To set the scene: we’re sitting around the family dinner table, my dad beside me, Cooper the mutt perched on his lap. I’ve asked him to spend a few minutes reflecting on one question: What is a typical “Food-Day In The Life" of Dr. Dale Bredesen?
DB: I typically go to bed fairly late, writing into the wee hours of the night. So I may not wake up until 8:30 or 9:30, sometimes 10 am. I know, I know…but I get my best writing done between midnight and 2 am, so, there you have it. I try to practice “Window Eating” – eating for 8 hours, fasting for 16 – so I usually have had my last meal around 7:30 the previous night, and I won’t eat my first meal until around 12:30pm.
The first thing I always do upon waking (which I actually don’t recommend but I do it anyway) is get up, grab my phone, and check for any urgent emails. I put my iPhone on airplane mode while I sleep, and leave it several feet away from the bed to minimize EMF (electromagnetic field) exposure.
Once I’ve checked my emails, I always start my day with a few things: first, a large glass of citrus water, usually with lemon but sometimes a little orange as well. Then, I take psyllium husk for prebiotics – mixing 1 or 2 tablespoons in about 8 ounces of water. This is beneficial for a number of reasons: it's a good source of fiber, it helps with detox, and it also lowers your glucose and improves your hemoglobin A1c, so it even has an anti-diabetic effect.
TB: And you do this before breaking your fast?
DB: Yes I do, because it's not feeding me, it's feeding my gut microbiome. It's not raising my insulin.
And then, if you’re hydrated enough, you should be urinating a fair amount, and it should be relatively light yellow. So, you know, in the morning I usually make sure that I'm on target with “that…”
"You actually get slightly shorter – very slightly – by the end of each day."
My last morning routine “to-do” is exercise. I like to mix it up: I’ll go on our cross country machine or do a DVD workout, and I’ll also do some stretching. I also use an inversion table that you can strap yourself to and hang upside down, which is actually really relaxing.
TB: You mean your torture chamber. Yes, I’ve seen it.
DB: Very funny. Believe it or not, you actually get slightly shorter – very slightly – by the end of each day, because there’s gravity pushing on your spine throughout the day. And each night when you lie down and sleep, you get that height back. But as you get older, you don't completely “re-grow” – you don’t get all your height back, because you lack the elasticity that you had when you were younger. So it's beneficial to hang upside down. Usually I’ll do it a few times in the morning and afternoon, for about 30 seconds each time. It’s good for your spine, and actually quite relaxing!
TB: So how much have you shrunk….?
DB: I was around 6’1, maybe 6’1 and a half at my peak… I'm probably an inch shorter now. But who knows? Maybe I would have been 5’8 by now without this machine!
"If you've ever been a smoker, or been exposed to a lot of cigarette smoke, sweating is a great way to remove those toxins."
Anyway, on some days I’ll do some weight training, and others will be more cardio intensive. And most every day in the afternoon, I go on a walk around the neighborhood or on a hike with your mother and Cooper. Weights are very good for insulin sensitivity, and it helps to prevent atrophy (sarcopenia), the loss of muscle that often occurs with age. And cardiovascular exercise is good for a number of things, such as increasing your ketones, getting more oxygenation, etc.
If I get in a good sweat, I’ll shower with castile soap. I've also been using the sauna in the evening to get in a good sweat, then go straight into the pool.
TB: You actually get into that pool? It’s freezing!
DB: Well, kind of — you just need to get a serious chill, you don’t necessarily need to submerge completely. Just like our Norwegian ancestors, I’ll cycle between extreme hot and extreme cold. I’ll do this a few times. And then after I’ve worked up a sweat in the sauna, I’ll shower with castile soap, which rids a lot of the hydrophobic toxins that are coming out in your sweat. There's a nice study from Dr. Stephen Genuis, looking specifically at which toxins are released through sweat. He compares the concentrations of various toxins that come out in your sweat to the corresponding concentrations in your blood. Interestingly, the toxin that is released the most (in terms of ratio) is cadmium, which builds up by smoking cigarettes. So if you've ever been a smoker, or been exposed to a lot of cigarette smoke, sweating is a great way to remove those toxins.
