Nutrition

Uncovering Truth: Where Are We in Genetics, Cannabis, and Traumatic Brain Injury with Tommy Wood

Boomer Anderson
November 25, 2020
79
 MIN
Listen this episode on your favorite platform!

Not one to shy away from controversy, Dr. Tommy Wood has worked with some of the highest performing athletes in the world. From Formula One to Ironmans, what are some of the key takeaways Tommy had on behavior change from that experience? You would be surprised at how little free time these people have. I also get the chance to pick Tommy's brain on the problems with nutritional epidemiology, genetics, and how to evaluate nascent supplements and compounds where little research may exist.


Who is Tommy Wood?


Tommy Wood is a Research Assistant Professor of Pediatrics in the University of Washington Division of Neonatology. The majority of his academic work has focused on developing therapies for brain injury in newborn infants, but also includes adult neurodegenerative and metabolic diseases, as well as nutritional approaches to sports performance.


Tommy received an undergraduate degree in biochemistry from the University of Cambridge before obtaining his medical degree from the University of Oxford. After working as a doctor in central London, he moved to Norway for his PhD work, and then to the University of Washington as a postdoc. Alongside his academic training, Tommy has coached athletes in a dozen sports, from weekend warriors to Olympians and world champions. He is the outgoing President of the Physicians for Ancestral Health society, a director of the British Society of Lifestyle Medicine, and sits on the scientific advisory board of Hintsa Performance, which includes researching performance optimization strategies for F1 drivers.


Tommy’s current research interests include the physiological and metabolic responses to brain injury and their long-term effects on brain health, as well as developing easily-accessible methods with which to track human health, performance, and longevity. He and his wife Elizabeth share their home with two energetic (and goofy) boxers, and in his spare time, Tommy can usually be found cooking, hiking, reading, or lifting something heavy.


Highlights


[7:21] Skepticism about nutritional epidemiology

[12:03] Where are we in Genetics?

[26:00] Genetic diet calculators

[32:05] How can we improve the research on cannabis?

[40:10] Improving Performance in Formula 1 drivers

[47:55] Cutbacks for Performance

[51:30] Current research on Traumatic Brain Injuries

[1:00:08] Exogenous Ketones


Resources


CHEMEX Coffeemaker

AeroPress Coffee and Espresso Maker

High Protein Intake Is Associated with Lower Risk of All-Cause Mortality in Community

23andme

When Brains Collide by Michael Lewis

Behave by Robert Sapolsky


Episode Transcript

Boomer Andersen: [00:00:00]Welcome to decoding superhuman. This show is a deep dive into obsessions withhealth performance, and how to elevate the human experience. I explore thelatest tools, science technology with experts in various fields of humanoptimization. This is your host Boomer Anderson. Enjoy the journey.

I love people who are willing to tackle tough topics. Forinstance, are genetics useful in personalizing nutrition are the blue zones,bullshit, traumatic brain injury and others. This is why I'm so excited to talkto dr. Tommy wood today. And he's a research assistant professor of pediatricsat the university of Washington division of neonatology.

The majority of his academic work has been focused ondeveloping therapies for brain injury and newborn infants, but also includesadult neurodegenerative and metabolic diseases, as well as nutritionalapproaches to sports performance. I'm in a link to his bio in the show notesbecause it's quite long, but Tommy's current research interests includephysiological and metabolic responses to brain injury and their long-termeffects on brain health, as well as developing easily accessible methods withwhich to track human health, performance, and longevity.

He lives currently with his wife, Elizabeth, and they shareit their house with two energetic and goofy boxers. And in his spare time, hecan be found cooking barbecue, which is something that we get into today.Mixing a good pot of coffee, hiking, reading, or just lifting something heavytoday. Tommy and I talk a little bit about those topics that I mentionedearlier are genetics actually useful?

For instance is nutritional epidemiology, just a usefulfield at all. We get into cannabis and how Tommy thinks about things like cannabidiol.And we tackle TBI and specifically for somebody like myself who had numerousconcussions growing up, what may be some therapies which have a good safetyprofile that one could potentially pursue.

The show notes for this one are decoding superhuman.com/tommy.And a shout out, goes to mr. Greg Potter for the introduction. Thank you, myfriend, let's get on with the episode.

If there's one staple in a high performance day, for me,it's a good night's sleep and a good night's sleep often starts with the nightbefore specifically taking care of my light late in the evening.

I am in some ways an entrepreneur. And so I do work quitelate in the evening sometimes, and often that revolves around getting in frontof a screen. And so how do I protect myself? Well, whether it's TV screens, badlighting or. Computer screens. I have my blue light blocking glasses on and thecompany that I've gone to now for years and refer people to anyone from myclients to friends, family, et cetera, is blublox.

B L U B L O X. And any met has been on the show. I love whathim and Katie have put together with blue blocks and they have just someamazing stylish frames. So if you want to get your blue light blocking glasses,Head on over to blue blocks.com B L U B L O X. And use the code D S 15. You'regoing to get yourself 15% off.

Let's get back to my conversation, with Tommy Wood,

Tommy,  welcome to theshow.

Tommy Wood: [00:04:00]Hey, thanks for having me.

Boomer Andersen: [00:04:02]So you're probably the first guest that I've had on that I would trust toactually advise me on how to make calls, what I hear your Cemex guy. And, youknow, I'm more of an Aero press person, but you have to sell me on the Cemex.How do you do it?

Tommy Wood: [00:04:21]So I. I have all of the, or at least most of the necessary paraphernalia, to,to do this properly.

So I have an induction, heated gooseneck, kettle, where Iget my, my water to 205 degrees Fahrenheit, which is on the warmer side. Youcould go a little bit. Cool. Is

Boomer Andersen: [00:04:39]this like the FA the fellow or whatever it's called?

Tommy Wood: [00:04:42]It's not the, the, the stock fellow. I have actually one made by Cemex calledthe chattel.

but yeah, it would be the same thing and you can dial up thewater, the water up and down, and then obviously, fresh ground beans. I have, Iuse a re a reusable metal filter, rather than a paper filter, which I reallyliked because, there's just something like some of the, some of the oils andflavors, and like, just like this tiny amount of the granularity that you get.

So certainly if you did it in a French press, You get aslight, you get a very different texture of coffee. And I like that and I likedthe flavor profile better. So I use that in my Cemex and then it's 16 to onewater to grounds by weight. So I usually do two ounces of coffee, first, twoounces of water.

and obviously, I don't know, I weigh both sides. So I havemy Chemex on a scale. As I put the water on, you can get really in depth withthe total brew times or how long, you know, you know, and how slowly you pourthe water. I'm still working on optimizing that. but everything else, thatthat's, that's, that's essentially my, the first part of my morning routine, issort of brewing all of those things, growing the beans and putting it together.

Boomer Andersen: [00:05:57]So, is it just the flavor profile of Cemex that you enjoy or is it the factthat you're getting sort of a larger filter versus an espresso? I'm justcurious how you arrived at Cemex.

Tommy Wood: [00:06:07]Yeah, so, so I, I used to do all of my coffee and a French press because Ipreferred that. to most other, brewing methods.

but this banana then sort of, as I upgraded things, Idecided to try the Cemex and then try this muscle filter. And I think it's areally nice balance, between the different ways to do it. I don't, I'm not abig fan of espresso. I like a big cup of black coffee, or I can really sort oftaste the coffee and try various different beans.

So it's, it's the way, you know, it's just, it's, it's the,yes, mainly the flavor profile, but I ended up getting out. that I've justreally enjoyed with it with, with a over

Boomer Andersen: [00:06:45]all right. Decoding, superhumans become the barista show today. So let's, let'sjump into a few things because there's so many topics that I could cover withyou.

And so, you know, I love a lot of your, your recorded talksand one of them you did on genetics and there's something in there that yousaid about the problems with nutritional epidemiology. And so I'm hoping we canget into that a little bit specifically, you know, why you're, you're skepticalabout it.

both nutritional epidemiology and genetics.

Tommy Wood: [00:07:20]So to start, I guess if we start with nutrition, epidemiology, The main reasonI'm skeptical of it is because it's complete trash science. I mean, it's just,it's just a hundred percent nonsense. and, and the reason for that is that itis really hard, basically impossible to get people to accurately.

