The Melanie Avalon Biohacking Podcast Episode #256 - Max Lugavere

TRANSCRIPT

(Note: This is generated by AI with 98% accuracy. However, any errors may cause unintended changes in meaning.)

Melanie Avalon:
Hi friends, welcome back to the show. I am so incredibly excited about the conversation I am about to have. I am here with a repeat guest. And okay, so the backstory on today's conversation, a long time ago, I should know this date, when did you first write Gina's Foods?

Max Lugavere:
2018 it came out

Melanie Avalon:
Okay, so 2018, I read a book called Genius Foods. I think I actually listened to the audio book, and it was absolutely incredible. That's when I was really getting into more health, wellness, biohacking, all the things, and I really appreciated its approach to diet and lifestyle for addressing health, in particular, preventing cognitive decline and supporting our brains. It was amazing, and what's really surreal, so 2018, I try to think like where I was in my life at that time. All I know is that I was in the beginning more of this show. The show probably wasn't even out yet, and Max Lou Gavir, the author of that book, I loved it so much. He was on my dream list of when I had this show, of something to have on the show because it was just so incredible. So when I had him on the show, I think a few years ago now, that was amazing. I really, really loved it, and since then, Max has released other books. So Genius Foods was New York Times bestseller. He also has Genius Life. I think that's what he came on the show for, and Genius Kitchen as well. He has the Genius Life podcast, and most recently, friends, I am so excited. I got an email from his team because Max had his directorial debut called Little Empty Boxes, and I honestly, I didn't know what to expect going in. I was wondering if it was going to be, so it's a documentary, and so I was wondering if it was going to be more about the science and interviews with different people and things like that. It has that. It definitely has that, but more so than that, it is this beautiful, haunting, tragic, overwhelming story shot over, I think years and years, so we can talk about that, of Max with his mom as she's beginning to experience and continues to experience cognitive decline. So you get an actual look into his life as he's going through this with his mom. So not only is there this incredible emotional connection, but then you really see what it's like to live with somebody with Alzheimer's or cognitive decline and all the different options that they and the family go through to help address it. It's beautiful. I really can't recommend it enough. We're going to talk all about it, but Max, thank you so much for being here.

Max Lugavere:
Thank you, Melanie. Yeah. You're, you're one of the few people who've seen it at this point. And so, and it's a project that I've been working on for a decade. It predates genius foods and pretty much anything else that I've done in the public sphere health wise. And so, yeah, I'm just so excited to have it out into the world. And your feedback is just so wonderful to hear. So yeah, thank you for that.

Melanie Avalon:
So actually, I had a moment with the film. So when I was watching it, my brain, speaking of brains, my brain did something weird because in the opening, and like in the opening credits and titles, there's a moment where it says Kathy Lugavere as mom. I don't know if I like looked away at that one second, but what I saw was like Kathy Lugavere, and I saw the word as and mom. And so in my head, I made a switch in my head and I thought for a moment that it was a reenactment, that like that there was an actor playing Kathy, playing your mom. And so for the first like 10 minutes, I was like, I was like, this acting is incredible. I was like this, I mean, this is like, like this is next level. So then I stopped and I went and checked. I was like, oh, this is like, this is real. And so then I was overwhelmed, honestly, like seeing that this was real life happening for you. So the timeline of that, how long did you shoot for?

Max Lugavere:
So we I started I decided to do a documentary in late 2014. So that's obviously 10 years ago as we record this. But I've actually been kind of filming my mom my whole life. Like I've always been into self documentation. And, you know, my family, we've always been lucky to have had the resources to have had, you know, early cameras, VHS cameras and the like. And so the film is peppered with footage that I've been shooting essentially my whole life. But when my mom became sick with this neurodegenerative condition in about 2011, it wasn't until 20 until 2014 that I decided that I wanted to make a documentary paying tribute to what it was that my mom was going through and, you know, transmuting it into something that was meaningful for me as an artist, I felt like that was my way of taking something that was really awful that was going on in my life and turning it into something potentially, you know, purposeful and meaningful. And that could have some kind of social impact, you know, ability. Intended with that, my mom loved, you know, being in front of the camera, and she was my biggest fan, and she would do anything to support, you know, any one of my cockamamie ideas at any given point. And, you know, she was fully gung ho with it. And then the real catalyst was was stumbling upon the research that these conditions are conditions that began decades before the first symptom and that there is a lot of research now going into our capacity to prevent them. And so for me, that was something that I felt really inspired to document and to do what I could to help move the needle on this disease. And I'm, you know, not a medical doctor, not a academic scientist, but this, for anybody who's, you know, at all familiar with my work, this documentary really does, it is the origin story. I mean, in the documentary, I'm not in any way an expert of any sort, I'm just a concerned son, going on this journey of discovery to try to find answers.

Melanie Avalon:
I'm curious, well, when you decided, like you said, to actually make the documentary, was it like, did you have just a moment where you decided to do that or was it a long mulling over process?

Max Lugavere:
I mean, I was, so I had, what's the least boring way to, to tell this, this story. I, you know, I had studied, I started college on a pre-med track and I ended up switching to a double major in film and psychology because I fell in love with filmmaking and storytelling in college. And in particular, I became really interested in documentary filmmaking because it was all done via digital, you know, with digital cameras, which allowed for an immediacy that traditional filmmaking, you know, disallowed because you had to measure lights and you had, you know, cutting film and changing cameras and all that stuff was just completely tedious to me, but documentary filmmaking, telling stories on the spot to me was really compelling. And so I gravitated to that in college and that led to me getting a job, which, you know, some people still remember me for, I was one of the main hosts for a TV network in the US that Al Gore co -founded called Current TV. And so on that network for six years, I was a, you know, I was a journalist, I was a presenter, I was, I got to, I got to hone my storytelling and filmmaking chops, and so I've been working in media and I'd been sort of, you know, doing mostly short form content, but you know, when my mom became sick, I was in between jobs, I didn't really have a job at the time and, and I just decided to, you know, what, I kind of did an inventory. I took stock of my skills and my abilities and I had media credentials. I was a quasi public figure and I had this filmmaking, you know, background. So I decided what better way to use, to, to make use of my college degree than to, than to do what it was that I was trained to do, which was to investigate this topic of brain health and dementia for the sake of my own family, really, and my skills at the time, again, I wasn't a medical doctor. It was as a journalist, as an investigator of sorts. So I procured a camera and I started reaching out to scientists and experts around the world who responded to my email because they were super excited to be a part of a documentary that for the first time ever was talking about dementia through the lens of prevention. And I was, you know, I had been a public figure on TV. I wasn't famous, but I, you know, I was verified on Twitter and so they, you know, I was able to get them to respond to my emails and to me that was just, it was very clear what I needed to do, you know, for me to have any impact on this condition, you know, for my mom, but also in terms of public health at large, which is something that I was really interested in doing given my background as being a, you know, a public facing journalist, I thought this was a, for lack of a better term, term, a no brainer for me to do. And so I just, I got to work and of course, you know, it was an incredibly arduous process, you know, making a feature length documentary is incredibly difficult. I didn't know what I was signing up for at the time. Cause this is my first time doing a feature length doc, but now 10 years later, it's, you know, I think the most important project I've ever done.

Melanie Avalon:
And now I'm curious about the timeline because when I watched it, I was assuming that I was assuming you had filmed all the footage with your mom. And then you had done all the interviews with the, like the different experts now. Cause it's, it's a lot of people that my listeners will be familiar with that I found the show. So like Nina Teichel, Dr. Perlmutter, Dr. Gundry, who I'm sure are all your friends now. So when did you interview them like now?

Max Lugavere:
No, these are all every single interview in the film was done around 2015 to 2016.

Melanie Avalon:
Oh, wow. Okay.

Max Lugavere:
Yeah. And the science really hasn't changed all that much since then. I mean, it hasn't changed at all with regard to the actual information that's delivered in the in the film. But yeah, all of those interviews are done. Everybody in the film looks 10 years younger than they are now because there were all these interviews.

