The Habit Healers

This article is based on my conversation with Chris Miller MD, author of the Chris Miller, MD Substack, this is day 5 of the first-ever Brain Health Substack Summit hosted by The Habit Healers.

Click here to join, our final conversation tomorrow with Chef Martin Oswald and we will dive into all the delicious recipes he created for each of our Brain Health Substack Summit panelists.

If you missed Day 1 of our Brain Health Summit with Julie Fratantoni, PhD you can watch it here. We discussed how to exercise your brain day to day.

If you missed Day 2 of our Brain Health Summit with Annie Fenn, MD you can watch it here. We discussed foods to decrease dementia risks.

If you missed Day 3 of our Brain Health Summit with Jud Brewer MD PhD you can watch it here. We discussed how to unwind your anxiety.

If you missed Day 4 of our Brain Health Summit with Dr. Dominic Ng, you can watch it here. We discussed microplastics in your brain.

Subscribe to get the updates on the Brain Health Summit each day!

There is a particular kind of tired that most people over 45 know well. You wake up and the day already feels heavy. You have a list of things to do and the motivation to do exactly none of them. You sit down to read something and the words just slide off the surface of your brain. You used to be sharp. You used to be a person who did things. And now you’re wondering what happened.

Most people chalk it up to aging. Or stress. Or some personal failing they can’t quite name. And what Chris Miller MD would tell you is that all of those people are wrong.

Chris is an emergency physician who spent over a decade working in the ER before her own body started fighting against her. It began with a swollen finger. Then more fingers. Then came the diagnosis: lupus, an autoimmune disease in which the immune system, the very thing designed to protect you, turns on your own tissue with alarming aggression. Her inflammation markers were sky-high. Her whole body was under siege. And eventually, the ER became too physically demanding to keep working in.

But what struck Chris most wasn’t the joint pain. It was what happened to her brain.

“I felt foggy,” she said during our discussion. “I was not motivated. I thought something was wrong with me, like I was lazy. But really, it was inflammation. My neurotransmitters were off.”

That distinction matters enormously. Because if you’re lying on the couch at 3 p.m. unable to will yourself into action, and the actual problem is an immune response happening inside your skull, then no amount of self-criticism will fix it. You’re yelling at yourself for something your brain chemistry is doing without your permission.

What’s Going on Exactly?

To understand what’s going on, you need to understand what inflammation actually is. And the simplest way to think about it is as a security system.

Your immune system runs 24 hours a day, patrolling your body for threats. A virus enters through your nose, the immune system grabs it. You cut your finger, the immune system repairs the wound. You breathe in polluted air, the immune system works to clear it out. Roughly 70 percent of your immune system sits in your gut, which makes sense when you consider that one of the biggest entry points for foreign substances is through the food you eat.

All of that is normal and necessary. The problem starts when the security system gets overstimulated.

If you’re eating highly processed food at every meal, breathing contaminated air, sleeping poorly, and running on stress hormones all day, your immune system never gets a break. It keeps releasing inflammatory signaling molecules called cytokines (think of them as alarm bells), which tell the rest of the body to ramp up the immune response even further. Normally, inflammation spikes when there’s a threat and then settles back down. But when the threats never stop coming, the inflammation goes up and stays up. That’s chronic inflammation. And that’s when things start breaking.

Fortunately, your brain has a built-in defense against all this: a structure called the blood-brain barrier. Picture the lining of a normal blood vessel as a single layer of cells. The blood-brain barrier is about 50 times tighter than that, reinforced with specialized support cells called astrocytes. It’s like a fortified wall around your brain, keeping out the inflammatory chaos happening in the rest of your body.

But here’s what Dr. Miller emphasized: when inflammation is chronically elevated, that wall starts to crack. The cytokines get through. And once they’re inside, they activate the brain’s own immune cells, called microglia, which then start releasing their own inflammatory signals. Now you have inflammation inside the fortress.

What Brain Inflammation Actually Feels Like

The symptoms are maddeningly vague, which is part of what makes this so tricky to spot. Chris described the most common ones from both her clinical practice and her own experience.

Fatigue is at the top of the list. Not the kind of tired you feel after a bad night’s sleep, but a bone-deep exhaustion that doesn’t lift. More than 80 percent of people with autoimmune conditions describe fatigue as their number one symptom, and Dr. Miller points directly to brain inflammation as the reason.

Then there’s the motivation problem. When microglia are activated and releasing cytokines inside the brain, they suppress dopamine, the chemical that drives you to start and complete tasks. Less dopamine means less motivation. They also reduce serotonin, the chemical involved in mood regulation. So now you’re tired, unmotivated, and a little depressed. The problem is biological, not personal.

And then there’s brain fog. Chris struggled to even describe it, which she acknowledged was sort of the point. “It feels like things are distant,” she said. “Like you want to calculate something and you almost can’t get there. Even though you know what you want to do, you just can’t.” I’ve dealt with Hashimoto’s thyroiditis (an autoimmune condition affecting the thyroid gland) for nearly 30 years, and I know exactly what she means. It feels like wading through molasses. You can see the thought arriving. You watch it come toward you. And then it either takes forever to land or it drifts right past.

Headaches can also be a sign. So can anxiety. The overall picture is of a brain that isn’t broken in any dramatic way but is running on degraded hardware.

The Surprising List of Things That Set Your Brain on Fire

Some of the causes of neuroinflammation (the medical term for inflammation specifically in the brain) are predictable. Autoimmune diseases. Head injuries. COVID and other serious infections. When you have a bad flu and feel that total withdrawal from the world, the foggy detachment, that’s your brain responding to the inflammatory cascade in your body.

But some causes are less obvious.

Blood sugar spikes, for instance. You don’t need to be diabetic for this to matter. Even if your fasting blood sugar and your A1C (a measure of average blood sugar over three months) look normal, the spikes that happen after meals can still damage the blood-brain barrier. Every time your blood sugar shoots up after eating, your insulin surges to bring it back down, and that surge creates a small hit of inflammation that chips away at the barrier over time.

Low estrogen is another one. Estrogen is strongly anti-inflammatory, which helps explain why so many women experience sudden cognitive changes during perimenopause and menopause. I lived this firsthand. I had such an abrupt cliff from perimenopause to menopause that I went from fine one week to not fine the next. That rapid drop in estrogen removes a major source of inflammation protection for the brain.

Chronically elevated cortisol, the stress hormone, directly activates the microglia. So living in a constant state of stress doesn’t just feel bad. It is physically inflaming your brain.

Air pollution is a culprit too. Chris described reading studies linking air pollution to dementia through glial cell activation. She even mentioned her frustration with neighbors whose wood-burning fireplace pollutes the air in her neighborhood. It’s one of those things that feels insignificant, a neighbor’s fireplace, but breathing contaminated air over months and years adds up.

And poor sleep. Sleep is arguably the most important factor in this whole equation, which brings us to one of the most remarkable discoveries in neuroscience in the last two decades.

The Brain’s Nighttime Cleaning Crew

Until about 2012, scientists didn’t know the brain had its own waste-clearance system. The rest of your body has the lymphatic system, a network of vessels that filters out waste and toxins. But the brain was thought to operate differently. Then researchers discovered the glymphatic system (the “g” comes from glial cells, which play a central role in the process), and it changed the way we think about sleep.

The glymphatic system surrounds the brain. During deep sleep, it activates, flowing through and around brain cells to clear out metabolic waste, damaged proteins, inflammatory debris, all the byproducts of a brain that’s been thinking and firing all day. Every time your neurons fire, they produce a form of cellular exhaust called reactive oxidative stress. The glymphatic system is what takes out that trash.

I like to use an analogy when I explain this to patients. During the day, the office workers are busy at their desks, tossing things into the trash can as they go. At night, the cleaning crew comes in and empties the bins, mops the floors, hauls everything away. If the cleaning crew never shows up, or only gets 20 minutes to do a full night’s work, the garbage piles up.

That’s exactly what happens when you don’t get enough deep sleep. The microglia that were activated during a stressful day, or by blood sugar spikes, or by any of the other triggers, are supposed to calm down during deep sleep and switch from their inflammatory mode back into their cleaning and repair mode. Without that reset, they stay activated. The inflammation compounds. And night after night, the damage accumulates.

The good news, Dr. Miller was careful to point out, is that a bad night here and there won’t ruin you. The brain is resilient. But chronic sleep deprivation is a different story, and improving your deep sleep is one of the most powerful interventions available for reducing neuroinflammation.

What You Can Actually Do About It

Dr. Miller outlined a set of strategies that collectively form a strong defense against brain inflammation. None of them are exotic. All of them are backed by research. And the cumulative effect of stacking them together is significant.

Lower your overall inflammation first. This is the foundation. If your body is chronically inflamed, those cytokines will keep battering the blood-brain barrier. Get tested: a high-sensitivity C-reactive protein (hs-CRP) blood test measures a protein your liver produces in response to inflammation, and an erythrocyte sedimentation rate (ESR) test measures how quickly red blood cells settle in a tube, which speeds up when inflammation is present. These are simple blood tests you can ask your doctor to order. They won’t catch every type of inflammation (some inflammation is localized and won’t show up on these tests), but they’re a solid starting point.

Prioritize deep sleep. This is when the glymphatic system does its work and the microglia switch back to their calm, repair-focused state. If you’re not sleeping well, start asking why. The solution will be different for everyone, but the importance of getting there is universal.

Manage stress actively. This means concrete daily practices. Deep breathing, time in nature, walking, yoga, laughter. All of these lower cortisol. Chris also mentioned the vagus nerve, a major nerve that runs from the brainstem to the gut and plays a key role in calming the body’s stress response. Stimulating it through practices like gargling, singing, or cold water exposure can help lower inflammation in the brain. I’ve recently started walking three times a day instead of just once, and the effect on my cognitive load has been noticeable.

Eat to fight inflammation. Omega-3 fatty acids are critical. Your brain’s cell membranes need them, and low omega-3 levels leave the brain vulnerable to inflammation. Fatty fish like salmon, mackerel, sardines, and herring are the most concentrated food sources. For people who don’t eat fish, flaxseeds and chia seeds provide a plant-based form (called ALA) that the body partially converts to the usable forms. Algae-based omega-3 supplements are another option. Beyond omega-3s, fiber-rich foods feed your gut microbiome, which produces short-chain fatty acids that travel to the brain and actively fight inflammation. Sulforaphane, a compound found in broccoli and broccoli sprouts, is particularly potent for brain health. Turmeric and ginger directly reduce inflammation by turning off a gene pathway called NF-kappa B (a master switch that controls dozens of inflammatory genes). Blueberries, tea, dark chocolate, and polyphenol-rich olive oil all contribute as well.

Build muscle. This one surprises people, but the research is clear. When you build muscle through resistance training, the muscle tissue releases signaling molecules called myokines, which are essentially anti-inflammatory cytokines. Muscle also triggers the release of brain-derived neurotrophic factor, or BDNF, a protein that promotes the growth of new nerve cells and strengthens the connections between existing ones. On top of that, more muscle mass improves your body’s ability to handle blood sugar, reducing those insulin spikes that damage the blood-brain barrier. Chris called it one of the biggest levers we have for slowing aging and protecting the brain.

Do cardio too. Aerobic exercise protects the endothelium (the lining of blood vessels), including the blood vessels that form the blood-brain barrier. Research has shown that people with good cardiovascular fitness maintain larger brain volume as they age.

Watch your blood pressure. High blood pressure is one of the most damaging forces acting on the blood-brain barrier, and it’s also one of the most commonly undertreated. Dr. Miller recommended keeping blood pressure below 120/80, and noted that some people have a genetic predisposition to stiffer blood vessels, which makes them more prone to hypertension. And I want to stress this: rising blood pressure with age isn’t inevitable. In populations studied in blue zones (regions of the world where people routinely live past 100), people maintain the blood pressure of their youth well into old age.

The Labs Worth Asking About

Beyond hs-CRP and ESR, Chris and I highlighted several other tests worth discussing with your doctor.

