With me in studio, if you're watching on the stream, you recognize him, Max Lugavere.
He's a health and sciences journalist, best-selling author, and the host of a podcast called The Genius Life, and director of a brand new documentary called Little Empty Boxes. Max, welcome back. Hey, how you doing? It's great to be here.
Great. Tell me about Little Empty Boxes. Yeah, so Little Empty Boxes, it's the first ever documentary capturing the science of dementia prevention, which is a global health threat now. 55 million people globally suffer from dementia.
And so the documentary, it focuses on my mom, which is my why, the reason why I got into this field. And it basically, we discuss the science that is enabling us to procure better brain health, years, decades down the line, possibly. Because it's preventable. Well, there are estimates that at least 40% of cases are preventable according to the latest Lancet Commission on Dementia. But I believe that the vast majority of Alzheimer's cases are, and possibly even Parkinson's disease cases are. For a layman like me, could you tell me the difference between dementia and Alzheimer's?
Yeah. Well, Alzheimer's is the most common form of dementia. So Alzheimer's disease affects about 6 million people, a little bit more than that in the US, and numbers are expected to explode in the coming years. But there are other forms of dementia. There's Lewy body dementia, frontotemporal dementia.
It was revealed that Bruce Willis, unfortunately, is suffering from frontotemporal dementia. Lewy body dementia is actually what my mom suffered from. There's vascular dementia. So there are all these different subtypes, which now are starting to be thought of as a whole, this category of dementia, like neurocognitive disorders that affect us related to age. And then Parkinson's disease is different. Parkinson's disease is a movement disorder classically, although many people who develop Parkinson's disease down the road will see a decline in their cognition. This is referred to as Parkinson's disease dementia. And Lewy body dementia actually has more in common with Parkinson's disease. So it's a whole category of age-related cognitive disorders. And it's really unfortunate. It's really sad. There are no cures, as we speak of.
And these are conditions that begin years, if not decades, prior to the onset of symptoms. Here's your trailer of the documentary that's ... How did we get this before rolling? LittleEmptyBoxes.com. So it's a fully independent release.
We had a national theatrical release a couple of months ago, but now anybody can watch it anywhere in the world at LittleEmptyBoxes.com. All right, let's listen, 41. We know that Alzheimer's disease starts in the brain at least 20 to 30 years before the first symptom of memory loss. The million dollar question, actually probably the trillion dollar question is, why do people get Alzheimer's disease? The rates of Alzheimer's have skyrocketed. What did we change?
The federal government in 1980 starts its guidelines. You take away butter, meat, dairy, eggs, cheese, all those things you ate. What do you eat on your plate? It's less. The brain only takes as much sugar as it needs. The overall problem is inflammation. What happens in Alzheimer's is you have low inflammation, but chronic low inflammation. Diet, stress, sleep, toxins, all these things have a huge impact.
The question is, how far gone are you before it's irreversible? So I did not know a huge increase today. It's not just that we're more aware of it. There's a huge increase in dementia and Alzheimer's. There is because the risk factors for Alzheimer's are increasing. So if you have hypertension, for example, that increases your risk for developing Alzheimer's. If you have obesity, if you have type 2 diabetes, and these are the diet-related modifiable risk factors, but these are all increasing. Today we're seeing now almost one in two of us are not just overweight but obese. That is a risk factor. Our food environment has become increasingly toxic. Our environment has become increasingly toxic in general. I think it's not quite a surprise that we're seeing rates of these increase. So when you hear about Ozempic and all these other drugs that are supposed to go to get the weight off, is that a way to avoid some of this?
Potentially. They are looking into these peptides like semaglutide as a potential disease-modifying treatment. I believe there has already been a phase one and phase two trial looking to see if these drugs can potentially prevent Alzheimer's disease. They've already shown that they can reduce the risk of cardiovascular events.
These drugs have been used for decades at this point as drugs to treat type 2 diabetes, and so only recently has it been approved to treat obesity. But insofar as type 2 diabetes is a risk factor for Alzheimer's disease, I think it can be expected that this might reduce risk. So for you personally, what you saw in your mom, was it behavioral or did she inherit that?
It is. So the heritability of these conditions are very low. So Parkinson's disease is minimally heritable. About two to three percent of cases are considered to be inherited. And with Alzheimer's disease, similar, only about two to three percent of cases. In analyzing where your mom got it, how do you think she got it?
Well, here's what's interesting. So my mom had a condition, again, called Lewy body dementia, which has more in common with Parkinsonism. And Parkinson's disease is now the world's fastest growing brain disease. And there is a growing body of evidence suggesting that Parkinson's disease might actually be caused by exposure to certain environmental toxicants.
So I mean, we could talk about diet until the cows come home. And I think that diet in many ways is setting us up for brain disease. But there are a class of herbicides and pesticides and certain industrial solvents that occupational exposure to these compounds has been associated with dramatically increased risk for Parkinsonism. And they actually use some of these compounds in animal models to create Parkinson's disease-like symptoms. And so whether you live in a rural area and you might be exposed to certain herbicides and pesticides, say you live by a golf course where they're routinely using this stuff, or you're a farmer and you're using these compounds like Paraquat or Rhodanone, or you live in a more urban environment and you're exposed to compounds like, for example, trichloroethylene, which is still today being used in dry cleaning applications. So you want to be really careful.
