shifts in the direction you want. The technique in its current form goes back about 55 years, to the late 1960s, and it was discovered by accident because it reduced seizures. It still works well for epilepsy and related seizure disorders, and it works well for the broad regulatory features of the brain: sleep, stress, attention, speed of processing, and brain fog.
Here is how a classic session runs. I put a wire on a spot on the scalp and a couple of clips on the ears. Say we put a sensor over a region on the right side involved in knowing whether you are paying attention, pumping the brakes on impulsivity, and staging in and out of deep sleep. That tissue uses beta waves to help you focus and theta waves to release behavior. You watch a game, an animation, a spaceship, a race car. Whenever your brain happens to make less theta and more beta for half a second, the computer rewards you, and the game moves better.
You cannot feel your brain waves, so this is involuntary. The brain notices the contingency even though the conscious mind does not. After three or four sessions it starts reaching for the state that gets rewarded. It is operant conditioning, the same learning that taught you to push yourself up as an infant and see further across the room. You do not later tell yourself to fire your right shoulder. You just do the thing. The brain works the same way here. If you want the deeper picture of training that right-side region, I wrote about it in SMR neurofeedback, and the full method overview lives in is neurofeedback legitimate.
What do the brain waves actually mean?
Going from slow to fast: delta runs around two cycles per second and is the heartbeat of the brain, the deep dreamless sleep and the deep metabolism that keeps the basics running. Theta is roughly four to seven cycles per second and acts as lubrication, releasing things to happen. Alpha sits around 10 cycles per second in adults and works like a car idling in the driveway, running fine but not going anywhere yet. Alpha is your speed of processing. Beta is the gas pedal across the little motors and engines the brain runs, things like the default mode network, the executive function network, and the salience network. Gamma sits at the top, where some aspects of consciousness may live. I cover alpha in depth in decoding alpha waves.
The sequence matters. You need enough delta at night to get the car out of the driveway. Make sufficient delta, and your alpha idles at the right speed when you wake, which lets you shift cleanly into your beta modes during the day.
How does QEEG brain mapping read your brain?
Alongside neurofeedback we usually run a quantitative EEG, or QEEG. You wear a cap, we use gel, you sit still for about 10 minutes with eyes closed and 10 with eyes open. Then we compare your resting brain wave amounts, speeds, and connectivity patterns to an age-matched database. The point is to find the unusual features and use them to generate ideas.
A few things show up visually. Close your eyes and the occipital tissue at the back should produce robust 10 Hz alpha, because nothing is coming in. If it does not, that is unusual. Open your eyes and that alpha should suppress and get replaced by beta. If it stays high, you may be looking at inattentiveness, or, in a different pattern, hypervigilance because the brain cannot shut it off.
In children, the ratio of theta to beta over that right-side attention region sorts ADHD from non-ADHD with about 94 percent accuracy, and a high-alpha-to-beta pattern flags inattentive spaciness with about 81 percent accuracy. That is diagnostically strong. The rest of QEEG is modeling, not diagnosis. You do not diagnose off this material. You come up with ideas, and if they ring true, you have found something. More on the assessment in the QEEG brain mapping guide.
Here is a worked example. If your alpha runs a standard deviation slower than other people your age, I would not panic. It might be normal variance, a six-cylinder car that runs fine. But I would ask: are you hunting for words, losing names, forgetting things you were just told? If the answer is yes, then that slow alpha is slower than you want it, probably slower than it used to be, and we have something to train. When you find things that are real, you can change them almost always. Understanding brains is hard. Changing brains is not.
What causes brain fog and word-finding trouble in midlife?
A lot of women hit their 40s and 50s and feel their brain turn to molasses. The words will not come. Speed of processing is slowing, which means the alpha is slowing. The hormonal route is real: progesterone drops, and progesterone supports deep sleep regulation. Without deep sleep, your alpha does not idle smoothly, and without a smooth idle you cannot shift gears, load words, and move them into working memory.
The same brain fog and word-finding pattern shows up after concussion, after COVID, after mold or Lyme exposure, after chemotherapy, after trauma that tanks deep sleep. If you have a hormone issue worth addressing, see your endocrinologist and weigh the HRT trade-offs against your history and genetics. For most of the women I work with, the speed-of-processing problem traces back to deep sleep, and that is what we tune. I unpack the circuits in biohacking brain fog.
