What Every Woman Over 35 Needs To Know About Menopause

Have flashes, night sweats, insomnia, depression, anxiety, brain fog, memory lapses. Your brain is having a party there, but then everything crashes down. Women's brains are not the same as men's brains. There's this misconception in medicine the sex does not matter and that women are considered like smaller, more emotional men. And that is just absolutely not true. Are you losing your mind?

No. You're getting a brand new one. Dr. Lisa Mosconi is, quite frankly, a scientific badass. She holds a PhD degree in neuroscience and nuclear medicine from the University of Florence in Italy. She ranks in the top 1% of scientists of the past 20 years by official metrics. The Times names her one of the 17 most influential living female scientists.

And get this. She's even been called the Mona Lisa of neuroscience. Lisa, I am so excited to talk to you. I have to say, I have been in up in Your world, and we're going to talk about all the books. But these brain food, the menopause brain, the Z brain, I am like, oh my goodness, I get to have a conversation with one of the most amazing neuroscientists ever.

And you're here. So, I have to tell you, brain food. Your first book was the one that really got me in first. And it's because of the subtitle, The Surprising Science of Eating for Cognitive Power. And like every cell in my body was like, yes, please. And P.S., I think that this cover is super dope. Do you have something you want me to tell the people about this particular cover?

I art, I actually, I art directed every single one of my book covers, I can't imagine. It was really interesting, this actually with my husband, who is, a designer by training, although he now works in science and his stats is his own breed of person, professionally. And he, he said he didn't like any of the options that we were.

Yeah. First entered and then I thought, you know, the really cute is to really show food as an experiment, because this book is so much about the science behind neuro nutrition or brain nutrition. And I wanted it to look science-y, but not like a pop science. Yes, cover something delicate, I would say a little feminine, which is kind of me.

And so I came up with this idea and I loved it. Yeah, it's so beautiful. And just as an aside, we're going to dive into everything brain related, neuroscience related, all of your incredible research and work. but we have so many authors in our audience, myself included, and a lot of people who are either existing authors or aspiring to write.

And the one thing we always talk about is covers. And like, I love my publisher so much, they are amazing. But my similar experience was when I saw some of the first options that were present. I was like, oh hell no. I was like, not on my. It just didn't, you know what I mean? And they're amazing people.

But I think for me, I'll speak for myself. Yeah, artistic expression and visual represents it's so personal and it's so subjective, and it is so challenging to have folks who you've never worked with before, you haven't done a mind meld with, come up with things that are going to be aligned with what your internal vision is. So it's like never a crack on the other folks.

But it's like sometimes we as authors have to feel and take that power back. And no, no, actually no how I want this thing to be represented. Because frankly, we do judge books by their cover. If we're in the world of, like, brick and mortar. Yeah. And I really wanted my books to be kind of like me.

Yes. You know where to be. An expression of who I am, what I bring to the table. Like for the menopause brain. The idea of the little light bulb. Me the flower is was my publishers idea. But they sent it to me with, like, tulips and daisies. There was like, roses with the thorns. Yeah. And they went, yeah.

You know, is that, you know, this is not a picnic. Yeah. It's not a picnic. We want to say that it's not scary that there's beauty in it. Yes, but there's a, you know, there's there's challenges as well. So a rose with the thorns is more of an expression. They will absolutely, absolutely love it. And so it's been really wonderful to work with Penguin Random House.

I have him in part because they give me a lot of freedom. Yes. So creative freedom. And there's a lot of back and forth. Yes. That collaboration. Yeah. Yeah. Me too. I really did too. I remember when I because I have no poker face and I have like no fair, you know what I mean? Like I am so terrible I'm like, nope, you know, and I'm like, I love you.

And they know how much I love and respect not only them, they're people, but the creative process. Right? It is. It's really nice to work with folks because same thing, portfolio with us. They're like, okay, what do you want? And I was like, okay, now it's on. Now we get to like dig in. So let's start with neuro nutrition.

So in your book was the first time I even saw that phrase and why our brain has its own unique diet, which is different and separate from the rest of the body. Like, why is this so important to understand? Obviously, if we want to have cognitive power now, but also if we want to really strengthen that ability as we advance in age?

Yes. It's such a fascinating topic, isn't it? And, so I'm a neuroscientist by training, and my favorite subject was neurochemistry forever. I was so fascinated with neurochemistry, and there was learning all about these different molecules and how they shape brain function and how they feed brain structure and how the different neurotransmitters communicate with each other. And then I realized sodium, potassium, glucose, tryptophan, protein, fat was it.

This is food. Effectively neurochemistry is neuro nutrition is the study of how these different chemicals and different substances effectively become the very fabric of our brains. We just don't think about it as such. And so when I started my career as a neuroscientist, which I have been for many, many years at this point, decades, I was so fascinated with the idea that the environment can become part not just of our bodies, but of our brains as well.

Right? Some beautiful way that we can bring the nature inside of us and really use those beautiful compounds and phytochemicals and everything that nature provides and use it to our advantage. And that was more or less the time that I moved to New York. I was I was born and raised in Florence in Italy, and we were just talking about the fact that I also studied in France.

I went to a French high school. And so my connection with food was always very passionate, you know, only the French and the Italian. Come on. Yeah, I love cafeteria. I've always been so enthusiastic about food. And then I moved to New York and my diet completely changed. Terrible. I had no idea what I was doing. Yeah, I was eating at the local cafeteria.

It was a PhD student. I didn't really have that much of a budget, to be honest, and it was my very first time cooking for myself and doing grocery shopping just for me. Without my family, without my mom and my dad, I gained 20 pounds. We didn't like a year. I remember I went back to Florida and I found in space.

So. Me? Yeah, exactly. Oh, God. The shock and the horror. Yeah. Like my mom has been doing, you know, just trying to give a straight face, like what happened to you through her. And so then I realized there's something wrong with the suit I'm using because I'm not doing anything different. Right. And then I took a deep dive into nutrition, not just for, something to prevent disease or how to eat when you have a disease, but nutrition for prevention as well, and how to support yourself and your body.

And thank goodness the pounds came off, which was great, but it was really quite eye opening. Like the effect that your diet can have, not just on your physical health, but your mental health. I could not think straight. Wow. I was going from a little bit of a slave to myself and I really love learning. Yes. Right. So there were days that I would just have my nose in a book for like 12 hours straight with very short breaks and no problem.

So 100% focus, great memory as soon as my diet changed, I just I found myself just reading the same thing over and over again because I could not remember what I was reading. And then I would forget what it was doing in the middle of like a statistical analysis, which was unheard of for me. I was just like, there's, there's something wrong with me.

And sick. And so I started going to the doctor, and the doctor offered me antidepressants. Wow. And they said, maybe you're depressed because you're homesick. I was like, maybe. But as as I know about test. And so I went back to the basics and the I changed my line of research because I was really interested in learning more about the ways that diet, exercise, and lifestyle can support brain health.

Yes, and they changed my diet right back. I actually believe I optimized my diet for brain health, and a lot of research that I was doing at that point in time was really about diet and nutrition for brain health, and they do brain imaging. That's my specialty. I have a PhD in nuclear medicine and neuroscience, so I really do a brain imaging all the time.

And we were able to to provide neurology correlates and brain imaging correlates to having or not having a healthy diet. What kind of nutrients are more closely associated with high brain energy levels, right, or better outcomes for brain health and also have reduced risk of Alzheimer's disease? Yeah, and let's talk about that for a second, because yeah, I feel like that's really big when we're thinking about this from a societal perspective and a collective perspective.

