Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
134: Make Louisa Nicola Make Sense, Part 1
1 Playsin 9 hours
In this episode, Sarah Court and Laurel Beversdorf begin a two-part investigation into Louisa Nicola and the rapidly growing industry built around Alzheimer's prevention, brain optimization, and women's brain health. They examine how legitimate scientific concerns about dementia become transformed into highly marketable narratives, and explain the difference between what current evidence supports and what many online health personalities confidently claim.
Sarah and Laurel break down the strongest evidence on dementia prevention, including findings from the 2024 Lancet Commission, and discuss what is known about exercise, vascular health, hearing, vision, education, social connection, and other modifiable risk factors. They also introduce concepts they call mechanism theater, evidence cosplay, and the fear-to-action marketing pipeline, showing how preliminary research is often stretched into certainty to sell protocols, supplements, and personal brands. Along the way, they critically examine several of Nicola's most common claims—including that Alzheimer's starts in your 30s, that women face six times the risk, and that heavy resistance training is uniquely protective—and compare those claims with the available evidence.
Part 2 of this series will continue the investigation into Louisa Nicola's recommendations, products, and marketing strategies.
SIGN UP FOR THE INTEREST LIST for Lift for Longevity
FREE Barbell Mini Course when you get on our mailing list
FOLLOW Movement Logic on Instagram
WATCH Movement Logic on YouTube
LEARN MORE on the Movement Logic website
Foldable Home Barbell Rack by Verse, coupon code MovementLogic10%OFF at checkout
RESOURCES
113: Debunking Menopause Grifters: Dr Mary Claire Haver and Dr. Vonda Wright
111: Make Stacy Sims Make Sense
The Lancet Commission: Dementia Prevention, Intervention, and Care: 2024 Report
Alzheimer's Association 2025 Fact Sheet
Narrative review on resistance training and Alzheimer's disease (co-authored by Louisa Nicola)
Dr. Vonda Wright podcast featuring Louisa Nicola
The Diary of a CEO podcast featuring Louisa Nicola
APOE4 and Alzheimer's disease research
New England Journal of Medicine (2024) biomarker study on preclinical Alzheimer's disease
Recommended
Transcript
Comparing Cognitive Training Methods
00:00:00
Speaker
The Lancet actually looked at an RCT that looked at high intensity interval training and moderate intensity continuous training and then a control group. The control group was not sedentary.
00:00:12
Speaker
So they were encouraged to follow the national physical activity guidelines. And by the end, 96% of the control group was meeting those guidelines. lines And there was no significant differences between the groups in cognitive function or the odds of developing mild cognitive impairment after five years.
Women in Strength Training: Changing the Narrative
00:00:32
Speaker
What do you think about that, Luisa Nicola?
00:00:35
Speaker
I'm Laurel Beversdorf, strength and conditioning coach. And I'm Dr. Sarah Court, physical therapist. For too long, women have been sidelined in strength training. Oh, you mean handed pink dumbbells and told to sculpt?
00:00:47
Speaker
Whatever that means. We're here to change that with tools, evidence, and ideas that center women's needs and voices. Welcome to the conversation.
00:00:57
Speaker
All right, welcome to the Movement Logic Podcast. My name is Sarah Court. I'm a physical therapist. I am your host and I'm here with my co-host who is also your host. Her name is Laurel Beaversdorth. She is a strength and conditioning coach.
00:01:10
Speaker
and a soon to be master of exercise science. Is that correct? Oh, I guess. Physiology. Whoops. It's kind of the same thing,
Rejecting Misleading Health Endorsements
00:01:18
Speaker
but yes. So Laurel and I, on a regular basis, we get solicited by PR companies and they're trying to get us to sell supplements or whatever. Like I just got one of these this morning.
00:01:29
Speaker
like a very typical one. And this typical one, i'm just going to read you a tiny bit about it. It says, hi, movement logic. I'm Gia at grin. I match creators with brands running programs on our platform and interactive comment, blah, blah, something, something looked like a fit sharing with you. Here's what this program includes affiliate $50 per sale.
00:01:49
Speaker
You know, we sell, what does it say? Health conscious adults, 35 to 65 who want natural daily support for blood sugar, metabolism, heart health, and energy without prescription medications.
00:02:00
Speaker
like all right fine So that's obviously totally horseshit. And I'm going to say no to that. Right. because I get ones like that all the time. And I'm sure you do too. Right. Uh-huh. Right. So I got a different kind though recently that I was like, what's going on here? So.
00:02:14
Speaker
I got the email, but what I noticed that was very different about the email is usually it says something like they said in that one where it's like affiliate $50 per social media post kind of thing or whatever, right like right? Usually it says something like, if you hold our product and make a post about it on your page, we'll give you 50 bucks or something like that. But this one, this email like highlighted the fact that you weren't going to be posting on your own page.
00:02:41
Speaker
And I was like, huh, that's weird because that I've never seen that before. i wonder what they're talking about. I was still not going to do it, whatever it was, but I was kind of like, oh, I wonder what this is. So I responded as if I was interested because I kind of wanted to just see it play out.
00:02:55
Speaker
And I, in my response, I asked, you know, if this is not going to be on my social media page, where would this content be that you want me to make for you? And they responded, great.
00:03:07
Speaker
Here's how to set up your audition. And I was like, what? What? Well, first of all, I don't want to audition for anything, but they didn't answer my original question. So I wrote back again and I was like, great. Could you just explain to me where this is going to be?
00:03:23
Speaker
And essentially what they said was they couldn't tell me. And I'm like, wow, Yet. But what I sort of figured out what it was, was this, which is like cadence, that shoe that I did an episode on, they had this where you have, you go on the cadence website and there's like Dr. Who's he face. And they're saying, I love the cadence shoe.
00:03:45
Speaker
that's the kind of thing it was for. So it was basically like, we want to take the fact that you are a physical therapist and put your face on a variety of products, web pages being like, I endorse this product.
00:04:00
Speaker
And I was like, wow, I've never gotten that one before. I'm still saying no, but that was an interesting new variation on a theme. They'll never stop. They'll never stop. It's really, it's just crazy. So that's about how much doctor endorsed or PT endorsed really means folks. Exactly. that's Right. That's, that's what went into that.
00:04:21
Speaker
Exactly. Exactly. Whenever you see these websites with, and they all have them, right. All of these supplements and products, they always have like various doctors. That's it's literally that person got an email saying, do you want some money? Yeah.
00:04:33
Speaker
Did you find out how much you were going to be paid for this? I didn't. Cause I didn't, Get past the audition stage. Because I was like, I don't. But oh, no, they told me. What did they say?
00:04:44
Speaker
Other people make upwards of $6,000. Upwards. Oh, yeah. Upwards of. Upwards of. i'm like On what time? what what Over 10 years? Like, what are we talking about? Anyway. This is what I'm talking about. The transparency problem with these companies and then just how shady they are in every single way. It's like, oh, God.
00:05:06
Speaker
Yep. If you wonder why we go after all these companies and all these people all the time, this is kind of why. like we're trying to We're trying to pull back the curtain a little bit and show you, hey, some of this is actually, I mean, not some of this, I should say all of this is absolutely bullshit.
00:05:23
Speaker
The emperor has no
Success Stories from 'Lift for Longevity' Course
00:05:25
Speaker
clothes. Exactly. Exactly. Well, here's here's something a little bit better news, I think, for folks. We got to, I mean, let me back up. It wasn't better news for the person who this happened to, but we got an email recently from one of our past Live for Longevity participants about something that happened to her. Our past participant, Kate, apparently suffered a pretty serious fall in her garden and ended up tearing her quadriceps tendon.
