Louisa Nicola is a Neurophysiologist and Brain coach to elite performers. She founded Neuro Athletics which helps high performers gain an extra advantage in their field. Neuro Athletics believes that the greatest insurance policy for humans is the brain. Louisa was a world championship triathlete and raced both nationally and internationally for Australia and competed at London, Beijing and Auckland. After retiring in 2012 Louisa followed her dreams and went to Sydney Medical school and graduated with a particular interest in neurophysiology. Louisa is the head performance advisor and CEO of Neuro Athletics.

Key point topics and studies mentioned:

• Strength vs. endurance exercise benefits
• Mechanism of how exercise can benefit the hippocampus, a region in the brain that is responsible for learning and memory
• Tips and advice to optimize aging brain health

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Transcription

 

Dr. Latt Mansor:

Hi, this is Dr. Latt Mansor, research lead of Health Via Modern Nutrition here on HVMN Podcast. In this episode, I interviewed Dr. Louisa Nicola, who's a neurophysiologist and a brain coach. She's also the CEO of Neuro Athletics. In this episode, we talked about brain health and exercise. Now we know the benefits of exercise and we know the importance of brain health, but what we do not know is the strong connection between exercise, muscles and brain health. And that's exactly what we discussed in this episode and how to improve brain health and cognitive performance via exercise, sleep, and nutrition. So if you want to find out more, tune in and let's get to it. Hi, we have Dr. Louisa Nicola here today at HVMN Podcast. Welcome.

 

Louisa Nicola:

Hi, I'm so excited to be here Latt, we've gone way back, so I'm excited to be on the other end.

 

Dr. Latt Mansor:

Yes, I am really excited to pick your brain on brain health, no pun intended. So I'm sure our listeners will be very, very interested in hearing your area of expertise around brain health or on what can you do to optimize brain health as well as physical activity and performance. So before we go deep into the area of expertise that you are in, let's tell our listeners a little bit about you, share what you do, what's your background, what are you passionate about?

 

Louisa Nicola:

So born and raised in Australia, loved exercise from a young age. I was a swimmer. I then started competing in triathlons and went to the World Championship series three times. I did Beijing, London, and Auckland. So fell in love with endurance sport. At the same time, I did an undergraduate degree in exercise science and teaching. So I finished that. I moved onto a masters and it was a masters of mathematics and I majored in neuroscience. So I was looking at neuronal signaling and looking at algorithms behind that. Fell in love with the human brain. And I then went into medicine. I thought, I'm going to dedicate my life to understanding the brain. And there was just something so beautiful about it and also mysterious. Dating back 10 years, we didn't have education like we have now on platforms that could inform us about the brain. So all I wanted to do was just go into the surgical room and see the surgeons cut into brains. To me, it was just a beautiful thing. So that's what I did. I finished my career in triathlons, went into medicine, specifically neurophysiology, which is a subset of neurology. You would go and see a neurophysiologist if you maybe had epilepsy, you need to get an EEG scan or a nerve conduction study or a muscle biopsy, anything like that. So I love that. And I moved to New York City and started my own company, Neuro Athletics. So I would call us an insurance policy for your brain.

 

Dr. Latt Mansor:

Okay. Okay, let's dive a little bit more into that. So what does Neuro Athletics do and how does one gain access to Neuro Athletics?

 

Louisa Nicola:

So Neuro Athletics, we really believe in having a democratized education platform for brain health. So we have a podcast where we talk about various brain health topics, how to have a better performing brain. Because at the core of everything I believe in, I believe that the brain always comes first. If you can optimize your brain, then you can optimize every other area of your life. And I think people still don't understand that. We see people going to the gym working just on skills and on muscle, but in order for your skills to take place, the brain has to be performing well. So we do a lot of brain health education. Our core product is the NAC Program, Neuro Athletics Coaching Certificate. I think there's a really big gap in the market here Latt. And you can actually chime in on this because I know you're a regular gym goer. You can go and see a personal trainer at the gym and these days it takes a personal trainer to be certified, what, two days? I believe the certification process is two days. I've seen it. I've really sifted through it. I did it when I was 19 and it really doesn't teach them anything that they are needing to understand. And the reason why I know this is because I sent my mother and my father to a personal trainer. Obviously they don't really go into the gym. I gave them a personal trainer. And this personal trainer had really no knowledge. And it was surprising to me that they had a job. And I know that sounds pretty fierce, but it was. So I saw this area in the market where I was like, Well, I should be training these trainers on the art and science of neuroscience. So we go out now, we certify trainers on neuro athletics.

