How to Win at Angry Birds: The Ancestral Paradigm for a Therapeutic Revolution [transcript]

Written by Christopher Kelly

Oct. 18, 2019

[0:00:00]

Christopher:    Well, Dr. Josh Turknett, our resident neurologist, thank you so much for joining me here at the Ancestral Health Symposium. We are on top of and the edge of the world that has a fantastic view of the Pacific Ocean from San Diego, quite incredible, as was your talk --

Josh:    Thank you. 

Christopher:    -- Josh. I thought that was absolutely fantastic.

Josh:    I appreciate it.

Christopher:    Can you give us the title?

Josh:    The title was How To Win At Angry Birds, and the subtitle was -- I don't remember. I have to look it up. 

Christopher:    I'm sure it will become obvious as we get further on into this talk. Talk about the premise. What's the problem? Before we get into Angry Birds, I don't think anyone will remember the parable of Angry Birds but get into the premise first.

Josh:    The way it came about?

Christopher:    Yeah.

Josh:    The premise is that -- so, I'm a medical doctor. I graduated medical school in 2001 and over that period of time, there haven't been any significant advances in medical therapeutics which pretty much means pharmaceuticals because that's about what we've been looking for. Even if you go back further, the last meaningful breakthrough, by that I mean a stepwise change from what had existed previously, whether or not we would consider it to be a clinical breakthrough but something that was, at least in order of magnitude, better than something that previously existed. 

    The last drug that, we would say, meets that criteria in neurology would be sumatriptan which came out in 1991. I've said that people who know me from the migraine world know that I would argue that that may have done, on balance, more harm than good. If we go further back to the breakthrough before that, it would have been levodopa for Parkinson which was 1961. So if you threw out sumatriptan, we've got 50 years where we haven't seen any meaningful progress in therapeutics, and that's for neurological disease. You can pretty much extrapolate that beyond because it applies to most of the major conditions, especially the chronic illnesses that are most of what a physician sees day in and day out these days.

Christopher:    So, you are saying no advances in pharmaceutical industry.

Josh:    That's right, no advances and particularly for the major chronic conditions that we see both in the neurology and general medical clinic. Again, I began my career in 2001 with the expectation that there will probably be pretty significant progress made in the course of my career, along those lines, and pretty much that was the prevailing belief.

Christopher:    Right, [0:02:30] [Indiscernible] pharmaceuticals.

Josh:    It may still be the prevailing belief. The strange thing is that it doesn't feel like people are reckoning with what has happened and what the facts would say that despite the enormous amount of resources that we poured into.

Christopher:    Do you know what's really sad? I met someone recently that was doing AI drug discovery so like this whole new level of complexity.

Josh:    Right, it's just like we're not smart enough. I know there a lot of things that are probably keeping people from -- if you figure the paradigm is wrong then there are some implications that are tough to deal with there that you have to figure out. The other problem that I talked about is the way the system is set up that you could still make money off of a new drug because it doesn't have to be better than its predecessor. 

    There have been new drugs in the course of my career, but they have all been what we call me-too drugs where there are no meaningful differences. It has taken on a new meaning, but they don't have to be an improvement upon. They just have to prove equivalency. So if you can find a different molecule and prove it's at least as good then you can put a marketing machine behind it and make money on it. It does seem like that strategy is slowing down. There has been less over the past few years of that sort of thing.

Christopher:    So, what the fuck, what's happening?

Josh:    What is happening? That's where Angry Birds comes in. The parable of the Angry Birds is to help think about why we might be seeing this spectacular failure in this particular realm. Imagine that there's alien planet and an iPhone lands there. It's loaded up with the game Angry Birds. The aliens have no iPhones. They don't have any computers. They're curious and competitive, so they decided they're going to hold a competition, an Angry Birds competition, so they break into two teams, meet back in a month, crown one team, the Angry Birds champion. 

    So, one team goes away and starts preparing for the competition, taking the usual approach that most of us would which is to just play the game over and over again, get really good at it, figure out the game mechanics, figure out how to manipulate the controls. That's their strategy.

    The other team goes off. I call them Team Game Level. The other team goes off, and they have a few scientists in their midst who get curious about what's underneath. So they start taking the game apart, realizes there's programming language and underneath that there's assembly language. Ultimately it's all just binary code that's controlling this game. So they think they've unlocked the secret. They're really excited, and they decided that their strategy is going to be figure out how they can just monkey with the machine code and play the game that way. They think they're going to blow the doors off the other guys.

