How the modern world affects our brains with Dr. David Perlmutter

In this episode we discuss:

• How inflammation affects decision making
• The disconnect problem and why we should connect
• Applying the test T.I.M.E. to use technology
• The beneficial effects of nature on our brain
• How sleep deprivation affects decision making
• How Mindfulness Improves Our Health
• Why social connection and empathy are so important

Show notes:

Hello everyone. Chris Kresser is here. Welcome to the next episode of Revolution Health Radio. This week I am very pleased to welcome Dr. David Perlmutter as my guest. Dr. Perlmutter is a certified neurologist and four times New York Times best-selling author. He serves on the board of directors and is a member of the American College of Nutrition.

Dr. Perlmutter received his MD from the University of Miami School of Medicine, where he was awarded the Leonard J. Rountry Award for Research. He is a member of the Editorial Board Alzheimer's Journaland published in peer-reviewed scientific journals, including Archive of Neurology, neurosurgeryand Applied Magazine nutritionIn addition, he often makes presentations at symposia organized by organizations such as the World Bank and the IMF. [International Monetary Fund]Columbia University, Scripps [Research] Institute, New York University and Harvard [University], and serves as an assistant professor at the School of Medicine, University of Miami Miller.

His books have been published in 34 languages ​​and include number one New York Times best-seller Cereal Brain: The Amazing Truth About Wheat, Carbohydrates, and Sugar – The Silent Killers of Your Brain more than 1 million copies in print. He is the editor of the upcoming collection. Microbiome and brain, [which] will be created by leading experts in this field and will be published in 2019 by CRC Press. Dr. Perlmutter's New Book Brainwashingwhich we will talk about today, was co-written with Austin Perlmutter, MD, his son, and is coming out this year.

Therefore, I am very happy to plunge into this book with Dr. Perlmutter. In a sense, this is a bit of a departure from his previous work, but also an iteration and continuation of some of the topics that he studied over the years. And I really like the direction he took in this book, and I think you do too. So let's dive.

Chris Kresser: Dr. David Perlmutter, it’s really nice to have you back on the show. Thank you for coming.

David Perlmutter: Well, I am very happy to be here. Again, this is great.

How inflammation affects decision making

Chris Kresser: I really look forward to talking to you about this book. It seems to me that this is a repetition of some books that you did before, but also a slightly different, slightly different direction. So what inspired you to write this?

David Perlmutter: This is a great question. And let me answer the iterative comment first. And this, you know, what we have been talking about over the years, and you, and many of us, have really focused on the powerful role of inflammation as a kind of cornerstone for many of our chronic degenerative conditions. , which, in fact, is considered the main cause of death on our planet.

So we looked at inflammation in context coronary heart disease, Alzheimer's disease disease, diabetescancer, you name it. But what we found when writing this book, and I think this is a transition to a new book, is the role of inflammation in decision making, And interestingly, the origin of this book, with which I co-authored [my] My son, Austin Perlmutter, also a doctor of medicine, he is an internal medicine specialist, in fact, the origin was right in the room from which I am talking to you right now. And we lay, raising our legs and asking, Austin asked me: “What is the most unpleasant thing in the practice of medicine?” And I said: “It's not that we don't learn as much as we can. We are trying so hard to learn as much information as possible, read all the studies and books and go to lectures, and then transfer all this information to our patients.

"Problem in a big malfunction occurs when patients take information and do nothing with it". So, studies show that between 50 and 80 percent of the information we provide to patients is not processed. And do they want to be vegetarian, Paleo, carnivorousor who knows what rich in fatsit doesn’t matter if they don’t use it. Thus, we began to understand what it was about patients, and to generalize it to the population as a whole, which underlies our ability to make decisions that, as we know, are useful for us or do not make these decisions. And we realized that in fact two fundamental areas of the brain are involved here.

One is called prefrontal cortex behind the forehead And this is a much more sophisticated decision-maker; he looks at the long-term consequences of what you decide to do today. He looks at the right and the wrong, unlike another area of ​​the brain called amygdalawhich is much more impulsive. I want a jelly donut right now, the future be damned. And we understand that there are so many aspects of our modern world, returning to our idea of ​​inflammation, which determines whether we will act in a more thoughtful, sophisticated way or that we are going to enter into impulsivity.

And how to judge fate, inflammation plays a key role in determining who makes decisions. Do we have an adult in the room and make the right decisions related to our future? Or the center of impulsivity is illuminated not only by the inflammatory nature of our life, but also by the inflammatory nature of our lack of sleepour lack of exerciseour lack of communication with natureand, of course, perhaps the tops on the list, is it the inflammatory nature of our modern Western diet? So, yes, we could say that, hey, our diets are involved in brain degeneration,

I wrote about this many years ago in Cereal brainBut to think that our diet, this modern Western / pro-inflammatory diet, influences our decision-making in order to determine, for example, what we should or should not do, in fact, I think it was a very deep discovery for us.

Chris Kresser: This is so exciting for me. And one of the reasons I was so happy to talk with you about this book is because I think we both came to the same conclusion about the problem, which is essentially behavior. If you look at the modern world, this is not just a lack of information that holds people back.

