Neuroscientist: If You Don’t Have These 3 Things After 40, Your Brain Is at Risk For Dementia

Key Takeaway

45-70% of dementia cases are preventable through lifestyle modifications, and cognitive function can be maintained or even enhanced at any age. The key isn't accepting decline as inevitable—it's understanding that what we expect often becomes our reality. Challenge your brain with new learning, prioritize genuine social connection over social media scrolling, and remember: doing the things that maintain function is what prevents the decline we fear.

Episode Overview

Dr. Tommy Wood discusses the preventability of dementia and the power of mindset in aging. The conversation explores how 45-70% of dementia cases may be preventable through modifiable risk factors including education, sleep, cognitive stimulation, and social connection. Key topics include: • The stereotype embodiment theory—how expecting decline creates a self-fulfilling prophecy • Why most people maintain cognitive function into their 70s and 80s • The hidden dangers of social media on perceived social rank and inflammation • How social isolation changes immune function and increases chronic disease risk • The importance of celebrating what we do rather than worrying about what we don't

Full Transcript

Transcript of Neuroscientist: If You Don’t Have These 3 Things After 40, Your Brain Is at Risk For Dementia from Feel Better, Live More. Auto-generated from episode audio; may contain minor errors.

You state that 45 to 70% of dementia cases may be preventable. You also state that when you say that to people, there's often disbelief and or resistance. Yeah. Yeah. Yeah. Where does that statistic come from? And why do you think so many people push back at it? That statistic comes from two separate studies. 45% comes from the Lancet uh commission on dementia prevention report. There have been two now. The first was in 2020. Uh most recent one was in 2024. They upgraded the uh the number from 40% of dementias potentially being preventable to 45%.

The 70% number comes from a study using UK bio bank data performed by Professor Yintai's group. Um and they sort of looked at all the different modifiable uh factors and risk factors for dementia to estimate you know if we removed all of these risk factors from the population what proportion of dementias would we expect to you know no longer happen and this is what essentially what the Lancet Commission report does as well. So they have these statistical ways of estimating how much a given risk factor translates to a proportion of dementia in the population.

It is an artificial way of doing it because we know that risk factors to any chronic disease are not a onetoone thing, right? And people often have multiple risk factors together and they compound and they interact. But that's the best way to to truly estimate right now how um different aspects of the environment and society impact dementia risk. And so it's things like 7% of dementias are thought to be preventable if everybody got access to high quality education um and you know high levels of educational attainment and then there are um uh risk factors related to smoking, head trauma, obesity um hearing loss etc.

and and and the the 45% number from the Lancet uh commission report, I think that could be conservative because they didn't include things like poor sleep, which we know is a risk factor. They didn't include things like um late uh later life cognitive stimulation, which we know is important as well. So, that's why potentially this, you know, 70% could be the the upper limit perhaps um of dementias that are preventable. But you're right that when you say something like that, first of all, people are surprised.

I think this is this is new information. Um, and then then then people, especially those who have some kind of relationship with dementia, they had a loved one or family member with dementia, they have a family history of dementia. dementia. dementia. If you say that dementias are potentially preventable, potentially preventable, potentially preventable, they might interpret that as if there's some blame on an individual who previously suffered from dementia or is currently suffering from dementia when that's absolutely not the case. Right? We've just said that we're only just starting to appreciate that dementia may be preventable or you know a certain proportion of dementias may be preventable, certain types of dementia may be preventable and we know it's very complicated, right?

Multiple risk factors may come together in an individual. uh genetic risk factors, environmental risk factors. Um, and I truly believe that each person is doing the best with the information that they have and the things that they can do at the time. So, it's more an idea of hope, right? Should we be able to modify our environment? Should we be be able to make societal change to remove some of these risk factors because some of them are related to socioeconomic factors? there is um the possibility of dramatically decreasing dementia burden in the population.

And yes, individually we can take that on and and uh decrease our own risk of dementia. But it's it's really um sort of an idea of of what's possible rather than saying, "Oh, because somebody got dementia, they did something wrong." something wrong." something wrong." Yeah. It's Yeah. It's Yeah. It's that whole thing about blame. It's something I think a lot about on the show because each week we're trying to empower people with the things that you might be able to do in your own life. It doesn't mean though that if you get something, something, something, you failed in some way.

Do you know what I mean? It's a tricky one, isn't it? It's also hard for us to to think about this as individuals because we're talking about probabilities, right? So right? So right? So it would be impossible to say that any individual case of dementia is preventable. It would be very possible to say were you to address certain risk factors, you will decrease your risk of getting dementia. But I could never say I can guarantee that one individual won't experience dementia. They may experience it later.

They may have, you know, less of a decline, fewer symptoms. They may not experience it at all. But it's sometimes hard to wrap our head around the fact that when you're talking about statistics, you're talking about probabilities rather than certainties. And often in the health sphere, we're sold certainties and black and white stories. And it can be difficult to understand that there's some nuance in in what we're trying to to get across and what we could potentially do. I think those statistics firstly, they're very empowering, but I think they're empowering on a couple of different levels.

I think firstly, it means oh wow, just cuz mom had it M maybe it doesn't mean that that's my fate fate fate and so oh let me learn more to see what I can introduce into my life. So I think it's hopeful on that level but I think deeper to that it it more broadly to me speaks to our collective attitude towards aging. Yeah. Yeah. Yeah. Right. Are we expecting our brains to get slower, weaker, poorer, whatever that might be as we get older, or do we actually think that that doesn't necessarily have to be the narrative?

And you know, in the new book, The Stimulating Mind, you very clearly make the case that that does not need to be the case. Let's talk a little bit about mindset and attitude to aging because I I think that's quite key, isn't it? Yeah, I think so. And this is something that we've embodied as a society almost that we expect a certain amount of decline as we get older. And I uh I lay some of this blame at the feet of Sir William Oler. If anybody's heard of him, he's a very famous physician.

Um he's a was a Canadian physician, helped to found John's Hopkins Hospital in the US and then he was a professor of medicine at the University of Oxford. And in the early 20th century, Osler helped to popularize the idea of retirement because before then, other than sort of like military pensions, it wasn't normal for people to to retire. But he gave this famous address at Johns Hopkins where he said that at the age of 60, the uh average adult is useless and should be put out to pasture.

And And And this then is something that we have internalized as a society and this is essentially what we expect. I will give him a little grace by saying that at that time average life expectancy in the US was in you know late 50s. So maybe he was right that once you were 60 you know the average individuals wasn't in great health. But that's no longer the case, right? With the advancement of of medicine and every everything we've been able to do to extend both lifespan and health span at the population level.

And despite that, I think we expect some level of decline and because of that, we do things or stop doing things that then make that inevitable. So uh there's this idea of stereotype embodiment theory um based on based on based on some of the work include like Ellen Langers work you know you know her work well well well she's great she's great she's great um and she talks about the fact that if you expect decline then you embody this idea that you will decline and therefore you stop doing the things that prevent decline and therefore it becomes a self-fulfilling prophecy.

So if we expect to lose physical function, we expect to lose cognitive function, then we stop doing the things that help us to maintain function. Oh, I'm too old to learn a new language. Oh, I'm too old to pick that up. Oh, you know, I might get might get injured. I don't want to do injured. I don't want to do that. Um and we stop doing those activities that challenge our physiology, which are inherently the things that help us maintain function. And as a result, um we we see decline.

So I think the most important thing to to realize and we could certainly go into the uh into the evidence that decline doesn't have to be inevitable but the first thing we have to realize is that there is this huge possibility to enhance function physical function cognitive function at essentially any age age age as long as we engage in these processes and uh skills and challenges that that help that to to happen. Yeah. Yeah. Yeah. When I think about how our attitude influences influences influences the reality of our lives, I I think about two two cases or or two sort of examples where there are some South American tribes uh running tribes where you grow up from from what I understand with the belief that as you get older you get faster.

