Connecting the Dots of Aging for a Healthy, Functional, Happy Life - LongevIQ Podcast with Dr. Kristine Burke, MD

Connecting the Dots of Aging for a Healthy, Functional, Happy Life

Building a foundation for healthy aging: practical habits to include, crucial risk factors and common mistakes to watch for

In this episode

In this episode, we’ll talk about various aspects of aging that are inextricably connected, which can not only affect our physical health but enrich our lives on all levels. Our guest in this episode is Dr. Kristine Burke, MD, a functional integrative medicine physician who combines a wide range of medical expertise to help people achieve a healthy, functional, and meaningful life as they age.

We all know that building a foundation for healthy aging may sound overwhelming at first. However, as we’ll discuss, even small habits can have a significant cumulative effect when maintained consistently. And for many people, it all starts with one small change.

Also in this episode:

  • Dr. Patti Shelton, MD, LongevIQ medical communications officer
  • Amir Ginsberg, LongevIQ founder.

Do you want to spend your final years in a nursing home, or do you want to finish your life off feeling like you could still take on the world? …We don’t just want to increase the number of years that we’re alive, maybe suffering. We want to increase the time and the number of years that we get to spend feeling good and able to do what brings us joy. That to me is healthy aging.

– Dr. Kristine Burke, MD

Related articles, podcast notes & links

  • Contact Dr. Burke: Website
  • Brain exercises tools: BrainHQ
  • Stress management and stress resilience tools & techniques: HeartMath

Main topics

  • (0:00:00) Podcast and episode intro, medical disclaimer
  • (0:01:29) What does healthy aging mean? healthspan vs. lifespan
  • (0:02:27) The pillars of healthy aging: an overview
  • (0:03:44) Building stress resilience
  • (0:05:15) Physical aging from the inside out
  • (0:07:55) Inflammation and aging
  • (0:10:21) Best exercise & movement for bone and muscle longevity
  • (0:13:13) Overtraining effect on aging: warning signs and practical tips
  • (0:17:51) Restorative movement for longevity
  • (0:19:48) The importance of maintaining good balance with aging
  • (0:24:59) Maintaining bone health and longevity
  • (0:29:12) Bone health, hormone balance, women vs. men
  • (0:30:25) How to protect the brain and cognitive function with aging
  • (0:32:30) Environmental toxins and cognitive function
  • (0:35:59) Eating for healthy aging
  • (0:38:24) Are supplements needed for healthy aging?
  • (0:41:41) Practical ways to challenge the brain
  • (0:44:18) The importance of social connections and healthy aging
  • (0:46:55) Connecting to your spiritual side: practical tips
  • (0:50:07) Detoxification, biotransformation & healthy aging
  • (0:56:06) Building a foundation for healthy aging: practical tips


This podcast episode was edited to improve readability.

Podcast and episode intro, medical disclaimer

Dr. Patti (00:00:00): This is Dr. Patti Shelton, and you are listening to the LongevIQ podcast. We discuss anti-aging and longevity science and how to benefit from it so we can all live long, healthy, happy lives.

Just before we get started, a quick medical disclaimer, this podcast is for informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease or to provide or replace medical advice. Please use this information to educate yourself as much as possible and share this information with a qualified health practitioner that you trust.

Dr. Patti (00:00:35): In this episode, we’ll talk about various aspects of aging that are inextricably connected, which can not only affect our physical health but enrich our lives on all levels. Our guest in this episode is Dr. Kristine Burke, MD, a functional integrative medicine physician who combines a wide range of medical expertise to help people achieve a healthy, functional, and meaningful life as they age.

We all know that building a foundation for healthy aging may sound overwhelming at first. However, as we’ll discuss, even small habits can have a significant cumulative effect when maintained consistently. And for many people, it all starts with one small change.

Also, joining us today, as always, is Amir Ginsberg, the founder of LongevIQ. Welcome, Dr. Burke. Thanks for being here with us today.

Dr. Burke (00:01:24): Thank you so much for having me. It’s my pleasure.

What does healthy aging mean? healthspan vs. lifespan

Dr. Patti (00:01:28): We would love to hear about your vision of healthy aging. What is healthy aging mean to you?

Dr. Burke (00:01:36): So I think I’d like to start that answer by asking you a question, and that would be, do you want to spend your final years in a nursing home, or do you want to finish your life off feeling like you could still take on the world? And that to me is really the difference between aging and healthy aging. So we talk a lot about longevity and lifespan, but what we all really are after is increased healthspan, the time that we get to spend feeling our best. So we don’t just want to increase the number of years that we’re alive, maybe suffering. We want to increase the time and the number of years that we get to spend feeling good and able to do what brings us joy. That to me is healthy aging.

The pillars of healthy aging: an overview

Dr. Patti (00:02:21): Beautiful message. Absolutely. Yeah, I think we can all relate to that. So what do you think are kind of the most important pillars of how people can support healthy aging? We can start with an overview and then dive into some specifics from there.

Dr. Burke (00:02:38): I think we all have a pretty good idea of what the things are that we need to do to try to promote healthy aging. We all know that we need to eat a healthy diet, rich in plant phytonutrients. We all know that we need to get some exercise or movement in our life. We know that we need to manage stress or manage the way that stress impacts us because sometimes there are stressful things that occur in life that we can’t necessarily modify or we have to live through them, but we can always modify the way that stress impacts us emotionally, spiritually, and biochemically. And so that’s a really important pillar of health as well. Sleep, of course, is very important, and not just the quantity of sleep, but the quality of sleep. And I think, you know, when we look at all of those pieces, we all know that those are the components that we need to have. But then, how do we do that? How are we going to change and what do we need to change to have the best outcomes?