The statistics I use often According to cdc [Centers for Disease Control and Prevention]only about 6 percent of people are constantly involved in the top five healthy habits:

• Maintaining a healthy weight
• Getting enough exercise
• No smoking
• Do not drink excessively
• Get enough sleep

And this is not because they do not know what it is, they must do it. Most people know this now. The fact is that they cannot fulfill those successful behavior changes, And I come to this with trainer training and from a behavioral point of view and a behavioral decision.

And I like that you approach this in terms of inflammation and how the biochemical mechanisms that depend on our choice affect our ability to successfully change our behavior. Therefore, it seems to me that we need to approach this problem from all sides in order to find a solution that will adhere to.

David Perlmutter: Well, that’s true, and you raised a very good question, and it is that we do not suffer from a lack of good information. Do you read Paleo Cure or Cereal brainthese books, that is your book, or my book, or many wonderful books – they are useless. Our books, your books are useless if people do not act on the basis of the information that you provide them.

Chris Kresser: Yes.

David Perlmutter: Therefore, we do not suffer from a lack of terrific information today, we suffer from a lack of implementation, And so we created a new book Brainwashing be a bridge between information and action. Now that you have the information, what are you doing with it? We well know what good food and bad food are. We know that we should sleep well at night, and we know that we must play sports. But many of us fight and blame ourselves. This guilt is so huge. And we, as medical workers, with all due respect, tend to blame patients for what they did not actually perform. What is wrong with these people? Where is their willpower?

As we wrote this new book, we learned that active interventions in this world make it impossible for us to make the right decisions. What is the power at work, be it pop-up ads, bait on the Internet, change [and] changing the modern diet, etc., so that these forces work to crack our brain and prevent us from accessing this prefrontal cortex, the adult in the room, the good decision-maker, again under the powerful influence of the diet on the brain wiring .

Indeed, we know that so much of what happens when we are online contributes to impulsiveness. And we devote a large part of the book to making our readers very clearly aware that active efforts are being made to attract your attention, to attract your attention when you do something on the Internet.

Chris Kresser: Yes.

David Perlmutter: Be it pop-up ads [or] the next regular video on YouTube, which turns out to be interesting because you watched it because ads would appear there, as opposed to the sensible use of, for example, digital media to accomplish something that you want to achieve. Like, we wrote this book on the basis of the Internet and unlimited access to information. But I think that we are all aware of the fact that these days it is really leaving us that 42 percent of active time for Americans is spent in front of one screen or another. This is more than six hours a day.

Add it to life [and] it's 22 years of screen time, which is harmful, potentially harmful in itself, but also time that is not wasted on what Chris Kresser talks about. Things that are good for us. And we must pay attention to this. And I think the first step is really realizing that this is happening. And later in the book we will talk about which two steps? What we do to promote this and what we do to restore communication with the part of the brain that can finally bring us [to] make a better choice?

Did you know that lack of sleep, too little exercise, and an inflammatory diet low in nutrients can affect your ability to make decisions? Check out this RHR episode to find out why. #optimalhealth #wellness #chriskresser

The disconnect problem and why we should connect

Chris Kresser: I am so glad to hear that you are talking about this and that you have included this in your book. We have a whole module in our health trainer training program about technological dependence, I think that at the moment this is perhaps the least recognized and most significant threat to our humanity. And this is so insidious, because with other addictions, such as, of course, drug addiction, alcoholism, maybe maybe less with drunkenness, but they are usually a little more obvious. And in the case of drug addiction and alcoholism is less culturally acceptable. But technological dependence has become a kind of default, by which it is not even recognized in most cases.

David Perlmutter: Well, this, of course, is not recognized as a diagnostic code. But when you look at the characteristics of dependence, which destroys a person’s ability to earn a living, destroys a social life, destroys family life, then [those] determination criteria, then about 6 percent of the world is now Internet addicted. This is a quarter of a billion people. This is five times the population of England. These people have a double risk of suicide. And if they are under 18, the risk of suicide is quadrupled.

So, as you say, this is underestimated, but this is the main problem in China. In fact, they have training camps to help these people reunite with the people around them. These are digital detoxification so that people can reconnect with real people. And we will describe in Brainwashing what is called separation syndrome, And this is in the physiological sense of pathophysiological significance, the detachment of the tonsils, impulsive brain from the primary control of the prefrontal cortex. It also means disconnecting from the people around you; this means disconnecting from messages in your genome, disconnecting from messages in your microbiome.

Therefore, we use this term as a very wide network. The whole mission is about reunion. And I have to tell you, I wanted to reconnect in the title of the book, but I was rejected. And they settled on Brainwashing, I’m like a pun, I understand.

Chris Kresser: Sure sure.

David Perlmutter: But it's all about reconnecting, We want to restore intracellular communication with our DNA messages, that it environmental mismatch between our heredity and the environment Today it is really the main player in almost all of our diseases. This is part of the basic doctrine of Paleo. If we can get back to the place to give our DNA the signals that it is used to, then we will be healthier. There is no doubt that this is a reality. The fact that we live in conflict with what our DNA wants to see. But this connection thing is much further. Connecting with us now, and even connecting with our future selves.