Yeah. Yeah. Yeah. Right. Right. Right. And look, I haven't seen the physiological dates. see the V2 maxes that they've measured or not measured, but apparently in your 60s and your 70s they are the fastest runners, right? And it and it, you know, we can look at the science go, yeah, but we know you lose muscle mass from the age of 30 and we know that this is going to decline, right? Or whatever it might be. And also, let's also not forget that if you grow up in a culture where it's believed that you get faster as you get older, how much of an impact does that have?

There's also some research I saw where if you live in a culture where older women are looked up to, right, and they're really valued, I think in some of those cultures, they have uh less reporting of menopausal symptoms. symptoms. symptoms. Now, I'm sure there's multiple complexities there. You know, are they reporting them enough? Are they are they doing them in the same way? whatever it might be. I just find this whole idea that our mindset and the influence it has and of course Ellen Langanger's work is hugely saying your mindset is massive.

It's kind of interesting, isn't it? it? it? Yeah. There's so many examples of how what we think and what we expect drives our physiology as well as driving our behavior and then essentially creates the the reality that we that we expect. And and you can measure this in many different ways and and you know Ellen Langanger's work is critical to that. Uh be that um you know manipulating how people think about their sleep then affects how they perform the next day day regardless of how they actually slept or manipulating clock time and um or how people think about uh the food that they ate which then affects their blood sugar responses to it even if you know it's a standardized meal under different conditions.

And so we know that what we think drives physiology as well as behavior. and then you sort of get the outcome that you expect uh to a to a certain degree and therefore I think we need to understand that this doesn't have to be the case when it comes to cognitive decline in particular and there's a a few different ways that we can approach that. the the the the the first thing if people think about cognitive function you think about a graph right so on one side you've got cognitive function like on the on the y- axis on the left hand side and then along the bottom you've got age and everybody might expect some they've seen some curve where you know it peaks around your 20s or early 30s this is like exactly the same with physical strength or muscle mass and then sort of just like declines from there and then eventually at some point you'll lose enough function that you might reach a threshold that we call dementia When you're doing those kinds of studies that result in those kinds of graphs, what you tend to do is you just sample a whole bunch of people, maybe thousands of people, and you measure their cognitive function, and you see that on average, yes, as you get older, the function is lower, right?

You add add up everybody's cognitive function divided by the number of people, right? You get the the the average. And yes, some people as they get older do lose function. So, there are people who are sort of dragging the average down. But asking what the average function is or the change in function in an average population over time is not the same as saying what's my function going to be in 10 20 30 years time. And so when studies have looked at that there's a a classic study I think it was one of the first studies to do this.

It was called the Seattle longitudinal study run by Warner Shai and he took individuals starting in the 50s um and he measured their cognitive function every seven years for multiple decades and every seven years he would bring back the old participants and add new participants. So in in the end he had data from people in their 20s up to people more than 100 years old. And what he saw was that the the the um the majority of people so like more than half of people maintained cognitive function into their 50s 60s and 70s.

So yes there were some people who lost function. They dragged down the average but the the norm you know more than 50% of people was to maintain function over time even into your 70s and 80s. And those data were actually used to raise the retirement age in the US because you know he showed actually that we can expect that most people will maintain function later into life. But if we don't understand that as individuals then all those things we just talked about come into play right because we stop doing the things that help to maintain function because we expect function to decline as we get older.

I think about that through the lens of public health messaging and you know let's let's take what you do or what I do on this podcast. You're trying to share information that people can then then then absorb and then if they choose to take on in their life. Yeah. Yeah. Yeah. But there's a there's a fine balance, isn't there? Because if you spend two hours talking about the problems of sleep deprivation sleep deprivation sleep deprivation Yeah. Right? On one hand, you're being honest. You're trying to educate people, but also you're also probably infusing this idea that it's really, really bad.

And actually, as you beautifully write about in your book, you know, we're pretty resilient. You can deal with a couple of nights where we don't sleep. But I I I've changed my messaging around sleep over the years. Let me put it, I've evolved it because I've realized actually that when you do these deep dives, it's great. And for many people, it's like, wow, I better start taking my sleep seriously. Yeah. Right. But then you of course get new parents who then send me messages saying, messages saying, messages saying, I'm really worried, you know, after that last podcast, you know, I'm I haven't slept well for the last 3 months cuz my young baby needs feeding through the night, etc., etc.

And then the unintended consequence is you're trying to help and empower people, but sometimes that same message can be very disempowering and frankly quite stressful. Yeah, there's so that particular example I there's a study that that I reference in the book that showed this is using UK bio bank data again showed that the more children that parents had both men and women the lower their risk of dementia and I thought this was fascinating because on the face of it having kids should be devastating for your cognitive function right stress sleep, you know, all the, you know, all these things that you don't get to do.

You don't get to look after yourself anymore because you're so, you know, busy worrying about this this um this new human that that now has to navigate the world. Um, but this is what happens what happens what happens when we focus on on the downside like downside of stress, downside of poor sleep, downside of, you know, what are the, you know, contaminants in seafood or is your food organic or not. In general, so many of these things, the benefits massively outweigh the downsides. So when you think about kids, right, they come with opportunities for joy, cognitive stimulation, social connection, pro-social behavior, which is just such a critical component of um humans and their evolution and what it takes to to you make them healthy.

Um you know, looking after other people and you know, building a community. And so those benefits seem to massively outweigh the the potent the potential downsides. And like this is then I think the important thing for us to remember. A we are incredibly resilient and adaptable and b usually the things that we're doing want to try and get the the the most benefit out of them as possible. So when we're then worrying about those minutia for like the potential downsides, we're actually offsetting offsetting offsetting some of the benefits that we're getting from all these amazing things that we're doing.

And I think a study that maybe we talked about previously, but is worth bringing up again is um a study where they looked at um physical activity, both actual physical activity and perceived amounts of physical activity. This was done by Alia Crumb, who actually trained with Ellen Langer um and now she's a professor at Stanford. And what they found was that people who um felt like they were doing less exercise than people like them, you you similar demographically, similar demographically, similar demographically, they had a higher risk of mortality.

And there was another study that found a similar thing for cognitive function. So if you if you thought you weren't doing as much exercise as people like you, they ended up having, you know, on average lower cognitive function. Um, and this was after adjusting for how much exercise people were actually doing as well as a whole bunch of, you know, health related confounders. So, what that says is if you spend all your time thinking, I'm not doing enough. I should be doing more, you are then essentially creating a situation where you're not getting benefit from the things that you are doing and creating this this chronic stressor that's that's having negative health effects.

So I so I am much more in favor of celebrating all the amazing things that we do do because those are probably offsetting any of the sort of like the minor things that we we would otherwise worry about. Yeah. And of course in the modern age now now now we'll maybe talk about modern technology and social media later but one of the things of course that many of us have experienced is comparison. Mhm. Mhm. Mhm. Right. And so, you know, maybe 100,000 years ago, you're you're kind of comparing yourself to your tribe.

Yeah. Yeah. Yeah. Maybe 150 people max, maybe less, who knows? Now, we can compare ourselves to the best in the world at anything, right? So, right? So, right? So, you go for your 30 minute walk around the block, the block, the block, but then you go on Instagram and someone's just done an ultramarathon, right? And so you you know your 30 minutes around the block is fantastic for your mental wellbeing, your physical wellbeing, emotional wellbeing, your stress levels, brilliant but there is a risk that you think, oh gee, yeah man, I did 30 minutes I've just done 30 hours or whatever it might be.

Yeah, be. Yeah, be. Yeah, there's there's there's um a really nice paper or set of papers and essentially work done by uh George Slavich and Steve Cole there. They're at uh UCLA uh UCLA uh UCLA and and and um myself and uh Julian Ael who's a retired palative care physician. We recently um curated and edited a set of scientific papers on the importance of community and social connection in health. And one paper was written by um Steve Cole and George Slavage and they talk about social stress and the effect that has on our physiology.