Building stress resilience

Dr. Patti (00:03:45): How do you support people that are dealing with stress? What would be some ways that people could enhance their ability to be resilient and to better tolerate stress?

Dr. Burke (00:03:55): Yeah, that’s exactly the term we like to use – stress resilience. I think there are many, many things that we could reach for in trying to manage stress and build stress resilience. There are a lot of tools out there. There are meditation tools. There are things like heartMath biofeedback where we’re harnessing the power of our body to be able to create what’s called a coherent state, where the change in the beat-to-beat variability of our heart reaches kind of a maximum. And that instills in us this state of calm and rest and repair where the parasympathetic or that repair and restore side of our nervous system is predominant instead of our sympathetic side, which is that stress, fight, flight, freeze, run, <laugh>. So if we can have tools in our toolkit that help us with that – for some people that may be prayer. For some people, it’s, you know, introspection and changing the negative self-talk that they have or the way that they look at different things or how they perceive what’s coming at them. So it isn’t always about changing the thing that’s coming at you, it’s about changing how we respond to it.

Physical aging from the inside out

Dr. Patti (00:05:14): Beautiful. Let’s talk about physical aging a little bit. As people get older, one of the things we don’t want to happen to us is that our bodies can fail and no longer allow us to physically move through the world the way we’d like. So, what tends to happen or what can happen as people get older? And then how can people support their bodies as they get older?

Dr. Burke (00:05:36): So, well, we all know a lot of things can happen to us as we get older. Our skin gets wrinkly or saggy and we lose muscle tone. Those are some of the more outward appearances of aging. And then we have things that are happening more on the inside with pain and arthritis. And then as that type of unchecked inflammation progresses in the body, then maybe we see bone loss. And then at its kind of ultimate and most complex, we see things like cognitive decline or metabolic impairments that end up resulting in a heart attack or stroke.

So there’s a bit of this progression and those things are all happening simultaneously in a lot of us, but what it really comes down to, whether it’s loss of cognitive function, loss of energy, loss of muscle mass, or bone, is that imbalance of inflammation in the system that drives these issues. And it drives all of those losses. It creates a state where we have an imbalance, not only an inflammation, but also in what we call catabolism – breaking down of our body tissues, and anabolism – building them back up. So we have imbalance and inflammation and then that drives these other imbalances. And when you’re in that more catabolic state where you’re breaking down tissues, that’s where you really see that connection to the things that I listed. So we’re breaking down collagen and hyaluronic acid in the skin, and we’re seeing the effects of that aging and we’re breaking down muscle and we see that as muscle loss and an increase in relative body fat. And then we’re breaking down the bone because those cells, those breakdown cells in the bone are stimulated or overstimulated relative to the bone-building cells. So we can have an impact on a lot of these different outcomes of aging if we really focus on what’s creating the imbalance in inflammation that’s driving those losses.

Dr. Patti (00:07:45): <laugh>, I could see we’re about to keep going.

Dr. Burke (00:07:48): I Know, I know. Well, there’s always more to say, but the monologue starts to carry on <laugh>.

Inflammation and Aging

Dr. Patti (00:07:55): Yeah. Well, what do you typically recommend that people do about excessive inflammation? How do we measure that? And then what might people do to kind of bring that down if there’s too much?

Dr. Burke (00:08:06): Those are great questions. I think in its simplest form, we in functional medicine have this expression that we use that’s called gets and rids. What does the body need to get more of to be able to function optimally for every cell and tissue and organ to have what it needs to be able to operate optimally? And then, what do we need to get rid of? And those rids – maybe things in our lifestyle, some of what we talked about a little bit earlier where maybe we have too much stress or too much sleeplessness and we need to get rid of those things. Or they may be environmental things, like environmental chemical toxin exposures. You know, you’ve got air freshener plugins all over your house or you’re, you’re using products with fragrance. And then all of these things we know are what we call endocrine disruptors.

And so they’re creating damage or demand for energy to process them in the body. And they may be things like mold toxins for example, or heavy metals, other types of insults that we accumulate either gradually over our lifetime or that we accumulate from a significant exposure, like a water damage event in the home, for example. And then mold grows and it’s invisible. You don’t even know that you’re living with it until slowly it starts to take its toll. So that’s really the bottom line. What do we need to bring in to create health and what do we need to get rid of so that we’re not having degradation of our health.

Dr. Patti (00:09:46): Awesome. That’s a really important thing to mention about fragrances. I think a lot of people aren’t really aware that anything you’re smelling is on some level entering your body.

Dr. Burke (00:09:54): Right? And anything that’s labeled fragrance almost always has phthalates in it. Because phthalates are a volatile organic chemical (VOC) and that means that they off gas, which is perfect if your goal is to off-gas that chemical into the air so that we can smell it. But it’s not so great once that chemical gets into our body and our body has to process that.

Best exercise & movement for bone and muscle longevity

Dr. Patti (00:10:21): And you were mentioning bone tissue earlier, also muscle tissue. So people tend to lose both of those as they get older. You’re a sports medicine doctor among many other things. So what do you recommend as far as exercising for longevity?

Dr. Burke (00:10:43): Well, really what I recommend is whatever you will do because you can have all of the best exercise advice, but if none of that speaks to your soul and speaks to what makes you happy that you are going to do over and over again, then it doesn’t really matter that it’s the best exercise in the world.

There are lots of different types of exercise that we can do, and people really have different physiologic needs for exercise. One of the things that are really interesting is doing a genetic profile and getting a sense of whether that person does better with more aerobic exercise or their genetics are primed for them to be more responsive to more strength training exercises. Or maybe they’re prone to having breakdown of the collagen in their tissues and they’re going to be more prone to developing arthritis. Maybe running isn’t the best sport for that person.