Melanie Avalon:
I should have picked up on that.

Max Lugavere:
Yeah, they were they were all done. I mean, myself included, you know, that it was all done, yeah, about about 10 years ago, and the the interviewees, we have a really, I think, compelling blend of interviewees in the film where, you know, for it for an independent documentary like ours, it's incredible to me that we were able to get permission to go and film at Brown University at Harvard, at Wild Cornell in New York City, at NYU Langone, where we where we shot a lot of the, you know, the the scan, the imaging stuff that we did with my mom. It's just incredible that we got that kind of those kinds of permissions. And we have researchers that are, you know, Ivy League, like the woman who the neuropathologist Suzanne de la Monte, who coined the term type three diabetes is interviewed in my film, you know, is the first it's the first time I've ever seen her in any kind of public facing media, she's a real scientist. And then in tandem with with those researchers that we that we have had the privilege of including in the film, we also have, you know, physicians and health experts who are more more public facing, you know, so that people, you know, can latch on to a familiar face, if you will, you know, like Dr. David Perlmutter, you know, Ty Choles, Mark Hyman, and the like. And so I think it's really, I think it's cool that we have a blend of both, you know, we have these like incredibly legitimate, you know, bench researchers in the film. And then we also have, you know, experts in health who are, you know, who have built careers on the translational aspect of, of science, which, again, is, you know, just as important as the science itself. So, yeah, it's, it's a really cool film. But it's, it's, I don't want people, you know, one of the things that I think is really important, was important to me in going into this process of editing the film, I don't want people to think that it offers some kind of magical diet, you know, or some kind of silver bullet, this dementia is of incredibly complicated disease. And, you know, if people walk away, you know, with questions, you know, follow up questions, I think that would be a real home run, you know, because there are no there are no easy solutions. But, you know, I think one of the one of the biggest take homes is that, you know, despite the fact that there is still so much left to learn, we don't have to sit idly, you know, as we await what's perhaps in our in our genetic, you know, in our genetic, you know, conditions that we might be genetically a risk for, you know, these are conditions that are not determined by our genes, they're influenced, certainly, but we do have a say. And I think that's like the primary message that, that I wanted to convey with the film.

Melanie Avalon:
To that point, that was actually a major, major question I had for you about the film. Because like I said, so much of it is this really personal, emotional journey that you have with your mom. I mean, we're basically just peering into your life, and we're seeing what it's like to live with a loved one who has this cognitive decline. I'm so curious when you had the idea, especially because how long it took for you to film this over a decade and to produce it and edit it and create it. How did you decide how much of the film you wanted to be that personal relationship with your mom versus how much you wanted it to be? Because you just said like, this is not a magic diet. There's not like a prescription here. So how much of it you wanted to be like the science and like teaching people versus the journey?

Max Lugavere:
I think my views on that changed over the course of the production process you know start going into it i think i very much wanted it to be more of like a nutrition documentary but then you know that was my goal ten years ago and it made a lot of sense for me at the time having come off of the al gore project and. You know and and and wanting to really kind of you know be more of the you know have more of a presence in the film as an investigator cuz that was my job at the time that's you know that made that made a lot of sense to me ten years ago but. You know a lot i think has changed both in terms of my perspective ten years ago but also the landscape in general you know we now live in a time where there are. You know every other you know month it seems like there's a new nutrition documentary coming out on the streaming platforms and the vast majority of them are terrible you know the vast majority of them promote like. You know seemingly a covert agenda whether it be you know plant based or what have you the vast majority of them actually i mean i would say that that's the agenda just being fully transparent like you know whether it's what the health the game changers the recent netflix twin study thing you are what you eat i mean they're all terribly biased and and you know and the and the truth is it's really hard to convey the nuance of nutrition in a documentary and make it something that's actually compelling to watch. Nutrition is an incredibly complex science and there are no easy answers and you know at the end of the day as a storyteller i really did want to create a film that was share worthy you know for it to make an actual impact and for people to. You know for people who are experiencing what it is that me and my family experienced you know i want people to be able to watch it and feel less alone you know to find solace and what it is that what it was that my family went through and so. I think over the past 10 years you know and the production process generally we really kind of skimmed back a lot of the more informational aspect aspects of the film. Even though it's it's definitely still there and it's definitely there's a lot there that you know people who are naive to this topic are gonna are gonna gain a ton of value from certainly i thought it was really important more to. In the service of the audience to provide a real raw and intimate window into what it's actually like to have dementia both from the side of the patient as well as the caregivers and the family because that's something that hasn't really been portrayed I think on film. In a way, you know that that is really something that really captures what that experience is like and I also wanted the film to be at the end of the day, a love letter to my mom who was the most important person in my life and to you know to use my mom's story to make this you know this like. Just another nutrition film I thought you know this film really has to be a tribute to what it was that my mom went through and because she really is my inspiration she is the inspiration behind everything that I do. And I wanted it to be a voice for her you know to speak to other families and you know other caregivers and other people with dementia so as to you know so that so that people. Will feel less alone in that in that journey because I know how I felt I felt incredibly alone, and so we really wanted to make it about you know about my mom she's the she really is the star of the film and i'm super proud of that and, in fact, she named the film.

Melanie Avalon:
She did

Max Lugavere:
Yeah, she well, you probably remember a scene in the film where my mom is trying as attempting to describe her in her world and she. Alludes to the these boxes remain empty boxes you know if you if you want to just you know for a second. Consider all of your memories and all of the experiences you've had you know piled into into boxes you know and then suddenly those boxes you go to check on them. And one day there there's nothing to be found my mom talks about that in the film and she's she's struggling and suffering but she she references this this idea of of of empty boxes and. My mom passed away in two thousand eighteen but you know as we're editing editing this film over the past three years that line really stood out to my co director in the project chris new hard and he brought it to the rest of the team myself included. And he was like what if this is the name of the film you know what if what if we let Kathy name the film and we did and and i'm so glad that we did.

Melanie Avalon:
Cause I remember that scene, it was really, really haunting. I thought you were saying that you had a conversation with your mom that she knew you were making it and she said that it should be called that. What I remember from that, I think it was the same scene. I was trying to remember the moments where you're talking to her and she's saying these things and you would like repeat it back to yourself, thinking about it. Cause I think she made some other comment, not like about like a grandfather and a person in the room or a man. I don't know, she was saying stuff and you were repeating it back to yourself. And what was so interesting about it, I personally don't have any family members who have had Alzheimer's. I did have, my grandmother had cognitive decline. It was after a stroke though and it was pretty fast. So it wasn't the, like the long drawn out, you know, experience that people often have with people like Alzheimer's and to clarify it, your mom had Alzheimer's and Parkinson's. So is Lewy bodies a combination of those two essentially?

Max Lugavere:
It has more in common with Parkinson's disease, but it's essentially like having Alzheimer's and Parkinson's at the same time in terms of the symptomology of the disease.

Melanie Avalon:
Okay, and I remember she said in the film that it's almost like you expected her to be most stressed by the cognitive decline, but she made the comments about, you know, the Parkinson's aspects being most troubling to her, at least, you know, at one point.