And one thing that was like particularly impactful to me was reading it and you you kind of they talk about social social rank perceived social rank right how we see ourselves compared to others. And and it as you sort of like read as you know I'm reading what they've written. And I'm like, this is why social media is so bad for our health. Because what happens is that you spend all your time seeing people who are doing more than you, more successful than you, richer than you, better than looking than you, whatever, like however you would perceive that compared to yourself.

And what we do is then we rank ourselves like where are we in the in the world? And we de demote ourselves internally because we see all these people who we think are better than us or doing more than us. And being demoted in your in your perceived social rank creates a social stress. And so it creates the a phys a physiological response similar to when we're socially isolated. And we know that when we're socially isolated, we see shifts in our physiology. It changes our immune function.

It changes baseline levels of inflammation. This is a evolutionarily conserved response, right? So, if you're isolated, then your immune system shifts away from being better at dealing with things like viruses, respiratory viruses, because you know, you're not surrounded by anybody to give you a cold or a flu, and it shifts more towards uh an acute response that makes you better with like wound healing, for example, which is survival. That's important, right? There's nobody to look after you if you get injured. And these things are, you know, we can measure them in our physiology.

However, that comes with a baseline lower level of inflammation because your body's like ready to respond to an injury. If you continue that long term, you then see an increased risk of many chronic diseases, heart disease, dementia because of this immune system shift, and that is driven by social isolation, but it's also uh driven by other social stresses such as a lower perceived social rank. social rank. social rank. Yeah, I remember reading that in I think this in the adapt chapter in the book, which is one of my favorite chapters.

Um, that whole idea that the immune system shifts, uh, I think is really interesting. So, I just want to clarify something cuz I think I don't know if you said lower inflammation or higher inflammation. inflammation. inflammation. When it shifts because you're lonely, the cost of that is a higher background level of inflammation. So, it makes us inflamed basically being lonely. Yeah. Exactly. Yeah. Exactly. Yeah. Exactly. Yeah. And some of that being a perception is quite interesting. I I once had a very successful author on the podcast uh Will store.

He's written some brilliant books. We chat about status and I remember chatting to Will and it came up this idea that Will is more successful than most authors in the whole scheme of things. Yeah. Yeah. Yeah. But he's not as successful as some in and let me define success in terms of book sales. Okay. There's many ways to define success. And so Will was, you know, quite honestly just saying, "Yeah, but all I see is all the authors who are selling more than me and who doing better than me." And it it just shows that it doesn't matter who you are, no matter how successful you perceive yourself to be.

I agree with you. I think that may be one of the darkest things that happens to our subconscious when we're spending a lot of time on social media cuz and this is one thing I I I thought I thought about a few years ago. We can talk about this stuff, right? People can know it. I go, "Yeah, when I'm on social media, um I don't take it seriously. It's there. It's just their highlights real, right? real, right? real, right? I don't think it matters. I think your subconscious is constantly being fed that you're not enough.

Yeah, that is better than you. And I know in my own life, so I've recently taken all my social media apps off my phone, so I can go on, but I can't easily get onto them on my phone. Um, and I just feel better. Yeah. Yeah. Yeah. Like that's subjective. I can't give you a trial for that. I just I just feel better. There are Well, there are actually trials that that do look at that, right? And it's interesting because the because the because the the the timeline matters, right?

If you if you ask somebody how they feel about quitting social media after just a week or two, they might not feel that good about it. You still get, you know, FOMO and these other things because you're you're not uh interacting in that world. It's like asking how a how a smoker feels 2 days after they quit. Um they don't feel great. Um, but if you go out long enough, four weeks plus, there seems to be an overall uh increase in in well-being. And this is also driven by what people do instead, right?

And this is where a lot of the issue uh with social media comes from, I think, because because because it can be um a way to increase social connection and social contact that you wouldn't have had otherwise. And we see this in studies in older adults where they're using Facebook for the first time. and they can communicate with family members that they would wouldn't have done otherwise, you know, share photos, that kind of stuff, that is a net benefit. But if you're using social media to consume content instead of going and meeting people in real life, that's a net negative.

And we see that very clearly in terms of uh well-being. So So So yes, you um there is maybe some benefit from at least decreasing our exposure to social media, but you can also curate the way that you use it such that it becomes a net positive. Plus, you need to think about what am I doing instead? Um, and then there are multiple different ways to navigate that. But just appreciating that these um these are potential issues based on the fact that if you're you're constantly, you know, uh being being exposed to to content from people that makes you feel less than either consciously or or unconsciously.

Um it might be having a a net negative effect on your health. Yeah, it's the tool, right? And and like all tools, it depends how you use it. I agree. And at the same time, I think something has happened recently which makes that even harder. So a few years ago, ago, ago, I thought, right, I'm going to cull everyone when it was still called Twitter, I thought I'm going to unfollow everyone and just follow the people who I think really are giving me value. Yeah. Yeah.

Yeah. Right. So some of these, you know, there's a few endurance uh coaches who I really like following a lot of they share research papers on exercise physiology and their experience coach, you know, the things that I really enjoy looking at. looking at. looking at. Yeah. Yeah. Yeah. And I did that and for a while it worked and thought, okay, cuz whenever I go on all I'm seeing is stuff from people actually I want to see stuff from, but I think algorithms have changed where you don't only see stuff anymore from people you follow.

Yeah. In fact, that's only a very small percentage of who you see. So I do think it's getting harder and you do talk about this in the book, right? You talk about the houseian days of social media and I I you know you were very early cuz I think your uni was like the third uni to get Facebook or something like that. Yeah. One of um one of the first unis to get uh Facebook outside of the US in 2004 I think we got it. Yeah.

Yeah. But I remember back sort of I don't know 2007208 Facebook was great. Yeah. you you you it was way of staying in touch with mates, you know, you'd share photos, you'd see what your mates are doing, you might follow a few people and see their content. And it was I think unless I'm looking at it through rose tints and glasses, it seemed to be connection like social connection. Yeah. Yeah. Yeah. I think for many reasons which you don't necessarily have to go into on this show today, but you're right about is it prime, but just explain what prime is.

Yeah. So, this is information that we prioritize as humans. um which um me so the prime stands for prestigious in-group moral and emotional and this is because because because we prioritize information that tells us something about our social environment because that's going to help us survive right and we are inherently social beings and so this then is what's I I think leveraged by the algorithms to have us stay engaged or you know continue scrolling and So they know that information that you will respond to either positively or negatively in a large way is the kind of information that's going to keep you keep you hooked in because your brain thinks this is important information about my social environment that I need to gather such that I will then survive better in my environment.

And so that will include the things that you want to see, right? But it might also include stuff that they know will elicit a negative emotional reaction because you get these large swings in dopamine that then drive learning, right? That dopamine dopamine um is largely um responsible for learning what's important. Um and that's that's done on purpose. And so like I think that social media takes advantage of our need for social information whilst giving us social disconnection, but we keep going back cuz we're like, well, next time I'll learn something that will really help me.

Um, and that's how you get sort of like stuck in the loop. loop. loop. Okay, Tommy. So, so far we're basically up to the point where we're saying that a lot of dementia cases are preventable, which is very empowering message. You've mentioned that the brain can adapt to any age. Again, very empowering. It doesn't matter how old you are when you're listening to this. Um, I don't know if we'll get to your owl story or not today, but you start the start the book with a beautiful story about owls, which really highlights this point, right?

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Okay. because well firstly I do have to tell you I think this is one of the best health books I've ever read. It's absolutely fantastic and fantastic and fantastic and it's it's so thorough. It's what I'll tell you what I like about it the most. Not only is it grounded in a lot of scientific research, it's very clear that you've got a lot of practical knowledge about the application of it as well. And that's not always the case. You know there are sometimes books from researchers which are great and you see all the science but you know as someone who spent many years practicing I'm like yeah but that doesn't that there is a different skill I think to application of these things for real life people who are busy.

