#58: How to Reverse Ageing (Part 2 of 4). Healthy Ageing with Dr Dan Levitin

1st Jul 2020

For the second part of our reversing ageing series, my guest today is Dr Daniel J. Levitin. A neuroscientist, cognitive psychologist, and bestselling author.

Listen now on your favourite platform:

He is Founding Dean of Arts & Humanities at the Minerva Schools at KGI in San Francisco, and Professor Emeritus of psychology and neuroscience at McGill University. He is the bestselling author of This Is Your Brain on Music, The World in Six Songs, The Organized Mind, and A Field Guide to Lies and Statistics.

Daniel is a thought leader in the field of ageing and neuroscience, he has read thousands of research papers on the brain through the ages and his new book draws on cutting-edge research from neuroscience and psychology to demonstrate the cognitive benefits of getting older.

On the show today we talk about:

  • The beliefs that surround the ageing process
  • Our assumptions around memory loss and our focus on lifespan instead of 'healthspan'
  • How our decision-making skills improve as we age
  • How Happiness improves in age
  • Practical and cognitive enhancing tricks for everyone to follow during each decade of their life
  • How to age joyously
  • We also dive into Dan’s food preferences, flair for music and some incredible stories from his life’s work

I would really recommend to check out Dan’s book - The Changing Mind - it really is well worth a read

Episode guests

Dr Daniel J. Levitin, PhD

Dr Daniel J. Levitin, PhD, is a neuroscientist, cognitive psychologist, and bestselling author. He is Founding Dean of Arts & Humanities at the Minerva Schools at KGI in San Francisco, and Professor Emeritus of psychology and neuroscience at McGill University. He is the bestselling author of This Is Your Brain on Music, The World in Six Songs, The Organized Mind, and A Field Guide to Lies and Statistics.

Unlock your health
  • Access over 1000 research backed recipes
  • Personalise food for your unique health needs
Start your no commitment, free trial now
Tell me more

Relevant recipes

Related podcasts

Podcast transcript

Dr Daniel J. Levitin: The fact is that although we can't to a large degree control what happens to us, we can control how we respond. And so our personality or mindset has an outsized influence on the way our lives will reveal themselves at any age or any stage. The idea is that you can change your personality at any age and choose a personality that you want, choose a personality that will give you a better chance of being happy and productive and living healthy.

Voiceover: Welcome to the Doctor's Kitchen podcast with me, Dr Rupy, where we discuss the most important topics and concepts in the medicinal qualities of food and lifestyle. This is the podcast to learn about actionable changes to your diet and your lifestyle that can lead to health benefits. For the second part of our reversing ageing series, my guest is Dr Daniel J. Levitin, a neuroscientist, cognitive psychologist, and bestselling author. He is founding Dean of Arts and Humanities at the Minerva Schools at KGI in San Francisco and Professor Emeritus of Psychology and Neuroscience at McGill University. He's also the bestselling author of This Is Your Brain on Music, The World in Six Songs, The Organised Mind, which is a personal favourite, and A Field Guide to Lies and Statistics. Daniel is a thought leader in the field of ageing and neuroscience. He has read thousands of research papers on the brain through the ages, and his new book draws on cutting-edge research from neuroscience and psychology to demonstrate the cognitive benefits whilst we get older. On today's show, we talk about a whole bunch of things, including beliefs surrounding the ageing process and why it needs a rebrand, our assumptions about memory loss and focus on lifespan instead of healthspan, how our decision-making skills actually improve as we age. And we also go into a bit of a tangent when we talk about different topics that afflict our patient population, those underpinned by community struggles, the psychological impact of childhood, as well as our own personal patient anecdotes as well. Daniel was an absolute pleasure to interview and to cook for as well. He's a bit of a foodie, as you'll as you'll see. And remember, you can check out the recipe that I made Daniel on YouTube, The Doctor's Kitchen. Do subscribe to the newsletter, you'll get weekly newsletter recipes, plus lots of tips that are based around exactly what we were talking about, particularly toward the end of our discussion as well. I think you're going to really enjoy this conversation and let's get to it.

Dr Rupy: Dan, thank you so much for coming in to the Doctor's Kitchen.

Dr Daniel J. Levitin: Thank you for having me, doctor.

Dr Rupy: It's absolute privilege to have you here. I'm going to be cooking you a Mexican dish. The reason why is because as I was reading your book, you talk a little bit about after you turned 60, you thought that your taste buds were sort of gradually diminishing. And then you went to Mexico and you were like, actually, no, it's the food. And you became a lover of Mexican food and spices and stuff like that. So I'm making you something in that vein. We've got some sweet corn, red onion, some pinto beans. We're hitting it with loads of different spices, paprika, epazote, which is a new dried herb that I've never used before. But you were smelling it earlier and it's got those sort of rosemary tones to it, which I think is brilliant. We're going to mix it all with some tomatillos, warm up some of these corn tortillas and we'll serve it all up together. Does that sound good?

Dr Daniel J. Levitin: I can't I can't just nobody is so thoughtful.

Dr Rupy: Thank you. No worries. No worries. This is what you should expect now whenever you do a podcast or a talk or anything.

Dr Daniel J. Levitin: Mary Ann, put this in my contract rider.

Dr Rupy: Cool. So, tell me about your trip so far and tell me about your incredible book, which I'm a massive fan of, obviously.

Dr Daniel J. Levitin: Well, I started, I left home on January 4th to start talking about ageing in the United States and Canada. And then I came over here just on Saturday to begin the conversation here. Really a conversation about, I'm hoping to push a societal conversation about what it means to be an older adult in our culture at this time.

Dr Rupy: Yeah. Because it strikes me as ageing needs a bit of a rebrand. It's been traditionally seen as not something you want to look forward to, something that's associated with all the medical ailments that we're all too aware of, loneliness, loss of connection with family members and friends, loss, grief. It doesn't sound very attractive, does it, as a period of life to look forward to?

Dr Daniel J. Levitin: It doesn't, but if as I do, I'm a I'm a developmental neuroscientist, I look at the whole lifespan. And when you do that, you realise there are every stage of life has something unpleasant about it. I mean, toddlerhood, you aren't toilet trained yet. You know, that's in retrospect unpleasant. And who wants to be 13 years old again and in the classroom with other 13-year-olds? I don't I have not yet met a person who wants to go back to that stage of their schooling. So, yeah, there are there are some unpleasant things about getting older, but they are overdone, as you say, it needs a rebranding because there's really a lot of hopeful things and positive things about ageing. Older brains get better in many respects. Older emotions, people are better able to regulate their emotions when they're older. And you know, when you look at society broadly writ, we have a long way to go in terms of combating various prejudices, the isms, racism, sexism, prejudice against people from other countries or religions or cultures, LGBTQ+ community members. None of these are even close to being solved, but they're at least part of the national conversation. But the two lingering big sources of bigotry, you know, just not liking a person for the way they are, one of them is obesity. It's very difficult for obese people to be taken seriously in jobs. It's more difficult for them to get health care. Doctors, as you know, often just say, well, you have to lose weight without giving them any kind of instruction on how to do it that will work. Some doctors won't see them, as you probably know. And then and there's ageism. Now, I'm not a metabolic expert, so I can't speak to the obesity problem, but as a neuroscientist, the ageism is largely unfounded.

Dr Rupy: Yeah, yeah, because you you you bring light to a lot of the myths around the ageing population about how they're cognitively slow, they're more stuck in their ways. And I think it was fascinating to read actually about how a lot of those are completely unfounded, but they're still ingrained in a lot of what people think of the ageing population themselves, right?

Dr Daniel J. Levitin: Yeah, I mean, we we tend to hold a narrative that old age is a time of decline, that every other phase of life, you're adding some skills and abilities, or at least in middle age, you're adding to your financial stability. At some point, however, the story is you just start losing everything and you fall down this steep precipice and nothing gets better anymore. It's as you said, it's aches and pains, it's infirmity, it's becoming incontinent. But that's not really the reality for most people who have been following healthy lifestyle practices all along, or even those who adopt them later in life. Memory won't necessarily fail, problem-solving skills get better. You mentioned depression, the peak age of happiness across 72 countries surveyed is 82.