Max Lugavere:
Yeah, we've, we've done, you know, it's been really interesting. We've done a little theatrical tour of the film in the US. And, you know, it's been great to show the film to audiences in person. And one of the things that I that's really stood out stood out from the Q &A is that we've been having after the film, is that many people with experience with Alzheimer's disease, you know, a lot of the times the patient is unaware of the cognitive decline that they're experiencing, which I think in a way is a is a is a bit of a grace of sorts, in the sense that they're, they're not fully aware of what it is they're experiencing of what their loved ones are experiencing. But in the case of my mom, she was fully aware of the degree to which her cognition was, was being diminished. And, you know, that was part of the reason why I think my mom was suffering to the to the degree that she was. And this is, you know, documented in the film. And it's, it's just a testament to, I guess, you know, how different these dementias can be. But irrespective of the dementia diagnosis, once you've seen one case of dementia, you've seen one case of dementia, they're also different. And that's something that I've that I've learned from interacting with people who've gravitated to the film and who've seen the film and, you know, who have had dementia in their in their family trees. It's just it's so different. Yeah, I mean, I wish in a way my mom was less aware of what it was that she was going through, because she really did suffer, you know, she she saw her life, you know, get just more and more diminished by the disease. And that's, I think, part of what made it so hard for for me to experience because my mom was somebody who had such an incredible zest for life. And to see that taken away from her by this condition was just it was it was heartbreaking. And I'm just so glad that we, you know, that we've been able to capture it in little empty boxes, because, you know, there are probably millions of people out there like me like her. And yeah, I just don't want people to feel alone in that process.

Melanie Avalon:
And to close out that loop on that scene I was talking about, I don't know what you were feeling during it, like when that moment happened or when you were editing it or the whole journey of it all. But for me as a viewer, the way it made me feel was, because I just remember it was when she was talking about the little empty boxes and the things and you kept repeating the words to yourself. And it's like you were searching for meaning in what she was saying. Like is there meaning behind what she's saying? And it was this haunting feeling of, for me, not knowing is there, like with the cognitive decline, is there meaning behind what they're saying? Like, what does it mean? Does it mean nothing? And it's just a very, I guess a lonely feeling like you were saying to experience with another person. I'm curious with the turnaround because she did, so in the film you go through this journey with her and then you do start implementing, like dietary changes, for example, and the scene when she's in the, I mean, it's not funny because I know she was not about it, but the scene when she was getting that scan that she didn't want to get for like an hour in the, it's really funny, she was not about it. Your relationship though with her is so, so sweet and so precious. Basically, she does not want to get this scan that she's worried about the radiation, which maybe, I mean, that's a tangent. Max encourages her to stay in it for like an hour and she's just complaining and like, and then there's like three minutes left and she's like, I'm out. I was like, no, three minutes, no, she made it through. You do start implementing these dietary changes and these different lifestyle changes with her from what you're learning. And there is a part where she, I mean, she seems to be making, doing a lot better. And I even noticed she's even like wearing more brightly colored clothing. I was wondering, did you like have her wear brightly colored clothing to signify that or did that just happen naturally?

Max Lugavere:
No, my mom was a fashionable woman. My mom, yeah, I didn't, I didn't influence her wardrobe at all. My mom was, uh, she loved to look good. And you know, it's just another aspect of how heartbreaking it all became when she, you know, when that aspect of her life became compromised. But yeah, she was a classy woman from New York City and was in the garment business in New York, in New York. And yeah, she loved it. She loved to wear nice things.

Melanie Avalon:
That's so incredible to hear. And because so much of it that I was watching, I was really curious how much of this, not that it was staged, but how much was, you know, your influence as a director and seeing this as a filmmaker versus just capturing literally what's happening in that moment. So that's, that's really interesting to hear. So when you start implementing some changes with her, like dietary life exercise, things like that. I mean, you guys thought about getting a puppy didn't, didn't quite manifest, right? You didn't get that dog, right?

Max Lugavere:
No, no, no, we didn't.

Melanie Avalon:
Did these changes make a difference for her? And did it give you a sense of hope? Did it give you a sense of false hope when she did ultimately succumb to the disease? So just what was that part of the journey like for you?

Max Lugavere:
Yeah, I mean, I when I started doing all this, all the research into diet and lifestyle, you know, I think I we hear this term a lot on social media now, like the the the diet zealot, you know, and I think in my own family, there was a small window where I became a bit of a diet zealot, and I tried to dramatically uproot my mom's diet and change things as I saw fit from the literature that I was reading. And, and that didn't last very long, because I learned very soon that people live the way that they want to live. And this is a incredibly complex condition. And they're, you know, it's a condition that probably was simmering in my mom's body for years, if not decades prior to the onset of symptoms. And, and, you know, it's a condition that really does rob so much of a person's dignity and joy in life. And for me to come in and try to, you know, take away, for example, the confectionary products that brought my mom joy at that time in her life, when she was she had become so limited in so many other ways, I just realized very early on that that would have been a real, real dick thing to do. And I'm not that person. And, and I wouldn't want my mom to feel any bit of shame or guilt about, you know, the choices, the dietary choices that she would make. So I mean, that that's part of it is that, you know, I really, I tried, I learned very soon. And early on that if I wanted to make any kind of dietary impact, I would just, you know, lead by example, and try to share the insights that I was learning in a gentle way, but primary, primarily to lead with love. And that's it just to lead with love and to, and to, you know, try to inspire change, you know, by, by living your by living my life as an example. So that's, that's pretty much it. And then, you know, also with dementia, what makes it even more difficult. So I mean, you know, I'm sure you you cover diet quite a bit on this show, as we all do, you know, anybody with a health podcast and dietary change is incredibly difficult for anybody. You know, for is for somebody without dementia, dietary change is one of the most difficult things to to achieve and sustain. And, you know, for somebody with dementia, that becomes exponentially more difficult. You know, there's for people with Alzheimer's disease, there's research that suggests that people with Alzheimer's disease actually begin to crave more sweet foods. And research is now emerging, showing similarly, that people with Parkinson's tend to consume more, you know, added sugar by at least 50% compared to healthy controls. So people, you know, as they get sick, they begin to crave, you know, sweeter foods. And, you know, who am I to stop my mom from consuming the kinds of things, kinds of things that she's craving, you know, I don't know, people listening to this might disagree with that. But it's just, you know, once you're actually in the trenches of chronic disease with a loved one, it's, you know, you have to, it's a really difficult tight rope to walk. And so I do think that one of the most productive changes that I encouraged my mom to make, and, you know, I'm not going to take full credit for this. My mom certainly, you know, she, she, she became aware early on of the benefits of exercise. And she started working out with a trainer, which is documented in the film as well. And I do think that that really helped my mom's spirits, if nothing else, but you know, her mental health, you know, I think that definitely played a role in terms of stabilizing her mood. We know that exercise is one of the best things that you can do for conditions like Parkinson's disease, Alzheimer's disease, mild cognitive impairment. And so I do think that that was incredibly helpful to her. And she worked, she found a trainer who she really connected with, and she, you know, she continued to work out until the end.

Melanie Avalon:
I haven't aired it yet, but I recently interviewed Leroy Hood and Nathan Price. Leroy, he came up with a lot of the... He's one of the oldest guests I've had on the show. He came up with a lot of the science behind the Human Genome Project, which is really, really cool. Their new book is all about... It's called The New Age of Scientific Wellness, and it's about the future of health and everything. They really hone in on cognitive decline as the thing that people are most interested in with just finding answers. When they're looking at it in the book, they talk all about it being a metabolic disease. All of these different signs and implications and factors we see in Alzheimer's and cognitive decline and how they can potentially relate to metabolic issues in the brain. You mentioned earlier in the show, one of the guests that you interviewed who coined the term type 3 diabetes, and now you're mentioning that your mom had all these sugar cravings and all these things. With that aspect of diet, sugar, insulin, the brain, especially with all the research you've done for so many years, how much of that do you think is causative? With your mom, do you think it could have been another way if she had followed a completely different diet? I know this is a really hard question, and maybe it's too personal, but do you think she might have not experienced cognitive decline if she had lived a different lifestyle?