When we talk about compassion, empathy for another person, we treat him with compassion, we may experience compassion for ourselves in the future. I can be sensitive to David Perlmutter in 10 years, curing, making decisions today that will be better for this person in 10 years. In the same way, we are talking about something very specific, called cognitive empathy, And what does it mean? This means that we can or cannot see things from the point of view of another person, regardless of whether we agree or not. This means that a democrat can accept the views of the Republicans and try them on, and vice versa, that vegans consider what carnivores are talking about, and carnivores think about vegans, Paleo or Keto, whatever we are talking about and talking to. We have so lost it.

Chris Kresser: Yes, imagine this world.

David Perlmutter: Yes, and that the isolationism of ideology is absolutely supported by our sites on social networks, [which] just fix us in one frame of reference, excluding everything else in the agora, from which we could learn and try on and possibly disagree with it. This is normal. But interestingly, this whole concept of empathy, and in particular cognitive empathy, is also a function of the prefrontal cortex, therefore it's so damn important for us to take a look at the tools we approved today that can allow us to recover, And I think it this is the first step, I mean, in any healthcare program, for example, if you want people to implement, we first need to work on their ability to make decisions. And this paves the way for them to later include the recommendations they receive.

Applying the test T.I.M.E. use technology

Chris Kresser: Absolutely. I want to support and emphasize what you said, because this is what I thought a lot, and I think that is the key. This, of course, was a key achievement for me, and I know that it is for many people, that is, you mentioned this in the context of technology. Like, there are neuroscientists and hackers who use these large technology companies to explicitly manipulate teach company how to manipulate our attentionSince we are not customers of these companies, we are their products. They sell our attention to advertisers.

And therefore, the more they can attract our attention, make us spend more time on the platform, the more money they earn. And you mentioned that they hire these scientists to do this. I think it’s really important for me that people understand that this is happening in many different areas of the modern world. And you point out this in your book that food, highly processed and refined food, engages those desires of the limbic system of the lizard brain that we have and overlaps our frontal cortex. Exposure to light artificial lightinghas the same effect. The sedentary lifestyle we live in.

The disconnected nature of our isolated nuclear family lifestyle has these consequences. So, you mentioned that for the right choice, we must have a brain optimized for reflection, balanced thinking and long-term results. Indeed those prefrontal processes are based on the cortex. However, we live in a world that is really trying to use the impulsive, emotionally responsive part of our brain.

David Perlmutter: This is so true, and why is this done? Because it is valuable.

Chris Kresser: Correctly.

David Perlmutter: What you do and where you go online is valuable to others. И это полностью монетизируется, и каждый человек, который сейчас на сайте делает что-то, приносит ценность и, если честно, то, на что вы обращаете внимание в Интернете, влияет на ваш выбор и является ценным. Итак, когда мы видим сейчас исследование, показывающее, что функциональная МРТ [magnetic resonance imaging] используется, чтобы увидеть, какие области мозга загораются, для улучшения рекламы. Раньше они пользовались тем, что называлось фокус-группой.

Крис Крессер: Правильно.

Дэвид Перлмуттер: Или они будут создавать рекламу и 20 человек [would] быть в комнатах. "Да, мне нравится." «Ну, мне это не очень нравится». Без разницы. Они будут голосовать. И теперь они смотрят на то, как реклама нацелена на нашу мозговую деятельность, на наши центры вознаграждений, и развивают конкретные рекламные объявления, чтобы осветить центр вознаграждений вашего мозга. Я имею в виду, это часть битвы Промывание мозгов первый, чтобы вызвать это.

Крис Крессер: Да.

Дэвид Перлмуттер: Как вы и сказали, мы это назвали. Что есть, то есть. Мы уверены, что, черт возьми, не придумывать это. Но мы предлагаем инструменты, чтобы вы могли, вы могли бы повысить вашу онлайн-самооборону, как бы. Термин, который, как мне кажется, я узнал только вчера у Абеля Джеймса Жиросжигающий Человек,

Крис Крессер: Да, я люблю это.

Дэвид Перлмуттер: Он придумал это. Я думал, что это было потрясающе. Я сказал: «Я собираюсь украсть это у вас». Но это правда. Итак, в книге, о которой мы говорим, например, онлайн, чтобы спросить себя, проходит ли ваш опыт онлайн испытание временем? ВРЕМЯ.

• T, как много время Вы посвящаете чему-то, что хотите сделать в Интернете? Чтобы узнать о какой-то научной вещи или восстановить связь со своими школьными друзьями, что бы это ни было, сколько времени?
• я, это намеренный? Какова цель? Что вы надеетесь получить от этого?
• Mты остаешься внимательный, помнящий когда вы находитесь в сети и знаете, какие усилия предпринимаются, чтобы взломать ваше внимание?
• И наконец, Е, ВРЕМЯ. Это чистый позитив? it обогащающий? Обогащение.

Другими словами, когда все сказано и сделано, чувствуешь ли ты, что это был хороший опыт перед экраном, или [do] Я просто, ну, как бы [hadn’t spent] последние четыре часа что-то смотрели на Netflix? Так что это отличный инструмент. Кристиан Ланге в 1921 году получил Нобелевскую премию. Он сказал, что технология – полезный слуга, но опасный хозяин.

Крис Крессер: Да, бедный хозяин.