So it's a beautiful blend of that. You also, and I know this whenever I talk to you, you seem to know a study for absolutely every I can literally say anything. anything. anything. And um you know a lot of studies, don't you? Uh yeah, that's part of it's an occupational hazard at this point. Um I think the the book has a reference list of um it it'll be about 2,000 studies um 99.9% 99.9% 99.9% of which are in humans um that people can have access to if they're interested in in in digging in further.

It's it's very rigorous. Um, which I think is great, great, great, but I I really love this 3S model that you put forward in the in the sort of the final third of the book as it were. Yeah. Yeah. Yeah. Stimulate, supply, and support. And I'll just before you you sort of go, you know, outline it for us. Something I read last night which I which I've been thinking about ever since is this idea that nutrition nutrition of course is important but I think it's only one of the assets.

Yeah. Yeah. Yeah. And I think that's quite novel because we think well what can I eat to support my brain? You're making this case throughout the book that actually stimulus to the brain is perhaps the most important thing. So it made me think well hold on a minute. If you think about physical health, right, we can talk about eating protein for your muscles, but if you're never stimulating your muscles with movement or with lifting weights, is that protein really going to translate to muscle growth? And then I thought about through the lens of the brain, we can have the right diet, the right omega-3s, and you know, all the things you talk about, right?

We we we can we can have them in our diets, but that seems to be only one of the S's if we're not also stimulating our brain. We're perhaps not getting the the full benefit. So, I said a lot there. I think it's interesting. Can you walk us through the model, then comment on anything I've just said that you feel is important. important. important. Yeah. Yes. So, so what you say is exactly right. And where the model comes from is all the different pockets of neuroscience that I've worked in or coached in over the years.

So I'm thinking about the developing brain. Um thinking about individuals who suffer some kind of brain injury during life like a traumatic brain injury or concussion or trying to help um elite athletes perform at their absolute best. Um and then also thinking about you know what are the factors that contribute to long-term cognitive decline and dementia. dementia. dementia. And you see the same things pop up again and again and again which sort of makes me feel like there are these core foundational inputs that the brain requires in order to perform at its best both on a day-to-day basis but then also long term.

So things that you can do right now to improve how your brain functions today or tomorrow then translate into uh a longer term um lower likelihood of dementia and you know much you're much more likely to maintain the function that you do have or maybe even improve it right in your 60s7s 80s and beyond. beyond. beyond. And And And there are a whole host of factors that we could talk about. We've already talked about several of them, right? But they for me they they coalesce around these three common areas which is what which are the three S's.

So stimulus, supply and support like you said. And I think that stimulus is something that we we inherently know is important. Everybody said use it or lose it at some point, right? But I don't think we've quite understood what that what that truly means in order to give our brains the stimulus that that or the stimuli that they that they benefit from the most. But I do relate it to this idea of physical performance and physical health because people we kind of inherently understand that, right?

If I want to get uh if I want to get bigger and stronger, right? I want bigger biceps, the most important thing to do is to do bicep curls, right? I can improve my response to my training with a higher quality diet and making sure I attend to sleep and recovery, but I can't just drink protein shakes and nap and hope that my biceps get bigger. Okay, this is great. So, so in that physical health example, right, you're making the case that the three S's are still important, but the stimulus is the most important.

Yes. Which I think makes intuitive sense if we step back and think about it. Ex. Exactly. And and in reality, the function of any part of your body is driven by how you use it. Right. And you can think about your bones when you do your weightlifting or you can think about your heart when you go running, right? The way that we use our body is the primary determinant of how it functions. And the brain is exactly the same. So I'm making the case that how you use your brain is the primary driver of how it works.

Okay. So we have this 3S model and I wonder if we could just go through the three of them and you know stimulate, how do we stimulate, supply, how do we supply, support, how do we support? Yeah. Yeah. Yeah. Um yeah, give us a sort of top line on that. that. that. Sure. So Sure. So Sure. So the the stim the stimulus that I think that we need more of and I will acknowledge that I quite like the title of the book the stimulated mind because it's provocative it's provocative it's provocative in a in a way because right now we are at the same time under stimulated and overstimulated.

Yeah. Everybody feels overstimulated, right? So Tommy, how can you tell me that my brain isn't stimulated enough? like I'm I'm constantly feeling stimulated. And so it's the type of stimulus that really matters. And I think we can talk about and you know social media is one of those things we can talk about how you can decrease these other stimuli that make us feel overstimulated or stressed because that's an important part of it that that will end up in our support bucket. But the the the kind of stimuli that drive the development of the human brain are learning, knowledge acquisition, skill acquisition, social interaction, pro-social behavior are, you know, languages, music, um complex uh movements in sports, uh social connection.

these things that require us to learn a skill and apply that skill um in a way that involves processing information quickly in a way that involves responding to the environment, responding to other people. Um and you know through multiple senses, right? Our hearing and vision and touch, taste, smell, like all of these things actually can can be important stimuli for maintaining cognitive function. And it's that kind of complex um skill development and expression across all those domains you including arts including computer games like like complex computer games can even improve cognitive function because it's the same thing you know multiensory complex cognitive stimulus cognitive stimulus cognitive stimulus these are the things that I think we need more of and we need to spend time really attending to them and focusing on them.

Is it the complexity of the stimulation? Is is you know you you mentioned this kind of the paradox of the time in which we live. You know the book is called the stimulated mind. As you say, many of us go, "Yeah, but most people are over stimulated." But is it that it's almost like a we've got too much of the wrong kind of stimulation, like the the uni-dimensional perhaps like the the scrolling cuz you know, let's say you wake up and you go onto your social media platform of choice for an hour whilst drinking coffee.

Okay, you're getting stimulation, right? You might in the hour see more information in the hour than maybe your ancestors would see in a year or maybe even longer, right? longer, right? longer, right? Okay, let's let's just work this 3S model. Let's say for that one hour you got all of this stimulus in, right? And then we go to the supply and go, yeah, and and you let's say you've got an exceptional diet and you're moving your body regularly, so you're getting supply and you're sleeping well that night to allow that learning.

In theory, could that stimulation be beneficial for the brain brain brain to an extent? So, if you're using Instagram and you're consuming educational content such that you're you know learning important facts and thinking and thinking and thinking and thinking. Yeah, absolutely. That can that can be an important stimulus. Um, we know that education and the environment are the primary drivers of brain development and educational attainment is one of the best predictors of long-term cognitive function and cognitive decline. So that's literally just every day your job is learning, right?

You're learning and you're applying that knowledge. That's why attainment is important, right? You're actually remembering things, applying that knowledge in exams or or however that that knowledge is is so so okay. So attainment that's so it's not just going to school and passively uh consuming stuff you have to actively engage in some way. Yeah. So the to kind of like really simplify that it's it's the difference between you know you spend 10 years at school and you you know pass your A levels or you you spend another few years and you get an undergraduate degree, right?

that those levels of attainment versus you spend 10 years retaking the same year in school because you never pass an exam, right? Those are two ve you spent the same time in education, but those are two very different outcomes in terms of applying your brain and making sure that you're, you know, using the knowledge that that you've that you've gained. And can the stimulation that we need like the primary stimulus to the brain um we don't all need the same cuz because you when you've been on the podcast you you have spoken a lot about you know when do we have peak cognitive status is it is it after university or yeah in your late 20s maybe in in kind of the modern western world in terms of how people who go through education and then they might go and study beyond that.