Teddy, what they eat. and no matter how you do it, I guessthe two most common or, or well-known studies based in the U S there's thoserun out of the Harvard school of public health by Walter Willett and Frank hu.So that's the, health professionals follow-up study and the nurses' healthstudy, and they do a yearly, food frequency questionnaire where you just getthis huge list of foods.

And then it says, On average over the past year, how muchdid you eat? And that's like, how many tablespoons of heavy cream did you have perweek for the past year?

Boomer Andersen: [00:08:19]I'm not sure I'm going to remember that for last week. Right? Tracking.

Tommy Wood: [00:08:23]Exactly, but literally every possible food. and then the, the other one is theN Haynes.

And what they do is a 24 hour diet. Should we call it? Sothey call you up and they say, what did you eat yesterday? And you tell them,and then they say, how typical is that? Of your normal diet, like, do you eatmore or less of these various and that's it. And then, and then they take thatdata and then 30.

Yeah. Or they say, Oh, because this person had two moretablespoons of heavy cream on average per week. Over the year that we askedthem, They're more likely to get heart disease, which is when you think aboutit is absolutely insane that we think that this is reliable data. And what'sreally nice is that people have actually looked at this.

And so there's a couple of, papers published, looking at thequality of their own Haynes data. And basically if you look at what theyreport, more than 60% of reports, the calories like the calorie, total caloriessupported are incompatible with that person being alive. so one example

Boomer Andersen: [00:09:29]too low or too high,

Tommy Wood: [00:09:31]the under-reporting by up to 50% in some places.

And then like, so like, even if that half is correct, you'vedone to what the other half of that kind of resolve, which is going to make ahuge difference. So, so one example. It was a very well cited study or paperpublished in cell metabolism in 2014, looking at protein intake and mortalityrisk. And they sort of, then they specifically said that if you're under 65 andyou have high protein intake, then you have an increased risk of, bothall-cause mortality and consultancy.

And so when you look at that data and it's hidden in a tablein the supplementary, like information for the paper, and this is based onenhanced data. Yeah. If you look at the, you look at the sort of thedemographics or, you know, the anthropometrics of the, of the, the peopleincluded and they, they were supposed to have that says underneath that BMI ison the table, but it's not that there is waste to conference.

And if you go by waste to conference, for, sort of like thelevel and what you would expect in terms of obesity, on average, these peopleare obese. or at least close to it, certainly overweight and in the highprotein group, which is the one where they're saying, because of this highprotein, you're going to have increased risk of death.

They are reporting 1500 calories per day on average. Sothey've definitely under-reported by 50% or more in the U S what are those 50%of Canada is going to be, they're going to be refined carbohydrates and fats isnot because they ate, you know, they're not under reporting their lean chickenbreasts.

Right. and you know, this, this is the quality of the data,and this is what we're using to say, Hey, if you eat more or less of this, thisis going to be your health outcome. and we just. Do not know the majority ofwhat people are eating in these studies. So there's just, there's no way.There's no way to understand this.

And, and people, again like Walter Willett and Frank, whowill say, Oh, but we verify that this is gold standard by doing blah, blah,blah, blah, blah. But you know, once it's out in the wild and once you're doingthis on a population size basis, this stuff just doesn't work. it's, it'sterrible.

Boomer Andersen: [00:11:33]And so I imagine that, and I kind of hinted that we're going to go into geneticshere.

You kind of have similar feelings about genome wideassociation studies and the sense that it's just massive populations and you'rekind of searching for a needle in the haystack, which may not exist.

Tommy Wood: [00:11:49]Yeah, I think. You know, we, we had this, you know, over the past 20 years,we've had this increasing, obsession with our genetics.

And it's been both on us on a, on

Boomer Andersen: [00:12:00]a popular ranking Craig veterinary

Tommy Wood: [00:12:03]population level, as well as, you know, this is going to be the key topersonalized medicine and all this kind of stuff. And what, you know, when youlook at this and it kind of depends on what you're trying to achieve, but whenyou look at this in terms of.

Say standard health outcomes. Like what are we worried abouton a population level in terms of population health? And we're worried aboutpeople being overweight and obese, you know, having high BMI and BMI is asketchy way to look at it, but that's the way it's reported in studies. maybe,you know, types of diabetes or, or fasting blood sugar, you know, when you,when you look at, Even polygenic risk score.

So, so basically you sort of sift your way through all ofthis information and you find X number of single or single nucleotide,polymorphisms, or snips associated with an outcome. So say it's weight or BMI.And by the current state of the art, I believe is 141 snips all use, put intoan algorithm to try and predict.

your BMI and as your polygenic risk goes up across these 141snips. Yes. Your, your average BMI goes up, but including all of these genes,it only explains 13% of the variability and BMI, which basically means that 87%is driven by the environment. and then when you look at individual genes, youalso see, similar effects.

So FTO is probably the one that people have heard of. You'reright. In terms of VMI or being obese, fat mass and obesity associated protein.And when you look at, individual populations, so again, they've looked at thisin the U S if you, FTO was only associated with an increase in increased riskof, or higher BMI or increased risk of obesity in the post-war era.

So before we had the, you know, the modern obesogenicenvironment, these things didn't even matter. Okay. So again, like even thegenes are associated with the outcome, you know, it's an interaction betweenthe gene and the environment and the environment is what drives almost all ofthe risks. So when we spend all this time baffling about FTO, gene means weshould do X or eat less saturated fat, which is like just crap sciencemultiplied by crap, nutrition, nutritional epidemiology.

We're just like completely missing the forest for the treesand, and. Or the, the, the, and then, you know, similarly in our kind of world,in the biohacking world, we would get like super focused on something likeMTHFR. Right? You have, You, you know, the languages, things like your MTHFRdoesn't work properly.

Right? That's the, that's that's the line.

Boomer Andersen: [00:14:38]Fear-mongering right.

Tommy Wood: [00:14:39]Yeah. And it really is. And so 5% of people have an MTHFR, gene or protein, butdoesn't function properly. Right. So then all of a sudden, so like the averageperson has a re has a reduction in function. So, so automatically you can sayit's not working probably because that's just part of the normal distributionthen.

When you look at how these things interact and you look atsomething that you might care about while your homocysteine level, while yourMTHFR, function like almost has no relations, your actual homocysteine level.Despite what Chris master, John will tell you about how much coli you need toeat for, like you're given X percent decrease of MCH population.

It's

Boomer Andersen: [00:15:18]just calling calculator.

Tommy Wood: [00:15:21]Cool. Yeah. And the, go for it. Yeah. So. I put my, my, my information into thecoding calculator and I actually have I'm. I'm ha I'm heterozygous for both ofthe major snips MTHFR. And what's nice about the fact that there's two snips,as you can kind of see how they interact in terms of function.

So I have more than a 50% loss of function. and because ofthat, I need to eat twice as much coding, supposedly, but the study that isused cited in the calculator to say that I should eat twice as much. Coding isthe study looking at folate deficient, a 13 folate deficient. Mexican-Americanmen.

And even in that study, eating more coding didn't affectmethylation status. Right. And then the fact that it's a small study, it'spoorly controlled. It's not relevant to me. It's of people of a differentancestry, and we know the ancestry plays a big role. So if you have an FTOsnip, but you're black. Then it doesn't have an effect on your weight, but itdoes if you're white.

So like all of this stuff comes into play and like, thenthere's the, then there's the fact that the main assumption that's made in thecoding type later is that if you look at the people with the most significantdecreases in function, then they assume that there's a linear effect in termsof like here's people with a hundred percent function, here's the people with25% function.

There's a, there's an assumption. There's a linear, a linearrequirement across MTHFR function and coding requirement. But those people whohave a very one specific snip, they're just completely different. And actuallyyou can overcome all of it with a very small dose of riboflavin and the effectisn't vignette at all.

So like all of the assumptions that go into the calculator,just 100% nonsense. now that doesn't mean that coding isn't important, right?the brain research of coding is very important for the brain, but just likewhen you bought it down to these very simplistic things, all you're doing iscausing fear-mongering.

That really isn't based in science.

Boomer Andersen: [00:17:18]So this is, I mean, it just goes back to the whole idea that the reductionistapproach to anything is probably not the right way to go. Right. so. Going backto genetics before I get into the overarching question of are these use or howthey can be useful. There's one that talk about fear-mongering AICPA Bowie, andjust sort of a Bowie in the saturated fat connection.