00:05:56
Speaker
and then had to have surgery. So she is going to be, she said to us, out of action for six to eight weeks. But she noticed that the strength that she was able to build in our course, Lift for Longevity, is making a huge difference in her recovery. So she lives alone, but she still finds that she's able to manage daily life because she has this increased upper body strength. She has increased single leg strength.
00:06:24
Speaker
And she noticed that immediately after the injury, she was strong enough to drag herself from the steep slope where she fell to a safer location.
00:06:37
Speaker
And then lower herself down the steps to the ambulance stretcher using just her upper body strength. So she wrote to us to thank us specifically and let us know that her work.
00:06:53
Speaker
Well, she let us know that our work in the course, but it was really her work in the course. Yeah, changed her life or helped her in this very important time where she really needed to have some strength. So she's looking forward to returning to strength training and we were just really floored by this message and.
00:07:12
Speaker
of course, like, we're happy to hear that she's on her way to recovery and that she got this benefit from the course and was able to use it when it really, really counted.
Challenging Stereotypes: Importance of Female Upper Body Strength
00:07:24
Speaker
Yeah. And it just makes me think of all the course participants that have gone through Lift for Longevity,
00:07:33
Speaker
and anyone who really strength trains at all, and how the benefits of strength are sometimes realized in these particular types of unfortunate accidents or these moments of illness or these moments where we're suddenly needing to draw on some reserves, right? Yeah. So pretty cool story from Kate. Thanks for sharing that with us, Kate.
00:07:54
Speaker
Totally. And yeah, two things I was struck by one is the upper body strength because for a lot of women, we tend to focus more on lower body, right? We get messages about getting around booty, but the sort of i think the, I think the fear, the bulky fear is often about upper body. Like you don't want to look like your arms are too muscular or something like that. Right. Right.
00:08:21
Speaker
But yeah. realistically life is going to throw shit at you. And if you don't have the capacity, I mean, I I'm just thinking about like the flip of this, if she had not done the course, she'd be sitting in her garden, unable to probably, it would be much harder probably to pull herself up this hill. It would have been much harder to get to the ambulance yeah and just getting around on crutches and stuff. All of that would have been so much harder. Yeah. And it can quickly become kind of a dangerous situation. Yeah. Especially living alone. Yeah. Yeah. You're living alone. You can't get to help.
00:08:52
Speaker
so Right. Exactly. So, and to your point as well, that sometimes people are like, well, why am i am I strength training? Cause I just want to have big muscles. What am i strength training for? We don't necessarily always think about or observe the power of this reserve, like having this capacity in reserve for when life happens.
00:09:13
Speaker
So I thought that was a great. Great testimonial from her, great story. I mean, i hate that it happened, but you know I love that she was ready for what happened. Yeah, it's we often use the analogy of a retirement plan, right? Strength is a retirement plan. It's also a insurance policy. yes And it can act as like a backup plan. Like, oh, I just landed myself in a a world of hurt here.
00:09:38
Speaker
And yeah oh, let me call on this backup plan, which is to get myself out of this world of hurt using my physical strength. Right. It's like your emergency here in Los Angeles. Everybody has a go bag or they should. Yes. In case there's an emergency, right likeing in case there's an earthquake, I should say, which is pretty common. But so this is like your go bag just for life because it might not be an earthquake. It might be you fall down a hill and that's your earthquake or something. Right. Right. So now.
00:10:05
Speaker
All right. What to tell folks. Lift for longevity starts on September 28th. And we are gonna be talking about it a fair amount. And so if that is something that you are interested in, then you wanna make sure, even if you're on our regular mailing list, you wanna make sure that you are on our Lift for longevity interest list, because that's gonna put you in the mailing list to get the discount, to get some free videos,
00:10:34
Speaker
from the course. So you can see, oh, is this the kind of thing that I think will be interesting for me?
Myths and Marketing in Alzheimer's Awareness
00:10:39
Speaker
You're going to get all kinds of other useful educational content from us. So we offer this course usually twice a year. This year, the only time we're offering it is in September.
00:10:50
Speaker
So if if you've been thinking about it for a while and you're interested, check out the show notes for the link to get on our interest list. All right, so in today's episode, we are talking about Dr. Louisa Nicola, one of those people who has two first names.
00:11:07
Speaker
We're going to cover her branding, which is almost entirely about Alzheimer's disease. And we're going to do some myth busting on her claims. We are also going to look at how her messaging and her brand has evolved over the years.
00:11:23
Speaker
And we're going to highlight her particular tricks that she uses to get people to buy her products, which we call mechanism theater. We'll define these all for you.
00:11:34
Speaker
Evidence cosplay. and the Fear to Action marketing pipeline, all of which we'll discuss in this episode. All right, why are we talking about Luisa Nicola?
00:11:46
Speaker
Well, if you are on Instagram and you follow us and you follow people like us, you may have also seen some posts from Luis Nicola. She's an online personality slash clinical figure and her MO is turning Alzheimer's prevention, menopause, exercise, and women's brain health into one urgent message. Some of her advice is generally good. And that is true for anyone with a platform, because if it's all bad and bullshit, no one's going to believe anything, you know, that is said. But because some of her advice is generally good around exercise, strength training, sleep, and cardiovascular fitness, she is
00:12:34
Speaker
is able to thread in a lot of information that is not good but the way she presents information is one of the ways that she's able to slide this pseudoscience and misinformation in undercover so Sarah already mentioned a couple of terms that we use to name these strategies but basically she'll turn mechanisms, associations, or preliminary evidence into certainty, into very certain confident claims, into protocols, which she has developed products around and sells, and then fear.
00:13:16
Speaker
Okay, so as we know, fear is a great way to convince people to take action, specifically to buy stuff from you. So We also have to mention that she sometimes presents information completely incorrectly. Like if you look at what she's, you know, reporting on and read it yourself, you'll notice that she gets it completely wrong. So it makes us wonder if, can can she read?
00:13:41
Speaker
Did she read it? One of those, you know. Yeah. I mean, obviously she can read, but did she read it? It seems to be a question a lot of the time. Yeah.
00:13:52
Speaker
You may know her from the Diary of a CEO episode, which is where you might know a lot of these people that occupy this this space of pseudoscience and misinformation.
00:14:06
Speaker
She's also on Dr. Vonderreit's podcast. We've done episodes about Dr. Vonderreit. She has a podcast and she interviewed Luis Nicola. The Diary of a CEO episode is titled The Disease That Starts in Your 30s But Kills You in Your 70s. It's subtle. And then the Dr. VonderWright episode is called Why Women Are Six Times the Alzheimer's Risk.
00:14:34
Speaker
Dear Lord. Yeah. You might also know her from the viral Kelly Casperson clip where she said the female brain literally eats itself during menopause without hormone therapy, right? You know, which is just batshit.
00:14:52
Speaker
Okay. Just batshit. Okay. So here are main questions in this episode regarding Luis Nicola.
00:15:03
Speaker
How does someone like Luis Nicola take a legitimate scientific concern, the fact that women are disproportionately affected by Alzheimer's, and then transform it into an entire brand ecosystem? That's what we're looking at today.
00:15:20
Speaker
Yeah. Okay. So before we get into the who and why of Luis and Nicola specifically, we want to make sure that we're all on the same page about what we do know about Alzheimer's and dementia prevention that is provable.
00:15:33
Speaker
The reason we're doing this is because one of Louisa Nicola's biggest sales tricks, as Laura was saying, is to take some incredibly preliminary, sometimes just animal studies, sometimes pilot studies, always more studies are needed studies.
00:15:50
Speaker
And then just present them to the general public as if they are stone cold facts. And this is not just Louisa Nicola. This is all of the grifters. This is Mary Lou Haver. This is Vonda Wright, right? Kelly Casper is all of them do this where there is a tiny bit of preliminary. This is interesting. And they're like, it's proof.