I read in your book, Alzheimer's in the U.S. alone is 5.3 million people. At this point, 6.20, 6.20. Okay. So can you imagine what has gone up? And again at, at the time of the writing, ballooning to 15 million by 2050. Yeah. And that 32 now that it's like wow. So all of us paying attention to this not only for ourselves but our loved ones, it's big, it's know it's huge is huge.

And I think what's changed in my field, which is the field of cognitive aging, Alzheimer's disease, brain aging is the understanding that your choices really have any impact on your outcomes. And things like a healthy diet, a healthy lifestyle, regular physical activity, stress reduction, sleep quality, those really all compound together to determine, at least in part, your odds of experiencing cognitive decline in old age and developing Alzheimer's disease in on age.

So when I started, that was unthinkable. no one or very few people actually believed that Alzheimer's could be the risk of Alzheimer's, could be impacted by everyday life. Well, and now it is such a well-established observation that there are Alzheimer's prevention clinics sprouting all over the world. And I lead one. I'm a lead one. I run the Alzheimer's Prevention Clinic at Weill Cornell Medicine, and a lot of what we do is lifestyle based.

It's really has become such an integral component to Alzheimer's prevention and just support the cognitive aging that I think is fascinating to see. Like this switch. Yes. Right. Not just in in research, in science, but also in clinical practice. Yeah. And that's why I wanted to I was so excite. Well, first of all, I'm obsessed with this stuff.

I'm obsessed with learning, obsessed with science. And also really excited to have this discussion on the show because, we actually learned our audience is shifting and changing a little bit. We have a lot more younger people watching our show these days. And of course, we have folks that are in their 30s, 40s, 50s and 60s plus, and all of us can benefit from this.

And I feel like, you know, as a business person and a marketer, one of the things I know to be true is prevention is actually one of the hardest things to sell, because when we're young, we're often like, oh, we have that kind of we're immortal. We're not, you know what I mean? So you're it's and but however, as the years go on and those of us that experience cognitive decline in those we love and start to face some of these challenges, it's kind of a good wake up call.

So I just I wanted to highlight that because this is so, so, so important for us to get now. Yeah. And the earlier we start the better our chances are of kind of having this not only individual healing but a societal healing. Absolutely. And actually, at the clinic we see similar effects, like people who come to the Alzheimer's prevention clinic range from 21, which is obviously the minimum.

Yeah, legal age for up to 100 years old and over. How cool. So it's really any age. There's never a limit, right? The sooner you start, the better. But it's never too late to take care of yourself and support the health of your brain. I love that messaging, and I feel like that's such an intrinsic part of who you are, because I've been so steeped in all of your books these past few weeks, and, and we'll get to, just some things that you wrote that really, really made a difference to me, especially in Menopause Brain.

We'll get there in a little bit. So you're going to have to keep watching and keep listening. so I thought that what was interesting you wrote about out of all of our organs, the brain can be one of the most vulnerable or susceptible to our diet. And then in brain food specifically, you had two amazing brain scan images of women that were in their 50s.

So around the same age and one brain scan was of a woman who most of her life had eaten a Mediterranean-style type diet, and the other one who was more of a kind of Western diet and those images were so starkly different. Can you speak to what you've seen in these thousands of brain scans? You've done? And I this was something new to me.

I didn't know this, that we cannot grow new neurons. So how does this incredible work that you do if we can't grow new neurons? And maybe you can break that down. what can we expect to see in terms of changes if we start adopting from a nutrition standpoint, neuro nutrition and also, of course, lifestyle? Yes. So that was quite impressive to me as well.

When we started to in brain imaging in women who were like in their 40s and 50s and men as well, but I specialize in women's brain health. So the images are from two women. and as you said, we have now hundreds and hundreds of people in the study, and we keep collecting information on diet, exercise, sleep, stress, all the things that could make your lifestyle is either wonderful or terrible for you and for your brain.

Right. And what we find, not just for those two women, those were like examples. But what we we have shown in published multiple times is that women who eat more healthily show better brain energy or higher brain energy levels. They remain consistent over time. Yeah, less brain shrinkage over time in just healthier looking brains overall as compared to women who follow more like, the standard American diet, the Sad diet, which is so smartly named.

It is very funny because for that group of women, it look, our participants have relatively healthy. Yeah. So it's very unlikely for us to find a lot of comorbidities, you know, so we have a fairly clean, squeaky clean population there. Very few people have diabetes. Very few people have high blood pressure. No one has a history of cardiovascular disease.

Nobody has depression. So these are very healthy women to start with. Wow. And still we could see a different rate of change where the brain's the the women understand during this sad diet, are not as healthy to start with a meat life and then show more brain shrinkage over time they lose metabolic activity over time. And we also see that they tend to develop Alzheimer's plaques.

Wow in their brains about midlife like late 50s, early 60s. It kind of takes off at that point. That's accounted for everything else. So we we take into consideration physical activity, sleep, stress, everything is in the model. But when you just adjust, you kind of remove the effects of all these other variables by saying, okay, if everybody exercise the same, if everybody's slept the same, if everybody had the same amount of stress, what's the impact of diet?

And their impact was sizable. Wow. So that was quite an eye opener for me. And what's important to realize to your point is two things. Number one, the brain has a very specific diet. I hear this over and over again that people come to me and say, if I eat more days, if I eat more of that, is it going to hurt my brain?

More? Like, look, the brain is not a sponge. It's not like you just can push stuff inside your brain. It's such a fantastic organ that is so protected and shielded and and it makes its own decision is like your brain has its own mind also, when it comes to eating. And the way it works is that the brain is protected by something called the blood brain barrier, or at least some kind of, system that shelters the brain from the rest of the body.

And this barrier comes with little receptors in there, like gates that are specific for certain nutrients, right? Only some nutrients and not others. And then the brain opens the gates when the brain wants to nutrient, not when you want the nutrient. Wow. You know, it's an active system. Well, like when the brain is hungry, these gates will open and the nutrients will come in.

When the brain doesn't want this nutrients, the gates don't open, which is very interesting and fairly understudied. But we know that from a number of clinical studies and preclinical work. So number one, the brain has a special diet. There are some nutrients that are very important and very welcome, and other nutrients that can't even get in. And if you want, we can talk about of course, no, we're definitely going to go there.

But then the other thing that you mentioned that I think is fascinating is that the brain is quite different from other parts of the body, where from the neck down our fibers, our tissues are built to change very quickly. So from the neck down a tissue, tissues and muscles are body fat. The storage in the system is built for a change.

And that's why if you exercise, if you change your diet, you can change your body weight quite quickly. It could impact your body weight quite quick. You can lose fat, you can lose, you know it can build muscle mass fairly quick in a couple of months, right? You can see significant changes in the brain. Not so much because brain cells, the majority of brain cells are born with us and space stay with us for life.

There is a little bit of turnover in regeneration, but only in very specific parts of the brain. And it's just a little bit is not like your entire brain keeps growing neurons. Otherwise we would lose our minds. We couldn't be able to remember anything. We would have to keep learning things over and over again instead. And neurons are there for the long run, which means that your brain is built for stability.

And what that means is that for a lifestyle to have an impact, you need to have consistency. it's not going to take a couple of months because that would make us weaker. From a brain perspective, our brains would be too vulnerable to changes in the environment. So if you want to change your brain with life, some modifications with diet and exercise, that takes time.

But the benefits are for life. That's amazing. You know, consistency is probably one of my favorite words. You know, when I'm teaching and coaching and working with people and myself, most importantly, it's like success doesn't come from anything you do occasionally. It comes from what you do consistently. And that's so fascinating to hear that with our brains. And I love how you I'm just reflecting this back to you probably know this intrinsically, but like you have such an incredible way of framing things in the positive, like something that could you know what I mean?