Dr Rupy: Which is astonishing. I think a lot of the listeners will will hear that and be like, no way, that can't be true. But it's and even I was very surprised to hear that.

Dr Daniel J. Levitin: Tens of thousands of people reporting. Now, of course, like anything else, this is a a distribution, right? And there are tails, a mound-shaped distribution with tails. So some people are going to be happiest at 100, some people are going to be happiest at 30. And there, yeah, there are a bunch of 82-year-olds who are miserable, but you know, I'm talking about the statistical aggregate, peak age of happiness, 82. And and that's robust.

Dr Rupy: I've heard you say, in previous talks that now has never been the best time to age. As in like we're in a period of time now where if you're going to be old, it's it's now because actually, you know, there are lots of movements, there's lots of different things that advancements that we can utilize right now. We know a lot about how to age well.

Dr Daniel J. Levitin: It is the best time to be older. And in fact, it's, you know, demographically speaking, there are more people over 75 on the planet than at any time in history. Even not just in raw numbers because the population's growing, but as a percentage of the population. And there are more people over 75 in the UK than under five.

Dr Rupy: Yeah, which is astonishing. That is, wow.

Dr Daniel J. Levitin: And soon it'll be more people over 75 than under 16.

Dr Rupy: That's incredible.

Dr Daniel J. Levitin: So, but that doesn't mean it's necessarily a good time to be ageing. But we're so we are living longer was the first point. We're also living healthier. There's this movement in the UK and in North America and in Western Europe called unretirement. People retire, they realise they don't like it. They still feel fit and capable and they go back to work in some capacity. Sometimes it's volunteerism, sometimes it's working in their field or teaching.

Dr Rupy: And do you think, because this is something that we've talked about on the podcast a little bit before, this new field, or it's not a new field, but it's definitely a revitalised interest in gerontology and the the interest in ageing, yes, healthy, but increasing lifespan at any cost. Do you think that's born out of a narcissistic endeavour by us humans just trying to, you know, capture everything and live the longest life and or do you think actually there is some altruism in that endeavour?

Dr Daniel J. Levitin: That's an interesting question. I don't have any insight into that. I'm just a simple country neuroscientist. I mean, this is a question for a philosopher, I suppose. And of course, I'm a boomer and so people have accused me of being boomer-centric and you boomers, you just, you know, you just want to lengthen your own lives because you think you're more important than the rest of us, ignoring the fact that if boomers figure out how to lengthen our lives, it'll trickle down to everybody. Is it is it altruistic or is it selfish? You know, I'm a scientist. So the interest for me is in understanding the underlying mechanisms of how it all works. And if there's something that is broken, how can we fix it? So, if somebody gets memory impairment, do we know enough about the brain to talk about things that can be done to restore their memory? That's what I mean by fixing it. And of course, as a GP, this is what you do. Somebody comes in, they've got an infection, you fix it, you repair it. It's not about, it's neither about altruism nor selfishness, you're just trying to reset something to its normal state. So the philosophical question really becomes, is ageing a normal state or is it effectively an evolutionary accident that we haven't because of diseases taking, picking off most of us historically at a young age, and you know, one in five children dying before the age of five throughout most of history, old age is an evolutionary anomaly. And so the fact that we die from a variety of things, is that just because evolution hasn't had enough time to act on it? And if so, how would it do that? Is it a process that we can use medical science to ameliorate?

Dr Rupy: And I suppose in that, when you put it in that context, it sounds very clear cut. I think when you're faced with a disease, a diagnosis, our aim as a collective healthcare professionals or scientists is to try and find out the cures and the treatments. There's a little bit in the latter stage of the book, and I love the symmetry of the book, by the way, of how you've gone into the developing brain, the current state of play with what the things that you can do now to improve your chances of successful ageing, and then the future. And there's a particular part in the future bit where you talk about neurostimulants and different advances that might be accessible to some people and less accessible to others. Where do you stand on that? Because it was very well balanced, your opinion, and I really enjoyed reading that section.

Dr Daniel J. Levitin: Well, I I try to keep politics out of the book because science should be apolitical. Scientists are often called upon, as you know, by public policymakers to comment, and I believe that we have an obligation as scientists to present the information without taking sides in what are public policy debates. Now, I'm framing it all this way because the question about the uneven distribution of wealth and resources across the world is a political question. If in that if it weren't for international tensions and boundaries and things of that nature, everybody would have clean drinking water and toilets and access to medicine, but they don't. So, my I I raise the question of if we've got cognitive enhancing drugs that make some people smarter, and we do, or if not smarter, allow them to function on less sleep without any impairment, or you know, looking towards the future, you know, it's not unreasonable to imagine there might be drugs that that really do add IQ points and allow you to work harder and longer and and improve your memory and processing speed. So the ethical question to have, and I don't take sides, but you know, is it fair for people who are already in wealthy countries and have a lot of advantages to have access to these while people who are living in poverty or you know, just remotely and don't have access to not have them? And then just to raise the stakes, what if there's a doctor who's on the verge of curing cancer or somebody in a public policy negotiation, two countries, two heads of countries negotiating, and one of them is representing third world countries, and this poor person has had a history of bad diet and bad medical care him or herself because of where they grew up, and they're being pitted in negotiation against somebody who's got all the advantages of wealth and good health care, would it be moral for that third world person to take it? Would it be immoral to deny them access to it in that situation where they could solve global poverty? I mean, it's these are the these are the boundaries of the discussion.

Dr Rupy: Yeah, absolutely. And I think, you know, it's part of, like you lovely described there, part of a much wider conversation about access to medicines in general. And ageing, as we go into this new dimension, is just going to become part of, you know, access to cancer medications, access to HIV care, and a whole bunch of other fields as well. I'm going to pause there for a second because I want to bring you back to this recipe that I've just made for you. I hope you're going to like it. Just to recap, we've gone in with some red onions, some sweet corn, some of these beautiful pinto beans that I'm a big fan of. I've added some tomatillo, as well as the epazote herbs and the paprika. So it's got a bit of spice there, mellowing it with a bit of coriander or cilantro, as you guys call it. Some avocado and a little bit of chilli. Are you all right with chilli? I should have asked you before I put it on there.

Dr Daniel J. Levitin: Which depends on how spicy it is.

Dr Rupy: It's not that spicy. And I haven't added the membrane or the seeds, so we'll get you to try this. That looks delicious. I hope I hope it tastes delicious as well. Yeah, yeah, I've Mary Ann will know, we cook for everyone here, so we'll have a little break, we'll have a little bite to eat and then we'll carry on. I really like this. This is a kind of thing that I look for at home. Oh, good. And it's hard to find.

Dr Rupy: Good. Well, I'm glad.

Dr Daniel J. Levitin: It's it's light. It's flavourful. A big problem, of course, with industrial restaurant kitchens is blandness. It tastes like fresh ingredients that you you taste like you chose the ingredients based on what looked good in the store, not a preconception.

Dr Rupy: Yeah, yeah. Well, I'm I'm glad.

Dr Daniel J. Levitin: Nice head of hair.

Dr Rupy: Thank you very much.

Dr Daniel J. Levitin: When time comes, will you take Propecia?

Dr Rupy: You know, I probably won't, actually. I think I'm going to try and age gracefully as much as I can. My lineage is Punjabi Sikh, and so you you must have come, I mean, Canada's like the second largest population outside India.

Dr Daniel J. Levitin: Well, I went to the Sikh temple in Delhi.

Dr Rupy: Oh, did you?

Dr Daniel J. Levitin: Yeah.

Dr Rupy: Oh, wow. When was that?

Dr Daniel J. Levitin: I was there in August of 2018 to meet the Dalai Lama. And I took an extra couple of days and we found a Sikh guide to take us and it was really wonderful.

