How to Future-Proof Your Brain from Dementia — Dr. Tommy Wood

In this podcast episode, Dr. Tommy Wood shares an extensive exploration of brain health, dementia prevention, and cognitive function enhancement. Drawing from his clinical expertise and research in neonatology, nutrition, and brain injury, he offers practical insights on how lifestyle choices can substantially influence cognitive outcomes at any age. The discussion spans infant brain development, recovery from brain injuries, the role of nutrition and exercise in cognitive resilience, the significance of sleep, the impact of sensory health, and the power of complex cognitive stimulation such as language learning, music, and dance. Dr. Wood also touches on emerging therapeutic approaches and his upcoming book, which integrates science-backed strategies for maintaining a sharp and healthy brain.

Preventability of Dementia Through Lifestyle

Dr. Wood confirms that dementia is significantly preventable, with estimates ranging from 45% to as high as 70% preventable cases based on strong epidemiological evidence. The 45% figure originates from the Lancet Commission report, which assessed various modifiable risk factors such as smoking, hypertension, hearing loss, and low physical activity through population attributable risk calculations. Other analyses, including a UK Biobank study, suggest that up to 72% of dementia cases may be preventable with comprehensive lifestyle and societal changes. The key takeaway is that while dementia cannot be guaranteed to be avoided individually due to genetic and environmental complexities, lifestyle factors wield considerable influence in reducing overall risk and delaying onset.

Infant Brain Development and Early Brain Injury

The conversation delves into fundamental neurodevelopmental aspects, emphasizing the unique fat composition of human babies, largely to support rapid brain growth. Fatty acids such as DHA (docosahexaenoic acid), an omega-3 fatty acid, and ketones serve as essential substrates and energy sources during brain development. Dr. Wood highlights how ketones are a preferred energy source in the developing brain and play a role in brain recovery. Treatment of common brain injuries in newborns, like preterm brain injury and hypoxic-ischemic encephalopathy (HIE), focuses mostly on hypothermia therapy for full-term infants with HIE, which significantly reduces death and disability when started soon after birth. For preterm infants, therapies like caffeine administration—not primarily for neuroprotection but to stimulate respiration—have been shown to improve cognitive outcomes, especially when followed longitudinally. Ultimately, Dr. Wood stresses the critical role of the home environment post-discharge in shaping long-term neurodevelopment.

Recovery Strategies After Adult Brain Injury

Transitioning from infancy to adulthood, Dr. Wood shares evidence-based strategies for managing acute brain injuries like concussions. Central to recovery is the prevention of fever, since hyperthermia exacerbates metabolic stress by increasing the mismatch between energy supply and demand in damaged brain tissue. Controlling blood glucose to avoid spikes is equally important. Nutritional support may include supplements such as creatine, omega-3 fatty acids, and emerging interest in exogenous ketones, which may provide alternative brain fuel and neuroprotection. Early, gentle reintroduction of physical activity that does not worsen symptoms is encouraged, as exercise promotes cerebral blood flow, neurotrophic factors like BDNF, and improved sleep quality. Conversely, caffeine is generally avoided immediately post-injury to prevent increased metabolic demand. These approaches highlight a multifaceted, pragmatic recovery paradigm.

The Importance of DHA and Omega-3 Fatty Acids

DHA is underscored as a critical structural component of neurons, particularly concentrated at synapses and within mitochondrial membranes, correlating with energy production capacity. Animals naturally produce DHA-rich brain tissue, but humans largely depend on dietary intake or endogenous conversion from shorter-chain omega-3s. DHA and EPA serve as precursors to specialized pro-resolving mediators—resolvins, protectins, and neuroprotectin D1—that modulate neuroinflammation and immune responses, particularly relevant in brain injury recovery and dementia risk mitigation. Clinical evidence from athletic populations suggests daily intake of 1 to 2 grams of DHA reduces markers of brain injury. Dr. Wood recommends regular consumption of seafood or supplementation to maintain adequate omega-3 status for brain health.