00:16:09
Speaker
So let's get some facts. So what is Alzheimer's? Alzheimer's is a type of dementia. There's actually many types of dementia. Some of them are associated with things like Parkinson's disease or stroke. Some of them are just general degradation over time.
00:16:26
Speaker
So if we talk about Alzheimer's disease specifically, there's actually two types, which I didn't know before I started researching this. The first type is genetic and the genetic type affects roughly one to 3% the population.
00:16:42
Speaker
This means it runs in your family and you are at an incredibly high risk of getting it, right? Much more so than the general public. This is a very, very unfortunate genetic condition that might be handed down to you.
00:16:58
Speaker
There's also a non-genetic type of Alzheimer's. And that's basically if everybody else got Alzheimer's. So that's roughly the 95 to 99% of the rest of the population. So Louisa Nicola is often refers to Alzheimer's as being 95% or 99% avoidable.
00:17:18
Speaker
I think this is what she's referring to. i think this is the number she's referring to, but like, that's not, that's not what that number means. Yeah.
00:17:28
Speaker
I think it's important to realize too that you can have Alzheimer's due to both causes, right? They could be genetic causes and non-genetic causes, right? And i think it's also important to know, and we're going to talk much more about this, that not all non-genetic causes are entirely unavoidable. Okay. Right. Cause shit happens. Yeah.
00:17:54
Speaker
And we don't believe it or not control every single aspect of our life, nor are we aware of every single threat to our health all the time. Exactly. Cause we are not omniscient.
00:18:04
Speaker
and all And all capable and all, you know. Okay. So in terms of risk factor for for getting Alzheimer's, the single biggest risk factor, as with most diseases, pretty much everything, is getting older.
00:18:21
Speaker
Because the longer you're alive, the more changes are happening to your tissues, right? The more possible mutations might be. created, dah, dah, right?
00:18:32
Speaker
After that biggest risk factor, then there are some other genetic mutations separate from that one to 3% of genetic occurrence. And then there's also a bunch of lifestyle factors. And then there's also some factors that are actually, if you're at risk from this factor, you personally probably can't do anything about it because it would involve government policy changing things like air quality, right?
00:18:55
Speaker
Women do have a higher lifetime risk than men, but that difference is much smaller than the effect of just aging. And researchers are still working to figure out why women have a higher risk. But what I wanna make a point out about with this is that Louisa Nicola's biggest selling points is, one of her biggest selling points is that women are most at risk, but the Alzheimer's Association says that age is the highest risk, not gender. Like that's the first risk on the list, right? Not not just being a woman, it's just how old you are.
00:19:32
Speaker
Yeah, I want to note that about this situation where getting older is the single biggest risk factor for dementia and and Alzheimer's, we're going to talk about how Luis Nicola will often state that, you know, this is not a natural part of the aging process, that this is something we can prevent, you know, stop treating dementia or Alzheimer's is her area of focus, like an inevitability. It's not a natural part of the aging process. And the thing is, is that no disease really is a natural part of the aging process.
00:20:12
Speaker
However, as was just stated, an overwhelming majority of chronic neurodegenerative disease states do occur in older adults because of aging.
Preventing Dementia: Insights from The Lancet 2024 Report
00:20:25
Speaker
So it's associated with age, but not necessarily caused by it. And I just wanted to state that because what I think Luis Nicola does a lot of the time is she creates this narrative that like everyone is just kind of accepting that this is what happens. Right.
00:20:43
Speaker
And that she tries to single out Alzheimer's as being specifically different in that it's not a natural part of the aging process. It's like, well, no disease technically is, but age is actually the biggest risk factor. Right. Right. Right. OK. OK.
00:20:59
Speaker
Well, and also the purpose of her doing that is so that she can sell you her product. Right. right she She needs to create tension between herself and what she's saying and then what this amorphous kind of unnamed entity is saying, right? That's the enemy, right? So the enemy wants you to believe that. That this is all just a natural part of the aging process. Nothing you can do. Yeah. Right. And you're just accepting it. You're just going to lie down and take it. Right. And so there's this, this story that's created around like her being sort of the bringer of the truth and the hero and then this enemy entity that is oftentimes science and what science has done to women or the pharmaceutical company and the way that they lie or doctors who just want to keep you sick or just this general idea that it's a natural part of the aging process is like first of all no one said that it's not a natural part of the aging process but age is the biggest risk factor right right
00:22:05
Speaker
All right, just because of what aging does to our body, right? So, you know, a couple of things like changes in protein homeostasis, inflammation, vascular health, mitochondrial function, all of these processes are altered as we age. And this increases susceptibility to neurodegenerative disease like Alzheimer's. Yeah.
00:22:26
Speaker
Okay. and and And yes, there are things we can do to mitigate that risk, but it is, it is you know, a part of the process. Okay, so um we're going to look at a paper by the lancet called dementia prevention intervention and care 2024 report of the lancet standing Commission.
00:22:46
Speaker
Okay, so this is a big paper that draws on a lot of different types of evidence, some of which is observational in nature, some of which include randomized control trials and also. systematic reviews and meta-analyses, some of which look at more mechanistic findings, some that take into account expert consensus, expert reports and consensus statements. So it's, it's a mishmash of a lot of things. On a scale of one to five, one being weak, five being very, very strong. This one is probably at about a four. So it's quite good.
00:23:23
Speaker
Why would you not give it a five? Because of the leaning into observational associations. Okay, fair. yeah The commission, it the last time it met was in 2020.
00:23:34
Speaker
So it's updated it for 2024. It added two new things to the risk factor list in 2024. But my sense is that they're drawing on all available evidence and trying to come up with a list of what these risk factors are.
00:23:47
Speaker
Yeah, and they hedge their claims, you know, very, very scientifically and, you know, aka responsibly. Right. By, you know, basically adjusting the the reader's sort of expectations for what, like, certainty we can assign to. Yes. these findings and what the actual what these findings actually mean so anyway great paper important paper recent paper yeah all about dementia not alzheimer's but dementia right all alzheimer's is dementia but not all dementia is alzheimer's okay allll yeah dementia is a bigger umbrella term and so the commission is going to go through some possible mechanisms for these 14
00:24:30
Speaker
fourteen risk factors that influence dementia and the mechanisms they emphasize, it's important to realize, operate through more than one pathway or rely more on more than one system and are multi influential and factorial in nature, right? So it's not a this or that, right? It's a kind of everything together type lens that you have to be looking through here. So this paper discusses the evidence for dementia prevention and risk reduction across the lifespan.
00:25:09
Speaker
And there are a couple of different categories in which we can think about these strategies. What particularly we are impacting within our body to reduce risk. Okay, so The first is about building cognitive and brain reserve right so cognitive reserve or brain reserve is the ability of the brain to be able to tolerate damage or disease before symptoms become apparent and there are a couple of different ways in which we believe this happens.
00:25:48
Speaker
Okay, one is. through higher educational attainment. In other words, lower educational attainment could be considered a risk factor for dementia and higher educational attainment and or engaging in cognitively stimulating work are thought to be ways in which we can build cognitive reserve. Okay. Yeah. It's a little bit of like use it or lose it, right? It's like do some hard thinking with your brain.