Max Lugavere:
That's a great question. I'm happy to offer my thoughts. One point that I think is really important to make, and I think made this in the film, is that my mom's diet could have had nothing to do with what it is that she developed. It could have played some role. It could have had everything to do with it. But at the end of the day, I'll never know. There are so many factors that might play a role in initiating these kinds of conditions. A topic that I've become increasingly interested in, and I was very honored to actually get to, I was invited recently to speak in DC at an event called the Brain and Environment Symposium. Now there's a lot of emerging research pointing to industrial pollutants, chemicals like certain pesticides, herbicides, chemical solvents as playing a role in mitochondrial dysfunction. Just because something is characterized as a metabolic disease doesn't necessarily mean that all fingers are pointing to diet. Diet plays certainly a role. Statistically, you look around at the US population. Many people are in a state of metabolic distress, and that is largely for most people driven by, or at least contributed to by, diet. We live in a world now where we're being exposed to innumerable pollutants that might play a role in damaging the mitochondria of the brain. There are compounds like paraquat, a pesticide, an herbicide, which is still being used in the United States that is likely driving the skyrocketing rates of Parkinsonism that we're seeing now in the US. It's now the fastest growing brain disease. My mom had a Parkinsonian condition. Other compounds like a chemical solvent that's now widely used in dry cleaning, or has been in the past, and now it's been supplanted by a related compound, is called trichloroethylene. Trichloroethylene, epidemiologic studies, admittedly small, but suggest a six -fold increased risk of developing Parkinson's disease when people are exposed to trichloroethylene, which is a compound that easily can get into groundwater. It's a volatile organic compound, so it readily evaporates. It essentially poisons the air and even fatty foods in the vicinity in which it's been used. They've identified trichloroethylene in dairy products and dairy fat and butter and things like that. My mom was somebody who worked in the Garment Center, so I have no idea if my mom was ever exposed to trichloroethylene, but it's not hard to imagine a scenario where because of its use in industrial manufacturing and textiles and the like, that my mom was at some point exposed. There are so many different variables. I don't think that it's necessarily 100% diet, but I do think that insofar as we can be mindful of this stuff and eat a diet that is maximally nutritious, I think that probably is going to be helpful as well. The whole insulin thing is really interesting and from my perspective, I think micromanaging insulin doesn't necessarily make a ton of sense. As much as just eating in a state that keeps your body not overweight and well -muscled, I think that that's my general dietary perspective these days, is making sure that you're metabolically healthy by optimizing for your muscle tissue, which is a lot of experts are now talking about, but that's something that my mom from a dietary standpoint, my mom could have been better at optimizing for protein and things like that, which I'm happy to unpack if you'd like.

Melanie Avalon:
My listeners know, especially on the Intermittent Fasting podcast, I love the protein muscle topic. One quick question before that, had she and you and your family done genetic testing for variants that are risk factors?

Max Lugavere:
Yeah. So great question. Both, neither Alzheimer's nor Parkinson's disease are predominantly heritable conditions. So the heritability, heritability of both of those conditions are very low. So Alzheimer's disease, you know, there is a well -defined Alzheimer's risk gene called the APOE4 allele. Both me and my mom carry one copy of the APOE4 allele, which puts us at increased risk, but about one in four people carry that. It's not a deterministic gene. Two to 3% of Alzheimer's patients do inherit a mutation in a gene that essentially is considered deterministic and it, and it, you know, somebody might inherit early onset familial Alzheimer's disease, but that's a small minority of patients. So it's, it's a largely non -heritable condition, but we have genetic risk factors, of course. And then with Parkinson's disease, the heritability is also very low. It's not thought to be a heritable condition. It's thought to be an environmental condition. In fact, a neurologist, a university of Rochester neuro neurologist and, and researcher Ray Dorsey, who is, he's doing incredible work. I've had him on my podcast and he was actually the organizer of the symposium that I spoke at in DC. He calls Parkinson's disease and Lewy body dementia man -made conditions. And I think that's just a striking way to think about it. And I don't, disagree based on the research that I've, that I've seen that he's helped to bring to light.

Melanie Avalon:
And that deterministic gene that, you know, like two or three percent of the patients do have, do they know like what the mechanism of action that happens there is? I just feel like there'd be so much to learn from that.

Max Lugavere:
Yeah, I think, you know, it's been a while since I've looked, but it's, it's either a due to a, just an overproduction of amyloid beta, which is this protein that aggregates and clumps and forms the plaques associated with Alzheimer's disease. So it's like, it's, it's basically a mutation that causes this overproduction of this, you know, plaque in the brain. And it might also impact, it might also impact clearance. So, you know, there's the issue of overproduction or under, you know, an under an inability to properly clear these proteins, which we all build in our brains, but you know, we do generally have the ability to clear them. So it's a mutation. It's a pathologic genetic mutation. It's not, it's not a snip, you know, it's not like one of these single nucleotide polymorphisms like the ApoE4 allele, which is not a mutation. It's actually a normal genetic variant. The early onset familial variant of Alzheimer's disease is due to a mutation. So that is no bueno. And it's, it's comparable, I guess, to familial hypercholesterolemia, where people will like either overproduce or under clear, you know, this, this lipoprotein that, that can become potentially atherosclerotic. So it's kind of similar. It doesn't, it doesn't reflect sporadic Alzheimer's disease, like the, the neuropathology of sporadic Alzheimer's disease, even though they're related by way of this protein, this, you know, this amyloid beta protein that they both have in common, they're completely different animals. And so that's why I think it's really important that people are mindful of that, that, you know, the vast majority of what's called late onset Alzheimer's disease is not a deterministic, it's not a condition that's predetermined by your genes.

Melanie Avalon:
I was literally just thinking how that sounds analogous to like the hyper, I can never say the word, the hypercholesterolemia, the familial, oh my goodness, use your words. But no, it's interesting because in that comparison, because there's so much debate about LDL and how problematic is it and what's the role of context and all these things, that said, you can have the situation like that word, I can't say, familial hypercholesterolemia, where there's going to be a lot more of it and that does seem to be an issue. And then kind of similarly to the amyloid plaque, there's so much debate about the amyloid plaque, especially now. And actually, that was one of the most mind blowing things that I learned reading Nathan and Lee's book that I mentioned earlier was, they were talking about how some of the amyloid plaque may actually, and I don't remember the entire science what they were saying, but it actually might be protective and what it's doing, which was fascinating to think about. There's all this debate. I'm curious what you think about the progression of the medication industry with all of that, and especially that the drama that has come out semi -recently with this idea that maybe a lot of these Alzheimer trials and these drugs were not what people were thinking. What do you think about that industry? You do make the comment in the film, and this was a while ago, obviously, when it happened when you're with your mom, but you make a comment about how you were weighing the cost benefit of her being on all these different drugs and that versus quality of life. I feel like that's a really hard decision that a lot of people have to decide. So where do you fall on, because I just had a lot of stuff, where do you fall on the history of and where we currently are with the medications to address this?