Throughout the day, I try to keep up with water intake. One liter per day is my goal. We have a filter that holds one liter, so I know that if the filter is empty by the end of the day, I’ve reached my goal.
TB: Except when your daughter comes home and fills her 40-ounce bottle with your fancy filter…
"If you’re in a state of ketosis, you are not going to be as hungry. It doesn’t feel like an urgent hunger."
After my morning routine, I get to work: emails, writing, meetings, calls, etc. I try to keep all meetings between late morning and afternoon, if I can. I’ll take a break around 12:30 or 1 pm for lunch (my first meal).
TB: And are you starving by then?
DB: I'm usually pretty hungry by about 12:30 or 1, yes. Or I may go a little longer than that. But if you’re in a state of ketosis, you are not going to be as hungry. It doesn’t feel like an urgent hunger.
TB: And do you track your ketones daily?
DB: We actually just got a ketone meter that also measures blood glucose. Usually I just go by how I feel, what I ate last, and whether I had more fats than carbs.
I typically have two meals per day. So if I have the first at 12:30, I’ll have the second around 6 or 7pm. My goal is to get as many greens and colors into each meal as possible. I’m not perfect when avoiding lectins – I love tomatoes, and I actually love nightshades, especially eggplant! Although I recognize that for some people, that's an issue. I do stay away from gluten, dairy and most grains.
I’ll occasionally have some rice with Thai or Japanese food. But my typical go-to lunch is a shrimp nicoise salad: baby greens, wild shrimp, potato, a hard boiled pastured egg for choline, and an olive oil lemon vinaigrette: olive oil, Dijon, red wine vinegar, and apple cider vinegar. All washed down with sparkling water from the Soda Stream.
TB: Any dessert after lunch?
DB: I try to stay away from dessert, but when the sweet tooth strikes, my favorite after-lunch dessert is a fruit salad: berries, strawberries and blueberries are so delicious together. And they’re next level if they’re from the farmers market. I never thought I’d say this, but I actually love chia seed pudding now too. Sometimes I’ll have an unsweetened A2 milk yogurt, or a handful of macadamia nuts. And of course, I love dark chocolate.
TB: Just curious, what’s your favorite “noncompliant” dessert?
DB: My favorite unhealthy dessert is either a hot fudge sundae or caramel pecan turtles. Don’t remind me!
TB: Ah yes, of course. The Motherlode.
DB: Between lunch and dinner, I try not to snack. If I get hungry, I may have some apple slices. But it’s best not to snack in between meals. We’ll go for a walk in the afternoon, followed by a few meetings, and then of course I have to check if a football game is on…
For dinner, the usual is the "Kitchen Sink Salad." It’s basically a mix of every vegetable we have in the fridge: romaine, tomatoes, carrots, avocados galore, Brussels sprouts or cauliflower, and another pastured egg. Now, if I'm having a cheat day, it may be penne bolognese, or a grass-fed burger from our favorite restaurant; but I try to make that relatively uncommon!
"If I combine those three things, my knuckles are sure to flare up."
I can actually tell when I've had a cheat day and eaten gluten. If we go somewhere that has fresh baked bread, it’s hard to resist, and it takes about 30 to 60 minutes until I start to actually feel it. I don't think I'm imagining it, because I often forget about it, and then I’ll be reminded when the symptoms appear. If I eat too much gluten, I’ll wake up the next morning and feel stiffness in my back. But usually with only a small amount, I'll just feel the stiffness on a few of my knuckles. Just a little twinge that lasts an hour, and then slowly goes away. It’s really pretty crazy. I can tell that something has changed. And on the other hand, when I'm eating really well, getting the right amount of sleep, etc., I don’t have any of these arthritic symptoms.
