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Welcome to the Memories Podcast. I'm your host, Jackson Nguyen, and I am a biochemistry senior at Worcester Polytechnic Institute. I am also a trained community representative of the Massachusetts chapter of the Alzheimer's Association. Memories is a podcast/interview series that features in-depth, one-on-one conversations with leading global experts across a wide range of fields to explore Alzheimer’s disease (AD) and dementia from numerous lenses. Through these conversations, I hope to deepen public understanding of AD and share the voices of those working to make a difference around the world. Memories is a personal passion project of mine where I hope to engage in fruitful conversations with experts to learn more about Alzheimer’s and spread awareness of its devastating condition to my community. Thank you for joining me!
Hi everyone, welcome to the Memories Podcast. I'm your host, Jackson Nguyen, and I'm a biochemistry senior at Worcester Polytechnic Institute in Worcester, Massachusetts. I am also a trained community representative of the Massachusetts chapter of the Alzheimer's Association. Memories is a podcast interview series that features in-depth one on one conversations with leading global experts across the globe to explore Alzheimer's disease and dementia from numerous lenses. Through these conversations, I hope to deepen public understanding of AED and share the voices of those making a difference across the globe.
Jackson Nguyen:Memories is a personal passion project of mine where I hope to engage in fruitful conversations with experts to learn more about Alzheimer's and dementia and spread awareness of its devastating condition to my local and global community. Thank you so much for joining. In today's episode, it is my utmost pleasure to welcome doctor Christo Kahler, who is a holistic brain health expert with nearly twenty years of experience working for those with brain related diagnoses, their families, providers, and advocacy organizations. She is a doctor of behavioral health with an educational background that spans the behavioral sciences, including lifespan psychology, gerontology and sociology. She's the founder of the Virtual Brain Health Center and a senior Atlantic Fellow for Equity in Brain Health with the Global Brain Health Institute, where she was the first scholar from The US to complete her residency training at the Trinity College of Dublin in Ireland on dementia prevention and the social determinants of brain health.
Jackson Nguyen:Collectively, through her educational training and applied experiences, she has received numerous international and national awards for innovation in brain health programs and wellness services with a global impact. Her professional contributions to the field of brain health have been acknowledged through the receipt of multiple personal awards at the local, national, and global levels. She's the author of a kid's book about brain health and host of a top 10 ranked best brain health podcast, Let's Talk Brain Health. She has an unwavering commitment to promoting brain health equity to individuals of all ages and the communities she serves across the world. Her mission is brain care for all.
Jackson Nguyen:It is remarkable to have you here, Doctor. Koller. Thank you so much for joining
Dr. Krystal Culler, DBH, MA:grateful to be here with you for this conversation today.
Jackson Nguyen:Thank you. And before we dive in, I was wondering, do you have any questions for me or anything you'd like to add before we get started?
Dr. Krystal Culler, DBH, MA:I appreciate the bio and I think to just share with other people, one of the other things I like to just share is, you know, I did study brain health science, but it is also something I have to live in my day to day work. I live with migraine disease and new daily persistent headaches. So I have to prioritize my brain care and I have a supportive family who does that. And also five dogs that serve as lots of support and usually are running around my office, at some point in time today, but hopefully you won't hear them on today's podcast.
Jackson Nguyen:Awesome. Doctor. Culler, so you've devoted most of your life to improving how we understand and care for the brain. I'd love to start with the story behind that passion. Like in retrospect, what was that moment or the experience that first made you realize that this was your calling?
Dr. Krystal Culler, DBH, MA:Yeah, I think I mentioned that I live with migraine and new daily persistent headache, but that was not always my tale. I was in my last semester of my PhD, my final class preparing for my comprehensive exams, which is like the time every doctoral student is ready to celebrate. And I had a grand mal seizure. My brain backfired on me. And I like to think it took that moment for me to realize I needed to be on a different path.
Dr. Krystal Culler, DBH, MA:It just, my body disconnected at that time. But I had to end up taking a break from graduate school by Ohio law and not able to drive for six months. And it took my brain almost two years to recover from that isolated incident. Fast forward a few years of working with a wide variety of practitioners. I found out I had a fluke reaction to a medication that I was on, luckily a very rare adverse effect.