But then it made me think about huntergatherer communities and I and I thought well thought well thought well do we know in these traditional societies whether they have high rates of cognitive decline if they've not done the same type of education but then then I think well but they would be getting stimulated in other ways maybe not in the conventional or the modern academic stimulus you know this stimulus can come in a variety of different forms can't it? Yeah. So I think that's an important um clarification to make because these studies are done in a typical west, you know, western environment.

We're doing specific tests of cognitive function, you know, related to a whole bunch of different um functions of the brain that could involve memory, attention, um decision- making, um processing speed, like how quickly you can process information. information. information. But this is these are just the data that we have access to. This is how we understand it, right? And what that what those data show is that the cognitive function peaks around the time that you leave formal education. So the the later you leave the the later you leave education, right?

So the longer you spend at school or you getting degrees, the higher and later your peak of cognitive function because I think you're just getting this stimulus on a day-to-day basis. But that doesn't mean that that's the way that you have to do it, right? This could happen outside of a formal educational setting. You know, in those, you know, traditional huntergatherer groups, they will actually constantly be learning and then at some point they'll transition from learning to teaching. Right? This is this is a big part of, this is a big part of, you know, um later life where we know that old adults in those communities in their 60s, 70s, and 80s are just as active as their as their younger community members, but they transition to being repositories of knowledge.

And that that is that's the expression of these complex skill skills and information that they've learned, you know, back to, you know, back to younger individuals who are now developing. So they they're still constantly engaging their brains. It's just then using the information that they've gathered. So cognitive stimulus of of this type can come from anywhere. um and you see very interesting studies looking at different um different types of skills that have the same core effects on the function of the brain. So there was this um one of my favorite papers of all time was published very recently.

It was called um creative experiences and brain clocks and what they did is they looked across multiple creative um experiences or skills. So they had uh tango dancers, they had um musicians, they had uh visual artists like painters and they actually also included um a computer game group gamers um including a randomized control trial where they had people game and looked at the effect on their brains. And across all those different um these are very different skill types but across all of them they had this as you gained expertise in these complex skills they saw the same effects on different networks and and functions within the brain.

So there you the the brain has all these different regions and each region has a specific function although but what we're now learning is that really functions are distributed across the entire brain into these complex networks and how well these networks are connected and how efficient they are is uh a primary determinant of how our brains function as we get older. So as we get older, these networks tend to become a little fuzzier and a little less efficient. Um that makes it harder to um say pay attention or maybe slightly harder to remember something.

But as people gained expertise in a complex skill, those networks strengthened regardless of what that skill was. Um this is networks like the front of priority network. It's really important for attention and memory. So what that says to me is that when we're doing these inherently human, creative, multiensory creative, multiensory creative, multiensory um things that requires us to pay attention. It requires us to focus. It requires us, you know, it drives neuroplasticity through learning. And then this is what's important for maintaining brain function, the function of these networks for processing uh information and you know uh language and you know the social aspects of of the things we want to do with our brains.

And that also then means depending on what you find interesting to do, right? I just listed four or five things that are very different but they all have similar effects on the brain. So that just mean that just means pick the one that you enjoy and you know start by not being good at it and get better. And it's in the getting better it's in the you know the learning and the failing that's what drives the improvement of connections in the brain. That's what drives um the you know the improvement in the in the function of these networks that then ultimately translates to improved cognitive function over long periods of time.

That whole interconnected nature of the brain but also more widely the body is also another theme that that underpins the whole book which I absolutely love. It's how I've always seen health and wellbeing and I think when people think about I guess the typical you know inverted commas lifestyle factors like nutrition, exercise, sleep, stress management, whatever it might be. I love that section at the end when and you there's you know you quote quite a few people there about the interconnected nature of health. You change one thing, you change everything.

everything. everything. Yeah. Yeah. Yeah. And I think that's really empowering for people especially when they get bogged down with well that expert said these are the benefits of yoga and that expert said that you know this is the benefit of running. of running. of running. Yeah. Yeah. Yeah. And that expert said these are the benefits of meditation and and yes yes and you don't have to do them all. Yeah. you do the stuff that you want to and you'll probably find that that starts to change other things in the body.

body. body. Yeah. So, so that's and I think to to to fully unpack that we can like flesh out the model a bit more because then you kind of understand how how this how this works which then gives us a lot more agency and it's a lot simpler um in terms to start applying this stuff and benefiting from it. So we have stimulus, right? You've stimulated your brain doing doing something, right? Starting to learn a new language. When the areas of the brain that are related to that skill that you're learning are activated, they ask for more blood flow.

There's this thing called neurovvascular coupling where the the neurons and the astrotes in that area stimulate the local blood vessels to bring in uh they need more oxygen, right? They need more glucose or whatever fuel you're fueling your brain with. Um, and so those blood vessels dilate, you know, they widen, they bring in more blood flow. This is then, so now we're in our supply bucket. And so that's where like cardiovascular health becomes important. We know that um things like high blood pressure, high blood sugar are important risk factors for long-term dementia.

And that's at least partly because they um affect the health of those blood vessels. if you want your brain to be able to react and adapt and do a whole range of different things that our blood vessels need to be healthy and respond accordingly. So, so you've stimulated your brain and now we're going to the second S supply. When you have chronically high blood sugar or you have poor metabolic health, you are negatively affecting the supply and the supply is important to get the most out of the stimulation that you just gave your brain.

Exactly. And is this why perhaps we read things where let's say we've done a 90-minute bout of work um and you know because my son's in his GCSE year I'm talking a lot to him about how he revises and how important it is to move his body and you know um so you know you do the stimulus let's say you've revi your whatever whether it's a child or an adult you let's say you work for 60 minutes on something quite cognitively challenging cognitively challenging cognitively challenging is it overly simplistic to say that if You then go for a walk or a run.

You've done the stimulation with a 1-hour work. The run and the walk has basically got your blood flowing. So your you know your supply from nutrients from oxygen everything is increased. Is that's correct? Right. correct? Right. correct? Right. Yeah. So one of the reasons why um movement is so beneficial for the brain in the in the very short term is because it improves blood blood flow to the brain. Um brain. Um brain. Um so the supply the second improve improve supply exactly and then that also translates longterm right longterm the more you if you're more physically active you may maintain better physical fitness then and physical health metabolic health then you maintain good good blood flow to the bl brain because your blood vessels are are healthier.

Um the the other part of that is that and uh we may get to this more later is that you inc if you increase uh arousal uh which exercise does you increase some of the neurotransmitters that are related to learning and focus and attention and that then afterwards once you've taken a chance to recover and adapt you you remember things better. So we know that if you do exercise before or after learning something, partly due to blood flow, partly due to um arousal and neurotransmitter release, you will then remember those things better.

So that's why um movement around learning can be really important. Plus, if you've been learning because you've been you you've been sat in a chair the whole time, we know that if you if you sit um very still for long periods of time, blood flow to the brain starts to decrease and that can decrease mood and attention a little bit. So it's another way to just kind of reactivate uh everything you know related to that learning process. We all know that moving our bodies more is good for us.

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Yes. So, you've stimulated an area of the brain or the networks in the brain. We're now bringing in more blood flow. Um, right. So we've talked about why uh physical health becomes really important there to maintain healthy blood vessels, maintain good uh uh glucose supply to the brain and we know that in individuals with Alzheimer's disease in particular um there's a there's a a decrease in in glucose getting into the brain that that may be there's two parts to that. One may be due to decreased stimulus, right?

If you're not using your brain in the same way, the brain is going to ask for less glucose, but there may be also an issue with the glucose getting in if we have poor physical health, metabolic health. So then the final part of supply is nutrients. The the critical nutrients that we know are important um both for cognitive function on a day-to-day basis, but also in terms of long-term dementia risk. So, the ones that we have the best evidence for, uh, vitamin D, iron, uh, omega-3 fatty acids, uh, B vitamins, especially the B vitamins related to methylation, like, uh, B12, folate, uh, B6 and rioflavin.

