Brain Health: How Music and Lifelong Learning Can Prevent Cognitive Decline

In our latest Bionic Health podcast, Dr. Jared Pelo interviews neurologist-turned-entrepreneur Dr. Josh Turknett about the science of brain health, cognitive decline prevention, and how learning complex skills like music can help maintain brain function as we age.

From Neurologist to Music Education Innovator

Dr. Josh Turknett's journey is anything but conventional. After completing medical school and a four-year neurology residency at the University of Florida, he spent years in private practice treating neurological conditions. But over time, he began to recognize a significant gap between what he could offer patients in clinical practice and what he believed they truly needed.

"I came to realize that a lot of the issues I was seeing as a neurologist were related to lifestyle and preventable types of things," Dr. Turknett explains. Through his own experience with migraines, he discovered that dietary changes had a more profound impact on his condition than conventional treatments—a revelation that would eventually lead him to reconsider his entire approach to neurological health.

While still practicing neurology, Dr. Turknett pursued his passion for music, specifically the banjo. Drawing on his background in cognitive neuroscience, he began integrating principles of neuroplasticity into his musical practice. This eventually evolved into BrainJo, an innovative platform that teaches musical instruments through neuroscience-based approaches.

The "Stimulate and Support" Framework for Brain Health

When it comes to maintaining cognitive health, Dr. Turknett advocates a simple yet powerful framework: stimulate and support.

"There are two things to think about in terms of keeping a healthy brain throughout our life," he says. "We have stimulation on one side and support on the other side."

Stimulation: Fighting Autopilot Mode

Cognitive stimulation is essential for maintaining brain health, but Dr. Turknett points out that many of us, especially in established careers, operate largely on autopilot. "The more you can spend your day on autopilot, the less cognitive stimulation you've provided," he explains.

Real cognitive stimulation comes from activities that trigger plastic reorganization in the brain—essentially, learning new knowledge and skills. This is where complex activities like learning a musical instrument come in.

BrainJo currently offers instruction in multiple instruments:

• Two styles of banjo (claw hammer and fingerstyle)
• Piano
• Ukulele
• Fiddle
• With guitar coming soon

Support: Giving Your Brain What It Needs

Just as important as stimulation is providing your brain with the resources it needs to maintain existing neural connections and build new ones. Dr. Turknett identifies several key pillars of brain support:

1. Physical activity - Particularly activities that combine cardiovascular fitness, strength training, and cognitive demands (like tennis or pickleball)
2. Sleep and rest - Critical for neural recovery and consolidation
3. Nutrition - Including key nutrients like B12, vitamin D, magnesium, zinc, and copper
4. Stress management - Limiting chronic stress that can damage brain tissue
5. Social connection - Perhaps the most underappreciated factor in brain health

On the often-overlooked importance of social interaction, Dr. Turknett notes: "Being around other people, conversing with other people, being in social situations is an enormous cognitive stimulus... one of the reasons that we see [cognitive] deterioration is because of the loss of that stimulus when people are isolated."

Assessing Cognitive Risk and Monitoring Brain Health

Many people, especially those with family histories of dementia or genetic risk factors like APOE4, wonder how to assess their risk for cognitive decline. Dr. Turknett emphasizes that while there's no single test that can definitively predict risk, there are several approaches to monitoring brain health:

• Regular cognitive assessments, whether through formal testing or self-monitoring
• Basic blood work to identify conditions like metabolic syndrome or nutritional deficiencies
• Lifestyle evaluation to identify areas for improvement

He recommends foodforthebrain.org for those interested in comprehensive cognitive evaluation with a nutritional focus.

Rather than viewing cognitive health as predetermined, Dr. Turknett stresses that "we are actively influencing our risk all the time." This empowering perspective frames brain health as something we can continuously improve through our daily choices.

Anyone Can Play Music: The Science of Learning at Any Age

Dr. Turknett's new book, "Anyone Can Play Music: How to Realize Your Musical Potential with the Laws of BrainJo," challenges the common belief that learning complex skills like music becomes impossible as we age.

"The reason we can learn anything at any age is because we have this ability to change the brain at any age," he explains. "Learning complex skills relies on neurological mechanisms that we all share."

The book outlines principles for leveraging these natural mechanisms, often requiring readers to unlearn ineffective approaches taught in traditional education. It's as much about how to learn anything as it is about music specifically.

A Prescription for Brain Health

For someone in their mid-40s concerned about future cognitive health, Dr. Turknett recommends:

1. Evaluate your current cognitive stimulation - Is your work challenging your brain, or are you on autopilot?
2. Incorporate complex real-world skills - Music, dance, or sports that demand coordination and strategy
3. Ensure physical fitness - Combining low-level movement, resistance training, and occasional high-intensity exercise
4. Monitor nutritional status - Particularly for B12, vitamin D, and other brain-essential nutrients
5. Prioritize social connection - Ideally through activities that simultaneously provide cognitive stimulation

The key is finding activities you enjoy that provide both cognitive challenges and social connection—like joining a community of musicians or picking up a sport like pickleball that combines physical activity, strategy, and social interaction.

