I am JJ Virgin, PhD Dropout, sorry, mom turned four time New York Times bestselling author. I’m a certified nutrition specialist, fitness Hall of Famer, and I speak at health conferences and trainings around the globe, but I’m driven most of all. By my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information that I uncover with as many people as I can, and that’s where you come in.That’s why I created the Well Beyond 40 podcasts to synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode we’ll talk about what’s working in the world of wellness, from personalized nutrition and healing your metabolism to powerful aging and prescriptive fitness.

Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out. 100. Don’t miss an episode. Subscribe [email protected] to start unlocking your healthiest, most energetic self. So I know we usually talk about women’s health and women’s issues on well beyond 40.

And I also know that we all have special men in our lives, and so today I’m going to dig into Men’s Health and give you the kind of operating manual on how to help them get healthier. I have the perfect, perfect doc with me today. It’s Dr. Miles spar. Uh, he went to the Michigan Medical School, worked as a humanitarian for Doctors Without Borders, and that really kind of triggered his appreciation for lifestyle and community as well as.

Uh, the personal engagement in each person’s ability to achieve their goals in health. And life in general. He has internal medicine training. He has training in integrative medicine at University of Arizona, Andrew Weill Center for Integrative Medicine, and he also established a free integrative medicine program at.

PQHQ in the LA area. He’s board certified in internal and integrative medicine and has now really focused on root cause medicine, medicine 3.0, which you’re gonna learn what that is. He’s the chair of the American Board of Integrative Medicine as well. I wanted him to come on. Because he is really focused on performance, high performance.

He’s worked with NBA players and high achievers all over the place. And what I wanted to bring him on and share was like, how do you talk about a man about his health? Because they tend to not be proactive, if you’ve noticed. And so what can we do to help there? And, um. What things should we be looking out for?

And that’s what you’re going to hear today. And also, he is the author of the Optimal Men’s Health Book and a TEDx Talk as well. So we’re gonna put that at the show notes at jj virgin.com/miles. And that’s m. YLES. But it will make it very easy for you to be able to have the conversation with the men in your life, or even young men in your life, and then get them started on the right path.

So I will be right back, Dr. Miles spar. Stay with me.

Dr. Miles Spar. Welcome to Well Beyond 40. Believe it or not, we like have never really talked about men’s health on this show, which is, uh, a disservice since we all have men in our lives. And you are the perfect, perfect person to do this. So I am super excited to have you with us. And where I’d love to start with is, one way I think we can get men ex inspired and motivated is to kinda relate it back to performance, because I know you’ve worked with NBA players and executives.

When you look at any. Guy, especially as they’re getting older, they, they worry about losing their edge and not being able to perform well. So what are some of the things that you’ve done with say, NBA players and high performers that could translate over to, you know, everybody else?

Yes. Yeah. Well, I think part of it relates to asking for help.

Every professional athlete I’ve worked with has specialists that help them, right? They have coaches, they have trainers. They didn’t have trainers for specific activities within their sport, so they’ll have a, for basketball, they might have trainers that really work with them on doing jump shots and not straining and ankle, and knowing what’s going on with their body at every point in time, and they’ll have someone else that’s working on other aspects of their body.

They have. One’s a specialized in recovery on supplementation, on nutrition. So again, looking for help, getting a coach doesn’t mean you’re weak. It means that you know that the best use of your time is not to do a deep dive in every single aspect of health and wellness. It’s to find out who you can trust and then take advantage of that expertise and bring that on.

Um, and I think the other thing is an acknowledgement among every really. Successful person, whether it’s a celebrity or a professional athlete, it’s having kind of a holistic perspective. And I don’t mean a woo woo perspective. Mm-hmm. But I mean, for example, we looked at professional NBA players. We found that their shot accuracy went down if they looked at social media before bedtime.

Because it affected their sleep if they were revved up looking at social media and that sleep affects their performance. So looking at all the aspects of your performance and what do you wanna win at in your life. Maybe it’s not being an NBA player winning a game, but maybe it’s really winning at work or in your relationship with your kids, whatever.

And then what needs to get you there and not being distracted by things that are gonna pull you away from that and understanding what all would contribute to you winning at that. It’s looking at. Stress again, with basketball players, we looked at, if they weren’t focused, they would have a much higher risk of having an ankle sprain, the number one injury in NBA players because they didn’t really think about how to do that jump shot correctly and land correctly because they were distracted.