[0:05:32]

    They meet back in a month, and I think most of us would predict what would happen next. They get annihilated because unbeknownst to them at the time they decided on the strategy, it's pretty much impossible, at least in this day and age. Even the person who programmed Angry Birds will have no idea how to play it at that level and do anything meaningful in the game. In fact, nobody can look at binary code and have any clue what's happening at the level of the software of the game.

    So, that's to illustrate that and the point there being, too, is that not it's acquiring that knowledge of what's happening at the deeper layers. Is it useful? It's just that we've taken the approach of thinking that intervening at that level is also the most powerful way.

Christopher:    The cart in front of the horse.

Josh:    Yeah, we did. So, Team Source Code got annihilated in our parable, and I would argue that that's the paradigm that we've been taking in medicine is the Team Source Code approach. A lot of that has to do with the lure of reductionism and thinking across the board, it's a superior form of knowledge.

Christopher:    Okay. Do you have any idea as to where that might originate? Why are we seduced by our passive reductionism?

Josh:    We're wired to figure the world out and so when we've unlocked some truth or secret that wasn't there -- I think we're driven to figure out, to acquire new forms of knowledge, and that's what that is. When we are able to give a level of explanation that's beneath the level we see, it feels like you've unlocked a secret. So in some ways it feels natural to believe that's some superior form of knowledge and that stuff that exists above it is just an illusion. Oh, that's just the illusion. You should play at this level.

    That's why the analogy of playing at the game, every level has its particular value and there are particular forms of knowledge that apply, that are best to apply at each particular level. It's really important to understand, you get that right but, yeah, that's why we're so seduced by it.

    One of the motivations for putting this together initially was because I felt like, especially Ancestral Health world, was taking the right kind of approach to all of this, taking an evolutionary perspective on health. At the same time, some people or some prominent voices in that community and also in areas like functional and integrative medicine where it's still a systems-based holistic type of approach, but we're still at times seemingly seduced by reductionist kind of ideas and interventions. I didn't want to see that happen.

Christopher:    Did you throw MTHFR under the bus?

Josh:    I may have.

Christopher:    What about nicotinamide riboside?

Josh:    I just had to give a couple of examples, nothing personal. Again, the point not being that those sorts of things don't have value, but it's just how do we think about our whole priorities in this realm? What do we consider to be most important? We like geeking out on these sorts of things, right?

Christopher:    Yeah, of course.

Josh:    So it's easy for people hearing that to get the perception that, even themselves but people listening as well, that because we're spending a lot of time talking about these things that they must matter a lot more than the basics. That's how people get obsessed about the MTHFR whatever and are still not paying attention to sleep or something like that. We've just flipped our priorities upside down. So it's not that these things aren't necessarily part of holistic approach to help, they're just fiddling, adjusting the margins rather than the foundation.

Christopher:    Right. So, talk about your four quadrant model.

Josh:    I think this game level-source code distinction, for me, is a good way of encapsulating what an evolutionary perspective applied to therapeutics looks like. So the idea was take that and then, oh, yeah, great, I can cheat. The idea was to use that idea to then kind of formalize how we think about an approach to therapies.

[0:10:04]

    The four quadrants, you can imagine there's a vertical axis where you have the level of the intervention, one level being the game level. Game levels you can think of as all the evolutionary forces to which we've been adapting to for the history of our species.

Christopher:    So, go back to Angry Birds, those are the guys that just play the game.

Josh:    Playing the game, right, and then you have the source code level interventions which are things that operate oftentimes at the cellular level. 

Christopher:    Right, tinkering with the mechanisms.

Josh:    Tinkering with the mechanisms, neurotransmitters and enzymes and co-factors and whatnot. That's on one axis. On the horizontal you have interventions that are supportive in terms of the goal. The goal of intervention is supportive. In that case, thinking of it in terms of, if you're trying to support what the body is already trying to do. You're trying to activate or amplify endogenous mechanisms for repair and recovery with the supportive. In the game level, that would be, most of the stuff there are targeted towards minimizing mismatch because we don't need this much support if we're already well-matched to our environment.