Beyond the Clinic: Making a Broader Impact

Dr. Turknett's transition from clinical practice to entrepreneurship reflects his desire to have a greater impact on brain health than the constraints of a traditional medical practice would allow.

"To actually fulfill the role that I initially signed up for... I could do a much better job doing what I'm doing now than I could in the clinic," he reflects. Through his online platform, books, and educational content, he's able to reach and help far more people than would be possible seeing patients one at a time.

This sentiment resonates with Dr. Pelo, who made a similar transition from emergency medicine to focusing on preventative health through technology. Both physicians recognize that while there will always be a need for excellent clinicians, there's also tremendous value in creating scalable approaches to health that can benefit millions.

Time Stamps:

00:01 - Introduction and welcome

00:13 - Josh's background and journey from neurologist to entrepreneur

02:59 - Josh's personal experience with migraines and lifestyle changes

03:59 - Discovering neuroplasticity and challenging fixed mindsets about adult learning

06:51 - Transitioning from clinical neurology to broader impact

10:09 - The challenge of leaving clinical practice and finding new ways to help people

11:40 - How BrainJo evolved to address cognitive health

14:33 - Musical instruments you can learn at BrainJo (banjo, piano, ukulele, fiddle)

15:26 - Assessing cognitive decline risk and preventative strategies

17:39 - The importance of monitoring cognitive function

18:37 - Key nutrients for brain health (B12, vitamin D, magnesium, zinc, copper)

20:33 - Why genetics isn't deterministic for cognitive decline

21:29 - The value of cognitive testing and brain games

23:27 - Practical advice for a 45-year-old to prevent cognitive decline

24:03 - The "stimulate and support" framework for brain health

29:19 - What types of physical activity are best for brain health

33:08 - The surprising importance of social connection for brain health

36:46 - Josh's new book "Anyone Can Play Music" and the science of learning

40:31 - Conclusion and where to find more information

Learn More

To discover more about Dr. Turknett's approaches to brain health through music, visit brainjo.academy. His new book "Anyone Can Play Music" is available wherever books are sold.

This blog post is based on a Bionic Health podcast interview. At Bionic Health, we believe in affordable, precision medicine for optimal health, delivered by doctors and AI working together.

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Understanding Your Metabolism: More Than Just Burning Calories

Ever wondered why some people seem to eat whatever they want while others gain weight just looking at food? The answer lies in understanding metabolism - your body's complex system for converting food into energy. Let's break down the science into digestible pieces.

The Building Blocks of Metabolism

Basal Metabolic Rate (BMR)

Think of BMR as your body's pilot light - it's the energy you need just to exist. Even if you spent all day binge-watching your favorite shows without moving, your body would still burn these calories to:

• Keep breathing
• Produce hormones
• Grow and repair cells
• Keep your heart beating

Resting Metabolic Rate (RMR)

RMR is like BMR's close cousin - it measures similar things but under slightly different conditions. The main difference? RMR can be directly or indirectly measured while at rest and is influenced by recent activity and meals. For practical purposes, they're nearly identical (only 10-20% difference).

Your Daily Energy Breakdown

Here's how your body uses energy throughout the day:

BMR: The Heavy Lifter (60-70%)

• The majority of your daily calories go toward basic survival functions
• This is why crash diets that drop below BMR are so dangerous

Thermic Effect of Food (TEF) (10-15%)

• Yes, you burn calories digesting food!
• Different foods require different amounts of energy to process:
  
  • Protein: Burns 20-30% of its calories during digestion
  • Carbs: Burns 5-10%
  • Fats: Burns just 0-3%

Exercise Activity (EAT) (5-10%)

• Calories burned during your workouts
• High-intensity exercise creates a longer "afterburn" effect
• More intense workouts = longer metabolic boost

Non-Exercise Activity (NEAT) (5-10%)

• The fidgeting, thinking, and random movements you do all day
• Can vary significantly between individuals
• Often decreases during dieting (you naturally move less as your body attempts to limit calorie burn, being in a deficit)

Smart Weight Loss: Working With Your Metabolism

Want to lose weight without wrecking your metabolism? Here's the smart approach:

1. Never eat below your BMR - it's like trying to drive a car without enough gas
2. Calculate your target calories:
   Daily Calories = (BMR × Activity Factor) - 250
3. Aim to lose 0.5-1 pounds per week (anything faster usually backfires)

The Calorie Quality Question

Not all calories are created equal. Here's why the type of food matters:

Protein: The Metabolic MVP

• Burns the most calories during digestion
• Increases overall energy expenditure
• Helps preserve muscle during weight loss
• Keeps you feeling fuller, longer

Carbohydrates: Choose Wisely

• Complex carbs require more energy to digest
• Simple sugars are "metabolically lazy" and digest quickly, great for a workout but not at rest
• Quality matters as much as quantity

Fats: Essential but Efficient

• Burn very few calories during digestion
• Important for hormones and health
• A little goes a long way

Practical Takeaways

1. Focus on protein - it's your metabolism's best friend
2. Don't crash diet - it's like putting your metabolism in hibernation and most people gain back all the lost weight and more once they end
3. Stay active - both planned exercise and daily movement matter
4. Choose complex carbs over simple sugars
5. Remember that healthy weight loss is a marathon, not a sprint

Your metabolism isn't just a simple calorie counter - it's a complex system that responds to how you eat and move. By understanding how it works, you can make better choices that support your goals while keeping your body's engine running smoothly.