Vitamin D should be checked and optimized. Most people don’t get enough from sunlight alone, and supplementation is often necessary.

Homocysteine is an amino acid your body produces as a byproduct of normal metabolism. It gets broken down by B vitamins (specifically B6, B9, and B12), but some people have genetic variations that make them poor methylators, meaning they can’t process homocysteine efficiently. High homocysteine damages blood vessel walls, including the ones feeding your brain, and is associated with increased risk of heart attack, stroke, and cognitive decline. If your level is above 10, it’s worth investigating. I’ve been checking homocysteine in my patients for a long time, and I recommend keeping B12 between 500 and 1,000 in lab results. Even when B12 looks adequate, homocysteine can still be elevated, which means something further up the metabolic chain needs attention.

Blood sugar markers including fasting blood sugar, hemoglobin A1C, and fasting insulin paint a fuller picture of metabolic health and its effect on the brain.

Thyroid function should be assessed, especially given the connection between thyroid inflammation and brain fog.

Nutrient levels for things like zinc and iodine are worth checking, particularly if you’ve changed your diet recently or have gut issues that could impair absorption.

The One-Habit Starting Point

It would be easy to read all of this and feel overwhelmed. Chris and I both anticipated that reaction. The advice isn’t to overhaul your entire life by next Tuesday.

“Find the one easiest lever that you can move,” I told the summit audience, “and make it the tiniest piece.” For one person, that might be a five-minute walk in the morning. For another, it might be turning off the TV 30 minutes earlier and going to bed. For another, it might be adding ground flaxseed to a morning smoothie.

The brain is remarkably sensitive to changes in both directions. When you’re not taking care of your body, it suffers. But when you start making even small improvements, it responds. Chris put it simply: “Every small change does add up and does help. And we can protect our brains. There’s a lot we can do.”

One of our Habit Healers readers had blood sugar in the prediabetic range. After four months of incorporating small daily habits she’d learned from the newsletter, her fasting blood sugar dropped to 91 and she’d lost weight. No dramatic overhaul. Just consistent small choices, compounding.

That’s the real takeaway from this conversation. The fog, the fatigue, the creeping sense that your brain isn’t what it used to be: these aren’t inevitable. They have a biological explanation. And the biology can be changed.

Key Takeaways from Day 5

Brain inflammation is real and underdiagnosed. Chronic fatigue, lack of motivation, brain fog, low mood, and anxiety can all stem from an overactive immune response inside the brain, not from personal weakness.

The blood-brain barrier protects you, but it has limits. When chronic inflammation, high blood sugar, elevated cortisol, or high blood pressure persist over time, this barrier breaks down and allows inflammatory signals into the brain.

The glymphatic system is your brain’s cleaning crew. Discovered only in the last 15 years, it clears waste and calms activated immune cells during deep sleep. Without adequate deep sleep, the trash piles up.

Muscle is medicine for the brain. Resistance training releases anti-inflammatory myokines and BDNF, which promote new nerve growth and strengthen brain connections.

Food is a direct lever. Omega-3 fats, fiber, sulforaphane (from broccoli and broccoli sprouts), turmeric, ginger, blueberries, and polyphenol-rich foods actively reduce brain inflammation.

Blood pressure is a brain health issue. Keeping it below 120/80 protects the blood-brain barrier. Rising blood pressure with age is not inevitable.

Key labs to discuss with your doctor: hs-CRP, ESR, vitamin D, homocysteine, B12, fasting blood sugar, hemoglobin A1C, fasting insulin, thyroid panel, and nutrient levels (zinc, iodine).

Start with one small change. The brain responds to improvements quickly. Pick the easiest thing you can do, make it tiny, and build from there.

Chris Miller MD writes on Substack, where she shares her journey leaving emergency medicine and discovering integrative medicine, after experiencing significant autoimmune and other health concerns.

Inspired by Dr. Millers’s brain health food recommendations, Chef Martin Oswald created the Anti-inflammatory Super Bowl packing incredible anti-inflammatory ingredients into a single dish for the Brain Health Summit.

This interview is part of The Habit Healers Brain Health Substack Summit. For more expert conversations on protecting and improving your brain health, subscribe to The Habit Healers.

PS. Want to train your brain with games backed by science? Check out my free weekly Substack, Train the Brain Games, where I share cognitive challenges focused on processing speed and other skills the research actually supports.

This article is based on my conversation with Dr. Dominic Ng , author of the Brain Health, Decoded Substack, this is day 4 of the first-ever Brain Health Substack Summit hosted by The Habit Healers.

Click here to join tomorrow for Brain Health Substack Summit Day 5 with Chris Miller MD, where will discuss the brain and inflammation.

*Our final conversation will be on Saturday with Chef Martin Oswald and we will dive into all the delicious recipes he created for each of our Brain Health Substack Summit panelists.

If you missed Day 1 of our Brain Health Summit with Julie Fratantoni, PhD you can watch it here. We discussed how to exercise your brain day to day.

If you missed Day 2 of our Brain Health Summit with Annie Fenn, MD you can watch it here. We discussed foods to decrease dementia risks.

If you missed Day 3 of our Brain Health Summit with Jud Brewer MD PhD you can watch it here. We discussed how to unwind your anxiety.

Subscribe to get the updates on the Brain Health Summit each day!

In December 2024, a neuropathologist named Elaine Bearer was looking through her microscope at brain tissue from two deceased dementia patients at the University of New Mexico when she spotted something she couldn’t explain. Strange brown lumpy things, she called them. They weren’t cells. They weren’t proteins. They weren’t any of the usual suspects you find when you go looking for what killed someone’s brain.

They were plastic.

This was the opening act of a study that would be published in Nature Medicine in early 2025 by Dr. Matthew Campen, a toxicologist at the University of New Mexico. His team did something no one had done at this scale before. They took brain tissue samples from people who had died in 2024 and compared them to brain tissue from people who had died in 2016. They dissolved the tissue into a slurry, spun it in a centrifuge, and pulled out a small pellet of undissolved material. Then they heated that pellet to 600 degrees Celsius.

What they found was about 4,800 micrograms of plastic per gram of brain tissue. If you gathered it all together, it would weigh roughly seven grams. That is the weight of a standard plastic spoon.

When I sat down with Dr. Dominic Ng for Day Four of the Brain Health Substack Summit, he held up that exact prop. A plastic spoon. “Don’t say I don’t come prepared,” he said from his home in Scotland.

Dr. Ng is a physician neuroscientist. He grew up in Hong Kong, moved to the UK for medical school, and took one of his earliest jobs working for the CJD surveillance unit, traveling around the country diagnosing prion disease (a rare and fatal brain condition caused by misfolded proteins). That work led him deeper into neurology, and eventually into Alzheimer’s disease and motor neuron disease, which Americans know as ALS or Lou Gehrig’s disease. He is now completing his PhD at the University of Edinburgh under some of the leading researchers in neurodegeneration and aging, and he writes the popular Substack newsletter Brain Health, Decoded.

He came on the summit to talk about microplastics. And the first thing he wanted people to understand is that this problem, while real, is more complicated than the headlines make it sound.

The Spoon in Your Head

The Campen study found that the amount of plastic in human brains had roughly doubled between 2016 and 2024. That tracks with what we’d expect as global plastic production continues to climb. More than half of all plastic ever manufactured has been produced since 2002, and production is on pace to double again by 2040.

But the study also turned up a finding that nobody predicted. Age didn’t matter. The brain of a 24-year-old and the brain of an 84-year-old contained approximately the same amount of plastic.

Think about that for a second. If microplastics were simply accumulating over a lifetime the way plaque builds up in arteries, you’d expect people in their eighties to have far more than people in their twenties. They’ve been alive longer. They’ve eaten more food, breathed more air, drunk more water from plastic bottles. The older brain should be packed tighter.

It wasn’t. And that one observation tells us something important. The brain appears to be clearing microplastics at roughly the same rate it takes them in. There is some kind of equilibrium going on, a biological trade where the brain absorbs a certain load and then dumps it. The amounts are the same across age groups because the intake and the outflow have reached a balance.

This is the first piece of genuinely good news in the microplastics conversation. Your brain isn’t just passively filling up like a landfill. It’s fighting back.

The Hitchhiker Problem

To understand why microplastics are concerning even if the brain can partially manage them, you need to know what plastic actually is.

Dr. Ng broke it down this way. Plastics are polymers, which means they are long chains of small molecules derived from fossil fuels. The word “polystyrene” means multiple styrenes linked together. “Polyester” means multiple esters. These long molecular chains are what give plastic its structure.

But the chains alone don’t give plastic all the properties we rely on, things like flexibility, durability, and heat resistance. To achieve those, manufacturers add chemicals. Phthalates go into PVC and cling film to make them bendable. Bisphenols go into thermal receipt paper and food containers. PFAS, sometimes called forever chemicals, coat nonstick pans.

And this is where the real trouble starts. Microplastics, Dr. Ng explained, probably aren’t doing most of their damage on their own. They’re doing damage because they carry things with them.

He used an analogy anyone who’s stored leftover tomato sauce in a plastic container will recognize. You know how the red stain never fully comes out? That happens because plastic absorbs what it touches. The same thing happens in the environment. As plastic breaks down into tiny fragments, about the size of a virus at around 200 nanometers, those fragments pick up environmental toxins, heavy metals, and industrial chemicals.

So when microplastics enter your body through the food you eat, the water you drink, or the air you breathe, they don’t travel alone. They bring hitchhikers. And those hitchhikers, the bisphenols and phthalates and PFAS, are what scientists call endocrine disruptors. Your endocrine system is essentially the body’s internal messaging network. It controls your hormones, which in turn regulate your body temperature, blood sugar absorption, metabolism, thyroid function, and reproductive health. When you throw foreign chemicals into that system, the effects ripple everywhere. Research has linked these disruptors to increased risk of type 2 diabetes, heart attacks, and kidney disease.

Why Your Brain Is the Perfect Trap

A single liter of bottled water contains roughly 250,000 plastic particles. Your indoor air carries about 500 particles per cubic meter, shed from your clothing, furniture, and carpet fibers. It enters through your gut, crosses into your blood, and from there, goes everywhere. But the brain accumulates far more than other organs. In the Campen study, brain tissue contained concentrations seven to thirty times higher than the liver or kidneys.

Dr. Ng explained why with another kitchen analogy. “Have you ever tried to clean bacon grease out of a plastic container?” he asked. Fat clings to plastic because both are lipophilic, meaning they are chemically attracted to each other.

Your brain, by dry weight, is approximately 60 percent fat. Your liver and kidneys contain much lower percentages. On top of that, the brain receives about 25 percent of your heart’s total blood output, despite accounting for only about 2 percent of your body weight. So you have a high-fat organ with a massive blood supply. If microplastics are floating through your bloodstream, the brain is essentially a magnet for them.

The technical term for the layer of fat that insulates brain cells is the myelin sheath. It wraps around neurons and helps regulate the speed of electrical signals. Campen’s team found that microplastics tend to concentrate in exactly these fatty myelin cells. The plastic lodges itself in the insulation of your wiring.

The Brain’s Drainage System

The reason younger and older brains contain similar amounts of plastic brings us to one of the more remarkable discoveries in modern neuroscience, and it happened only about a decade ago.

In 2012, researchers identified the glymphatic system, a waste-clearance network in the brain. Think of it as the brain’s internal plumbing. While you sleep, cerebrospinal fluid (the clear liquid that cushions your brain and spinal cord) flushes through channels between brain cells, washing away metabolic waste products. This is the same system responsible for clearing out the protein fragments associated with Alzheimer’s disease.

Dr. Ng believes this is almost certainly how the brain manages its microplastic load. There is no published research yet directly connecting glymphatic clearance to microplastic removal, and he was careful to say that. “We’re still in pretty early days when it comes to this research,” he told me. But the logic is sound. The glymphatic system is the only known route the brain has for clearing foreign material, and it is most active during deep sleep. Exercise also appears to enhance its function.