Дэвид Перлмуттер: Итак, еще раз, мы не призываем людей выключать, Вы и я общаемся прямо сейчас с невероятной цифровой технологией. Замечательно. Но мы уверены, что, черт возьми, хотим прояснить, что усилия по манипулированию вашим мозгом и продвижением вашего мозга, я могу добавить, очень реальны, [it] что это такое, но что вы можете сделать, чтобы увеличить свою защиту?

Крис Крессер: Мне нравится, как вы подчеркиваете это не только с помощью технологий, но и с современной системой питания; Промышленно обработанные пищевые компании также нанимают людей, чтобы максимизировать зависимость этих продуктов и заставить нас есть их больше.

Дэвид Перлмуттер: Вы ставите. Это 68 процентов продуктов из 1,2 миллиона продуктов, проданных в Америке, имеют добавлен подсластитель,

Крис Крессер: Да.

Дэвид Перлмуттер: Теперь зачем это делать? Ну, потому что люди будут есть больше. Дело не в том, что они добавляют что-то действительно хорошее для нас.

Крис Крессер: Нет.

Дэвид Перлмуттер: Не в наших интересах добавление сахара в нашу еду.

Крис Крессер: Но это не провал индивидуальной воли. И я всегда прилагаю усилия, чтобы указать на это, и вы также делаете это в своей книге, потому что я думаю, что это помогает людям выбраться из игры с чувством вины, вины и стыда, которая парализует и скорее приводит к бездействию. чем действие. Принимая во внимание, что когда люди понимают, что эти вещи с ними делают, они фактически становятся субъектами этих экспериментов, которые проводятся. И я не говорю, что у нас нет личной ответственности; конечно мы делаем. Но я думаю, что это может дать людям возможность понять, что они подчиняются этим силам, и они действуют на них, которые на самом деле не имеют своих интересов в глубине души.

Дэвид Перлмуттер: Крис, твоя точка зрения абсолютно глубока. И это то, что мы пытаемся сделать здесь, чтобы остановить вину. Что, угадай что? Вы не выполнили свои новогодние обещания. Вы читали чью-то книгу, думали, что это здорово, но вы не делаете тех вещей, которые, как вы знаете, полезны для вас. И на самом деле, вы принимаете неправильные решения.

Крис Крессер: Да.

Дэвид Перлмуттер: И люди смотрят на себя в зеркало и винят себя. И мы говорим: «Угадай, что? Ваш мозговой механизм для того, чтобы сделать этот хороший выбор, был забран. И вот как вы можете восстановить это. И я скажу, что это, безусловно, начинается с нас в мире здравоохранения, что мы склонны обвинять тех людей, которым мы оказываем помощь. Мы обвиняем их в том, что они не следуют важной информации. Мы считаем, что это здорово, что мы так усердно учились и пытались приобрести, и все же [it] не действует со стороны клиента / пациента, и мы должны это остановить. Мы должны понять, что у миссис Джонс нет механизма наверху, чтобы принимать правильные решения.

Таким образом, мы сейчас включаем помещения Промывание мозгов at Функциональная медицина Программа коучинга, только что договорилась пару недель назад. И вначале мы действительно обучаем поставщиков медицинских услуг, а не концентрируемся на первой неделе, раздавая лист бумаги с этой специфической диабетической диетой для похудения. Но когда мы впервые находимся с пациентом, мы фокусируемся на изменениях, которые могут привести к лучшей способности принимать решения. Это настоящая цель. Потому что, если вы не работаете над лицом, принимающим решения, то все остальное, что вы предоставляете пациенту, опять же совершенно бесполезно.

Таким образом, мы должны принимать более правильные решения для пациентов, чтобы начать с них. И затем вы признаете, что это все мы, потому что, являетесь ли вы пациентом или нет, мы, люди, живущие в нашем современном обществе, испытываем это мощное разъединение в наших умах. И оказывается, что есть некоторые мощные вещи, которые мы можем сделать прямо сейчас, которые могут позволить нам восстановить контроль, вернуть взрослого в комнату и, в конечном итоге, сделать лучший выбор и стать более чуткими и сострадательными на этом пути.

Благотворное влияние природы на наш мозг

Крис Крессер: Не могу согласиться больше. Так что это хороший переход к некоторым решениям, о которых вы говорите в книге. И один из моих любимых, лично природа и связь с природой как противоядие от стресса и технологических пристрастий, Не могли бы вы немного рассказать о том, что наука говорит нам о том, как природа влияет на мозг?

Дэвид Перлмуттер: Конечно. Что ж, позвольте мне начать с того, что никто не гуляет на природе и не чувствует себя лучше, чем сидеть дома и смотреть видео. И мы все это знаем [if] мы выходим на прогулку среди деревьев и на свежий воздух, мы чувствуем себя лучше, И оказывается, что есть действительно хорошая наука о том, почему это происходит. Мы знаем, что воздействие природы, большая часть этой работы [is] на самом деле делается в Японии, [and] некоторые из них [is] делается здесь. Природное воздействие даже на 10 минут значительно снижает уровень гормона стресса, кортизола.