 

Dr. Latt Mansor:

Yeah, I mean it's fascinating that after centuries of medical advancement that there is still so much more that we haven't learned about the brain. And now more than ever, we are learning the connection between the body and the brain. Because most of the time people think about physical health, they think about, Okay, I'm going to do endurance exercise, I'm going to do strength training, I'm going to improve my physique and then I'm going to do something separate to my brain because it's almost like a different process, different part of my body and different function. But today, Louisa is going to share with us what she has found in her research about the connection between the body and the brain and how vital it is for us to train our body, but keeping our brain health in mind and how does that connection play a role in our aging brain as well as maximizing our performance at work, our performance in a race, our performance in a competition for example. So yeah, let's dive straight into it. How does having more muscle mass help with brain health? Let's start with that question.

 

Louisa Nicola:

Okay, we can start with that question. I want to first preface this by saying that as we age, our brain ages too. And what does that mean? That means that, so we've got the cerebral cortex, we've got the gray matter of our brain, then we've got white matter. And white matter is where all of our myelinated neurons live. So as we age, we get thinning of our cerebral cortex and therefore we get the loss of cognitive functions. Cognitive functions such as thinking, information processing, speed, focus, attention, memory. This all starts to decline. And this is just a natural aging process that we're all going to go through, unfortunately. And I actually posted on Instagram an MRI image of a 90 year old's brain and you really see the cerebral cortex was very thin. So that happens, but something else also happens. And that is that we are now experiencing an acceleration in this brain aging process. And that is because of lifestyle factors. Lifestyle factors that I think from the research that I've gathered that are the most important to preserving brain health and stopping that brain aging process is sleep, nutrients, specific nutrients and exercise. So we can start on exercise because you just mentioned having more muscle mass and instead of focusing on having more muscle mass, I think that having more muscle mass is great in the area of mitochondrial health. So we know that more mitochondrial, mitochondrial biogenesis is better for overall immunity. And we know that as we increase in muscle cell size, we increase our mitochondria. But instead of looking at it like that, let's take a step back and look at, well what does the literature say about strength training and exercise? So when the first studies were done between exercise and brain health, they were done on mice, obviously. And we always start there. And what they found was that mice who were running on a treadmill or a wheel for six months, what they did was they increased the proliferation of cells within the hippocampus. So the hippocampus is a seahorse structure, seahorse shaped structure I should say, in our brain. And it's deep in the temporal lobes and it's really involved in things such as memory formation. And what they found was that these mice had greater capacity to grow new neurons in this area. And they thought, well how is this happening? And that's when they found out that exercise, aerobic physical activity, which is generally summed up as long rides, rowing, running, et cetera, increases the amount of circulating BDNF in the bloodstream. BDNF, brain derived neurotropic factor, is just a growth factor for the brain. So they thought, Wow, this is incredible. And that was literally after six weeks. And in fact what they did was they then replicated it in humans and they found the same thing. But what they also found was that the hippocampal volume grew by at least 12 to 16%.

 

Dr. Latt Mansor:

Wow.

 

Louisa Nicola:

So that's big.

 

Dr. Latt Mansor:

That's significant.

 

Louisa Nicola:

That's significant. So then they thought, oh my gosh. So the nineties and the early two thousands were all about BDNF. People were running around in the magazine articles of BDNF. It was this huge thing. Then at around, I think it was around 2012, researchers were like, Okay, well we know this is happening now in humans and in mice, what's happening in when it comes to strength training? And when they started to do systematic reviews, they started to do more studies on clinical, meaning human studies and in rodents, they found out so many more things were happening and we'll go through them. So one of the things that happens during bouts of strength training, and strength training actually in this aspect means lifting weights, is we get a rapid release of these certain myokines. Myokines are muscle derived or muscle based proteins. So they get released from the muscle and they go into the bloodstream and they happen at 300 times X than what you would have in aerobic physical activity. And in some instances these myokines and hormones aren't released during aerobic exercise. So we'll start-

 

Dr. Latt Mansor:

And as we know, because myo is related to muscles and myokines in this sense acts as a signaling molecule to then initiate any form of pathway or events that then drive a reaction in the body.

 

Louisa Nicola:

Yeah, absolutely. I love that. I love how you're defining the terms and please keep coming in on this. But I've got my notes here because I don't want to miss anything because there's some really interesting, I've sent you a review, but there's some really interesting data around these myokines. But let's talk about the first one, which I'm sure you can piggyback off me with this, IL-6, interleukin 6. It's part of the interleukin families and we see this being released in response to an immune response and sometimes it's a bad thing, correct?

