What The Heart/Brain Connection Means To Your Health, with Dr. Steven Masley

Dr Daniel Amen: Welcome to the Brain Warrior's Way Podcast. I'm Dr. Daniel Amen.
Tana Amen: And I'm Tana Amen. In our podcast, we provide you with the tools you need to become a warrior for the health of your brain and body.
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Dr Daniel Amen: Welcome back. We are here with Dr. Steven Masley, the author of the Mediterranean Method and a number of other books. Stephen is a physician but also a trained chef.
Tana Amen: That's so awesome.
Dr Daniel Amen: What a great combination and Steve and I have this idea that if you want to keep your brain healthy, you have to prevent or treat the 11 major risk factors that steal your mind.
Dr Steven Masley: Yes.
Dr Daniel Amen: And I came up with a mnemonic called Bright Minds that helps us remember them and the B in Bright Minds is for blood flow. Low blood flow is the number one brain imaging predictor of Alzheimer's disease. It's also associated with depression, schizophrenia, ADHD, and a host of other problems. And so why is that important, is we're going to talk about the heart. If you have any form of heart problems, vascular problems, it damages your brain. And so I love the podcast we're going to do now where we're going to talk about the brain heart connection.
And the first time I knew anything about this was 1982, I just graduated from medical school. My grandfather had his second heart attack and this is one of the happiest people I'd ever known in my life, who began with a major depression and ended up on antidepressant medication. He cried easily, he was negative, he was irritable. This was not my grandfather. And came to learn that 60% of people who have a heart attack, will develop serious depression within the next 18 months. So there's this huge connection between your blood vessels, your heart and your brain. So can you talk to us about that?
Dr Steven Masley: Well, I really noticed that in the research in my clinic too because when we looked at... we tried to... I tried to answer a question, what would be the number one predictor of your brain processing speeds using something like CNS Vital Signs? And we looked at weight and activity and strength and lab tests and blood pressure, but if you're growing plaque, that was the number one predictor by far. So plaque growth is intimately associated with your brain processing speed and your memory. And I think it's twofold. One, obviously we need perfusion. We need circulation for any of our tissues in our body to work well. Our heart, our muscles, our genitals, our brain, any of them. But I think there's also something that we have physiologic needs that support the whole body and whatever is supporting your brain is intimately connected to the same things that support your heart and help prevent heart disease.
Dr Daniel Amen: So what increases plaque?
Dr Steven Masley: My bias is that the number one thing that's associated with arterial plaque growth is sugar and insulin resistance and uncontrolled blood sugar. That's the number one cause. It's not cholesterol. I'm not saying don't worry about your cholesterol, but I don't think cholesterol is the number one thing. I think it gets so much attention because we can test it in a lab and prescribe a drug for it pretty easily. But blood sugar is really essential. But there's several factors that we looked at what things predict it. Your fitness predicts it. Your nutrient and vitamin intake predict it. Whether you eat enough fiber or not has an impact. So nutrients, fitness, food. Yeah, I didn't have an adequate way of measuring stress. I'm sure stress has an impact on it. I was not able to measure that, but I believe it's really true.
Dr Daniel Amen: So how do people know about the level of plaque in their blood vessels?
Dr Steven Masley: Well, probably nationally the more common thing is they go out and get one of these CT heart scans and it looks at old calcified plaque. I much prefer to see new plaque with ultrasound. There's no radiation. You can do it serially over time and see if your plaque's growing, shrinking or staying the same. So Intima-Media Thickness is the measuring of the lining of your artery whether there's plaque in it or not and the thickness and the carotid artery right here on your neck is like the easiest place in your body to measure that. Well if you're growing it here compared to when people had a heart study, there's a 95% correlation that if you're growing plaque in your carotid, you're growing it in your heart and vice versa.
Dr Daniel Amen: So what study do they ask their doctor for?
Dr Steven Masley: Carotid Intima-Media Thickness, Carotid IMT. Very different than like a duplex flow that's looking for blockage. That's something that surgeons looking for to see if you're blocked enough to document and justify surgery. My goal is you'd never need surgery on the arteries in your neck...
Tana Amen: [crosstalk 00:06:15].
Dr Steven Masley: ... if we prevent that by intervene sooner and preventing that. And so in the hospital we tend to measure... our medical clinics, we measure blood flow and we looked for a square. I think, cynically I would say we're looking for someone who's at least 70% blocked so you can justify surgery.
Tana Amen: Right.
Dr Steven Masley: My goal is to find people way sooner than that and try to avoid ever needing that.
Tana Amen: Yeah. So you're literally focused on prevention. So you talked about blood sugar. What is your thought on saturated fat or animal fat? And I'd love to give people a tip before we wrap this up.
Dr Steven Masley: I've changed on this over time. For a long time I was telling people to follow a low saturated fat diet, but I think the evidence linking that to heart disease is become most controversial. Whether it really is a huge big factor or not. So I think an excess of saturated fat might be unwise. I think if you're having it in moderation, I don't really have... I think it's more important that when you're... if you're eating animal protein that it's clean, it...
Tana Amen: Grass fed.
Dr Steven Masley: ... free-range, grass fed, wild. It wasn't that it come from a feedlot. I think that's more important than the saturated fat contents. That's why I usually advise people to get their saturated fat intake to modest, but my emphasis on eating good fats, healthy fats, nuts, olive oil, avocado. I don't want someone on a low fat diet. I want them on a healthy fat diet and saturated fat in moderation I'm okay with.