Max Lugavere:
Yeah. I mean, it's, that's an important question because it's, you know, I'm not anti -pharma. I, if there was a drug that I could give my mom that was going to provide some kind of symptomatic relief for her, I would in a heartbeat have, you know, ran to my local pharmacy and had that prescription filled, but there's, there was nothing. And nonetheless, by the end of my mom's life, she was on 14 different pharmaceuticals. So it's just crazy to me that this is allowed, you know? And the drugs are minimally effective. I think that, you know, from a treatment standpoint, it's very unlikely that we're gonna see a drug. I mean, you know, I'd like to hold out hope, but it's very unlikely that we're gonna see a drug that is, you know, disease modifying and even symptomatically effective for a condition that begins decades prior to the first symptom. I mean, here's the thing. Once you're diagnosed with Alzheimer's disease or any other form of dementia, you're essentially in the late stage of that disease. You know, whether or not you were just diagnosed yesterday. I mean, these are conditions that they're diseases of midlife with symptoms that emerge in late life, but these are conditions that begin far earlier than the presentation of symptoms. And that's why the idea that we're gonna have some kind of magical drug come along, it's just like, it's very unlikely. And that's why we need to really continue beating the drum about prevention and how important it is to be mindful of these different variables and to clean up our world, essentially, you know, in a way that makes this effort less effortful because it is a lot today to be mindful of these industrial toxicants and, you know, our diets, which, you know, I mean, I'm just like everybody else in that, you know, my food environment is 73% processed just like it is yours. And so, you know, there is a lot, but yeah, the drug stuff is really disheartening and there's a lot of fraud in the industry as we've seen recently with regard to Alzheimer's disease, drugs in particular. And it's, I think because amyloid beta, which has been the target for drug discovery for so many decades, as you alluded to, you know, it's not the bad guy. There is evidence to support that it's actually, it plays a potentially protective role in the brain. Similarly to LDL cholesterol, you know, like we think LDL, these LDL lipoproteins are the boogeyman, right? That they're inherently atherosclerotic, they're not. I mean, they're potentially atherosclerotic, certainly, you know, but our bodies are making these compounds for a reason. And with amyloid beta, there's this idea that it is, you know, it's there to play a protective role. It's production seems to be upregulated in the presence of certain viruses during states of inflammation and the like. And the problem is that when it over aggregates and it forms these, you know, these misfolded proteins that then clump and become less easy for the body to dissolve and wash away, that's when it becomes, you know, problematic. But what's causing the amyloid to be there to begin with? You know, like what's causing it to, you know, to form these clumps and to aggregate? Is it poor sleep? Is it shitty diet? Is it, you know, is it mitochondrial dysfunction due to exposure to these, you know, these environmental pollutants? I mean, there's a lot of questions that need to be asked, but the latest research published by The Lancet in 2020 identified at least a dozen modifiable risk factors for Alzheimer's disease, you know, being type two diabetic, having hypertension, chronic depression, social isolation, hearing loss, hypertension. These are all risk factors that are modifiable and might play a role in keeping, you know, your brain free of this amyloid plaque decades before it would otherwise emerge. So yeah, so I don't think that amyloid is the boogeyman. I mean, certainly in the late stage of the disease, it's problematic and by then it might be too late because we have drugs that are now very effective at clearing amyloid from the brain. And they don't seem to be clinically meaningful from the standpoint of improving the symptoms, right? Like adjacatumab, you know, this monoclonal antibody, which was approved despite, you know, lots of, lots of pushback by the FDA. It was fast -tracked for approval because it was so great at clearing the brain of amyloid. Of course it led to, you know, side effects and even a death in those early clinical trials, but it was great at clearing the brain of amyloid. And nonetheless provided minimal, you know, improvement in terms of the cognitive, you know, features of the patients, you know, to which the drug was given. And very recently, just over the past couple of months, the FDA or Biogen actually said that they were pulling the drug, they were stopping, you know, their support for it. And yeah, so it's just, it's just crazy. And that's why I think like, you know, we should do our best to minimize risk and, you know, and, you know, at the end of the day, you could do everything right and you could still develop dementia. I mean, that's really the tragedy of the disease. But I think like we do have a degree of agency and we shouldn't feel hopeless. There are things that we can do and having hope I think is so incredibly important.

Melanie Avalon:
Oh, I think it's so, so important. And speaking of how it can happen either way, and then you mentioned the word too late, if a person does start exhibiting symptoms of cognitive decline, is there like, I know you said earlier that every case is different with the way it presents, but do you feel like if people start making changes right at the beginning that there is a lot more hope? So basically how much hope is there based on where a person is at in their symptoms and is there always like a point in time when it's just too late?

Max Lugavere:
I think that if you can take a kitchen sink approach and start exercising, you know, regularly and I'm talking about, you know, light cardiovascular activity to support your cardiovascular system, but also resistance training is really, really important. I think if you can do that and if you can start eating a healthful protein rich diet that's high in healthful sources of, you know, fat like omega -3 fatty acids, which are really important to the brain, rich in antioxidants, devoid of, you know, industrial additives and chemicals and pollutants, rich in foods like dark leafy greens, which are provide, you know, a number of important benefits to the cardiovascular system to brain health specifically. I think that you might potentially be able to improve symptoms, slow the progression of the disease, but it's important to be clear that nobody's ever survived Alzheimer's disease. You know, these are conditions that have not been, we have not been able to reverse them just yet. So I do think that by, you know, if I were to be diagnosed with Alzheimer's disease one day or Parkinson's or Lewy body dementia, I would likely try for myself a ketogenic diet. I'm not saying that a ketogenic diet is a cure for this condition, but there is some research on that. I mean, ketogenic diets dramatically change brain energy metabolism and supply the brain with an energy substrate that it can continue to use even when it's struggling to create energy out of glucose, which is its normal primary energy substrate. Dom D 'Agostino talks a lot about this, you know, he's a researcher in the field. So I would probably try that, a ketogenic diet. I wouldn't, you know, it's certainly not a cure, but the earlier you adopt one, there seems to be, you know, an effect in terms of improving quality of life and the like. But yeah, I don't, you know, I think prevention really is crucial. And, you know, once you're diagnosed, I think there are certainly things that you can do, absolutely, you know, particularly when, you know, earlier on. So for example, if you have mild cognitive impairment, you know, making sure that you are, you're getting your blood pressure into a healthy state, making sure that you're optimizing your hormones with resistance training. And, you know, if you're a female, maybe even HRT, you know, Lisa Moscone, who's an interviewee in my, in my film, she does a lot of incredible research and advocacy for women on the value of HRT and the right setting, you know, which is something that I think there's still a lot of confusion about. I'm by no means an expert in that topic, but, you know, but it seems to be the case that there are the benefits outweigh the risks for, you know, for most women with that regard. And women are at higher risk for developing dementia, you know, double the risk as compared to men. And so I think, you know, that could be, that could be a potentially disease modifying, or not disease modifying, but a potential effective prevention strategy, you know, more research, we need to do more research on that. But I think there, you know, at the end of the day, there are a lot of things that you can do, whether you have it or not, it's just important to be clear about what the, you know, the potential and the, you know, what we currently know, and what we don't know, and the like, because giving, you know, anybody false hope, that's not my, that's not my goal. But, but there is a lot that we can do. And, and I think that's important.

Melanie Avalon:
I'm fascinated by the HRT thing. I do think that there's a lot of, like you said, confusion out there and that a lot of fear mongering surrounding like the women's health initiative and the findings from that, which were not quite, I don't think, communicated properly based on the actual risks from that. Why do you think, though, cognitive decline and dementia and everything is more common in women? Do you have any theories?

Max Lugavere:
Well, I think estrogen normally plays a protective role. And I think, you know, during that menopausal shift, it's like the rug being pulled out from beneath your feet. And then you throw into the mix everything else that every human being is suffering from, metabolic dysfunction and the like. And I think it's just, it creates a perfect storm. Yeah. I mean, that's pretty much that's, that's pretty much my read on the situation. I, you know, I think like if you're, if you're female and I, you know, I don't, I'm not a woman. I don't know what it's like to, to be a woman, but I think from my purely anecdotal vantage point, you know, it's like, it's only recently that women are really starting to embrace resistance training and you know, that this whole myth about, you know, weight training, making you bulky has, where, you know, we're, I think the wellness industry, we're, we're doing a pretty good job, I think of debunking that silly myth. And I think I'm seeing a lot more women embracing resistance training and, and how valuable that is from the standpoint of metabolic health. But who knows? Maybe, maybe this is something that, you know, and also women might have tended to under eat protein in the past. You know, I know steak and foods like that are considered more manly and you know, people like yourself, like Gabrielle Lyon, like others are really doing a great job speaking to women about how important it is to optimize for protein in their diet. But I don't know, maybe in that, maybe historically women have just under consumed protein and they haven't really embraced resistance training as much as they now are. And maybe that, you know, you throw that into the milieu of this menopausal shift and all of the ultra processed foods that were all generally over consuming and it just creates this perfect storm. So that would be my, that would be my hypothesis.

Melanie Avalon:
And women, I don't know the data, but women do live longer, so it's possible, or does it not line up?