So there’s a lot that we can glean from our genetics that can help us to make choices about what the best long-term exercises are for us and for our health that are going to be the best fit for how we’re wired. But when we’re looking at trying to create things like the term autophagy, where we’re encouraging the cells to break down and dispose of the used parts within the cell so that the cell can be renewed and basically behave in a younger fashion, those types of exercise are going to be things like high intensity interval training (HIIT). And what’s nice about HIT training, which is the abbreviation for that, which probably most people are aware of, is that you don’t have to exercise for a super long time to get a lot of benefit over those intermittent intervals where you’re pushing your body. And so when people are really busy, that’s a great way to bring in a high-impact exercise activity that doesn’t take a huge time commitment. So that’s one of my favorites. But I also love things that are restorative to the body. So I love yoga or tai chi so that we’re bringing in that balancing side and we’re bringing in some of what we talked about earlier in terms of building stress resilience. So we’re not only getting movement activity in, but we’re building in that component that is bringing up that parasympathetic side that rest, restore, repair.

Overtraining effect on aging: warning signs and practical tips

Dr. Patti (00:13:10): And you alluded to this a little bit. I think most of us are aware that there’s such a thing as too little exercise, but maybe not everyone is aware of too much exercise as well or going too far with it. How would someone know if they’re pushing too hard or too far and what would they do if they figure that out?

Dr. Burke (00:13:32): Yeah, I love those questions cuz you’re right. I think a lot of people don’t really think about what too much exercise looks like. And again, some of that’s going to come back to how you’re genetically programmed, but not everyone is going to know what that looks like for them. They may not have that testing done. If you exercise and you feel exhausted the rest of the day, that was too much exercise. Or if you’re in agony and muscle soreness, delayed onset muscle soreness (DOMS) for multiple days after an episode of exercise, then that was too much.

A good rule of thumb is to bring your activity in or begin your activity at about half of what you think you should be doing <laugh>. And then you start there and read your cues. So if you feel fine, you’ve barely broken a sweat or you just don’t feel like you really got very much out of it, you’re not sore, then you can increase it by 10%. And if you follow that 10% rule, either 10% in duration, 10% in intensity, or 10% in effort, one of those three things you want to increase. If you increase by that amount gradually day by day until you reach the point where you’re feeling like you’re getting a good workout. You’re having a good sweat, you’re getting your heart rate up if you’re doing something that’s aerobic. Or if you’re doing something that’s more strength oriented, you’re not sore for multiple days, then that’s really where your sweet spot is going to be.

Dr. Patti (00:15:05): And if someone is sore, would you recommend they just take kind of time off from exercise until that resolves? Or what should they do about that?

Dr. Burke (00:15:12): Well, that’s a good question. It kind of depends on the severity of the soreness. If you can barely get up out of your chair and walk across the room, you probably need to rest for a couple of days. But if it’s just that you have more soreness than you’re comfortable with or it’s an amount that makes you not want to exercise again, then I think other than obviously the next time we’re going to reduce the amount of effort that we’ve put in, I think that you can definitely hydrate more to help with that. Sometimes magnesium can be helpful in alleviating those symptoms or some of the anti-inflammatory herbs that we often use. Curcumin, for example, is a good one.

Dr. Patti (00:15:53): Beautiful. How many days a week do most people need to exercise? And I know that this probably varies person to person, but for most people, is it every day? Should we be doing three times a week? What’s kind of average for the right target?

Dr. Burke (00:16:09): Well, the overall recommendation is four to five times a week. And it does definitely vary depending on the person, depending on their preexisting level of fitness, and depending on the level of intensity of the exercises that they’re participating in. Because there’s a big difference between someone who’s doing tai chi five or six days a week and someone who’s training for a marathon six days a week. So we have to take some of that into account.

And that brings us back a little bit to what you had asked me about earlier with overtraining. One thing that we didn’t touch on there is that we can actually see with over exercise that it creates more damage in the body. So we can see evidence of elevated markers of inflammation. For example, if we happen to be measuring the urine, we can see evidence of muscle breakdown products in the urine. So we can see that over-training has occurred in those instances. And so we do know that that can create more oxidative stress. So that kind of rusting of the cells, if you will. We can see that that creates more damage in the tissues if we’re pushing the body too hard and we’re exceeding the capacity to quench that oxidative stress. So the number of antioxidants that we have in our body that are available to help us offset that stress that we’re creating within the metabolism and within the physiology.

Restorative movement for longevity

Amir (00:17:45): And I think one key takeaway for people to listen, and I’m super curious about your opinion too, is there a differentiation between an exercise that causes let’s say more damage to a movement that helps the restoration. Do you have this differentiation?

Dr. Burke (00:18:06): Yeah, it is. So a couple of the ones that I mentioned, so yin yoga, restorative yoga, slow movement yoga, that’s really breath-focused. Tai chi, because in Tai chi we can modify the amount of exertion based on how deeply we set down in the knees and how much tension we create in the body as we’re doing the movements. Qigong is another really lovely restorative form of movement. Just walking is a nice restorative form of movement. I’m trying to think of some other great examples. Being in the water, not necessarily swimming laps, but being in the water and moving against the resistance of water is another nice way to move the body.

We were just talking this morning in our morning meeting about a study that had just come out talking about just raising your heels off the floor while you’re sitting about an inch or two, just that small contraction. Doing that multiple times throughout the day can have a significant impact on reducing insulin resistance, that kind of pre-diabetic state, and improving the way our body utilizes that glucose or that sugar as fuel. So I thought that was really interesting because anybody can sit and raise their heels off the floor. Almost anyone can do that. So that’s a great one to keep in mind too.

Dr. Patti (00:19:38): Yeah. And really remembering that simple things can be very, very powerful when you add them up over time.

Dr. Burke (00:19:44): <affirmative>. Exactly. Small things repeated have big results.