Um, other things that we see are important for long-term cognitive function are like the antioxidant um, vitamins like vitamin C and vitamin E. Um, antioxidant polyphenols. There's very cool things that you could get from, you know, that make berries purple and red or that make um, you know, fruits and veggie veggies orange and red. So like lutein um zeazanthin, aanthin, that's what makes uh shrimp um uh and salmon pink. These antioxidant polyphenols um seem to have really uh interesting benefits for the brain both in the short term and the long term.

Um and then some other minerals like uh magnesium and zinc things like that become important too. So those are the critical nutrients that we're hopefully getting from the diet that then get directed to the parts of the brain that are building new connections, building new signapses as it sort of cements the things that you're learning, right? And so that's that's that's the final part of supply. And then you've stimulated a part of the brain, you've brought in all the resources it needs to do the thing that you've asked it to do.

Then we know that for a tissue including the brain to adapt to a stimulus, it needs uh a period of time to do that. And that's usually during rest, right? So um it's the same if we uh if we if we're going training for something like a marathon, right? You don't get faster while you're running. You get faster while you recover after the training run that you did. And so the brain is the same. This is where sleep is really critical. So now we're in the support the third S.

Um so sleep is a big part of support that that's when all those connections that we've made are cemented. That's when um you know we're building that function in the brain based on the stimulus that we've applied. Um but we can also further support that adaptation through a variety of different things. So that's where hormonal status can become important. That's where other factors that get released uh by the body can support um the neuro neuroplasticity and development in the brain. Things like brain derived neurotrphic factor which is released during during exercise.

These can kind of help to support the direction and and creation of new connections in the brain. Um and then uh sort of the other side of support is want to avoid things that inhibit that process. So um smoking, excessive alcohol, um air pollution, uh other things that can cause um chronic increases in inflammation. So we already talked about the social side, but that could include like uh uh dental dental health and oral health is is a an increasingly recognized risk factor for dementia because uh either because of the direct effect of the bacteria, but also maybe the inflammation that they create.

Um, and then chronic stress uh plays a role here too because we know that if you never get a chance to fully switch off um because you're chronically stressed, then that that can sort of like impair our ability to to to adapt. So then you you realize that all these different buckets are interconnected, right? So um stimulus drives supply and stimulus also drives support. So when somebody um does a cognitively challenging task, they then have a greater need for sleep that evening. So they actually they they may sleep better because they have a greater uh drive for it.

it. it. So So just sorry to push you there. But that could mean if someone's listening to this and they sometimes struggle to sleep and there's many reasons for that. One of the reasons might be that you're not stimulating your brain enough. Yes. So uh one of the ways that we know know that um one of the ways we understand it the best is through exercise. We know that exercise improves sleep uh can improve sleep onset as well as sleep quality. But there are really interesting studies in older adults where they have them do a brain training program uh for a few weeks.

And what they see is that compared to a control group who are just um doing much less cognitively stimulating stuff on a computer, they were using like um paint to just like you know make some things. But it's not the same as like really challenging your your cognitive function with some of these brain training programs. Those who are cognitively stimulated, they ended up sleeping better because they're creating greater sleep drive. And so I often wonder if part of the reason why as we get older we sleep less is because we're not using our brains in the same way.

We're not stimulating them. We're not asking as much of them. So we're not creating that that pressure, that sleep pressure, that drive to sleep. And so because all these things are connected, connected, connected, that then means exactly what you said earlier, which is when you change one thing, you change everything. So, we know that if you start to sleep a bit better, then your blood pressure improves and your blood sugar improves. Um, and the next day you feel more sociable, so you're more likely to engage with other people in like some kind of social interaction.

We also know that if you're less fatigued because you've slept better, you're more likely to engage in a cognitively stimulating task because we avoid cognitively challenging things when we're tired. Um, and the the same is true, right? If you stop smoking, right, blood pressure improves, uh inflammation improves, you're more likely to exercise, you're more likely to make um a more like nourishing meal choice. If you start to um exercise, then you sleep better and all those other things um kind of come off that. So if we understand that these are these are not a long list of things that or all these things we have to do but instead even just within one bucket you would identify something where you're like oh yeah I could start to make a small change there we know that benefits tend to be linear right a little bit more is going to have is going to have some benefit right you don't have to do four hours of exercise in order to see benefit right anything is going to start to be beneficial but you pick the thing that you feel like you can make some change in, you're you would enjoy doing or you know you're able to do the whole network starts to shift in your favor and then you can start to come in from other places as well.

But understand that it's not a a long to-do list that's overwhelming. It's a network that allows you to come in pretty much anywhere and start to see big benefits big benefits big benefits that has huge practical application. I think back to earlier on in my career and I very quickly learned that if I was to tell a patient patient patient or give them loads of things that they could do, you know, say, "Hey," and and I give them the research, say, "Hey, you know what? If you do this, it's going to do that.

If you do that, it's going to do that." And they come back four weeks later, they haven't done anything. Yeah. Yeah. Yeah. Right. I was like, "Oh, I've actually just overwhelmed them." Have you found that to be true yourself in in your own sort of coaching in your own life? life? life? Absolutely. I think that right now it's very common on social media to see here's a list of things to do for your brain health. And they can all be very evidence-based, right? It could be all the things we've talked about today.

But I've seen time and time again, you give somebody a list of 37 things, they will do zero things, right? For those exact reasons. And my my favorite personal experience is the first time I worked in Formula 1. I um you know had sort of interacted with the team a little bit before. This is I do all of my Formula 1 work through a company called Hinsa Performance. Um and I was invited to go to the the US Grand Prix in Austin and I was going to be in the paddock, you know, meeting with coaches and drivers and team principles and all this, you know, all these amazing people and like I was a big Formula 1 fan.

So this was like a this was a big deal for me. You nervous? are very nervous. And then I did what any good nerd would do and I massively overprepared. I was like I went in armed with a hundred things and 200 studies to be like I'm ready. I've got all these things that people could do right to to improve performance and health and all this kind of stuff. And I I remember having a conversation with a coach coach coach um and so the the way that um Hinsa works is the majority of the drivers that we work with, they have a hint coach.

This is usually somebody they have like a master's degree in strength and conditioning or they're a physio or a you some of them are have a psychology background just depending on what the driver needs. But they're there like inserted into the into the life and world of the driver. They're there every day. They hold the helmet next to the car, hold the umbrella. They're doing all the warm-up drills. They're doing all the training and they're looking after diet, all this kind of stuff. They're sort of like organizing their lives.

And these are these are the individuals that I spend most of my time interfacing with like how can I help the coach do their job better? And so I'm meeting with this coach for the first time and I think I'll probably start throwing out all these different ideas. And he he's like, "We've got time for maybe one thing maybe." Right? What you don't realize or maybe don't think about is that first of all, your drivers are essentially jetlagged nine months of the year because they're constantly flying from place to place.

Plus, you have to do all the um well, there's the races, but then there's all the preparation in between. There's media days. There's you got to go and smoo the sponsors, right? Cuz everybody wants their piece. Plus, you've got a million people like me showing up and be like, "Hey, try this thing. Do this thing. Hey, right." And so so then it it it come he's like right we've got time for one thing what's the one thing that you think would have the biggest impact and so like ever since then that's the mindset that I've had to take in like if we we can start with a big net but first of all like where's the biggest potential anchor or issue that's affecting this one individual?

What's the highest return thing that that person could do with the time and resources and things they have available? And that's that's where you start. Um, and yeah, sometimes you get it wrong. Um, and that's true for all of us, right? We we experiment. Yeah. And like, of course, like some of some of this requires some trial and error, but but but starting with the one thing that you think is most likely to have an effect is always going to be much more likely to actually start to move the needle because you'll actually start to do it rather than thinking about a hundred things that I've suddenly thrown at you like, well, I just don't know where to start, so I won't do any of it.

of it. of it. Yeah. You mentioned Formula 1 and I know we've I've always wanted to delve deep with you about your experience there because it's super fascinating. Um, as you were describing the drivers there and the pressures on them, the pressures to compete, to perform at high level, to deal with jet lag, sponsors, everyone wanting a piece of their time. I thought, "Wow, that must be quite stressful." And perhaps some of these extra commitments that they have potentially are going to get in the way of their ability to perform, which is ultimately what they're paid to do.