On the broader claim that estrogen decline drives women's dementia risk: most classic dementias, Alzheimer's, the Parkinsonian conditions, frontotemporal dementias, are metabolic, not infectious. Women carry a more active innate immune system, amplified further by childbearing, and amyloid is an immune molecule. In a dirty microbial environment with high APOE4, like traditional populations in Papua New Guinea eating starchy tubers, amyloid does its job and Alzheimer's rates stay very low. Put a person in a clean environment and flood them with sugar, and the amyloid oxidizes into something that destroys the brain. Estrogen and progesterone drops unveil and provoke the fog, but the whole dementia story rests on metabolic factors, not estrogen alone.
How do you protect deep sleep and clear the fog?
Lean into circadian signaling, the information your brain uses to know what time of day it is. The single strongest external cue for circadian rhythm is meal timing. Eat in the time zone you want to live in.
On fasting, most people run their window backward. Skipping breakfast to extend the morning fast is the wrong direction. The research on early time-restricted eating (eTRF) shows better metabolic outcomes when the longer fasting window sits at the end of the day. Open the window early, close it mid-afternoon, and you get the evening hours plus the whole night fasted, a longer low-insulin stretch. The full framework is in strategic fasting.
For premenopausal women I do not recommend a window as narrow as eight hours unless there is a specific goal. Young women suppress hormone production easily by overdoing caloric or time restriction. Think about food as three levers you can adjust independently: time, calories, and macros.
Two rules carry most of the weight. Leave at least three hours of no calories before bed. If you go to bed with high blood sugar or high insulin, you completely suppress the growth hormone pulse that releases a couple of hours after you fall asleep, and growth hormone is what drags you into deep sleep. And do not eat the moment you wake. What wakes you is cortisol squeezing your liver to feed you breakfast in the form of glucose. Move first. Ten to twenty minutes of low-intensity movement, a few sun salutations or a walk you can talk through, burns off that cortisol and glycogen without calling for more. Flooding your system with orange juice on top of a cortisol spike builds resistance to both. Save the high-intensity training for the afternoon, when cardiac output is best and cortisol is lowest. The morning protocol is in biohacking your morning, and the sleep side is in biohacking sleep.
How should you measure your brain and sleep data?
For brain fog I track two things: deep sleep quality and breath ketones. On a sleep tracker, deep sleep is the metric that flexes in response to your behavior. REM numbers on most consumer trackers are not reliable, so ignore them.
For ketones, measure your breath. Blood reacts to your last meal within minutes. Breath acetone takes two or three days of behavior to shift, because it reflects the deeper enzymatic state of both production and burning. Urine strips are useless for anyone fat-adapted, because once your body is using ketones efficiently the strips read low even while you are making plenty. I check breath acetone on waking and before meals. The morning I taped this I was at five, which proxies to about 0.5 blood ketones, light ketosis. A 36-to-40-hour fast puts me into the 20s or 30s on that meter.
One point on fuel that confuses people: total fuel use in the body is only about 15 percent split between glucose and ketones. The other 85 percent is free fatty acids and triglycerides. You can shift the glucose-ketone balance hard, but you never reach zero glucose, because the brain always wants some. When carbs are absent, the liver makes sugar through gluconeogenesis, partly from the glycerol backbone of triglycerides, and you only need about 20 grams of carbohydrate in circulation to stay alive.
On obsessing over numbers: the risk is orthorexia, and you can get that with anything. The value of the data is that it makes you your own scientist. If you understand your blood lipid panel, you know that low triglycerides and low VLDL on a low-carb high-protein diet mean LDL is acting as a firefighter, not an arsonist. Get a CAC scan, confirm there are no plaques, and you can read your own numbers without panic.
How does the brain age, and what slows it down?
The brain slows down across the decades for two reasons. You lose cell bodies, so fewer neurons fire the message. And you lose myelin, the fatty insulation on the wiring, which slows transmission. When myelin loss is pathological we call it multiple sclerosis, but a milder version happens to everyone.
You can watch this in the P300, an evoked wave that rises about 300 milliseconds after you notice something you care about. In your 20s it might peak near 300 milliseconds at 25 to 30 microvolts. By your 70s it can drift 30 to 50 milliseconds slower and lose a third of its amplitude. I can predict roughly how old a brain is from that wave alone.