Interaction of Omega-3s and Methylation/B Vitamins

A nuanced interplay exists between omega-3 fatty acids and B vitamins involved in methylation, especially vitamins B12, B9 (folate), B2 (riboflavin), and B6. Elevated homocysteine, an intermediary metabolite, is a risk factor for cognitive decline and is modulated by B vitamin status. Trial data illustrate that the cognitive benefits of B vitamin supplementation are contingent on adequate omega-3 levels, and vice versa; both are required for optimal incorporation of DHA into neuronal membranes and gene regulatory pathways. This interdependence underscores the importance of a holistic nutritional approach, reinforced through regular blood testing and personalized supplementation as needed.

Brain Energetics and Cognitive Demand

Dr. Wood challenges the simplistic "type 3 diabetes" model of Alzheimer's disease that posits impaired brain glucose utilization as purely supply-driven. Rather, diminished glucose uptake in Alzheimer's may reflect reduced neural activity or "demand." Functional neuroimaging shows that cognitively stimulating tasks can normalize glucose uptake in affected brain regions in early disease stages. Therefore, sustaining and stimulating brain activity through mental and physical challenges may maintain energetic demand, supporting neuronal metabolism and resilience. This concept encourages engagement in diverse activities that keep the brain functionally "online," bolstering cognitive capacity.

Exercise and Brain Health: Intensity and Skill Complexity

Physical activity's neuroprotective effects vary by modality and intensity. Coordinative and open-skill exercises—such as dance, team sports, and martial arts—combine physical exertion with constant adaptation and cognitive engagement, showing greater benefits for brain structure, function, and dementia risk reduction than repetitive, closed-skill exercises. Among these, dance appears notably protective, likely due to its multimodal sensory, motor, social, and musical elements. Aerobic exercise with high intensity, exemplified by the Norwegian 4x4 interval training (high-intensity bouts with rest), produces lactate which enters the brain and promotes locally produced BDNF, essential for hippocampal health and neuroplasticity. Such protocols have demonstrated durable cognitive and structural brain improvements lasting years post-intervention. Alternatives like blood flow restriction training provide efficient strength maintenance through short, low-load workouts, viable for busy or traveling individuals.

Nutritional Supplements Beyond Basics

Beyond omega-3s and B vitamins, other supplements with emerging or substantiated cognitive benefits include creatine, noted for its mitochondrial energy support; choline, vital for membrane synthesis and neurotransmission; magnesium for neuronal stabilization; vitamin D for immune and neurovascular health; and antioxidants/polyphenols derived from berries, nuts, coffee, and tea. Creatine, in particular, demonstrates cognitive effects in sleep deprivation and brain injury contexts, typically dosed at around 10 grams daily in a single morning dose to avoid sleep disruption. Citicoline (CDP-choline) is highlighted as effective in improving cognitive outcomes and recovery post-traumatic brain injury. The advice emphasizes quality, dosage, and individual responses.

Sensory Health: Vision, Hearing, and Oral Care

Sensory impairments, particularly hearing loss and vision decline like cataracts, are associated with increased dementia risk. Importantly, interventions such as hearing aids and cataract surgery can reverse or reduce this risk, likely by restoring sensory input and promoting social engagement, which are critical drivers of cognitive stimulation. Oral health is also pivotal; periodontal disease contributes to systemic inflammation and may facilitate pathogen invasion into brain tissue, as implicated in amyloid plaque formation. Xylitol-containing products support oral microbiota balance and reduce bacteria responsible for cavities and gum disease. These findings emphasize sensory health maintenance as a modifiable target in cognitive decline prevention.