Dr Rupy: So you're well aware that our hair is, you know, a symbol of our sort of commitment, growing the hair, it's one of the 5Ks. And my both my my father and my grandfather who passed away a few years ago now had good, strong hair. So I think I've just been blessed with good genes.

Dr Daniel J. Levitin: Well, sure, you've got hundreds of generations selecting for that. You don't have it, you don't get mated. You've got good hair as well. Well, I had to start taking finasteride.

Dr Rupy: Okay.

Dr Daniel J. Levitin: I don't know what the brand name is, but

Dr Rupy: Finasteride. We don't use brand names here in the NHS.

Dr Daniel J. Levitin: So you know finasteride. I had to start taking it a couple of years ago for BPH.

Dr Rupy: Okay.

Dr Daniel J. Levitin: So I mean, my hair hasn't changed, but it might have otherwise.

Dr Rupy: Yeah, or it might, yeah, exactly. Prophylactic.

Dr Daniel J. Levitin: Yeah, exactly. I use prophylactics. I don't know how I'm going to conduct this interview without laughing the whole way through it. No, it's great though, because one of the things that you talk about in your book is to keep laughing. And I can tell you're you're you're doing exactly what you preach. So that's good.

Dr Rupy: How's are you?

Dr Daniel J. Levitin: Yeah, thank you. Appreciate it. Well, I'm I'm glad you enjoyed your lunch.

Dr Rupy: Very much.

Dr Rupy: Good, good. I'll give you the recipe. Don't worry. You can make that at home, I'm sure. So, I wanted to ask you, I've done a little spider diagram here of the different sections. So we've got the developing brain, which is the first bit, the second bit was your life's choice, and the and the third being the future. And I love that sort of flow. You're really taking on a journey through your book, because at first it seems like quite an intimidating read, like 400 pages, but actually it's it's an effortless read because it's just so engaging and captivating. So really, really like big fan of it and your previous books as well. I wanted to ask you about why different personalities age better than others and how that comes into the conversation around healthy ageing, because I I it was it was quite new to me.

Dr Daniel J. Levitin: It's a it's a rather new way of thinking about the lifespan. Of course, the the three foundations on which our our lives take shape are genes, and then the environment. And the environment has, and as it's no no longer in science anyway, do we talk about nature versus nurture, meaning genes versus environment. They're two inextricably linked. One influences the other. They both influence one another. You know, your genes influence the kinds of things you may do in your life, but the things you do have a backward effect on the genes, the gene expression can be changed. Your your genes can be rewritten by experience. So, within the environment, you've got two components, which are the culture in which you're raised and the values of your family and community and society. And then you've got the odd things that happen to you, chance, random things, opportunity. And the fact is that although we can't to a large degree control what happens to us, we can control how we respond. And so our personality or mindset has an outsized influence on the way our lives will reveal themselves at any age or any stage. So, the idea is that you can change your personality at any age and choose a personality that you want, choose a personality that will give you a better chance of being happy and productive and living healthy.

Dr Rupy: Yeah, because you you talk a bit about conscientiousness at the start and the end, and gratitude, which I find fascinating. So, a bit of context, I I've been doing gratitude for a number of years now.

Dr Daniel J. Levitin: It's part of your cultural tradition.

Dr Rupy: Absolutely. Yeah, I think, you want to go into that a bit?

Dr Daniel J. Levitin: We can do. Yeah, yeah.

Dr Rupy: So the the act of selflessness, or there's a concept called seva, which is basically giving to others. In different religions, there are, I mean, I'm not practicing Sikh, and I'm definitely not a scholar, but in different religions, there always seems to be this theme throughout them of service to others. In Islam, I think you're given a proportion of your income away. In Sikhism, we deliver food to anyone who comes into the temple as part of seva. You will be either someone who provides the food, cooks the food, serves the food. I've done all those different roles, and I think it's great. It's a wonderful way of cultivating gratitude for the very simple thing of eating that a lot of people don't have.

Dr Daniel J. Levitin: I attended a Sikh meal. Oh, did you? In the Sikh temple in New Delhi, the the main Sikh temple. It was really wonderful.

Dr Rupy: The food's incredible, right?

Dr Daniel J. Levitin: Well, that and the people too. They're very warm and interested people.

Dr Rupy: Yeah, exactly. And so this this concept of gratitude has always been there throughout my sort of like upbringing. I'm just cherished to be born and and raised with those sort of um those sort of background influences. But I formalised doing a gratitude exercise by thinking of three things that I do every single day that I'm grateful for. And it can be something as simple as stepping outside and it not being raining. Or if it is raining, then I'm I'm grateful that I had my umbrella with me or something, you know, simple.

Dr Daniel J. Levitin: Or there's not snowing.

Dr Rupy: Or that it's not snowing, exactly. Or that actually we have rain here, whereas in Australia they're begging for rain because of the fires. So I decided to share that on social media every single day to sort of encourage people. It started off as 10 days and then it went into 30 days and then people were just like, carry on, carry on. So it ended up being over 700 days of gratefulness every single day, three days shared with the public. I stopped doing it formally in that way because I felt that there were some personal things that I wanted to talk about and I didn't want to share that on social media, but I do it intermittently. But I'm fascinated with the practice of gratitude and how there is some evidence base behind how that how that cultivates conscientiousness and how that can lead to better ageing.

Dr Daniel J. Levitin: Well, so yeah, let's touch down there on gratitude and come back to conscientiousness if that's all right with you. Um, gratitude is the people who study happiness, the neuroscience of happiness, uh, are in uniform agreement that really the surefire way to be happy is to be grateful for what you have and not focus on what you don't have. And everybody has something to be grateful for. Uh, it's not always easy when bad things happen or you're thwarted or you've just gotten yelled at or cut off in traffic or any of these things. Um, but it does become a mindset. It takes a little bit of practice. Some people are born into a family that encourages and nurtures that practice. Others come to it quite late in life. Fortunately, almost all of us will come to it eventually because gratitude becomes a mindset after the age of 65 and 70, just through normal neurostructural and neurochemical changes to the brain. But from a neuroscientific standpoint, when you're experiencing gratitude, you're not experiencing cravings and jealousy, uh, destructive emotions like anger and rage and, uh, feeling, um, that you need to get revenge. Uh, you're not absorbed by rumination of how come he has this and I don't have it. How come she got the promotion? You know, you you're grateful for what you have. It encourages a calm, peaceful state of mind, and that releases neurochemicals in the brain that actually kickstart the immune system. Uh, and so you can't really point to one thing that is the key. Uh, just like you can't say, oh, there's this one supplement you have to take or this one food you have to eat. It's all part of what I call healthy lifestyle practices. So it, yeah, it's diet, it's exercise and movement, it's sleep, and it's mindset. It's practicing gratitude, which has a neural basis. We've scanned the brains of monks that the Dalai Lama sent over and found that, um, they've got some structures that are thicker, uh, that lead to beneficial brain health, other structures that are deactivated, negative self-talk being one of them. Oh, I'm I'm bad, I'm this, you know, I I don't deserve this, uh, you know, this bad thing happened to me because it's my fault. That kind of negative self-talk turns off in experienced meditators.

Dr Rupy: And so you you talked a little bit about the neuroanatomy and how that changes throughout ageing. One of the things that sticks in my mind from medical school is the shrinking of the hippocampus. And um, maybe we can talk a little bit about that. But there are some advantages of changes during ageing, as you just alluded to there.

Dr Daniel J. Levitin: Well, shrinkage of the amygdala for one, the fear centre. Um, and um, changes in the way some areas connect with others, such as the precuneus. And the relevance to these changes is that they tend to cause a positivity bias, just a fancy way of saying that older adults are more apt to focus on the positive experiences in their lives, even their their memories, they're more likely to pull out positive than negative memories, and more likely to see the positive in people that they meet.

Dr Rupy: Yeah. And one of the things also that I'm fascinated by is um, this concept of there being a neurochemical basis behind how we are evolutionary designed to be in communities and social cohesion. What is what is that specifically referring to? I think you talked about the putamen, uh, in the book and and and I didn't know that there was there was actually some, you know, neuroanatomical evidence behind that.