Which means the same habits that protect you from Alzheimer’s disease may also be protecting you from microplastic accumulation. Sleep, exercise, and keeping your brain’s waste-clearance system running well.

The Dementia Question

One finding from the Campen study raised eyebrows. Brains from patients who had died with dementia contained three to five times more microplastics than brains from patients without dementia.

That sounds alarming. But Dr. Ng pointed out what the researchers themselves noted: the cause likely runs in the opposite direction. Dementia makes the brain more porous. The blood-brain barrier, which is the tightly controlled gateway that normally filters what gets into brain tissue, degrades as dementia progresses. A more porous brain means more plastic gets through. The dementia came first. The extra plastic followed.

That said, animal studies have shown that microplastic exposure can trigger chronic inflammation in the brain. Your immune system recognizes the particles as foreign material and mounts a defense, releasing chemical signals that put surrounding cells on high alert. In the short term, this is useful. It’s the same mechanism that fights off bacteria. But when the alarm never shuts off, that sustained inflammation damages healthy tissue. And we know that chronic inflammation is one of the central drivers of neurodegenerative disease.

Dr. Ng was also frank about one frustrating reality. The immune system can’t actually break down the plastic. “Part of the reason we choose plastics is because they’re so durable,” he said. “Those chemical bonds are really strong.” Even at the nanoscale, the particles resist degradation. The body can move them out, but it can’t destroy them.

What You Can Actually Do

When I asked Dr. Ng whether we should all be panicking, he referenced the Leonardo DiCaprio movie Don’t Look Up, where an asteroid threatens Earth and everyone either ignores it or spirals into hysteria. “That’s not where we’re at,” he said. “But I also don’t think we’re at the point where everything is fine.”

He put it this way: it is perfectly rational to want to reduce your exposure, even without definitive proof of a specific threshold for harm. You don’t need to wait for ironclad evidence to make reasonable changes.

His practical advice for reducing exposure came down to a few key habits.

Swap your containers. Replace plastic cups, bottles, and food storage with glass or stainless steel. Heat accelerates plastic breakdown, so never microwave food in a plastic container or drink hot beverages from plastic-lined takeaway cups. This is one of the single largest sources of microplastic ingestion.

Filter your water. A reverse osmosis filter removes about 99 percent of microplastics from tap water. Standard pitcher filters, many of which are housed in plastic, are less effective and may even add microplastics back in. Canada has already begun implementing advanced filtration at the municipal level, with pilot programs in Ottawa removing about 90 percent of particles from public water supplies.

Clean your air. Indoor environments carry roughly 500 microplastic particles per cubic meter, released from synthetic clothing, upholstery, and carpeting. Vacuuming more frequently and using a damp mop picks up settled particles before they become airborne again. An air purifier with a HEPA filter adds another layer of protection.

Be smarter about laundry. Synthetic fabrics shed microfibers every time they go through the wash. Reducing load frequency and washing fuller loads cuts down on fiber release. You’re not generating less dirty laundry, you’re just being more strategic about how you process it.

And then there are the habits that support your brain’s own clearance system.

Sleep. The glymphatic system does its heaviest work during deep sleep. Chronic sleep deprivation means your brain’s plumbing runs at reduced capacity, whether the waste is protein fragments or plastic particles.

Exercise. Physical activity enhances glymphatic function and increases blood flow to the brain. It doesn’t have to be punishing. Dr. Ng emphasized that it should be something you enjoy, ideally with other people.

Social connection. This one surprised me, but Dr. Ng was emphatic. Connection with family and friends, initiating gatherings, staying socially engaged: these are among the most protective factors against cognitive decline. He admitted it sounds soft coming from a neuroscientist, but the data is consistent.

The Future of Alzheimer’s, and Why It Matters Here

Toward the end of our conversation, Dr. Ng shared something from his Alzheimer’s research that reframes how we should think about brain health in general.

He described a gap between how researchers talk about Alzheimer’s and how patients talk about it. Patients think of it as something that happens to you in old age, a diagnosis you receive when memory starts failing. Researchers increasingly see it as a process that begins 20 years before any symptoms show up. And the tools to detect it that early already exist.

Blood tests can now measure levels of amyloid beta and phosphorylated tau, two proteins whose accumulation is a hallmark of Alzheimer’s pathology. The vision Dr. Ng described is one where a routine blood draw in your forties or fifties could flag elevated levels, and a doctor would sit you down and say: here is what we need to change. More exercise. Better diet. Better sleep. More social connection. Not a drug. A prescription for living differently.

This is the same prescription that protects against microplastic accumulation. The same habits that keep your brain’s clearance system functioning. The same behaviors that lower chronic inflammation.

It all points in one direction. The basics work. And they work across multiple threats simultaneously.

As Dr. Ng put it, people spend too much energy chasing the 5 percent optimizations while ignoring the 80 percent. Supplements, biohacks, and boutique protocols are fine in their place. But the foundation is diet, movement, sleep, and human connection. Get those right and you’ve pulled the biggest levers available.

Takeaways

Everyone already has microplastics in their brain. The 2025 Campen study found approximately seven grams, the weight of a plastic spoon, in human brain tissue. This amount has roughly doubled since 2016.

The brain accumulates more plastic than other organs because it is 60 percent fat and receives 25 percent of the body’s blood supply. Microplastics are lipophilic (attracted to fat), so the brain acts as a concentration point.

Age doesn’t predict how much plastic you carry. Young adults and elderly adults had similar amounts, which suggests the brain has an active clearance mechanism, likely the glymphatic system.

Microplastics are Trojan horses. The particles themselves may be less harmful than the chemicals they carry: phthalates, bisphenols, PFAS, and environmental toxins that act as endocrine disruptors and trigger chronic inflammation.

You can meaningfully reduce your exposure. Switch to glass containers, use a reverse osmosis water filter, avoid heating plastic, clean indoor air with a HEPA filter, vacuum and damp mop regularly, and wash laundry in fuller loads.

The same habits that fight Alzheimer’s fight microplastic damage. Sleep fuels the glymphatic system, exercise enhances brain clearance, diet reduces inflammation, and social connection protects against cognitive decline.

This is not an asteroid-level crisis, but it is not nothing. Dr. Ng says we are somewhere in the middle. Concern is rational. Panic is not. The most protective steps are also the simplest ones.

Dr. Dominic Ng writes Brain Health, Decoded on Substack, where he translates cutting-edge neuroscience into practical tools for cognitive performance and mental wellbeing.

Inspired by Dr. Ng’s brain health food recommendations, Chef Martin Oswald created the Pumpkin Seed-Crusted Salmon with Sauce Gribiche, Roasted Beets & Leeks, packing seven brain-boosting ingredients into a single dish for the Brain Health Summit.

This interview is part of The Habit Healers Brain Health Substack Summit. For more expert conversations on protecting and improving your brain health, subscribe to The Habit Healers.

PS. Want to train your brain with games backed by science? Check out my free weekly Substack, Train the Brain Games, where I share cognitive challenges focused on processing speed and other skills the research actually supports.

References

* Nihart AJ, Garcia MA, El Hayek E, et al (Campen MJ). Bioaccumulation of microplastics in decedent human brains. Nat Med. 2025;31(4):1114-1119. doi:10.1038/s41591-024-03453-1

* Iliff JJ, Wang M, Liao Y, et al. A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012;4(147):147ra111. doi:10.1126/scitranslmed.3003748

This article is based on my conversation with Jud Brewer MD PhD, author of the Inside the Curious Mind Substack and the book, Unwinding Anxiety among others, this is day 3 of the first-ever Brain Health Substack Summit hosted by The Habit Healers.

Click here to join tomorrow for Brain Health Substack Summit Day 4 with Dr. Dominic Ng

If you missed Day 1 of our Brain Health Summit with Julie Fratantoni, PhD you can watch it here. We discussed how to exercise your brain day to day.

If you missed Day 2 of our Brain Health Summit with Annie Fenn, MD you can watch it here. We discussed foods to decrease dementia risks.

Jud Brewer MD PhD is a neuroscientist and physician who discovered something about worry that medical schools never taught him. It changed how he treats every patient.

In 1987, right around the time Prozac hit pharmacy shelves and promised to change everything about how we treat mental illness, a researcher published a two-page paper that almost nobody noticed. The paper proposed something that sounded, frankly, ridiculous: that anxiety might be driven by the same brain mechanism that gets people hooked on cigarettes.

The paper sat there for decades. Psychiatrists kept writing prescriptions. Patients kept struggling. And a young psychiatrist named Jud Brewer, who would go on to run habit-change research labs at both Yale and Brown University, never even heard about it.

I sat down with Jud for the third interview in our Brain Health Summit series to talk about this discovery and what came after it. Jud and I have been friends for a while now. I have lost count of how many times he has been on my podcast. But this conversation was different because we went deep into the science of why your brain treats worry like a reward, and what you can actually do about it.

For years, Jud did what most psychiatrists do with anxious patients. He prescribed medications. And he watched most of them walk out the door no better than when they came in. The best medications available for anxiety only produce a meaningful reduction in symptoms for about one in five patients. That means for every person a doctor helps, four others are still gripping the armrests. Jud describes this as “playing the medication lottery.” You write the prescription. You hope for the best. And most of the time, you lose.

Then something unexpected happened. Jud had been running programs to help people who struggled with binge eating. Those patients started telling him something he had not anticipated: anxiety was driving them to eat. Could he build a program for that?

The question sent him back to the literature. And that is when he found that forgotten two-page paper from the 1980s. He had never considered anxiety as a habit. But he knew quite a bit about how to change habits. That single realization changed the entire trajectory of his clinical work.

The Worry Loop Your Brain Doesn’t Want You to See

To understand how anxiety works as a habit, you need to understand how all habits work. And the basic formula is surprisingly simple. Every habit has three parts: a trigger, a behavior, and a result.

Take stress eating. You feel stressed (that is the trigger). You grab ice cream from the freezer (that is the behavior). And for a few minutes, you feel distracted from whatever was bothering you (that is the result). Your brain files this away as useful information. Calories, good. Pizza, very good. Stress gone, even better. As Jud explained during our conversation, our brains hit what food scientists call the “bliss point,” and the loop locks in

Smoking works the same way. So does scrolling your phone at 2 a.m. The trigger-behavior-result loop is the engine that drives nearly every habit, good and bad.

But anxiety? Anxiety is sneakier.

The formal definition of anxiety is a feeling of worry or nervousness about something that might happen in the future. Notice the problem buried in that definition. The trigger is the feeling of being worried. And the behavior? Also worrying. The feeling of worry drives the act of worrying, which produces more feelings of worry, which drives more worrying.

It feeds itself. It is a loop with no exit ramp.

So why would a brain do something so obviously counterproductive? Because decades of research show that worrying feels better than doing nothing. When you feel scared or uncertain, sitting still with that discomfort is almost unbearable. Worrying, even though it accomplishes nothing, gives your brain the sensation that you are at least doing something. And doing something, it turns out, is rewarding enough to lock in the habit.

There is another trick your brain plays on you. If you worry constantly, and then you happen to solve a problem, your brain connects the two events. You worried. The problem got solved. Therefore, worrying solved the problem. Jud calls this the fallacy of causality. Both things are true on their own: you were worrying, and the problem did get solved. But the worrying did not cause the solution. You just happened to be doing both at the same time. If you have generalized anxiety disorder (a condition where worry is your brain’s default setting), you are almost always worrying, so every good outcome looks like proof that worry works.

On top of that, worrying gives you what researchers call an illusion of control. I know this one personally. During our conversation, I admitted that I call my own version “mother worrying anxiety.” As a mother of three, I spent years convinced that worrying about my children was part of my job description. If I did not worry, who would? It felt like a form of vigilance, like standing guard. But as Jud pointed out to me, in what was essentially a live therapy session (you’re welcome for the free entertainment), worrying about my kids never once kept them safe. Three decades of worrying gave me exactly zero protection and probably a few extra gray hairs.