Max Lugavere:
That, yeah, they don't they don't live long, they don't live so much longer that that would. Okay, the effect. Yeah. Yeah, because I mean, these are conditions that begin in midlife, essentially. So it's not, it's not a, it's not a function of lifespan. It'd be great if we could, if we could chalk it up to that, you know, that's an easy answer.

Melanie Avalon:
One last question about the keto diet thing, where do you stand on supplementing that with MCT oil or coconut oil? Does that seem to have an added benefit?

Max Lugavere:
There's very limited research on that. I would freaking try it if I was ever diagnosed. Mary Newport is a physician who has done a lot of advocacy on behalf of medium chain triglycerides. And there actually is an FDA approved food product on the market called Axona, which is based on MCTs. So hell yeah, I would try it. But the research on MCTs are not super exciting, unfortunately. There's not a lot of really compelling stuff there. It's certainly not a cure. But the whole mechanism by which they may work is by supplementing the brain with an energy substrate, ketones, which the brain research suggests will continue to use as a fuel source, even when suffering from Alzheimer's disease, which actually creates glucose, the state of glucose hypometabolism in the brain. So the brain essentially, in Alzheimer's disease, it struggles to make energy from glucose, which is its normal fuel source. But its ability to generate energy from ketone bodies is largely unperturbed. And so that's why there's this thinking that you can essentially keep the lights on in the brain by supplying it with ketone bodies, which the brain will happily use as a fuel source. Up to 60% of the brain's energy requirement can be furnished by ketone bodies, which when you consume MCTs, you're essentially supplying your body with ketone bodies. And there's now a bunch of ketone products on the market, which may play a role. There's virtually no research on them. But trust me, if I was suffering from Alzheimer's disease, I have no affiliation. There's a company called HVMN. I've worked with them in the past as a sponsor. So they've sponsored my podcast in the past. But I don't work with them currently. And I have no vested interest in the company or anything like that. But they make a ketone IQ product or something like that, which I'm not necessarily endorsing. But if I had this condition, it's not an ad for them. But it's like a pure ketone. I would probably try something like that. And I would just see if it did anything. I don't know if it would do anything. But I would try anything.

Melanie Avalon:
It's like ketone esters.

Max Lugavere:
Yeah, exactly.

Melanie Avalon:
Yeah, I find it so fascinating. I find it really interesting that there's not more studies on it, just because, like you said, since it is a fuel that the brain can immediately use and bypass that whole glucose issue, it just seems really promising. But I guess there's still the glass ceiling or the issue that the brain does require a portion of glucose. So it's not like you could completely switch over, which would be nice.

Max Lugavere:
Well, and that's and that's fine because glucose is I mean, you know, our bodies are, are very efficient at using glucose as a fuel source. The problem is like when you're insulin resistant in your body, the degree of insulin resistance in the body correlates inversely with or actually a core correlates positively with the degree of starvation that your brain is experiencing. So you know, somebody who's more insulin resistance resistant is going to have a higher degree of glucose hypometabolism in the, in their brains. So, you know, you want to make sure that your body is insulin sensitive and not being over fat. That's I think a great, you know, great way to make sure that you're, you know, you're, you're supporting your body's insulin sensitivity, resistance training regularly, avoiding exposure to, you know, these plastic compounds, which may might play a role in increasing insulin resistance.

Melanie Avalon:
Doesn't the same enzyme that degrades insulin also degrade? Is it amyloid? Or isn't it the same enzyme in the brain that does both?

Max Lugavere:
Yeah, and you brought this up on our first interview, and I was super impressed, but it's insulin degrading enzyme in the brain. It breaks down amyloid and keeps it soluble so that it can be flushed away, but it also breaks down insulin in the brain, which is an interesting mechanism. I'm not 100% sure that we fully know how those two, how that enzyme interacts with both insulin and amyloid, but it stands to reason that the more insulin you have in circulation, the more that enzyme is going to focus primarily on breaking down and clearing insulin.

Melanie Avalon:
controversial question, maybe a little bit. So I remember last time that I had you on, around the same time, I also had on the Sure's Eyes from Loma Linda, they wrote a book, they wrote the Alzheimer's solution, I think. So they're very vegan, very vegan. And they have a whole book about a vegan plant -based diet for reversing cognitive decline or preventing, I don't know what words they use exactly. My question here, this question haunts me. This question, actually, this speaks to a larger question I have about this show in general, because on this show, I bring on people of completely opposite perspectives and not people that I don't always complete. I definitely don't always completely agree with the perspectives, but I think it's really valuable to expose people to all different viewpoints. And if I don't, you know, talk to the other side, how it helps with me feeling like I'll be less biased in my own perspective. So my question here is, do you think, especially because you were talking about how there's all these different lifestyle factors that are potentially playing a role in, in this issue of cognitive decline, if a person has not tried dietary changes for their Alzheimer's or whatever, or whatever they have, and then their exposure to that concept of like cleaning up their diet comes through like the plant -based world or the vegan world, do you think that's doing more harm than good? Is it doing good because they are, you know, cleaning up their diet and putting a focus on diet? I'm just really curious the benefit versus the harm of people being exposed to things like a plant -based and vegan diet that's, you know, whole foods based for dementia and cognitive decline.

Max Lugavere:
Yeah. Well, the question you always have to ask is what are we comparing this dietary pattern to? If we're comparing it to the standard American diet, I would say it's a healthy alternative to the standard American diet. If we're comparing a plant -heavy vegan diet to a plant -heavy diet that also includes grass -fed red meat and eggs and wild fatty fish, do I think that that's optimal? I would say absolutely not. I think incorporating animal -sourced foods like grass -fed beef, eggs, fish, even certain dairy products, if you're not sensitive to it, I think that is far superior than a diet that excludes those products. So I think veganism is the wrong approach. I think at the very least, even the most nutritionally orthodox expert will acknowledge that there's good evidence on fatty fish, the benefits of fatty fish, for brain health. But even eggs, even the advocates for the mind diet, Martha Claire Morris, she was one of my first guests on my podcast. She was a huge fan of eggs and all of their nutritional value. So yeah, I'm not of the opinion that the vegan diet is optimal. Is it better than the standard American diet? Sure. Does it reduce risk for cardiovascular disease and other conditions compared to the standard American diet? Sure. Do I think it's better than a diet that is just as high quality but inclusive of animal -sourced foods? No, I think including animal -sourced foods is the way to go for sure.

Melanie Avalon:
I do have somebody who thinks a vegan who thinks the fatty fish is not the way to go. I'm currently, I'm currently prepping to interview Dr. Michael Greger. Have you had him on your show?

Max Lugavere:
Yeah, he's just, he's so well known as being like a vegan, you know, biased vegan covert activist. And I think it's fine to be an activist. It's fine to ethically decide to abstain from animal source foods. I think that's fine, but it's just the, my problem is when these people convolute their message with health messaging, which is inaccurate and pseudoscientific and Michael Greger pushes a lot of pseudoscience. I mean, there's some stuff that he talks about that's great and accurate, but he pedals a lot of like really what I think is like really bad misinformation at times. And even vegans like within the vegan community will agree with that. So I'm not, you know, I don't like trash talking anybody because look we're all just trying to help people and do our best in this crazy life. But yeah, I think veganism is suboptimal. You can say, look, our oceans are polluted, fish contain microplastics and whatever, but you know, veganism is a, is a nutrient depleted diet. It doesn't contain, I mean yeah, veganism doesn't contain preformed omega threes, which I think are really important. You know, there's myriad nutrients, which we know that animal source foods contain that you can't get on a plant based diet. And at the end of the day, protein, I think is a really, is a really important macronutrient to prioritize in your diet for the maintenance of your musculature, for all of the other really important nutrients that that tend to cohabitate protein in the food environment. And if you're demonizing whole foods today in a time when 60% of the calories that your average person consumes comes from ultra processed foods to demonize a whole food like red meat, eggs, things like that, you're just, I think it's like the wrong message. So that's just, yeah, that's my, my perspective. And, and that's what prevents dementia or protects the brain in any capacity. There's just no evidence there. It's just like, you know, this fringe concept cobbled together by lots of epidemiology, which is notoriously weak in the field of nutrition. And I just think it's, yeah, it's a, it's a huge missed steak. No pun intended.