Dr Daniel J. Levitin: Well, and it makes sense because we are primates and primates are social species. Uh, not all species are social. Some are perfectly happy to be alone, spiders, as far as we know. Uh, and others, uh, there are some mammals that are content to be alone. I'm not a biologist, so I couldn't rattle off the list, but primates are a social species, in the way that dogs are a social species. Cats not so much. And um, it makes sense that we've evolved brain structures that um, give us a a neurochemical shot of delight and that bring us towards wanting to be with others. One explanation for this is that when we left the cover of the trees and started headed out on the savannah, early humans had to cooperate and work together in order to fend off land-based predators like lions and tigers and bears. Oh my. And uh, and flying monkeys and uh, we needed to band together to kill mastodons and buffalo to get food because one person couldn't take them down. And those early proto-humans who were had a more social brain just by evolutionary accident were the ones who were likely to fare better.

Dr Rupy: And so putting that into context of today where there was a statistic that really shocked me in the book about how there are 200,000 adults in the UK, it was a specifically a UK statistic I think you used, um, that haven't had a connection with another human being, like a hug or a phone call for over a month. And that for me was was really harrowing. Um, how does this manifest, this loneliness? How does it manifest in clinical symptoms and physical symptoms that we see?

Dr Daniel J. Levitin: Well, um, I want to make a distinction between loneliness and solitude because loneliness is the emotion, solitude is the the state, right? I mean, the the physical configuration, right? Solitude is you you aren't around people. Loneliness is an emotion where you feel that you're not connected to others and it often accompanied by feelings of being underappreciated or misunderstood, um, yearning for contact. And you can be lonely in a crowded room. You can be lonely in a committed relationship. So, loneliness is not the same as solitude. And some people who are in solitude are not lonely. Perfectly happy. Not many of us, but a small percentage, again, genetic variation. But, uh, for most of us, uh, who are not, you know, that 1% of the population who are hermits by choice, um, loneliness is the number one killer. Uh, it leads to a weakened immune system. Uh, this isn't widely known, but one of the things your immune system does, the NK cells, sort of the James Bond of the immune system, attacking the most difficult cases. Many of us are developing tumours all the time. Uh, they go undetected because the NK cells, when functioning properly, recognise them as invaders and eradicate them. Uh, and uh, that's the way it's supposed to work. Of course, we get cancer because some cancer cells have mutated and and they trick the immune system or they become too much for a compromised immune system. Uh, but yeah, loneliness, number one killer.

Dr Rupy: Yeah. And it's associated with a whole bunch of different biomarkers of disease as well, increased inflammation levels, IL-6 and

Dr Daniel J. Levitin: Right. Right, exactly.

Dr Rupy: Yeah. And and that I think, um, I mean,

Dr Daniel J. Levitin: and maybe that means lonely people should uh, uh, eat more turmeric and ginger, but

Dr Rupy: I think, well, this is where it gets interesting because as a medic and and as medical professionals, we're inclined to think about disease in a very binary fashion. Uh, someone has inflammation, we can treat that. Let's use some NSAIDs or yes, let's use some food or whatever. But really, A, it's just an association, and B, it's indicative of a much wider issue which has a root cause, which is a lot more multifactorial. So really, we have to think out the box of how do we actually tackle loneliness if that is the cause of a whole bunch of different conditions, or at least in part contributing to. Um, with some innovative thinking. Um, and you know, it could be as simple as joining a singing class, as ridiculous as it sounds. And I'm not too sure if this is the same in in Canada or the US, but we, um, the the fashionable buzzword right now in general practice is social prescribing, whether it be prescribing your patient to go to do a park run. And there are park run organisations up and down the country. Uh, or a walking group that starts at the practice with a few people who are like-minded. And you never know what different connections people will make and how that ignites different connections in their brain as well.

Dr Daniel J. Levitin: So that, yes, I'm I'm very much in favour of that. Book clubs, uh, walking groups, um, volunteering is a good way to meet people. Uh, now, there's some interesting research, uh, from my colleague Barb Fredrickson at University of North Carolina. She and I were in graduate school together at Stanford at the same time. And um, she finds that, um, for people who are lonely or not lonely, the biggest social change you can make or the social change you can make with the biggest impact is to just strike up conversations with strangers. That feeling that you're part of the fabric of society, talking to somebody on the street, uh, talking to somebody you're standing next to in a queue at the grocery store. Um, that's a big predictor of health and happiness at any age and particularly in older ages. And, um, concomitantly, research shows that people who know their neighbours and actually talk to their neighbours in cities and suburbs are much happier and do much better. And um, the fact is my wife and I, um, like spending time together, we like spending time with the dog, we are very, we're both neuroscientists, we're very much immersed in the world of ideas. Um, but we've always had dogs and when we walk the dog, um, it's a very natural way to strike up conversations because you're out on the street, you're not in a particular hurry usually, and you meet other dog owners and um, and you meet your neighbours. And um, even without, you know, there's a lot of people walking in our neighbourhood, we live in Los Angeles where the weather's good a lot of the time. So, you know, about half the people are walking dogs, the other half are, you know, uh, holding a script in their hands and trying to hand it to somebody, but just kidding, but almost. But you know, we we strike up conversations with the neighbours and one of the neighbours, you know, has become, you know, a real friend. I mean, we go out with them, we we make it a point to see them. And it's just the random occurrence of us living near them. But living in that kind of an environment, I can say from personal experience, which is usually not relevant to a scientific discussion other than that it puts a story on the existing science, it's really improved our quality of life. And now we say we we wouldn't imagine ever moving or living anywhere else.

Dr Rupy: Yeah. As you were talking through the list of things that people should try and be encouraged to do, it just sounded terribly un-British. Like, like striking out conversation with people in shopping markets and

Dr Daniel J. Levitin: Well, and it's very un-US urban. It's it's very frowned upon in Los Angeles and New York.

Dr Rupy: Oh, is it?

Dr Daniel J. Levitin: Um, New Yorkers typically avert their gaze because they're packed in this city like sardines. Los Angelinos, uh, typically don't talk to each other. But I find that when we do, uh, it's a game changer.

Dr Rupy: Yeah. I've even started talking to the homeless. Uh-huh. And to schizophrenics. I had an experience with the homeless that really pushed the needle for me.

Dr Rupy: I think I I think I've seen you talk about this before. Yeah, it was when you tell that story, actually, it made me quite emotional. When um, I don't know if you want to share it, but uh

Dr Daniel J. Levitin: Well, I I have a friend named Peter Himmelman, uh, who's an Orthodox Jew, a practicing Jew. We were when you were talking about Sikh, the Sikh religion, Sikhism, uh, the uh, the emphasis on gratitude resonated with me because I'm of Jewish culture and heritage. And I know that in the Jewish tradition, uh, people who follow the religion as Peter does, wake up every morning and and as soon as they wake up, they have a special prayer, thank you for letting me wake up. I'm grateful to to be conscious again. And thank you for giving me a night of restful sleep. And then when you go to the bathroom, there's a special prayer every time you go to the bathroom, you're grateful that everything works, that you know, nothing's plugged up or stopped up, this intricate system of tubes and wires and things. And so Peter really lives, uh, in the way it sounds as you and your family live, uh, the best parts of the teaching. Uh, and in this case, it's to love your fellow human, which can be very difficult to do. Um, when I spoke with the Dalai Lama, we talked about this, uh, notion attributed to the Buddha, uh, and some of the writings that came after that, um, along these same lines, uh, you know, you're you're a student in this world and the whole world, everybody in the world are your teachers, and the people that you find the most difficult to get along with are the most important teachers. That's that's where you learn something.

Dr Rupy: Yeah, absolutely.