And you mentioned saturated fat or slightly earlier. I'mcurious your thoughts about that, especially since my understanding, at leasthistorically is that we evolved from an API before variant, but I may have thatwrong.

Tommy Wood: [00:17:55]Yeah, no, that that's right. The oldest is the oldest barrier. And for when weclimbed down from the trees, essentially, and it is, you know, your APOE fourstatus.

Is is probably one of the future, or I think like anindividual snip is associated with a certain outcome. So particularly forAlzheimer's disease, but also potentially cardiovascular disease, but theeffect is quite small. So it explains about your AP four States has explainedabout 5% of the variance in your outcome with respect to cardiovascular diseaseand Alzheimer's disease.

So it, so it has a meaningful effect, but relative to allthese other things, I think the effect is quite small. however, it does seem tobe associated with a slightly more inflammatory quote unquote inflammatoryphenotype and potentially, there's an interaction with saturated fat. however,I don't think that it's necessarily, that means that if you are APOE E fourheterozygous or homozygous, you should avoid saturated fat.

But I think, it's. It's some it's somewhere where maybe youhave to make, you know, just pay a little bit more attention to things. I thinkthat that's worth, that's always worth thinking about. however, again, in the,in the grand scheme of things, the effect is, is very small. And if you look atthe age of onset of Alzheimer's disease in APOE four homozygotes, versus thosewho are.

Non APOE four homozygotes. So it could be Apple fallhatches, I guess, or, you know, various combinations of twos and threes. Onlyabout a third of people with who are APOE, four homozygotes are diagnosed withAlzheimer's earlier than you would expect to be diagnosed if you had any of thoseother. Yeah. So in my mind then there's only a third of people who have, whoare Appleby for homozygous who have like a significant penetrance of that.

Genetics. Right. Because you know, then the other two thirdsare diagnosed at a time that fits the normal distribution of people with othercombinations that are Bowie. So, so there is a significant effect, but it'sprobably smaller than most people, say it is. and there's also interestingstuff like.

If you look at the Bolivian seminary, who are a hunter-gatherertribe, who've been studied very intensively, in terms of their health outcomes,because, you know, there aren't that many where we've been able to sort of goin and study things. And of course, like, anytime you go in and studysomething, you you're going to change it.

But this, this is, this is sort of the way we look at it.And in that group, if they have a high parasite burden, which either, you know,you see the parasites directly or have an eosinophilia, no high eosinophils ona blood test and they have apathy for either heterozygous or homozygous, theyactually have a protection of cognitive function.

So there is a, an interaction between the environment andthe gene and what is expected. And I think, you know, the, my. my personalapproach is to try and sort of use, you know, takes an information from whatmay have been, you know, your ancestry or the environment that you evolved in.I think the APOE for a lot of people who have Apple Apple before, they just,you know, they will.

Likely or potentially that will potentially have, a greaterdetrimental effect from like the environmental mismatch that we're exposed toin terms of diet and sleep and stress and all that kind of stuff. So again, Ithink, you know, it's, it's possible that those people may just have to pay alittle bit more attention to their lifestyle in order to make sure that theydon't see the negative effects of that.

Boomer Andersen: [00:21:19]And so for people out there who are either have already spent money on like a23andme or something like that, or, have invested a lot of time. Kind ofperusing, I guess Promethease was sort of the database that I went tooriginally. you knew what kind of useful stuff can we get out of this? Is thereanything we can get from a performance perspective or is it purely pretty muchgenetic disease driven?

Tommy Wood: [00:21:45]Yeah. there's not very much. From a 23andme report that I find particularlyinteresting or

Boomer Andersen: [00:21:52]the, the ancestry one is kind of just like boring in a way it's depends onwhere they cut the borders.

Tommy Wood: [00:22:00]Yeah. Yeah, exactly. And so I think there's some potential, and this isobviously where 23 and me will make most of their money is with the deal withGlaxoSmithKline.

So to do better pharmacode genomics, that's kind of, that'sbeen the whole. A business plan all along right setting to sending one, $200.Genetic tests is never going to be a long term business plan. So from the snipsin say the slides from people 50 enzymes and how you metabolize differentdrugs, that's probably one of the areas where, the evidence is strongest for aneffect.

And I would say, you know, I certainly think that that couldbe beneficial for, you know, Dosing and personalizing, you know, when you'regoing to be taking medications, you know, knowing like whether you should takemore or less of something, cause you know, it's going to change his half-lifebased on a given snip and you know, the D the, the data there is reasonablygood.

And so then that may affect your capitalized. You'll see a Ptwo, a one, your caffeine metabolism rise, fast or slow caffeine metabolizer. Ithink that there's some potential, potentially useful information there. Icertainly, if you're a slow metabolizer, you know, less caffeine. Earlier inthe day, certainly is probably gonna have an effect on sleep.

and then also there's an increasing amount of data lookingat, caffeine metabolism. And then whether you respond to caffeine as anergogenic aid in sports performance, and those who are fast metabolizers seemto, respond better to caffeine isn't ergogenic aid. Okay. Sort of if I had topick one sort of broad outcome, but that doesn't mean it's bad for the rest ofus.

So I'm, I'm, I think I'm a heterozygote for that. So I'm amoderate. so that's probably the area where I think the status is potentiallyuseful, but when it, when you're looking at disease risk, You know, obesitytype two diabetes, you know, and, and, and the problem is that most of the datayou get directly from 23andme, they've done it through subjectivequestionnaires or, you know, sending people a questionnaire.

So like when I learned that I'm a moderate caffeinemetabolizer or whatever, then 23, it tells me that I have, I'm more likely todrink more caffeine. What does that mean? That literally means nothing. That'sjust, cause you ask people about that, about, you know, that you know, whattheir, what their genotype is, and then you ask them about that caffeinedrinking habits.

That's not useful to me. and so that's what, and thenthere's other stuff like, Oh, you have this. So you're more likely to move andyou'll sleep like a Ray, what does it, how is that useful? But this is like,sort of, it gives you the, it gives the, The illusion of useful data, which isnot really meaningful.

And obviously that's because their, their, their business,is, is elsewhere and they have whatever it is, a few million genotypes thatthey have enough to then do the other stuff that they want to do. And so theydon't really care about giving you meaningful data.

Boomer Andersen: [00:24:47]So, have you seen any of these sort of, online genetic diet calculators thatare even worth their weight?

Because I find, for instance, the single snip analysis oflike whether or not you are a higher, low fat diet, that just kind of irks me alittle bit, especially if it's not an eight Bowie.

Tommy Wood: [00:25:05]Yeah. There's so there's no evidence to support those whatsoever. and when,when you actually look at people, who've tried to examine this, you might have,so there's there, the food, the food for me studies, based in Europe.

So they, they look to giving targeted nutritionalinterventional advice. So it was a FTO. Would you saturated fat, MTHFR.increase, it was increased Foley and, and you know, all that kind of stuff. Andwhen they look well, there are two important outcomes. One is that when they,when they looked at people, who've got the different advice, basically beingtold about your genetics doesn't affect your behavior.

And that is, that is reflected across multiple differentstudies. There was a mess analysis that came out a few years ago that showedthat again. And then equally, even in those people that got the advice thatdidn't really make any difference in terms of any of the things that theymentioned. so, and then there's then there's the, another example like, ChrisGordon has diet fits study where they randomized people.

It's a low, fat, low carbohydrate, both. Generally improvingdiet quality. And then eventually people were allowed to sort of iterate theirway into something. They felt that it was sustainable. and then they looked at,you know, supposedly low fat or low carb genotypes in the two different groups.And basically regardless of your genotype and the diet, you were randomized toeverybody lost the same amount of weight.

so, so again, like there was no, and there were no othersort of biomarkers that suggested that because you have a low fat genotypemeant that you did better on the low fat diet. There's really no evidence tosupport any of that. So any of, you know, so, I'm trying, there's the.

Boomer Andersen: [00:26:39]so I can imagine like, I, I'm just wondering, there's a flip side risk factorhere that if you tell somebody that, you know, they have  or, I mean, the MTHFR, one's still myfavorite.

it tells somebody that they have dopamine issues and thenthey just kind of become neurotic. Right. And just, I can imagine causes moreharm than good in this case.