 

Dr. Latt Mansor:

Yeah, it's an inflammatory signaling molecule that gets secreted when we have an inflammatory response. And I've spoken about this in a lot of podcasts, that a lot of people think inflammation is bad, but inflammation is also a necessary mechanism which our body needs in order to battle against foreign invaders, bacteria, stress and all of that. It's a way for our body to tell the rest of our cells that we are dealing with a certain threat and therefore we need to have a mechanism to overcome it. So inflammation in and of itself is not necessarily bad. However, chronic inflammation, when you turn it up all day every day, that's when it becomes bad. So just a clarification out there, but IL-6, I know for a fact that in exercise you increase it hundreds of times because of the stress that you're putting your body through as well as the progressive load that you're putting your muscles through. Your muscles are tearing, you are telling your body, hey, you know, need to repair this. So, that's IL-6, interleukin 6.

 

Louisa Nicola:

Interleukin 6, also they found that instead of being a detrimental thing, because it does get released tenfold, it is also released from the muscle into the bloodstream, crosses the blood brain barrier and has an effect again on the hippocampal subregions in a positive way.

 

Dr. Latt Mansor:

Oh wow. I did not know that.

 

Louisa Nicola:

And so that's a really important factor. Another important myokine that is released is irisin, also a hormone. So irisin comes from the Greek word iris and Iris was a messenger to the gods and this was founded in 2012 as well. And this is also doing the exact same thing. It's acting as a messenger molecule. It's actually, they've now coined this term which is, muscle brain crosstalk. So this also, once it's released from the muscles, has an effect on the expression of BDNF. So when it crosses a blood brain barrier, it shoots right through to the hippocampus and it helps with the expression of BDNF, therefore helps with the proliferation of neurons in the hippocampus and the areas around the hippocampus. So that's a beautiful thing.

 

Dr. Latt Mansor:

Let's recap here. Let's recap here. So what I'm understanding is that when you exercise, you increase the secretion of IL-6, you increase the secretion of irisin and that goes to your brain, bypassing the blood brain barrier, giving signal to the hippocampus to release BDNF, which in turn increase the proliferation of neurons within the hippocampus and therefore creating a bigger mass of neurons so that you can function better, you can have an improved performance in cognition. Is that what I'm understanding?

 

Louisa Nicola:

You've said it absolutely correct. Now there is this thing called neurogenesis, the creation of new neurons. And that's what's happening, the proliferation. Now, adult neurogenesis doesn't exist throughout the cerebral cortex. So it's not like you can go out and say, Wow, I can grow my brain. It doesn't work like that. If it did, we'd all be walking around with skulls just expanding. So that's not what's happening exactly. But it does happen within the hippocampus, which is why exercise is the best and first prescription when it comes to individuals who have been either diagnosed with early onset Alzheimer's Disease or Alzheimer's Disease. And lifestyle interventions with for neurodegenerative diseases often involves exercise to some capacity.

 

Dr. Latt Mansor:

So that's a very interesting area that you just got in because what I've understood is that as an adult we can't really grow neurons, like you said. That's what I've always understood. And then when this paper came out, it talks about neurogenesis and you're really growing neuron in the hippocampus. So in your sort of expertise, what is the difference between the hippocampus area versus the rest of the brain that you can't grow new neurons? What's the physiology behind it? Why can't we grow new neurons, but you can grow it in the hippocampus?

 

Louisa Nicola:

I wish I knew, I've never even been asked that question. I wish I knew the answer to it. But look, my understanding would be, we've got something called adult neuroplasticity, and we know that when our neurons fire together, when they wire together, they fire together, which is creating our internal habits, that's happening in the deep white matter regions of our brain, which is where the myelinated neurons live. My understanding is that these receptors, so we have receptors all over our bodies, our liver, our heart, where these myokines go to and they attach. So these myokines that I've mentioned also attach and have an effect on endocrine organs as well, I'm only talking about the effects that it has on the brain. Whether the mechanism of pathway is affected, the reason why it just goes through to the blood brain barrier and goes into the hippocampus. Maybe it's got to do with the receptors within the hippocampus and there there's just no receptors or pathway that goes to the prefrontal cortex to activate that. But I may be completely wrong with that. But as soon as we get off here, I'm going to start looking into that.

 

Dr. Latt Mansor:

Amazing. Yeah. And also listeners do know that apart from neurons and the number of neurons we have, as we age, we also lose brain network stability, which means we have different regions in the brain and as we age the connection, the interaction between these regions also decrease. And that's the term, brain network stability. So they have seen this via functional MRI where an aging adult, especially if you are at a high risk of developing cognitive impairments such as Alzheimer's or dementia, you get a decreased stability between these brain networks. And there are a couple of things that have shown to improve brain network stability. One of them is the availability of ketones, ketogenic diet or exogenous ketones. And we can go into that when we talk about nutrition, because I remember you talked about the three pillars that contribute to brain health. One was exercise, the other one was nutrition and the third one was sleep. So let's wrap things up around exercise and then we can go on.