But of course, they have to appease the sponsors and all that kind of stuff as well. well. well. From all your time in Formula 1 and having worked with several drivers, would you say there is something that's common to all of them? like an a an a a skill or an attribute that actually you know what they all seem to have that something that something that something that I I see across you know all the successful athletes I've either worked with or interacted with is in a way that's relevant to them focusing on process above results because and I think this is This is also relevant to to everybody.

Yeah, for sure. Because Because Because you will never achieve the result or and you can never guarantee the result. Yeah. Right. Yeah. Right. Yeah. Right. Um but you can enjoy the process and figure out what works best for me. How can I make this better? How can I continue engaging with that? Um how can I be more targeted in the things that I do and don't do so that I have better better overall balance. I think it's people who who love that process and really focus on improving the process itself then end up consistently uh achieving high levels of anything.

And this is this works in academia and sports and you know any kind of um area that that you might think about. The other thing that I see very consistently and I don't just say I like we as as a team the team that I am part of I'm head scientist for motorsport for hensa but you know we have doctors we have coaches we have a bunch of performance experts psychologists right that we all and we all work together the thing that I see most consistently then is is this need for down regulation and recovery right so if we're thinking about our 3s's unlikely unlikely that we can come in and somebody's already, you know, performing at that level and say, "Do you know what?

You need more stimulus." Right. Right. Right. Right. Right. Because they've spent their entire lives learning how to drive those cars and dedicated to that craft. They Right. You're driving around a track at 200 miles an hour. You're getting you're getting plenty of stimulus, right? Um and you know, we spend a lot of we spend a lot of time, you know, looking at blood work, looking at diets, you tweaking those things just to kind of make sure that they have all the bases in in in place.

But really recovery is is where a lot of the the benefit is going to be seen. Like how can we get the allow these guys to rest, recover, downregulate, adapt so that they can get the benefits from the the stimuli they're receiving that, you know, physical um in their training, you know, in the car, you know, everything they have to do around engineering and and working with the teams there. So, so the third S, third S, third S, the third S becomes really critical um for them and that's probably where we spend a lot of our time focusing because in driver development and this is something we we we do a lot of now as as a company and we're we're doing more and more over time and and trying to improve these processes.

You know, if you have a a young driver wants to be in Formula 1 in 5 10 years time, yes, we might focus on stimulus. how can we build skills and and and fitness and performance um cognitive physical um and so like that's maybe where we focus. But once you get up to that tip, it's it's thinking about how can we make sure they're getting the most out of what they're doing and you know so that they can sustain performance for long periods of time. Yeah.

It reminds me a little bit of um I think a case you write about in your book when you first started coaching perhaps. Was it a was it a a runner who was Well, you can tell the story because it's it it it really now I'm looking at that fresh through the lens of the 3S's going you can stimulate all you want and supply all you want but if you ain't got the capacity for the support for the rest the sleep for you to absorb the stress and adapt to it you ain't going to get any faster.

Yeah. And and so this is this is something that's very common in amateur athletes. So like this this this uh individual wasn't they were they were a high performer. They comp they competed at a high level but they were they were an amateur um as in you know they weren't paid to take part in their sport. And so this was a runner who who came to us several years ago and did felt like his um performance was going backwards. So like he wasn't getting the race times that he wanted and was also sort of like slipping back in the field whenever you compared compared to others.

others. others. But he was training wasn't he? He was training. Yeah. So he and was training very very hard. Plus you layer on top of that um the a travel schedule that was that was quite brutal because every two or three months he would travel internationally to to compete. Um and so the reason why I tell this story in the book is because it was the first time that I you know because as a coach previously um I would focus on stimulus right what's the training program like how can we improve that but it was the first time when I looked back well I looked you know across everything that I had from this individual and thought all these other pieces are the are the most important pieces and so like I think the first thing I said to him was if you continue this the only thing I can guarantee is that you'll get a divorce right And um it was a bit tongue and cheek, but basically you're seeing somebody who's overtrained, not eating, not able to eat enough calories to to um or not able to have the the cognitive bandwidth to focus on getting enough calories in because they're so focused on their training plus a brutal travel schedule.

Plus, right, they're a they're a husband, they're a father, right? they have a family to to to that they should spend time with that they're not that they're not focusing on because they're just like so focused in on on their training. Um, and this then essentially made me realize that it's all these all these other things are going to affect our capacity to a get the benefit of the stimulus that we're applying. Um but you know be like the the overall picture of of what it even means to be an athlete or be an individual in the world that that we want to be right.

He presumably and I think this was the case and you know he he made changes to his training program and his and his his race schedule to kind of uh take take account for these things right having a a family and being a husband and father was was more important than racing. But like once you're so deep into this and you're um you know so stressed and um overworked, you become very focused on singular things like what's the thing that I can control? And what he felt he could control was I'll just train more.

I'll just do more, right? That's the thing that I I I that's the needle I can move. when actually that was the thing he he needed to pull back on so that he could then benefit from that and actually think about like who is actually who is the person who who is the person I want to be that yes is an athlete and performs well but also does all these other things and so then by focusing on the recovery aspects by focusing on these other areas maybe even training a little bit less making sure that he was eating enough right enough supply to kind of support this the adaptation then he ended up doing less but performing better because he was taking care of these other areas.

I imagine a lot of people listening are probably thinking, well, yeah, I could probably get more stimulation, you know, I could probably learn new things or get more social connection or whatever it might be, learn new skills, all that kind of stuff. Regular listeners to this podcast will of course know about the importance of regular movement, good nutrition, the the stuff that you'd put in that second bucket of supply. Yeah, but I think this third S of support is something that a lot of people need help with these days.

So many people struggle to downregulate and switch off and maybe they're not getting the right kind of stimulation in the day or when they're scrolling in the evening. But it is so common now for people to feel wired but tired, right? They are knackered but they can't switch off and fall asleep. Yeah. So I know you sort of there's a whole chapter on this in the book but have you got some sort of practical guidance for people who might be experiencing that at the moment? I think I think one of the thing things that ends up being very common is is is because of the way we structure our workday.

workday. workday. We get to the end of the workday and we're still we're still we're still sort of stressed about what we have and haven't done. haven't done. haven't done. Plus, we're sort of desperate for some kind of way to to switch off that that we end up um spending a lot of time on screens, social media, right? And and those things can be beneficial if we if we or you know they they they don't have to be that detrimental if we we if we craft our experience with them.

But a lot of what happens when people can't sleep you know this sort of like tired and wired thing I think is downstream of our um lack of structuring how we spend our days. So days. So days. So in in in um you one of the first um you one of the first people that I met when I was working when I started working with Hensson is a guy called uh James Hwitt. um he's uh he he used to be a professional cyclist and now he's a sort of a a cognitive performance specialist performance specialist performance specialist and and and he wrote a book with Akiha who founded Hinsa called exponential where they they outline this idea of cognitive gears and it sort of again relates to sort of like the physical side and physical training and but basically we have three gears in which we can use our brains.

Um, high gear is sort of really deep focused work. Like this is when we're paying attention to one thing at a time. We're doing something complex. We're learning. We're problem solving. Um, you know, these big tasks that we have to get done in our days. Um, low gear at the other end is, you know, when we're fully, you know, switched off, relaxed, you know, our brains free associate, right? you know, this is why we have uh moments of inspiration in the shower because we're not sort of constantly having to deal with other other inputs or this is, you know, often happens when I'm in the gym.