Tommy Wood: [00:27:00]Yeah. And you know, what you tell people actively affects their physiology. Sothere's a great, so, so on the, on the dopamine front, there's, there's a greatquote from Robert Sapolsky, which says that, thinking that you have the warriorgenotype, which is COMT, so how fast or slow do you metabolize dopamine willhave, you know, thinking that you have that genotype will have a greater effecton your physiology than actually having it.

and there's, there's loads of very nice information. But,and, and studies that show that telling somebody they have a specific gene it'slike, even if they don't directly affects their physiology. So there was astudy where they took people, they put them on an exercise like treadmill test.Then they told them either you have the good copy of the aerobic gene or thebad copy of the aerobic gene, the people who were told they had a good copywhen they redid the test, they did just as well as they did before the peoplethat were told they had a bad copy, they did less well.

On the exercise test, because they've just been told thatthey have, that they have, you know, poor aerobic, the genetics. And again,like I know evidence to support that, but if you tell somebody that they havepoor genetics, you will, will negatively affect their physiology. So like,there's almost for most of these things, particularly from the direct toconsumer side, there's almost no benefit.

And there's a potential for significant harm.

Boomer Andersen: [00:28:16]I'm just, I guess it's not, you said that it's not the flip side of thepositive. So in my future kids life, I can't like secretly say like, Hey, youhave good genes. Even if they don't have good genes and then potentially makethem into a professional athlete.

Right. It doesn't quite work like

Tommy Wood: [00:28:29]that. Fortunately, we had the, unfortunately it could actually be the languagethat we use. So if you change the language and you were like, your genetics areamazing, this is gonna, you know, this is gonna mean that like, When you'replaying basketball, you're going to be all the kids you're going to I'll runthem.

I think there's possibly, like you could possibly seesomething there, but in general, the way we talk about genetics is like easilyor normal. Either you have MTHFR function of a hundred percent, which only 15%of people do or you're abnormal. Right? So you can't say like, there's only POthere's only possible.

Like there's only a possibility of being worse, right? Likeeverything is either normal or bad, which again, like. Isn't doesn't make anysense, in, in normal physiology. So if you change the language and so there'sone example. Where this potentially happens in, in that same study, where theydid the aerobic test and tell them about their genetics or randomized them totell them about the genetics.

They also did it with the FTO gene. And so they said topeople like you either have like the good version or the bad version of the FTOgene in terms of, you know, you're less likely to be overweight or more likelyto be overweight. And the people who they told him they had the good copy, lesslikely to be overweight after a standardized meal the second time after theytold them.

And again, this is regardless of the relative, their actualgenetics, they had higher, GLP one signaling and grades is the time. So youfrom a, from a. a single male. So being told that they had the genocide thatwas protective against gaining weight, they got, you know, they got moresociety from a given meal and you saw that in terms of satiety, hormonesignaling.

So that was actually a benefit of saying, do you know whatyou have the protective genotype? They were, they were going to feel more fullafter a meal then. Then over time, they might end up eating less or havingbetter society regulation. But that's the one example that I have of a benefitof being told about your gender.

Boomer Andersen: [00:30:20]I might have to use this one with Thanksgiving dinner table with some of myfamily members, but I want to transition here Tommy, to something that. I'vejust kind of delved into the research a lot lately or what exists of theresearch. And I'm kind of curious how you look at just sort of the world ofcannabis, because the research is to my understanding somewhat limited.

but also some of the ways that the research is conducted isby surveying clinicians and sort of getting the effects from clinicians and.For somebody like you, how do you look at cannabis and sort of how thosestudies are done? And what, what needs to change other than the schedule, onebeing dropped in order to learn more about it?

Cause I mean, you hear a lot of practitioners using it,particularly in California, West coast, and here in Amsterdam, but you know,how, what do you think about cannabis and what can we do to make the research alittle bit better?

Tommy Wood: [00:31:22]Yeah, I think the problem with the way that research that you mentioned inparticular was conducted is that we can't really extract any meaningfulinformation from it in reality.

And this is something, so, so I mean The first step of anyof trying to answer a scientific question, well, you know, develop a hypothesisand then test it, is this kind of stuff. you, generate either pilot data oryou, collect what is currently known. And so that is an important first step.

however it then requires actual testing and What you seeacross all the different realms of health-based research is that, you know,when you, when you have one clinic or one group of people who, who usesomething, because they believe in it, First of all, we're going to get strongplacebo effect.

Second of all, it's uncontrolled. So you don't have anythingto compare it to. And as you know, the, the classic Voltaire quote is that theart of medicine is entertaining the patient while nature cures the disease. Soyou, you, you basically, you have this thing that you, you tell the patient issuper important, right?

They get great placebo effect, and then, you know, they keepcoming back and you keep working on them. And then over time, They're probablygoing to get better anyway, but  youascribe it to the intervention that you put in place. and so that's where Ithink a lot of that positive data is coming from, and it doesn't mean that Idon't think there is a benefit there.

It's just that that's, that's all that you can say from thequantity of data that exists. when you're then isolating individual compoundsand want to test them. Right? So the majority of my work is testingneuroprotective compounds, or potentially neuroprotective compounds in animalmodels of brain injury.

That's, that's kind of that's my bread and butter. And sothere is a lot of interesting info, you know, data on CBD. Say if we just goingto isolate one component as a neuroprotective agent and we have tested it inall out, or we did in the lab, I did my PhD. And I actually didn't see much.however, there are other labs that have seen benefit and I'm not going to saythat we did the right science and theirs is wrong.

So I think there is a potential benefit. So CBD it's alsoused in pediatric epilepsy and high doses. I have a colleague who does thatand, you know, sees some, some interesting benefits. So, so in that respect, Ithink we're kind of at the point where. The animal data is probably good enoughto suggest them and we then need to go into clinical trials and those are beingdone.

But, you know, we don't really have the outcome data tosuggest yes, in this specific setting say CBD is neuroprotective. and the sametime, with there's a huge sales push. For this stuff already. Yeah. To suggestthat it's beneficial and like there's some potential downsides there becauseit's already being taken up as already being sold.

People are using it. and there's really no evidence tosupport that. So in athletes, CBD is supposed to improve recovery, but reallylike there's no good data, on that.

Boomer Andersen: [00:34:24]Yeah, I kind of think like CBD just kind of looks like Bitcoin was a couple ofyears ago in terms of a bubble though. I mean, Bitcoin is making a little bitof a resurgence right now, but, and I mean, if there's no.

What what's going to prick the bubble that is CBD. I mean,is it these clinical trials coming on? I mean, how do you get the clinicaltrials ramped up faster in a way?

Tommy Wood: [00:34:45]Yeah, it's really, so I think that you are just like the, the psychedelics, formental health research, you know, the there's always going to be a bit of pushback when, you know, these components.

you know, come from something that is a schedule, ascheduled drug, with, with, I mean, CBD is probably a little bit easier becauseyou can get it from hemp oil. They've changed it, such that as long as it'sless than 0.3% THC, it's not classed in the same way as cannabis. So likethere's been some movement that's going to potentially allow that to happenfaster.

but in reality, You've basically got to rely on research asbeing inserted enough, to convince whichever NIH study section, they submittheir grants to that, you know, this is going to be worth 10 or $15 million totest in a certain intervention. And there's only so much money to go around.So, you know, we may be particularly interested in CBD, but there could be.

How many other compounds and how many other diseases thatalso require some investigations. So, you know, unfortunately this stuff is, isalways going to be fairly slow moving because that's sort of the nature of thebeast in terms of like how what's the total pot of money available? What arethe total, the number of diseases to look at and then the number of differentdimensions.

and so that's always going to keep things fat, you know,fairly slow or slower than we'd like.

Boomer Andersen: [00:36:06]So with cannabidiol, you've kind of heard it, at least in this bubble that weexist in, used as sort of a potential sleeper agent, potentially an NZ alytic,maybe even anti-inflammatory. and you mentioned neuroprotective of those.

Are there any that we can just strike out and say like, Hey,that it's not possible right now? Or is it star TBD? When it comes to hosting apodcast, things like focus, short-term memory and verbal fluency become veryuseful. In fact, those three are very useful in almost any aspect of life and.Slightly over a year ago, I came across an early prototype of what becameBluetooth, carnitine.