So it’s about learning that you control your reactions, doing breath work, meditation, doing work on really understanding yourself and. Knowing how to stay focused, working on sleep, working on nutrition, all these different pillars. So I’d say the two things are getting help when needed from expert and really having a very holistic understanding of what contributes to performance.

I love that you framed it in terms of winning. I.

Yeah.

Because those are like, I did this, um, study with Alison Armstrong and she talked about the different words that you would use for like asking a man how they feel and they’re looking at you like, what are you asking me? Versus what do you think, you know?

Right. And framing things about winning, you know, it changes, changes the game. Uh, there’s so much talk out in the world of women’s health mm-hmm. About cortisol. Mm. Yes. And you just don’t hear it in. The guy’s world at all. Yeah. Like how, how does a man identify this is an issue for them? Yeah. You know? And how do you make something like focusing on your sleep?

Because I’ll tell you, when I met my husband, I. He was sleeping five hours a night. Mm. I’m like, oh, this is not gonna work, honey. Right, right, right. At all. Now I’ve turned him into like a major sleeper. Now he meditates like he does all the things, but none of that was like he, he slept five hours a night and he ran like crazy.

And I’m like, okay, we’re gonna lift weights and we’re gonna meditate and we’re gonna get good sleep. Like Nice.

Yes. Right? Yes.

Yeah. He wouldn’t have done it on his own. Right. I saved his life. I always remind him this.

There you go. Yay. Good on you. And good for him. Um, yeah, I think so you start out asking about cortisol and so that does play into all this.

I think one key point for listeners to understand is cortisol is toxic to your brain. Literally, it’s toxic to your, it’s toxic to your brain. It kills brain cells. It decreases something called BDNF brain. Derive neurotropic factor. That’s very important in growing brain cells. We know, you know, when I was in med school, we learned, well, you’re born with your brain and that’s it.

No, the brain continues to grow and you can continue to develop what’s called neuroplasticity, more synapses, more pathways, hopefully in good ways and not in bad habits. But to do that, you need this. BDNF cortisol is toxic to that and the ratio of cortisol to a male hormone that women have as well, but are especially important in male called DHEA is actually very important.

And DHEA is protective for those brain cells. So the first thing to know is if you have too much cortisol and not enough DHEA, both of which can be measured, then you need to adjust that by a. Affecting your cortisol and getting it down by managing your stress better. Some guys mistakenly feel that, oh, when I’m really stressed, I’m really productive and I need that adrenaline.

Guess what? No, nobody is. You may think you are, but you don’t think creatively when you’re in fight or flight mode, you think, how do I get out of this? And just get out of it and not think more broadly. So typically, if you think about it, sometimes you can’t think of the most obvious, like an escape room.

If any of your listeners did escape rooms. The people who are most stressed can’t think creatively of how to figure out the solution. Whereas the people that are just chill, we’ll get this, we’ll figure it out. They are able to think creatively. ’cause when you’re stressed. That takes away brain energy. So it is a myth to think high cortisol is making you productive.

It’s like someone on crystal meth thinking they’re getting a lot done when they’re actually just running around, not getting a lot done. So that’s the first thing. And then I think what is contributing to high cortisol, I. It’s not managing stress in a mature way, so looking at breath work, looking at meditation or mindfulness, there are millions of great apps that can just help you tone down that stress feeling, which is cortisol and measuring it.

Everything’s about measuring that’s, and we will get to that, I’m sure, but part of this medicine 3.0 is really measuring how you’re doing and that’s where we should be in 2025. You can measure something called heart rate variability or HRV. You can measure that on an on a a smartphone or use a device like an AA ring or a whoop band or an Apple watch.

And that’s a great measure of how your cortisol or your sympathetic nervous system is. And then you can try experiments to lower your nervous system, which is gonna lower your cortisol. You can try sleeping more like your husband to see how that affects it. You can try. Breath work. You could try journaling, prayer.

You could try. Doing a sauna, try different things ’cause it’ll be different for everybody. What effects it may be even supplement, but I think the key is assessing where you’re at with your stress response and your cortisol and then trying things out and you’ll see how much more productive you are. Not less productive.