You're like, oh my God, my brain's not going to change so fast. And then you're like, oh, wait, this is a good thing. And I'm like, oh, it's a good thing. This means it's more stable and we're less vulnerable. Yes. And so whatever changes you're able to make will be preserved. Oh, right. The brain would preserve them because our neurons are built to only change when the change makes sense.

In a way, unless you're doing something bad for a really long time and then you, you may actually negatively impact the health of your brain, which I think is very important when you make a choice. Like I like to think of my lifestyle as function and information as something that was helpful to me was realize that these nutrients are not just nutrition, it's not just something you eat for fun or that actually function, but most importantly, they are information.

So what they do is they they reach your brain, they go inside your brain cells and they travel all the way to your DNA. And then they talk to your DNA and will say I'm here, you know like let's say in omega three fatty acid, which is mostly anti-inflammatory, it can travel all the way inside the brain and activate a neutral genomic pathway where it says to your brain, I'm here to take care of the inflammation and go make more protein.

Right. But if it's not there, then the brain knows that there's a risk of inflammation throughout the body. And what anti-inflammatory compounds need to be made. Well so it's a little bit of checks and balances system. It's built I think it's very beautiful to the outside becomes part of the enzyme. It's quite poetic. And I think it is also really connective in terms of, I think a place that we need to go individually and collectively is that level of recognizing what is outside is coming in and what is inside can go out and like on a very deep kind of quantum physics level, it's like, no, it's all energy, it's all information,

and we're all stars. Yeah. Comes from the stars is so true. So another thing that I did not know that I was like, another thing to underline in Lisa's book was that the brain is 80% water and the body is 60% water. So I want to talk about because I feel like this is probably and I'm curious if you would agree to this, like one of the simplest, easiest things that we can do immediately to start taking better care of our health is stay hydrated.

And I'll tell you yesterday, on our team call on so my company, everyone is completely distributed. So we're always on our team meetings are on zoom. And I was like, guys, Mascagni's book. I'm like, everybody take a big drink of water right now. And I'm like, all water is not created equal. So let's break this down. I know you said as little as 3 to 4% hydration can almost immediately impact your brain.

And this is something that I realized recently. I love to dance and I love to work out. And there's times where I don't feel like I've adequately rehydrated myself after. And then I feel like I've got a headache, you know what I mean? I'm like, I gotta take a nap. And I'm like, oh shit, it's not because I worked out too hard, it's because I haven't rehydrated properly.

So walk us through this. Absolutely. And this is very funny because when I wrote Brain Food, I thought this was obvious in the thought. Everybody knew that hydration is so important for brain health. And I realized and nobody really talked about it. And everybody was fascinated by this knowledge because it's so intuitively like you can tell. Yeah, that that's the case.

So the brain is really mostly made of water. And water is effectively a nutrient for the brain because it's needed to power every single cellular reaction that takes place inside the brain is the medium that provides cushioning for the brain, shelters the brain so that if you hit your hand, you know you don't get a hematoma away. But but also it really has, a nutrition, a trophic effect in some ways in which interesting is that even just mild dehydration, which is a 2 to 4% water loss inside the brain, right?

Not just in the body, but specifically inside the brain, can trigger neurological symptoms from headaches and dizziness, migraines. Vertigo is brain fog, mental fatigue, which I deal with a lot because a lot of participants, a lot of patients come to us for brain fog and those. So this is interesting. So we do brain scans and it is a type of brain scan.

It's called a Pet scan. Put where we need to do an IV. It the first thing I do with every single patient who walks in the door I'm like, okay, when is the last time you had a glass of water? Actual water? Don't tell me purified water. I don't care about seltzer. It's so that it's not worth. You know, I was in the bay, like 2 or 3 hours ago.

Great. We're going to drink a nice glass of water. Hot? Yes. Warm water is a vasodilator. So what it does is that it makes events pop. So number one I can get the line here much faster. But also for you you really support rehydration. So if you ever feel dehydrated warm water is the best way to get the electrolytes in and give you volume.

Wow. Yeah I didn't know that. Yeah. Yeah. So that's a good trick. So let's talk about because the kind of what are you drink matter. So I went down this big rabbit hole. So from other testing I've done, I learned that I've got some excess old lead in my system. Yeah, right. Same. Get out. Same. And so, we have in two places we have reverse osmosis.

And I was like, oh, so, you know, the the reverse osmosis, you know, great for getting out contaminants, great for getting out different things that we wouldn't want to be drinking. Not so good because it takes out some of those essential minerals like the magnesium. Right. And and calcium. So let's get down to brass tacks because I know in your book, you know, talking about natural spring water.

Amazing. If we can best bet we can do so if you're going out to dinner or you're going out, or you have an opportunity to have that in your home, all thumbs up. Wonderful. Yeah. What is your opinion? And I'm asking, this like personal questions for me. What's your opinion on the best ways to get some of those electrolytes or those core minerals back in?

and this is not about particular brands. I'm just gonna say it because they're easy for me to get. But we can talk broadly based on where people are in the world and they can find things that are good for them. Like, I know obviously a lot of electrolyte and, things that you can pour in your water that I've been doing, like I've chosen sugar free versions, you know, really looking at the ingredients to go like, what's the simplest?

The sodium. Yes, the simplest things that I can put back in this to give my body what it needs. Because I know that the water coming out of my filter is it's purified, but it's stripped of all the minerals. Yeah, that is unfortunate. You know, one thing you can do that we did was to call the city 301, and they come to your house and do the testing, and then they give you a list of possible filters.

They you can put that under the sink. Oh, really? Yeah. We have one for the entire house. Okay. Now I'm going to do that. Really? Well, it takes all the impurities and heavy metals out but leaves the electrolytes in. Oh great. That's a big that's okay. Yeah. But it's it's something to do. I also was looking to and Josh and I were looking at this and I was like, oh there's Remin or Eliza's.

Have you heard of those. You. Yeah. What do you think of those? I don't there isn't a lot of research on it. They make sense to me. In principle. The question is always the sourcing of what are like the sourcing, the origin and how complete that might be. So in invoice it, of course we know that there are some salts and minerals, but there's a lot of compounds that have never been tracked or studied.

Okay. So there may be more to water than just those things that they're realizing. Well yeah okay, so I did, but I'm not sure. So I would like to see more research. More research okay. But last question on this one. Just because again, I think it's it's in are everything important? Yes. I think it's important to realize that your brain doesn't just want something wet.

Yes. So and water mains fluids. Yeah. With nutrients that can promote hydration. Yeah I know this sounds weird, but seltzer doesn't have any. And this is carbonated water does. Yeah. If it's naturally carbonated from a spring source like San Pellegrino, which I'm not promoting, I don't know that I'm like, yeah, yeah, no, no, no. It's just as an example that's a natural, a natural spring source that just happens to have bubbles.

Yes. And that's why I wanted to talk about this, because one of the things I think I always get frustrated with, not with your work by the way, but whenever work, I'm kind of going down a health rabbit hole here. I'm like, yeah, but I need to know what to do. You know, any like, I need to know exactly what my options are.

And so that's why I wanted to just open this up, because I'm sitting there and y'all know we all know what the internet is like these days. You don't know what the hell you can trust. You don't even or what you can't trust. So the last thing I'll ask you is about, and again, it's not about this particular brand, but it's the one that I have access to.

It's like these Volvic minerals that you can put in. It's called black, and you can put it in your water. I'll show you offline. Okay. But, when I went down that little research rabbit hole, it was about the electrolytes and putting minerals back into our water. That makes it. I think that makes a lot of sense. I think if you have access to clean water.