Dr Daniel J. Levitin: So Peter talks to homeless people and he engages with them. And uh, I'll keep this brief, but we were on a subway platform in New York City at 10:00 at night and a very unkempt, uh, malodorous and unappealing homeless person came up towards us. And Peter engaged in conversation with him and we had a guitar. I had just done a performance, uh, with my band at a club, and Peter had been in the audience because we had co-written a song together and he was just to cheer me on. And um, Peter took out his guitar and he played a song for this fellow. And uh, he used the person's name in the song. And Peter improvised. It was it was a wonderful song and the the man, when he heard his name in a song and somebody really engaging with him, he just started smiling and he melted. And Peter started adding lines about, I can see that you are a man. You deserve dignity and respect, but those are things that here you cannot get. And I was in tears. The man, I think, didn't know quite what to make of it, but he was certainly happified. And when he left us, his entire bearing was different. He was not stooped over, he was not dragging his feet or shuffling. 35-year-old man was suddenly invigorated like a kid. And I don't know how long that lasted, but it was a gift that Peter gave him. And so, I've been making an effort to stop and talk to homeless people and just find out their story. And it's surprising. I met a woman in uh, in Seattle in the winter who uh, said she had been living in a rented apartment with her boyfriend. She was a waitress, he was a a chef, well, not a chef, a cook's assistant, uh, fancy word at that cafe for dishwasher. And the restaurant burned down and didn't have insurance. They lost their jobs. Uh, and the guy who owned the restaurant also owned the apartment complex they were living in. And um, one uh, thing that happened was they couldn't pay the rent and he wouldn't let them stay and they became homeless because of that. I heard about another woman in Los Angeles who told me, uh, she was living in a place where there was a murder in her apartment building, you know, a kind of skid row apartment. And she and her her boyfriend decided they did not want to live in an apartment where murders were taking place, but that that was all they could afford. It was rent controlled. They couldn't they couldn't afford to move, so they were on the street.

Dr Rupy: It's incredible the stories that you hear from homeless people. I I'm I would say one of the reasons why that story that you told about your friend with the guitar spoke to me because, um, it definitely spoke to my shortcomings. You know, I practice gratitude, I'm very grateful for everything. I'd like to think of myself as a compassionate person, but it made me realise, you know, there's so much more you can do still. And

Dr Daniel J. Levitin: It had the same effect on me. Uh, although I was inspired by it, I realised my own shortcomings. I do not have the courage and the compassion that Peter has. I could not have done that. And I don't know that I'll ever be able to, but it's something to work toward.

Dr Rupy: Yeah, absolutely. I I think it's harder to do that in in real life in public scenarios where, you know, even if you are a kind, compassionate person, you still want to be safe as well. I'm really privileged to work in A&E, uh, ER, as you guys call it in America. And um, we come face to face with a lot of patients who are vulnerable, who are IV drug users, who on the face of it, you would look at and uh, and interact with and you would say, well, you know, they've brought it on themselves or they're being disruptive or they're shouting in the in the A&E room or, you know, they're being abusive to the staff, etc. And I get that. No one should ever make any sort of um, exceptions for people who act in that manner. However, I've had a couple of experiences over the last couple of years where I've put that to one side, spoken to them one-on-one, told the team to go into another room, and the amount of pain and hurt and vulnerability that you reveal from just having a conversation and allowing that person to feel empowered, which is exactly what Peter did in that story that you told me, or you told the audience, um, is fascinating because you realise there is so much more to their story than how they are reacting or appearing on the surface. And despite having those interactions, you know, on a daily basis when you're walking around, it's hard to be compassionate in that way. You know, I don't have a guitar to pull out. I don't have ways in which I can empower people, but there are different things I think we can do beyond just giving someone money.

Dr Daniel J. Levitin: Right. Uh, and you know, Peter Peter's a big, strong guy. So I'm not, for those of you who can't see me. And so I'm the 98-pound weakling, you know, he he he looks like a guy who could take care of himself. So there's a different thing there, but maybe that's just an excuse. Now, do you know Robert Sapolsky?

Dr Rupy: Yes, yes.

Dr Daniel J. Levitin: Biologist, uh, his new book is terrific.

Dr Rupy: I need to read it, actually. He talks a lot about stress and um, social communities.

Dr Daniel J. Levitin: He's studied, yeah. He and I had coffee together a couple of weeks ago. And um, we've collaborated on research papers and he's a really interesting thinker. Um, he uh, is spending a lot of his time now in courts testifying about brains in criminal trials. And he he says in case after case, you you look at at what happened and it's sort of inevitable that these things would have happened, that these people would have behaved badly when you sort of look at the whole picture. Um, and so he says, you know, we often talk about free will and having a choice and being able to behave in certain ways. But he he said, you know, the reality is that genes, culture, and opportunity don't always give you the full freedom that you and I have the luxury of talking about. You and I can choose to talk to a homeless person. We can to some extent choose not to be homeless. We're privileged. He told this one story about a trial where a fellow who had been in and out of juvenile detention facilities his whole life, his mother was a prostitute, he never knew his father, his mother was also a drug addict. Um, he was taken away from her and put in these facilities and he was abused in a couple of them and in others they just took the money, the foster parents just took the money for themselves and didn't feed him properly and you know, he ends up, uh, you know, with a lot of missed days from school and you know, poor diet, can't study well in school. He ends up in jail and he's been in and out of prison. Uh, and he finally gets released from prison on at one point and he's 32 years old and he's got no money, uh, but he somehow is able to find a menial job, uh, and they pay him at the end of the week. And he's got now, um, $300 in cash in his hands. So given that background, as Robert tells the story, what's the logical thing that you do? You only have $300, what do you do? Well, you steal a car because this is your life. This is what people you know do. You steal a car, um, you you uh, or you borrow a friend's car, which is what he did in this case. Um, but I mean, he's he's amalgamating different stories, but okay, he borrows a friend's car, he's got his $300, uh, he goes out and he buys a bottle of liquor, of course, logically, that's what you would do. Uh, and as he's driving around in this car with a bottle of liquor, you know, logically, he sees a prostitute on the street, he picks her up. And um, they're in the uh, the car and uh, they're negotiating what her price will be, and he offers her, uh, he shows her, well, you know, uh, I I got this money and he pulls out the wad of cash and he says, and I got this bottle of liquor, you know, and you know, most of it's still there and you know, maybe I can give you less money. So logically, what does she do? She's a prostitute, she's 15 years old. She's been on the streets for three years. She takes a knife out, of course, uh, in order to rob him, uh, because she thinks she can overpower him. And uh, so logically, what does he do? He wrestles the knife from her and he stabs her and he pushes her out of the car and leaves her to die in the gutter. Uh, and in her last 30 seconds before she bleeds to death, she calls her 30-year-old mother. She's a 15-year-old prostitute, her mother's 30. You can do the math. Her mother had her at 15. We find out later the 15-year-old prostitute who's dying was carrying a child. She calls her mother, she says, "Mom, I love you. I'm not going to make it. I love you so much." Click, dead. So now the guy's on trial for murder. And it's not funny, it's it's it's but I mean, it's it's tragedy, but it's I'm nervous laughter on my part here. The guy's sort of, to say that he had free will at any point, yes, I guess technically, but given his life and who he was, it's one thing sort of led to the other inevitably and he's on trial for murder. And um, in the US, anyway, this is not a conversation we have about what do you do in cases like this because, uh, among all Western countries, not Malaysia and Singapore as far as I know, they're they're particularly punitive, but you know, we tend to just throw people in jail and not think about prevention or rehabilitation at all.

Dr Rupy: Well, this is the thing. I think prevention and rehabilitation are the two key points there. And to your point about free will, there are a catalogue of things, and this is something you talk a lot about in your book in terms of your environment when you're when you're growing up, the genes that you've inherited, the environment that your parents are in as well, because we know a lot about epigenetic changes now as well and the propensity towards psychological issues, um, from the state of the parents. Um, it's almost a given that considering the environment which they've grown up and everything that's happened to them, that they will make those choices. So, yes, free will has almost been marginalised because you only have a limited things that you can do in that in that situation.

Dr Daniel J. Levitin: Limited repertoire of skills.