And since you brought it up, medicine 3.0.

Yes.

What, what is this? What is that? Yeah, what is it?

Well, I think, I think it was Peter Attia that kind of made it famous, but it’s become kind of the, the thing that we’re all working towards now that are more cutting edge, modern clinicians that are really trying to help move our field of medicine and healthcare forward.

So Medicine 1.0 was kind of very early before we really even understood the germ cause of. Disease. Right? Then Medicine 2.0 was like, oh, there are these things called bacteria. They cause disease. Let’s develop antibiotics. It was amazing in creating the ability to treat acute disease, all about treating disease though, and that’s why we are great at treating acute disease because Medicine 2.0 got us their intensive care units and emergency surgeries to open a blood clot and put in a stent and all these amazing, amazing developments.

But there wasn’t much focus on prevention and how do we participate more as individuals in our own health. So Medicine 3.0 is the evolution of that saying, well, let’s try not to need all those Medicine 2.0 interventions by actually looking at what can we do? How do we participate in our own health, by what we eat, by what supplements we take, by how we exercise, how we sleep, how we manage stress.

In the name of prevention and I would say in a proactive way, and then measuring it so important in this medicine 3.0 is. Using metrics, and that’s a very guy thing against stereotypically. Mm-hmm. Right? With every man I work with, I have some metric tied to what their goal is, what’s their individual goal they’re trying to achieve, and how are we gonna measure it, and how can we show where they’re moving in that direction?

And if they’re not, then how do we hold ourselves accountable? So it’s really looking at measurable goals, working a little bit to stay healthy, so that participation and being very preventive focused.

So in Medicine 3.0, like what are the labs and things that you are measuring and looking at to give you this information?

I’m assuming it’s not like the old stuff that they used to do. Right,

right, right. No, no. Yeah, I mean, I. Honestly, the old stuff you get in your annual physical is actually based on what insurance reimburse is not and what would help you. And I know that’s kind of sounds like conspiracy theorists, but it’s just the absolute facts.

Um, I actually have a TEDx talk on this that talks all about this, um, that it’s all about what? Was done to see if you’re really sick and need to get treatment right away. But if you’re really looking at prevention and looking around the corner and staying well, you need to do a deeper dive. And it doesn’t have to be crazy expensive, honestly.

But there are certain labs, like for example, the number one killer of men and women is cardiovascular disease. A regular lipid panel is literally gonna miss the majority of people who are gonna have a heart attack. The majority of people who have a heart attack have normal cholesterol. So you need to dig deeper.

You need to look at other particles that are like cholesterol that increase your risk. So these are called, uh, a OB is a big one or something called LP little A, and then inflammation markers like CRP. So I would absolutely add those three to a cholesterol panel. A OB is. All of the particles that are dangerous for heart disease risk that are like one of the things you see in your lipid panel called LDL, but much more expansive and they’re looking at the number of those particles and all of them all together, not just the one you see in that LDL that increased risk.

LP little A is a marker of genetic risk. I don’t know if y’all, your listeners, remember Bob Harper, who is the host of the biggest Cruiser? Mm-hmm. Fit guy. Young and had a heart attack. His cholesterol was fine, but his LP little A was off the charts. And actually I contributed to a New York Times piece on this of why aren’t we all getting LP little a, I mean, look at this.

That would’ve identified him before he had his heart attack as being at risk. Thankfully, I

saved him a lot of money. I mean, here’s the thing, like I’m, it’s, I’m listening to this going, okay, if the insurance company is doing this because they’re trying to do risk reward and save money, they actually are.

Not saving money. No. By not looking at these things.

No, I know. I know. You can make yourself crazy. Trying to make sense of it. It doesn’t make sense, but So getting that LP little a, again, it’s not crazy expensive, but ask for that, especially if you’re over 40 for sure. And then also looking at, well, and you only have to do that once.

Right. That exactly. I mean it, you can follow it over time only if you’re doing very aggressive interventions or some injectable medications to lower it. So, but other than that, you’re absolutely right. And then inflammation. Okay, so we know most disease, including early cognitive changes, and I.