Это играет роль с точки зрения нейротрансмиттеров, с точки зрения того, что происходит в кишечнике, с точки зрения проницаемости кишечника, следовательно, воспаления. Но воздействие природы также напрямую снижает этот воспалительный процесс, который, как я упоминал ранее, отделяет нас от префронтальной коры. Таким образом, воздействие на природу очень быстро дает нам возможность воссоединиться с префронтальной корой, восстанавливая лучшую способность принимать решения и позволяя нам быть более чуткими к природе. Вернуться к окружающей среде. И когда мы впервые говорим об этом, я думаю, что люди как бы кивают головой, думая: «Ну, я не живу рядом с национальным парком. И это не будет возможно для меня.

Но то, что показывают исследования в действительно хороших научно-контролируемых исследованиях импульсивности, например, в лаборатории, заключается в том, что просто показ людей с изображением природы всего за 10 секунд резко сокращает, например, количество активности в центре страха. в миндалине, когда этим людям показывают угрожающие фотографии. Так что всего 10 секунд на просмотр картины природной среды. Еще более сильным является физический контакт с природой, например, в виде комнатного растения в вашей гостиной или на кухне. Или как бы в некоторых исследованиях, в больничной палате или в приемной. Так что это действительно довольно просто, но все же драматично.

Вам не нужно жить рядом с Йосемити и совершать двухчасовой поход четыре раза в неделю. Если у вас есть доступ к парку, это здорово. Это может быть всего 20 минут. Исследования показывают, что они продемонстрировали, что даже при измерении уровня гормона стресса кортизола в слюне, даже в городской среде, но в естественных условиях в городской среде, например в небольшом городском парке, измерения кортизола в слюне измерение стресса, если хотите, снижается довольно резко. Итак, еще раз, чтобы сделать это более удобным для пользователя. Вы знаете, мы говорим о сне, медитации, диетических изменениях и физических упражнениях, а не о том, чтобы действительно бросить книгу людям, какими вы должны быть.

Но каждый из них является потенциальным стимулом для отдельного человека, который позволит ему или ей, после этого двигаться вперед, иметь небольшую трещину в двери с точки зрения лучшего принятия решений. Что это может быть просто растение в горшке или вылезание на природу для одного человека, в результате чего другому человеку действительно не хватает восстановительного сна. Целевой это.

Крис Крессер: Да.

Как отсутствие сна влияет на принятие решений

Дэвид Перлмуттер: Посмотрите на синюю освещенность вечером, посмотрите на температура в комнатеПосмотрите на потребление кофеина в конце дня, что бы это ни было. Но вот человек, который должен сделать лучший выбор в отношении его или ее диеты. [The] в первый раз, когда вы с этим человеком, вы говорите: «Знаете что? Мы даже не будем говорить об этом сегодня. Я собираюсь поговорить о чем-то, казалось бы, не связанном со сном. И это поднимет брови. Но оказывается, что даже одна ночь без восстанавливающего сна связана с повышением активности миндалины на 60%. Это означает, что на следующее утро ваши решения будут гораздо более импульсивными, у вас гораздо больше шансов наговорить людей, и вы сможете участвовать в гораздо меньшей эмпатии, чем человек, который хорошо выспался ночью. И все мы знаем, что это правда.

Крис Крессер: Да.

Дэвид Перлмуттер: Если по какой-либо причине вы не спите всю ночь или плохо спите, мы все немного раздражаемы на следующий день. Но проблема в том, что теперь вы настроили себя на принятие плохих решений в панораме выбора образа жизни, включая еду. Так что на следующий день, что ты делаешь? Вы едите плохую пищу. И что это делает? Усиливает воспаление; [it] увеличивает, в конечном итоге, жировые отложения. И чем больше веса вы набираете, тем менее качественный сон вы получите.

Так что это буквально, и извините за каламбур, процесс прямой связи. Было продемонстрировано, что люди, которые хронически плохо спят, будут потреблять в среднем примерно на 380 калорий в день больше без подобного увеличения затрат энергии. Это означает, что это фунт жира примерно каждую неделю. Вы растягиваете это на пару месяцев, и что происходит? Люди набирают больше веса. Жир провоспалительный, что приводит к большей импульсивности, приводит к плохому сну, и это создает такие циклы прямой связи, которые так характерны для нашего современного мира. Вы идете через аэропорт, вы видите людей, которые явно страдают.

Массовое увеличение веса в нашем обществе, и теперь, я должен признать, я смотрю на этих людей, думая: «Почему вы не можете просто сделать изменения, о которых такие люди, как вы, мы с вами пишем? Почему ты не можешь просто сделать это? И затем, опять же, когда вы понимаете, что, поскольку они набирают жировые отложения, они будут есть больше. Гари Таубс однажды [had] отличная цитата. Он сказал: «Мы не набираем вес, потому что едим больше. Мы едим больше, потому что набираем вес ». И это другая точка зрения, но я думаю, что чрезвычайно важно понять, как телесный жир контролирует наш голод, наш грелин, усиливает воспаление и отвлекает нас от принятия правильных решений.

Крис Крессер: Да. Да, я не могу не согласиться. И я думаю, что сон, к счастью, получил больше внимания у людей, но не только потому, что он может повлиять на настроение и когнитивные функции. Но очень прямая связь, как вы указали, между сном и кардиометаболической функцией, которая сейчас вне всякого сомнения. И я также видел исследования, предполагающие, что плохой сон влияет на суждение о еде. Даже одна ночь плохого сна может повлиять на выбор, который мы делаем о том, что мы едим на следующий день. Что касается вашей точки зрения, это не просто информация, это наша способность принимать правильные решения. И это будет значительно ухудшено из-за недостатка сна.