Why Willpower Will Not Save You

Before Jud got into his solution, he made a point that might be hard to swallow. Willpower, that thing we have been told our whole lives is the key to changing bad behavior, has zero evidence supporting it in the neuroscience of habit change.

Zero.

He acknowledged that this can be a lot to take in. If you are not ready to accept it right now, that is fine. But neuroscientists do not even use the word willpower when they study how habits form and break. What they study is reinforcement learning, which is the actual mechanism that determines how strong a habit becomes and how it can be dismantled. The concept has been researched for over fifty years and is considered the most well-established model of behavior change in all of neuroscience. The basic idea: if something feels rewarding, your brain will push you to do it again. If it stops feeling rewarding, your brain starts to let it go.

This is how habits form, and it is also the key to breaking them.

Jud illustrated this with his smoking patients. Instead of telling them to resist cigarettes through sheer force of will, he does something that sounds insane. He tells them to go ahead and smoke. But he adds one instruction: pay attention while you do it.

What happens? They notice that cigarettes taste awful. Really awful. The experience without autopilot running is so different from what their brain expected that it creates what neuroscientists call a negative prediction error. That is the technical term for what happens when your dopamine system fires a signal that basically says: “Hey, this is not nearly as good as you remembered.” That signal updates the habit. The cigarette loses its grip. Not because the patient muscled through a craving, but because the brain revised its own math.

Jud calls this the Santa Claus moment. It is like being a kid and pulling down on Santa’s beard at the mall, only to see your neighbor Dave underneath. Once you see it, you cannot unsee it. The spell is broken. You cannot go back to believing.

The good news? This same mechanism also reinforces good habits. When you pay attention while exercising or eating a healthy meal, your brain registers a positive prediction error: “Oh, this actually feels better than I expected.” The good stuff gets stronger. The bad stuff gets weaker. Same system, working in both directions.

And here is the part that should make anyone dealing with anxiety sit up a little straighter: this same mechanism works for worry.

Seeing the Gig Is Up

Jud walked me through what he calls the three gears method. It is the core of his book Unwinding Anxiety and the foundation for his clinical programs.

First gear is simply recognizing the behavior. Not analyzing it. Not asking why you are anxious. Not diving into your childhood or trying to trace the worry to its source. Just naming the behavior. “I am worrying.” That is it. Jud has found that when patients spend too much time asking why they are anxious, they burn energy and get stuck in yet another unproductive loop. He now teaches a rapid version of this gear: just identify the behavior and move on.

Second gear is the Santa Claus moment applied to worry. You ask yourself one question: what am I getting from this? And then you actually feel the answer in your body. Not intellectually. Physically. What does worrying actually feel like? Tight chest. Clenched jaw. Racing thoughts that go nowhere. You sit with that experience and you let your brain register what is really happening. No sugar coating. No story about how worry keeps you safe. Just the raw deal: worry feels terrible and does not produce anything useful.

This is where disenchantment happens. Disenchantment is a term from psychology that means losing your positive illusion about something. When you truly see that worrying gives you nothing of value, the habit starts losing its power. Your brain gets that negative prediction error, just like the smoker who finally tasted the cigarette. You cannot go back to pretending worry was helping you.

Third gear is what Jud calls finding the bigger, better offer. Your brain needs a replacement. Not a distraction, not a coping strategy, but something that genuinely feels more rewarding than the old habit. During our conversation, Jud actually put me on the spot and had me do this exercise live. He boiled the rapid version of this gear down to a single comparison: what does it feel like to worry versus not worry? My answer was instant. Worry felt like a tight chest, stress, and the sensation that I could not breathe. Not worrying felt like peace. It felt like trusting that my children would grow up and figure things out on their own. Your brain can hold both of those experiences side by side and decide which one it prefers.

The Difference Between Planning and Worrying

One of the most useful things that came out of our conversation was the distinction Jud makes between planning and worrying. They look similar from the outside, but they are completely different animals.

I got personal during our discussion, and I want to expand on that story here. When my oldest daughter was five, someone tried to take her at a mall. It was terrifying. My husband was deployed and I was alone. Afterward, I was afraid to take her anywhere. My pediatrician told me I had to go back to that mall with her, which felt impossible. But I did it. I picked her up, held her tight, walked through the building, and left.

After that, I enrolled in Krav Maga. I put the kids in self-defense classes. Those were plans. Those were concrete actions I could take to increase our actual safety. But alongside those plans, I also started worrying constantly about my children. And all those defense classes? They never reduced the worry. All they did was reinforce the feeling that I had to keep doing something, anything, to make sure my kids were okay.

Jud pointed out something that stopped me cold: learning self-defense after a scary experience is a reasonable response. Walking through life expecting to be attacked at any moment is not. One is preparation. The other is a habit that runs on fear.

And that distinction matters enormously for parents. We live in a culture that mistakes worry for good parenting. Social media amplifies it. You see influencers modeling a version of parenthood that nobody can actually maintain, and then you feel guilty because you cannot keep up. Jud told me that anxiety is more learned than genetic. There are genetic components, sure, but we do not have control over our genes. What we can control is whether we pass our worry habits down to the next generation by modeling them every day.

He and I both grew up in the era that people now call “free-range parenting,” which at the time was just called parenting. My mom opened the front door, told us dinner was at five, and did not expect to hear from us until then. We survived. And yet the generation raising kids today has been conditioned to believe that anything less than constant vigilance is neglect. That conditioning is, itself, a habit loop. Jud is writing an entire chapter about this in his upcoming book, and it is about how parents can break the cycle so their kids do not inherit it.

From Unwinding to Flourishing

The most exciting part of what Jud shared is the work he is doing now that goes well beyond reducing anxiety. His new program, called Going Beyond Anxiety, uses a rapid induction method to teach people the three gears faster than ever. Instead of working through an entire book to understand the framework, patients can learn the essentials quickly and get back to what Jud calls baseline, meaning a state where anxiety is no longer running the show.

But baseline is not the finish line. As he put it during our talk: “Who wants to be normal? I don’t want my patients to be normal. I want them to be exceptional.”

Once the foundation is solid, the same reinforcement learning mechanism that broke the anxiety habit can be used to build new habits around things like generosity and patience. Jud runs live group sessions where he teaches the science of gratitude and how it can be reinforced just like any other habit. Gratitude feels good. It is relatively easy to practice. The hard part is remembering to do it, and then pushing into what he calls the advanced level: being grateful even to the driver who just cut you off in traffic, because that person just taught you something about your own reactivity. There is a Tibetan teaching that says “be grateful to everyone,” and Jud takes that seriously enough to build clinical exercises around it.

His clinical results back all of this up. In randomized controlled trials funded by the National Institutes of Health (the government agency that funds medical research in the United States), Jud’s approach produced a 67 percent reduction in anxiety among people with generalized anxiety disorder. The group that received standard clinical care? Fourteen percent. That fourteen percent lines up almost exactly with the one-in-five odds of the medication lottery he was playing years ago.

He also mentioned something his Substack readers have been wondering about: the pause in new articles over the past couple of months. The reason is that he has been writing his next book, and he now has 42 chapters done. He will be back to publishing on Substack soon, and the book, which builds on everything since Unwinding Anxiety, should be out next year.

One more myth worth busting, and we had a good laugh about this one. The popular idea that it takes 21 days to change a habit has no basis in science. It came from a 1960s book by a plastic surgeon named Maxwell Maltz called Psycho-Cybernetics. Maltz noticed that his patients took about 21 days to adjust to their new nose. Somehow this observation about rhinoplasty became a universal rule about habits. The real answer, as Jud put it, is that the right question is not “how quickly can I change this habit?” but “what do I need to change this habit?” Because once you understand the methodology, the habit changes at whatever speed your brain can process the new information. Nobody Jud has ever worked with has said “all I needed was three weeks.” If it were that easy, he and I would both be out of a job.

A Practical Guide to Breaking the Anxiety Habit

Based on our conversation, here is a framework you can start using today.

Recognize the behavior, not the cause. When you notice anxiety, do not spiral into trying to figure out why you feel this way. Just name what you are doing. “I am worrying.” “I am ruminating.” “I am catastrophizing.” Naming the behavior without judgment is the first gear.

Ask yourself: what am I getting from this? Do not answer this in your head. Feel it in your body. Notice what worry actually does to you physically. Does your chest tighten? Does your breathing get shallow? Does your stomach clench? Let yourself experience the full reality that this habit does not deliver what it promises. This is how your brain becomes disenchanted with the old pattern.

Compare the two states. What does it feel like to worry versus not worry? Hold both experiences side by side. Let your brain do the math on which one it actually prefers.

Stop confusing worry with preparation. Making a plan is useful. Running disaster scenarios on repeat is not. If your action produces a concrete result, that is planning. If it just produces more of the same feeling you started with, that is a worry loop.

Know that this takes practice, not willpower. You are not weak for having anxiety habits. You are running software that was installed by experience, reinforcement, and a brain that is doing what brains do. The update comes from paying attention, not from gritting your teeth.

Consider structured support. Dr. Brewer’s Going Beyond Anxiety program and his book, Unwinding Anxiety, offer a step-by-step framework with clinical evidence behind it. He also has free resources on his website for anyone who wants to start with the basics. I have referred my own patients to his programs and watched them come back with life-changing results.

Dr. Jud Brewer’s gratitude article mentioned in video from Inside the Curious Mind on Substack.

Click here for Chef Martin Oswald’s recipe, created specially for Dr. Jud Brewer.

Resources

Jud Brewer MD PhD is a psychiatrist, neuroscientist, and author of Unwinding Anxiety, The Craving Mind, The Hunger Habit, and the forthcoming book on going beyond anxiety. He is the director of research and innovation at Brown University’s Mindfulness Center and writes the Inside the Curious Mind Substack. You can find his programs and free resources at his website.

Books by Dr. Brewer:

* Unwinding Anxiety

* The Craving Mind

* The Hunger Habit

Want to keep your brain sharp between summits? Check out the free Train the Brain Games Substack for puzzles, challenges, and brain-boosting exercises you can do anytime.

In this episode, I’m unpacking a new warning that caught a lot of people off guard: a late-2025 conference abstract suggesting long-term melatonin use may be linked to higher rates of heart failure and worse outcomes. The headline is scary, but I’m going to walk you through what it actually means, what it doesn’t prove, and why this one study raises questions that a single abstract can’t answer.

I’ll explain why melatonin isn’t just a “natural sleep gummy.” It’s a hormone and a timing signal, a darkness message that helps run your circadian clock. And because your circadian system also helps regulate blood pressure, heart rate, vessel tone, and stress hormones, melatonin has real cardiovascular effects. I break down what we know about those effects (including the ways melatonin can lower nighttime blood pressure and shift the body into a calmer “rest-and-digest” mode), and why dose and timing matter more than most people realize.

Then I get into the messy part: the evidence is mixed. There are studies suggesting melatonin could be protective in certain situations, yet there are also case reports and mechanisms that hint it might cause problems in specific people, especially at high doses or with certain health conditions. So I lay out the most plausible explanations for the new association (confounding from insomnia and other risk factors, masking symptoms, interactions, supplement quality issues), and how clinicians are thinking about it right now.

If you take melatonin nightly or you’ve ever assumed it’s harmless because it’s “natural”this episode is my practical, science-first guide to what to do next: how to interpret the risk, what questions to ask your doctor, and why “lowest effective dose for the shortest necessary time” is the safest default until we have better data.Dr. Marbas Substack: https://drlauriemarbas.substack.com/

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This article is based on my conversation with Annie Fenn, MD, author of the Brain Health Kitchen Substack and cookbook, this is day 2 of the first-ever Brain Health Substack Summit hosted by The Habit Healers.

Click here to join tomorrow for Brain Health Substack Summit Day 3 with Jud Brewer MD PhD.

If you missed Day 1 of our Brain Health Summit with Julie Fratantoni, PhD you can watch it here. We discussed how to exercise your brain day to day.