Dr. Krystal Culler, DBH, MA:So hopefully that won't happen again to me in my lifetime, but that did trigger the onset of headaches and migraines for me. But at the same time, while I was navigating that journey, my mother was spending a few years getting a diagnosis of MS and my grandmother was traveling her journey with dementia. So the most important women in my life who were my pillars of support and champions of me and my higher education. Women's brain health was at the forefront. So it wasn't just something I was studying.
Dr. Krystal Culler, DBH, MA:It's something we were all living and navigating. I thought, well, how do I make this journey better for people behind me? And so I did the unthinkable. I transferred doctoral programs and went to study a program in doctorate of behavioral health with a concentration in healthcare management, because I thought for me, I was missing the policy and services piece. How do we build programs and better for families and people and the providers that work within those systems, the more applied program.
Dr. Krystal Culler, DBH, MA:And I don't recommend that to anyone. It was a journey that I had traveled for myself, but it has worked for me in the types of work that I want to do in my career. And I always just have kind of taken that as what drives me to do what I do is the experience that I have, or the people that I have support in life that share their stories with me is how do we take the problems or the gaps in care and do something better for the next person behind us. So hopefully they don't fall through those gaps and they don't have those experiences. How do we just keep improving?
Dr. Krystal Culler, DBH, MA:And I think for the broader conversation we're going to have today is there's lots of areas that we can improve, but we're on the cusp of doing that today in Alzheimer's and dementia and brain health. A lot is changing at a fast pace.
Jackson Nguyen:Incredible. And with your nearly twenty years of experience working with those brain related diagnoses, their families, providers, and these various advocacy organizations, how has your understanding of the human brain changed throughout time?
Dr. Krystal Culler, DBH, MA:Yeah, think one of the most important things I had started to learn throughout this is, you know, there are brain based conditions. So there are changes with Alzheimer's and dementia that are neurodegenerative. The brain does change. And I came from early on my experience was working with children with autism and the developmental disability space. So we would always see behaviors.
Dr. Krystal Culler, DBH, MA:So there's something that happens an antecedent before behavior. And then there's a consequence. We talk about this ABC and, you know, how do we support people? And then when I think about the neurodegenerative space of there are these brain changes that happen and we're trying to support people along the way, environmental, it could be pharmacological, non pharmacological support. This happens over years for individuals.
Dr. Krystal Culler, DBH, MA:And on the flip side, when it's younger, it's people's entire lifespans. And so I just kept thinking is how do we devise services and support for everyone in the social network, not just the individual. And that has kind of been my whole path. Cause that was even my thesis work was how do we do trainings for families and how do we do late life care planning? What are people's wishes for later life?
Dr. Krystal Culler, DBH, MA:What do they want to be able to express? How do they want to have retirement look like? And there's all these different types of conversations that come around that. But for me, when it came back to the brain was understanding what are the actual physiological changes that happen in the brain and how do we communicate that to people? And whether it's the care partners so that they can better understand what's happening to make, when they might want to make decisions or to the individual what's happening so that they can make decisions or that we can put in supports in place.
Dr. Krystal Culler, DBH, MA:And so I think it's always linking those brain changes with behaviors and supports and a lot of education. Cause I even think for my own personal journey, when it comes back to me and my mom and my grandma, when it was, when you actually understood what was happening to your brain and getting that education piece, then what decisions do you want to make? And that could be about your own health and well-being, your treatment, your life planning, your situations, and the support that you want. And that's all your quality of life.
Jackson Nguyen:Wisdom of those experiences, what inspired your mission, like brain care for all. And I was wondering, could you like elaborate a bit on this mission and like share with us some of your personal values that guided you on that mission?
Dr. Krystal Culler, DBH, MA:Yeah, I think for me it just started to come down. It sounds overly simplistic where I just wanted everyone to have brain care. And a lot of it came down to so many people around the conversation of brain health or the care of their brain. For some reason, we think it's not for us. It's not our conversation for us.