Dr Rupy: Exactly. And, you know, honestly, I'm flicking through a whole bunch of patients that I've seen in the last 10 years, um, in A&E and outside, where this applies in in maybe not in in that extreme example, but in other examples as well.

Dr Daniel J. Levitin: Well, yeah, of course they have high blood pressure. Of course they have diabetes. How could they not? It's not their fault.

Dr Rupy: And it's a wider conversation that we're beginning to have around obesity, because I think it's been, uh, it's still very pervasive, as you said earlier, in medical, uh, professionals to discriminate against people who are overweight because we feel that they've brought it on themselves. When in reality, you look at the environment, how on earth are people who are genetically predisposed to to obesity going to cope when they're given lots of, uh, contradictory dietary advice and they're in an environment where there isn't the availability of foods to help them. And there are a whole bunch of other things going on as well, poor sleep, poor stress, uh, financial issues. I mean, it's a really wider conversation beyond calories in, calories out.

Dr Daniel J. Levitin: Well, right. And a lot of it is genetic. Poor sleep patterns, uh, I um, all the men in my family had sleep disorders. I inherited a sleep disorder. Uh, and um, that's not my choice. Uh, but um, it's more than that. There's a genetic predisposition towards alcoholism or diabetes or thrill seeking or uh, all these things that uh, certainly a genetic predisposition towards high blood pressure. Now, on the Twitter sphere, this conversation that you and I are having, and I know this from experience, I've been accused of being a bleeding heart liberal with a political agenda. And um, I know that this idea that criminals are not responsible for their bad acts, uh, and or that uh, sick people are are responsible for becoming sick, uh, to some right, people on the right side of the political spectrum, um, what we're talking about has a political overtone. The you know, the right would say, well, everybody has has the choice, uh, and and you know, just got to buckle down and and be tough and um, to me, I'm not saying what society should do about it. I'm not taking political sides. Like you, I'm just trying to present the evidence from science and from medical clinical experience that these are the realities. Uh, these things are not their fault. Uh, uh, in terms of how you hold criminals accountable, that's a that's a political issue, not a scientific one. In terms of how you treat patients, to some degree, that's a political issue because the NHS and other agencies have to understand that there are some things that are out of a person's control.

Dr Rupy: And it's interesting that you've had the same experience because when I talk about, uh, issues like cancer, for example, or diabetes or obesity, I'm bringing light to the fact that we can prevent them. And there is a, you can prevent all these different conditions. And there, you know, there's a ton of evidence around that. I mean, I've done a, doing my masters in nutritional medicine. On the flip side, you'll get somebody talking on the Twitter sphere about, okay, well, are you trying to suggest that it's people's fault for getting cancer in the first place if a third of these are all preventable? And that's not what we're trying to suggest here. It's literally empowering people with information so they can make better choices to prevent and reduce their risks.

Dr Daniel J. Levitin: Well, and uh, in my previous book, The Field Guide to Lies and Statistics, I talked about this in that, of course, you know, with healthy practices that we're talking about, let's focus on diet. Uh, almost every one of us can improve our diet and eat a more varied diet, a healthier diet. Um, but it's, uh, we're taught when we talk about it preventing cancer, of course, we mean statistically. There are some people who are going to get cancer anyway. All you can do is move the needle. You can tilt the balance in your favour, but uh, you can't prevent cancer or Alzheimer's anymore than you can prevent having a comet hit your house.

Dr Rupy: Switching gears, and that's a nice segue into back to the the book, which is called Successful Ageing in the US. We have a US audience as well. Um, and here it's called The Changing Mind. You in the second bit, like go into diet, activity, um, sleep. Um, I want to focus a little bit on diet because you're a fan of omega-3, not in supplemental form, but in fish. And tell us a bit about omega-3.

Dr Daniel J. Levitin: We need fat in our diet. Fat is not the enemy of health. We need fat, uh, particularly for brain health, uh, in order to create myelin, the insulating sheath around neurons and for other things, we need fats. The good fats are the ones that are omega-3 fatty acids. Um, when you get them in so-called fatty fish like salmon and mackerel, uh, uh, they're coming with a bunch of micronutrients. Um, if you take them in a pill, they're not. And um, I was agnostic about supplements. I have no horse in the race or skin in the game or whatever you say over on this side of the pond.

Dr Rupy: Skin in the game, yeah.

Dr Daniel J. Levitin: Uh, I have no bias, but I became convinced after reading hundreds of papers that there's zero evidence that any supplements at all can help us, unless, of course, we have a vitamin deficiency. If you're iron deficient or B12 deficient and your doctor has told you so and and you can't address the underlying cause of that, then yes, you should take it as a supplement. And I believe in vitamin D supplementation, particularly for people in northern or cloudy climates or people who are shut in. But you know, all the other ones that people take, um, there's no evidence that they work and in the particular case of fish oil and vitamin E, there's a mounting body of evidence that they actually raise your risk for certain cancers. And the frustrating part about this is is that nutrition scientists and biologists don't really understand why that is. The current notion is that because you're taking them in isolation from all the different micronutrients that normally accompany them and activate them and facilitate their metabolism. We don't even know, for example, um, for sure, and I have this on good authority from people at the at, you know, nutrition scientists and people at the National Institutes of Health, we don't even know that eating blueberries or acai berries or taking antioxidants in food form actually increases antioxidant levels in the blood. We know that it's good to have high levels of antioxidant in the blood. Uh, they reduce inflammation, they clean out senescent cells, they they do a lot of cellular housekeeping work, but we don't know that dietary sources of antioxidants are good and we don't know if they're better in food than in supplements, complete unknown.

Dr Rupy: Yeah. This is quite interesting because, um, I think we like in science to reduce things to, okay, I'm eating blueberries because it's got antioxidants in. When in reality, you know, there's an orchestra of different micronutrients there that may be providing benefits in a multitude of different ways. You know, there's different fibres, you know, in an onion, you're not just eating it for the allicin content or the different phytochemicals, you're getting prebiotic fibres that might be good specifically for ageing because we have an ageing microbiota that loses its diversity over time.

Dr Daniel J. Levitin: Absolutely. I'm a big fan, since you brought it up, of probiotics.

Dr Rupy: Oh, really? Great. Tell us a bit more about the probiotics because I'm aware that, you know, as we age, we do lose diversity and so there might be a rationale for for taking probiotics.

Dr Daniel J. Levitin: Well, so the gut microbiome, uh, is responsible for a lot of things. It makes 95% of the serotonin that ends up in your brain, uh, which is a mood elevating and stabilising neurochemical. It's uh, it's responsible for helping your immune system function properly. Uh, it's really a marvel system. But yes, we lose some diversity anytime you take an antibiotic, you're destroying some good, uh, good bacteria. And um, I mean, it's having a healthy gut is good for uh, digestion, for um, what's a nice word for uh, regularity?

Dr Rupy: You can say pooping. Yeah, regularity. Yeah, regular bowel evacuation.

Dr Daniel J. Levitin: Yes. And it's good for brain health. Uh, increasingly being shown that having a healthy microbiome is good for brain health. Um, fecal transplants in which you take the fecal material from somebody with a healthy microbiome and implant it in someone who does not have a healthy microbiome are turning out to be effective and with minimal symptoms if done properly. Uh, there's the disgust factor with those and of course, this is not something you want to try at home on your own.

Dr Rupy: There's a few YouTube videos out there just so people are aware of of like how to do it yourself.

Dr Daniel J. Levitin: Are there really?

Dr Rupy: Yeah, yeah, which I obviously don't recommend. But you want to be careful about anyone that's teaching you the basics of using a basting. Yeah, it's it's pretty um, pretty gruesome.

Dr Daniel J. Levitin: No, and and if you are going to do it at home, make sure there's not a fan nearby. Because if the material hits the fan, But um, the no, what I I'm in favour of is is micro uh, microbiotic, probiotic, uh, restoration. And the frustrating thing here is that although there are lots and lots of pills and capsules being sold and things that you have to refrigerate and they can be terribly expensive, um, almost none of them actually work because they don't survive the harsh acidic environment of the stomach. I only was able to identify two that have scientific research behind them. I list them in the book. One of them actually is a pill. The pill needs to be refrigerated. The other is a liquid suspension and that one is called Symprove. I don't own any stock in the company. I don't know anybody who works for the company. Uh, they're not friends of mine, but it's spelled S Y M P R O V E. It's made here in the UK.