 

Louisa Nicola:

I just want to point in on that, I think with the decline in the network, also there was a study that came out at the beginning of the year which showed what you just said. And they think the link may be because as we get older, so your brain, through neuroplasticity, you've got different regions in the brain and they all need to be exercised. When we are young, think of a kid, the kid is at school, they're running, they're jumping, then they're seeing this and they're seeing art, then they're going to soccer, they're doing so much. So the brain is just firing at all different angles. So it's growing. And then what happens as we age is you get a bit tired, you just want to stay home and your brain is not able to see, it's not able to play tennis to socially interact with other people. Therefore those regions that are responsible for this social interaction per se, or tennis or painting, they start to die off. And I think that may be a reason for that. So then there's no pathway for the brain to keep going down. So let's move on. The only other thing I'm going to point out with myokines that I think is extremely important is Cathepsin B. So have you heard of Cathepsin B?

 

Dr. Latt Mansor:

No, I have not. Tell us more about what Cathepsin B is.

 

Louisa Nicola:

So it's also a myokine that is released from skeletal muscle. And when it's released it does the same thing as irisin. It crosses the blood brain barrier, goes into the hippocampus, increases the proliferation of BDNF. So when it does this, it has an effect on our cognitive functions. So to sum that exercise portion up, we know that exercise when done in a proper fashion, what they found is that you need to do three times a week at 70% of your one repetition max. So you can't just go out there with small weights, you need to do heavy weights. And it's gradual, so over two weeks, if you're lifting the same weights, you need to then up it and you need to keep going up.

 

Dr. Latt Mansor:

Progressive load.

 

Louisa Nicola:

Progressive load, that is what we call it. So you need to be doing that. You also need to be doing Zone 2 cardio to get the full brain benefits of everything I just mentioned.

 

Dr. Latt Mansor:

Yeah, great. While we are on exercise, actually good thing that you mentioned cardio. What sort of role does cardiovascular exercise or aerobic exercise versus strength training? We talked a lot about strength training about, you need to lift heavy, you need to have that stimulus so that your muscles can get that stimulus and then release those signaling molecules. What about the role of aerobic exercise here and how much should one do weight training versus aerobic in order to maximize brain health?

 

Louisa Nicola:

So from what I can see, the studies really lie in doing a low intensity cardio at a zone 2 pace. So zone 2 is generally looking at around 65% of your max HR, it's actually measured from lactate, so on at around two millimole. But we won't go into that. But it is looking at, at least three hours a week of zone 2 cardio. And the why, I believe, lies in the fact that that is the perfect place for you to train the mitochondria of the cell. And what we don't see a lot of when we hear podcasts like this is, people talking about the role that mitochondria plays in the brain. So we have enormous mitochondria, especially in the frontal lobe and the latest studies that are coming out for Alzheimer's disease shows that it could be an astrocytic response, meaning that it could be the lack of mitochondrial efficiency in the frontal lobe. So the frontal lobe houses our prefrontal cortex and that's decision making, processing speed, it's the CEO of the brain. So if we are not training our mitochondria and getting the mitochondrial biogenesis, we've got mitochondria all throughout our central nervous system as well. So that would have an effect on that aspect.

 

Dr. Latt Mansor:

So just a brief explanation. So mitochondria, as we all know, is a powerhouse of the cell. It is the organelle, it is the component within the cell that creates energy. It generates ATP, which is a currency for energy within our cells. So when we work out, like what Louisa said earlier, when we do strength training, you are telling your muscles that you need more energy, you need more power to lift this heavy weight and therefore that encourages mitochondria biogenesis, which increases the production of mitochondria because your body is telling your muscles that you need more powerhouses in order to meet the demand of energy. And that is why it is so important. And as for why the nervous system and the brain has so many mitochondria in these organs is because, on a daily basis, especially the brain, we are working 24 7, the brain does not stop working even when we're sleeping. So we need that large amount of energy being channeled into these different regions so that we can function the way we do.

 

Louisa Nicola:

Yeah, that's absolutely correct. And like I said, we have to now think about this as mitochondria within the brain as well, because we always hear about mitochondria in the body. So I'm happy that we pointed that out.

 

Dr. Latt Mansor:

Yeah, absolutely. And so you said at least three hours of zone 2 cardio.

 

Louisa Nicola:

Cardio. Yeah. And that has to be, to actually get into that effect that we spoke about, that has to be a minimum of 50 minutes per session. So it can't just be three hours a week broken up into half hour sessions. You actually have to stay on a bike, a stationary bike, for a minimum of 45 to 50 minutes.

 

Dr. Latt Mansor:

45 to 50 minutes. And then in terms of strength training, what would you recommend?

 

Louisa Nicola:

Three days a week if you can. Look, the more that you do, the more robust the effects are going to be of these hormones that are going to get released. But you want to caution it with injury recovery.