Yeah, even tap, that's great. If you don't, that's a perfectly variable route. Yeah. And yeah, if you can't access spring water obviously that's great. It doesn't have to be fancy. Yep. But you can go to target and it's not super expensive. I mean tap would be better, but a lot of people unfortunately don't have access to clean water.

So I think in that case, yeah, rehydration salts and minerals, can be helpful. Coconut water is another really nice way to rehydrate. It is sugar. Yeah, we got to watch out for that. I remember, you know, I was in the grocery store yesterday, actually, after I washed, I had driven for a few hours and I came home and I felt it, and I was like, I went to the store.

I was like. And I looked at it like, holy, you know, it was wet. This particular brand was way too much sugar for me. So I was like, I'm going to put that down. But you also noted, aloe vera juice. Oh, I love it. Yes. So that's another way. Your local health store. That's another very nice way.

Another one. So this is always interesting to me how in this country a lot of people have said to me that they don't like to drink water and because it doesn't have any flavor. I taste it and I like the people in Italy where I'm from like oh this is this kind of water and this water is not as good at this other world.

Right. Yeah. So I think your palate has something to do with that. Perhaps, but something that I find interesting, especially now that my daughter is little and sometimes she would like to drink something else, not just water. I do liquid chlorophyl. Oh, minty. Yes. Minty. Chlorophyl. And I think that that's also nice in terms of rehydration and like little drops.

And you could probably get them in the store on Amazon. On Amazon. Yeah. Easily. Like a teaspoon. Makes everything taste minty and fresh. It looks green. So it's kind of cool. Yeah. But it also the specific brand and thinking about in this that I thought was a good one, very clean. also contains salts and minerals. So you want to say it because people are gonna almost say in the comments, What's Lisa like?

I don't recall, I don't recall. Okay, we'll find out and put it in the comments. I yes, yes, I remember exactly what the body looks like. But now I'm kind of blacking out and the actual brand will find it. No, I know there's so many things out there, so, so let's keep going and talk about some of like the best and worst foods for our brain.

So we know that water a yes hydrate hydrate hydrate be let's get it with those electrolytes and minerals in it. And in terms of food for the brain. And again, you go into so much incredible detail in your book. So for all y'all, you want the big, full on, you know, uninhibited less you have to pick up the pieces.

But we're going to talk about some, some top line things. And then I want to mention one thing that surprised the pants off me that I want to dig into more. So now I'm curious. Yes, but tell me, what are some of the top line things, like when it comes to, let's say, amino acid profiles? What are the foods that give us the best support for mental clarity and sharpness for life?

There are several nutrients in there for foods that contain the nutrients that have been shown time and time again to be associated with better outcomes. When it comes to the health of your brain, where the outcomes can span from, better mood to better sleep to better cognitive performance, and there's a whole range and there really are whole foods.

and that is really important to say in, in nature provides for us in diversity is key. So there are so different types of apples. There's so many different types of nuts and seeds and whole grains and legumes. And animal food is a different story. But that is helpful to, can be helpful if if you enjoy animal foods as well.

I would say my top five. Yeah, I actually on the cover of the book. Yeah. And I'll tell you the the number one is caviar. Yes. That was the one that surprised the pants off me. Can I tell you I have literally never had caviar in my life. Never had it. So I was like, okay, I need to go shopping.

And either I don't want I know it's expensive. I was not trying to sell caviar to people for sure not. But you're a scientist and yeah, we got to be mature, you know, like we have to have conversations where it's like, not everybody's buy everything. And I never buy something like everything. And everybody's got, you know, I love there's a term.

It's like the bio individuality. You know, my best friend in the whole world, she's like my soul sister. She's a vegan. So she's been for a long time. Yeah. So it's like I, my friends, all of us, it's like we're eating it to the best of our ability in a way that we believe. Yes. That works for you.

Yes. But is the health fullest or most helpful for ourselves? The planet, like everything. Like we're doing our best. So any, you know, doctor Lee Saint telling us like go out and do like this, I so I mean, I misspoke, I was vegan, you were vegan. Yeah. I've been a vegetarian for a really long time, but an Italian vegetarian.

So I do eat fish. Yeah. On occasion. And but again, I'm not trying to say you had to buy a car that I'm aware that is expensive. I'm aware of the way that is produced. I'm aware of a lot of things. I was talking about the neurochemistry. Yeah. Let's talk about that again. This is important to talk about.

We can be sure and know that there are considerations. It's. Yes. So eggs. Yes. In general, regardless of source of provenance, are a fantastic brand food because they're high in lean protein, complete protein. They're very high in fat especially fish eggs because they're high in a very specific type of fat. It's called omega three fatty acids are polyunsaturated fatty acid, which is basically the best brain food with the best brain fat.

Right. So this is what I was talking about before about this little gate that open and closed. So the brain very specifically needs polyunsaturated fatty acids for function. Because all the membranes of your neurons are made of saturated fat and polyunsaturated fat. But whenever a cellular reaction takes place, like synaptic activity is the polyunsaturated fat that is being consumed.

The saturated fat lasts for a very, very long time. Is that the myelin. Yes. The analogy but also when you look at the tip of the neuron, there's a part that's called the synaptic cleft and the synaptic button where the neurotransmitters come out from while so yeah. So it's literally the membrane folds in to make like a little pouch that is filled up neurotransmitters.

And then the pouch is released in is like a bubble that bursts in the synaptic cleft. And all of that is fat and protein, fat and protein, fat and protein. So there is quite a bit of cellular turnover in the kinds of fat that are being used to make the membrane and rebuild the membrane. are based on polyunsaturated fatty acids, predominantly omega threes, Mega sixes.

A mega nines is a lot of different types. Yes. So that's the kind of brain fed that the brain really wants and needs. Whereas a lot of people are surprised to hear that cholesterol can't get inside your brain. there are no gates for cholesterol. And I think it's important to clarify that because many people are aware that the brain has a lot of fat, contains a lot of fat, and then the assumption is that you need to eat a lot of fat to replenish with other fat is in your brain.

And I'm always like, no cholesterol and no saturated fat so much either. So the gates for saturated fats are quite open when we're little and we're children, but they're kind of they're not very responsive as we get older. Interesting. Yeah. And there are no gates for cholesterol. Why not? Because the brain makes its own. Yeah. So salvation complete.

Yeah. In terms of cholesterol. Yes. And then it really shields the cholesterol away from the rest of the body in the circulation. So there's some cholesterol, can come out either from the blood or cerebrospinal fluid, but no cholesterol can get in unless there's a damage. Well, in your blood brain barrier. It's huge class. So it's a very big, chunky molecule.

So it's more efficient for the brain to just make its own interesting. And so okay. So fish is great. So fish is great. Any food that contains omega three is really so almonds hazelnuts I love hazelnuts. Me too. You too. Oh, my. I love chopping hazelnuts and like, dark chocolate salads. Oh, you get about it like hazelnuts that can't even like I got to watch myself.

But also. Right. Chia seeds. Chia seeds are good. Yeah. No, it's really surprisingly good. green peas. Yeah. For omega threes. No. This sweet. Yeah. Yeah. So they're good sources. phospholipids. They're they're bound to the omega threes. Amazing. Surprising. And they're also quite high in protein. So for vegetarians vegans that's actually a good source of brain fat I love it.

Walnuts too. And I was walnuts. Is it so soy soybeans. Yeah. No I mean edamame. Really good. And what do we think about is there really a distinction there with black walnuts versus regular walnuts or not really a little bit. You know, I say when people say brown rice is so much better than white rice, but the amount of fiber is not, you know, yes, it's better, but it's a subtle difference.