00:26:13
Speaker
Yeah. exactly Exercise your brain. Right. Right. Yeah. Another way is hearing loss. Okay. So hearing loss could be a considered the risk factor. Right. And so finding ways to aid your hearing. If you experience hearing loss, appear to be protective against dementia. And I think this makes sense because if you can't hear, you're not as stimulated. If you can't hear what the person or people next to you are talking about, you can't engage cognitively in that. And again, it kind of goes back to this like,
00:26:46
Speaker
cognitively stimulating quote unquote work or just cognitively stimulating existence right you need to be able to participate in conversation which can be cognitively stimulating but if you can't hear you can't really maybe you tune out and start thinking about other things My sense of the way that a lot of older people feel about hearing aids is that they've been embarrassed to use them in the past, right? They don't want to look like they need a big bulky thing on their ear. Now a good thing, they've gotten much, much smaller and almost impossible to see, which is really good. yeah But I think it's, This is not like people who are born deaf and learn sign language. This is people who have lost their hearing and maybe aren't being as social anymore because they like can't hear anything. So they're not going out. So they're again, they're not getting the stimulus.
00:27:32
Speaker
Exactly. And then vision loss, which is something new that was added, right? That's one of the new two things that were added. And so the exact mechanism is really uncertain, but again, it comes back to this idea that reduced sensory input leads to reduced cognitive stimulation. Right, so vision loss is the risk factor.
00:27:52
Speaker
The way we reduce the risk of dementia is to do the things that we need to do to make it so that we can see. And then finally, in this category of building cognitive reserve,
00:28:05
Speaker
is social isolation. And this is a really big one that's becoming more and more talked about, I notice, which is this this epidemic of social isolation, which I think started before the pandemic, but became very severe during the pandemic.
00:28:20
Speaker
Social contact helps build cognitive reserve It helps to promote also healthy behaviors. It reduces stress and inflammation. So it has a lot of crossover with some other categories we're going to talk about. And of course, also it creates cognitive stimulation.
00:28:36
Speaker
Exactly. Another category is to reduce vascular damage, right? So this is where cardiovascular health overlaps with brain health. ah Another recent finding in addition to vision loss being a risk factor for dementia is that high levels of LDL cholesterol are also a risk factor for dementia. Isn't that wild? Yeah.
00:28:59
Speaker
I mean, it makes sense because, I mean, I don't know much about this, but I know my dad had vascular disease and kidney disease and experienced some cognitive decline, very noticeable cognitive decline.
00:29:16
Speaker
Dementia, not Alzheimer's, but dementia in his later years as probably a result of maybe, and this is probably overly simplified, but his body's ability to get blood to his brain.
00:29:29
Speaker
Right. Right. He, yeah. So also other risk factors that are under the category of vascular damage include high blood pressure, Obviously smoking, right? And then diabetes.
00:29:43
Speaker
Again, this one's not as well understood, but diabetes likely contributes through multiple pathways, but also it is involved in inflammation, metabolic dysfunction.
00:29:56
Speaker
So it's not solely a vascular contributor. And then also obesity. Those are all under the umbrella of vascular damage. And then we finally we have stress and inflammation as being another category.
00:30:07
Speaker
Here they include depression and the Lancet treated depression and social isolation as separate risk factors, although they often coexist. And then here's where we have physical inactivity, okay? is where Louisa Nicola focuses a lot of her messaging around is this particular risk factor of physical inactivity. But what we'll soon learn is that she selects out only one of very many ways to be physically active and decides that that's the way you have to be physically active, even though there is literally no evidence for.
00:30:43
Speaker
this claim, right? we we're We'll get into it. Okay. It likely reduces stress and inflammation, but of course it also benefits vascular health, right? And potentially also cognitive reserves. So,
00:30:55
Speaker
There are some that weren't clearly categorizable according to the Lancet, but they also deserve mention here, which is excessive alcohol consumption. This could fall under the category of reducing stress and inflammation, but it also likely affects dementia through many different mechanisms, including direct neurotoxicity and then also vascular disease. And then finally, traumatic brain injury.
00:31:20
Speaker
You know, this is one of those things that like shit happens. Right. You can't always control everything that happens to you. Sometimes you get hit in the head. Yes. And traumatic brain injury, you know, obviously is going to increase.
00:31:34
Speaker
i mean, that that one's just it seems kind of common sense. Right. Right. Yeah. If you play a sport, right, like football or you're a boxer, even soccer, yeah rugby, like these all place you at a much higher risk of dementia. yeah If you're if you're a position that's getting hit a lot.
00:31:49
Speaker
Right. But but also like, you know, swimming, I have to sign a waiver. Every year my daughter does a swim team about hitting her head. and yeahp And you can, you just be walking along and a branch falls on your head too. Like shit happens.
00:32:03
Speaker
People hit in the head. does Yeah. Under the category of choosing to put yourself in a situation where you might be more at risk for a traumatic brain injury, American football was a horrible example of this. Still is in some ways. And we know about all of that CTE. Yes. And- There was a great documentary about it a few years ago, and and it showed how like the opening credits for like Monday night football were two helmets ramming into each other. yeah And there was this idea that if I have my helmet on, it's fine. I can smash my head into somebody else. But unfortunately, we've discovered that's not the case. Yeah, it's the is their brain hitting the inside of the Inside of your head, exactly. Like people think your brain is actually attached to your skull.
00:32:44
Speaker
um Newsflash, it's not. And then the other people that often get a traumatic brain injury are people in the military who do things like bomb explosion. What's it called when you make a bomb not dangerous anymore? Let me let me see. A bomb disposal technician? Yeah. In any event, I i think if you're, if you're in in the military at all, you're at risk of like bombs going off near you, things like that. And that's another one where traumatic brain injury happens very, very often.
00:33:09
Speaker
Yes. And then one more, one more to put under the category of uncategorized is air pollution. Yeah. They place it under vascular damage, but it also potentially could go under inflammation.
00:33:22
Speaker
This is a very different one because this would involve some population level policy intervention rather than an individual behavior change. Right. Like you may not be able to move away from the neighborhood that you live in where the air is not great.
00:33:38
Speaker
Right. That may or may not be up to you. Yeah. Whereas the rest of them are potentially depending on how privileged you are and what your access is to health care and and a lot of other, you know, education, a lot of or all of the rest of them are potentially under the control of an individual. But air pollution, not so much. Yeah.
00:33:59
Speaker
Yeah. We just discussed whether they're all really modifiable. Here's where I want to talk about this 45 percent figure. OK. Yeah. So the Lancet. estimates that about 45% of dementia cases are statistically attributable to these 14 potentially modifiable risk factors.
00:34:22
Speaker
And they found this after accounting for the fact that many people, of course, have more than one risk factor. This estimate comes from what's called population attributable fraction modeling, okay which combines How common each risk factor is in the population, how strongly each risk factor is associated with dementia, how much overlap there is among the risk factors, and what this population attributable fraction estimates is basically that if a risk factor truly causes dementia
00:35:05
Speaker
And if it could be completely eliminated from the population, how many dementia cases might theoretically not occur? Okay, so this is, if you're a little lost or a little overwhelmed, just know that this 45% is coming from a statistical model, okay? It's not the result of a single intervention study.
00:35:30
Speaker
It does not mean 45% people can prevent dementia It does not mean eliminating these risk factors would definitely prevent 45% of dementia.
00:35:42
Speaker
It does not mean 45% of dementia is proven to be preventable. It does not mean every person can realistically eliminate every risk factor. Right. It simply means that if we were to completely eliminate risk factors from the population, this is the number 45% dementia cases might of dementia cases might theoretically not occur.
00:36:07
Speaker
Theoretically not occur. Right. It's all theoretical. So this number is like, it is embedded in Annabella Krautnernick- qualification after qualification after qualification drawing from 14 different modifiable factors that overlap that are multifactorial and influence that may or may not be causal that. Annabella Krautnernick- Do you see how complex this is and how much evidence went into this this paper, which is quite a strong paper but. still also has to lean on observational data because, again, we can't set up one-to-one longitudinal studies looking at multiple different interventions or realities, right?