Tana Amen: What about butter versus margarine because that's a big question we get?
Dr Steven Masley: Margarine, I think, hydrogenated fat is like embalming fluid.
Tana Amen: Right.
Dr Steven Masley: So I would definitely go with butter...
Tana Amen: That's good.
Dr Steven Masley: ... rather than I would go with margarine.
Tana Amen: Okay.
Dr Steven Masley: But I would prefer they use olive oil than butter...
Tana Amen: Interesting.
Dr Steven Masley: ... on most things.
Dr Daniel Amen: Well, and most butter is from cows that were given antibiotics, hormone, and that were grain fed...
Tana Amen: Well you can...
Dr Daniel Amen: ... corn fed.
Tana Amen: ... get grass fed from the cows, but...
Dr Daniel Amen: You can...
Dr Steven Masley: Yes...
Dr Daniel Amen: ... but it's...
Dr Steven Masley: ... you can.
Dr Daniel Amen: ... harder and I don't know that there's actually a benefit to it. It's just so interesting. I want to go back to cholesterol because my understanding, and I know you've written about longevity, is that what people don't talk about is low cholesterol. Under 160 is been associated with homicide, suicide, depression, autism...
Dr Steven Masley: Depression.
Dr Daniel Amen: ... ADHD, and...
Dr Steven Masley: Memory loss.
Dr Daniel Amen: ... death from all causes...
Tana Amen: But aren't we creating...
Dr Daniel Amen: ... that cholesterol makes...
Tana Amen: ... a whole...
Dr Daniel Amen: ... a significant amount of the fat in your brain is made up of cholesterol. Cholesterol also is the mother hormone in a sense that hormones are made from cholesterol.
Tana Amen: ... but when we prescribe statins...
Dr Daniel Amen: And so...
Tana Amen: ... are we like creating this whole slew of people?
Dr Daniel Amen: ... well so many cardiologists, they want your cholesterol to be as low as possible. And I have a brother-in-law who's got like monster high calcium scores in his vessels and whenever his cholesterol, because the cardiologist pounds the statins, he gets depressed. I mean he actually gets...
Tana Amen: Right.
Dr Steven Masley: Yes.
Dr Daniel Amen: ... sad and tearful and I'm like, no, you cannot go below a total cholesterol of 160. Do you have more to say about that?
Dr Steven Masley: Well, I think if people actually followed the lifestyle you and I recommend, if they were to follow more of a Mediterranean diet, most people wouldn't qualify and need statin meds. Let's face it. If they really did this, they wouldn't need a cholesterol lowering medication. And when you do on them, no, I'm not into ultra aggressive therapy. I mean muscle aches and, it lowers your testosterone too. You said cholesterol, you're right, it is the mother hormone. Without cholesterol, you can't make testosterone, and you end up with testosterone deficient, which impacts men and women. So it's not... I think there's so many side effects with statins and it's not that I never have written for them, I have, but my goal again is how do you not need them and if you are on them, how do you be on the minimal dose so you can still shrink your plaque and document you have serial plaque shrinkage that's regressing heart disease at the same time. And I think following a Mediterranean lifestyle is probably the most effective way to accomplish that.
Dr Daniel Amen: And would you agree or disagree with people when they say LDL is bad cholesterol?
Dr Steven Masley: Well, I'll be honest, back in 1996 I called H for healthy and L for lousy for cholesterol. But it's a lot more complicated than that as we have learned over time. And really the particle size is far more important than the total number of total cholesterol or LDL cholesterol.
Tana Amen: Right.
Dr Steven Masley: So if you've got big fluffy LDL, it doesn't really grow plaque. If you have little tiny inflammatory, and that has a lot more to do with your activity and your stress and your blood sugar control than anything else. So I think really we have to... if we're going to follow cholesterol, we need to be looking at advanced markers...
Tana Amen: Right.
Dr Steven Masley: ... and particle size.
Tana Amen: Well, and part of why they... isn't it true that part of why they said that in the past was because we didn't have the testing methods we have now, it's changed, right?
Dr Steven Masley: True. You're right.
Tana Amen: So it's not that it was right or wrong...
Dr Steven Masley: I totally agree.
Tana Amen: ... it's that we've advanced?
Dr Steven Masley: Yes.
Dr Daniel Amen: So there's an evolution to our knowledge.
Tana Amen: Right.
Dr Daniel Amen: I'd love this. This is so important. Two quick tips before we have to stop on how to have a better brain and a better heart.
Dr Steven Masley: On food. I mean eat real food. Vegetable, fruit, beans and nuts, spices and herbs. Cook with olive oil. If you're using... when you use animal protein, make sure it's clean. It didn't come from a feedlot. That it's wild, grass fed, natural food without preservatives and chemicals and sweeteners. That's number one. And number two is, how do we eat. It's about being joyful and leisurely and not being stressed out and not eating in front of a computer or phone or television. It's eating with people and interacting with people. So there's not just about what we eat. It's how we eat, I think is equally important.
Dr Daniel Amen: Great.
Tana Amen: Excellent.
Dr Daniel Amen: Stay with us. We're here with Dr. Steven Masley, the author of the new book, the Mediterranean Method out December 31st. Stay with us.
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