The importance of maintaining good balance with aging

Dr. Patti (00:19:49): You mentioned a little bit about balance. I would love if you talk a little more about the importance of balance, like maintaining balance as we get older. Some of us think about strength and flexibility but may not always realize that balance changes as we get older too.

Dr. Burke (00:20:04): Yeah, that’s a really important one that we often see a decline with aging. And I think part of that comes from inside our minds. We never really stop feeling like we’re our 30 year old self. You may be 80 years old, but inside you, you still feel like that 30 year old person. Now you look in the mirror and you realize that you are not that 30 year old person anymore, but your internal experience of yourself remains the same. So we kind of have this tendency to believe that everything that we have accomplished is going to just stay with us because we still feel like that person. And so balance is a perfect example of this. You maybe had great balance when you were in your prime of life, but as you get older, if you’re not doing something to actively maintain your ability to have a good balance, then you will definitely lose that balance.

And then how we see that, is people will start having a little bit wider gait, or they don’t swing their steps through, as their stride gets shorter because they don’t have the balance to be on one foot long enough to bring that other foot forward in a full length stride. So you’ll see the strides start to shorten that wider base of the gait. You’ll see feeling a little bit uneasy when you turn quickly or you know, losing your balance when you get up from your chair. That get-up and go test that we often do with people, where we have them sit in a chair and then try to stand up without touching the arms of the chair or swinging their arms or their upper body to give them momentum. So with no momentum, just standing straight up from the chair, that’s a great way to see how you’re maintaining your core strength and some of that balance as well.

(00:21:57): So again, it takes me back to things I love, like yoga and tai chi where we’re bringing in the two sides of the body. We’re asking them to coordinate and to balance of each other in these different movements. And we’re taking our body through positions in space that we wouldn’t otherwise occupy. So, as you get older and you’re going through life and you’re getting up and you’re going to the bathroom and then you’re maybe brushing your teeth, going to the kitchen, sitting on the couch – those rote movements become this narrowing of your balance field. And so you don’t have as much variation in what you’re asking of your body, but you’re doing the same things every day. So it feels like everything’s okay because those narrow things that you’re doing, you’re doing fine. Until you are not. And that’s when we see a fall happen and older people are often very taken by surprise that they’ve fallen because they don’t even feel it coming. They don’t feel off balance. Just all of a sudden they hit the ground and it’s because they’ve lost that movement outside the norm. And so the body doesn’t recognize it in time to correct it.

Dr. Patti (00:23:13): So doing exercises that kind of give your body more of a challenge in that way

Dr. Burke (00:23:17): Mm-hmm. And take you out of your comfort zone of the types of things that you’re just doing every day, which is why walking is good, but walking at a brisk or pace is better because it makes you have to balance and for your body to integrate and coordinate those different movements in a different way and in a different pattern in your brain. And that’s what helps.

We have that expression, neurons that fire together wire together and the stronger those pathways get – I like to call them ruts, kind of like the old covered wagon days, right? So the wagons would follow these ruts in the trail and it was very hard for them to be outside of those ruts. Well, the same thing kind of happens in our body. So if you have these same patterns, you do things the same way every day, then you’re creating ruts or these patterns that fire together, and then it’s harder for your body to have flexibility or to be able to compensate when you do something that’s outside those ruts, it makes it unstable.

Dr. Patti (00:24:22): So walking on a surface that’s maybe uneven, for instance, like walking in the forest instead of on a sidewalk, would that be a way to kind of train that in?

Dr. Burke (00:24:32): Yeah, I think something like that would be good. That’s certainly not where I’d want to start. Like with an older person, I wouldn’t want them to start there, but yes, you’re exactly right. Or walking on a beach where you have the sand and you have the unstable surface, walking where the terrain may change like you’re on pavement for a little while and then you’re on the ground for a little while and so it’s just a little bit different and your brain has to integrate different information.

Maintaining bone health and longevity

Dr. Patti (00:24:58): And then thinking about falls also makes me think about bone health since when people fall, we want to make sure their bones are strong and don’t fracture. What can people do to help keep their bones strong?

Dr. Burke (00:25:12): I think when we’re talking about creating strong bones, we’re coming back again to that concept of gets and rids. What do the bones need to get? And the thing that we’ve focused on for such a long time is just calcium – Oh, if we just get more calcium in the bones, they will be stronger. Well, that’s kind of like saying, oh, if I just have a bunch of bricks delivered in my yard, I will have a beautiful patio. That’s just not how it works, right? Something has to take that calcium and build it into the bone and those cells are called osteoblasts, the bone-building cells. Those cells are stimulated when we have a healthy environment with low inflammation. So we need to have all of our good nutrients around, we need to have plenty of protein and collagen and we need to have a lack of high processed foods and things that have a lot of chemicals in them that create inflammation that’s going to distract our bone building cells from doing their job and increase the activity of the bone breakdown cells called osteoclasts. They’re the ones chewing up the bone, and the builders, the blasts, are building it up. And so it’s a constant battle over who’s going to win that. And in order to build healthy bone we need those osteoblasts to be in the winner’s circle. And so we want to have more of that anti-inflammatory environment going on in order to stimulate those building cells.

Dr. Patti (00:26:48): And how much weight bearing do the bones need to stay healthy for someone who maybe weightlifting isn’t their favorite thing? How much do you really need to make sure your bones are getting that stimulus to stay strong?