Remember: The best approach to managing your metabolism is one that you can maintain long-term. Quick fixes might work temporarily, but they often lead to metabolic adaptations that make maintaining weight loss harder in the future.

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Nutrient Timing: A No-Nonsense Guide to Fueling Your Workouts

Let's talk about nutrient timing - your secret weapon for better workouts and faster recovery. Think of it as a GPS for your nutrition: right food, right time, better results. Here's everything you need to know about eating around your workouts.

The Basics: Protein Throughout Your Day

Getting your protein right is like building blocks for success:

• Aim for 20-40g protein every 3-4 hours (that's about 0.25-0.40g per kg of body weight)
• Choose quality protein sources - your body will thank you
• This steady protein flow keeps your muscles happy and recovery strong for optimal muscle protein synthesis

Remember: Your needs might vary based on your age, fitness level, and goals Consult a dietitian or your Bionic Advisor!

Strategic Meal Timing Guidelines

Pre-Exercise Nutrition (3-4 Hours Before)

Key Objectives: Minimize gastrointestinal distress, provide sustained energy and support performance. This can be adjusted for different eating schedules (e.g., intermittent fasting), though carbohydrates are recommended before endurance training.

Think of this as laying your workout foundation:

• Go for foods that won't upset your stomach (low GI is your friend)
• Easy on the fiber - now's not the time for that extra-fibrous cereal
• Balance is key: plenty of carbs, light on fats, moderate protein

Try This: A bowl of Greek yogurt topped with berries and a sprinkle of granola. Simple, effective, delicious.

Immediate Pre-Exercise (15-60 Minutes Before)

Focus Areas: Easy digestion, quick energy availability, performance support

Quick energy time:

• Choose easily digestible carbs - they're your immediate fuel
• A little protein goes a long way
• Consider caffeine if it's your thing - it can help spare glycogen and boost performance

Perfect Snack: A banana with a bit of peanut butter or a couple of rice cakes with honey.

Intra-Workout Nutrition (During Exercise):

For those longer sessions (60+ minutes):

• Fuel up with 30-60g carbs per hour
• Sip on a sports drink (aim for 6-8% carb solution)
• Take 6-12 oz every 10-15 minutes

Go-To Options: Sports drinks, energy gels, or even some dried fruit or banana.

Immediate Post-Exercise (0-2 Hours After)

Primary Goals: Trigger insulin release, facilitate carbohydrate storage, support muscle repair, This is your golden opportunity for recovery:

• Quick-digesting carbs are your friends
• Pair them with protein for the perfect recovery combo (2:1 Carb: Protein Ratio)
• If you've been sweating buckets, get 12-16 oz of fluid with those carbs per lb lost

Example: Try a turkey and hummus wrap on whole wheat with some fresh veggies, or keep it classic with chocolate milk, a classic post-workout option that provides carbohydrates and protein for muscle recovery and glycogen replenishment.

Extended Post-Exercise (2+ Hours After)

Recovery Objectives: Transition to anabolic state, accelerate waste elimination, replenish glycogen stores, support muscle repair and growth, strengthen immune system

Now we're talking proper recovery:

• Focus on quality whole foods
• Keep those carbs flowing, especially after long distance endurance work
• Match your intake to how hard you worked

Perfect Plate: Grilled salmon with a sweet potato and some steamed broccoli for a balanced combination of protein, carbohydrates, and vegetables for recovery.

Pre-Bedtime Nutrition Strategies

If you’d like to incorporate a post-dinner snack, end your day right:

• Aim for 30-40g of slow-digesting (casein) protein
• Add some complex carbohydrates for good measure
• Skip the sugary stuff - your sleep is precious

Benefits include: enhanced protein synthesis for muscle growth, increased overnight metabolic rate (burning more calories at rest!), and supported recovery.

Bedtime Snacks:

• Hard-boiled eggs with a slice of whole grain toast
• Cottage cheese or Greek yogurt with berries for the sweet tooth

The Bottom Line

Think of nutrient timing like seasoning your food - it can make a good thing great, but it won't fix a bad recipe. Focus first on eating quality foods consistently, then dial in your timing to level up your results.

Remember: These aren't rigid rules - they're guidelines to help you perform your best. Experiment, adjust, and find what works for your body and schedule. The best nutrition plan is the one you can stick to consistently.

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