Annie Fenn, MD is an OB/GYN turned culinary school graduate who lives in Jackson Hole, Wyoming. She spent twenty years practicing medicine, the last ten focused on menopause, before leaving to pursue a lifelong dream of cooking. She came back to Jackson Hole and started teaching people how to make healthy food that actually tasted good.

Then, around 2015, her mother was diagnosed with mild cognitive impairment. It progressed to Alzheimer’s.

Annie did what any doctor does when disease hits close to home. She went to the research. Not the surface-level stuff. The deep literature. She was looking for anything that could slow her mother’s progression, and what she found changed the direction of her entire career. There was a dietary pattern, backed by real studies, that appeared to protect the brain from developing Alzheimer’s in the first place. And for people with early dementia, there was evidence it could slow things down.

That discovery became Brain Health Kitchen, first as a cooking school, then as a bestselling Brain Health Kitchen cookbook, and now as a Substack and worldwide community where Annie takes people on retreats to longevity hotspots around the globe. When she showed me her original copy of the book during our live conversation for Day 2 of the Brain Health Summit, it was held together by love and tape. She carries it everywhere. Her guests sign it.

What she built from that research is something I think every person reading this needs to know about: a food pyramid designed specifically for the brain.

Ten Rungs on a Different Kind of Pyramid

When Annie wrote her cookbook around 2021, she wanted to create brain-healthy eating guidelines that anyone could follow, regardless of whether they were vegan, Mediterranean, or somewhere in between. She drew from two dietary patterns with the strongest evidence for protecting the brain against dementia: the Mediterranean diet and the MIND diet (which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay). Then she layered in newer research that neither of those original frameworks had included.

The result is a food pyramid with ten brain-healthy food groups, and when Annie walked me through it during our conversation, a few things genuinely surprised me.

Vegetables sit at the base. No surprise there. But what is surprising is the second rung: leafy greens, broken out as their own category. In most dietary guidelines, leafy greens get lumped in with other vegetables. The MIND diet pulled them out separately because the data warranted it. Studies showed that people who ate at least a cup of leafy greens per day had brains that looked 11 years younger on MRI scans.

Eleven years. That is not a marginal benefit. That is a decade of aging you might be able to offset with a daily salad.

Whole grains come next, though Annie is careful to point out that most people have the wrong picture in their head when they hear this term. She is not talking about hamburger buns, flour tortillas, or English muffins. None of those are whole grains. She means red rice, black rice, quinoa, millet, steel-cut oats, and breads where actual wheat is the first ingredient on the label. The distinction matters enormously, especially for people who carry the APOE4 gene variant (a genetic risk factor for Alzheimer’s), who may need to emphasize lower-glycemic options and lean harder on vegetables, legumes, and leafy greens instead.

Berries hold their own rung because they are the only fruit singled out as an official brain-healthy food group. The data links berry consumption specifically to better performance on memory tests.

Beans and legumes are next, and Annie pointed to something that I think is underappreciated: beans are one of the few food groups found on the table in virtually every blue zone on the planet, from Costa Rica to Okinawa to Sardinia. They contain a type of fiber that reaches the lower intestine, where many of the gut bacteria that influence brain health are waiting for nourishment. Most processed food never makes it that far. For people who believe they cannot tolerate beans, I suggested during our conversation that they start with lentils in small amounts, cooked well, and gradually increase from there before moving on to heartier beans. Annie built on that and got even more specific: start with red lentils in particular, the kind that fall apart when cooked. They are lower in fiber than other varieties, need no soaking, and tend to be the gentlest entry point for people rebuilding their tolerance.

Nuts and seeds follow, drawing on cardiovascular research that has shown for years that a handful of nuts four to five days a week reduces the risk of heart attack and stroke. Annie included seeds as well, because many people have nut allergies and seeds carry similar brain-protective properties, including monounsaturated fats and flavonoids (the colorful pigment compounds in plants that are emerging as significant players in brain health).

The Surprising Rungs

This is where the pyramid gets interesting.

Fish and seafood occupy the next level, and Annie has actually built a separate pyramid just for this category. At the base are small fish like sardines and anchovies, which are highest in omega-3 fatty acids and lowest in environmental toxins. Cold-water fish like cod and wild-caught salmon sit in the middle. She designed the fish pyramid around three criteria: omega-3 content, environmental sustainability, and toxin accumulation. Low intake of fish and seafood, she told me, is itself a risk factor for Alzheimer’s disease, supported by many studies. For people concerned about microplastics, she noted that omega-3 supplements are now purified and filtered, making them a viable alternative. (Algae omega-3 supplements for those who are plant-based will also work.)

Fermented foods earned their own spot on the pyramid, which is a departure from the Mediterranean and MIND diets, neither of which addressed fermentation directly. Annie drew on research from Stanford showing that adding even a few servings of fermented food per day increases the diversity of the gut microbiome (the vast community of bacteria living in your intestinal tract), which is increasingly understood to be a key driver of brain health. This includes yogurt, kefir, cottage cheese with live cultures, kimchi, sauerkraut, and even authentic long-fermented sourdough bread.

Speaking of sourdough, Annie had something to say about what that word actually means. A loaf of sourdough from the supermarket that sits on the counter for a month without going stale is not what she is talking about. Real sourdough, the kind baked in Sardinian villages using old-fashioned long fermentation, is a different product entirely. Now, an important caveat here: the beneficial bacteria that develop during sourdough fermentation do not survive the oven. Baking temperatures kill them. So sourdough does not deliver live probiotics the way yogurt or sauerkraut does. But the long fermentation process still changes the bread in meaningful ways. It lowers the glycemic response, improves digestibility, and produces organic acids and prebiotic compounds that may support gut health even without live cultures. That is why communities in Sardinia that eat traditionally fermented sourdough bread daily still seem to benefit from it. The fermentation does real work on the grain before it ever reaches the oven.

Meat, poultry, and eggs appear near the top of the pyramid, meaning smaller portions and less frequent servings. This is the most individualized category. Annie explained that previous studies had lumped processed and unprocessed meat together, making meat look uniformly bad for the brain. But recent research from the UK Biobank separated them out and found that unprocessed meat may actually reduce dementia risk, while processed meat remains among the worst foods for the brain. Eggs contain choline, a nutrient important for brain health and nerve function, though people who are cholesterol hyper-responders may need to limit them.

Sweets sit at the very top. Annie refuses to live in a world without brownies, and I respect that. But her sweets are strategic: packed with fiber, made with nutrient-dense ingredients, and built to minimize the glycemic spike that comes from white flour and white sugar. Her rule of thumb is that fiber must accompany sugar to blunt the blood sugar response.

Two additional categories run alongside the pyramid. Extra virgin olive oil is the primary cooking fat, consistent with both the Mediterranean and MIND diets. And the final category is one that tells you a lot about how brain nutrition science has evolved.

What Got Kicked Off the Pyramid

In the original MIND diet, the tenth brain-healthy food group was red wine. That recommendation held up for years, supported by the idea that moderate drinking might offer some protection. Annie kept red wine on the pyramid when she first built it. Then the data changed.

Around 2021, large studies from the UK Biobank and the British Medical Journal dismantled the moderate-drinking hypothesis. We now know there is no amount of alcohol that is safe for the brain. If you drink at all, light drinking, defined as under six drinks per week, is the least harmful option. Annie took red wine off and replaced it with three things we actually have solid evidence for: coffee, tea, and water.

The coffee research in particular has gotten remarkably specific. The largest study on coffee ever conducted, from the UK Biobank at the end of 2024, confirmed that regular coffee drinkers are more protected from dementia and finally sorted out a question that had lingered for years: is it the coffee or the caffeine? The answer is both.

But Annie laid out four conditions that determine whether your coffee is actually helping your brain.

First, caffeinated coffee provides the protection. Decaf is not harmful, but it does not appear to reduce dementia risk. Second, it should be unsweetened, and that includes artificial sweeteners. The UK Biobank study actually looked at what people put in their coffee and found that additives can undermine the benefits. Third, skip the creamers. Even high-quality dairy cream may bind up the polyphenols (the plant compounds responsible for many of coffee’s health benefits) and reduce their effectiveness. In European studies, where people tend to drink coffee black, the results were always strongly positive. American coffee culture, with its syrups and creamers, is a different story. Fourth, use a paper filter. Unfiltered coffee from a French press or espresso machine allows compounds called diterpenes through, which can raise LDL cholesterol.

As for tea, green tea performed especially well in the research, thanks to its high concentration of catechins and EGCG, both types of polyphenols with brain-protective properties. And hydration itself turned out to be more important than I expected. Annie’s point was direct: you need to be well hydrated for your brain to thrive. My simplest recommendation is to drink water first thing in the morning. Rehydrate the brain after a night of sleep.

The Supplement Question

Supplements came up frequently during our conversation, and Annie’s perspective as a physician who is also deeply skeptical of the supplement industry made her advice especially practical.

She recommends a brain-focused multivitamin. The one she takes is called Relevate, made by a company called NeuroReserve, where she sits on the scientific advisory board. It combines omega-3 fatty acids in a specific DHA-to-EPA ratio, vitamin D, B vitamins, choline, lutein, and flavonoids into three capsules. She noted that it simplified her routine because she no longer needed to take multiple separate supplements.

For people who prefer a more widely available option, she pointed to the Centrum Silver multivitamin, which was used in one of the largest supplement studies ever conducted. That study, called COSMOS, found that people who took a daily multivitamin had a reduced risk of dementia. The likely explanation is a catch-all effect: when you give a multivitamin to a large population of older adults, you end up correcting iron, folate, B12, and other micronutrient deficiencies that many people do not even know they have. Those deficiencies, left uncorrected, can contribute to cognitive decline.

Creatine was the other supplement we discussed at length. Annie said she is highly skeptical of supplements in general, so anything that makes her list has to impress her. Creatine did. The data on creatine and muscle maintenance during resistance training has been solid for years, but in the last five years, brain health research has caught up. A pilot study looked at creatine in people with Alzheimer’s and found a slight improvement in cognitive symptoms with no adverse reactions. There is also emerging data on creatine during perimenopause. Annie herself started using it as a jet lag protocol during her frequent international travel, doubling her dose for three days upon arrival in a new time zone, based on military sleep-deprivation research.

Dr. Darren Candow, the top creatine researcher in Canada, spaces his creatine away from coffee and sips it in his water bottle throughout the day. Annie does the same. I put mine in my oatmeal every morning, which also works.

For any supplement purchase, Annie stressed the importance of third-party testing for heavy metals and verification. I recommend a site called ConsumerLab.com, which costs about $90 a year and independently tests supplement quality.

Building Your Own Pyramid

One of the things I appreciated most about Annie’s approach is that she does not insist everyone eat the same way. The Brain Health Kitchen food pyramid is a foundation built on the best available science. But she encourages every person to build their own version of it, based on what they enjoy eating, whether they like to cook, what their personal health vulnerabilities are, and what their goals look like.

If you are APOE4 positive, you might dial back whole grains and emphasize leafy greens and legumes. If cholesterol is a concern, you might skip the eggs and choose soy milk, which Annie’s research identified as the top milk for brain health due to its ability to lower LDL cholesterol. If you cannot eat beans, you can increase cruciferous vegetables, nuts, seeds, and other high-fiber foods. If dairy is part of your life, go organic, especially after researchers like Dr. Ray Dorsey have established strong links between pesticide exposure in conventional dairy products and Parkinson’s disease risk. The pesticides concentrate in animal fat, which means full-fat conventional dairy carries more risk.

The point is not perfection. The point is getting the big picture right and making it your own.

Your Brain-Healthy Eating Action Guide

Based on my conversation with Annie, here are the most actionable takeaways:

Eat a cup of leafy greens every day. This is the single food habit with some of the most dramatic brain-imaging data behind it. Spinach, kale, arugula, romaine, Swiss chard. Put them in a salad, blend them into a smoothie, wilt them into a soup. The method does not matter as much as the consistency.