Dr. Burke (00:27:02): So that’s a hard question to answer because it really depends on so many other factors that are going into that balance that we were just talking about. But if we just assume for a moment that we’ve created a good environment for bone growth to occur, then I think you’re going to want to have at least the majority of the days of the week where you have some form of compressive force on your bones. For example, when you take a step and you have kind of that weight, the thud of your heel hitting the ground, that’s a compressive force, that’s a weight-bearing force as opposed to maybe sitting in a chair. Now, if you’re bouncing up and down in your chair, that’s creating some compressive force. So being mindful of how you move your body and taking advantage of times when you can create a little bit more bounce in your step, if you will, because it’s that bounce in your step that’s going to create the compressive force then taking it to the next level. You can have things like you mentioned where you’re using actual weight training to create force across the bones and across the joints. And that’s going to accelerate it. The bones will tend to respond to demand if they have the right building blocks available to be able to respond.

Dr. Patti (00:28:26): So it’s both giving them that, like making them need it and then giving them what they need in order to put it in there and build the strong bone tissue.

Dr. Burke (00:28:35): Exactly. And then one of the other things that bones need really to be strong and healthy is they need hormone balance. If we don’t have good hormone balance, then that takes away one of those pushing forces on the building cells. So we kind of ease off the accelerator on the building cells when we don’t have a healthy amount of hormones around anymore. And that’s of course one of the reasons that we see an increase in bone loss for women in particular after they go through menopause. And we lose the benefit of that force, that pressure behind the bone building from our hormones.

Bone health, hormone balance, women vs. men

Dr. Patti (00:29:12): Do both men and women need to think about their bones as they get older? We think of it as kind of an old women’s problem. But, is this a problem for everybody?

Dr. Burke (00:29:23): It can be a problem for everyone. Certainly, women are at a much higher risk of having bone loss as we age because we’re programmed to lose our hormones. Men will often have their hormone level, their testosterone levels drift down as they age. But some men can maintain a healthy hormone level well into their late years, whereas that doesn’t ever happen for women without having support, without having hormone replacement support. So it is something that men need to be aware of, especially if they have other symptoms of low testosterone, like, you know, loss of interest in things that they used to enjoy, a decrease in their sex drive, decrease in their athletic performance capability that’s different than what they would expect from their level of activity. Those are the kinds of things that can start to give us a clue that the testosterone level may be waning and then that’s going to increase the risk for bone loss for the man as well.

How to protect the brain and cognitive function with aging

Dr. Patti (00:30:25): Let’s shift gears a little bit and start talking about the mental aspects of aging. So I’m thinking about brain health and I know you have some expertise in how to protect the brain as we get older. So let’s talk a little bit about what we can do that may help prevent dementia.

Dr. Burke (00:30:42): Yeah, that’s a big topic and definitely one that’s near and dear to my heart because we have a memory protection program here at our center and I’m also currently involved as one of the principal investigators for the randomized controlled trial that’s going to be going on for dementia reversal. So I’m very excited about that as well. I think this is one of the most complex areas of decline because there are so many facets to the gets and rids puzzle that play in cognitive impairment and loss of our cognitive function.

So the first thing, if we go back to our same analogy, what are we missing? What do we need to get? So common things are a lack of omega-3’s, a lack of specific nutrients in the right amounts like B vitamins and coQ10, vitamin D for example. So lots of nutrients that our body stores tend to wane over time if we haven’t actively replaced them.

We talked about hormones and how important hormones are for bone health and also for our mental health, but in addition to the maintenance of the cells within the brain. So our hormones, our thyroid hormone, our sex related hormones, those all contribute to maintaining cells, the number of cells that we have in our brain, and then the number of connections that we maintain between the cells, which is really what we’re talking about when we’re looking at reversing cognitive decline – repairing those lost connections. So that’s some of the things that we need on the gets side.

Environmental toxins and cognitive function

Dr. Burke (00:32:31): And then things that we need to get rid of that are damaging the brain or damaging the cells killing off cells within the brain. Cuz in the end, what we’re talking about is a loss of brain cells and brain cell connections. Those are going to be things like environmental toxins. So we talked a little bit about chemicals when we were talking about Phthalates and things with fragrance, but there are so many other chemicals.

We have 10,000 chemicals that our bodies are exposed to now that didn’t even exist on this planet 200 years ago. So our bodies have to deal with a lot more chemical burden, even just in our day to day life. One of the things that’s always funny to me is people say, Well, I don’t have any toxic burden. Like I don’t have any toxin exposure and it just makes me laugh because we just take for granted that we don’t think about all the chemicals that are in the water that we drink, that are in the air that we breathe, that are in the food that we’re eating.

(00:33:33): We have a huge burden of chemicals that we come in contact with every day and that means good, bad or indifferent. Our body has to process those and get rid of them through our liver detoxification process called biotransformation, changing it from something the body can’t get rid of into something that the body can get rid of. But that’s a very highly energy dependent process, so it needs a lot of energy to fuel that. So it’s basically like having your factory running on high all the time. And just like if we were thinking about that in terms of a real factory, you’d spend a lot of money on electricity and you’d need a lot of staff and you’d run through a lot of supplies. The same is true in your body. So if those supplies aren’t coming in, if you can’t kind of, you know, write the checks to cover that, then we’re going to start to see decline.

The same would be true with other environmental toxins like mold toxins for example. We do a lot of mold work. We see mold related toxicity in almost all of our patients that we treat for cognitive impairment. So it’s a really important thing to be aware of and really to intervene on long before you’ve reached the point where you’re seeing cognitive impairment as an end result.

We mentioned heavy metals briefly at the beginning of our conversation. We have a whole variety of different heavy metals that we are exposed to in our everyday experience. People in my generation had a lot of lead exposure. There was the lead in our gasoline, lead in our paint, and there was the lead in our crystal. Lead was everywhere and it was just a part of life. And one of the things that are interesting about lead is that its favorite place to be stored is in the bone. So what do you think happens when a woman goes through menopause or a man’s testosterone levels start to decline and we’re breaking down bone? What’s being released in the body? All that’s stored is lead. So we see this increase in lead exposure and we know that lead really impacts cognitive function in terms of attention and focus and memory.