Cardiovascular disease is all related to inflammation. So you wanna measure what is your inflammation like in your body. The best way to do that is through something called CRP C-reactive protein. Again, not crazy expensive, really important because if you have, let’s say normal cholesterol and normal A OB and LP A, but really high inflammation, you’re still gonna be at risk and you need to do that.

And there’s a lot you can do and we can talk about that if you want to. I’m sure you’ve had episodes on decreasing inflammation. And then the last thing I would say is. For cardiovascular disease risk, looking at actually has that risk expressed itself by getting some kind of scan if possible. And if it’s accessible to you of the arteries are in your heart to see if you already have blockages.

So we can go into that if you want. But, and the

scan you’re talking about specifically is what? Like a CT angio or what?

CT angio, ideally. ’cause that looks at what’s called soft. Plaque and calcified plaque. Um, can we

talk about the differences between those because I think this is super important.

Yeah, sure.

So, yeah. So, you know, heart disease happens when you have a plaque in your vessel taking blood to your heart, and it ruptures, explodes, and causes a blockage of blood flow that has to do with inflammation and a plaque being there. That plaque could be hard or soft. So there are coronary calcium scores which are helpful, that look at the hard plaque to see have you had plaque built up over years that’s been there so long it gets calcified and that’s certainly helpful and good to get to see.

Have I had issues for a while that I need to make sure I address? The newer, even better, is one that looks not only at that hard plaque, but what’s a soft plaque? So you can think of it as newer plaque. It hasn’t been around long enough to get all calcified, but it’s still there and can therefore rupture and cause a heart attack or stroke if it’s in a blood vessel leading to the brain.

So it’s a more and expensive and invasive test. If you’re at risk based on first doing those tests and then you see you’re at risk, then investing in a test like that can be really helpful, um, to know where you’re at. And I think what can help you decide what all testing you need is doing a genetics test.

And that’s kind of where I like to start, just to see where do I need to focus my attention? Do I have risk of diabetes and I need to test for that? Do I have risk for heart disease? Do I have risk? For Alzheimer’s, where are my, my kind of weak spots genetically, which doesn’t mean I’m predestined to have a problem, but it means I need to work a little harder to attenuate that risk and do a little deeper dive in that direction.

So changing gears over to my favorite subject of all.

Yes,

and that is muscle Uhhuh. You know, I’d love to address muscle and yeah. Testosterone, those two things. Yeah. Um, but where, where does muscle come into this? ’cause again, when I met my husband, he was, i’ll, I’ll tell you a little interesting story that you can unpack is, uh, he’d always been a runner.

Mm-hmm.

And a very tall, uh, lanky guy. You met him. And we went and did DEXA scans a couple years ago. Mm-hmm. And his DEXA scan for an athletic guy who eats healthy and he would go work out. But I was like, I kind of felt like he was phoning it in, but I wasn’t gonna say anything. You know, it’s like no profit in your hometown.

But, um, his DEXA scan was 25% body fat.

Wow. Okay,

so normal weight, if anything, a little on the light side and you know, 25% body fat. I’m like, honey, you’re a skinny fat.

Yeah.

You know it, he kicked it into gear and what he did was, um, his testosterone was sitting at around 300. He cranked it up 900. Mm-hmm. And then we did everything else, like up to his protein, like added like up to his weight training, everything.

Got him from 25% down to 10%.

Nice.

And what was cool was he dropped 27 pounds of fat and put on 24 pounds of muscle.

Amazing.

I wish we’d done one intervention at a time because it was eight months. And I always tell people testosterone had to do, uh, like a good part of that, right. Because. There’s no way you’re putting on that amount of muscle in Yeah.

You know, in eight months, unless your testosterone’s really gotten kicked up. But I’d love, love you just to unpack that. Talk about the role of muscle, because here’s the thing that, that made me crazy about this. You go to the typical doctor’s office, you step on a scale, he was normal weight. Mm-hmm. He looked, you would never have suspected this.

Right. Right,

right. And you know, the difference is insane, but no one would’ve ever known. Right. Unless they were looking at body composition and, you know, and then unpacking and, and again, they would’ve kept a testosterone at this lower level too. Oh, that would

make insane have at it. What do. Muscle and then we’ll get to testosterone.

So muscle’s hugely important, right? Especially in the last, I don’t know, five, 10 years, we’ve seen that loss of muscle mass, which is called sarcopenia, is correlated with early mortality.