Add a fermented food daily. Yogurt (unsweetened, unflavored, with live cultures), kefir, sauerkraut, kimchi, or cottage cheese with CFU counts on the label. These deliver live beneficial bacteria that support gut microbiome diversity, which in turn supports the brain.

Rethink your coffee. If you drink it, make it caffeinated, black, unsweetened, and paper-filtered. If you use a French press, pour the coffee through a paper filter before drinking it. If you prefer pods, Green Mountain appears to be one brand that includes a small paper filter.

Eat fish or seafood regularly, or supplement with omega-3s. Low intake of omega-3 fatty acids from seafood is a documented risk factor for Alzheimer’s. Prioritize small fish like sardines and anchovies, or cold-water fish like wild-caught salmon and cod. If fish is not part of your diet, a purified algae omega-3 supplement is a reasonable alternative.

Swap processed grains for real whole grains. Red rice, black rice, quinoa, millet, steel-cut oats. If the first ingredient on the bread label is not “whole wheat” or a recognizable whole grain, it is not a whole grain product.

Eliminate processed meat. The distinction between processed and unprocessed meat is now well-established in the brain health literature. Hot dogs, deli meat, bacon, and sausages carry clear risk. Unprocessed meat in moderate amounts sits in a different category entirely.

Consider a multivitamin. Either a brain-specific formulation like Relevate or a well-studied general multivitamin like Centrum Silver. Think of it as insurance against the micronutrient deficiencies that accumulate with age.

If you drink alcohol, know the current science. There is no amount that is safe for the brain. If you choose to drink, keep it under six per week and understand that you are accepting a tradeoff.

Want to go deeper? Check out Dr. Annie Fenn’s Substack, Brain Health Kitchen, and her bestselling cookbook, The Brain Health Kitchen: Preventing Alzheimer’s Through Food.

Read Dr. Annie Fenn’s article here.

Order The Brain Health Kitchen cookbook here.

Brain-Healthy Recipe from Chef Martin Oswald

As part of the Brain Health Substack Summit, Chef Martin Oswald created a special brain-healthy recipe inspired by Dr. Annie Fenn’s food pyramid. This recipe brings together several of the brain-healthy food groups into a single dish.

See Chef Martin Oswald’s recipe here.

Want to train your brain with games backed by science? Check out my free weekly Substack, Train the Brain Games, where I share cognitive challenges focused on processing speed and other skills the research actually supports.

This article is part of the Brain Health Substack Summit, the first-ever summit of its kind on the Substack platform. All week long, I am sitting down with leading experts in neuroscience and cognitive health for live conversations and in-depth articles. The summit is hosted by The Habit Healers. Subscribe to both The Habit Healers and Brain Health Kitchen so you do not miss a single conversation.

References

* Morris MC, Tangney CC, Wang Y, Sacks FM, Bennett DA, Aggarwal NT. MIND diet associated with reduced incidence of Alzheimer's disease. Alzheimers Dement. 2015;11(9):1007-1014. doi:10.1016/j.jalz.2014.11.009

* Morris MC, Wang Y, Barnes LL, Bennett DA, Dawson-Hughes B, Booth SL. Nutrients and bioactives in green leafy vegetables and cognitive decline: Prospective study. Neurology. 2018;90(3):e214-e222. doi:10.1212/WNL.0000000000004815

* Zhang Y, Chen J, Qiu J, Li Y, Wang J, Jiao J. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. Am J Clin Nutr. 2016;103(2):330-340. doi:10.3945/ajcn.115.124081

* Kim JH, Kwon YJ, Lee Y, et al. Associations of Individual Beverage Types and Substitution with Dementia Risk: A UK Biobank Cohort Study. J Nutr Health Aging. 2026;30(1):100740. doi:10.1016/j.jnha.2025.100740

* Baker LD, Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimers Dement. 2023;19(4):1308-1319. doi:10.1002/alz.12767

This article is based on my conversation with neuroscientist Julie Fratantoni, PhD, author of the Better Brain by Dr. Julie Substack, as part of the first-ever Brain Health Substack Summit hosted by The Habit Healers.

Click here to join tomorrow for Brain Health Substack Summit Day 2 with Annie Fenn, MD.

In the late 1990s, I was sitting in a pharmacology lecture during my first weeks of medical school, staring at a stack of handouts thick enough to be mistaken for a semester’s worth of reading. It was two weeks of material. I had three children at home. My youngest was ten months old.

So I started drawing cartoons.

I drew a Pepsi bottle to represent peptidoglycans, a class of molecules in bacterial cell walls. Then I drew a little van driving across the Pepsi bottle for vancomycin, the antibiotic that targets those molecules. I colored the van red, because vancomycin can cause a flushing reaction known as “Red Man Syndrome.” When test day came, I didn’t need to scramble for facts. I could see the picture in my head. The van. The Pepsi bottle. The red.

My classmates noticed. They started borrowing my cartoons, which forced me to explain the drawings out loud, which meant I had to think even harder about what the relationships between the drug classes actually were. Nearly thirty years later, I still remember pharmacology details I probably have no business remembering. My daughter later went to medical school and adopted the same method. We published books about it called Visual Mnemonics.

I did not know it at the time, but I had stumbled into something neuroscience now has a very clear explanation for. And it is not what most people think of when they hear the words “brain exercise.”

That is exactly what I wanted to explore when I sat down with Julie Fratantoni, PhD, for the opening conversation of our Brain Health Substack Summit. Julie is a neuroscientist, the author of the Better Brain Substack, and someone who works directly with clients on cognitive performance. I expected her to talk about brain-training apps and puzzles. Instead, she dismantled almost everything I thought I knew about what it means to exercise your brain.

The Basketball Problem

Julie likes to use basketball to explain two very different approaches to brain training.

Imagine you are coaching a youth basketball team. You run drills: dribbling, passing, shooting. Each skill gets practiced on its own. This is what researchers call bottom-up training. You are building individual abilities one at a time, rep by rep. My husband coached our youngest’s basketball team, so I know this routine well. You drill the fundamentals first, because no strategy in the world matters if you cannot get the basics right.

Now imagine game day. Suddenly your players need to decide when to pass, when to shoot, how to coordinate with teammates, how to adjust when the other team changes formation. That is top-down training. It requires the prefrontal cortex, the part of your brain right behind your forehead, which handles planning, problem-solving, decision-making, and the ability to pull separate pieces of information together into something useful.

The same split exists in cognitive training. Bottom-up brain exercises target single skills like working memory (the ability to hold information in mind temporarily), attention, or processing speed (how fast your brain takes in and responds to information). Top-down exercises challenge your prefrontal cortex to do the harder work of organizing, judging, and thinking critically.

Here is where things get interesting. Most commercial brain-training apps focus on bottom-up skills. And the majority of research shows that getting better at those games does not translate into real-life improvement. You get better at the game. That is about it.

Julie was blunt about this during our live conversation. The majority of research shows that these games do not generalize to real life, she said, and she wanted to say it loud and clear because it is the question she gets asked more than almost any other.

The 23-Hour Experiment

There is, however, one notable exception, and it comes from one of the largest cognitive training studies ever conducted.

The ACTIVE study enrolled about 3,000 adults aged 65 and older and assigned them to one of three types of cognitive training: speed training, memory training, or reasoning training. A fourth group served as a control and received no training at all. The participants trained over a period of three years and were then followed for two decades.

The result that caught everyone’s attention was this: the speed training group showed a 25 percent reduction in the risk of developing dementia, including Alzheimer’s disease. The memory and reasoning groups did not show that same protective effect.

But Julie pointed out something most people overlook when they read about this study. The speed training was adaptive, meaning it automatically adjusted its difficulty based on how each person performed. The other two types of training were not. That distinction matters, because it suggests the key ingredient may not have been speed itself, but the fact that the challenge was always calibrated to the right level for each person.

And then there is the dosage. Over three years, the total training time amounted to about 23 hours. Julie did the math. That is less than an hour a month.

Less than an hour a month, and it moved the needle on dementia risk by a quarter.

The Posture Problem

So should we all just download a speed-training app and call it a day? Not exactly. And this is where Julie’s thinking takes a turn that changes everything.

She asked me to think about posture. Say you spend twenty minutes at the gym working on your form and alignment. That is great. But then you go home, sit hunched over a desk for eight hours, and repeat that for months on end. What is your posture going to look like in five years? Probably not great, because the eight hours of slouching vastly outweigh the twenty minutes of effort. We both immediately sat up straighter when she brought this up during the live, which I think proves her point.

The brain works the same way. If you spend an hour a month on a brain-training app but the rest of your waking hours are filled with chronic stress, constant distraction, and information overload, your cognitive health is going to reflect those thousands of hours, not the handful of training minutes.

Your brain is on all the time, Julie said. We are in this age where a lot of us are information workers. You take your brain home with you at the end of the day and you are always thinking. It never turns off.

Her argument is that we need to stop thinking of brain exercise as a separate activity that gets scheduled into the calendar and start thinking of it as the way we use our brains all day long. The question changes from “What brain exercise should I do?” to “How am I using my brain during the sixteen or so hours I’m awake?”

And she has a specific four-step framework for doing exactly that.

Exercise One: Reinterpretation

The first exercise has nothing to do with puzzles or games. It has to do with stress.

Your prefrontal cortex, the part of the brain responsible for planning, judgment, critical thinking, and complex problem-solving, essentially goes offline when you are stressed. Not a little offline. Functionally offline. When your body shifts into a threat response, your amygdala (the brain’s alarm center, which processes fear and strong emotions) takes the wheel, and your higher-order thinking gets sidelined. You cannot exercise a brain region you cannot access.

Julie teaches a technique called reinterpretation, which is a form of cognitive reframing. The idea is simple. When something stressful happens, you deliberately look at it from a different angle.

Here is her example. You send a friend a heartfelt message and hear nothing back. The default emotional response might be hurt feelings, or offense, or the start of an anxious spiral about the state of the friendship. Reinterpretation asks you to pause and consider: maybe your friend had a terrible week. Maybe something happened in their life that has absolutely nothing to do with you.

I had to laugh when she gave this example, because I know exactly where my mind goes in that situation. My worried-mother brain skips right past “they’re ignoring me” and lands on “are they in a ditch somewhere?” But there is also a possibility people forget about entirely: maybe there was a plain old technical glitch and the text never arrived. That happens more often than any of us want to admit.

The shift in perspective is not just a feel-good trick. Brain imaging research shows that people who practice reinterpretation regularly show decreased activity in the amygdala and increased activity in the prefrontal cortex. The actual pattern of brain activation changes. You are, in a measurable sense, training your brain to stay in thinking mode rather than reacting mode.

This matters because chronic stress does not just feel bad. It damages the brain over time and increases risk factors for cognitive decline. Getting good at recovering from stress, at catching yourself before the spiral, is one of the most protective things you can do for your long-term brain health.

Exercise Two: Single-Tasking

Once your nervous system is regulated and your prefrontal cortex is back in business, the next exercise is deceptively simple. Do one thing at a time.

Julie is emphatic about this. Multitasking is not a productivity strategy. It is an added source of stress, and most people do not realize it. Every time you bounce between browser tabs, glance at your phone while someone is talking, or try to follow a podcast while answering emails, your brain has to work to suppress the distractions. That suppression burns through your cognitive resources the same way running too many programs slows down a computer.

But the real cost of distraction is this: your brain cannot encode what it never paid attention to.

This is the answer to the question people ask Julie more than almost any other: “How do I improve my memory?” Her answer does not involve mnemonics or supplements. It involves giving something your undivided attention in the first place. If you were only half-listening, there is nothing to remember, because the information never fully entered your brain.

There is also a compounding effect. Julie points out that neuroplasticity, the brain’s well-documented ability to rewire itself based on experience, works in both directions. Every time you practice sustained focus, you strengthen the neural pathways that support attention. But every time you toggle between tasks, you reinforce the pattern of distraction. The brain you have is a brain that you have built based on how you use it every day, she said. If your daily habit is fragmented attention, you are literally building a more distractible brain.