The levers: keep inflammation down, and as an elder, keep protein up, around 0.82 grams per pound or a gram per kilogram. That is counterintuitive, because too much protein in your 30s, 40s, and 50s appears to shorten life, but enough protein in your 60s and 70s protects against muscle and brain loss. Humans do well on either extreme, very high protein and very low carb, or very low protein with high-quality carb and no saturated fat. There is nothing in nature that combines fat, carbohydrate, and protein all at once, and the middle is where people get into trouble.
Even if your decline is exactly average for your age, that is not a reason to accept it. Brain training is somewhere between exercise and physical therapy. Once you train the resources of attention, stress, sleep, and speed of processing, the brain practices them daily and makes them permanent. I expand on this in the critical aging window and the broader frame in biohacking intelligence.
Is screen time causing an explosion of ADHD in kids?
The reference data we use for aging is the same as it was 50 years ago, and so is the rate of ADHD. Screens do not damage the brain. Stimulus is stimulus, and the brain manages it. Radio and television drew the same fears, and screens are not magically different.
What is real is an epidemic of childhood anxiety and childhood sleep problems. Kids are anxious and under-slept, and that is what shows up as trouble. If you always hand your kid a screen, that is a stimulus reward you have to manage, the same as any other reward. Manage stimulus, fix sleep, and the picture changes. For the parenting side of attention and frustration, see why does my ADHD kid make me yell and the neurofeedback for ADHD guide.
Should kids play contact sports?
A child's brain should not take contact-sport hits before it finishes developing. Soccer carries real injury risk, and young girls take roughly double the injury rate of boys from it. American football is worse. Non-contact sports are the right call until your child is an adult and can weigh the risk themselves.
Half of all brain injuries are silent, with no symptoms at the time, and they bloom five to ten years later as slow processing, degraded sleep quality, and word-finding trouble. Even a simple concussion or a post-COVID brain often shows no effect for three months, then settles into a foggy state. Watch a kid six months after a hard head impact, not just in the days immediately following it.
The most important rule: if a kid gets a concussion, the season is over. The second concussion does the catastrophic damage. Once the tissue is stiff and fragile, a second hit a week later is the one that destroys the brain. Note every hard head impact, because in four or five years you may need to trace a problem back to it. If a determined teenager truly wants to play, set the rule in advance: assessments to minimize inflammation and maximize recovery, and a two-month shutdown after any hard hit, because a second injury landing on inflamed tissue is the one you cannot recover from.
Why I use the brain map to remove stigma
People attach guilt to a struggling brain in a way they never would to a broken arm. They feel they should be able to control the obsession, the anxiety, the tic, the seizure. When I show someone the QEEG and point to the big red blob of beta locked in rumination behind a PTSD pattern, or the beta that will not switch off after 25 years of drinking, something shifts. They can be frustrated without being ashamed, frustrated without being angry at themselves. The map pulls the teeth of the stigma. Then I show them the first ten people like them whose brains we changed a few months later. That moves the conversation out of what is going wrong and into what is happening and how to steer it. The clinical anxiety frame is in biohacking anxiety and the research in neurofeedback for anxiety.
What about drumming and yoga for the brain?
Music brings the brain online globally rather than parking it in one hemisphere. Non-Western music with polyrhythm and two-handed coordination pulls in bilateral involvement. I learned Malinke drumming from the Mande tradition of Mali, Burkina Faso, the Ivory Coast, and Senegal, where about 16 core rhythms run across many instruments and the downbeat does not resolve the way Western ears expect. Systems like TaKeTiNa show the same thing: as you learn longer rhythmic phrases, the brain integrates better. I found it deeply integrating, and before the pandemic we ran drumming groups at our centers to put people into embodied time, which is useful for change.
Ashtanga yoga stacks several biohacks at once. Ten sun salutations first thing in the morning move the whole body, burn off cortisol and blood sugar, hit the timing right, and stay short enough to be just enough. A sun salutation is about nine poses that become overlearned, so once you know them you have a direction to look, a way to breathe, and a movement that takes a minute to ninety seconds. Do ten and you have a 20-minute exercise session and a moving meditation, which is easier than sitting if a still mind bores you. More on that in biohacking meditation.
The through-line across all of it is the same: find what is real in the brain, name it without shame, and train the underlying resources. Start tonight by leaving three hours between your last meal and bed, and move for ten minutes tomorrow before you eat anything.