In some ways it isn't a ton of fiber, right? Whereas if you get a red rice but a black rice, now we're talking. Then there's right now it's like party on when it comes to and there's more fiber. Yes. Even bedroom with berries or spelt. Okay. There's more fiber. They're great. Yeah. With the spelt has more protein than quinoa.

Oh, wow. Yeah. And it tastes so much better now. Yeah. Okay, so that has to be on my list because my tummy is not happy with all the other. Thank you for all the good ideas that came on. It is okay. So let's talk about what's the number one nutrition tip you have for brain health. Like the thing that we should stay away from.

Oh away from. Can I tell you what my number one tip is for the pro for pro brain antioxidants okay. Yes. Tell me tell us. The top one of research. A ton of research has shown that antioxidants are extremely important for brain health. Why? Because the brain is the most metabolically active organ in the body and neurons do not regrow.

So what happens when you're metabolically active and you burn glucose for energy is that inevitably you're going to suffer from free radical reduction, and increased oxidative stress is just a byproduct of running on glucose, right? The same when when you, with regular fuel cars, there's anyway you get more, and so what's really important to realize is that the oxidative stress will damage your neurons in the long run.

and it's really important to counterbalance that kind of rusting effect. And the only way to do it is to bring in antioxidants from your diet. And there's a ton of research, in my opinion. There's plenty of research to suggest that a diet rich in antioxidants is really supportive of brain health. And we see that with the brain scans, with brain imaging, especially for women in our studies, to be replicated, to be confirmed, at least in my hands.

the intake of antioxidant in the diet is strongly, indirectly, correlated with brain energy. Wow. In midlife. We work with women who are like 30 to 6570. Yep. And yes. And I think that's really important because brain energy I mean you can't do anything not to think right. Absolutely not. Right. It like leads. It's like a domino effect which we'll start talking about.

But okay. So to me see vitamin C but I love vitamin E I think is really a little bit underrated when it comes to brain health. But the research shows that it's really a supplement or food form. Like let's talk. Yeah, let's talk about real food sources for both. so the overall recommendation is to get your nutrients from your diet.

Yes. In part because the nutritional synergies and in part because we haven't fully mapped out all the phytochemicals in foods. So antioxidants for the vast majority come from plant based foods fruits, veggies, not blackberries. Wild blueberries. Yes yes yes yes. Goji berries. Goji berries source of vitamin C, Amla. The Indian type of mulberry. Yes I'm going to say that out okay.

Goose fat amla and is probably one of the best sources of concentrated sources of vitamin C that you can find in foods like antioxidants. And then I would say coffee. Yeah, it's a great source. And that's the nectar of the gods. I mean, I was like a cow. Oh yeah. Right. Come on. Also really good source of antioxidants.

Yeah. So you can have a good time. You can get all your antioxidants and have a really good timing. Oh, for sure. Yeah, sure. They eat the rainbow. It's like an antioxidant. So yeah. Leafy greens, dark leafy greens usually are a good source of antioxidants as well as spinach, kale. Yes. Oh, sorry to all the rainbow leafy. Yes.

The skittle of the of Whole Foods. Just not Skittles. Speaking of. Yeah, yeah. The worst of the worst of the worst. And I was guilty of this for so long. So y'all, when you hear this and I just want to tell you about my recent journey, go for it. well, processed foods, heavily, highly processed foods have been really strongly correlated with increased rates of cardiovascular disease, stroke, diabetes, obesity, and to some extent also with dementia.

Yeah. And they also have been linked with an earlier onset of menopause for women and reduced reproductive fertility. And yeah. So anything processed. So obviously if it comes in a bag, if it comes in a box right. Yeah. If you look on the back you don't know what the hell these ingredients are. You can barely pronounce it. But I think this is important too, because I think for years I kind of let myself slide on this one.

as an Italian American, there's a lot of really yummy deli meats. Okay. Well there's chocolate chip cookies. There's all of like, you know, again, in this country, like we're here in Soho and in the West Village, there's an Italian, for lack of better word, a place that does the most amazing sandwiches. So it's got the salami, the mortadella, this, the that any other.

And you're just like, yeah, no muss. Right. Can't do it. It's like terrible. So can you break down? It's not just the stuff that's in chips and crackers and all that stuff. It's also food that's highly processed, like the bacon's the sausage for sure. The deli meat. Delany. Yes, yes. But also you know, Wonder Bread. Yeah. They're kind of bakery goods.

So they're everywhere. Yeah. It's incredible. There's I mean I can't say specific brands. I think it would be unkind, but like, you just look around. They're all sorts of candy and treats in the dough. And, then you know what they are, but they're like muffins on the go. Yeah. Things that are just packaged and last forever. Yeah, it's something last forever.

It can't be good for you. It can't be natural. Yeah, that's a good rule of thumb. Also, if it has really weird colors, I think that's a good way to is bright green or bright blue. It's very hard to make a natural dye that looks that color right. Unless it's like blueberries or blackberries. It's they don't look bright.

No, that's true. Right. They look more like darker and saturated. Yes. Yeah yeah yeah yeah. So that's it. Like for my daughter I always said this to her. Did you see what color do it. Is it. Sure. Okay okay. What a great way to teach her. That's awesome. Gets it. And that's you know it's good to provide healthy alternatives.

So it's not a deprivation you can't eat. That is more like why don't you have that instead. Yeah. So in there now she's happy and she eats everything. I mean, the other day she was like, mommy, what are my dreams? Oh yes, ma'am, that is. Yeah. It's my soul. not surprising coming from you. Okay, well, I want to shift gears and talk about menopause brain.

Yay! So congratulations. Thank you, new York Times bestseller. So many different bestseller lists that you've hit. Yes! How frickin awesome. It's fantastic. I know you look surprised. You should not be surprised. I was surprised instant. It was an instant New York Times bestseller, USA bestseller in Canada and then in England. And there was I was, yes. You know, like the reason I was surprised.

It's a good book, I promise. I love it, but it's specifically about women. Yeah, about menopause and about brains in menopause. So it's kind of like a very specific target audience. Yes. Right. And I'm so happy that it's it's been well received. It has been. And it will hopefully continue. And I hope we got a lot more folks getting their hands in this.

From a business and marketing perspective, it's actually the best way to sell anything is the more specific you are, Yeah. So so again, home run, you open up with, this nice little subhead, which I loved. Am I losing my mind? And then a portion of your sentence between the ages of 30 and 60, many women will wake up one morning and wonder what hit them.

Brain fog. Not being able to remember words or names, emotional darkness, depression. So a lot of women feel like this. I've certainly felt this and was like, what the hell's going on? Like, are we losing it? And one of my underlines in your book, you say, the truth is women brains are not the same as men's brains. They are hormonally, energetically and chemically chemically different.

Can you break that down and talk about why it is so friggin important for every woman between the ages of 30 and 60 to educate themselves on that fact, on the fact that their brain is different and it's important to pay attention to it. Yes. And this is actually the main focus of my research is really about women's brains and the reason being is that I have a family history of Alzheimer's disease then impacts the women in my family and my grandmother, who was one of the very first women in Italy to go to university, graduate from university, and her two sisters who also went to university.

I mean, it was so adorable. They would say that every morning they lived in Parma, but they had to go to school like hours away. So they would just wake up at dawn to catch the train. You know, it was in the 1950s, I suppose, in Italy, and she was so brilliant and so bright. But then she started showing signs of cognitive decline, which ended up being a diagnosis of dementia at that point in Italy.

But it was obviously I mean, it was so textbook out simmers now, did I know more about her assignments? And then her two younger sisters also developed dementia, Alzheimer's disease, and died of it, whereas their brother was spared even though they all lived to the same age. Wow. And that brought me to ask a lot of questions about Alzheimer's, but also about women's brain health more generally, and what I think the most interesting take away from our research, and from everything I've learned in more than 20 years of thinking about this, is done.