If you regularly dry clean your clothing, Brian, you want to make sure that you're using a green dry cleaner, a dry cleaner that doesn't use compounds like trichloroethylene or its related compound perchloroethylene. And my mom was in the garment district in Manhattan. She worked in the garment center here. And in all likelihood, she was likely, you know, she was probably exposed to these compounds which are used in manufacturing.
Wow, that's incredible. And when did she first start experiencing symptoms and how long did she deal with it? She was 58 and she passed at 66.
And it was really difficult. And, you know, I'll never know what pulled the trigger for my mom with regard to these conditions, to the condition that she had developed. It could have been related to diet. It could have been related to, you know, exposure to any one of these, you know, toxins.
I'll never know, unfortunately. But what I do know is that the modern world has become dysregulated in so many ways. I mean, the food environment is 73% ultra-processed.
We know that insofar as food can, you know, increase risk by causing diabetes, causing type 2 diabetes when we overeat these kinds of ultra-processed junk foods, which most Americans are now doing, that it can drive up risk for these conditions. So what have you changed in the knowledge that you've acquired? How have you changed your diet and your activity? Well, I've become a lot more, and this is not to sound alarmist or to fear monger, but I've become a lot more aware of my environment. I try to, you know, make sure that I'm breathing in clean air. I've replaced the air filters in my HVAC system in my home regularly.
I have an air purifier because we know that indoor air can be up to 100 times more polluted than outdoor air, actually, due to the off-gassing of our furniture, the exposure to volatile organic compounds and the like. I try to filter my water. I try to drink clean water.
I try not to drink out of plastic. What about the overall meals? Do you eat less meat, more meat, pasta, meat? No, I take a protein-centric approach.
I think that's really important in terms of warding off frailty, which we know is a risk factor for developing dementia. And so, yeah, I take a protein-centric approach. I prioritize grass-fed red meat, wild fatty fish, eggs, things like that. There was a recent study that found that egg consumers compared to non-consumers had a 50% risk reduction for the development of Alzheimer's disease, thought to be attributed to choline, which is a nutrient that eggs are the top source in the American diet. And so protein-centric. And then I round out my meals with dark leafy greens, which we know are super nutrient-dense and provide compounds which are directly supportive of brain health.
So I try to take a whole foods approach and I try to prioritize high-protein foods and dark leafy greens and low-sugar fruits and things like that. Max Lugavere is here. His podcast is called The Genius Life.
And this is his documentary he's out called Little Empty Boxes. Here is Kathy. This is your mom? Yeah. So here she's talking about being diagnosed.
Ask you some general questions. Do you remember what the date is today? What the date is? No, I can't.
Well, how about the month? No. So you had some studies done. The findings were fairly striking. So it's clear that part of what's going on here is Parkinson's disease and likely something called Lewy body dementia, a disease that's somewhat in between Parkinson's disease and Alzheimer's disease, where there's both memory problems and then some movement issues as well. So that must be tough to hear that.
Super tough. Did she recognize you? She recognized me, yeah. Once you've seen one case of dementia, you've seen one case of dementia. So she always recognized me and unfortunately in my mom's case, she was hyper aware of the decline that she was experiencing, which made it really torturous actually for her and my family. I'm not a clinician, but I've encountered a lot of people that have had dementia in their family. With certain forms of dementia, I think Alzheimer's disease in particular, the patient is not always aware of the decline. It's usually the family members that see the change and end up walking with them into the neurologist's office.
With my mom, she was aware at every turn the decline and it was really difficult. And Parkinsonism, again, it's the fastest growing brain disease. It might be a man-made condition.
These are conditions that were only first defined essentially in the medical literature just a handful of decades ago. You know, Ali was convinced it wasn't his punching. It was Parkinson's syndrome. I'm not sure if they ever looked at his brain.
Yeah. I mean, if you're genetically at risk for developing Alzheimer's disease, your brain is just more vulnerable to the insults of modern life and particularly when you're getting hit repeatedly in the head. I mean, that will… Probably has something to do with it. Probably has something to do with it.
When they see other boxers have no problems, it's really strange. Having said all that, I don't want to put you into politics, but that is the conversation we're having now about the current president of the United States who's had two aneurysms. So he's had brain surgery already and we see the slow movement. We see him put his hands up so slow.
We see the gate. Does any of this stuff sound familiar from your research? Totally. I think, you know, I don't know if, first of all, I've, you know, I've never even been in the room with Biden, but from my intimate experience with Parkinson's like conditions, it's, I think it's pretty clear that he has, he has some Parkinsonian stuff going on. There's the bradykinesia, the slowness of movement.
You can see the rigidity when he turns. His voice, I mean, his voice has become so quiet. That's a, that's a… That's a sign of what? Hypophonia. Yeah. So that is a hallmark characteristic of Parkinsonism. My mom experienced that.