00:36:48
Speaker
And then see, like, did this person get dementia? It's so complex. that I think that it's just important. The reason we went through all of this wasn't to make you pass out or...
00:37:00
Speaker
Feel like you need to take a nap. it's It's so that you understand when we talk about Louisa Nicola's claims, what she's saying versus what the evidence is saying.
00:37:19
Speaker
When people sign up for a Lift for Longevity, what are we actually giving them? They're getting a lot. So our six-month Lift for Longevity barbell course includes two live classes a week taught by Laurel and myself with recordings that you then are able to access forever after the six months as well.
00:37:42
Speaker
That's 48 live classes. There is also pre-recorded content where we talk about important strength training terminology that you're going to want to understand. We talk about osteoporosis, which is a big concern for women as we get older. And that has been shown in evidence to be something you can improve with resistance training.
00:38:04
Speaker
We have demo videos of all of the exercises that you're going to do in the course. So you can always refer back to those videos as well as receive all of the live coaching that you get in the class.
00:38:17
Speaker
We also have some warmup videos. We have some other special videos for things like if your ankles or your wrists need a little more attention, you also get to join our private circle group, which is like a private Facebook group.
00:38:33
Speaker
with the emphasis being on private, which is where you access us, you ask your questions of us, you can submit video demonstrations, like short clips of you doing an exercise and we'll give you feedback on your form. So that's what you get if you join this course. And the purpose of it being six months is we're really trying to establish this as a habit.
00:38:55
Speaker
And the nice thing as well is once you're finished with the six month course, you could just start from the beginning again. And because you're going to be stronger, if you've been lifting weights for six months, those numbers will increase and you could just keep doing the program on your own forever and ever. If you would like to make sure you hear about a future upcoming Lift for Longevity course, get on our interest list via the link in our show notes.
Luisa Nicola's Career Evolution: From Athlete to Alzheimer's Advocate
00:39:22
Speaker
All
00:39:27
Speaker
right, so now we know what are the risk factors. and what percentage is modeled that might be reduced, possible to reduce. Let's talk about who Louisa Nicola is, what is she up to?
00:39:44
Speaker
So Louisa Nicola is a clinical neurophysiologist. Some people say, or I think she says, she's an Alzheimer's focused brain health expert. She's the founder of neuroathletics.
00:39:59
Speaker
And she's host of a podcast called the Neuro Experience Podcast. She currently, or in the past, has worked with elite athletes, executives, high performers.
00:40:09
Speaker
Her brand is sort of this mashup of brain optimization, always be optimizing, Alzheimer's prevention, elite performance goals, women's midlife and menopause fears, and something called protocol culture, which is when when general evidence-based behaviors get repackaged as precise formulas.
00:40:32
Speaker
So instead of the more general advice being move more and sleep better, now the protocol is follow my exact system or you're leaving your brain vulnerable.
00:40:45
Speaker
She's selling you supposedly a roadmap for protecting your future brain. And I mean, look, I think that's a really compelling offer because Alzheimer's is a disease that people really fear getting, right? It's this idea of being, I'm here, but I'm not totally here. I'm alive, but I'm not aware of my surroundings. I don't recognize people anymore. it's a scary sounding disease. Don't you think?
00:41:11
Speaker
Yeah, very scary. So Alzheimer's is a, I guess the most common cause of dementia. And I guess it accounts for 60 to 80% of dementia cases.
00:41:23
Speaker
And there's a lot of different changes that happen to the brain as the results of Alzheimer's. But what it really results in is your inability or having problems forming new memories before you're affecting other cognitive functions. It's very much an identity robbing disease. And it what's, I think, most disturbing about it is that it robs you of your identity, but the people who suffer, I think, probably as much or more, i don't know,
00:42:01
Speaker
People who suffer severely from this identity
00:42:09
Speaker
disruption or degradation are the are your loved ones because they are no longer necessarily people that you recognize the same way or at all.
00:42:22
Speaker
And therefore, you, to them don't really know who they are. Yeah. Yeah. i It's devastating. Totally. I've worked with patients with dementia, not with Alzheimer's specifically. And I will say you often typically see with with these patients that they get angry sometimes and they get angry because they're frustrated. And I would be frustrated too if I could not remember this morning, let alone yesterday, let alone five minutes ago.
00:42:55
Speaker
I think what you said, robbing you of your identity, I think that's exactly it And I think that's something that a lot of people are scared of, right? And so, you know, she's leading into that fear by making really unsupported claims about how you can avoid it, essentially.
00:43:16
Speaker
So before we get into these claims, if you only just heard about Louisa Nicola from like the Kelly Casperson, your brain is getting eaten alive conversation, you might assume like, oh, she's, this is the Alzheimer's lady. She's always been the Alzheimer's lady, but her earlier brand was much more about like neuroscience and optimization and elite athletic performance, not so much degenerative brain disease. So in the beginning, sort of early 2000s to 2012, she was actually an elite triathlon competitor. She represented Australia internationally.
00:43:49
Speaker
And apparently I didn't, I didn't go into this too much, but she had a, an accident and that the the rehab sparked her interest in the brain and the nervous system. She, in 2012, she went to the university of Sydney and got a degree called a master of medicine.
00:44:08
Speaker
So she studied clinical neurophysiology. This is not, I just want to clarify, it's not a medical degree, but she says, this is where she realized that elite sport teams were, you know, leaving something on the table in theory by not focusing on brain function.
00:44:22
Speaker
So then 2014, she forms her company, neuroathletics. And the focus is about helping athletes optimize performance, reaction time, cognition, that kind of stuff.
00:44:34
Speaker
In 2016, she relocated to the US and started working with NFL players, and NBA players, things like that. So now she's really in the like US s professional sports executive performance world. They're talking about things like sleep, nutrition, VO2 max, supplementation, hydration, you know, datadada not really talking about Alzheimer's very much.
00:45:00
Speaker
at this point. So around 2020 to 2022, her brand became much more embedded in the US podcast slash longevity ecosystem. and This is also the period where people like Andrew Huberman, Peter Atiyah, Gabrielle, or Gabrielle Lyon, and other optimization slash longevity figures become central to the online health conversation.
00:45:30
Speaker
So to be clear, we do not know what is in Louisa Nicola's head. We do not know and cannot say that she definitely moved to the U.S. and decided to chase trends. But we can say that her messaging evolved in a very similar direction as the broader U.S. longevity movement did.
00:45:54
Speaker
So around 2021, 2022, 2023, the online health conversation shifted toward lifespan, health span, biomarkers, protocols, and optimization for everyone.
00:46:08
Speaker
And within this conversation, there is a shit ton, a metric shit ton of mechanistic theater going on. What is mechanistic theater, you ask?
00:46:20
Speaker
We've defined this term, which I believe we are responsible for creating. When we talked about Stacey Sims and make Stacey Sims make sense. She is a perpetrator of me mechanistic or mechanism theater. So this is when you use dense biological or physiological explanations to make a claim, something that you are claiming, sound more scientifically credible or certain But when you dig into the claim, you find that the evidence for it is extremely thin or non-existent.
00:46:57
Speaker
It is a type of theater. Yes, it is. Okay. There's a lot of mechanism theater around longevity. Overstating evidence, misinterpreting evidence, cherry picking evidence, using fear mongering.
00:47:11
Speaker
And so now the message is, how do we preserve the brain for the next 50 years, right? That is a much larger market than elite athletes for Luis and Nicola to target. This is the optimization, bro tech, but no longer just bro tech crowd, the disposable income crowd for sure.
00:47:33
Speaker
the people trying to find, you know, the exact right formula to becoming as close to a mortal as humanly possible, or people who are just afraid of dying. Yeah.
