HoldsUp

Max Lugavere

Max Lugavere is a filmmaker, health and science journalist, and author. His work focuses on the relationship between nutrition, brain health, and cognitive function. He has published on a food-first prescription for cognitive longevity in Missouri Medicine.

31 claims checked on air: 5 context 1 contradicted 23 supported 2 unverified

What they said on air - supported

0:07:03supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Neurodegenerative conditions like Alzheimer's begin 20 to 30 years prior to the presentation of clinical symptoms.

"these conditions begin decades before the presentation of symptoms, by some accounts 20 to 30 years." (said at 0:07:03)

Biomarker and neuroimaging studies demonstrate that the pathophysiological changes associated with Alzheimer's disease—specifically amyloid-beta accumulation, tau pathology, and subtle structural changes—begin 15 to 25 or more years before the clinical manifestation of symptoms. For instance, data from the Dominantly Inherited Alzheimer Network (DIAN) demonstrated significant declines in cerebrospinal fluid (CSF) Aβ42 beginning approximately 25 years before expected symptom onset, followed by detectable amyloid-PET retention and elevated CSF tau approximately 15 years before symptoms appear.

0:14:41supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Processing speed is one of the first features of cognition to decline in Alzheimer's disease.

"They boost an aspect of our cognition called processing speed, which is one of the first features of our cognition to decline in Alzheimer's disease" (said at 0:14:41)

Longitudinal biomarker and neuropsychological studies indicate that processing speed, alongside episodic memory and attention measures, shows some of the earliest detectable declines during the preclinical stages of Alzheimer's disease. For example, in longitudinal PET imaging of clinically normal older adults, emerging beta-amyloid accumulation is associated with early declines in processing speed measures (such as the Digit Symbol Substitution Test and Trail Making Test Part A) even before widespread neocortical tau deposition and extensive memory deficits emerge.

0:16:14supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

A University of Georgia study found that supplementation with the carotenoids lutein and zeaxanthin resulted in a 20% increase in visual processing speed in young, healthy college students.

"There was a wonderful University of Georgia study that found that in young, healthy college students, that supplementation with carotenoids, these plant pigments called lutein and zeaxanthin, led to a 20% boost in visual processing speed." (said at 0:16:14)

Researchers at the University of Georgia's Vision Sciences Laboratory conducted randomized, double-blind, placebo-controlled trials evaluating macular carotenoid supplementation (lutein and zeaxanthin) in young, healthy college students. They demonstrated significant improvements in objective measures of visual and neural processing speed, including temporal contrast sensitivity function (tCSF), critical flicker fusion thresholds (~12%), and visual motor reaction times (~10%).

0:17:16supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Creatine is found naturally only in animal products like beef and fish, and is absent from non-animal products.

"creatine is considered a carnonutrient, it's found only in beef and fish, so you don't find creatine in non-animal products" (said at 0:17:16)

Published nutritional and biochemical literature confirms that naturally occurring dietary creatine is found almost exclusively in animal tissues, primarily meat (such as beef) and fish, and is virtually absent from plant-based foods.

0:17:46supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Based on the Digestible Indispensable Amino Acid Score (DIAAS), animal protein possesses the highest protein digestibility and protein quality found in nature.

"we know, thanks to the Digestible Indispensable Amino Acid Score, that animal protein is the highest that we find in nature with regard to protein digestibility and protein quality" (said at 0:17:46)

Under the Digestible Indispensable Amino Acid Score (DIAAS) framework recommended by the Food and Agriculture Organization (FAO), animal-source proteins (such as dairy, eggs, meat, and fish) consistently demonstrate the highest standardized ileal amino acid digestibility and overall protein quality scores (frequently exceeding 100%, classified as 'excellent' protein quality). In contrast, unprocessed and typical whole-plant proteins generally exhibit lower digestibility and DIAAS values due to matrix constraints and limiting indispensable amino acids.

0:18:16supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

A study found that frailty increased the risk of developing Alzheimer's disease by threefold among individuals at high genetic risk.

"there was a study, Dr. Perlmutter, that came out actually that looked at people who were at high genetic risk for developing Alzheimer's disease, and what was the key characteristic that determined in this study one's risk by threefold? Frailty." (said at 0:18:16)

Large prospective cohort analyses from the UK Biobank have evaluated the combined impact of physical frailty and genetic predisposition on incident dementia and Alzheimer's disease. These studies demonstrated that frailty substantially amplifies dementia risk across genetic strata: overall, frailty was associated with a roughly 2.3- to 2.8-fold increased risk of dementia, and individuals with both high polygenic risk and physical frailty had an approximately 3.9-fold higher risk of developing dementia compared to non-frail individuals with low genetic risk.