    The other goal of intervention would be a disruptive intervention where we are deliberately interfering with the physiological status quo. Some things are going one way, and we're going to redirect it another way because we think that's better. Why would you do that? The primary scenario would be where you have a regulatory system where you're convinced it's broken and beyond repair. An example there would be giving insulin to a type 1 diabetic. The status quo is no insulin, so you're going to do something different by giving it.

    Another side is disruptive or exploitative. Exploitative is where you're exploiting some physiological mechanisms that you've understood, in some capacity, to promote a particular objective. One game level type of exploitative intervention would be temperature extremes whether it's on or cold exposure where you're taking what happens in the body in those conditions and then using that to improve health or enhance health in some way.

    

Christopher:    Right, so let's summarize that four quadrant model. We'll of course link to Josh's talks, so you can see the whole talk with his slides on YouTube. That will be live by the time you hear this. I'll link to that in the show notes that you can find over at nourishbalancethrive.com/podcast. Or if you poke around inside your podcast, you'll surely find the show notes, and there will be a hyperlink there to Josh's presentation on YouTube. For the sake of those who are listening right now, we'll summarize this four quadrant model. In the top left hand quadrant, there is… 

Josh:    Game level interventions that are supportive.

Christopher:    That are supportive.

Josh:    So, again the target -- yeah.

Christopher:    I can think of these in terms of importance in this sequential order. These are the things I want to worry about first. 

Josh:    Top left is number one.

Christopher:    Okay, so I'm a primary care physician. Somebody just walked into my office. They're feeling tired. The first thing I should think about is…

Josh:    Right, things like sleep, sleep and then maybe their diet. The frame you're going to use is how is their sleep and their diet mismatched right now or [0:13:23] [Indiscernible].

Christopher:    We're looking at this problem through the evolutionary lens. What are the inputs this person's genes are expecting? How do we minimize mismatch? Are they sleeping? Are they getting adequate sunshine during the day? Are they eating a species-appropriate diet? What are they drinking? Are they drinking too much caffeine? Are they drinking alcohol at night?

Josh:    Right, physical activity.

Christopher:    Physical activity, they have sufficient sleep pressure from physical activity.

Josh:    Oh, right, right.

Christopher:    And then what about stress management? How's the accumulation? I had trouble sleeping last night because I was just too overstimulated talking to people about Ancestral Health, maybe a little bit too much caffeine as well.

Josh:    Right, yup.

Christopher:    So, that's quadrant one, minimizing mismatch. Do we move to quadrant two after that, disruptive, exploitative?

Josh:    Right, game level interventions that are disruptive or exploitative. Most of these, I think, we'd fall under the exploitative category, at least in the way I think about them. That will be like, like I said, temperature, heat, cold, different physical activity that you do like high intensity training. I would consider things like mindfulness and even psychotherapy to be game level interventions that are exploitative, fasting, anything there. The idea being that so these are level two, because you'd want to pay attention to all the category one first before you add these things on top. There are a few scenarios where you would not do that. That's second in the prioritization schema. We're prioritizing game level over source code initially. We're going to get all of our mileage out of that first.

Christopher:    There's a really good chance that if you do that then…

Josh:    Really good chance, yeah, and I would -- 

Christopher:    The fatigue is going to go away. 

[0:15:00]

Josh:    I would almost argue that if you just, regardless of what someone's initial complaint is, you start it with level one.

Christopher:    Listen carefully to their symptoms and then ignore them.

Josh:    Just implement that diagnostic to let the body figure out and then source code.

Christopher:    Yeah, so then we're onto the third quadrant. This is like the third set of things that you might think about, and this is source code level. So, now, back to the Angry Birds analogy, we're no longer playing the game. We've dealt with all that.

Josh:    Right, these are notes so another thing to map this concept of game level and source code on the evolutionary perspective. Game level interventions are evolutionarily familiar and then source code interventions are evolutionarily novel, so they're also, by that nature, mismatched. It's another type of mismatch. We've been pursuing therapies that are, by their nature, mismatched which of course introduces all the same hazards and risks as the very mismatched behaviors that cause the diseases to begin with. Something doesn't feel right about that either.

    This category is source code interventions that are supportive in nature. Probably the most common category here would be taking a supplement that's designed to correct a deficiency that exists, whether it's magnesium or zinc or whatnot, common things that are deficient in our diet. For some reason, for whatever reason, you can't get it through food. That will still be our preference, but there may be situations where you can't so you use supplement.