Starting small works. Even two minutes of genuine, undivided focus on a single task is a beginning. You build from there. The goal is not to be locked in every second of the day. The goal is to protect your attention for the things that actually matter. And as I mentioned during our conversation, that level of focused engagement is also how you get into a flow state, those stretches where hours pass and you barely notice because you are so absorbed in what you are doing.

Exercise Three: The Heavy Lifting

This is the one Julie calls the strength training for the brain, and it is the step most people skip.

After you have calmed down (step one) and focused in (step two), the real exercise is engaging deeply with whatever information is in front of you. Julie calls it integrating information. It means taking what you just read, watched, or heard and doing something active with it in your mind, rather than letting it wash over you.

Think about the last book you read. If someone brought it up at dinner next week, could you say something meaningful about it? Or would you find yourself saying, “Oh yeah, I read that, but I don’t really remember what it was about.” Julie says that experience is completely normal, and also completely avoidable. Forgetting is actually a protective feature of the brain. We do not need to store every single thing. But for the things that matter to you, the things you invested your time in, there is a way to make them stick.

Her approach is to ask yourself a few questions after you engage with something that matters. What is one thing I learned that updates my thinking? How does this apply to my life? What would I tell a friend about this, and why should they care? These do not need to be formal. You do not need a journal or a worksheet. A minute or two of honest reflection is enough.

What you are doing, at the neurological level, is creating hooks. New information that just passes through your brain has nothing to attach to. But when you actively connect it to something you already know or care about, you give it anchor points. The more connections you make, the more likely you are to remember it later and to use it when it counts.

Julie takes this a step further and recommends adding a social component. If you saw a great film, went to an exhibit, or listened to a conversation that struck you, challenge yourself to share the core takeaway with someone. Not a blow-by-blow summary, but the essence: what was meaningful, and why. This forces you to distill, which is itself a high-level cognitive skill. And it gives you a reason to do the thinking in the first place. One of her clients, a woman with grown children in their twenties, uses this as motivation. She processes what she learns so she can pass it along to her kids. The purpose drives the practice.

Julie also made a point that I think matters for everyone reading this on Substack. When you share an article or a podcast with someone, tell them why. “Oh, you should read this” is easy to ignore. But “this changed the way I think about how I learn” gives the other person a reason to engage, and the act of putting that into words forces you to figure out what the takeaway actually was.

And here is the part that connects back to that pharmacology lecture in the 1990s. I was not just memorizing drug classes. I was drawing cartoons, which forced me to identify the key relationships. Then I was teaching classmates, which forced me to explain those relationships out loud. Years later, sitting with a patient who mentioned a medication, the red van on the Pepsi bottle appeared in my mind and helped me recall a critical side effect. The information had hooks in every direction. It had been used, shared, applied, and reapplied. That is why it stuck.

Julie explained the neuroscience behind it perfectly. Memory is not about perfectly freezing and preserving the past, she said. Memory is about what you need for the future. Your brain remembers things you are going to use again. So if you can create a connection to how something is relevant to your life, how it helps you, how it helps someone else, those are the things that get remembered.

Exercise Four: Do Nothing

The fourth and final step is the one that surprises people most. After all that effort, after calming down, focusing in, and thinking hard, the most important thing you can do is rest.

Not rest as in watch Netflix. Not rest as in scroll through your phone. Real rest. No new input at all.

Neuroplasticity, the process by which your brain forms new connections, requires rest to complete. Exposure to new information starts the process, but the actual rewiring happens during downtime, when your brain is not being asked to take in anything else. Think of it like concrete. You can pour it and shape it, but it needs time to set. If you keep pouring new concrete before the first batch hardens, you end up with a mess.

Julie recommends short, strategic breaks throughout the day, particularly after periods of focused learning or engagement. They do not need to be long. Even 30 seconds to two minutes of sitting with no input, no phone, no podcast, no music, can make a difference.

She also pointed to something called ultradian rhythms, which are natural cycles your body runs through during the day, roughly 60 to 120 minutes of focused capacity followed by a 20-minute period when your brain needs to recover. I recognize this pattern in my own work. After about 45 minutes of reading and writing for my Substack, I start losing the thread. When I find myself going back and trying to re-read the same paragraph, I know it is time to get up. I keep kettlebells nearby and usually head outside and walk around for a bit. I come back sharper, with better ideas, and ready for the next session.

The reason for this is not just physical refreshment. When you stop focusing on a task, your brain activates what neuroscientists call the default mode network. This network, sometimes called the creativity network, is responsible for making unexpected connections between ideas. It is the reason you often have your best insights in the shower, on a walk, or in the middle of doing something completely unrelated. By resting, you are not wasting time. You are giving your brain the space to do work it literally cannot do while you are focused.

Julie described the same thing from her own experience. She will be writing something, go take a walk, and then come back with all these ways to make it better and new ideas she would not have had if she had just kept pushing through.

The uncomfortable truth is that most of us have almost no real rest in our day. When we take a “break,” we reach for our phones. Scrolling through social media feels like a break, but it is actually flooding your brain with new visual and emotional stimulation. Julie mentioned someone she spoke with recently who had a significant realization about this: scrolling is not rest. Netflix is not rest. Only true absence of new input qualifies.

Driving in silence is one of Julie’s favorite recommendations. She says people hate it at first. Then they start to crave it.

The Four-Step Framework

To recap Julie’s four brain exercises:

Reinterpretation. When stress hits, practice looking at the situation from a different angle. This calms your amygdala (your brain’s emotional alarm center) and brings your prefrontal cortex (the thinking part of your brain) back online. This is a brain exercise.

Single-tasking. Do one thing at a time. Give important tasks your full attention. Your brain cannot form memories of things it never properly noticed in the first place. This is a brain exercise.

Deep integration. After engaging with something that matters, pause and ask yourself: what is one takeaway? How does this apply to my life? What would I tell someone about this? This creates the mental hooks that make information stick. This is a brain exercise.

Rest. Take short breaks with no new input. Let your brain consolidate what it just learned. Allow the default mode network, your brain’s creativity system, to come online. This is a brain exercise.

None of these require an app. None of them cost money. None of them need to be scheduled into a separate block of time. They are ways of using the brain you already have, all day long, in a slightly different and much healthier way.

Your Brain Health Action Guide

Based on my conversation with Julie, here are practical ways to start putting these four exercises into your daily life:

Start with stress recovery. The next time you feel a stress reaction building, pause before reacting. Ask yourself: what is one other way to look at this situation? Practice this once a day. Over time, you will get faster at it, and your brain’s stress response will literally become less reactive.

Protect your attention. Pick one activity each day, a conversation, a chapter, a work task, and commit to giving it your complete focus with no phone and no other screens. Start with five minutes if that is all you can manage. Build from there. Notice how much more you remember afterward.

Reflect after learning. After you read an article, listen to a podcast, or finish a meeting, take 60 seconds and ask yourself: what is the one thing I want to take from this? Even better, tell someone about it and explain why it mattered to you.

Schedule real rest. Build at least two or three short breaks into your day where you have zero new input. No phone. No music. No screens. Just your own thoughts. Try it after a focused work session, or even during your commute by driving in silence. If you find your mind wandering to new ideas and connections, that is not a failure of focus. That is your default mode network doing its job.

Adapt your challenge level. Remember the ACTIVE study: the training that actually reduced dementia risk was adaptive. It met people where they were. Whatever you are working on, whether it is a new skill, a puzzle, or a demanding project, make sure the difficulty is appropriate. Too easy and your brain coasts. Too hard and stress shuts down the very systems you are trying to strengthen.

Want to go deeper? Check out Dr. Julie Fratantoni’s article on this topic, How to Exercise Your Brain, on her Substack, Better Brain.

Read Dr. Julie’s article here.

Brain-Healthy Recipe from Chef Martin Oswald

As part of the Brain Health Substack Summit, Chef Martin Oswald created a special brain-healthy recipe inspired by Dr. Julie’s work. Good nutrition is one of the foundations of cognitive health, and this recipe was designed with that in mind.

See Chef Martin Oswald’s recipe here.

Want to train your brain with games backed by science? I recently launched a free weekly Substack called Train the Brain Games where I share cognitive challenges focused on processing speed and other skills the research actually supports. It grew out of my own curiosity about whether the puzzles I love are actually doing anything for my brain. Turns out, some of them are. Subscribe for free and give your brain a real workout each week.

This article is part of the Brain Health Substack Summit, the first-ever summit of its kind on the Substack platform. All week long, I am sitting down with leading experts in neuroscience and cognitive health for live conversations and in-depth articles. The summit is hosted by The Habit Healers. Subscribe to both The Habit Healers and Better Brain so you do not miss a single conversation.

References:1. Coe NB, Miller KEM, Sun C, et al. Impact of cognitive training on claims-based diagnosed dementia over 20 years: evidence from the ACTIVE study. Alzheimers Dement (N Y). 2026;12(1):e70197. Published 2026 Feb 9. doi:10.1002/trc2.70197

Thank you Marg KJ, Afsi, Lydia R, Tony, and many others for tuning into my live video with Chef Martin Oswald!

This week on Habit Healers Live, Chef Martin and I turned brain science into brain food, literally. Inspired by Dr. Dominic Ng’s recommendations for the Brain Health Substack Summit happening next week, Chef Martin prepared two stunning salmon dishes designed to preserve omega-3 fatty acids and pack as many brain-boosting ingredients as possible into every bite.

The result? Seven of Dr. Ng’s recommended brain health ingredients in a single recipe. Here’s what we learned.

The Science Behind Today’s Cook

Dr. Ng’s brain health food list breaks down into several key categories, and Chef Martin built today’s dishes around them:

Gut-Brain Axis: Kimchi, kefir, sauerkraut, and leeks — Chef Martin chose leeks as the foundation for his vegetable sides.

Cerebrovascular Blood Flow (or as I put it, “blood to the brain”): Roasted beets, spinach, and kale — beets and spinach both made it into today’s dishes.

Neuroinflammation: Extra virgin olive oil, berries, and turmeric — olive oil was used in cooking, and turmeric appeared in the French spice blend.

Neuroplasticity: Sardines and anchovies — a Moroccan sardine dish is coming later this week (stay tuned!).

Neurotransmitters: Eggs, pumpkin seeds, and turkey — eggs showed up in the gribiche sauce, and crushed pumpkin seeds became the crust on the salmon.

Dish #1: Pumpkin Seed-Crusted Salmon with Sauce Gribiche

Chef Martin’s first dish was a thick-cut Atlantic salmon fillet with a crushed pumpkin seed crust, served over water-sautéed leeks, French lentils, beets, and spinach, topped with a classic French sauce gribiche.

Key Cooking Tips for Preserving Omega-3s

Why it matters: Omega-3 fatty acids begin to oxidize at around 160°F. The whole goal is to cook salmon slowly at lower heat to preserve these essential brain nutrients.

Cook skin-side down first. The skin acts as a protective barrier, shielding the omega-3-rich oils from direct heat. Sear skin-side down for 5–7 minutes on medium heat.

Don’t flip too early. If the skin sticks, it’s not ready. When properly cooked, the salmon will release from the pan on its own.

Use a stainless steel pan. Chef Martin recommends stainless steel to avoid particles from coated pans breaking off with use.

Bring fish to room temperature first. Let salmon sit out for about 30 minutes before cooking. Cold fish won’t cook evenly, it’ll stay raw in the center.

Sear the sides. A restaurant trick: briefly press the sides of the salmon against the pan to seal all around. This prevents those white protein spots from forming on top.

Use the paper towel trick. After cooking, rest the salmon on a paper towel to absorb the oxidized cooking oil before plating. This is what the best restaurant chefs do.

Check temperature: For home cooks, use a thermometer — 125°F is the target for medium-rare salmon that preserves the most omega-3s.

Oven method alternative: You can also slow-bake salmon at 250°F for about 45 minutes (for a one-inch fillet). It comes out buttery, creamy, and incredibly nutrient-rich.