00:47:44
Speaker
I think that's the same thing. Yeah. um All right. So then after this, now she's sort of like in this world of longevity and biomarkers, then around 2023, Alzheimer's becomes this organizing principle So now everything that she talks about goes back to Alzheimer's prevention, women's brain health, menopause, biomarkers, et cetera.
The Art of Scientific Language in Health Claims
00:48:10
Speaker
This is also when she begins publishing work specifically related to resistance training and Alzheimer's disease, while also making Alzheimer's the dominant theme of her podcast and her media appearances. So now her brand has this one unifying story, which is everything matters because everything affects Alzheimer's, right?
00:48:31
Speaker
I mean, that's a really solid brand. with but With that, you could be like, listen, don't use that toothpaste. It's gonna give you Alzheimer's. look Don't do this. It's gonna give you Alzheimer's, right? yeah At the same time, and I don't know if this was on purpose, if she saw something in the water or if it just kind of happened,
00:48:49
Speaker
Menopause commercialism around the same time also excluded exploded and women's midlife health became a huge commercial sector in online health.
00:49:00
Speaker
Menopause, HRT or MHT, I should say, protein, creatine, osteoporosis, brain fog, metabolic health rate. These all become these very big topics. We get the menopause who suddenly occur, right? We've talked a lot about all of them on previous episodes.
00:49:19
Speaker
So now this is actually an incredibly useful entry point because if your if your brand is Alzheimer's prevention, menopause is a great entry point because one of the most common menopause complaints is brain fog.
00:49:33
Speaker
And so it's a very easy jump to, wait a minute, is this... Do I have Alzheimer's? Is this the beginning of dementia? What's wrong with my brain? Right? So the message is lift weights, not because muscle matters, but because it could determine whether or not you recognize your grandchildren.
00:49:52
Speaker
I mean, the stakes couldn't be higher. Right? I call this the brand glue. Ooh. It's the glue that holds everything she says and all of her narratives and claims and products together.
00:50:07
Speaker
And it's very important to have brand glue. Oh, do we have brand glue? Yeah, we do. I think we do. I mean, we can we can have a meeting about it later. Because I don't know that we're totally 100% clear on it. But I'm sure we have it somewhere in some closet. Somebody wrote it down. You've got to dig for it in the in the craft drawer. Yeah, brand glue. So it it basically it's like a thesis statement, you know, so so Peter Atiyah, perhaps, okay, his brand glue, i hesitate to say is I feel like he's he's he's finished.
00:50:41
Speaker
His brand glue was yeah that modern medicine waits until you're sick. So by a aggressively identifying and managing risk decades earlier, you can dramatically extend your healthy years of life. And this has allowed him to push a lot of very strange interventions.
00:51:01
Speaker
Yes. And to justify them. Although the message itself It's not totally wrong. It's not totally wrong. That's the problem. That's why it's always a problem because the basic message is not totally wrong. It's not totally wrong.
00:51:14
Speaker
Yeah. They just then take it to crazy places. Yeah. And so his optimization strategies, the use of metformin, all the crazy shit that he did in the name of aggressively identifying and managing risk decades earlier. Right, right. Yeah. And then we have Stacey Sims, right? What's her brand glue? Women are not small men.
00:51:33
Speaker
Right. Okay. And okay, sure. Women are not small men. They're also not large rodents. And I'm also not a small man. I'm kind of a tall man. Yeah. ah it fall Her brand glue falls apart pretty quickly.
00:51:46
Speaker
But she uses this one short pithy statement to justify all of her female specific training, nutrition, recovery,
00:51:58
Speaker
optimization advice because the the the message there is that, okay, women are not small men. Okay. There is some truth in that.
00:52:09
Speaker
Of course, women are not small men. And also, yes, female physiology is different from male physiology in some ways. But when you look at the evidence for the outcomes of interest, it turns out that men and women respond very, very similarly to exercise, to nutrition, and to recovery interventions.
00:52:32
Speaker
And so then she will use things like rat studies to show that female physiology is different. And that's where we're like, well, but women are not large rodents. Right. Right. Yeah.
00:52:45
Speaker
Okay. Let's move on to talk about Louisa Nicola's big brand glue, her big theme now, which is that Alzheimer's is almost certainly coming for you if you're a woman, but you can definitely out train it.
00:52:59
Speaker
And her reoccurring themes include Alzheimer's starts in your thirties. Women are at a much higher risk. Okay, it's true. Exercise is the most powerful intervention. I don't know if that's been shown. Resistance training in zone five are especially protective.
00:53:20
Speaker
There's no evidence for that. Menopause and estrogen loss is a brain health crisis, believe it or not, also unproven. Creatine, omega-3s, sauna and cold therapy, cognitive training, and protocols of the like can optimize the brain. Maybe, but there's not a lot of strong evidence, if any, for those claims.
00:53:43
Speaker
So we're gonna go through all these claims because the problem is not that everything she's saying is wrong. Some of the things on the list, like the fact that women are at a higher risk of Alzheimer's than men is true, but others are at best a big stretch.
Resistance Training: Necessity vs. Sufficiency for Cognitive Health
00:53:59
Speaker
And at worst, just flat out, she pulled it out of her ass incorrect. Okay. And this is a feature of grift. This is not a bug.
00:54:09
Speaker
This is a feature of grift. This is how you spot grift. With all of these online personality doctors, the problem is that some of what they are saying is true or based on the truth, but then they overstretch that truth and they turn it into a story, oftentimes a scary story that of course has a product attached to it.
00:54:30
Speaker
All right. Let's start with what she gets broadly correct before we talk about what she gets completely wrong. So she is right that Alzheimer's is a big problem in the U.S. The Alzheimer's Association estimates 7.4 million Americans age 65 or over are living with Alzheimer's in 2026.
00:54:53
Speaker
So that's about one in nine people over the age of 65 that has Alzheimer's. Wow. That's a big problem. She is also right-ish that women are disproportionately affected.
00:55:06
Speaker
That's not true in all countries. One meta-analysis that had nearly a million people in it from 205 studies in 37 countries identified that, yes, increased incidence and prevalence of dementia in women compared with men,
00:55:22
Speaker
were explained by differences in life expectancy and education. But she often says the difference between men and women is not explained by life expectancy, but actually it is. Women live longer.
00:55:35
Speaker
The longer you're aging, the longer that aging process is going to have the organic breakdown that is the human condition, right? So of the 7.4 million people that have Alzheimer's in the U.S., about 61% of them are women.
00:55:57
Speaker
So that's often rounded to almost two-thirds, right? as Yeah, I want to say, too, that recent U.S. estimates support the statement that about 10.8 to 11% of Americans age 65 and older have Alzheimer's dementia, and that is a one in nine.
00:56:13
Speaker
Yeah. Estimate. That is a lot of people. That's crazy. A lot of people. Yeah. This is people over 65. 65. Yes. Not all people, but then two thirds of those are women. women Yeah.
00:56:26
Speaker
Okay, so this why women more than men, it part of it is because of longer life expectancy, even though she, for some reason, says it isn't. There are other plausible like biological and social contributors, but there's no single agreed upon explanation as to why more women than men demonstrated in the research.
00:56:48
Speaker
This also means, according to the Alzheimer's Association report from 2025, that women have about double the lifetime risk, 20% versus 10% than men do of developing Alzheimer's.
00:57:01
Speaker
So she gets that kind of right-ish little asterisk next to that. yeah yeah she's also right Luis Nicola is right that exercise matters physical inactivity is recognized as one of those 14 modifiable dementia risk factors. Karen Hollweg, the 2024 lancet Commission which we talked about earlier and again estimated that up to 45% of dementia cases could theoretically be prevented or delayed if we eliminated.