Дэвид Перлмуттер: И это правильно. И было продемонстрировано, что даже после одной ночи плохого сна возникает повышенное желание калорийной, непитательной пищи. Я имею в виду, большинство людей, вероятно, испытали это. Но вы знаете, проблема в том, что когда качество и количество сна со временем снижаются, эти решения укоренились в нас, и мы принимаем дальнейшие плохие решения, которые, как я уже говорил, [are] сильно влияет на наш сон. Итак, опять же, что мы сделали в Промывание мозгов создается вне рампы. Как вы выходите из этих циклов? И, конечно же, гигиена сна это так важно.

Все рекомендации, которые мы сделали в отношении снова время показа вечером, to possibly using a little melatonin, to using a white noise generator in the background if you’re not able to sleep in a quiet area, to our timing of sleep, our timing of eating, our timing of exercise, not going to sleep with a full belly because you just finished dinner. And so many things that play a role in our ability, as Dr. Matthew Walker described in his book Why We Sleep, that are really very important. I’m glad that you and I went there first, because we should spend about eight hours of our 24-hour cycle sleeping. We don’t spend eight hours eating or exercising, right? Maybe you could, I guess.

Chris Kresser: Hopefully not.

David Perlmutter: But food and exercise is what everybody talks about. And I think it’s great to talk about those things. But the big thing that we do for most of our lives, in terms of a lifestyle choice, is sleep or not. And it’s great that people are writing these books like Michael Breus writing The Power of When, and, as I mentioned, Matthew Walker, because it’s, especially in our society where one third of Americans [do] not get enough restorative sleep. And in Japan, it’s close to 70 percent of adults.

Chris Kresser: Да. I had Matthew on my podcast, Because when I talk about this with patients, I have a feeling that a lot of patients suspect that they’re in that extreme minority of people who can thrive on just six to seven hours of sleep. And Matthew is very clear about pointing out, when he says seven and a half to eight hours of sleep, that’s not time in bed; that’s sleep. So, depending on what your sleep efficiency ratio is, you might need to spend eight and a half or nine hours in bed to get eight hours of sleep.

But a lot of people I talked to think that they’re in that minority of people who really can be fine with six hours. And he said something that really struck me and I haven’t forgotten, is that you have more of a chance of being struck by lightning than you do of being in that tiny, tiny minority of people that can thrive with fewer than seven and a half or eight hours of sleep.

David Perlmutter: Yeah, I mean, there [is] a very, very small group of people. I mean, there’s one, there’s a mutation gene that’s called ADRB-1 that may allow a very small number of people to sleep as little as four and a half hours a night and then not feel tired. I don’t know how specifically they’ve been studied in terms of their amygdala activity the next day and their choices, whether they’re impulsive or not.

Chris Kresser: Or what are the long-term health consequences of that?

David Perlmutter: That’s true.

Chris Kresser: Да.

David Perlmutter: So, it’s very interesting. I think for all of the rest of us, we need to get a good night’s sleep. And guess what? Everybody kind of knows that or should know that.

Chris Kresser: Да.

David Perlmutter: I mean, with all the things being written these days, these wonderful books and podcasts talking about sleep, it’s really time that we ratchet that up probably to the top of the list. You can fast for weeks and weeks if not months; you can decide never to exercise again. But you know, sleep, miss out on sleep for a few days and you won’t survive.

Chris Kresser: Game over. Да.

David Perlmutter: Yep, that’s right. And it powerfully, powerfully disconnects us from the prefrontal cortex. It’s a powerful player as it relates to disconnection syndrome. But more importantly, it’s such an important callout for us in terms of building a program, to regain connection to the good decision-maker and that part of the brain that allows us to share opinions with other people. That’s, again, this cognitive empathy that we sure need to think about these days. Because our world is so divided. And it’s okay for us to have this diversity of opinion. But when we share our ideas with others, then we can move forward with a consensus and go to a better place. We can make progress. But when we’re all locking ourselves into our unique ideologies, how can we make progress that way?

The Ways That Mindfulness Improves Our Health

Chris Kresser: Да. Let’s talk a little bit about something I think that’s connected to sleep and everything, of course, that we’ve discussed so far in the show, which is mindfulness, Because it’s always been my argument that if we can’t be aware of what we’re doing, then we have little hope of making any kind of successful change, Awareness is really a precondition to making change. And mindfulness is one of the best ways of cultivating awareness. So you write a little bit about mindfulness as being one of the strategies for reconnection in your book. Tell us what you learned in your research on how mindfulness impacts these mechanisms in the brain.

David Perlmutter: Конечно. Well, mindful practices are absolutely the superhighway to the prefrontal cortex. Whether it is a mindful breath program or a mantra-based program, which is in a sense, mindfulness, or it’s deep religious prayer, whatever it may be, it is, again, just a really powerful way to light up the prefrontal cortex. Let the amygdala calm down. And the health benefits associated with mindful practices are legion. And I think many of them, in fact, are derivatives of the role that these practices have on reconnection to the better decision-maker in your brain and also with respect to lowering cortisol and lowering inflammation, which happened to be powerful players in the etiology of so many of our chronic diseases.