I loved it so much that, well, I eventually became involvedwith the company. There's obviously a few steps missing there, but bluecarnitine is something that I take sort of when I need it. Not every day. And Itake a half a Turkey, which is something that goes in your upper lip. I let itdissolve. And I have what is called.

Or what we refer to as limitless mode for four to six hoursthat allows me to focus and it allows me to be verbally fluent. And it allowsme to talk to guests like Tommy in a way that, well, I can ask hopefully.Intelligent questions. If you want to join the Smurf nation. And if you want toreally get yourself a blue tongue and be in limitless mode for four to sixhours, I encourage you to head over to Trish.

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Let's get back to the show.

Tommy Wood: [00:38:10]Yeah, I think all of them have a little bit of TBD, sort of attached to them.The, the information, the data that I find most interesting is in terms of inflammationin the gut, w with CBD, because then you don't need to worry about it beingabsorbed and cycling. And the up in the brain and bioavailability is.

Pretty much a problem with any promising compounds, likegetting it to the place where you want it to be. But there's some interestingdata in mouse models of inflammatory bowel disease, where, you know, areasonable dose of CBD is, is quite protective for the gut. and so I'ddefinitely like to see more of that.

certainly had people again, try it in IBS and IBD and, youknow, they feel like they, they see benefit. Again, is that, a $3 a day placeboeffects? I'm not sure, but if they feel much better and healthier, then maybeit's worth it, for, for sleep. probably that's probably the closest to where I,I don't think it's really what people have said it, it is.

And when they've looked at CBD in, you know, Re so in smalldoses, it doesn't seem to have an effect on its own in large doses. So we'retalking like two to 300 milligrams. It seems to worse and asleep. again,there's one study in healthy volunteers where it seems to show the CBD on, onits own, actually, you know, may, you know, made sleep worse, where it hasshown benefit with sleep as in.

Chronic or like neurologically the pain or neurological disorderssuch as multiple sclerosis. And then it's as something like the, which has someTHC in it. So a combination of CBD and THC in that setting may be beneficialfor sleep. But again, hasn't been tested in like normal, healthy participantsor athletes or somebody who's trying to sleep better for recovery that's inlike specific, you know, specific neurological pain based conditions.

And then the combination seems to be important. So like CBDon its own, the sleep. I'm not really convinced based on what we know so far.

Boomer Andersen: [00:40:00]And some of the doses that you just mentioned are not exactly what you get atsort of your local pharmacies CBD, right? Like it's very hard to find 200milligrams CBD.

Tommy Wood: [00:40:12]And if it's, and if it's high quality, that's going to cost you a lot of money.

Boomer Andersen: [00:40:15]Yeah, of course, of course. all right. So going on from cannabis, I want tocome into sort of part of what you do. On a day-to-day basis. And to the extentthat you're able to talk about this as, working with kind of the formula one,one world, and this kind of group of elite high performers, and some of thethings that you and I have talked about before is what you can actually do it.

These people who are at the top of their game to improveperformance. And I'm just kind of curious, because, you know, when you. Sorry,working with these people there, you had a big roadmap in terms of what you canpotentially do in terms of behavior change and what have you found reallyeffective and what have you found very hard about working with somebody who is,constantly plugged into let's say the driver's seat, if you will.

Tommy Wood: [00:41:07]Yeah. So the interesting thing about working with this particular group is thatthey're probably more like the average person. With respect to both their,their lifestyle, you know, other than the jet setting and the incrediblefinancial resources and the jet.

Boomer Andersen: [00:41:27]I mean, you don't have a Casa or collection or something like that.

Tommy Wood: [00:41:31]No, sadly not. Although I could probably think of better things to spend mymoney on, but, the, the intense of the capacity and ability to make change,they're much more like the average person than the people I'd worked withpreviously, which would be. Well, you know, we'd call like optimizes. SoTaipei, you know, high-profile, high-paid job also wants to be an internationaltriathlon athlete, you know, on the side.

and those people will literally try anything and everything.They'll spend thousands of dollars to speak to every expert and try all of it.and as soon as you tell them to do something, they'll do it. yeah, it's, it's,it's a nice group to work with because they'll just do what you say or at leastthey'll try it out.

Like, well, none of this really sticks longterm. but they'lltry it out, but like the vast majority of people, that's not the case. soformula one, drivers are actually the same, you know, they have a limitedcapacity to start making significant change a because they have linked likelimited cognitive real estate to do it right.

Because they're just like continuously moving continuouslytraveling. They have huge media commitments that then the, in the simulatorwhere they're working with engineers to improve the color, there's just only somany hours in the day. and so what you see is that. W you reminded of the factthat picking the low hanging fruit is by far the most important thing.

And so you can, and you can see significant benefit in termsof, just like moving those big rocks and making sure that they're, that they'removed. And so I think of, one like one example where I was looking at somesleep data and, you know, somebody was con like concerned about their sleep.One of the drivers was concerned about their sleep and you just see.

Right. Like you can get with this fancy data. And it wasfrom a favorite, fancy sleep monitoring ring, and like all these other, all,you know, all this stuff that comes out. But like you just look at one numberit's just not, not spend, not spending more than five and a half hours in bed.You just need to be in bed for longer.

Right. But no other fancy dates are required. and so it'sthings like that. And then when you, when you sort of shift that and you are,you allow that to happen, they sort of build and re you know, then you talkabout, well, why is it you're not spending much time in bed? You know, why isit that as soon as you wake up, you want to get out bed rather than thinking,well, maybe I could do some things to relax and get that sleep.

so focusing on those things, then you start to see reallybig improvements. And again, it's just like the, the, the, the simple thingsthat we know are important. And so, like that is even important. That is evencrucial at that, you know, the sort of the pinnacles of performance, and, youknow, focus on the things that are most likely to matter because you justcan't.

Try and fix everything. and then like the other side, which,which, you know, for thinking about lessons learned from working in this arenais that even when, you know, when you, when you're working with these,high-performance like, you can look at somebody and say, you know what, you'redoing, absolutely everything wrong.

And the blood markers don't look great. And like, everythingthat I would say you should do, you're not doing. And yet you can still likefunction at a level that most humans are just not capable of. Hmm. and sothere's th this, this is a reminder that the, the human physiology isincredibly robust and incredibly resilient.

And we often talk, like, we often talk about these thingsfrom a position of frailty, right? Like we talked about like MTHFR is notworking properly. Therefore you're going to be, you know, you're going to haveall these risks, but in reality, you know, if you, you know, particularly ifyou sort of put the, the, the body in a fairly, Supportive environment.

it's incredibly resilient and robust and, you know, shouldbe able to handle a lot of these stresses. And we just, we talk ourselves intothis sort of frailty mindset. And I think that's, that's where a lot of theproblems come from. And we're obviously, we're always trying to optimizesomething at the same time.

We we're telling ourselves that we're not optimal.Therefore. We're going to have a detriment in performance. We're going to be adetriment in our long-term health. and I think that mindset is actually drivingnegative effects on physiology, rather than actually what, you know, what isactually going on in the environment.

So those are some of the interesting things that come outfrom working with that group.

Boomer Andersen: [00:45:39]And, and this is interesting. The element of long-term health is a particularlyfascinating. Topic of discussion in the sense that do you think, because theseguys are so focused on the near term becoming the next F1 champion, whatever itis that the element of longterm health and concern of long-term health fadesand therefore they're able to do this, or is it, is it some other drivingfactor?

Like, I don't know if you want to throw out the purposeword,

Tommy Wood: [00:46:08]Yeah.

and, and you could definitely think, well, I mean, you can,I mean, all elite athletes pretty much have to sacrifice some element oflong-term health in order to, to achieve immediate, performance. And so likethe, the tenent is that the athletes are very fit, but they're not necessarilyvery healthy. you know, and there's a, you know, if I was going to recommendthings that somebody do to, to maximize their opportunity for, you know,long-term health, most of the things that the athletes have to do to achievethat given performance, I would not recommend.

and this certainly a case of. You know, to really perform,you need to liquidate some assets, and sort of give those up and, and to getthat performance, but maybe that's going to cause longer-term problems. And sonot being focused on the future. I think it does allow you to then get these,these moments three, elements of performance, but equally, you know, not.

If you had the worry about long-term health and performance,you know, that that was potentially going to hold you back because I mean, anyperson who wants to live a long and healthy life with a long and healthy brainis not going to spend a lot of time driving it a wall at 200 miles. Right. Imean, probably don't go hand in hand.