Christopher:    Right. I'm doing my best to maximize magnesium intake, but perhaps it’s always fucked and so I need to take some additional.

Josh:    Exactly, and then our --

Christopher:    Fourth quadrant.

Josh:    Fourth quadrant.

Christopher:    It's like danger, Will Robinson, danger.

Josh:    That's right. That's why it's in red. It will be source code interventions that are disruptive, typically, so that would be all pharmaceuticals.

Christopher:    I wondered about this. Is there really nothing -- 

Josh:    I've tried. I would love if you could think of an example. I haven't gone a long period of time trying to find one but all the ones that I commonly use, I can't think of any one that I would consider to be supportive. I don't even think we know enough. You know about many of the drugs we use, we just don't even understand the mechanism.

Christopher:    I don't think that means what you think it means. I don't think that works the way you think it works.

Josh:    Exactly.

Christopher:    The pleiotropic effects.

Josh:    Right, so to say that it will be awfully improbable if that happened to be supporting [0:17:31] [Indiscernible], have no idea what's happening.

Christopher:    It's like what Tommy says about EMFs. It has to do something. It might be good.

Josh:    The odds are low, but it's possible. Yeah, all pharmaceuticals I would put into that category. I think it's important to understand that that's what we're doing, anytime we're saying, giving a prescription to a patient. It's a pretty big decision to take seriously.

Christopher:    Yeah, you're tinkering at the source code level.

Josh:    Right, tinkering with the source code in a way that's overriding the status quo. I'm saying I'm certain that what your body is trying to do even though I don't know what this drug does.

Christopher:    We're laughing but it's -- 

Josh:    I know. It's tragic.

Christopher:    Take statins as an example, HMG-CoA reductase inhibitors, like it's cutting this tree off. All the stuff happens below, and the drug is going to affect all of those things.

Josh:    All of those things and we think that that's worth it. There should be an extremely high burden of proof to do something like that. Anyways, that's why it's category four. Of course the modern medicine schema is not this because -- 

Christopher:    Unless you go straight to quadrant four the moment someone walks into your office.

Josh:    Right, and I think part of that stems from never having an evolutionary perspective on all of this. Because if you do, I don't think you -- I mean, there are other factors as well but certainly that's absent. So the decision algorithm that I would give would be essentially prioritize quadrant one over quadrant two over quadrant three over quadrant four unless you had evidence that says an intervention in one of the lower categories is clearly better for some particular objective than one in the higher category.

Christopher:    So someone walks into your office, you're going to use this as an operating procedure.

Josh:    Yeah, at least in the back of my mind because I realized that I was using something like this already.

Christopher:    So you just wrote down --

Josh:    What is the nature of this thing that I'm using? How could I best communicate it? Because it was already there on some level and having it, like we talked about, we're all lured into reductionism, so it serves as a good reminder just to have it as a -- this is my framework. This is the North Star to keep myself oriented, remind myself of what I consider to be most important.

Christopher:    I think it's not just useful for practitioners who are trying to figure out the operating procedure. I think it's also very useful for listeners of the podcast, like me, when you hear someone talking about the latest pill or potion or device or hack. Simon loves the word hack.

[0:20:07]

Josh:    Yeah, 100%, this will be super -- especially people who are in this kind of space who have decided, hey, I need to look elsewhere for answers. It can be easy even going into this world to think that the source code is where it's at just because we spend a lot of time talking about those things.

Christopher:    Right, so before you put your DNA into some filter that tells you how many eggs you should eat.

Josh:    Right.

Christopher:    Where are we now?

Josh:    So, yeah, it would be incredible if every patient that walked in the door to see me already had this framework in their mind. That will be amazing. There's so much it could do. Yeah, it will be great for listeners.

Christopher:    It's a checklist.

Josh:    Yeah. It embeds a lot of the ideas that we consider -- the principles that we consider to be most important.

Christopher:    I want to start using this language in the hope that it catches on --

Josh:    Catches on.

Christopher:    -- and become trendy. So, this new supplement that we're talking about, where is this? Which quadrant are we in right now?

Josh:    Right, right, right, give it a label.

Christopher:    Yeah. Oh, okay, it's just a three, all right. I was hoping for environmental mismatch.

Josh:    That's right. It's not a one. I only do ones.

Christopher:    It's interesting because if you only do ones then…

Josh:    Yeah, I know, you may never need another.