Okay, but stop right there because here’s my issue with sarcopenia.

Yeah.

We don’t even have a really good clinical definition of it.

And no one’s looking for it. Right? Like how are they looking for it?

Right. No, it’s a great point. But in general, I would say doing like a DEXA scan and looking to see what is your muscle mass versus your fat mass. Mm-hmm. And for guys, and it’s different for women, they have a higher general fat mass. Um, U under 15 is really should be the goal.

So your goal isn’t just like your husband, not on the scale, that’s not gonna help you. It’s what’s your waist circumference If you can’t get a, a DEXA scan or through a DEXA scan or another, they have the dunking ways to measure your body.

Oh God, we had to do that in grad school. Yes, exactly. Horrible.

I know.

So try to get you, Dex has the gold standards and they’re not that expensive. But yeah, under 15% is what you kind of wanna go for. But the reason this is so important is. That amount of muscle mass is number one important for longevity. Number two, it’s actually hormonally active muscle is not just blob tissue, just like fat tissue doesn’t just blob muscle actually makes myokines.

They make hormones that affect your heart disease, risk, your liver, your testosterone, your pancreas, insulin resistance. The big issue right now, we’re all metabolically dysfunctional and we all have high blood sugar and insulin resistance. And the more muscle mass you have, the more insulin sensitive you are, the less muscle mass, the more insulin resistant.

And that’s directly related to things you’ve probably heard about and J J’s podcast here, A MPK, and all of these, these inflammatory mediators that are actually. Favorably impacted by more muscle mass. So number one, it’s not just about having your beach body, it’s about your longevity and your health.

That’s a side benefit.

That’s a right, exactly the the mu. And that’s why you need to work out your lower body and do your legs, guys. That’s the thing guys. Now.

Oh, I know. Biceps and chest. Biceps and chest. I’m like, come on,

come on. You have giant muscles in your legs and so you’re not gonna get all these benefits of muscle mass just from your chest and biceps right back, especially, and quads and your glutes.

Don’t forget this. So anyway, so muscle mass is important for metabolism. And for testosterone production. Okay, so it’s, it’s this like positive cycle. The more testosterone you have, the easier it is to build muscle, the less muscle you have, the lower testosterone, and then it’s harder to regain that muscle.

It’s this kind of vicious cycle or positive cycle depending on which cycle you’re in. So absolutely assessing where you’re at hormonally with your testosterone and your estrogen. Are really important as you’re trying to build muscle. Testosterone helps you build it. It’s what’s called androgenic. Um, estradiol, which we have as men.

We have less than women, but we have some should also be checked. The biggest mistake I see around testosterone is guys will get their testosterone checked and they’ll say, oh, my doctor said it was fine, but all they had was just a regular testosterone check. So for. Women listeners out there, if you’re thinking about your husband, your father, your son, anybody, and you’re wondering what’s going on, and their body isn’t looking great and they’re depressed and they’re losing muscle mass, check a hormone level, but check, not just total testosterone, check what’s called free testosterone or bioavailable testosterone.

Not that hard to do in addition to testosterone, but that’s really, really important. And then also check in estradiol because. A guy will have the same issues with high estrogen that he has with low testosterone. So we start with that, and then if it’s in the three hundreds, like your husband, that’s very, very low.

What also makes me crazy is,

but here, miles, I’ve heard this is normal. I can’t tell you how many times I, I literally, someone DM me on Instagram, they said, my husband’s testosterone’s 300, and the doctor said, fine. I’m like, ah.

Yeah, so like two things with that. One is, yeah, you know, for some labs it might be considered normal, but guess what?

The normal range on labs, it’s about the average of the men who went there and got a testosterone drawn, which is not healthy and not optimal. You want what’s optimal, not what just normal by that LabCorp request lab. Okay. And so we know that 300, 3 50 is low. Um, it is not optimal at any age. Um, the other thing I would say is that that doctor probably told that person is, yeah, testosterone declines with age.

You just deal with it. Well, that’s like saying, oh yeah, you get a cataract when you age, just deal with it. No, you get the cataract fixed, you get the cataract taken out. You don’t just deal with it. You don’t have to just deal with testosterone declining. Yes, age is the number one cause of lower testosterone, but it doesn’t mean you just deal with it because it has impacts.