So there's definitely a certain personality type, butobviously, you know, the focus on the near term is it's going to be a big partof what allows them to perform in the way that they do.

Boomer Andersen: [00:47:32]Okay. wow, this is fascinating. So with, with these guys, the typical kind of behaviormodifications that you're able to do with them, or what are sort of the topthree things that you wish some of these guys would change in order to maybeperform five, 10% better?

Is it sleep duration or is it, or that other things?

Tommy Wood: [00:47:55]Yeah, so I think the, the most important things that. Come up for that, like,sleep is always going to be super important, particularly because they'rebasically in a content except for this year where they've been a bit moreconstrained in terms of that travel.

They're basically in a continuous state of jet lag. and likeyou just said, there's no opportunity to establish a normal circadian rhythm.So, so sleep finding ways to sleep, I think is probably for these guys, themost important. and then, Nutrition is probably is probably the next one. Andit's very variable from driver to driver.

They all have very different, requirements, but alsointerests in terms of, in terms of their nutrition. And, and so then that givesyou a little bit of a, an additional, interesting factor in terms of optimizingthe stuff. However, they're also in a position where they can offload some ofit. So they, so the way that I work with these guys is mainly with theircoaches.

So each of them has like a body person who was essentially,you know, if, if you know who they are and then you, you watch formula one likethat always next to the car that always next to the driver. Like they are thereall day, every day. 300 days a year, sometimes

Boomer Andersen: [00:49:04]it's like the consiglieri that does everything for them.

Right?

Tommy Wood: [00:49:08]Exactly. And so, you know, when it's appropriate and you know, when the coachhas the interest and the driver has the interest in them, the coach may likeliterally take over all aspects of food. Right? So this is a coach for themaster's degree in certainly conditioning and a huge, you know, the body of, ofwork and experience.

And like they're the one. Scrambling the eggs to put in the,in the burritos, drive it as they get out of the car, because, you know, if youwant this stuff to happen, you're going to have to do it. And so, you know, I,again, I think there's some, there's some potential benefit or like, becausethese guys don't have to, like, they don't have to worry about feedingthemselves because they may have like an incredible chef.

You just like, here are mine macros for the day. You know,go for it. Right. And the food just appears. So, you know, offloading some ofthese worries again, I think allows them to then put their cognitive processesinto things that are going to matter more for that performance. But thedownside of that or potential downsides are that they're maybe less engaged insome of these aspects of lifestyle that.

That could be important to health. And again, this is veryvariable from drivers drivers. So like no sweeping statements, it really is, isjust, this is a potential, outside. and then the, and then the other one isthat. You need to work very hard to convince them that something is worthdoing, because people always want, you know, these guys to test out thatgadget, that device, that product, you know, so you have to show up with somereally strong data to say, you know, this is actually worth your time.

And I think that's a, that's an important thing to do aswell, because. You know, we're always like, Oh, you know, here's this thing,maybe it's beneficial. Like, but when you've got 50 people at any one time whowas saying that to you, you're going to say, well, show me why. and then that'simportant as a sort of a coach or a consultant or an advisor, because then youneed to be really certain that there's a high chance of this is this is goingto be beneficial before you stop badgering.

Somebody to implement that. And again, I think everybodyshould have that sort of barrier, of evidence required for you before youstart. Unloading all this stuff onto people, because again, that just becomesits own burden.

Boomer Andersen: [00:51:14]Yeah, absolutely. Otherwise you just become sort of an affiliate commission,man, which is a little bit of what's going on in the world these days.

Let's talk about TBI. Cause you talked about brains goinginto walls at 200 miles an hour. And you know, I grew up in a day and age withguys like junior PSEO being linebackers in the NFL, and he's a pretty prominentcase of TBI related suicide. And. You're doing a lot of research on this, andI'm just kind of curious first off, if we can qualify, just kind of, what, whatdo we know about TBI in terms of like, if you had a particular type ofconcussion, if you had a certain number of concussions, should you be concernedand is there a way for our brains to naturally heal themselves in these cases?

Or do we have to take precautionary measures?

Tommy Wood: [00:52:11]Yeah, I think. The sets and the enough data to suggest that after a significantTBI and what constitutes a significant TBI is going to be buried. Differentfrom person to person, for a number of, for a number of reasons, but youconcerned to get long-term changes and save them the inflammatory state of thebrain.

you know, the, the general function of the brain and thenthe vulnerability of the brain to say, feature insults. So like you could havemultiple concussions and then say you get a stroke later in life. is that goingto have a most significant effects or is it going to increase your risk ofdementia?

Which certainly seems to be the case and, and these thingsin some way, I don't know whether they're additive or synergistic, butdefinitely the more exposure you have, certainly the greater the risk. and soif. You are going to think about way. So say if you you've had some, someprevious concussions where you have some kind of previous injury, I think thereare a few things that, could potentially be beneficial.

And when I think about what is required to. Heal the brainin my mind is very similar to what is required to grow a brain in the firstplace. And so then this is where some of my work in developmental neurosciencehopefully informs what you might do after an injury later in life. So things Ithink are important are omega three fatty acids, so DHA and EPA, and there's alot of interest in that and that, there are clinical trials.

There are people who, You know, recommending very high dosesoff the TBI, maybe 20 grams a day. So Michael Lewis wrote Lewis wrote the bookwhen brains collide. and he's done a lot of work on this. He has as a megathree protocol and it's very high doses. And so this is like after the acuteinjury in people who have significant cognitive deficits, if you then take acouple of, you know, a couple of pounds, handfuls of a good quality fish oil.

You know, what's the likelihood of there being a downside.It's very small. you know, is there some potential benefit? Yes. Because youknow, DHA is required for the, the normal function of neuronal signups is, andmitochondrial function. So there's, there's there's so I don't necessarilythink that everybody had a concussion should take 20 grams of official a day,but you know, certainly ensuring that these are in the diet, I think isimportant.

and, you know, we can certainly get into the weeds if wewant, but it it's, it's not just, you know, the function of the brain itself,but it's also, you know, having these present in the brain in the setting ofinflammation helps to resolve a normalize inflammatory processes because theyare metabolized into things called pro resolving mediators or specializedproteins.

I'll be mediated since that people may have heard of.Protectins Morrisons, resolvins these come from EPA and DHA and they help tosort of normalize inflammatory processes after an injury. So it's both usefulin the injury itself and the chronically, but then also potentially if you arein, at risk of a future injury, and creates a, you know, I would put into thatbucket as well.

there's a lot of very interesting data on creating as aneuroprotective agent. both. If you have it on board before and after theinjury. and the, again, the, you know, all of the things that I'm going torecommend, I like super low risk. Do I have several randomized controlledtrials to tell you that this is going to be beneficial?

No, but you know, they're so well studied and have such agood safety profile that I'm very comfortable recommending it to people. Socreating this is probably the best reset supplement of all time. and has.Almost no real risks and then has been studied in multiple animal models, aswell as human, disease, you know, disease States in terms of improving bothmental health and cognitive function and reducing, response to injury.

So that's another one. we obviously talked about, Weobviously talked about sleep already and I think sleep again is incrediblyimportant. I would probably have, a lower threshold to recommend somebody takessomething like melatonin to help establish normal circadian rhythms,particularly if they're not sleeping well, you know, they have previousconcussions and in line with that, I think is very important.

Basically, if somebody has ongoing symptoms after some kindof brain injury to do a full pituitary hormone check. So like the pituitary, ifpeople don't know it well, is this like tiny little grape hangs on a stalkinside your brain? And it's where most of the hormone regulation in the bodyhappens. And it's very susceptible.

to, to brain injuries. And so when, whenever anybody comesas sort of like come to me or has thoughts about ongoing symptoms after, aftera brain injury, you should just do a full pituitary screen. So LH FSH, whichwas to regulate sex, hormone production, growth hormone, TSH for thyroid, andyou know, You, you can often see detriments that either appear over time orthey may happen early and then resolve, but it's just, those things are alwaysworth checking.

And then, particularly if the pituitary isn't asking forenough hormone, then maybe you need to think about how to replace that. theother, the other two sort of nutritional things, I think it potentiallybeneficial are blueberry anthocynins. which, which I think a very interestingboth because they may have like a direct pharmacological effects to some of theblueberry anthocyanins or bury anthocyanins seem to inhibit a Metro, a matrixmetalloproteinases.