Thank you, said women's brains are not the same as men's brains. But there's this misconception. In medicine and in neuroscience, the sex does not matter and that women are considered like smaller, more emotional men with different reproductive organs. But just those reproductive organs notwithstanding, everything else is supposed to function the same way and grow the same way and age the same way.

And that is just absolutely not true. So what we've learned it. You've seen this graphs where they show age over here in brain cells or neurons up here. And then they say, oh, you know, it's pretty much stable in midlife. And then you just go down a little bit linearly. It is a little bit you lose a little bit of neurons every year.

But we say we talk about this all the time. Absolutely not. That's a mean. That's what happens if you're a man. That's a man's brain. Yes. You're stable. Go down a tiny little bit unless something happens. Of course illness and neurological disease sets in for women. It's a whole different thing. And I wish I could draw it for you, but basically, we're born with a ton of neurons, like a lot of nodes.

And then we hit puberty. And from then onwards, aging does not look linear. Let me tell you, a puberty for both girls and boys, the brain shrinks. But the timeline is different. For girls, that happens earlier and it tends to coincide with puberty. They will reach a peak on neurons and then which is shed. Its interest is called pruning.

Yes. And the louder neurons are being discarded. And I have a whole explanation for this if you're interested. But for now, we lose the neurons in the connectivity in the brain, changes in brain energy levels. Change is a lot of changes. But then what happens? The boys, the brains kind of settle down and you keep going. For girls, we get the menstrual cycle.

And what people don't realize is that their brains, as women, are profoundly connected with the ovaries. So much so that every time your ovaries cycle throughout the month, your brain micro cycles, it's really in sync with the sex hormones that come out of the ovaries. Go straight inside the brain and convey messages to the brain in the brain.

Since hormones back right down in a feedback loop, that is really important not just for menstruation and fertility, but also for brain health. And that's for your entire life, your entire reproductive span. And then let's say you get pregnant, right? There's this neuroendocrine system that connects the brain with the ovaries that get super over activated every time a woman is pregnant, where your brain is having a party there, right?

In many ways, I mean, you get all these wonderful hormones and there's this boost in a lot of different things, but then everything crashes down once the baby's born, and there's a phase that is quite hard on the body as it is on the brain, the postpartum phase. Every time a woman gets pregnant. And guess what? The brain loses neurons when we're pregnant.

Even more after the delivery. And then there's a little bit of a recovery, but mostly there's a rewire and just all these changes that take place and they keep happened. Then you get back your menstrual cycle, your brain keeps cycling until you hit menopause. And people think menopause, which by the way, every woman goes through menopause, whether it's part of aging or because medical interventions but all woman, all women who live long enough go and go through menopause.

And we think menopause is something that is more like one day on the calendar. Right. We think about it like puberty. One day you get your period and you're an adolescent, you're a teenager. But menopause is a process that can take at least ten years from start to finish, because it starts a few years before the final menstrual period.

And for many women, it takes a few more years for everything to kind of adjust and settle down. And then your brain needs to basically regroup, because now all these beautiful hormones right there will keep your nose healthy and young and energized and severely reduced, and you need to find another baseline and keep carry on. So it's much more like a stepladder.

I would say if you're a woman and we don't fully appreciate the impact the having ovaries has on the brain, one of the things I love about your framing of this, and I want to thank you for it, because when I read The Menopause Brain, it was really the first messaging that hit home that there was possibility of, like, optimism and upsides, because I feel like especially in maybe the past few years, you know, there's a lot of menopause talk and this is awesome.

Like this is thumbs up all the way around discussions, understanding and talking about all the different ways that all different women can navigate this particular transition. But, I haven't heard much about how coming out on the other side that we can actually be stronger and better. And so I feel like you have such a great sense of humor, and I want to get into the upside of menopause.

What can you tell us about menopausal perks? Yes, I think it's important to put everything in context. So the first thing is that the menopause brain is a brain in transition. Right. So menopause is a neuroendocrine transition state, which means that your brain is changing just as much as your ovaries are. And your endocrine system, your hormones system and every endocrine state neuroendocrine transition state comes with pros and cons.

And we're used to really focusing on the cons and not really talk about the pros. Whereas I think it's important to have a balance right. So what are the downsides. They're obvious especially when it comes to the brains the brain symptoms of menopause, which a lot of women don't know it. They come from the brains are just that.

So when women say that they're having half flashes night sweats, insomnia, depression, anxiety, brain fog, memory lapses, those are all neurological symptoms of menopause. They have nothing to do with your ovaries. those are signs that your brain is being change, is being rewired and transforming because of menopause. Right. So those are neurological symptoms. And they do impact over 75% of women.

So more than three out of every four women experiences at least one neurological symptoms. And there's more than 30. I have a whole list in the book just because it's important to know there's certain things like tinnitus could happen as you go through menopause. And it's not your ears, right? It's your brain that's creating those symptoms or skin crawling sensation.

It could be really scary. he like your thermoregulation, is all over the place, but you can have electric shock sensations as well. Wow. Which is a neurologic cause, is more rare, of course, but there's a whole range and menu, a sentence that comes from menopause that are neurological in origin. And we don't know how to talk about.

We don't. Most women don't know why they're having them, and most physicians don't know how to address them because menopause is usually ob gyn, veteran and big guys. They're not trained to be fair, to manage your brain health. Right. That's what neurologist psychiatry psychologists do. But then brain specialists are not trained to manage menopause. Right. So we are a little bit in the soup in that respect.

But things are changing. So those are the downsides. There are upsides because these transformations have an evolution in evolutionary significance. There's a reason that they happen. And I think the best way for me to explain it is to compare menopause with puberty and pregnancy. So with puberty the brain is shrinking, the connectivity is changing, energy is changing as well.

And there are symptoms. We all know that adolescents are foggy brain. They have trouble concentrating. Sometimes there's sleep is all over the map, and there's this feisty emotion. So how you track them in Rex's reckless behavior, there's a lot of crying and big emotions may feelings, but the same transformations they trigger those symptoms in the brain are really important for the brain to strengthen some connections in the theory of mind networks.

Now, theory of mind is our ability to mentally or to put yourself in somebody else's shoes, which is the fundamental basis for becoming a grown up and living in society. So the symptoms are a side effect of this very important transformation that your brain is undergoing, not just your body, but your brain is undergoing. So do you able to take care of other human beings.

Yeah. So that's the perk. the teen brain or the teenage brain. Something similar happens in pregnancy. The brain shrinks another time and the connectivity is changed so that the same exact network, the theory of mind network, is strengthened even more. Why? Because there's a new mother with a child who can't speak for a very long time.

You need to be able to literally read minds for a long time, and you need to be able to protect this child no matter what. So your intuition is up to the roof, right? Your ability to foresee what's going to happen is off the charts. Your ability to multitask and plan and function and no sleep. Your endurance is improved at the same time.

You may have mommy brain. You may feel sad. You may feel weepy. You may have postpartum depression. You can have the brain fog. 30% of pregnant women have have flashes, is the same brain is the same system, the neuroendocrine system that is impacted by hormonal changes. And now we get to menopause. Menopause is the same process from a brains perspective in reverse.

So now all these neurons that were so important to give you a menstrual cycle, right, to support a pregnancy should a pregnancy occur. Who gave you these instincts when you're a mother, when they made you capable of taking care of your child, this is known as the need. You just don't need them anymore and is a brain. It's very expensive to have a ton of neurons.