In fact, low T is associated with mortality as well. So getting it treated, and we can go into that if you want ways to treat it. But it’s absolutely important in longevity, but also in muscle mass and in making sure you don’t get metabolic syndrome and heart disease and all these other downstream effects and where are you trying to get it to?

Well, so that depends on, you aren’t just treating a number, you’re really, really treating the symptoms. So if you have a guy, symptoms of low T, for example, are obviously some sexual issues, low libido, sexual dysfunction, ed, erectile dysfunction. But it can also be things like moodiness and not able to put on muscle despite working out gaining more fat mass.

Um, so if fatigue, so you’re looking at. At what point do you get those symptoms? Better by giving t, but generally the upper third or so of the range. So we’re talking like 700 to a thousand for total. Testosterone levels is generally good. You’re not, if somebody still doesn’t feel great at a thousand, you’re not gonna make ’em feel much better.

At 1500. There’s something else going on. I don’t buy it that, that. They wouldn’t, they would have a testosterone issue if it’s in that range. But typically the upper third, and I don’t agree with labs that say, oh, a normal range for a 30-year-old is a nor different from a normal range for an 80-year-old.

No, optimal levels are optimal levels no matter the age we, it’s safe. And this big study just came out last year called the Traverse trial. Very big studies showing once and for all that even in. Older guys at risk on testosterone. There was no increased risk of using that testosterone if they needed it to get them into a normal range, it did not increase risk of cardiovascular disease.

So it’s safe and improves quality of life and improves exercise, improves bone health, a big cause of frailty in aging as bone issues and men just like women and low T contributes to that. So it’s very important to normalize it.

You, you know, you look at this and it’s the same with. Um, women in hormones.

I go, but all of our health problems happen when these hormones go down.

Mm-hmm. Yeah. So why are

we sitting here afraid of

this? No. And for women, didn’t we learn lesson with women For years, we made the mistake of trusting those trials that came out in the eighties that said, oh, don’t use hormone. Hormone is.

Terrible and dangerous. And finally in the last 10 years, we’ve realized, oh, we really did a disservice to women in poo-pooing hormone replacement. It has a lot of important effects and if done correctly is really actually healthy. Same thing with men, like we don’t need to relearn the same thing.

Now I know that, um, that the guidelines have shifted a lot.

Like years ago it was any man going on testosterone also needed to go on like something so that it didn’t convert to estrogen.

Mm-hmm.

So where are the guidelines now with that?

Yeah. Yeah, I mean, basically you wanna measure your estrogen. So testosterone gets converted to estrogen. It’s via ar, an enzyme called aromatase.

And so some guys will need a blocker of that enzyme. This is where the genetic test can be helpful. It can tell you, are you a guy who’s more prone to converting testosterone to estrogen? If I give you testosterone, you’re just gonna convert it all to estrogen, in which case I have to give you a blocker.

Or are you somebody that doesn’t over convert that? So there aren’t guidelines on, on testing for that genetic. Test, but that’s where we can get to this personalized level, right? Where I can know for Jim, I give him testosterone with a blocker for Ted. I don’t need to, but it’s So generally the guidelines are to at least test estradiol and then retest after you start testosterone to see if it’s gone up.

And if it’s gone up, you block it. Some guys will make the mistake of. Blocking it too much. We do need some estradiol. We don’t want zero. It’s important for bone health, for heart disease. And some like guys who get OIDs in the gym, frankly, that aren’t as healthy and reputable, they might hear from other guys at the gym, oh, and take this blocker.

You wanna get your level down to zero. That actually isn’t healthy. You wanna get it down to a healthy level. So that would be between 10 and 40 for men, for estradiol. Um, if it’s much over 40, you could have symptoms. But you don’t want it under 10 because that actually is dangerous.

Now you mentioned briefly about brain health.

I don’t know the statistics for men. I’ve been paying attention to the statistics for women and they’re pretty high. I think women are a higher risk for dimension cognitive decline.

Yeah, true. But

what is the risk for men and what can they do here?

Yeah. Yeah. So the top 10 premature cause of death. So preventable cause of death.