So these are enzymes that are produced in the setting ofinjury that, basically break down the extent of the matrix, but also decreasethe integrity of the blood-brain barrier. and then also there's, there's somestudies looking at these and assessing it both pediatric, you know, or, or inkids or in adults with mild cognitive impairment.

And they seem to maybe improve, both acutely andchronically, cognitive function. and maybe also, like if you look at, neuroactivation or FSRI in a setting of a, of a memory task, that seems to be someimprovements. So it's basically like. A cup of wild blueberries and blood, thewild blueberries that blue, small and blue in the middle.

And not those big in America

Boomer Andersen: [00:58:12]that day, you get it. What was the source Safeway or something like that isprobably,

Tommy Wood: [00:58:15]yeah. Yeah, yeah, exactly. So like a proper wild blueberry, and again, so likewhat's the worst that could happen. You just had a nice cup of blueberriesevery day. and then, then the final thing is coding.

And again, like obviously Coleen forms a part of thebackbone of the phospholipids that, that build essentially a brain. andthere's. But a lot of interest in CDB, Coleen, particularly. So Citicoline inthe setting, right.

Boomer Andersen: [00:58:41]Thing else you hear about the new Tropic world quite a bit, right?

Tommy Wood: [00:58:44]Yeah. and they've actually, there were, there were, there was a study, I think,back in the seventies where they compared thoracic time to set a Coleen.

In the setting of traumatic brain injury and Citi coding hadhad a better overall effect, but it was, it was a very, it was a very, I mean,it's very small study. you know, and most of the studies that do show benefitare again, very small. So I comparing seven people with concussion on codingversus seven people with concussion on placebo.

so there does seem, you know, again, it's one of those lowrisk, high potential benefit. supplements, the largest trial to date, the Cobratrial, basically compared traumatic brain injuries of, of a wide range that hadto be hospitalized and they gave them two grams of coding a day. And I actuallydidn't see benefit.

but the problem with that particular trial, this is justthat people are looking at it. The problem of that particular trial is thatless than 50%, I think 44% of people in the Coleen arm got 72 of took 75% ormore of their doses. So basically more than half the people in the trial didn'teven get. A dose.

And so that's maybe one of the reasons why they didn't seeanything. So like, those are things where, you know, people, particularly ofpeople that, you know, think they have either a risk or some kind of cognitivedeficit, after concussions or TBIs, then you know, DHA, creatine, we ransign-ins coding a potentially exogenous ketones.

 

Boomer Andersen: [01:00:07]Oh, that's an, that's an interesting one. Okay. Why exogenous? Ketones? Let'sjump into it.

Tommy Wood: [01:00:13]Yeah. So that's a great question. And again, it comes back to what, how youbuild a brain in the first place and you, so you could potentially go on atherapeutic keys, genic diet, you know, if people want to try that, that'sgreat.

And some people, you know, Anecdotally report that they seebenefit there. And there are also clinical trials of this currently ongoing,the easy way to do it, although potentially a much more expensive way to do itis, but there's always a ski fan. So I don't think that the source of theketones matters.

but when you look at neonates, who had, who were activelytrying to grow a brain, they are at least for the first week of life. And thenit's a bit of the. For weeks and months off to the bone in a state of ketosis.And that's either because there's EMTs, there's MCTs, medium chaintriglycerides, actively made in breast milk to encourage the production ofketones or because, you know, in the fostered state, they go into ketosis veryquickly within a few hours.

and that's because ketones are the preferred syntheticprecursor for fats and cholesterol in the brain. So if you give the developingbrain either glucose or ketones, The ketones will go into synthetic pathwaysand the glucose would go into energy metabolism. Now, of course, the brain canalso use ketones for energy metabolism, but the ketones specifically seem tobe, preferred, but synthetic precast.

And so if you're trying to build fatty membranes and putcholesterol into it, Then, and most of that is synthesized locally in thebrain, rather than coming from the circulation. Then Teton seemed to be, avery, seemed to be the preferred source. So I think that that's one reason why,again, if you, if you think there's some risk or some folks that depths that wewill try and to recover the brain, and then I think ketones are potentiallygoing to be beneficial.

The other side of that being that. The brain really doesn'tlike high spikes in blood sugar, particularly acutely after the injury. but youknow, I would also say that if you have a vulnerable brain, because you'veexposed it to these, these traumas previously, then trying to keep your bloodsugar under control, or at least avoiding, you know, multiple, large spikesevery day is probably going to be beneficial as well.

Boomer Andersen: [01:02:14]Okay. So there's a few things that I want to dissect here, but let's start,start at the beginning because there's a number of people listening to this,myself included who were sort of at a younger and much more competitiveathletes. Like the last concussion I had was 18 years ago. I spent a night inthe hospital, but the information that we had on TBI back then was.

Not very much. And I, or it could also be the doctor that Iwas working with at the time. Right. And so is there a certain qualifier thatyou would go through as kind of a working professional today who had. Childhoodbrain injuries that would say like, Hey, this is something that I need to payattention to.

Is there like an amount of concussions, sort of the types ofconcussions? Is there anything that we can do around that?

Tommy Wood: [01:03:06]I think that's, it's pretty difficult to put. so like a definition on that,just because again, that data, it doesn't necessarily exist like with, withjust in the last five years, maybe really starting to appreciate the effect ofearly life concussions, multiple concussions.

and so, you know, I'm working now with, ex you know, expertsin P say pediatric concussion who have large clinical databases of kids who hadconcussions. you know, and just now that starting to develop the data of like,you know, the severity, how they interact, what it may, may, how it may affect,long-term neuro development.

what's the effect of other environments or exposure. So I'mparticularly interested in, babies who are born preterm, which is often, oftenassociated with, change, or sort of inflammation that at the start and mayaffect. I don't know the brain. And then what happens if those kids dofunction?

You know, normally the majority of them, if they then playsoccer or football and get concussion later in life. So we're just starting toput that data together. however, there's definitely an increasing appreciationof, you know, particularly. So if you think of, if you think of kids and. TBIis still the, the most common cause of death in the U S and kids age zero tofour, as well as later in teenage years.

So it's very common. and then obviously like the kids, youknow, the majority of kids don't die, but you know, they fall and hit theirhead. And then what happens to the years after, and, you know, there'sdefinitely an increased, Risk of behavioral or mental health disorders in thesekids. Cause they took a buying so early in life.

So, you know, when you have a history of that and you startto see these things, then I think you can, then you can say, well, you know,maybe. you know, maybe the brain injury is a part of that. and again, like whatwould you then think about doing it? You know, it's all, there are plenty ofnutritional and lifestyle strategies that you can start to put in place.

None of which are particularly onerous. and again, like con.Yeah, there's no huge clinical data set to say this may be beneficial, but youknow, so putting those things in place, I think certainly worthwhile. so, soagain, it's, it's very difficult to say yes, because this happened, you'regoing to have, you know, you're definitely gonna have this, or, you know, youhave some kind of noticeable deficit, you know, however, you know, people whoare really interested in this, obviously there are, a number of.

Cognitive tests and tasks and things that you can try outwhen yourself. And certainly if you want to put things into place, you can thensee whether things improve. and then there's also, you know, I'm a big fan ofsubjective quality of life. you know, and if somebody is having troublesleeping or they have brain fog or, you know, any of these other symptoms andthey have a significant history of concussions, then I would probably be in aposition to say, yes, these will at least part of that.

and then, you know, again, you know, thinking about puttingsome of these things in place. Okay.

Boomer Andersen: [01:05:55]This is awesome, Tommy, thank you so much. So before we kind of move on intowhat I like to call the final four questions, because I want to talk to youagain, but I know cognizant of time that I don't want to take your entire day,especially because it's busy election day.

but, barbecue. Completely unrelated topic. And at some pointwe're going to have to do an in-person challenge because I have a bit of abarbecue history myself. How did you pick it up? And what's sort of your, areyou talking grilling? Are you talking low and slow on the smoker kind of thing?

Tommy Wood: [01:06:32]Yes.