Dr Rupy: Yeah, it is, yeah.

Dr Daniel J. Levitin: And as soon as I knew I was, so as soon as I heard about it, I bought a 12-week supply. It's a 12-week program. Uh, and what you do is you drink a little bit of this fluid, about a third of a cup, um, first thing in the morning before you've had anything to drink or eat. You wait 10 minutes and then you need to seed it. You need to uh, plant uh, something uh, that will get it activated and that usually would be fruits, any kind of fruit to give the uh, those new probiotics something to process, to feed on. And then you can eat a regular meal and you do whatever you want. And after the 12-week program, which I found uh, quite effective at um, just making me feel healthier overall. I I can't put a finger on it, but I felt healthier. I lost a little bit of weight. I was less susceptible to colds and things. Uh, you're supposed to do a tune-up and there's not much research on how often you should do it. But when I knew I was coming over to here, I ordered some on Amazon. I had it sent to my hotel.

Dr Rupy: Oh, nice. Okay.

Dr Daniel J. Levitin: And so I got a two-week supply. I'm here for two weeks. But you know, I was able to import it to the States also.

Dr Rupy: Yeah.

Dr Daniel J. Levitin: Um, and uh, the other one, I bought the the other one, I forget the name of it. I bought the pills and the weird thing about micro about probiotics is they're different formulations of different billions of different bacteria. I took the pill for a few days and I just felt in a sour mood. I did not feel good. So I'm sure that it works for some people, but for my type, the Symprove is the one.

Dr Rupy: Yeah.

Dr Daniel J. Levitin: And maybe for others, it's the pill.

Dr Rupy: Yeah, you know, this whole area is absolutely fascinating, very much in its infancy, despite the claims that people will make based on limited research. Um, and that's the fault of a lot of the manufacturers of these different pills and and um, there's other liquid-based and uh, probiotics as well. But I think there's definitely a lot to learn around how we can effectively match different types of probiotic, um, or different taxa of bacteria to your genome and your current microbiome.

Dr Daniel J. Levitin: Yeah, exactly.

Dr Rupy: I know, uh, John Cryan's doing a lot of this work in Ireland.

Dr Daniel J. Levitin: Yes, I spoke to him too.

Dr Rupy: I actually met one of his research team.

Dr Daniel J. Levitin: Oh, you spoke to him for the book, did you? Oh, yeah. Oh, yeah, yeah, you do talk about it. Yeah, the whole rise of psychobiotics and stuff. Which I think is a very interesting future. Um, but at the moment, there's limited evidence for, I think, um, specific types for different people. Um, so

Dr Daniel J. Levitin: That was my understanding. What do you recommend to your patients?

Dr Rupy: So I think as a rule of thumb, probiotics are generally safe and potentially effective, but there isn't a guideline in the NHS or NICE, National Institute of Clinical Excellence, that we give probiotics with antibiotics. But if it was me, and this is what I tell patients, I would take probiotics during and after a course of antibiotics at least, uh, with a high fibre diet and looking after other mechanisms that can improve your microbiota, so sleep and a little bit of exercise as well if you're well enough. Obviously, if you're taking antibiotics, you're probably not going to be that well. Um, taking bouts of probiotics, I haven't done that myself yet, but I don't I don't think it's um, unsafe to do so and experiment with different types, actually. Um, I tend to get my probiotics from food. So I'll have like kimchi, sauerkraut, pickles.

Dr Daniel J. Levitin: Yes, my wife and I too. We we've been eating more pickles. I don't particularly care for kimchi, but we eat it now and then. We have sauerkraut and I I drink kefir every morning.

Dr Rupy: Kefir. Kefir, yeah. That's a really popular drink here now, actually. Um, I did notice on your dietary guidelines for the show, you said, I'll eat protein, but I won't have gizzards, brain, uh, offal. I don't know whose kitchen you thought you were coming to. Well, it, you know, I lived in Quebec for a long time. Oh, really? Yeah, yeah. And you know, they they serve brains and organs and all kinds of and slippery things like, you know, snails and

Dr Rupy: No, we'll keep it pretty, pretty standard here. It's not that exploratory. So, in terms of um, a successful day in ageing, what does that what does that look like for you if you're you're doing this at the moment or what would you recommend as a successful day?

Dr Daniel J. Levitin: Yeah, well, I I think everybody's different and everybody has to find their own way. There's no one thing that works for everybody, just like there's no one diet or one form of therapy or meditation or one religion. It's everybody has to find their own way. To me, a day, a single day of successful ageing is you wake up after eight or nine hours of uninterrupted sleep. You wake up at the same time that you've been waking up every morning for the past few weeks. Um, you're filled with excitement for what the day has because you're not stressed out or carrying resentments from the previous day. You're not hung over. Um, you wake up, uh, in uh, a living space with somebody you care about there. Uh, maybe a pet. You have a a good meal of a variety of foods, uh, and um, you walk after each meal, just minimal exercise, even just a walk around the block or moving around doing some, uh, if if the weather's bad, doing some, uh, walking in place or going upstairs just to help, uh, help the digestive system and the insulin signalling. Uh, you, uh, you're engaged with some sort of meaningful activity, whether it's paid or not, that makes you feel valued and helps you to feel you're contributing to others in some way. Uh, you do that as a doctor. I I like to think that I do that as an educator.

Dr Rupy: Very much so.

Dr Daniel J. Levitin: Some of my students may disagree, but uh, then, uh, you know, some people have one more meal in the day, some don't. They have two or they have none. It's not about that, uh, but it's about when you do eat, eating a variety of foods, more fibre and more plants than we usually do. Um, avoiding refined sugar, more whole grains, um, avoiding processed foods, which doesn't mean, look, I had a bag of potato chips last night. You have to have fun once in a while.

Dr Rupy: Yeah, absolutely.

Dr Daniel J. Levitin: Crisps, you call them here. And I, uh, for many of us, a successful ageing, healthy ageing is a nap at some point. A 15-minute nap in the afternoon can be the equivalent of an hour and a half extra sleep the night before. Uh, at some point during the day, in addition to walking after meals, maybe you do a 20 or 30-minute walk in nature, if you can, on an uneven surface and have to navigate that and keep your balance and your sense of, uh, orientation and, um, muscle coordination. Um, you find some time during the day to do something that's purely pleasurable, making love, listening to music, uh, having a good meal, talking to friends. Uh, you try to do something new, maybe not every day, but once a week, do something you've never done before or something that you like doing but in a new way, a new restaurant, something like that, meet a new person, talk to a new person. That that's all of it.

Dr Rupy: It seems like your parents were a big inspiration to writing the book itself. And then in the end, they were doing everything right anyway. So it was just reaffirming what what they were doing, right?

Dr Daniel J. Levitin: Well, right. So what what Dr. Rupy's alluding to is that, uh, I one of the reasons I set off to collect the information in the book is that my parents had turned 80 and I wanted to give them some advice. They're now 85 and 87 and they don't need the advice. They're doing everything intuitively that's in the book.

Dr Rupy: Yeah. And your mother is writing plays now, I believe.

Dr Daniel J. Levitin: Yeah, she's writing plays and painting, things that she just started at 80.

Dr Rupy: That's incredible. Yeah, I would love to like, you know, start something new every 20 or 30 years, you know, just keeping everything fresh. Have you started anything new? Because you're a musician, you've done a whole bunch of different things in your career.

Dr Daniel J. Levitin: I started, um, two things new after after realising the importance of putting yourself outside your comfort zone. Um, one was, this is rather mundane, but I started doing resistance training because I read about and learned about sarcopenia.

Dr Rupy: Maybe you're better equipped to explain that.