00:57:34
Speaker
JoAnne Hanrahan- physical activity as one of those 14 modifiable risk factors we eliminated physical activity, along with the other 13 right okay so also Luis and Nicola. JoAnne Hanrahan- right that resistance training is relevant okay and she herself has co authored a 2024 narrative review describing how preliminary data shows that resistance training has the potential to be beneficial to people with alzheimer's cool.
00:58:02
Speaker
True, yes. couple things. A narrative review is when experts read studies and then write a summary of what they think the evidence is is showing.
00:58:14
Speaker
Unlike a systematic review, they don't have to follow a strict pre-planned method for finding or selecting studies, and so there is a lot more room for judgment and bias in what gets included and how it's interpreted Now they're valuable for generating ideas they're also valuable for summarizing a field, but because they don't have.
00:58:36
Speaker
To systematically include all the evidence they're way more vulnerable to cherry picking than a systematic review or meta analysis a narrative review. represents an interpretation of the literature, not some new experimental evidence and it definitely does not possess the rigor of a systematic review it's it's actually relatively weak form of evidence.
00:58:59
Speaker
yeah okay so let's take just a brief look at this narrative review right it looked at. a number of studies, two of which were particularly strong on the stronger side.
00:59:17
Speaker
So one of them is called the Brain Power Study. It looked at 155 women aged 65 75 years old and compared high intensity resistance training and compared highintensity resistance training Which is, you know, in the six to eight rep range. So yes, I would agree. That's, that's pretty high. I think we could safely call that high intensity resistance training. The only problem was that the control was not another intensity of resistance training. It was like balance and tone classes.
00:59:46
Speaker
Okay. And then another trial, which was quite large, a hundred adults with mild cognitive impairment did high intensity resistance training. And they were compared against two active controls, one of which was aerobic exercise and the other was some kind of balance, kind of stretching, relaxation class.
01:00:07
Speaker
So the rest of the controls, from what I can tell in the studies that she's using to write this narrative review, use a non-resistance training control group to compare against some form of resistance training.
01:00:24
Speaker
And the problem with that is that Luisa Nicola will often make claims that it has to be heavy that the resistance training you do for your brain and your brain health has to be heavy resistance training.
01:00:36
Speaker
But notice how none of these actually looked at heavy resistance training against moderate or light light loads. It looked at resistance training against non-resistance training. So what we can say very, i think, confidently, potentially, is that resistance training is good for your brain.
01:00:54
Speaker
Yeah, it's sufficient to lift heavy, but it's not necessarily required. If you want to understand better the difference between what is sufficient versus necessary, if you want to understand more clearly what ah the difference between sufficient versus necessary. And this is a really important distinction, especially if we're trying to make exercise more, not less accessible to people.
01:01:14
Speaker
is that we shouldn't say that something that is sufficient is necessary because other things could also be sufficient. And wouldn't we like for people to know all of the options that they have so that they can choose the one that works best for them? No. Louisa Nicole likes to pull out heavy resistance training, and she doesn't have any evidence to say that it's necessary. She does only have evidence to say that it's sufficient.
01:01:41
Speaker
right. Luis Nicola uses this paper that she authored and cites it as evidence all over the place. Sarah, where does she cite it as evidence? Oh, my God. So she, in her substack, which is a very active part of her social media, she made it like a huge news about resistance training and...
01:02:02
Speaker
dementia. She made an Instagram reel about it. She doesn't just cite her own study, which is, that's not weird. People do that all the time. The study says things like preliminary findings, suggests possibilities, could reduce risk.
01:02:19
Speaker
But then suddenly by the social media posts, it becomes the science says yes, targets early Alzheimer's risk markers. It becomes much more confident and certain.
01:02:29
Speaker
Yeah. And to be to be fair, like this evidence looks at how resistance training alters the structure of the brain, which brain structure is considered a marker of dementia or Alzheimer's. But what these studies don't actually look at is if resistance training reduces Alzheimer's risk directly. Okay. That's number one. Number two is that She can, I think, very safely make the claim that resistance training could or can reduce the risks of Alzheimer's because of its impact on brain structure.
01:03:08
Speaker
And I think that physical activity includes resistance training and the more physically active you are, it's true. That does reduce your risk of dementia. Okay. But what I don't think she can say, but she says all the time is that it has to be heavy.
01:03:20
Speaker
Yeah. So, you know, as we said, it's not weird that she published a narrative review. Stacey Sims publishes tons of them. Lots of scientists publish narrative reviews, but it's how she talks about the paper afterwards, where we seeing her starting to stretch, uh,
01:03:36
Speaker
the research like on diary of a CEO, she recommended lifting at about 80% of your one rep max to produce neural effects, which is what we would call heavy lifting, right? It's getting up there, but, and I love that they did this, that show actually has an independent research aspect where they go in and they talk back to whatever claims the person is is making.
01:04:00
Speaker
And so that shows independent research notes pointed out that systematic reviews and meta-analyses do not identify a hard intensity cutoff for neural adaptations, right? It's not like 80% or bust, rather sufficiently challenging resistance training. Yeah.
01:04:17
Speaker
Can produce neural changes, not a specific load. right How many episodes have we spent talking about the difference between heavy and sufficiently challenging? Seriously. right So her the certainty of her recommendation is much greater than the certainty of the evidence.
01:04:33
Speaker
So let's look at where she actually definitely over packages the evidence and gets into these myths.
Clarifying Alzheimer's Risk Factors and Prevention Claims
01:04:41
Speaker
So we talked about this at the beginning that this is maybe why you know her. So I want to play the intro to the episode of the Vonda Wright podcast, where she was on as a guest. The episode is titled why women are at six times the Alzheimer's risk. And then in parentheses and the exercise protocol that fixes it.
01:04:59
Speaker
right It's just so awful. Vonda Wright is trash with that episode title, right? How dare you claim that you're on the side of women with that fucking National Enquirer sounding, you know, one weird trick that fixes Alzheimer's BS fear-mongering asshat of an episode title. i hate it so much. I don't know if you can tell. So this clip yeah ah should put the fear of God into you.
01:05:26
Speaker
And it also might make you wonder if Vonda Wright is a little drunk. Alzheimer's disease is not a disease of your 80s, it's a disease of your 30s and 40s because it takes 20 to 30 years for this buildup to occur. It's like osteoporosis. It's not a disease of old people. it is a disease of young people manifesting as an old person. up to 95% of all Alzheimer's disease cases, which is currently 60 million people worldwide, could have been prevented.
01:05:54
Speaker
If you are a woman and you have one copy of the ApoE4 gene that raises your risk by six times, your insurance policy is exercise. Your brain will only survive if it does hard things. To preserve cognitive reserve, you must do hard things. You must shock it. Is that why I get off my treadmill and I am smarter than I ever am? My brain is like on fire. Your brain is like, use it or lose it And if you don't use it's like, well, i need to preserve energy. So I'm just going to kill off this area of the brain because I don't need it. Shut it down. I believe you when you say this, you are going to cure Alzheimer's by the end of your career.
01:06:36
Speaker
I mean, I don't believe that, but anyhow. Yeah, it's just super bananas. The music. The music, the, what does she say? Is that why I get off my treadmill and I'm smarter than I ever am?
01:06:50
Speaker
I'm like, smarter than you ever am? That doesn't sound smarter than you ever am. Okay. So, yeah. I think that the the music reminded me a lot of that, you know that television series called 24? Yes. Kiefer Sutherland was like always like diffusing a bomb the last five seconds of the episode, and then the episode would end as the bomb started to explode, and then you'd have to like turn on the next one. Yeah.