 

Dr. Latt Mansor:

Injury risks and all that, and recovery. And remember guys, it's progressive load. So once your body is used to it, you need to either switch it up, different exercise, different sort of range of motion, focusing on the eccentric or increase the weight. So there are many ways to confuse your body or add new stimulus. Doesn't necessarily have to be just increase the weight and increasing the risk of injury. Make sure you get your form right, make sure you are recovering well, as well. So I think all those aspects play into the role of this. What do you think of the role of HIT, high intensity interval training, in all of this?

 

Louisa Nicola:

No, look, HIT is fine. So HIT, more so, a lot is correlated with all cause mortality. And the reason I say that is because there has been numerous studies done to link higher Vo2 max with all cause mortality and higher Vo2 max comes from increasing your fitness, therefore doing HIT, getting your heart rate up can really help with that process. But when it comes to brain aging, you really only have to stick to zone 2, strength and maybe include, you have to really do 15 minutes a week of getting your heart rate up to that real maximum standpoint. You really don't have to do anything more than that. And I'm talking about someone who's not out there trying to be a CrossFit champion, this is literally just for the brain aging process. That's where we're going wrong in exercise. This is why a lot of women are afraid to exercise because they think that just going for a walk is not really doing anything. Well, maybe fast-paced walking is doing something, but slow intensity exercise is going to do something. You don't have to go and kill yourself five days a week.

 

Dr. Latt Mansor:

Right, right. Yeah, that's the thing. I think a lot of people are paralyzed by paralysis via analysis. They analyze it so much, they sort of think about it so much they end up not doing it at all. I think doing some form of exercise, even brisk walk, is better than none. And for people who may want to lose some body fat and retain some muscle mass, HIT is also a good choice in that sense to make sure that your muscle mass is retained and as you do progressive load and growing those muscles and increasing those myokines secretion to affect your brain, that could be a good option. Mix and match as well.

 

Louisa Nicola:

Yeah, absolutely.

 

Dr. Latt Mansor:

All right. Well let's move on to the next pillar that you mentioned, nutrition. So what are your thoughts around nutrition and brain health? What sort of food people should pay attention to? What sort of food people should avoid? Is there a specific feeding window, feeding lifestyle? Tell us more.

 

Louisa Nicola:

I do really advocate for fasting and you and I have spoke about fasting and getting into the ketogenic state, obviously increasing the ketones which are available as the fuel source for your brain. I love that. I also provide a lot of emphasis to my clients on ingesting omega-3 fatty acids. So a omega-3 fatty acids from fatty fish, for example, is made up of three parts, EPA, DHA, and ALA. ALA is a form of a omega-3 fatty acids, but it comes from plants. It's a plant source form of a omega-3. Things such as flax seeds and chia seeds, they contain ALA. But I'm more interested in EPA and DHA. And EPA and DHA have been found to be absolutely unbelievable for the brain and for the body as well. They help with cell membrane fluidity. What I'm really interested in is how do we get this EPA, DHA to the brain? And it turns out that DHA, a liposomal DHA, can go through and cross the blood brain barrier and it has an effect on the brain in there. There was a wonderful study done this year or maybe last year, and it was maybe an NIH study, and they came out with risk factors for death and we know them. They just reassess them each year. They've gone from nine to 10, I think there's around 17 now, risk factors for premature death and all cause mortality, cardiovascular health is one, et cetera. Smoking is one. They now found that having a low omega-3 index is now also a risk factor for all cause mortality.

 

Dr. Latt Mansor:

Wow.

 

Louisa Nicola:

That's got to be insane, right?

 

Dr. Latt Mansor:

Yeah, absolutely. So let's talk about the basics here. What are the roles of these omega-3 fatty assets in the brain? Is it used for energy or is it used for structural composition? Is it used for signaling? What is it being used for?

 

Louisa Nicola:

So one of the biggest things that it's used for, and this happens actually throughout the brain and body, is it acts as a really good down regulator of inflammation. We're getting inflammation, which I know that you mentioned earlier, a little inflammation is good, but have you ever felt that moment, people ask this a lot, Louisa, I've woken up with brain fog or my thinking is not clear and I'm just having a decline in my performance. More often than not, what we are doing is we are creating a lot of neural inflammation, that is the inflammation of the central nervous system, brain and spinal cord. And omega-3 fatty acids, EPA and DHA, can go in and actually down-regulate these inflammatory responses. So I think that's really a key thing to pick up on. The second thing is the cell membrane fluidity. We want to be able to have, what have we got in the human body, 30 trillion cells, 3 trillion? So imagine all these tiny little sticky balls just floating around. If they're not fluid, it's going to really stop the, I don't know how to explain the opposite of fluidity, but having-

 

Dr. Latt Mansor:

Rigidity.