Eating for healthy aging

Dr. Patti (00:35:56): So paying a lot of attention to environmental factors. Are there particular foods and patterns of eating that you recommend to people? Like things to eat, things to avoid eating in order to support the body’s ability to protect the brain?

Dr. Burke (00:36:11): Yeah, there are a lot of things that we can do and some of them are really pretty simple. So the most important one is minimizing our exposure to sugar. We eat pounds and pounds of sugar per person in this country. And I’m sure I’m speaking to the choir when I’m speaking to all of you, but all of that sugar has a hugely negative impact, not only on our cellular machinery in terms of our energy production, but also when we have excess sugar in the body, that sugar has to be stored somewhere.

And what the body does is it melts it onto our proteins and that’s called glycation. And those advanced glycation end products (AGEs), the proteins that have sugar irreversible stuck to them are very damaging to our tissues as well. And that’s an irreversible process. Just like when you burn sugar in the oven,. You can’t take it back and make it look like it looked before ever. It’s irreversible. The same thing is true within us. And so that has to be replaced or restored or repaired. And so sugar creates a huge amount of damage in the body, both metabolic and in terms of brain health.

Then on the other side, we have all of the positive things that we want to bring in. So lots of brightly colored fruits and vegetables, all of those different colors mean all kinds of different phytonutrients. And those plant-based nutrients are protection mechanisms that the plants have developed to protect themselves against the same types of things that we need to protect ourselves against. Against inflammation, protecting us against cancer cells developing or being more effective at being able to identify them and get rid of them when they do, and protecting us against radiation damage. Because a plant’s rooted in the ground. When it gets sun all day long, that radiation all day long, it has to be able to protect its cells from damage from the radiation. So they’ve developed all kinds of plant-based nutrients that help to do that. So the more of those things that we can bring in, then the more protections that we have as well.

Are supplements needed for healthy aging?

Dr. Patti (00:38:24): And are there any supplements that you commonly recommend for people to help their body with this process of getting rid of things? Or, for most people, is food and getting rid of environmental problems enough?

Dr. Burke (00:38:41): Oh, that’s a really good question. You know, I wish that it was enough to choose healthy foods and to eat those and to try to minimize the toxins that are in our environment. But it just seems like we’ve reached a tipping point where we can’t necessarily do it just all naturally. I think that’s definitely the goal and that’s what we want to strive for.

But most people need a few core things at a base level. You need a high-quality multivitamin because if you look at the US Department of Agriculture report…so they put out a report about once a decade or so, every 10, 12 years where they analyze the nutrient content of the foods in our agricultural supply. And it’s a published report. You can go online, you can look at it. And if you look at the difference between the report in 1960 and the report, let’s say in 2000, or I think 2010 might have been the most recent one. I can’t remember the numbers off the top of my head, but I’ll just, for the sake of discussion, I’ll toss them out. Cause I know they’re huge numbers, like 70 plus percent reduction in the amount of magnesium in certain foods and a huge drop in vitamin C in our citrus crops and just all of these nutrients. So eating the same piece of fruit now or vegetable now that you would’ve eaten in 1960 gives you a fraction of the nutrients. So it is really hard to eat what we need now. So I recommend a high-quality multivitamin, preferably one that also has some antioxidants in it and has a measured antioxidant capacity.

Most of us need vitamin D. It’s very hard to get the amount of vitamin D that you need just from the sunlight. The older we get, the less efficient our body is. The enzymes in our skin help create vitamin D when we have sun exposure. And so oftentimes people will say, Well, I don’t need vitamin D because I play golf three times a week. But then you measure their vitamin D level and it’s really low. It’s just sometimes it’s just not enough. So I do think it’s important to test that one, that’s the ideal situation. And then to supplement, to achieve a healthy level, which in my opinion is about 50 to 70.

Almost all of us need omega-3s unless you are a robust pescatarian. The American diet, the way that we eat, even with a lot of effort, it’s hard to get all of your omega-3s just from the foods that we eat. So most people are underrepresented for omega-3s when, and we test everyone, we test all of our patients for these nutrients. So those would be the core things that I find that almost everyone needs to have.

Practical ways to challenge the brain

Dr. Patti (00:41:41): Beautiful and beyond the physical needs, what about training the brain with cognitive exercises? Do you recommend anything like that and, what can people do to help keep their brains working and flexible?

Dr. Burke (00:41:56): Yeah, that’s a great question too. There’s, there’s a lot of different things that we can do. And in fact, the old, old expression variety is the spice of life, is really a true statement. The more variety of things, the more variety of ways that we are challenging our brains – the more new connections we create demand for. So if we’re doing the same things every day, even if those are good things, even if we’re doing the crossword puzzle every morning, if we’re kind of doing the same activity, that skill will improve, but we won’t necessarily improve our overall brain function.

So one of the most well-studied and the one that we use in our memory protection and dementia reversal program is called BrainHQ. And it is a computer-based game system. I don’t have any interest in this company or any financial interest. The software is constantly assessing your level of performance and always making your individual games that you’re participating in a little harder for you than it was the time before. So it’s always creating new challenges and different challenges and that performed very well in research studies compared to things like crossword puzzles or Sudoku or memory games for example. So that’s the one that we recommend and that we use.

Dr. Patti (00:43:29): And would you recommend things like going out and doing new things like trying to challenge your brain with your environment?

Dr. Burke (00:43:36): Absolutely. Absolutely. And the other things that are really good for the brain are things like musical activities. So if you know how to play an instrument, or maybe learn a new one. If you don’t know how to play an instrument, doing something with music, like movement to music dance for example, because that integration of hearing the sound, hearing the beats in the sound, moving the body to match that, that’s an entirely different integration within the brain than either just listening to music or just moving. So it creates another level of that integration and that asks for more brain activity as well.