Christopher:    That's super helpful. So, scaling.

Josh:    There are probably multiple reasons why we haven't come to grips with this glaring problem, and one of them being absence of an evolutionary perspective, but another one being that drugs and supplements scale very well. It's easy to build a big profitable business off of them.

    The other thing is, because the randomized controlled trial has somehow become the only valid way of advancing knowledge in the realm of therapeutics, that has also limited our search to source code interventions because they're really the only thing that can be tested in that model, with a randomized controlled trial. We all know how impossible it is to conduct a real decent diet therapy or any kind of game level therapy in the context of an RCT, so you've got that problem as well.

    So, you've got this issue with how do you -- that lends to the critique about anybody who would advocate for this sort of approach to health, who would advocate for, starting with diet and lifestyle. How are you going to advance that knowledge? They'll argue, if you don't have trials, it's not scientific. So you've got to have solutions that scale, and you have ones where you can validate them. You'll still need a research system for advancing knowledge in that realm, but it needs to be independent of randomized controlled trials.

    The next thing I argued for was how to build a model that works like that, a scalable model that can also advance knowledge in a way that's credible and scientific and furthermore, that allows us to actually leverage the advances that we've made in science and technology towards progress in medical therapeutics. One of the most remarkable things about the fact that we've made no progress is how much progress we've made in other domains of human life. 

    In just the biological sciences alone, think about the knowledge we have now compared to 1991 which was the last breakthrough. Why has none of that made its way into therapeutics? Why has none of that translated into improvements despite its exponential growth? So, to having a model that allows us to apply those advances to the development of medical therapeutics.

    You take, basically, how do you play any game, which is you play, you take an action in the game then you get feedback from what happened. You compare that to what your objective is, and you find your approach, and you take another action. That's how you learn the game, and that's how you acquire knowledge about game level interventions.

    Almost all of what we know about what we consider to be ground truths in human health was not acquired through randomized controlled trials. It was acquired through other ways of acquiring knowledge. We need to allow for that and figure out how to formalize that into a research ecosystem so, yeah, in the talk that I gave, examples of how you can apply the tools of science and technology at each level in that process of playing the game, assessing the results, refining accordingly and playing again. All game play that works, and that's how you create this virtual cycle of continuous improvement. 

    Even in the best of scenarios right now, even if you come up with a good drug, you're then stuck waiting for the next drug to make another improvement. You don't have any real mechanism for making that iterative the newest process nor do you have any mechanism for understanding individual variations and how therapies work or contextual dependencies. What's the context of saturated fat in the context of someone eating low carbohydrate diet versus a high carb diet? We have no real way of understanding those contextual dependencies right now, so we act like they don't exist.

[0:25:24]

Christopher:    Right. Well, there are companies using that kind of stuff. Can I use your genetic data to understand drug metabolisms to make a more targeted approach, just like source code level interventions on top of source code level interventions.

Josh:    Exactly, right. We could be so much better at getting that kind of knowledge if we just change how we look at it.

Christopher:    So the right way to do things is the same way that you learn to play anything. How do you learn how to play tennis? I hit the ball. Where did it land? Oh, that went a bit long. Let me try hitting it slightly differently. Oh, yeah, that went a bit shorter, but that's too short now. Let's try a third time. Oh, that's just right. It's how you learn how to play anything. You have this feedback.

Josh:    Feedback loop and you're acquiring knowledge about the game itself. There are layers of explanation about the game that exist beneath that game level. You could start looking into the physics of hitting a tennis ball or aerodynamics of ball flight. There would certainly be other applications for that knowledge, but it wouldn't help you in playing the game anymore. So, understanding it, and that's another thing that I talked about is that what we need to do is completely dissociate how we research therapeutic knowledge versus mechanistic knowledge, how things work rather than trying to do both at the same time.

Christopher:    Figure out what works before you figure out how it works.

Josh:    Right. What works can certainly help us to figure out mechanisms and then ultimately that can possibly enhance either our interventions or -- right now, I would say the best place to apply our source code knowledge of mechanisms is in monitoring, assessing our interventions, so looking at disease markers, looking at labs and imaging to know our game level. Interventions moving us towards an objective, particularly talking about treating a particular disease.

Christopher:    As you know I'm a particularly big fan of this, and that has been my complaint for a while is that you generally don't get that feedback. Malcolm Kendrick talked about how in cardiovascular disease, quite often the first symptom is death.