0:19:09supportedlowWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Gut bacteria produce postbiotics like butyrate that directly support neuroplasticity.

"churn out compounds referred to as postbiotics, like butyrate, which directly support neuroplasticity." (said at 0:19:09)

Gut bacteria ferment dietary fibers to generate short-chain fatty acids (SCFAs) like butyrate, which act as bioactive postbiotic metabolites along the gut-brain axis. Experimental and preclinical research confirms that butyrate directly modulates neuroplasticity by enhancing hippocampal long-term potentiation (LTP), acting as a histone deacetylase (HDAC) inhibitor to upregulate brain-derived neurotrophic factor (BDNF) and neuroplasticity-related genes, and protecting neurogenesis. However, direct evidence for these mechanistic pathways comes primarily from animal, ex vivo, and cell-culture models, with human clinical trial data remaining preliminary.

0:19:10supportedlowWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Research from Rush University showed that people who consume a serving of dark leafy greens daily have brains that test up to 11 years younger cognitively.

"Researchers out of Rush University actually found that people who consume a big bowl of dark leafy greens every day have brains that perform up to 11 years younger." (said at 0:19:10)

A prospective study from the Rush Memory and Aging Project (Morris et al., 2018) followed 960 older adults (ages 58–99) over an average of 4.7 years. Participants in the highest quintile of green leafy vegetable consumption (median 1.3 servings/day) had a significantly slower rate of cognitive decline compared to those in the lowest quintile, equivalent to being 11 years younger in age after multivariable adjustment. Because this is an observational prospective cohort study, it demonstrates an association rather than proven causality.

0:23:59supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Nine in ten adults in the United States have at least one component of metabolic syndrome.

"research showing us that nine in ten adults have some component of metabolic syndrome" (said at 0:23:59)

A nationally representative analysis of the National Health and Nutrition Examination Survey (NHANES 2009–2016, n = 8,721) evaluated metabolic health using standard cardiometabolic risk components (elevated waist circumference, elevated fasting glucose/HbA1c, elevated blood pressure, elevated triglycerides, and low HDL cholesterol, or being on medications for these conditions). The authors found that only 12.2% of American adults were metabolically healthy (meeting all optimal criteria without medication), indicating that approximately 87.8% (nearly 9 in 10) of US adults had at least one suboptimal component of metabolic syndrome.

0:23:59supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

By the year 2030, one in two adults will be obese.

"by the year 2030, one in two adults are going to be not just overweight, but obese" (said at 0:23:59)

A landmark projection study published in the New England Journal of Medicine (Ward et al., 2019) analyzed data from over 6.2 million US adults in the Behavioral Risk Factor Surveillance System (BRFSS), corrected using measured data from NHANES. The authors projected that by 2030, nearly 1 in 2 adults in the United States (48.9%; 95% CI, 47.7 to 50.1%) will have obesity (BMI ≥ 30), with prevalence exceeding 50% in 29 states.

0:25:15supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Protein is the most satiating of the macronutrients, more so than carbohydrates and fat.

"We know that protein is the most satiating of the macronutrients, more so than carbs and fat" (said at 0:25:15)

The claim accurately reflects the established nutritional evidence regarding the satiety hierarchy of macronutrients. Controlled dietary trials and reviews demonstrate that, calorie-for-calorie, protein produces the strongest and most sustained suppression of hunger and subsequent ad libitum energy intake compared with carbohydrates and dietary fats (protein > carbohydrate > fat). This satiating effect is mediated in part by prolonged suppression of ghrelin and enhanced release of anorexigenic gastrointestinal hormones such as cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), and peptide YY (PYY).

0:25:23supportedlowWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Studies show that people who consume higher amounts of dietary protein tend to have lower amyloid burden in the brain.

"We see studies that people who consume more protein tend to have lower amyloid burden in the brain" (said at 0:25:23)

A cross-sectional study of cognitively normal older adults from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study evaluated dietary intake and brain amyloid-beta (Aβ) deposition measured via PiB-PET scans (n = 162). Participants in the lowest and middle tertiles of protein intake had 12.59-fold and 8.43-fold higher odds, respectively, of having high brain amyloid burden compared to those in the highest tertile of protein intake. Because this evidence is cross-sectional and observational, causality cannot be established, warranting a low certainty rating.