Like that's when I'm not thinking about anything else and sort of like ideas kind of appear. Same when you go for a walk, right? walk, right? walk, right? And ideally your brain spends a lot of time in this kind of mode because you need that mode to recover from this like complex cognitive work that that you've been doing been doing been doing even during the day like in addition to sleep sleep sleep where we spend most of our time if not all of our time is in the middle gear.

So think about high gear is like sprinting, low gear is like walking and middle gear is kind of like jogging or running. running. running. And we basically spend our entire day running. And if you imagine like how exhausting is it to run all day? You couldn't do it, right? But you just like keep trying to keep keep going. Um, and this is essentially what we're doing to our brains in the modern work environment. And it's uh the middle gear is, meetings, uh, emails, dealing with Slack and Teams and all these different inputs, multitasking or task switching across multiple like trying to deal with multiple things at the same time.

like you're trying to do some work and then an email comes in or a message comes in or we you know we get to the point where we're so used to distractions that we distract ourselves. There's some really nice work from from Gloria Mark, fantastic book called Attention Span if any if anybody's interested in this. But basically, if we're distracted a lot, our brains get used to distractions and then we go looking for distractions, you know, like when you go to pick up your phone, even though it hasn't gone off and there's no I mean, you you I mean, you have your your framework like why now?

Why am I doing this? Like what what what is it for? But we basically get to the point where our brain gets used to distraction and goes goes looking for it. And so we know that when we're forced to multitask or, you know, we're interrupted in our work, which is essentially everything we're doing in the modern work environment, it's inherently stressful. It it creates this low level of stress. And then you layer on top the fact that you never get a chance to do the really high quality work that makes you feel useful, right?

This this is what I'm good at. Like this is this is a job that I'm here to do. Um, and it could be, right, researching or writing a book. It could be uh you know preparing presentations for a a board. It could be you know luckily um you know if you're like a a surgeon right they get to remove all the distractions and actually do their their their work but that's the kind of thing that we want to be doing like focused this one thing that we're doing.

This is the thing that we're good at really applying ourselves. But we'll do that with a surgeon because we know that someone's life depends on it. it. it. But without being flippant, you could kind of make the case that all of our lives depend on it, right? Like if yes, we're not surgeons or many of us who are listening are not surgeons. I'm sure there are a few surgeons listening, but but but you know, the quality of your life probably does depend a lot on how you're spending each day.

Yeah. Yeah. Yeah. Right. So, yeah, a surgeon has a reason to do that, but we kind of need to give ourselves that reason as well, I think. Exactly. And so we want to feel we want to feel useful and productive, right? We're no longer, you know, as as a species, our history was largely, you know, our productivity was largely due to physical work, right? Hunting, gathering, farming, but now the product of our work is due to our brains, right? We're knowledge workers. Um, I'd like to call us all cognitive athletes, right?

And so like that's important because the best athletes like I was saying earlier they know they have very targeted training they have very targeted stimulus and then they focus on recovery adaptation how getting the most out of their training whereas we just spend all day jogging and never think about the recovery that our brains need in order to perform at our best. So well then what happens is at the end of the day you've felt very busy and very stressed because you're constantly bouncing around between all these different things.

You know you're in in Zoom while you're also writing an email but you're like not paying proper attention to either of them. Um and so that is that process is inherently stressful. Um and we know that people make more more mistakes and errors and feel more stressed when they're interrupted or they have to multitask. And then you're stressed about the fact that you didn't actually do that really high quality focused piece of work that you needed to do because you were so busy in meetings and multitasking.

Um, and so then when you get to the end of your day, you're like you're stressed about the fact that you didn't do do those things. Um, and then you have to try and somehow wind down and go to sleep. So you then may rely on other things that could that you feel like are allowing you to relax but could could compound that. So it could be social media or it could be, you know, a glass of wine which then, you know, impairs your impairs your sleep and then or you two glasses of wine and then the right then the next day the whole kind of cycle starts again.

So I kind of start by thinking about how can I structure the workday so that even if it's just for 30 minutes I can just get the get the thing that I need to get done today done and you do that by if if you can structuring your day so that whenever you feel best like each of us feels most focused mo most alert most you know attentive at one specific time of day and it could be in the morning it could be in the evening right depending on chronoype and other things during that period of the day like just get just set aside half an hour to like do the thing that you need to do.

And then you can also set aside time to do the the do the meetings and other things, right? And the emails. We we all have to do that. But in between those things, allow yourself time to get to to have a break. Can you go for a 5-minute walk, right? Can you just like look outside at something green? Right? There are studies that show that we can um become reinvigorated and less cognitively fatigued just by looking out a window at greenery for 90 seconds. Right? So it doesn't necessarily take that much.

There are also some nice studies where uh people feel reinvigorated after 5 minutes of watching comedy clips on YouTube, right? Just something to completely disengage from the work that you're doing. So can you build some structure in that allows you to do high quality focused work? Can you build in breaks during the day that um so that you can you know recover just like in between bouts of sprinting, right? You can't sprint forever. You have to like take a break and then you go back and do it again.

And then at the end of the day, if there's anything that's still on your mind, you know, that you need to get done or your to-do list, like we know things that like mental offloading can really help with sleep. So, like you write down your to-do list or you write down the things you're worried about. Um, and then that um helps people fall asleep helps get it out of your mind. Get it out of your brain. Yeah. Exactly. And and then maybe you can also think about those other things that you might be doing in the evening that that could impair your ability to sort of wind down and and recover.

But I kind of think about it in that way that your sort of like tired and wired thing starts at the beginning of the day. Um, and then there's also like the cycle of alcohol and caffeine which is very common that can then also impair that process. Um, but just thinking about how we structure how again how we use our brains I think sets us up for the ability to wind down in the evening. Yeah, I love the idea that if you're feeling tired and wired in the evening, evening, evening, think about how you started your day.

Yeah, Yeah, Yeah, it's not just about what's happening in the evening, right? The whole day plays into that. into that. into that. One thing I've often spoken to patients about is this idea of a stress threshold and that you accumulate all these stress doses in the day. And when you get to your personal stress threshold, and we all have one, and you know, each one of ours can be different depending on our resilience, depending on what we've got going on in our life, but it's when you hit that threshold that the problems often start or when you get close to it, your back goes, your neck goes, you react to an email, you said something about you shouldn't have done or whatever it might be.

And I have seen over the years if once people understand that stress threshold concept and go yeah so I' I've been working for a couple of hours I'm I'm getting closer to it to it to it can I take a five minute break just move myself away from it in the day you just keep you never let it accumulate to the point where you hit because once you've hit it it's hard you can downregulate with you know there's breathing sections in your book that you you know different exercises people can do and there's all kinds of things but if you can and if you do have a degree of autonomy over your Okay.

Building in those like regular sort of micro breaks. Yeah. Yeah. Yeah. It has an outsized effect in my experience. experience. experience. Absolutely. Um especially if you can so so like um like I said any any kind of hard cognitive work right you need you need a break from just like with just like with physical work and it doesn't have to be that long. It just has to be something that completely dis you know allows you to to disconnect. And you know even better if you can pair it with just like a very brief exercise snack or period of movement because like I was mentioning earlier if if we if we spend long periods of time sitting mood starts to drop right maybe that's where you know maybe like our stress threshold decreases right uh blood flow to the brain decreases a little bit you know we don't have quite the same sort of level of cognitive um function so just like breaking up sitting and using that as a as a cognitive break if you can go outside or you and just like do anything.

You can just like step back. There's multiple things that then happen at that that moment in time that allow you to then go back into it, you know, just a few minutes later. If you enjoyed that conversation, then I think you are really going to enjoy this one. This is probably the most effective diet that's ever been promoted on the planet. This protects our body against decay, disease, and the root causes of aging. is not only good for you but will make you live longer.