Josh:    Right, exactly.

Christopher:    That's too late. I need to know before then, that my vegetarian diet is not working. Maybe a vegetarian diet could work if it was done really well and appropriate feedback will tell you as such.

Josh:    There are lots of questions that we would love to know, and we have the tools to figure this out. We have the tools to do this.

Christopher:    There is so much dip shittery and uncertainty that's created by not having any way to assess that though. Even here at the Ancestral Health Symposium, you have someone propose some idea. Well that's interesting. I quite like to explore that, but how do I assess that it's working? Do I wait? Maybe there are even transgenerational effects, or maybe my great, great grandchildren will tell me whether that was a good decision or not.

Josh:    Right, and in the meantime, you play the game. You get level one taken care of. There are certain things we have to acknowledge, the limits of what we know.

Christopher:    Yeah, be okay with not knowing.

Josh:    We're so bad at that. That's why saying we don't have a robust mechanistic explanation of how a particular intervention works is seen as undermining it somehow when it's not in any respect. We're so hung up on thinking that that's needed.

Christopher:    Also, humbling things or at least things that I find humbling that made me realize that there are certain things I can't understand. For example, I've just finished reading Dave Deamer's book on Origins of Life. I found it a little bit frustrating because I felt like he was just moving the problem around. What happened with the origins of life, he relies on stuff turning up from outer space, on comets. Does this happen to be the right fatty acids in this comet? You can put it in a blender and you'll get, say, coconut oil out of it. Okay, so what happened before the Big Bang? What did happen before the Big Bang? That's an interesting question. You Google it, and it turns out that asking what is before the Big Bang is like asking what's south of the South Pole?

Josh:    You understand there's actually nothing at the bottom.

Christopher:    Yeah, and I'm like, oh, I guess I just can't understand that. I don't have the apparatus to --

Josh:    Right, and that there are certain things that are just assumptions that you just have to grant.

Christopher:    Yeah. Does it come with any value in it? That's an interesting question as well. Once you know that something works and you're comfortable with not knowing how it works, is there any value in it?

Josh:    In exploring it?

Christopher:    And exploring it to find out the details, the technical details, the source code.

Josh:    I guess it does because it reveals if something works that you didn't know worked before, so when you find something that works that didn't work before, it's surprising. Clearly there's some knowledge to be gained there. You didn't understand and potentially -- 

[0:30:04]

Christopher:    So maybe that insight gives new insights into what else might work. Right?

Josh:    Right, for sure, and then exploring then figuring out how it works could still lead to other valuable information. It's like there is value in just exploring curiosity about the world. So many of our advances that we've made, major technological advances, just started with someone, what the heck is this, and had no idea that one day would turn into a magnificent technology. So there's certainly value in that. For me, it's simply, the primary take home message is understanding where it applies. What is it good to use for and what it isn't?

Christopher:    It's a false dichotomy to say it's an either-or.

Josh:    For sure, yeah.

Christopher:    This doesn't mean that you can't investigate mechanisms and tinker around at the source code level. It's just that first you must play the game.

Josh:    Right, yeah, either-or thinking is another huge issue. I was thinking about that with the talk because I use Alzheimer's as one of the poster children for this insanity. How many resources have we poured into it and come up empty despite how much hype there was around it? You had, for years, people debating, is it amyloid or is it tau? As if, A, it had to be either-or. Why we ever thought that, I don't know. B, is it the fate of what happened, whether our success depended on which one we got right? It's going to be one of those two.

Christopher:    Yeah, those models, they always make me -- we've seen it before. Like I say, in the integrative field, Bredesen, is it glyco toxic or is it toxic toxic? Is it insulin-resistant or is it -- it's great. It's catchy and, oh, this is a system I can go -- Mickey mentioned Gretchen Rubin's tendencies. Am I questioner, or am I --

Josh:    Right.

Christopher:    You couldn't be two at once or it wouldn't change for different situations.

Josh:    They're cognitive heuristics, but they're not truth. We wouldn't mistake them for that.

Christopher:    How do we spread the word? I've been coming up with this idea of a TED Talk. You might have to get rid of me and distill it down a bit in order for it to be...

Josh:    18 minutes long.

Christopher:    18 minutes long. 