 

Louisa Nicola:

There you go. Rigidity. They're going to be more rigid and make it harder to get to their destinations. But omega-3 fatty acids help with the fluidity of these cell membranes, the outer layer so they can flow through evenly.

 

Dr. Latt Mansor:

So to recap, they help with almost like a signaling molecule to help lower the inflammation process. And then the second is structural benefit to the cells and making sure the fluidity and really assist the flux of different molecules, different substrates, going in and out of the cell. Yeah, go ahead. If you have anything to say.

 

Louisa Nicola:

No, I was going to say a third one so you can keep talking.

 

Dr. Latt Mansor:

Oh, I was going to say we at HVMN, since we have our product, which is Ketone IQ, is an exogenous ketones and the way we explain what ketones are, you produce your own ketones when you're low on carb reserve. But more importantly, why does our body produce ketones, is because our brain use primarily sugar or glucose for energy. But when you're low on carb resources like glycogen and glucose, your brain still needs that energy. But fat cannot bypass the blood brain barrier and therefore cannot provide the energies directly to the brain. So it needs to be converted to ketone, which is a smaller molecule that can bypass the blood brain barrier in order to provide energy for the brain. And then the question comes where people ask, So what about omega-3 fatty acids? And these are fatty acids. And people are like, we know that omega-3 fatty acids is good for the brain so they can go through. So then what I found out is that yes, they are good for the brain, but as you said, it works as a signaling molecule. It helps with the neurons, the cells, and the structure building. It's like creating the fluidity and all that, but it does not directly provide energy to mitochondria.

 

Louisa Nicola:

That was a really great point. Before I move onto my third one, my question for you is, which is what I get asked often is, well what's the difference between an ester, a ketone ester and a salt?

 

Dr. Latt Mansor:

So the difference between ketone ester and a salt. So the main three ketones bodies that are produced in our bodies are beta hydroxybutyrate, acetate, and acetone. And one of those three is primarily used for energy, which is beta hydroxybutyrate, which is what we measure when we prick our finger and our blood ketone levels. When people talk about blood ketone levels, more often than not they're talking about beta hydroxybutyrate. Now, ketone salt is when these sellers, the suppliers, use a BHB bound to a salt, either magnesium, potassium, sodium, because beta hydroxybutyrate in and of itself is acidic. So if you're just consume a lot of BHB, you're just consuming a lot of acid and that causes a lot of GI issues. But if you neutralize it by binding them to salt, you sort of reduce that sort of GI issue. But then you are stuck with increased salt load in some sense. In some sense, it may be good if you're working out, you're losing salt and you want to replenish, that's fine. But also because of that limitation, you can't get your blood BHB level high enough to get a significant benefit. Now, ketone ester is BHB bound to butanediol. That's a ketone monoester, whereas the most sort of ubiquitous ketone ester out there. So instead of salt, it's just bound to butanediol. Now butanediol enters the liver and it gets converted to BHB. So if you think about it, it's more of a two-step BHB delivery system to the body, because you have a BHB bound to butanediol, it enters the gut, it gets cleave by your esterase, so it releases the BHB straight into the blood, and then the butanediol goes into the liver and acts as a slow release BHB that sustain your ketosis.

 

Louisa Nicola:

Okay. The reason I ask that is because beta hydroxybutyrate is also a molecule that is released during intense exercise as well and has an effect on the brain.

 

Dr. Latt Mansor:

So yeah, most people think, how do I increase blood BHB? How do I be in ketosis? A lot of people know that you can get it through keto diet, where you have extreme carb restriction, you can get it via intermittent fasting, where you fast and you really deplete your glycogen stores and therefore your body starts breaking down fat into ketones. But what people don't realize is that when you exercise, you are also telling your body you need that sort of energy and therefore it's also breaking down and increase BHB levels.

 

Louisa Nicola:

There you go. Okay. The third thing I wanted to point out with omega-3 is we now know that with high doses of omega-3, specifically, I'm talking about two grams of EPA and two grams of DHA. So that's four grams in total per day, can actually go in and clear out some of the toxins and debris that build up due to brain aging and due to environmental factors and stress. One of them is the clearance of amyloid beta, which is a hallmark of Alzheimer's Disease. So DHA can go through and clear out the amyloid beta that could potentially clog up and form these plaques and tangles. So, that's the third one.

 

Dr. Latt Mansor:

I know they have done a couple of studies looking at using ETA and linoleic, all these different APA and DHA in combating Alzheimer's and cognitive impairment. Do you know if there are any studies that are out that has significant results showing a really stark correlation between those two?

 

Louisa Nicola:

Yes. I put it up on my Instagram. I can't pull it up right now, but I put it up as a reel, and this was only a week ago, so I can send it over to you or people can go over and look at that.

 

Dr. Latt Mansor:

And while we are at it, how can people find you on your Instagram?