Men win at nine of them, but women win it. And that’s Alzheimer’s. So Alzheimer’s die more often of Alzheimer’s than men do, so that is true. But men do get Alzheimer’s and they get early cognitive changes. And the thing we know now is a lot of that is due to inflammation in the brain and it has to do a lot with.

Blood sugar in the brain. David Perlmutter talks about type three diabetes and he’s he among others. Looking at how blood sugar in the brain getting rid of blood sugar, actually the enzyme that gets rid of blood sugar competes with the enzyme that gets rid of plaque in the brain. And so if you’re working on getting rid of blood sugar, you’re gonna have more plaque.

We now know there’s a lot more than just plaques that weigh into dementia. So. There’s a big tie in with metabolic issues that we hear about with heart disease and risk of early cognitive decline. So what I would say to keep it simple is anything that’s gonna help the heart is gonna help the brain because you’re gonna help blood flow and you’re gonna help inflammation.

So I would really think of those together. If you wanna get. More kind of nuance. There are some specific supplements and nutrition regimens that can really contribute if somebody already knows they have bad genes around Alzheimer’s or if they’re having some early cognitive changes, even early Alzheimer’s.

There’s Dale Bredesen wrote this amazing book called The End of Alzheimer’s, how you really break down and see based on lab tests, what. Particular issue does that person have contributing to their dementia? And what should they be doing with sleep or stress or inflammation or blood sugar? But for the most part, anything that helps heart disease around blood flow and inflammation is gonna help.

Um, brain health and one. Quick. Interesting thing, JJ, that I found out that I read about recently. So it used to be that guy’s number one concern in terms of longevity and getting older was around prostate cancer and now their number one concern is brain health and early cognitive decline even more than prostate cancer.

Hmm. So it is top of mind, no pun.

So should we, if someone did have say, you know, the A POE four genotype

Yeah.

Should they be more proactive or would it be that being insulin sensitive and exercise and sleep and all the things would be enough? Or would they wanna go farther than that?

Yeah, great question.

Yeah, I would go farther. It depends to some degree if there are what’s called heterogeneous or homogeneous, right? So you get two genes. I know your listeners know that one from mom, one from dad. If both are this E four copy, then you’re at about 10 to 12 times the risk of early Alzheimer’s. So I get more aggressive with my patients like that, which basically means nutri, absolutely op, dialing in sleep, dialing in stress.

Exercise hugely important, but also looking at specific supplements and diet. So supplementation. There are supplements that really help boost what I just said earlier. This brain derived neurotropic factor BDNF. There are supplements that can help things like um, acidic choline and phosphatidyl seine, and I love mushrooms and not.

Me too,

right? Yeah. But especially like Lion’s Mane, and these are called No Tropics and they’re absolutely shown to really help with cognition. The most important thing is to use your brain. And so learning a language, constantly doing something that builds those new pathways that I talked about, that’s a huge one.

Um, but the exercise is a big thing. I think that. We forget in people that are at higher risk because the more you exercise, like I said, you’re gonna promote growth factors all over the body and in your brain especially. So I think that’s a, a big part to include. Um, and just being really aggressive with that.

Yeah. When you look at cognitive decline, the, and you could only pick one intervention exercise beats everything. Down. Yes. Hands down. Yeah. Which makes me so happy.

Yes.

I was like, I finally feel like the exercise physiologists are getting their due here. Yes. You know? Yeah. You’re always the low men and women on the totem pole, and now it’s like every single longevity marker.

We’re like, exercise, exercise, exercise.

No, it’s true. And I would just say, just to clarify, to break it out into the various types, right? And I know your listeners know this, but it’s looking at not just the cardio, which a lot of people focus on, and that’s hugely important that it’s

hugely, but I think it’s.

Actually the least important of all of them.

Yeah. I mean, I think strength training, like we talked about muscle and how you stimulate growth factors, how muscle is, is hormonally active. It will stimulate brain development and then flexibility to prevent falls and then core strength. So like those are.

Four really important pillars, and you could do some things that touch all of ’em. Yoga can touch a lot of those things, right? It’s a little bit of strength, body weight, resistance, strength. It’s certainly flexibility and certainly core Pilates touches a lot of those, but you gotta incorporate all those elements.

I love that. Yeah. That’s why you could just do high intensity functional training.

Mm-hmm. You

know, and get everything.