TB: Which foods make you feel that twinge in your knuckles?
DB: There’s a triad: gluten, dairy, and sugar. The symptoms are especially apparent when I have had two or three of the triad. For example, if I have a sweet role or a piece of bread with cheese. Or a sandwich with cheese followed by a dessert. If I combine those three things, my knuckles are sure to flare up.
TB: How has your diet changed since discovering that nutrition is part of the equation in preventing and reversing Alzheimer's?
DB: Dramatically. When I look back at my time as a medical student, there was only one (one!) nutrition course in medical school, and it was optional! It also only covered the very basics, like “What is Vitamin C.” And most students opted out of it anyway. It’s unbelievable. Essentially all I knew was that salad bars were healthy, and salad bars were big in the late '70s when I was finishing medical school. So I’d go to the salad bar, pile my plate with canned peaches in sweet juice, then pour on loads of the sweetest dressing they had.
As an intern, we were required to be alert and working, sometimes for 2-3 days straight, so to help me stay up, I would drink a can of coke because it had both the sugar and the caffeine to really keep me rolling. If I was falling asleep at 3 am and had more patients to work up, I’d get something sweet. As long as you are digesting something, it keeps your eyes open. When I’d be at my wit's end and I had more people in the ER to work up, I would get a sweet role. And then I would find that I could stay up longer and finish my work-ups. It just shocks me to think about it when I look back, when I think of how much this diet was hurting me. In fact, when I first started my internship, I became incredibly arthritic. I would walk up and down the halls seeing to patients for 48-72 hours straight, and I developed severe arthritis in my ankles. My ankles swelled up so badly that I was hospitalized: they swelled so intensely, I had to literally stuff them into my shoes. Finally, one day I could not get my shoes on anymore. So I went to the Duke hospital and got a full blown work-up, and of course everything came out negative. Looking back on it, what I think I had was the combination of eating horrible food, a tremendous amount of stress on my joints, and a severe lack of sleep. Things just fell apart. I probably affected my microbiome tremendously during this point in my life.
"It’s a process, and I’m not perfect, but I’m getting there."
TB: So what was your diet like before you learned the importance of nutrition in your practice?
DB: My favorite meal back then was pizza and coke! I also loved really sweet Chinese food, sweet and sour pork or chicken, cheeseburgers and fries, meat and potatoes with a side of peas (which I thought at the time was a perfectly adequate dose of vegetables). I liked pasta, which in the '80s was all the rage. Funny enough, it was supposed to be the “healthy” choice, to get your glycogen stores and help you run farther. I even went through a period where the only thing I drank for months at a time was Coca Cola. I mean, truly, very little water. Unbelievable.
So now we’ve changed. We eat much less meat. “Meat is a condiment,” as my father-in-law would say, and we really only eat seafood now. I must admit I don’t love fish, but I do like wild shrimp. And so many more vegetables! My main food group now is vegetables. And I don’t tire of them, when they are prepared in all sorts of different ways. I still have to work hard at it since I still have a sweet tooth. And I still have bread every now and then. But I’m working on making those occurrences less and less common. It’s a process, and I’m not perfect, but I’m getting there.
These Are a Few of My Favorite Things
Favorite food product: Kirkland Macadamia Nuts from Costco.
Food you couldn’t live without: Now - “Kitchen Sink Salad.” Ten years ago - pizza with onions and mushrooms.
Favorite recipe: Broccoli Stir Fry.
Favorite food as a kid: Steak with french fries, and brownies for dessert.
Last night’s dinner: Salad with a plethora of leftover roasted vegetables.
Favorite drink: Now – sparkling water (not too acidic) with a hint of lemon and orange. Ten years ago - coke.
Go-To Snack: Pistachios, popcorn, hummus and veggie plate (celery, carrots, Daikon, fennel, jicama).