Melanie Avalon:
I mean, that kind of all, it touches on a lot of things I was talking about because like I said, I'm reading his book right now, it's called How Not to Age. It's very long as his books often are. And he'll, he references like a ton of studies. So it feels very scientific. But then if you go look at the studies, I just feel like there's a lot of careful, you know, plugging and playing and potential cherry picking of everything and then I, you know, get haunted. I'm like, should I even be having this conversation on the show? But I do learn a lot and I do have a lot of questions. So that's the whole thing.

Max Lugavere:
Yeah, there's, I mean, he's definitely put out some factual stuff. I mean, but that's kind of how the bait and switch maneuver works. You know, you put out like, you know, two pieces of a factual, you put out two factual statements and you follow, you know, to build trust. And then you follow it up with something that's like just completely inaccurate. You know, like I've, I think I've read some stuff from him that I've integrated and I've checked out the studies and you know, they, whenever he's talking about the benefits of certain plants, I think that's when he's doing a benefit to society, right? Like stick to that, you know, like, tell me about how, you know, just eating a handful of Brazil nuts, you know, can help improve like lipid homeostasis in the body or how sulforaphane is this, you know, really interesting potential cancer fighter, cancer fighter found in cruciferous vegetables, like all that stuff is great. Like that's all adding, I think, positively to the, to the discourse on nutrition. But then when, you know, these vegan activists, fear monger, animal source foods, I think that's the real harm. And I, and I think it does real harm because it dissuades people from eating foods that are incredibly helpful. You know, I can't tell you how many, you know, women, for example, follow me and who, you know, who've read my books and have started eating, you know, they've been on plant based diets for seven years and they finally started eating red meat again and they got their periods back and their blog has lifted and their, you know, and their depression has improved and like, and I just think it's, you know, we're, we're adapted to be omnivores. We can argue about the appropriate proportions of, you know, the different food groups in our respective diets, but we know that protein is essential. We know that we have an essential need for certain fats, which are found primarily in animal source foods. And, you know, and so like to fear monger and to encourage people to take these foods completely off their plate, I think is does real harm and it pisses me off. But, you know, it's just me being passionate.

Melanie Avalon:
What's weird about it is like if you just subjectively look at because they always, they always reference the blue zones and the longest live populations. But if you look at that objectively, the majority of them all have animal products in the diet. So if you were to just like completely objectively say what is the best diet for longevity, it would be inclusive of animal foods based on that logic.

Max Lugavere:
Yeah. Blue Zones advocate, they misrepresent the diets like the, in Okinawa, the, they eat tons of pork in, you know, in Ikora, Greece, they eat tons of lamb. They drink goat milk and stuff like that. You know, I mean, go to any region in the Mediterranean, they're eating prosciutto. Where do you think we get these, these delicacies, delicacies from, you know? And so to mischaracterize the diets of these long live people, look, I mean, you referenced some doctors from the Loma Linda, you know, health system Loma Linda is, is, it's a seventh day Adventist health system. Anybody who comes out of that system is going to have a bias towards veganism and veggie and vegetarianism, but primarily veganism because that religion issues the consumption of animal project products. Most people, you know, to be pious and virtuous in that religion are vegan. And we know that social connection and all that stuff are really important when it comes to longevity. So, you know, their longevity has little to do with their vegan diets and mostly, you know, to do with the fact that they are, it's this tight knit community, but pretty much any, any data to come out of that system and any quote unquote expert to come out of that system, you can, I will, you can bet money that they're biased. That system, you know, the Loma Linda, the seventh day Adventists also even have their own medical journal. They even have their own health journal and all the research that they publish is pretty much like anti animal source foods, but they're not, they're, they're not forthcoming with that bias. Yeah. A lot of, a lot of the nutrition research, which is why it's, it's so annoying because nutrition is such a, I love nutrition, but so much of the research is so incredibly weak. It's all predicated on nutritional epidemiology, which there is some value to it. It's hypothesis. It's meant to be hypothesis generating, but by and large, you know, there are so many problems with nutrition epidemiology. When you look at the population level at people who consume meat, for example, people who consume meat tend to smoke more. They tend to drink more alcohol. They tend to be more sedentary. And that's why you tend to see, you know, meat associated with poor health outcomes. You know, it's, it's not surprising that meat is so consistently meat consumption is so consistently correlated with worse health outcomes because there are all these confounding variables and nutrition researchers can't possibly adjust for all those different potential confounders. And then you take the fact that, you know, our, do those, how reliable even are those associations when they're assessed by way of these food frequency questionnaires, which are administered generally like once a year asking you to over the past year, how much meat did you consume? You know, like they're notoriously unreliable. So you get that thrown into the mix. And then you throw into the mix the fact that the effect sizes themselves are so incredibly small that it's like you'd have to be a fool to assume that that's a causal connection, right? What needs to be done are long -term randomized control trials where you put people, you know, on diets that are of sufficiently high quality, equated actually for quality. And you've got, you know, you take one group that's on essentially a purely plant -based diet and you take another group that's on a plant -based diet or a plant forward diet with, you know, with lots of animal source foods and you see who does better. And you don't just look at, you know, LDL cholesterol, which might be higher in the group that's consuming meat because that's not a clinical outcome. That's a biomarker, right? And so that these are all the ways in which nutrition science is skewed. And I think it's, it's really problematic. And nonetheless, these are the kinds of studies that are used to, you know, to sway public purchasing, you know, consumer behavior used to create careers in the field of nutrition and so much more. And it's just like, you know, my whole thing is helping people, you know, just see the truth of it all and make better decisions for themselves. And it's not like I'm promoting any one magical diet. I just, you know, my whole thing is people should be eating animal source foods and they should be eating plants. And that's it. End of conversation. The more whole foods you can eat, the fewer ultra processed foods you can eat, the better off you're going to be.

Melanie Avalon:
Yeah, I really don't think we can escape the implications of the healthy user bias with all of this. And it's kind of like, do you remember, it was sort of recently that fasting study that came out, speaking of, you're talking about food frequency questionnaires, I bet you saw it, it was where they said that intermittent fasting was causing cardiovascular disease. And the setup of the study, I can't even like say it, it's so awful, they looked at data of people saying what they ate on like two different days over years. And then they applied that, they were like, oh, that's what they're doing, fasting wise. And then they applied that to I think, like the next, I don't know, eight years or so. And then they drew conclusions about outcomes from that based on like two surveys of what people were eating on two days. It's, I don't even know how that even got slightly, potentially, barely green lit. It just doesn't make any sense. But do you practice intermittent fasting?

Max Lugavere:
I don't really so much anymore. I think it's really important to eat a hefty bowl of protein soon after you wake up. I try not to eat too late at night, so I guess that's my way of practicing it. I try not to eat for two to three hours before bed because circadian biology is showing us that we're really meant to eat earlier in the day and to not eat too close to bedtime because that's when our metabolic faculties start to wind down. That's pretty much the extent of it. I don't have a goal of I've got to spend 16 hours every day or what is it? 16 hours? Yeah, fasting. I've got to hit my 16 -hour target every day. I definitely don't think about it in terms of a fasting and feeding window. I usually will get hungry 30 to 45 minutes after I wake up and that's generally like I like to work out in the morning, so I'll eat something before I work out like a protein -forward meal. Then I eat a big dinner generally around 7 to 8 p .m. I generally won't eat after that. That's pretty much it. That gives me a good 10 hours of fasting. I don't obsess too much over the number of fasting hours or anything like that. I just don't think it's that important.