So in my opinion, menopause and other people's opinions. Of course, menopause is a biological clue for your brain to go through pruning again, shed all these neurons that are not needed anymore and and rewire all these different neurons in a different direction. So yes, you have the side effects. It unfortunately, which can last a while because the transformation takes over.

The remodeling takes a while, but the renovations take longer than we want them to take. Yes, yes. Especially because you can't you know, your neurons need to stay with you for another 30 years. Yes, yes, yes. So you better go. Come. Yeah. You want you don't want to make mistakes, right? Take your time. But the idea is that these changes will prepare women for the next phase of their life, which is not reproductive, but is supposed to be productive.

Yeah, right. So your ovaries can close down shop, but your brain needs to keep going. Yes. So it is rewiring. In a way it's helpful because there are neurological changes that take place. This seem to give women more empathy, more calm, more peace of mind, and more emotional mastery. Yes, and I love it. And in your book and you said the polite version, I will say the full version known also known as giving fewer scenario, which is fantastic.

And I loved kind of how you threaded all of this together, because my friends and I, we often talk about this and I have friends, of all age groups and but I've noticed and I've watched and witnessed especially friends, that are older than I am. I'm like, oh, oh, oh, you know, like feistier and fiercer and more transparent and more just know this versus this versus this.

And I love it. It's like beautiful and amazing. And so when I was reading this, I was like, yes. Emotional mastery, also known as giving for the brain, is growing leaner and meaner, discarding information and skills that we no longer need and growing new capabilities that we do. I Love You also wrote interests, priorities, and attitude shift in a positive way.

This notion of like a second adulthood, for many a rush of physical and psychological energy and, Oprah's quote, it's a moment to reinvent yourself after years of focusing on the needs of everyone else. Those are all amazing. Like. And I feel like I'm so happy that you have highlighted this and also are shining a light on it, because we do need a more balanced viewpoint of it.

Yeah, because otherwise the entire focus besides this narrative of menopause is the beginning of the end. Yeah. Which is good. Yeah, yeah. But also then the focus is all about treatments. Yeah. Right. If you don't also have a balance in your understanding, not menopause is and isn't, then you just scared about the sentence in, you're just going to obsess about getting this treatment and that prescription medication.

Which is not to say that they're not helpful, of course. Right. But I think the spirit or the attitude matters. That's where your mindset matters. Yes. And knowing that there's an evolutionary reason, according to many scientists and many clinicians, for women to go through menopause is important because so what most women don't know, to be fair, is then menopause is quite unique.

If you have ovaries. Menopause is a fact of life, but in reality it's a little bit of a biological riddle because all over the planet, most females die right after menopause, right? So the end of fertility queens sides with the end of your lifespan. for almost every female animal species on this planet, except a handful women killer whales.

I love that you know how it is. So cool. nor also believe another type of whale. Some whales, a type of giraffe. A type of elephant. The Asian elephant. I love elephants, and they're so adorable. And an insect, the Japanese aphid, which I don't know if you've ever seen one. No, I don't know if I have. I hadn't until I was looking, you know, because the menopause.

And what happens with these little things, then as they, they become known fertile, they sprout spikes, they turn, like, into a kind of chestnut, like, do not touch me. And I mean, that is really, really funny. They they go from looking like a bug to a kind of. That's a hedgehog, you know? Yes. Okay. Two things I do want to talk about some practical steps.

Yeah. and then I want to get back to mindset, because that's the place where I feel like it's so, so important. And again, we haven't had enough light shining or emphasis on that piece. So in your book, you talk about a lot of very practical steps for women to take to take care of themselves and their brains during this transition.

Things exercise, stress reduction supplements, botanicals, and even self-talk. I like the botanicals. Oh, I love the botanicals too. I feel like I can so see that. And your design and everything. And I even that word I love. Like anything with botanicals, it's like a little magnet for me. Like I'm a sucker if it's one of my favorite, like, pieces of skincare, it's like all botanical based on like, yes, I'm in.

okay, exercise. Let's talk about how much exercise we really need. weightlifting, which I'm a huge fan of. Gentle. How does exercise impact us and what does the research tell us? Yes. So first of all, there isn't a ton of research as you can imagine. Right? But the research that we do have shows the different types of exercise may be more helpful for specific symptoms or specific needs or challenges.

Different menopause. And there's three major exercise groups that have been identified as being beneficial for the menopause brain and just the body. Overall. So cardiovascular activity like cardio seems to be quite effective for hot flashes and for brain fog. Weight training and resistance training is obviously helpful for bone density, muscle mass, but also for mood. Seems to be really uplifting and energizing in terms of mood and, and then just flexibility in balance exercises and mind body techniques like yoga, pilates, tai chi and more gentle if you will, exercises that require coordination and posture.

Yeah. See where form is really more important than intensity in some ways. And those are helpful for stress, for stress relief and sleep as well as flexibility. So ideally one would do everything. Yeah right. But if time is a constraint as it is for so many women, then I think it's important to know that some types of exercise may help more or less with specific concerns.

Yes, and you can always find ways, I think, to mix them up. Yeah, you can do weight lifting. That also stimulates cardiovascular activity completely. Do it right or the other way around. You can walk but with a heavier, you know, with a vest with a weighted vest on. So this little gangster ankle. Yeah, we can answer size like that was one of my favorite things.

So I'm going to go to Florida in a few weeks. And I feel like I'm going to put on my ankle weights and just prance or size my ass all around springs or palm Beach. I love politesse me too. You know I do, I do, I love that I love yoga. Well, I, I actually change it up because, I have a little bit of an ADHD brain and I just like variety.

So weight training, dance, yoga and Pilates are like, I just kind of cycle through. Yeah. And you don't even, you know, because it has to be sustainable. Yeah. I think with most important is something that you can do consistently. There's that word again. Yeah. It's a magic word. I think it's important. You know, there's nothing you can do for a couple of weeks that will have a long lasting impact.

And again menopause lasts for years. Yeah. So if exercise is one way that we want to support our brains and having it have a gentler menopause, then I think it's important to find things that give you joy. That is not a chore. Yes, right is something that you want to look forward to. And for me, that's polite. I even got a reformer.

Oh, in your house? Yeah. Good for you. And we just get to treat me like a bigger trainer because I love practicing running yoga. I'm not into weightlifting at all, but I'm trying. I was taking with JJ. Yeah. And she was giving me a little tip, so I had to try decide to try it out. You know what?

You're here in New York, right? Yeah. Yeah. I'm going to take you to class. Oh, you're going to come with me, and I think I can. I'm really good at that. So one of the things. Am I going to die? No, I would not take you to anything that would potentially make you. I wouldn't even take you to anything that would, like, be scary.

I'm only going to take. I only took friends to, like, super joyful things. But my really dear friends, I always know I'm. I'm really good at helping people kind of move through little challenges, so I will we'll talk about it when we're done. Okay, now I want to go to mindset because, it's so fascinating to me and I love how you put a lens through other cultures.

No side of here in the US. And you know, I love our country. I love being in the US. I love being American. And, you know, there's every place that has its pros and cons. We have some awesome, amazing things and we've got some things that are challenges. Yeah. So, you write what I find particularly striking is the complete absence of any sense of achievement or gain and status associated with becoming menopausal.

how many societies in the East and West see this milestone as a kickoff that moves you to a place of honor? So my my favorite thing was this Konecki. And if I'm not pronouncing that right, someone will correct me. That's cool. But the Japanese word for menopause, what does it mean? Renewed energy? Oh come on, this is a season of renewal and energy.

And I thought it was interesting. You noted that, only about 25% of Japanese women report experiencing hot flashes. Now, of course, we don't know if that's about the reporting or whatever. Just interesting to note, I think it's interesting to note that in Japan, the most common complaint in menopause is frozen shoulder. Interesting. Yeah, it's more like aches and pains.