So when we see less coronary artery disease, less diabetes, even some suggesting of [a] reduced risk of cancer related to mindful practices, I think it could be through these mechanisms. And what we’ve learned is that eight weeks of meditation is able to change the brain almost as dramatically as is seen in lifelong meditators, and that it may only take 12 minutes a day. So we’re really very specific about calling out to our readers that we don’t have to retire to an ashram to gain the benefits of a mindfulness practice. And it’s all about being in the moment. Not thinking about what happened yesterday, or what one plans to do tomorrow or this evening. It’s about just being in the moment. And incredibly and ironically, if you can practice being in the moment, being in the now, it paves the way for you to plan for the future even better.

To make better decisions so that the future outcome will be better. That’s one of the important things about reconnection to the prefrontal cortex, is that it lets you be with the experiencing and understanding what might be the long-term consequences, either positive or negative, be of the decisions that you’re making today. As opposed to just making these decisions, come what may, in terms of our lifestyle choices, in terms of how we invest our money, how we treat people, and not worry about the future consequences.

And frankly, Chris, this is the time in our discussion today to indicate that this reconnection to the prefrontal cortex is associated with more pro-environmental behavior. Research demonstrates that. We talk about it in the book. Meaning that the better connected we are to this part of the brain, the more likely we will be engaged in acting in a pro-environmental way. I mean, you talk about making, having some consideration for the future; let’s have some consideration for the future of the planet on which we live, in terms of the actions that we engage today.

Chris Kresser: Absolutely, yeah. And it’s mindfulness. To me, it’s one of these meta capacities that enhances everything else. So we talked a lot about technology addiction and how to address that. Well, if you’re mindful, you’re able to catch yourself engaging in one of those patterns more quickly, and then make a conscious decision with the prefrontal cortex to not do that, You’re able to make better choices about food because you’re paying closer attention. You’re able to make better choices about sleep, about exercise.

As you’re saying, you become a better citizen of the world. Because likely, for a lot of reasons, but you’re paying more attention, you’re more engaged, you’re more connected to yourself, [and] you’re more connected to the world around you. So it’s one of these things that, I think everything that we’re talking about, good diet, exercise, it has kind of, like, a virtuous cycle effect where you start doing one thing, as you mentioned before, that can be different for different people, and then it makes it easier to do the other three or four things. And you start to do those things, and you start to build this upward spiral rather than the downward spiral that most of us have been stuck in.

David Perlmutter: Вот так. And just to go back to the application of what we’re talking about to the, kind of the worldview. You’ve talked about the changes in human nutrition that we characterize as the modern Western diet, which I think we will all agree is a very pro-inflammatory diet. And that’s becoming the global diet. The global diet is becoming this very highly processed, highly containing sugar diet inducing inflammation. It’s the global [diet] which the [is] responsible for these dramatic increases, upticks in coronary heart disease, diabetes, cancer, Alzheimer’s, all the inflammatory disorders.

When you consider the role of inflammation in changing brain wiring, keeping us out of the prefrontal cortex and locking us into impulsivity, into us versus them, and keeping us away from empathy, then think about the implications of the globalization of this Western pro-inflammatory diet. It’s changing the mindset, the worldview of people around the world, making them more tribal, more locked into this us versus them mentality, less able to make good decisions for the long term, and, frankly, less able to engage in this cognitive empathy whereby they can listen to other people. We’re watching it happen.

I mean, you just, it’s happening all around us. I’m not going to suggest that food is the only reason that it’s happening. But I think that it’s playing a role and to identify inflammation that we’ve all been talking about for at least the past 15 years, to identify inflammation now in the role of changing how we see the world puts a very important new spin on all the things that we do.

Why Social Connection and Empathy Are so Important

Chris Kresser: You mentioned empathy. You’ve mentioned it a few times actually throughout the podcast. And one of my favorite studies actually mentioned in the chapter on social connection in my first book, The Paleo Cure, is a study that found that lack of social support is a greater predictor of early death than smoking 15 cigarettes a day. I’m not sure if you’ve seen this one. But tell us a little about why connection and empathy and bonds with people are so important to our brain.

David Perlmutter: Well, man is a social animal. When I say man, we are a social animal, and we thrive when we are able to relate and interact with other people. And the problem with that is that this becomes a very powerful hack. This thing called social media, for example, is a powerful hack into our desire to be social. It worked for us very well when we lived in groups where we could have specialization of labor based upon people’s skill sets. And this is what, social media, why it’s so pervasive now, because it hacks into that.

Much as sugar and our desire for sweet was a powerful adaptive great thing that humans had. That when we ate sweet, we would make body fat and we would then survive through periods of caloric scarcity. So that was a hack, as well. So I think it’s, what you’re bringing up about loneliness, I think lonely, and the reason I went there is loneliness is fostered by social media despite its name. We know that it is a powerful influencer in terms of risk for disease. Forty-three percent of seniors feel lonely on a regular basis in this country. Forty-five percent, rather, of these seniors, have a 45 percent increased risk of what is called all-cause mortality. These are the lonely individuals. And, like you say, that statistic correlates, according to the research, with smoking about 15 cigarettes a day.