0:25:55supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

A study by Stuart Phillips of McMaster University found that high-protein, animal-sourced foods contain micronutrients that are commonly underconsumed in their most bioavailable form.

"There was a study published by Stuart Phillips, who's a protein expert at McMaster University, who found that high-protein foods, and particularly animal-sourced foods, tend to contain micronutrients that are typically underconsumed, and not just that, but in their most bioavailable form." (said at 0:25:55)

Stuart Phillips (McMaster University) and colleagues have published analyses of dietary protein sources and nutrient profiling systems emphasizing the micronutrient density and bioavailability of animal-sourced foods. Specifically, Phillips and co-authors note that evaluations of diet quality often fail to account for essential shortfall nutrients and bioavailability, and point out that animal-source foods (such as dairy, meat, and fish) provide critical, highly bioavailable micronutrients that are frequently underconsumed in target populations.

0:33:24supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Only 11% of the sodium consumed by the average American comes from salt added directly at the table or during home cooking.

"However, it's important for people to recognize that only 11% of the sodium that your average person ingests comes from what they add to their food via their own salt shakers or what they add to their foods when crafting various recipes." (said at 0:33:24)

Dietary assessment studies evaluating sources of sodium in the US diet confirm that approximately 10.5% to 11.3% of total dietary sodium comes from discretionary salt added at the table or during home cooking combined. In a landmark multi-region study of US adults (Harnack et al., 2017), salt added in home food preparation accounted for 5.6% and salt added at the table accounted for 4.9% of total sodium intake (totalling 10.5%), while commercially processed and restaurant foods outside the home accounted for over 70%. Earlier landmark research (Mattes and Donnelly, 1991) similarly found that table salt (6.2%) and cooking salt (5.1%) combined accounted for approximately 11.3% of total sodium intake.

0:36:47supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Bread and rolls are the number one source of dietary sodium in the Standard American Diet.

"But I think it is important to recognize that the number one source of dietary sodium in the Standard American Diet, it's not processed meat, it's not canned foods, it's bread and rolls, Dr. Perlmutter." (said at 0:36:47)

National dietary surveillance data from the CDC and the National Health and Nutrition Examination Survey (NHANES / What We Eat in America) identify "bread and rolls" as the leading individual food category contributor to daily sodium consumption among Americans, accounting for more sodium intake than categories like cold cuts/cured meats, pizza, or canned soups. While individual servings of bread are not necessarily high in sodium density, the high frequency and volume of bread consumption across the population make it the top aggregate dietary source.

0:38:46supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

25% of the total cholesterol in the human body is located in the brain.

"25% of the cholesterol in your body is housed in your brain." (said at 0:38:46)

Human lipid physiology establishes that the central nervous system, despite accounting for only about 2% of total body mass, contains approximately 23% to 25% (roughly one-quarter) of the unesterified cholesterol in the human body, predominantly within myelin sheaths and neuronal/glial cell membranes.

0:39:04supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

About 90% of adults do not consume the adequate daily intake of choline.

"In fact, an egg yolk is the top source of choline that I'm familiar with in the modern food environment, and about 90% of adults don't consume the adequate intake for choline on a daily basis." (said at 0:39:04)

Nationally representative dietary survey data from the United States (NHANES) consistently show that approximately 90% to 93% of adults fail to meet the Adequate Intake (AI) recommendation for choline. Analyses of NHANES data found that only about 6.6% to 8.0% of US adults aged 19 and older achieve the AI for choline from food sources, with egg consumption being a primary dietary factor associated with reaching the AI.

0:40:20supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Dietary tryptophan provided by protein serves as a precursor molecule for the synthesis of the neurotransmitter serotonin.

"Protein provides, for example, tryptophan, which is a precursor to serotonin, which is an important neurotransmitter implicated in healthy mood and executive function." (said at 0:40:20)

Dietary protein supplies the essential amino acid tryptophan, which is the direct biosynthetic precursor for the neurotransmitter serotonin (5-hydroxytryptamine). Brain serotonin synthesis depends on plasma tryptophan availability and its transport across the blood-brain barrier, where it is converted into 5-hydroxytryptophan and subsequently serotonin, playing an established role in mood and cognitive functions.

0:46:35supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

The SPRINT MIND trial found that intensive pharmaceutical lowering of high blood pressure produced a significant risk reduction for mild cognitive impairment.