Sleep and Cognitive Health

Sleep is identified by Dr. Wood as a non-negotiable pillar for brain health, influencing dementia risk, cognitive function, and mood regulation. Despite the prevalence of sleep tracking and wearable technology, he cautions against over-interpretation and anxiety about minor sleep disturbances, noting that acute sleep loss mostly affects processing speed and mood rather than accuracy of cognitive tasks. Maintaining consistent, sufficient sleep outweighs obsessing over perfection. Practical sleep hygiene strategies include establishing a shutdown routine, avoiding late-night work, blue light blocking, using eye masks to reduce light intrusion, optimizing bedroom temperature, and integrating cooling technologies. The discussion also touches on emerging pharmacotherapeutics like orexin receptor antagonists (DORAs) for sleep disorders, which may aid those with clinical insomnia but are not broadly necessary for dementia prevention in otherwise good sleepers.

Cognitive Stimulation: Language, Music, and Dance

Engagement in complex, multi-sensory, and skill-intensive activities profoundly benefits brain network integrity and cognitive reserve. Studies reveal that lifelong bilingualism is associated with enhanced executive function and delayed onset of dementia, likely through improved response inhibition and cognitive flexibility. Language learning in adulthood also confers cognitive benefits when approached with consistent effort. Music, especially learning to play an instrument, engages multiple brain regions and supports cognitive health; attentive music listening similarly promotes benefits. Dance uniquely combines physical exercise, coordination, musicality, and social interaction, fostering neuroplasticity. Video gaming—specifically titles with high cognitive demands like Super Mario 3D World—has been documented to improve certain cognitive domains. The unifying theme is cognitive challenge and the opportunity for error-driven learning, which fuels neuroplastic changes.

Error Detection and Neuroplasticity

Learning and cognitive improvement depend on encountering and overcoming errors or failures, which creates a performance gap that drives adaptive neuroplasticity. Without challenge or the risk of mistakes, the brain lacks the stimulus for structural and functional improvement. This has parallels to muscular adaptation through training to failure. Activities that integrate novelty, complexity, and feedback optimize brain aging and resilience by enhancing neural networks and capacity.

Practical Personal Regimen and Tracking

Dr. Wood and the host both share personal regimens emphasizing a Mediterranean or slow-carb diet, omega-3 sufficiency, B vitamin supplementation for methylation, physical activities including Zone 2 aerobic training and weightlifting, and innovative tools like continuous glucose and ketone monitors. Brain age assessments via MRI and cognitive batteries provide baseline data to tailor interventions over time. Blood flow restriction training and practical resistance work with bands simplify exercise adherence during travel or time constraints. The approach is comprehensive but prioritizes sustainability and incremental progress.

Air Quality and Environmental Factors

Air pollution and poor indoor air quality elevate cardiovascular and dementia risk by promoting systemic inflammation and vascular dysfunction. Using air purifiers, especially in polluted environments or wildland fire seasons, can reduce this burden and support brain health. The importance of good ventilation and lower indoor CO2 is also linked to better sleep quality and cognitive performance.

The Stimulated Mind: A Science-Driven Guide

Dr. Wood's upcoming book consolidates these insights into an accessible, well-referenced guide aiming to empower individuals to future-proof their brains. It balances scientific rigor with practical recommendations across diet, sleep, exercise, social connection, and stress management. The book advocates implementing one positive change at a time, recognizing that improvements in one domain often cascade to others, creating a virtuous cycle for cognitive health and dementia risk reduction. The work fills a gap in current literature by offering a middle ground between exhaustive clinical manuals and oversimplified self-help advice.

Personal Insights and Cultural Notes

The discussion touches on Dr. Wood's linguistic background, his Icelandic heritage, and humorous anecdotes about traditional fermented foods illustrating cultural perspectives on cognitive stimulation and resilience. The host shares personal experiences with cognitive testing and lifestyle adjustments inspired by the conversation, highlighting the individualized nature of brain health strategies.

Final Thoughts

Dr. Wood encourages engagement with scientific literature, openness to new evidence, and sharing of feedback on his work to enhance collective knowledge on brain health. He underscores that maintaining cognitive function and preventing dementia involves a broad, interconnected lifestyle approach rather than reliance on any single intervention.