So, cigarettes are a tangible metric, right? You can count out the cigarettes. You know what it means. It’s something you can see. But loneliness is something that is kind of hidden in the background, and is not fostered by our online experience, I mean, social interaction. Loneliness is made worse by the time that we spend isolated in front of our screens and interacting with so-called social media. So it’s a pervasive issue. It’s worsening with time. And that said, as I mentioned earlier, I wanted to call this book something that had the term “reconnection” in it, because reconnection is really important, especially for older adults.

It’s been estimated that the, we say that loneliness and isolation has its play out in terms of these chronic degenerative conditions. And it’s been estimated that $6.7 billion of our annual federal budget is attributable to treating the problems that are associated with social isolation among older adults. So you make a very, very good point. And this is a big deal. And it’s all about reconnection. One of the powerful metrics of the Blue Zones is that people have both a sense of purpose in their lives and are socially integrated. Socially integrated across generations and socially integrated in their communities.

These days, that’s just not happening. And it, to some degree, I think, gets back to this lack of cognitive empathy whereby we’re just unwilling anymore to listen to people talk, because they might have a viewpoint that’s different from ours. I might be a Democrat, they might be Republican, or vice versa. And again, they may be all in on being vegan and I’m, let’s say all in on another dietary choice, and we’re just not going to have a connection. I recently interviewed on my pod, a very good lesson for me to learn, I interviewed somebody who was a proponent of veganism. And just saying, “Look, I’m not vegan. I certainly will eat some grass-fed beef and some free-range chicken and eggs for sure.” And this individual was respectful of that but offered up her viewpoint, and the pushback that I got was breathtaking.

Chris Kresser: Да.

David Perlmutter: And the main reason I did this interview was I thought that there, that she had some interesting things to say that we could debate and talk about. The main reason I did it was to challenge the audience with another viewpoint just to see if they could take a deep breath and listen. It was very sobering.

I interviewed a guy a couple of years ago, you may know him. His name is Dr. John Douillard, and he wrote a book called Eat Wheat, Now why would Grain Brain guy, me, interview Eat Wheat guy, John Douillard? Well, I did it for a couple of reasons. First of all, I’ve known John for 25 years and I really love him. He taught me Ayurvedic medicine so many years ago, A. B, I think he’s very thoughtful, and does his research. And C, I thought it would be fair to vet an alternative opinion to mine. I thought it would do me some good.

So we do our interview, and you know, you’re looking at the comments. And the comments had nothing to do with [the] content of our podcasts. Nothing to do with gluten and gliadin, gut permeability, whatever it was; the comments were that, “Wow, you guys had such divergent opinions, but yet you were respectful of each other.” And mission accomplished. That’s what I wanted to do. I mean, I wanted to get his word out there because he had an opinion, and I had my opinion. And I certainly did not agree with him in a lot of what he was saying, but it was respectful.

And it’s like reaching across the aisle. People need to listen to each other, and it’s just not happening anymore. And that’s a function of the prefrontal cortex. The modern Western diet is threatening our ability to communicate, to share ideas, and to keep people from feeling lonely.

Chris Kresser: Well, David, I really enjoyed this conversation, and I love this book. I think it’s such an important contribution to the conversation around health for all the reasons we’ve discussed, and especially in the introduction. That we both have done this work long enough to know that it’s not just about hammering more information into people’s heads. That’s the definition of insanity, right?

David Perlmutter: Right.

Chris Kresser: It hasn’t worked. It’s not going to work ever. And so we need to find a different approach. And I particularly love the approach that you’re taking. I’m looking at it from a slightly different angle with the health coaching, but certainly we both zeroed in on the problem. And I think it takes a whole bunch of different ways of getting at it to make the change that we need to make. So thank you for writing this book. And can you tell everyone where they can find out more about it and pick up a copy?

David Perlmutter: Конечно. Well, the site for the book is, as you might guess, BrainwashBook.com, It’s available at all the bookstores, the airport, wherever you want to find books. I’m really excited that the book was just published, and is now being published in 16 countries, 16 languages around the world, which is a great thing. Including, I will say, including Russia, Korea, Turkey, France, and Germany. Places, the more people that we can get on board with the idea that we can make better decisions that will help each and every one of us, but help us at large, as well, I think the better.

So I’m so excited about that. And Chris, thank you for everything you do. And you know what it’s like, I know what it’s like, that people say what you’re doing is outside the box. And I’ve always said that well and good, but our mission is not to get in the box, but rather make the box bigger so that it’s more inclusive of some of our ideas. And so thank you for staying in the batter’s box and also giving me the opportunity to spend time with you today.

Chris Kresser: Absolutely, David. And I enjoyed it, and I’m 100 percent with you on the need for, the dire need really, at this point, to be able to have, to respectfully disagree and have those conversations in [the] public forum. I think the health of our society and the world at large depends on that. So I couldn’t agree more that we need to do everything we can to get back to being able to do that as a people.

David Perlmutter: So true.

Chris Kresser: So thank you again. BrainwashBook.com, I highly recommend this book. Go out and pick up a copy. And I look forward to seeing you at Paleo f(x) in a few weeks.

David Perlmutter: Yeah, looking forward to it, my friend.

Chris Kresser: All right, take care.

David Perlmutter: Okay, bye for now.