About Sauce Gribiche

The word of the day! Gribiche (G-R-I-B-I-C-H-E) is a classic French sauce made with hard-boiled eggs (for choline and neurotransmitter support), capers, parsley, shallots, mustard, and apple cider vinegar. The acidity of the sauce balances the richness of the salmon, a key flavor profiling principle.

The Vegetable Side

Chef Martin kept this intentionally low-calorie to balance the richness of the fish: leeks cut into strips and water-sautéed (no butter, no oil), French lentils (recommended by Dr. Chris Miller for fiber), pre-cooked beets (for nitrates and cerebrovascular blood flow), and fresh spinach wilted in at the end.

Get the full recipe for the Pumpkin Seed–Crusted Salmon with Sauce Gribiche, Roasted Beets & Leeks here.

Dish #2: Matcha Salmon Noodle Bowl

The second dish was inspired by Dr. Julie Brantantoni’s recommendations. Chef Martin used the belly portions of the salmon, the fattiest part with the highest concentration of omega-3s, cut into small, fingernail-sized pieces and cooked very quickly to avoid oxidizing those delicate fats.

What’s in the Bowl

The base is konjac noodles (also called sweet potato starch noodles), a great option for anyone managing blood sugar, as they have essentially no carbohydrates. Just rinse with hot water and they’re ready.

The star is a matcha dressing made with matcha, tahini, garlic, ginger, and date syrup. Chef Martin’s advice from legendary German chef Witzigmann: when you name a sauce after an ingredient, that ingredient should be the star. Let the matcha shine.

Finished with shiitake mushrooms sautéed in a touch of sesame oil (only about 30 calories to flavor an entire dish, compared to 120 calories of olive oil for the same impact), leeks, spinach, hemp seeds (plant-based omega-3s and protein, added at the very end to preserve nutrients), black sesame seeds, and fresh torn mint leaves.

Full Matcha Salmon Noodle Bowl recipe coming soon.

Wild vs. Farmed Salmon: What to Know

A viewer asked whether wild salmon is better than Atlantic farmed salmon, and the answer was a clear yes. Chef Martin explained that cheap farm-raised salmon often contains synthetic omega-3s and added coloring. The fish can fall apart when you lift it, a sign of how much oil has been added. Wild salmon (like coho) has a naturally darker, deeper red color.

If you’re buying farmed salmon, invest in higher-quality options from reputable farms. Avoid the cheapest mass-produced options, which can come with concerns about water quality and antibiotic use.

Don’t Eat Fish? Here Are Your Options

For those who don’t eat fish (myself included!), Chef Martin and I discussed several alternatives. You can substitute tofu or azuki beans in these dishes for protein and texture. Konjac noodles add substance without spiking blood sugar. Omega-3 supplementation (EPA and DHA) is another option, Chef Martin himself eats mostly vegetarian and takes omega-3 supplements, inspired by Dr. Dean Ornish’s 2025 Alzheimer’s study. I take omegas daily. Hemp seeds, ground flax, and chia seeds provide plant-based ALA omega-3s and can be sprinkled on any dish.

What’s Coming Next

Moroccan Sardine Charmoula recipe — dropping mid-week on Chef Martin’s Substack

Summary article with all Brain Health Forum recipes — coming next Saturday with Chef Martin reviewing everything together.

Don’t Miss: Brain Health Substack Summit Starts Monday!

Starting Monday, February 23rd at 10:00 AM Pacific, I’m going live every day next week with a different brain health expert for the Brain Health Mini Substack Summit. Half-hour live interviews each day, covering how we can increase our brain longevity. The lineup includes Julie Fratantoni, PhD on Monday, with five more experts throughout the week, and Chef Martin Oswald closing it out with a full recipe roundup.

Join the Brain Health Substack Summit live here.

I highly recommend subscribing to Chef Martin’s Substack for all his incredible brain health recipes, he and his wife, Carolyn, work tirelessly to bring you dishes that are as nourishing as they are delicious.

Subscribe to Chef Martin’s Healing Kitchen Substack.

In this episode, I’m digging into a question that sounds almost absurd until you look at the data: why is pickleball—arguably the “sweetest, safest-looking” sport in the park—sending so many people to the emergency room?

Pickleball looks harmless. The court is small. The serve is underhand. The ball is basically a wiffle ball. And yet, ER records tell a different story: fractures (especially wrists), sprains, strains, and a pattern that’s hard to ignore—older adults showing up for pickleball injuries at rates that started to rival tennis. I walk through what’s really happening, and why the sport’s design quietly creates the perfect setup for falls, tendon overload, and sudden-stop injuries.

I explain how two rules—the double bounce and the kitchen—shape the way your body has to move: quick lunges, short sprints, abrupt decelerations, and reactive steps at the net. It doesn’t look like sprinting, but it often acts like sprinting in bursts. And that mismatch—between what the game demands and what many bodies are prepared for—is where trouble starts.

But I’m not here to villainize pickleball. In fact, I make the case for why it’s one of the most powerful “stealth health” activities out there: it’s fun enough that people actually show up, it can hit moderate intensity, and studies suggest benefits for lower-body power, cognition, and even chronic pain when it’s introduced with a smart ramp-up. The problem isn’t pickleball—it’s the gap between enthusiasm and preparation.

We also get specific about the injuries that worry clinicians: the Achilles rupture story (tendons adapt slowly, even when you feel “fit”), the rare-but-serious eye injuries that can threaten vision, and the overuse problems the ER doesn’t capture—things like tennis elbow and shoulder tendinopathy that creep in when you play back-to-back without recovery.

And then I give you the practical fix: how to make pickleball safer without ruining the fun. I walk through a simple warm-up framework (RAMP), the strength and balance basics that reduce fall risk, and the small decisions that matter more than people realize—court shoes, gradual play-time build, rest days, and yes, eye protection if you’re living at the net.

This isn’t about playing harder. It’s about playing longer.Dr. Marbas Substack: https://drlauriemarbas.substack.com/

A Big Thank You To Our Sponsors:

If you want the best supplement to help you on your plant-based journey, you have to try Complement: https://lovecomplement.com/?aff=62

Thank you Marg KJ, Afsi, Sherrie McGraw, Eve Franco, Tony, and many others for tuning into my live video with Chef Martin Oswald!

Brain Food That Actually Tastes Good: A Feast for Your Neurons (and Tastebuds)

We went live today from Las Vegas to Vienna, and if you missed it, you missed a masterclass on how to turn “medical advice” into a culinary masterpiece.

We are gearing up for the Brain Summit (Feb 23rd–28th), where we’ll be interviewing experts like Annie Fenn, MD , Jud Brewer MD PhD , Chris Miller MD, Julie Fratantoni, PhD, and Dr. Dominic Ng. But today wasn’t just about talking science; it was about putting Dr. Chris Miller’s anti-inflammatory protocols directly onto a plate.

The goal? Decreasing stroke risk, fighting atherosclerosis, and keeping those blood vessels wide open to feed your brain.

Here is the breakdown of the “strategic dishes” Chef Martin whipped up.

The Strategy: Avoiding “Flavor Fatigue”

Chef Martin Oswald introduced a fascinating concept today: Flavor Fatigue.

When you eat a dish that tastes exactly the same from the first bite to the last, your palate gets bored. To keep healthy eating exciting, you need layers. You need a mix of hot and cold, cooked and raw, spicy and tart.

Here is how he built the ultimate Anti-Inflammatory Bowl.

1. The Roasted Base

Martin didn’t just throw veggies on a pan; he layered the antioxidants:

* The Power Move: He started with cauliflower (cruciferous) and dusted it with turmeric.

* The Fiber: Chickpeas went in for their soluble fiber to help grab cholesterol and feed gut bacteria.

* The Spice: He used Garam Masala. It’s Martin’s favorite spice blend because it is loaded with high-polyphenol spices like clove.

Chef’s Tip: Watch your oil. Instead of free-pouring olive oil, Martin suggests using a teaspoon or even a splash of water to keep the calorie density low, which is crucial for stroke prevention.

2. The “Raw” element (Vital for Vitamin C)

Here is something we often forget: Vitamin C is heat-sensitive. If you cook your peppers or fruits, you lose a significant amount of that nutrient.

To solve this, Martin created a raw Purple Coleslaw right in the middle of the bowl:

* The Crunch: Red cabbage (the cheapest, most effective antioxidant bang for your buck).

* The Surprise: He added blueberries directly into the slaw instead of raisins.

* The Dressing: A mix of tahini, lemon juice, and a touch of date syrup to break down the cabbage fibers.

3. The Endothelial Boosters

To finish the bowl, he added cooked beets and raw arugula. Why? Nitrates. These are essential for the endothelial lining of your blood vessels, ensuring good blood flow to the brain.

Get the Full Anti-Inflammatory Bowl Recipe Here.

Dessert: “Carolyn’s Clafoutis” (The Healthy Remake)

We can’t talk brain health without talking about berries. Dr. Jud Brewer loves them, and so do we.

Martin’s wife, Carolyn, makes a healthy version of the classic French Clafoutis, that usually loaded with heavy cream, butter, and sugar. Martin is sharing her recipe and how she turned it into a brain-healthy powerhouse without sacrificing that custard-like texture.

The 5-Ingredient Fix:

* Frozen Blueberries: He used frozen because they are picked at peak ripeness and retain their nutrients.

* The Liquid: Almond milk (or oat milk) mixed with a little yogurt for acidity.

* The Binder: Tapioca flour (or arrowroot) mixed with almond flour.

* The Omega-3s: Soaked ground flaxseeds.

* The Sweetener: A touch of date sugar or maple syrup.

The result? A purple, custard-like treat that melts in your mouth, minus the saturated fat.

Eat the Rainbow

By the time Martin finished plating, we counted nearly 15 different plants in just one meal. From the shiitake mushrooms to the fresh parsley garnish, this is what gut diversity looks like.

Read my article on “The Rainbow Plate: A System So Simple It Will Change the Way You Eat Forever”

Coming Up Next

We are back next Wednesday for another live cooking session. We’ve covered veggies and berries; next week, we are diving into healthy fats. Martin will be demonstrating the smart way to cook Salmon (for those who eat fish) so you don’t destroy the delicate Omega-3s with high heat.

See you then!

In this episode, I’m sharing a movement that looks a little ridiculous… but tells you a lot about your body in seconds: the duck walk—walking forward while staying in a deep squat.

I take you back to where it actually came from: not fitness, but medicine. In the 1950s, orthopedic surgeons used the duck walk as a quick stress test for knee problems—especially the meniscus—because deep bending under body weight can reveal issues fast. And that’s exactly why it’s so interesting: it’s not just an exercise, it’s a snapshot of your mobility, strength, balance, and joint tolerance all at once.

I break down what the duck walk really is (deep squat + tiny controlled steps), why it feels brutally hard almost immediately, and what’s happening under the hood—your quads and glutes staying “on” the whole time, the higher energy cost, and the balance/proprioception challenge that makes most people wobble at first.

Then I share my own story: after breaking my left ankle and spending weeks in a boot, I struggled to fully get my mobility back—even when I stretched. The duck walk surprised me. It helped restore ankle dorsiflexion, made my deep squat steadier, and the improvement was noticeable enough that I kept it as a long-term practice.

But I’m also very clear about the fine print. This movement asks a lot from your knees. I walk through the key structures it stresses (patellofemoral joint, tibiofemoral joint, meniscus), the warning signs that mean you should stop (sharp pain, swelling later, catching/locking, giving way), and who should skip it or only do it with guidance.

Finally, I give you the practical “how”: treat it like a skill, start supported, keep steps small, modify the depth, and progress through simple phases over a few weeks instead of turning it into a knee lottery. If you want a fast way to assess where your weak link is—ankles, knees, balance, or strength—this episode will help you figure it out and build it safely.Dr. Marbas Substack: https://drlauriemarbas.substack.com/

A Big Thank You To Our Sponsors:

If you want the best supplement to help you on your plant-based journey, you have to try Complement: https://lovecomplement.com/?aff=62