"it was called the SPRINT MIND trial, that found that for people with high blood pressure that were treated with a pharmaceutical to lower their blood pressure, they saw a significant and robust risk reduction for the development of mild cognitive impairment, which is pre-dementia, essentially." (said at 0:46:35)

The SPRINT MIND randomized controlled trial evaluated the effect of intensive blood pressure control (systolic target <120 mm Hg) versus standard control (systolic target <140 mm Hg) in 9,361 adults aged 50 and older with hypertension. Intensive blood pressure lowering resulted in a statistically significant 19% relative risk reduction in adjudicated mild cognitive impairment (14.6 vs. 18.3 cases per 1,000 person-years; hazard ratio 0.81, 95% CI 0.69-0.95).

0:47:15supportedlowWhat to Eat for Optimal Brain Health - with Max Lugavere | T

A study found that using antiseptic mouthwash twice daily doubles a person's risk of developing hypertension.

"But there was a startling study that found that for people who frequently use antiseptic mouthwash—I'm talking about two times a day, every day—that they saw a doubling of their risk for hypertension." (said at 0:47:15)

The speaker accurately describes a 2020 longitudinal cohort study from the San Juan Overweight Adults Longitudinal Study (SOALS). In 540 overweight or obese individuals followed for 3 years, individuals using over-the-counter mouthwash twice daily or more had a more than twofold increased risk of developing hypertension compared to non-users (IRR = 2.17, 95% CI: 1.27–3.71) and an 85% increased risk compared to less frequent users (IRR = 1.85, 95% CI: 1.17–2.94). The biological mechanism is hypothesized to involve the eradication of oral nitrate-reducing bacteria necessary for systemic nitric oxide production. Because evidence comes from an observational cohort of overweight/obese adults relying in part on self-reported diagnoses, certainty is low.

0:47:15supportedhighWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Oral bacteria reduce dietary inorganic nitrates found in vegetables like beets and arugula into nitrites, which subsequently enter the nitric oxide pathway to promote vasodilation.

"oral bacteria reduce the nitrate to nitrite. They convert nitrates in fruits and vegetables into compounds called nitrites, which then enter the nitric oxide pathway, which helps reduce blood pressure and increase blood flow all throughout our bodies." (said at 0:47:15)

Dietary inorganic nitrate from vegetables is absorbed and concentrated in saliva, where commensal oral bacteria reduce nitrate (NO3-) to nitrite (NO2-) via bacterial nitrate reductases. Once swallowed and absorbed into the systemic circulation, nitrite is further reduced to nitric oxide (NO), promoting vasodilation, blood flow, and blood pressure reduction. Disrupting the oral microbiome (e.g., via antiseptic mouthwash) abolishes the rise in plasma nitrite and prevents these blood-pressure-lowering effects.

0:53:37supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Using antiseptic mouthwash immediately after a workout negates the blood pressure-lowering effects of exercise.

"a study found that people who used antiseptic mouthwash immediately after a workout negated all of the antihypertensive effects of that workout because oral bacteria also recycle nitric oxide." (said at 0:53:37)

A randomized, double-blind, crossover trial in 23 healthy adults evaluated the impact of using an antibacterial (chlorhexidine) mouthwash following moderate-intensity treadmill exercise compared to a placebo rinse. In the placebo group, systolic blood pressure significantly decreased post-exercise (by 5.2 mmHg at 1 hour and 3.8 mmHg at 2 hours), accompanied by an increase in circulatory nitrite. When participants rinsed with antibacterial mouthwash, the blood pressure reduction was attenuated by 61% at 1 hour and fully negated at 2 hours post-exercise, alongside a blunted increase in circulating nitrite. This demonstrates that oral commensal bacteria, which reduce nitrate to nitrite, play an essential role in mediating acute post-exercise hypotension.

0:58:44supportedmoderateWhat to Eat for Optimal Brain Health - with Max Lugavere | T

Eating while distracted increases food intake by approximately 15%.

"And also studies show that distracted eating, eating while distracted, whether it's with your smartphone, a magazine, or, yes, the TV, leads to an increase by about 15% in—" (said at 0:58:44)

The claim that eating while distracted (such as watching television, using a smartphone, or reading) increases food intake by approximately 15% is supported by meta-analytic evidence, particularly when looking at passive distractors and memory-mediated effects on intake. Robinson et al. (2013) conducted a systematic review and meta-analysis of experimental studies evaluating cognitive processes and eating, finding that distraction during a meal produced a moderate increase in concurrent food intake (SMD = 0.39) and a substantial increase in subsequent meal intake (SMD = 0.76). More recent updated meta-analyses show that passive distractors like television or screen viewing consistently increase meal intake, with effect estimates aligning with a modest percentage increase (~10–15%).

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