Melanie Avalon:
For the protein, because we've talked a lot about the role of protein for how important it is, what amount do you recommend? Do you think there's an upper limit? I always wonder if I'm eating too much protein. I eat a shockingly large amount of animal protein.

Max Lugavere:
Yeah, there doesn't, there doesn't really seem to be an upper limit. I mean, the upper limit would be the upper, the, the, the upper limit would be if you're eating so much protein that it because, and protein is so satiating that it's disallowing you from eating other foods, you know, there is a limit at which point, you know, eating too much protein, the body doesn't really derive all that much energy from protein. And so you, you know, there's this whole phenomenon known as rabbit starvation where, you know, if you're not eating enough fat and you're not eating any carbohydrates and you're just eating too much protein, like your body will effectively starve to death. You know, a lot of these like feeding studies with protein, you know, the upper limit is like 40, 40% of calories from protein. So that that would be what I would consider to be like the general upper limit. And there's really no need to consume more protein than, you know, maybe one gram per pound of body weight from a, from a body composition standpoint and muscle maintenance standpoint. But yeah, I mean, my, my target is generally, you know, I try to get 1 .6 grams of protein times my weight in kilograms. That's what the research suggests as being, you know, the target that you want to hit to optimize your, your muscle. And I, you know, spend a lot of time resistance training and, you know, um, I want to keep my gains as long as I can. And so I'm trying to get, generally for me, I'm about 195 pounds right now. I'm, I don't know, something like 160 grams of protein a day. So if you divide that over four meals for me, that's like 40 grams of protein per meal, which is a pretty easy lift for me, for somebody of my size. So yeah, I try to hit that protein target every day. And then, you know, protein associating. So for people who are like, you know, most people are trying to lose weight. I recognize that. But if you're trying to gain weight, you know, there is some value potentially needing a little bit less protein to make, again, room for more, for more energy, for more carbs and fats.

Melanie Avalon:
this finding, because people often ask me. They always want to know what I'm eating. I'm like, don't ask me, because I eat a lot of protein. So bringing things, because this has been absolutely so amazing, bringing things back to the film, how we were, you know, the purpose of today's conversation. I'm really curious, so how do you feel about it? What has the reception been? Because you mentioned in the beginning, you know, what you were really hoping to accomplish with the film. How do you feel with everything? Now that it's, and congratulations, by the way.

Max Lugavere:
Thank you. It feels incredibly cathartic. You know, it's been a 10 year journey and I'm just so excited for people to see it. I mean, I'm excited for people to see it because I think it's a really moving piece. It's the most important thing I've ever done. And I think that, you know, there's a lot of people going through this about 6 million people in the United States alone have Alzheimer's disease, about 1 .2 million have Parkinson's disease. There are other forms of dementia and it's a really alienating condition. And, you know, insofar as my film presents a true portrait of what it's really like, both from the patient and caregiver side, I think, you know, that's a tremendous value add to anybody who's, who's going through this. And you know, selfishly, I'm just excited that my mom will get to live on in the hearts and minds of the people who choose to watch the film. There's also some really great, you know, research in there. So for anybody interested in, you know, a broad strokes picture on what you might do to potentially prevent dementia. I think it's a great starting place to, you know, to, to instigate further inquiry. But yeah, you know, this has been a labor of love and there were many times over the past 10 years where I thought it was never going to see the light of day where I thought it was just a failure and it was really, it was really painful for me actually. But the fact that it's now finished and on June 27th at little empty boxes .com, we're going to have it, you know, out for all the world to see that to me is just, it's just an incredible, yeah, it's not something I take lightly. And and I can't wait to get the response from it, you know, and, and, and see how people, you know, resonate with it. That to me is going to be really cool. Cause you know, it's a, it's been a labor of love to say the least.

Melanie Avalon:
I can really tell and like we're talking about in the beginning, I think it really is the perfect blend of being just this really haunting, riveting story. Your mom is just so riveting, like she's so everything she, like the way she sees the world and the way and the things she says and she's like just funny and fascinating and seeing your bond with her and you care for her and also the struggles that you go through, you know, just try and find answers. I just feel like it's going to resonate with so many people and then it provides, you know, just the right amount of all of this science and things that like we've been talking about on today's show to get people, A, give people implementable things that they can do now and also I think really make people curious so that they'll, you know, walk away with more questions and wanting to seek more answers which then it's just unending the amount of information people can find when they're on that journey. Is it in theaters? Is it in some theaters right now?

Max Lugavere:
Yeah, so we did a theatrical release in the US in select theaters. And so yeah, I believe it's still currently playing in a in a handful of theaters, but we obviously want everybody in the world to be able to see it. So that's why we decided to do a fully independent release on our own website. And yeah, it's, it's important, you know, this isn't something that was influenced by any streaming platform. It wasn't, you know, that wasn't even the goal, to be honest, of making it, it's something that we, you know, just decided to do fully independently. So, you know, anybody who wants to watch it to support independent film, you know, and this, this effort, which again, has been like 10 years in the making, I mean, it would be incredible to have, yeah, to have it go far and wide and for people to, you know, to support it, because there aren't that many outlets for independent film, you know, I know a lot of comedians these days are, you know, doing their own specials and self funding their own specials and putting them online. And I know that there's a big market for that. But, you know, independent documentaries, that has yet to be, that's a business model that has yet to be proven. So yeah, so hoping we can get the support from, you know, all your listeners and everybody, like, you know, to come and see it and to support the effort, that would be amazing.

Melanie Avalon:
And I'm so happy, just one last thing. I'm so happy for you with the theatrical piece because especially in today's world with like, and you know this being a social media influencer as well with TikTok and Instagram and even with podcasts, like when people listen to podcasts, they can be multitasking. Like you got to have this experience of people, because people pretty much, I feel like being in a theater, like seeing a show is like the one time people aren't on their phones, like they're actually just engaged. So it's really exciting to know that so many people actually have that moment of, you know, just being there with your film and experiencing it. And then, so for listeners, because when this, I think we're airing this to align, I believe with the release. So we're gonna listeners go to watch it.

Max Lugavere:
Yeah, so littleemptyboxes .com is our website. It's the name of the film. Yeah, people can watch it there. That's the ask. Just watch the film and really feel it, dedicate an evening to it. Watch it with family. It's been at the theaters, it's been really powerful. A lot of people have been showing up, mothers and daughters, fathers and sons, mothers and sons. It's just been incredible. And siblings have been showing up. It's a really powerful film to watch with family because it is a film about the ones we love. It's a film about family. And yeah, just make a night out of it.

Melanie Avalon:
I'm gonna have to watch it again with my family. Okay, so friends, go to littleemptyboxes .com now. I promise you, you will not regret it. It is such an incredible journey to watch it, so definitely go there now. We'll put links in the show notes as well. The last question I ask every single guest on the show, you might remember it from last time, but it's just because I do really, really appreciate the importance and value of mindset. So what is something that you're grateful for?

Max Lugavere:
Oh, well, I'm grateful, I guess, for my family. I'm grateful for my mom, of course. She was an amazing mom, and the only mom I'll ever know. Grateful for my dad, who's still alive. And I'm grateful for my brothers. My mom raised me to, and my brothers, to be very close with one another, knowing that family is everything. I know a lot of people who don't have the kind of relationship with their brothers that I have with mine, and I'm super grateful for that. We're all incredibly supportive for one another during this time, which was the most traumatic time I've ever experienced. I'm grateful for my cat, Delilah, who is the best cat on Earth. She's amazing. Yeah, that's it, family.

Melanie Avalon:
I love it. Well, thank you so much, Max. I am, like I said, I'm so grateful for everything that you're doing and I have been for years and you're changing so many lives and to see you do it in this, you know, new medium is just astounding. So thank you so much. I look forward to everything in the future.

Max Lugavere:
Thank you, Melanie, so much for having me. It was an honor.

Melanie Avalon:
Thanks Max. Bye.