The importance of social connections and healthy aging

Dr. Patti (00:44:19): What about social aspects? Some people as they get older, find themselves just really a lot more isolated than they used to be. So talk a little bit about what’s important about staying socially connected.

Dr. Burke (00:44:30): Oh, relationships are so important, so important. I’m sure you guys are aware of some of the research coming out that loneliness is sometimes more impactful on health outcomes than even things like a smoking history can be. It’s a really important thing, and it’s something that we saw a lot of people lose during the pandemic. We lost a lot of the ability to maintain that social connection, especially in person. And we see health outcomes as a result of that. So having relationships, maintaining relationships, and doing things that bring joy with other people, all of those are part of that social connection.

You know, in the end, we are all energetic beings. We aren’t just static in our persons. We are energetic and we create an energetic field because there’s a lot of electrical activity going on in our system. Our heart creates electrical activity that we can measure on an EKG. Our brain creates electrical activity that we can measure on an EEG. So all of that electrical activity creates a magnetic field. And so we have this human electric field around us and it expands about three feet or so around each person. And so if you’re not coming into close contact with other people, you’re losing the opportunity for those biomagnetic energetic fields to co-mingle. And that creates a change within us. So social connection, literal physical connection, and bioenergetic connection are all really important. And then that leads us into kind of the ultimate connection, and that’s our spiritual connection with whatever that represents for each of us individually, whether it’s religion or it’s a connection to kind of a broader higher being, or it’s a connection to nature or however we experience that. Having that spiritual connection is another really important part of our overall health.

Dr. Patti (00:46:45): So a whole lot of things to consider.

Dr. Burke (00:46:47): Yeah, a lot of things to consider. <laugh>.

Dr. Patti (00:46:50): Amir, did you have any questions that you wanted to ask or anything you wanted to kind of follow up on?

Connecting to your spiritual side: practical tips

Amir (00:46:55): Yeah, I’m super excited about the last thing you mentioned, which is the spiritual connection. I think a lot of people may be under the assumption that, oh, we’re physical bodies, that’s it. But they’re kind of missing such a big factor of not just health and wellness, but life on its own. So how do you educate or open a person that may be a more non-spiritual to this side, make them inspired, make them a little bit more interested in that or open to that because some people have resistance toward that. And if they do, then they’re basically limiting their life and their healthy aging as well.

Dr. Burke (00:47:36): Mm-hmm. Yeah, that’s a very challenging thing to try to bring someone to a place of openness to that. I think one of the places that you can start is by asking them to think about and imagine experiences where they feel joy or where they feel gratitude because those are two of the emotions that have some of the strongest connections to our spiritual selves, even sometimes more than love. And so that gratitude and joy – connecting to those and then thinking about when are you experiencing those feelings? You don’t have to make it spiritual in that moment, but when are you experiencing those feelings? And then what could we do to have you experience that more often? And just really starting very simply with those experiences that we know are more likely to represent a spiritual connection. And then building from there.

We do the heartMath that I talked about earlier as one of our stress management and stress resilience techniques. And I think with heartMath, where you’re imagining your breath coming and leaving your body through your heart, not obviously physically, but just this is what you’re imagining. And then you’re focusing gratitude at your heart focus. Just teaching people how to do that, and then being able to measure it with the heartMath device so that they can see the impact of that – that starts to connect some of that energetic flow. And that can sometimes open the window for having them take that maybe to the next step and maybe doing a guided meditation where they have someone that’s speaking and taking them through that experiential process so that they have an opportunity to feel that sense of connection to the greater spiritual space around them.

Amir (00:49:43): I love this. It’s, uh, the spirituality without labeling it as spirituality and then a person spontaneously will find themselves more open and aware and without even needing to label it, which is really what spirituality is, right? <laugh>

Dr. Burke (00:49:58): <affirmative>. Mm-hmm. <affirmative>. Exactly, Exactly. That gave me goosebumps.

Amir (00:50:03): Yeah, likewise. Likewise.

Detoxification, biotransformation & healthy aging

Amir (00:50:08): You mentioned something huge, which is detoxification. And I know this is not something that a lot of people think about in terms of healthy aging because they would say, well, I don’t have toxic exposure or exposure to toxins. But like you said, it’s not even a question of if, it’s a question of how many. Maybe there are genetic factors that influence the ability of a person to actually process and handle toxins, I know in mold exposure, that’s huge. So maybe we can talk a little more and educate people about it, because it’s not a question of if you have toxins in your body, it’s a question of how well your body is actually eliminating them.

Dr. Burke (00:50:46): Mm-hmm. So this is a huge topic, and literally, when I lecture on functional medicine at Loma Linda University, I do four hours on this, and I’m talking about twice as fast as I’m talking now. <laugh>. I mean, there is so much to cover in this arena, but I think, there’s been so much kind of commercialization maybe and pushing this idea of doing a detox and having it labeled in a way that makes it seem like it’s something other than what the body normally does.

So I think first dispelling that myth. This isn’t something that you do to yourself to create a different situation. It’s what your liver is doing 24 hours a day, seven days a week. Every moment of every day, your blood is flowing through your liver, and your liver is seeing the toxins as the things that don’t belong in your body, the things that aren’t a part of us. And then it has to identify them. And as I mentioned earlier, it has to change them from the way that it is existing and staying in the body, into a form that the body can get rid of it. And we get rid of everything through all of our water-soluble pathways. So almost all of these toxins are what we call fat soluble. They dissolve like oil and water, right? So those are the things that would dissolve in oil. And in order to get rid of them, we have to turn them into things that dissolve in water because our sweat is water-based. Our urine is water-based. Our stool, our fecal matter is water-based. So all of those detox exits are all based on those things being what we call water soluble.