So I must admit that right now I am more of an accomplishedbarbecue eater than a, than a barbecue. Producer. but, but certainly when I've,I've learned that when, what I called a barbecue in the UK is what should becalled grilling. Oh,

Boomer Andersen: [01:06:52]very, very true.

Tommy Wood: [01:06:55]And definitely not what barbecue is, in, in the U S so I, I can, I can puttogether a pretty decent, slow cooker pulled pork, that, that, you know, Atleast I can get southerners to eat.

like some of my wife's sounder oil from North Carolina,which, you know, in North Carolina, barbecue is like

Boomer Andersen: [01:07:15]vinegar sauce too. Yeah.

Tommy Wood: [01:07:18]Which I really like, I much prefer like the vendors, vinegar sources or mustardbased sources are certainly my preference. But I set a limit.

Boomer Andersen: [01:07:28]It's just like, I grew up. So you don't know this about me, but I grew upcompeting in barbecue and probably have a more accomplished barbecue resumethan most things I've ever done in my life.

but I grew up doing Memphis barbecue, which is a little bitdifferent. So, I mean, look, I can appreciate a good Carolina sauce. One. Ifind a good Carolina sauce,

Tommy Wood: [01:07:49]but, but I will say, that my personal preference is brisket. Like I could eatgood brisket all day, every day. And this is one of the, this is one of themain benefits of working with formula one is that every year?

Well, not this year, but every year the us grand Prix takesplace in Austin. And so I get to go to Austin and basically brisket for everymeal for three days. well, five days before I applying,

Boomer Andersen: [01:08:16]Austin's certainly a great place to find brisket to like Texas makes the bestbrisket. I can't can't hold a candle to them.

All right. So going into the final four questions now thinkof these as kind of, rapid-fire just fun questions. If you will. what's yourtop trick for enhancing your focus? Is it your chemics coffee or somethingelse?

Tommy Wood: [01:08:36]yeah, the, the top Trek that I have, I learned from a friend of mine calledJames Hewitt, who I also know through, instead of working with the formula onedrivers, which is basically, avoiding what he calls cognitive middle gear.

So it's just a void. It's essentially the avoidance ofmultitasking. if you can get rid of all these other things that are trying tojust distract your attention, which basically results in you doing lots ofpoor, poor quality work, which actually, and there's an analogy in, training orany kind of training, particularly in Germany training, which is that mostpeople spend most of their time in middle gear, which is just thrashingthemselves around lactate threshold, which has the biggest effect in terms of.

like physiologically, demanding on the body with thesmallest return in terms of performance. And so, the cognitive middlewaremiddle gear is the same. And if anybody's interested in that, I definitelyrecommend looking him up, but that's, that's the basically eliminates themultitasking, which I was never any good at anyway, is, is the best way toimprove performance,

Boomer Andersen: [01:09:36]favorite book, or actually let's reframe that book, which has most impactedyour life.

Tommy Wood: [01:09:43]I think. Just because of all, just the, the amazing things that I learned about,humans and animals from it is probably behave by Robert Sapolsky. hasn't hasn'tbeen beaten yet. and just so much, you know, if you want to know about whyhumans behave the way they do and why most of the things that we're concernedabout.

Really make such a small difference. then definitely readthat it's an Epic tome. I will say that and very dense, but just fascinating.

Boomer Andersen: [01:10:16]You know, I've had it sitting by my bed for awhile. And just because as you sayit is an Epic tome, it's been one of those things that I've been delaying. Itwas actually recommended by Greg who was the guy who connected us.

But I, after this, I'll have to start picking it up and seehow we go with it. What excites you most about the health world right now?

Tommy Wood: [01:10:40]I think what, what I think excites me and is hopefully going to pan out is theincreasing focus on helping people change behaviors. and because. We we know.And I know as somebody who spends most of my time, giving people informationabout their health, I know that giving people information is not what improvestheir health.

it's actually supporting them to, to make those changes,which is very difficult, particularly in the environment that we exist in. Sothere's a big focus on behavior change, which is actually finally starting toinclude experts in behavior change rather than just. Some tech kids fromStanford saying, Oh yeah, I can change

Boomer Andersen: [01:11:26]by shortening your feedback loops.

Tommy Wood: [01:11:28]Yeah. I'm just failing massively because they don't understand the problem. so,so that, I think. Is, it is definitely something that asides about. And thenthe other thing that I'm excited about is the fact that there's an increasingfocus on, diversity and inequity, particularly in health data. and so like whenI'm looking at polygenic risk scores and they've removed all the data fromnonwhite people, because it makes.

The polygenic risk score, less accurate, like immediately. Ijust, I just so frustrated to throw my hands up in the  

Boomer Andersen: [01:11:59]right.

Tommy Wood: [01:12:00]It's absolutely infuriating. And these, you know, in general, if you thinkabout the U S the UK are the populations, the people who require this the mostare the people who you're removing from the data set because they make itthat's accurate.

I mean, it's just, it's just insane. Mean it's just, I'vebasically said before, and I've gotten some pushback from him, believe in itthat when you do this, You're essentially encoding racism into science, right.Because you're just, you're propagating these inequities. and so it's from ahealth data standpoint.

So again, like most of the, if we think about cardiovasculardisease, risk markers, they were developed from the freemium cohort in, inFramingham, Massachusetts, which is essentially all white people. And then whenyou look at those biomarkers, they don't predict cardiovascular disease nearlyas well in black people or people from other heritages.

So all of the data that we have. Isn't relevant to this hugesection of society, but we're also, you know, have far less privileged, but formany other reasons. So, I'm really happy that that people are starting to,focus on that. The, the one potential downside, which still has a lot of workto be done is that, you know, we look at demographics and when we're trying toanalyze health data, so we'll, we'll say, you know, how, how do you identify asblack or Hispanic or white or something else?

But the problem is that when that's the only major identifythat you have, and you put that in as into a statistical analysis, what yourisk doing is saying that, race has a distinct biological effect on health.Which is lots of data to show that it doesn't, but if you don't do it correctlyand acknowledge the fact that the reason why being black is, you know,associated with the worst health outcome is because of.

The sort of distal societal problems rather than becausethere's some health effects of being black, which the most healthcare groans isabsolutely not the case. So we just have to be really careful about how weanalyze the data, because you can also, again, start sort of encode theseinequities and assume that it's an effective race when in fact it's aneffective society.

so I'm really excited that people are starting to focus onthat as well. I think that's what I kind of moved away from some of the eliteperformer world. I mean, I still do some of it, but I'm doing less of thatbecause I think the people who need this the most are the people who don't havethe privilege and the money, to, you know, immediately change theirenvironment.

And, so that's, that's what I'd like to focus more onmethods.

Boomer Andersen: [01:14:30]Amazing Tommy. We didn't even get into blue zones and resistance training.There's so many topics that I can go down wormholes with you on. where canpeople find out more about you?

Tommy Wood: [01:14:42]the, the best place probably come as Instagram.

That's where I probably post most frequently some app. Soit's tell me about it on Instagram. I have a website, dr. ragnar.com rag, NAR,which hasn't been updated for a while, but there's some old blog posts there.And when the RSS feed is working, then when I post on Twitter and Instagram andstuff, it pops up there and there's, there's also usually a list of all mypublications and stuff.

If people are interested in this kind of thing, Very

Boomer Andersen: [01:15:06]cool, Tommy, thank you again for coming on. This has been such a funconversation. I'm sure we're going to have to do it again and do it again soonover some. Yeah.

Tommy Wood: [01:15:15]Yeah. We'll have coffee and brisket.

Boomer Andersen: [01:15:17]There you go. It's an interesting combination. Maybe split out over brisket isfor breakfast.

Yeah, exactly. Excellent. Well, thank you, sir. I reallyappreciate all your time.

When Tommy and I were exchanging emails and messagesbeforehand, I came up with numerous topics that I wanted to tackle with him.And we only got through about three of those today. So suffice to say, I'd loveto have Tommy back on the show. And I want to hear from you guys, what you gotout of this episode.

If you get head on over to Apple podcast and leave thepodcast, a five star rating, it really helps or leave a comment on YouTube,Instagram, wherever you are, and just let us know what you thought. The shownotes again for this one are decoding superhuman.com/tommy. And thank you againfor your time. Dear superhumans, it's been a pleasure.

All feedback can be fed into podcasts at decoding. She bringhim in.com and I wish you an absolutely Epic day.

 

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