And there's a micrographia is another thing. If you actually were to be able to look at his handwriting, you know, the handwriting becomes really small and diminished. So I think physically it's pretty clear that he's got some Parkinsonian stuff going on.
I don't think you'd be able to diagnose dementia without complex neuropsychological testing. Because I was watching him on D-Day with the soldiers that were in World War II. Some of them were over a hundred and they were moving better. I watched James Clyburn, 84 years old yesterday, look like he was ready for the Olympics. Well, you can, you can clearly tell the rigidity, the stiffness, the, the shuffling, you know, of his gait.
He doesn't have a normal stride anymore. So it's clear. And, you know, obviously the Parkinson's disease expert that's been to the White House a handful of times and his recent tweet that they intend on, you know, quote unquote tackling Parkinson's disease or whatever it was that he tweeted. I mean, I think it's, it's pretty clear. I mean, it's, it's, it's actually difficult for me to watch him because it hits so close to home. So you know exactly what you're saying.
Yeah. And it just hits really close to home. I mean, it reminds me, I have empathy because it reminds me of what I saw in my mom.
And that's not something I would wish upon my worst enemy. Did she have good moments? Did she have moments where you thought, wow, this is, this is fine. We're having a normal conversation. Then other moments when she did forget the month and the day.
It was... Because Joe has, seems to have decent moments. Yeah. Well, when you're stressed out, when you're under slept, which I can, I can imagine that there's a lot of stress and, you know... Being present. Yeah, of course. So I mean, that's all, that's going to, whenever, if you're at risk for cognitive decline, particularly in old age, if you have so much as a, as any kind of infection, it goes systemic and it affects the brain. So the brain doesn't sit in isolation. And my mom, you know, when she was well slept and when she was, particularly when she was exercising, I mean, she was, she definitely did have more of a spring in her step and cognitively was a bit more lucid.
So yeah, it's, it is, it is variable to some degree, but in general every day was difficult because, particularly because she was so aware of what it was that she was going through. What you did is use it to help other people. So that's why you put that in this documentary. If people want to get it, go to littleemptyboxes.com.
Yeah, littleemptyboxes.com. So we're doing this fully independently and, you know, we don't have a big streamer getting behind us and it's just been a grassroots effort. And, you know, people around the world now, every, you know, almost everybody that I encounter has some, has had some interaction with dementia, with Alzheimer's disease, with Parkinson's disease.
And so it's going to, it's a film that not only provides insight and provides a light, but also provides solace for people that have gone through it. All right. A few more minutes with Max in just a moment. Max Lugavere, a lot of people after you came on last time, people said, who was that guy that you had on? So I got to remember to keep saying your name. Max Lugavere's here. Little Empty Boxes is the movie and his podcast is The Genius Life. Back in a moment. Expanding your knowledge base.
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That's 800-2040-239. Should he, as some people have suggested, just go ahead and take a cognitive test and demand that Donald Trump do the same? I don't think that it'd hurt, to be honest, but at the end of the day, you know, I think that he should take a cognitive test.
I don't think it would hurt. And that's Governor Whitmer taking questions on her book tour about Joe Biden. Should he take a cognitive exam as George Stephanopoulos brought up? And he said, I don't need to do it because I get tested every day.
Max Lou Revere is here, health and science journalist, best-selling author and host of the podcast, The Genius Life, and go pick up his documentary or download it at LittleEmptyBoxes.com. Do you have any idea when people want to take a cognitive exam, do you know what that would consist of or what that would reveal? Yeah, I mean, the gold standard test is a four-hour long neuropsych test administered by a neuropsychologist.
And that, I mean, there's so much at stake now with this election. I think he should absolutely voluntarily volunteer to do it. I mean, watching him, I'm not a medical doctor and I've never been again in the room with him, but it looks so similar to what it was that my mom had. The decline in processing speed, the clear decline in processing speed, the change to his voice, even his facial features, the reduction in observable affect that you can see. To me, he could have a condition like Lewy body dementia, which generally what differentiates Lewy body dementia is that at its onset, you'll see both the movement symptoms that are associated with Parkinsonism as well as the cognitive decline.
It's not necessarily a decline in memory, but it's just generalized cognitive decline, a reduction in processing speed and the like, which to me, I mean, it just looks really similar to what I've seen for almost a decade, what I observed in my mom. And I imagine that when you go behind closed doors, the family would see it. Like you saw it, right? Yeah. I mean, look, if this was your father or your grandfather, you would be walking them into a neurologist's office.
There's no question. So I think it's just denial or I don't know. I mean, there's obviously stuff going on. It could be essentially a Parkinsonian condition. It could be Parkinson's disease. It could be another form of dementia. Again, it looks similar to what I've seen in my mom, Lewy body dementia, but I don't know for sure.
But it's definitely cause for concern. Max Lugovir, thanks so much. Good luck with your Little Empty Boxes documentary and your podcast, The Genius Life. Great to see you man. Thanks, Brian. Thank you.