And that process in the liver is actually a two-stage process. There are enzymes involved in phase one, turning it from being completely oil soluble into something that’s kind of in between. And then phase two that takes it from in between, into something that can be excreted with all of those water-soluble methods. And those enzymes are determined by our genetics. So we all have different copy numbers of these enzymes. We have different variations in how those proteins are made, and how they fold. And that can create as much as a thousandfold difference between the way that enzyme works in you versus me, for example. And so we have hugely variable detoxification capabilities. Our ability or biotransformation is the real physiologic process. So our ability to biotransform these things varies dramatically between people.

Then as you mentioned, you have the variation in the load of things. I don’t know if you guys are old enough to remember that I love Lucy series, but there was that episode of Lucy in the Chocolate Factory while the chocolates were going along on that conveyor belt at a nice low speed. She could do everything perfectly, but once the speed sped up, then she’s stuffing them everywhere, sticking them in her clothes and in her hat because there she couldn’t process what was coming by. And really the same thing happens in the liver. So if we have more toxins than our body can process, then we start tucking them away under the carpet, up in the closet, up in the attic, in the spare room, and we start accumulating these toxins in our body. Well,  as we talked about, these toxins are fat soluble, so where do they get stored? They get stored in the fatty tissues of our body. So body fat is one obvious one, but what’s the other tissue we have that’s made predominantly of lipids or fats? It’s the brain. Exactly. So we start to get this toxic burden accumulating within the brain as well.

(00:54:47): And then that leads into what we were talking about with some of the brain degeneration, and then the problems that we have, trying to get toxins out of the brain because it’s a protected area. So it’s hard to get things in to help shuttle them out. So there’s so much going on with biotransformation and each of those enzyme pathways. The multiple enzymes in each of those transformation stage one and stage two – all need nutrient cofactors. Things like B vitamins or zinc, for example, or they need amino acids as a cofactor, the thing that makes the enzyme work. So that’s all of our proteins. So you start to see how it all begins to fit together that what we eat not only is used as the building blocks, the bricks, if you will, of building ourselves, but it also is what we use to help get rid of the things that are damaging our bodies. And that’s why at its core, those healthy food choices are the most important thing that we can do to help facilitate healthy aging because it impacts all of the other things that we need to do.

Building a foundation for healthy aging: practical tips

Dr. Patti (00:55:56): I’d love to have you sort of sum up your kind of most inspirational message about healthy aging and what people should focus on.

Dr. Burke (00:56:06): Okay. Practical tips for healthy aging. So I think we want to start with the end in mind. Because we’ve talked about an overwhelming number of things that we would want to try to focus on to achieve healthy aging. And that is not a room that’s going to be built in a day. So we have to start somewhere and we want to start with the end in mind. So think about why you want to have your health in your later age. What are the things that bring you joy? What are the things that you want to be around? What are the things that you want to experience or do or have or be? And that’s the end that we’re trying to accomplish.

So I want to exercise so that I can have a sharp mind when I’m in my eighties or nineties, or maybe I want to make sure I get enough good sleep because my brain offloads its toxins during the night, and I want to get rid of that so that I can hold on to my brain cells and keep my memory healthy.

Like, what are we really trying to accomplish? And not looking at these things as good choices or bad choices. They’re better or they’re worse <laugh> in terms of accomplishing those things. And then we’ve talked a lot about the what’s, like what do you need to do and when you need to do it. So I think if we evaluate our lifestyle choices and we’re looking from that gets and rids, what do we need to do more of and what do we need to do less of? And then we can start by focusing on those individual things. Because it’s not just about getting more of what we need, it’s also about letting go of or getting rid of the things that are doing us no good. And sometimes that’s an easier thing to do than adding a new habit. And so that can be another nice place to start.

(00:58:04): And then I think lastly, picking one thing at a time and incorporating that and making that a habit, which takes about 30 to 45 days so that you can build on each thing as you’re moving along. Now, some things can be easier to do as a big swipe, Like you could certainly go through your house and minimize the number of chemical toxins that you’re getting exposed to, but that’s a pretty expensive endeavor. So, maybe a more manageable task is going through your house and identifying all of the things that have the highest level of toxins. And the environmental working group, for example, has a great database for that.

And there’s a couple of different apps you can use where you can scan the barcodes and you can get red, yellow, or green – like this is horrible, this is eh, or this is a good choice. And then you get rid of just all the high toxic things and you slowly replace the intermediate things as you run out and it’s time to buy something new. So I think there are ways that we can start incorporating these changes and recognize that every step we take towards healthier aging is going to take us that much further than if we didn’t do anything at all.

Dr. Patti (00:59:20): Yeah. So not getting overwhelmed by how much there is to do and remembering that small things added up have big results.

Dr. Burke (00:59:27): Exactly. Exactly. And the younger you are, when you start, the more time you have to accomplish all those changes.

Dr. Patti (00:59:36): Yes. Healthy aging is not something we start thinking about when we’re 65. It’s, it’s important to start as soon as you can to think about maintaining your health.

Dr. Burke (00:59:45): Exactly. Cuz the more things that you can do to reduce that damage to your health, then the less repair you have on the other end, the less pain you have, and the less fatigue you have. Not just the cognitive function that we’ve talked about.

Dr. Patti (00:59:59): Yeah. Almost thinking of it as a savings account. So like something you start as soon as you can. Beautiful. Thank you so much for being here with us and sharing so very much wisdom and knowledge with everybody and a really inspirational message about how we can all stay as vibrant and energetic and healthy as we can for as long as possible.

Dr. Burke (01:00:21): Thank you so much.

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