Joint stiffness. Yeah. But there are other societies where women also don't really report hot flashes, but they have like in some parts of India, the major concern is vision that they can't see as well. Or there that could be aging, but it seems to really be part of their menopausal experience. Then there are some societies and groups in South America where women have no symptoms, even though they tend to go to menopause through menopause earlier.

Fascinating. Yeah. And their hormonal levels are all the same. So it's not like for us there's a drop in estrogen that is more severe than men in other countries. It's all the same level of hormonal concentration in a way. And of course in our lifestyle plays a role. Culture plays a role. Diet. The genetics obviously play a role, but I think it's really important to know that the the experience of menopause is not universal.

Yes. And there are women who do not suffer in Europe. All the studies showing that life contentment actually improves after menopause and remains higher and higher and higher over time. This is what I'm talking. We're done in Europe and I think the you know, there's not like there's so different from us. Yeah, yeah. Many it's just not that different.

I think it's so cool. Like I know I'm, I'm getting on board with that, that one of my fascinations is in life and like my book, everything is figure out is like this. How this one simple belief can help you change your life in the world. And I'm like, look, beliefs are just these thoughts that we think again and again and again and that we believe are the truth.

So, you know, regardless of whether or not we can quote unquote, prove it, I'm like, I'm going to pick some good to believe because it absolutely has positive impact. I've seen it in my life. So regardless. So I love that about the life satisfaction. And then I love the rural mind, women who actually gain in social status after menopause.

And another thing they don't have, they don't report symptoms. I thought that was I was like, let's go for mindset, let's go for this mindset. And I think it's a well known phenomenon in science that there's a placebo. Yeah. But there's also nocebo. Yes effect. Right. So if you think this something would be good for you, you may experience a positive effect even though you're just taking a sugar pill.

But if you think that the same sugar pill will give you side effects, it would be harmful to you. You're more likely to experience a negative change. So we think menopause is something that can harm us, is something that we have to fear, is something that needs to be fought, something that needs to be avoided. It's possible that the experience will be worse, yes, and of would have been otherwise.

So I think mindset just in general, I think the way that you experience and go through life, it's a powerful determinant of how you yourself react to think that the same thing can be very upsetting or not. Yes, it's something I've learned from meditation. I love meditation, which is strongly recommended, is to practice non-judgment when you're having a hard time or mentally, especially just look at the same situation without any judgment, right?

Do not evaluate it as good or bad. Just look at the thing for what it is, and that sometimes just takes some of the anxiety away. And that leads to relief in some ways. And I'm not being I swear, I'm not being patronizing or downplaying the severity of the symptoms. Oh no, of course not. Absolutely not. It just one more tool.

Yes, there. We may consider to feel better and support yourselves as we go through menopause. Look, what are going to go through it 100%. Yes. So it's important, I think, to spend those years because we're looking at years. Yes. As happy as we can. 100%. Yes. No. Brilliant. So, we've covered a lot of ground. and I want to wrap up and I'm going to ask you if there's anything else that you want to leave us with.

I obviously highly recommend all your books, and people can just kind of pick or choose whichever one they want to start with. but I loved at the end you wrote, are you losing your mind during menopause? No, you're getting a brand new one. And I was like, hell yes, Lisa. So is there anything else that you want to wrap with today or share with our audience?

what everybody wants to hear from me is about hormone therapy. how if you do. I mean, listen, I'm always open when people ask the questions and if that's what the people want to know. I'm super, super interested, and I'm one of those open minded people. I'm not like, no, never to this or yes, always to this dominator.

I am not like necessarily pro HRT I'm really pro solutions. Yes. Yeah, yeah. And I'm also anti suffering okay. We're going to you know we're going to have a lot of fun together. I really like this pro solution to anti suffering. Yeah. So many women suffer. And I'm saying this really with my patients in mind our participants in mind because so many women are terrified a brain fog.

It's a common symptom very very widely overlooked symptom of menopause impacting over 60% of all women, at least in the United States. And sometimes the brain fog, the the cognitive fatigue is so severe to really, stoke concerns around dementia. There are so many women who come to us because they're, I'm going to say, terrified, perhaps concerned that they may be experiencing early dementia.

so I think I would like to clarify, the brain fog is very common in menopause and that there are things that one can do to find out if it's menopause or something else, right? Then just medical attention, intervention or prevention. And this is something we do with Alzheimer's prevention program a while kernel. And we're open to see participants there.

Patients. Oh great. Yeah. Yeah. Where can people find that. How can they where on the Upper East Side and 72nd in York. And we have brain imaging available for pretty much all our participants get brain scans. we do cognitive testing, which is so helpful with brain fog because, yes, you may be experiencing a change in performance, but it's still helpful to know if your performance is actually within normal limits relative to other women your age and education.

And I also strongly recommend for women who are scared. Maybe those with a family history of Alzheimer's come to us if you can, before you have an actual problem, so that we can do a baseline and it's every doctor stream to have your baseline before there's any issues so we can compare you to you. And I think that's also really helpful to have for life.

So that's one thing I wanted to say. The other thing is hormone therapy. I would say that it's been evaluated for brain fog, and Alzheimer's prevention is not approved at this point. But many more scientists like myself and investigating this in detail at this point, whereas the research was simply just not there for a long time. And for now, hormone therapy is quite effective, is actually, honestly is very effective for symptoms like hot flashes and night sweats, and also prevention of osteoporosis and relief of genital urinary symptoms in lonely beta, recurrent UTIs, vaginal dryness, which are really a common complaint for so many women going through menopause.

Also, pairing menopausal women right now, just after the last, menstrual period, the critical time, the difficult time is prior. So it's good to seek help. And also for two other brain indications, which is sleep. Sleep disturbances relate, especially when related to hot flashes in night sweats. And really for mild depressive symptoms, not clinical depression, mild depressive symptoms either due to the perimenopause or menopause.

I think it's important to know that these are FDA approved indications for hormone therapy, and that this therapy can help. That's awesome. Yeah, I would just like all women to make a decision based on information rather than fear. Yes. Or outdated findings and things that they're just been told for like 20 years that are no longer valid. You know, they've been disproved.

Now we know better. Professional societies have changed their recommendation. So what I always say when women say to me, you know, my ob gyn won't give me hormones, even though I think I'm eligible. Say, you know what? Download the guidelines. The 2022 guidelines of the North American Menopause Society. They're free on the internet. Download it set to PDF.

Just read through. Find the part that's important to you, print it out and go to your doctor and say, look, can we read this together? If I'm not eligible, I'm not eligible, but there's a chance they might be. Can we talk about this? And I think that that's quite helpful. Could be oh, it's hugely helpful. I'm thank you.

I'm so glad that you walked us through that because, myself included, I know earlier parts of my life, I've gone to doctors and asked for a particular test and just been kind of shut down. And, you know, I'm from new Jersey, so I get really angry and really feisty and, you know, I mean, it's like I'm flipping birds.

I'm like, whatever, I'm out of here. And, but it's it's to feel empowered and to be able to take care of our own health and to be educated and to be able to walk in and have a collaborative, intelligent, fact based conversation to, quote unquote, hashtag end our suffering when there are potential treatments available that can help us cognitively take care of our brains and our bodies and our mental and emotional and physical health.

It's like we need to know this information. So thank you so much for taking the time to be on. I can't wait to I'm going to take you around some twirls for classes. We're gonna have so much fun. And for everybody get your hands on this book. They are life changing. And, we'll see you soon. Thank you, thank you, thank you for having me.

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