Understanding Brain Aging and the Fight Against Alzheimer's

In the latest episode of Medicine 3.0, Dr. Jared Pelo sits down with Dr. Christin Glorioso, physician, neuroscientist, and founder of NeuroAge, to discuss brain health, Alzheimer's prevention, and the cutting-edge science of measuring brain aging.

A Personal Mission Driven by Family History

Dr. Glorioso's journey into brain health research began with personal experience—her grandmother suffered from Alzheimer's disease, and she recently discovered she carries an APOE4 allele, which increases her own risk. This personal connection has fueled her 20-year career studying brain aging and what can be done to slow it down.

"My life has been dedicated to coming up with better solutions for people who have high risk of Alzheimer's, which if anyone lives long enough, that's really all of us," Dr. Glorioso explains.

The Science of Brain Aging

After completing her MD-PhD at the University of Pittsburgh and Carnegie Mellon, followed by postdoctoral work at MIT, Dr. Glorioso has focused on understanding the molecular changes that happen in the brain as we age. Her research reveals that approximately 2,000 RNA transcripts (about 10% of the genome) change with age in ways that can either protect against or increase the risk of neurodegenerative diseases.

One of the most encouraging findings: people whose brains are biologically five years younger than their chronological age are significantly protected from Alzheimer's disease—even if they carry genetic risk factors like the APOE4 allele.

The 40% We Can Control

While genetics plays a significant role in brain aging, Dr. Glorioso emphasizes that approximately 40% of our risk is determined by lifestyle factors we can control:

1. Exercise - At least 30 minutes daily, with particular benefits from getting your heart rate into zone three, which releases BDNF (brain-derived neurotrophic factor)
2. Diet - Mediterranean diet, coffee, tea, and foods rich in polyphenols (like berries)
3. Social connection - At least an hour of social time daily
4. Stress reduction - Cortisol is particularly harmful to brain cells
5. Mental activity - At least an hour daily of mentally challenging activities
6. Sleep - Quality sleep is essential for brain health

Measuring Brain Age

NeuroAge has developed multiple approaches to measuring brain health:

• RNA biomarkers - Blood tests measuring 52 RNA transcripts
• Cognitive testing - "Neuro games" that assess various cognitive functions
• MRI brain imaging - Measuring volumes of 26 different brain regions
• Genetic testing - Identifying genetic risk factors

While MRI provides the most accurate assessment followed by blood biomarkers and cognitive testing, Dr. Glorioso notes that even simple cognitive tests can help determine whether memory issues are normal for your age or potentially concerning.

The Future of Alzheimer's Prevention

Beyond testing, NeuroAge is working toward developing therapies to reverse brain aging—essentially creating a "statin for Alzheimer's" that could safely prevent the disease. The data collected through their testing program contributes to this research in a privacy-protected way.

"We're creating therapies to reverse brain aging... something that's safe, you know, a pill that people can take that is going to prevent Alzheimer's in the future," Dr. Glorioso shares.

This partnership between Bionic Health and NeuroAge represents an exciting opportunity for members to assess their brain health and take proactive steps toward preventing cognitive decline. As Dr. Pelo notes, even without extensive testing, everyone can benefit from living as though they're at high risk—the lifestyle interventions that protect brain health also enhance overall quality of life.

Timestamps:

• 00:18: Introduction and Dr. Glorioso's background
• 02:11: Dr. Glorioso's path to neuroscience and MD-PhD training
• 07:27: Research at MIT and Pittsburgh on human brain aging
• 15:04: How RNA transcripts relate to brain aging and disease
• 18:22: The six key lifestyle factors affecting brain health
• 24:12: NeuroAge's three main testing approaches
• 27:59: The future goal: creating therapies to reverse brain aging

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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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