01:07:15
Speaker
Yeah. All right. So let's unpack some of these myths. So she says that very clearly here. She says women are at six times the risk of getting Alzheimer's. So here's what she actually says. If you are a woman and you have one copy of the APOE4 gene,
01:07:34
Speaker
that gives you a six time greater risk of Alzheimer's disease. So let's just talk about this for a second. If you're someone who's read a lot about Alzheimer's, you're probably familiar with this, but if you aren't, like I wasn't, APOE4 is one version of the APOE gene.
01:07:51
Speaker
The APOE gene tells your body how to make apolipoprotein E, which is a protein that helps transport cholesterol and other fats around the body, including in the brain. So there's several versions of this gene, and they have definitely identified that the APOE4 version is associated with a higher risk of a developing later onset Alzheimer's.
01:08:18
Speaker
you inherit a copy of this gene from each parent. So that means you could have zero of this variation, the APOE4 variation, or you could have one copy of it, or you could have two copies of it. And the more that you have, the greater at risk you are, right?
01:08:38
Speaker
So there is a 2016 review that summarizes that this APOE4 risk is greater for women than men. But again, we know that risk factors are not just one thing at a time.
01:08:51
Speaker
and even having that gene, the risk of people who have that gene is still going to vary whether you have one copy or two copies, what your age is your ancestry, what you're comparing it against, right? Because a risk is not, it's a factor, it's a percentage, right? so The bottom line is the size of the effect of these APOE4 gene is still a very active area of research. So it is not at all accurate to summarize it simply as women with APOE4 have six times the Alzheimer's risk.
01:09:28
Speaker
Also in the title of the episode, it does not say women with this gene are at six times the Alzheimer's risk. The title of the episode is why women are at six times the Alzheimer's risk. So it's just absolute misappropriation of the data, right? So she takes what is a very complicated risk landscape, as we've been discussing, right? Lots of different factors.
01:09:51
Speaker
And she turns it into a headline that sounds like a diagnosis, right? If I read women are six times more likely to get it than men, that sounds to me like, well, fuck, I guess I'm getting it, right? It's it's like a certainty in the language that just, it does not exist in the research.
01:10:09
Speaker
Yeah. Okay. So her next claim, Alzheimer's starts in your thirties. So the diary of a CEO episode that she was on is titled, the disease that starts in your thirties, but kills you in your seventies.
01:10:25
Speaker
So we're going to listen to a clip from the diary of a CEO where, where we hear this, this old chestnut. This disease, dementia or Alzheimer's disease is a disease of midlife. And so it generally starts in our 30s.
01:10:41
Speaker
It starts in our 30s, but the first symptoms show up in our late 70s and beyond. seventy s and beyond When you say it starts. Yes. Our brain fully develops at around 25 years old, 25 to 30. And after that, that's when we, if we don't take care of our brain, we start getting a decline in these functions. Over time, through things such as sleep deprivation,
01:11:06
Speaker
poor diet, lack of physical activity, environmental toxins. This slowly erodes at the functioning of the brain. And over time, this starts to compound because that's what biology is. Everything is compounding. One night of sleep deprivation raises your risk of amyloid beta, which is one of the hallmarks of Alzheimer's disease pathology, by 4%. That's just one night of sleep deprivation. Imagine a new mother or a shift worker or a physician in their residency getting countless nights of sleep deprivation day in and day out. Imagine all of that compounding.
01:11:43
Speaker
And what happens? Well, we end up with either neuronal loss, which is like the complete atrophy of certain parts of the brain. And that's what is mild cognitive impairment.
01:11:55
Speaker
Mild cognitive impairment is a pre-dementia state. Okay, I think that's enough. h mechanism mechanism theater much yeah right sir i mean she's literally fucking holding a brain in her hand i think she's she's sitting there holding a fucking brain and it has a name she she like named it henry or something i can't remember what the name was but like I think what I hate so much is the the proximity of her boobs to the brain.
01:12:26
Speaker
i think this is why I don't like her. And I feel this is not a real reason, but I, and I, and I'm certainly not trying to like shame anyone, but it's always lips and boobs and then terrifying facts.
01:12:41
Speaker
It is. If you look at her content, it's boobs, lips, fear. It's like Fox news. Right. yeah Yeah. Yeah. Blonde woman being like, we bombed Iran today. Right. Like anyway, the the pitchfork waving mob is coming for you with that one, sir. Yeah, I know. i know. But you know what? Come at me. Tell me about just go at me at this point. What do I care? All right. it' So, okay. So essentially what she's suggesting is that behaviors and lifestyle changes that we engage in in our 30s impact our risk of dementia but the problem with that statement is that while true it is also literally true for every single chronic disease that is known okay now there is real evidence that alzheimer's pathology
01:13:34
Speaker
Yes, it can begin many years before symptoms. For example, the New England Journal of Medicine published a 20-year biomarker study in 2024 that found that Alzheimer's biomarkers were detectable in cerebrospinal fluid between 15 and 20 years before these same people were diagnosed with Alzheimer's dementia.
01:13:58
Speaker
But preclinical pathology is not the same thing as Alzheimer's starts in your 30s. Biomarker change, risk state, clinical disease.
01:14:13
Speaker
These are not like interchangeable terms, okay? But when we say Alzheimer's, we mean disease, right? And so a more accurate statement possibly would be that Alzheimer's related biological changes.
01:14:30
Speaker
may begin decades before symptoms in some people. it's less It's less scary more accurate. It's more accurate. I mean, another example that I think might resonate to some listeners is the idea of being pre-diabetic versus actually having diabetes.
01:14:50
Speaker
There are lots of people whose glucose range is in that like upper, upper level of what's considered normal or maybe a little bit above it. And they'll start to say, well, you're, you have, you have
Conclusion and Preview of Next Episode
01:15:01
Speaker
pre-diabetes, but As my internist patient told me when we were talking about this, he said, look, tons of people will have, you know, quote, prediabetes and never actually get diabetes.
01:15:16
Speaker
This is not the same as that, but it's a similar kind of thing where it's like, you could have biomarkers, whether or not that develops into full-blown Alzheimer's. It's not, you cannot say that confidently yeah as a fact.
01:15:31
Speaker
Yeah. Okay. So new myth, myth number three, 95% of Alzheimer's cases could have been prevented. Okay. So we talked about the Lancet commission already a lot that it's talking about potentially preventing or delaying possibly based on models, 45% of dementia cases. If we removed those risk factors, if we eliminated them. Yes.
01:15:56
Speaker
So not, it's certainly not talking about 95% Alzheimer's cases. right? That estimate that 45% refers to a population risk. It's not an individual person's guaranteed risk reduction, right? When they say up to 45% of dementia cases could be prevented by addressing certain risk factors, they're not talking about you. They're not saying you do all the right things, you cut your risk by 45%. It means that if an entire population had
01:16:27
Speaker
perfect blood pressure, hearing, exercise, education, air quality, and so on, the total number of cases in that population might be about 45% lower. So a much more accurate statement instead of Alzheimer's is 95% preventable is some dementia risk is modifiable and public health interventions may prevent or delay a substantial proportion of cases.
01:16:53
Speaker
yeah But you can't sell shit with that sentence. no Right? That's the problem.
01:17:04
Speaker
Hey everybody, it's Sarah here. So when we recorded this episode, it ended up being over three hours long and we felt like that was a bit too much to ask of you. So we have split this episode into two parts. This is the end of part one.
01:17:19
Speaker
And in two weeks, you'll get part two where we continue to break down these myths that Louisa Nicola is perpetrating. In the meantime, please rate, review, subscribe to our podcast.
01:17:32
Speaker
Get on the interest list if you are interested in joining our Lift for Longevity cohort this September. The link to that is in the show notes. And we will see you in two weeks.