Absolutely. Yep. And

get the hit. And get everything else. All right. So. To put a bow on this. Yes. You’re going to give our listeners one thing that they could go back to their favorite man in their life and say, this is the one thing I would love you to do.

What would it be?

I can only pick one. Oh my God. Okay. Well,

1, 1, 1, 1.

I’m, I mean, I think it’s, it’s, I would say measure. I would say measure is the other. No. One thing. And then I want you to measure. When you’re gonna start an exercise program, get your body fat down to 15%, measure your stress. Um, so I think finding what matters to that guy and measure how it’s moving and then coordinate interventions to move that mark.

I think that makes a ton of sense because first of all, I am, I made big measure person, like what you measure and monitor, you can improve, but especially in the male psychology, yes. It’s hugely effective. Yes. And again, was the only way, like the way I got my husband to do to, to get, you know, to get moving on this stuff was taking him to get a DEXA scan.

Yeah. And it incorporates this competition a little bit and gamification a little bit. Mm-hmm. And really respond too. Um, but the other last thing I just wanna say, and, and, and you can totally. Edit this out, but we didn’t touch on. It’s so important is relationships and connection and we don’t talk about that enough with men.

I think women talk about that. That’s hugely important. We learned in Covid, men didn’t do well in Covid ’cause we didn’t have nearly the relationships. What

is up with you guys though? Like, here’s the thing I watch, I watch my husband, all my guy friends and they just don’t. Like women have such a different way with relationships and we sit and talk through all our stuff and guys like they don’t do it.

I know, I know what that I, again, I think it’s an embarrassment in front of other men, but that’s why it’s like a shoulder to shoulder thing with guys instead of face to face. So they’re activities you do with a guy that will helps you. Then suddenly as you’re helping him with, you know, with his deck, you can be like, Hey, I’m not.

Speaking of wood, this is, you know, as opposed to just confronting them with it.

It was funny when I had, you know, when I had people one-on-one, I would do all the nutrition and fitness stuff, but I would get them out working out, and then it was like, blah, blah, blah, blah. Okay. All right.

Exactly.

Yeah. None of the stuff you could ever ask him just.

Flat out they wouldn’t tell you, but Right. Then, you know, once they’re ready to talk. Same with my sons. Once they’re ready to talk, it’s coming out. Yes. You never know

when it’s gonna happen, but Right. Gotta be there.

Now you’ve written a book that’s the perfect, like manual for men. Tell us about it.

Sure.

It’s called Optimal Men’s Health. Um, and it’s really an easy to read kind of list of things to look for, things to talk to your doctor about what kind of labs like we’ve touched on you should be getting, and really my toolkit. Around how you know, because men love a toolkit around what you can do to really get into this idea of how I stay healthy as long as possible.

Perfect. And the TEDx talk that you did, what’s the title of it? Because I wanna link to all of this in the show notes.

Oh my god.

Well, we could just look for Dr. Miles spar then. Yeah,

I’d have to look that one up. It’s been a while. Alright. Change your annual checkup to a check in and live longer. Oh, it’s a horrible, oh.

There you go. Catchy ca check up to check in. Yes. So, okay, we’ll put both of those at jj virgin.com/miles. M-Y-L-E-S,

right?

Yes. M-Y-L-E-S. And thank you so much. All the, uh, all the women here. Thank you for giving us the tools to get the men inspired in our lives. And, uh, think just keep doing, doing your stuff.

We need you out there.

Ah, thank you so much. I appreciate it. Great to talk.

Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life. To ensure you look and feel great and are built to last, check me out on Instagram, Facebook, and my website, jj virgin.com. And make sure to follow my [email protected] so you don’t miss us.

Single episode. And hey, if you’re loving what you hear, don’t forget to leave a review. Your reviews make a big difference in helping me reach more incredible women just like you, to spread the word about aging powerfully after 40. Thanks for tuning in and I’ll catch you on the next episode.

Hey, JJ here, and just a reminder that the Well Beyond 40 Podcast offers health, wellness, fitness, and nutritional information. That’s designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment.

If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Make sure that you do not disregard, avoid, or delay obtaining medical or health related advice from your healthcare professional because of something you may have heard on the show or read in our show notes, the use of any information provided on the show is solely at your own risk.

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