 

Louisa Nicola:

Yeah, just go to Louisa Nicola. I'm quite active. I do 30 to 60 second tutorials on how to perform better. I have a podcast, the Neuro Experience, on all major platforms, which the lads over at Ketone IQ and HVMN have been on it. And you can find me on Twitter, Louisa Nicola.

 

Dr. Latt Mansor:

Yeah. Nice. And I will also include all of that in our description as well. So I just want to have a little plugin so that people know where to find you and find all this information. So Louisa always pumps up a lot of educational content guys, so go ahead and follow her. I follow her myself, and sometimes I'm like, Oh wow. As a fellow scientist, I'm like, I didn't know this actually works. For example, this myokines and hippocampus and neurogenesis correlation, I didn't know that before. So this is really good to know because people say, I go work and then after a workout I feel so much better, I feel more focused. Obviously focus comes from the brain cognitive performance and there has to be some connection. So now we know, now we know mechanistically, what is driving that benefit when you exercise, it's not just for looking good. I always tell people our bodies are not programed to prioritize aesthetics. Our bodies are prioritizing survivability. So when we work out, we are manipulating that sort of stimulus response to make sure that we get the desired body, but also getting all the benefit that comes with it.

 

Louisa Nicola:

Absolutely. Yeah, that's it.

 

Dr. Latt Mansor:

In terms of aging, let's talk about aging for a bit. Because we know as we age, we also lose muscle, it's called sarcopenia. And now that we know how important muscles are in brain health, as our brain is aging and we are losing muscle, what is the best way to combat all those?

 

Louisa Nicola:

Well, it obviously is with proper nutrients, nutrition with proper exercise, but it also comes with proper sleep. And that's another factor that ties into this whole brain aging process. Because wonderful things happen during sleep. We've got four stages of sleep primarily where we've got stage 1, 2, 3, and then the fourth stage. So stage one and two is your light sleep. Stage three is what we call slow wave sleep or deep sleep. And then we've got REM sleep, which is stage four. And these two, stage three and four, are the most critical stages of sleep. And stage three, deep sleep, two specific things happen during deep sleep, is the first thing that happens is we get the release of certain hormones just like in exercise, but these get released during sleep. Things such as testosterone for men, estrogen for women, and IGF-1. And IGF-1 plays a critical role in muscle replenishment and muscle synthesis. So we want to be able to recover using IGF-1 and this gets released during deep sleep. And what happens is as we age, we actually have a decline in IGF-1. So exercising increases the production and secretion of IGF-1 from several different areas, one being the muscle, but it also gets released during deep sleep. And it's like this circle effect, as we age, we kind of sleep a bit less and less, but if we sleep less and less, we don't get that release of IGF-1.

 

Dr. Latt Mansor:

And IGF-1 stands for insulin growth factor.

 

Louisa Nicola:

Insulin growth-like factor. And so we really need this, so therefore we need to practice good sleep hygiene. So we need to practice, how can we get into deep sleep? The second thing that happens during deep sleep is we activate a system called the glymphatic system. And the glymphatic system is like a sewage system. It happens in your brain and what happens is all of our neurons, they decrease in size and they do this so that the cerebral spinal fluid can circulate through the brain and wash out all of the debris, and that washes out all of the toxins as well. One of them is amyloid beta, the hallmark to Alzheimer's disease. So that's what's happening there. So it all plays in. If we want to increase muscle mass or we want to just preserve muscle mass, we have to be sleeping well, we have to be exercising. BDNF is also released in the resting state from the muscles just to preserve muscle mass. We also, during REM sleep, REM sleep is a really critical component of sleep. And it ties into the aging process as well, which I won't go into it, but I will say that during REM sleep, that's where we get all of our emotional first aid, and that's where we get all of our memory formations from the day. They get into our brain and that's how we see long term memories. Vivid dreams also occur during REM sleep. So we really need to be working on sleep hygiene and working on looking at our life and thinking, what is kicking me out of deep sleep, what is kicking me out of REM sleep, light exposure, alcohol, stress, these things kick you out of REM sleep. So we need to make sure that we are staying on top of those for a better sleep performance.

 

Dr. Latt Mansor:

And also to add onto that, for you guys who are active and exercising. When we talk about recovery, we always talk about sleep, but this is exactly what happens biochemically in your body when you sleep. All these different hormones are being released at specific time at night and when you're at rest. So that it helps you repair your body and also retain the muscles and retain all the positivity that you get from exercise. And at the same time cleaning all the debris, all the toxicity that have been accumulated throughout the day. So that's how important sleep is. It's not just us relaxing our body, your body is at work even though you are fully asleep.

 

Louisa Nicola:

Yeah, absolutely. So there are your three key pillars to ultimate brain health. That's how we say you can create a neuro athletic brain.