Josh:    I'm happy to talk about this wherever anybody will have me. People can watch the YouTube video and share that too and, yeah, get in touch if anybody wants to help, help spread the word, help share the message.

Christopher:    Maybe one thing you do is listen to The Intelligence Unshackled podcast. 

Josh:    Of course you can, yeah.

Christopher:    I've very much been enjoying The Intelligence Unshackled podcast. It's one of my favorites.

Josh:    Excellent, yeah.

Christopher:    You want to tell us about that for the one person that's left that doesn't know about The Intelligence Unshackled podcast.

Josh:    That's right. I didn't know there were any. It's obviously related to some of these ideas. I'm a neurologist and so human intelligence is one of my interests and as is realizing human potential by helping people to get more out of their brain. So the unshackled refers to the fact that human intelligence and our brain and cognitive function is constrained in multiple ways in our current modern environment. That's both, at least pertaining to this discussion, one of those constraints is compromises in its biological function.

    Our intelligence and our cognition is ultimately the result of an organ, and it's important that organ functions well if we want to improve our intelligence and cognition. The primary constraints, I would argue, arise from mismatches. Just like with other domains of health, the easy wins for improving cognition are first taking care of mismatches. People who have been through it understand the difference between sub-optimal and optimal sleep, so just getting things like that dialed in makes a huge difference in cognition.

    The mission of that is to explore all the ways that we might cultivate and improve human intelligence and starting with removing the collective shackles which, like I said, we have the biological ones and then in the software side as well which is our capacity to learn and add new skills and capabilities as we go throughout our lives. There are several ways in which that's constrained as well, starting with some limiting beliefs that have been handed down to us for a long time and that are still fairly pervasive.

Christopher:    Very relevant to anyone interested in improving their cognition but also interesting for people who are interested in education which is basically everyone with kids. I really enjoyed --

Josh:    Good.

Christopher:    -- the First Do No Harm approach to education. I'll resist the temptation to get into that here, instead defer people to the Intelligence Unshackled podcast. I was listening to that on a plane, and I made Julie put on my noise-canceling headphones so that she could hear that section on the First Do No Harm.

Josh:    First Do No Harm, get out of the brain's way.

[0:35:02]

Christopher:    Yeah, I really enjoyed that style where you as a neurologist tell that story that you might call a case study that presents this interesting example, what might be going on here, as a detective. Of course you have the answer, but you have to wait and get the explanation. I do enjoy that style. It's very well done.

Josh:    Thank you. We're curious creatures, so curiosity will keep the listeners around, hopefully.

Christopher:    If you want to support Josh on Patreon, you can do so by -- what's the best link for people to go to find you on Patreon?

Josh:    The best link is to go to elitecognition.com. There's information there about joining the Brainjo Collective. So, if you want to become part of that and support on Patreon, you can do that and look at the private forum for members of the collective along with the brain fitness challenges.

Christopher:    I love that forum. It was Simon's idea actually when we started that. You've got quite a diverse group of users. It was Simon's idea some time ago. It now gets 10,000 paid views a month, what the heck.

Josh:    Wow. 

Christopher:    There are a lot of people interacting, but there are a lot of people just reading stuff. 

Josh:    Yeah.

Christopher:    So, Josh has been posting these lessons that will teach you how to play the ukulele as a perk of being part of the Brainjo Collective. I'm still on Lesson Three., still on Lesson Three.

Josh:    Take your time.

Christopher:    So, yeah, join Josh on the Intelligence Unshackled podcast and as part of the Brainjo Collective. Is there anything I forgot about -- oh, and if you know anyone with a migraine, where do you send them?

Josh:    Go to mymigrainemiracle.com.

Christopher:    Just trips up the tongue, mymigrainemiracle.com, I love it. Is there anything else people should know about, Josh?

Josh:    I think that's good. We've given them enough.

Christopher:    Okay. Well, thank you for suffering my infliction of the environmental mismatch that is recording podcast at 20 to 9 p.m. It's dark as we're nested here on top of the apartment in San Diego. It has been a fantastic Ancestral Health Symposium. We just found out that there's not going to be one next year. The year after that is going to be in LA.

Josh:    Yeah, UCLA.

Christopher:    Maybe we'll see you in a couple of years' time in Southern California.

Josh:    Looking forward to it.

Christopher:    Excellent. Thanks, Josh.

Josh:    You're welcome.

[0:37:12]    End of Audio

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