Dr Daniel J. Levitin: Yeah, sure. So sarcopenia is essentially where you lose the muscle lean muscle mass, um, and you replace it essentially with fatty tissue. It's associated with high inflammation levels and it's one of the reasons why, um, it's definitely a contributing factor to different chronic lifestyle related illnesses, uh, associated with meta-inflammation. And um, one of the reasons why we really fear when, uh, people from an older population have, um, falls and they they break their bones and stuff, um, it's one of the contributing factors.

Dr Rupy: So I started practicing resistance training and I've got a a network of like 12 machines I use at the gym and go around and just try to keep my muscles in shape. I'm not trying to build up bulk, I'm just trying to

Dr Rupy: I'm a big advocate for for resistance training for people of all ages. I think it's fantastic.

Dr Daniel J. Levitin: Jane Fonda is doing it at age 81.

Dr Rupy: There you go. Yeah, yeah.

Dr Daniel J. Levitin: Uh, you know, appropriate for your your own life stage and body type. Um, the other thing is, you mentioned I've been a musician all my life. Uh, I'd also been writing songs all my life, but not playing them for others. I just wrote them for myself. Okay. Um, in a lifetime of being a musician and performing, I've heard a lot of bad songs. I've heard a lot of bad singers. And the thought of doing it badly really terrified me. I mean, I enjoy writing songs and singing them to myself and to my dog. Yeah, yeah. Uh, but and I never really had studied singing. I was one of the kids who they told to just mouth the words.

Dr Rupy: Right, right. Yeah. Yeah, yeah.

Dr Daniel J. Levitin: So, a few years ago, I decided to take my songwriting and singing more seriously because it was so far outside my comfort zone. And I got some help in, uh, I got I took voice lessons. I worked with a vocal coach, uh, and I I wouldn't say I took songwriting lessons so much as I went to mentors who told me how to approach my songwriting. In a couple of cases, they said, oh, change this word or, you know, you need to have a different section now. Yeah. Uh, you know, it's too much of the same or whatever. Uh, but it wasn't like co-writing. Yeah. And it wasn't like a teacher red-lining stuff. Yeah, yeah. Um, and in my case, my, uh, songwriting mentors were Rodney Crowell, Uh-huh. and, uh, Joni Mitchell, Uh-huh. and Paul Simon. Right. And then my singing teacher was Jerilyn Glass, who's a Broadway singer who had performed with Rex Harrison in My Fair Lady.

Dr Rupy: Okay.

Dr Daniel J. Levitin: Also an opera singer. Uh, and then once I got the fundamentals from her, I felt I needed to learn how to express my songs, uh, in a way that would connect emotionally with an audience. And I I didn't know how to do that. I'm a scientist. And Rodney Crowell told me that when I he when we got to the point where Rodney, who's a very has a very high bar and is a tough critic of songwriting. He's he's one of the great American songwriters alive today. Uh-huh. All my songwriter, most of my friends are songwriters and most of them hold him in the highest regard. Got you. Uh, and Rodney at some point said, yeah, these songs are good. He said, but you sound like a scientist singing them. Uh, and then I have a friend Michael Brook, a film composer and guitarist, uh, and he said, yeah, you you got to take acting lessons or something because you know, it's this isn't working. So I went to Joni, Joni Mitchell, and I said, you know, people are telling me that I'm not connecting with my voice. And she worked very closely with me, uh, kind of like surgery, looking at individual syllables and vowels and really helping me to gain a system for how to approach singing. And I worked at it for a couple of years. Um, it was all very much out of my comfort zone, of course. I'm used to being in the background in the studio where I can't be seen or on a stage, you know, not in front of the band, but in the back as the bass player or, you know, any of those things which I've done. So, um, I've put out, I I went out and I started performing as the front person.

Dr Rupy: Wow.

Dr Daniel J. Levitin: I did a tour of 12 cities with a singer-songwriter friend named Tom Brousseau.

Dr Rupy: When was that?

Dr Daniel J. Levitin: Uh, 2017, just the two of us, guitar and voice, each of us on the stage at the same time. We we traded back and forth. And then after Tom and I went out, I did a, one of the shows was actually in Los Angeles and Joni Mitchell came and sat in the front row and cheered us on and she became a fan of Tom's music then. A lot of people in that audience, uh, Madeleine Peyroux, uh, Don Was, uh, Grammy-winning producer of, Larry Klein, Grammy-winning producer of Sean Colvin and Joni Mitchell and others. Wow. Um, and uh, Stephen Stills, I mean, it was it was really

Dr Rupy: That's incredible.

Dr Daniel J. Levitin: something. And then I put out a record just six weeks ago.

Dr Rupy: Really? What's it called?

Dr Daniel J. Levitin: It's called Turnaround.

Dr Rupy: Turnaround. And what's the band name? Or is it under, is it

Dr Daniel J. Levitin: Daniel Leviton.

Dr Rupy: Daniel Leviton. No way.

Dr Daniel J. Levitin: I'm totally out of my comfort zone.

Dr Rupy: Oh my god.

Dr Daniel J. Levitin: If you don't like it, I'm responsible. I've got to take the heat.

Dr Rupy: Can we use the music in this podcast?

Dr Daniel J. Levitin: Absolutely.

Dr Rupy: Oh, great.

Dr Daniel J. Levitin: Yeah, it's on, you heard it here. So we can use it. It's on all the usual outlets. So Google Play, Apple Music, Spotify.

Dr Rupy: What's the, do you do you look at the comments or have you have you got some feedback from people outside of your friendship zone that will be a little bit

Dr Daniel J. Levitin: I've gotten a little bit of feedback, um, in that, uh, I didn't know you could look at comments on Spotify and these other things.

Dr Rupy: No, but like if it's been shared on like, um, uh, SoundCloud or something like that.

Dr Daniel J. Levitin: Yeah, I I haven't looked.

Dr Rupy: Oh, great.

Dr Daniel J. Levitin: Uh, but um,

Dr Rupy: We'll look at the comments on the at the end of the podcast and ask people to comment and to show.

Dr Daniel J. Levitin: It's it's 12 original, well, I don't know if they're original, but 12 songs that I wrote. You have to decide if they sound original or not. Uh, and I sing them and uh, I had some friends help out with the instruments. My friend Elliot Randall, who was a founding member of Steely Dan, played the guitar solo on one and I had Victor Wooten, great bass player, play on a tune. Another friend of mine, Steve Bailey, who's played bass with Jethro Tull, Willie Nelson, and uh, Dizzy Gillespie plays on one tune.

Dr Rupy: Incredible.

Dr Daniel J. Levitin: Uh, really nice collection of friends helping out.

Dr Rupy: That's amazing.

Dr Daniel J. Levitin: And then, um, I heard from Graham Nash, Crosby, Stills & Nash and the Hollies, and from Donald Fagen of Steely Dan, uh, from Renée Fleming, the great Broadway and opera singer, uh, in the United States. Yeah. Uh, that they really liked it.

Dr Rupy: Brilliant.

Dr Daniel J. Levitin: And so, wow, that was

Dr Rupy: Amazing.

Dr Daniel J. Levitin: something.

Dr Rupy: Wow. Well, I can't wait to listen to that. It's uh, that's news to me. I had no idea that you just put out some new music. So, you know, you're really practicing what you're preaching.

Dr Daniel J. Levitin: Well, I'm trying to and I I didn't I'm not putting it out to uh, to monetise it. No, of course. I'm not really promoting it, but I do like it when people hear it. And I I've gotten some emails from people who said, uh, I found this and I really liked it or, you know, a couple of uh, podcasters and radio and radio hosts said they wanted to interview me about it. CBC Radio in Canada, uh, played one of the songs.

Dr Rupy: That's great.

Dr Daniel J. Levitin: So, yeah, the reception's been more positive than

Dr Rupy: That's great. You could be pivoting your career into rock stardom.

Dr Daniel J. Levitin: You know, I would be delighted to to keep on making music and have people enjoying it.

Dr Rupy: Yeah, that's amazing. That's great.

© 2025 The Doctor's Kitchen