 

Dr. Latt Mansor:

Neuro athletic brain.

 

Louisa Nicola:

Sleep, fitness, nutrients and exercise.

 

Dr. Latt Mansor:

And so in terms of sleep, also another good point, because you mentioned we have to keep track of what kicks us out of REM, what really disrupts our sleep cycle and the way that we can do that, obviously via observation. But with technology nowadays, there are so many devices out there that allows you to really measure your sleep quality, that really measure your REM period and really makes you sort of aware of how good is your sleep quality, really. And if it's not that good, you need to go in there and really look at different factors that are driving the quality down. So I think that in and of itself is a blessing. With technology, we're able to do that now instead of saying, Oh, I wake up and I feel really tired, I don't know why. Whereas now you sort of, Oh, okay, my recovery score is a bit low. What have I eaten last night? What have I drank last night that's causing that? Is the temperature well regulated? Is my bed comfortable enough? As simple as that.

 

Louisa Nicola:

But also what I find is that we've got the other end of the extreme where people are looking at their devices like their ordering or whoop strap, and they're basing their whole day on that instead of just being a human as well. So I think that, yes, while trackers are amazing, it also comes with a lot of stress. So use it at your will. Use it just to be tracking your overall performance. And if one day it's just not well, then don't kill yourself over it.

 

Dr. Latt Mansor:

Yeah, yeah. It's a working progress and it's a lifestyle. What I tell people, it is a journey and it's a lifestyle. Enjoy the journey and celebrate those accomplishments because you can kill yourself and just sprint towards the goal, but then what? There's a whole life ahead of you. So therefore it's important to remind yourself that enjoy the journey along the way and then once you reach each small goal, celebrate it. Because that's our lives. We want to strive for better health, better nutrition, and better sleep.

 

Louisa Nicola:

Yeah, I love that.

 

Dr. Latt Mansor:

So one last question for you before we go is, this is something that I've started, so since from now on I'm going to be the main host of HVMN podcasts, I'm going to start asking all my guests this last question to close off is, what does health and modern nutrition mean to you?

 

Louisa Nicola:

Wow. So I don't know if this is a different take than what everybody has. I think modern nutrition really means understanding who you are at a cellular level. We now have access to a wide variety of resources that can help us enhance our performance and enhance our health. However, it's not a one size fits all. So understanding what is good for you, what levels you're at in terms of get getting a blood test, assessing your vitamin D levels, for example, and optimizing from there because that's when you will get healthy. And that's doing it through a modern approach rather than a one size fits all approach.

 

Dr. Latt Mansor:

Yes. Personalized nutrition. It's always the way to go. And I just recently gave a presentation at the ObesityHelp National Conference, and I told people that ultimately everyone, you guys are the PhDs of your body. Nobody will know your body better than yourself. So listen to your body and try different things, trial and error, and see what works best for your body.

 

Louisa Nicola:

Absolutely. Latt, thank you so much.

 

Dr. Latt Mansor:

And for those-

 

Louisa Nicola:

Oh, sorry. Yeah, no, I was going to say thank you so much for this amazing conversation.

 

Dr. Latt Mansor:

For those out there who are into personal training and interested in neuro athletics certification, where can they look out for it? Where can they find more information about it?

 

Louisa Nicola:

Well, we're so excited because we're about to release our very first big one in person. And I'm not going to reveal the city, but we're going to close it off to 50 trainers. Last time we had over a hundred. So if you just go to the neuro athletics website, neuroathletics.com.au, you'll find all the information. But I'm sure if you follow me, you'll see me just posting a ton, a ton about it.

 

Dr. Latt Mansor:

Amazing. Amazing. I know you sort of said it earlier, but we should recap it now that it's the end, all your contact info and on your platforms, and then we'll close it from there.

 

Louisa Nicola:

Yeah, so you can follow me on Instagram. I'm quite active, Louisa Nicola. You can follow the podcast, which is the neuro experience that's on all major platforms. We also write a weekly newsletter, so it's neuroathletics.substack.com, and you'll find all of our scientific literature and tips there.

 

Dr. Latt Mansor:

Amazing. It has been such an educational and informative session, Louisa, and thank you so much for coming on to HVMN podcast. And thank you so much for being my first guest.

 

Louisa Nicola:

Yes.

 

Dr. Latt Mansor:

After being the official main host of Health Via Modern Nutrition podcast, and we look forward to having more conversation as more data around brain health, exercise and performance comes out. I hope you have enjoyed this episode, and if you did, please like, share and subscribe. And if you have any feedback or suggestions, please leave it in the comments. HVMN podcast and myself are powered by Ketone IQ, the most effective way to raise your blood ketone levels for optimal cognitive and physical performance, as well as metabolic health. Thank you for listening. Until next time.

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