Dr. Krystal Culler, DBH, MA:Some people will think, well, I'm too young or my brain's not there yet. There's not enough symptoms or concern or worry. And for some reason we put all these restrictions in place. And I just want it to be a conversation for every single one of us to have and to engage in and to not think it's not a place or a space for us to walk into. And at the same time, I think we put in those same restrictions of why we don't care for our brain of why we don't sleep a little bit more, why we won't eat a food that's a little bit better for us.
Dr. Krystal Culler, DBH, MA:That gives us more energy in the day. We, for some reason, we always negate away the things we don't do. And I want just to open up a floor and a space for us to have the, all of those conversations and for all of us to kind of step into that space and brain cares for every single one of us. Even if you have a neurodegenerative disease, even if you have a mental health condition, there's no restrictions. And unfortunately the older message around brain health was exclusive.
Dr. Krystal Culler, DBH, MA:We always thought it was just for the healthy. We've gotten a lot of that messaging over the years, but to really reinforce that it's for all of us, all ages and stages of life.
Jackson Nguyen:And now with that concept of brain health, I want to, it does sound a bit like abstract. If you were to have to describe it, how would you explain it? What it means to really take good care of your brain?
Dr. Krystal Culler, DBH, MA:I'm so glad you asked this because it, the definition has really evolved. And before we would have broadly said it's your thinking, feeling and doing. And under that is a lot of things. If you think about it most of the time, if we say brain health, we tend to lean heavily on cognitive skills, our memory, our decision making, how we remember, learn, plan, or concentrate things that involve multiple steps, but it's just a demand of your brain. And I'm really grateful.
Dr. Krystal Culler, DBH, MA:A few years ago, the world health organization put out a much broader, I think, holistic definition of brain health. They say good brain health is a state in which every individual can realize their own abilities and optimize their cognitive, emotional, psychological, and behavioral functioning to cope with life situations. So realizing it's multi dimensions of our overall health and our well-being. And the way we like to talk about it at the virtual brain health center is it's really our brain's ability to grow strong and thrive at any age. So we really lean into the neuroscience that our brain has this idea of neuroplasticity.
Dr. Krystal Culler, DBH, MA:It can change and grow through the way that we are living our day to day lives, our actions, our lifestyles, our habits. We're constantly kind of sculpting and reshaping our brains, and we can be intentional about that. And I know we're going to get into those lifestyle habits and the science behind that later in the conversation, but to let people know all of the things we're doing or not doing of an investment of our time and energy really are having an impact on our brain. So it's a lot more malleable than we do think.
Jackson Nguyen:And I really love how you said, you know, brain health is beyond just the memory and the intelligence. Like what aspects of brain health do you think are often like neglected, like emotionally, socially, spiritually?
Dr. Krystal Culler, DBH, MA:I think you hit on the main ones that we tend to overlook is that social health, the spiritual health, the emotional, the psychological, and the behavioral. We lean so much when we hear brain that we think it's just that cognitive domain and we don't realize all those other elements are interconnected to our brain health and our well-being. And we think of all those dimensions of wellness when we have heard in other areas, but they're so vital to our brain health and our well-being. So it's kind of pulling it back to say brain health is really all of the things I've joked with people over the time of, if you throw something at me over all these years, I haven't not been able to link it back to the brain, but I welcome the challenge at any point in time. So really, if you're starting to think about it, anytime you're spending your leisure, anytime you're challenging your brain, if you're doing the things to rest, all of those things are your brain health, but I accept the challenge.
Dr. Krystal Culler, DBH, MA:You can write into you or to I and throw something at us, but I have a suspicion that we're going to link it back to brain health.
Jackson Nguyen:And what do you think, like, what are some of the misconceptions that we still have today when people discuss brain health?
Dr. Krystal Culler, DBH, MA:I think one of the top ones we talked about earlier about that it's not for us. And then the other one is that it's not health. For some reason, we tend to think it's almost this nice to have or a luxury item still, almost like the way we view sleep or rest. Like it's this not necessarily high important area of our health and well-being, which is almost counterintuitive to most of the international and national surveys we have when people rank, what are the areas of your health you're most concerned about? The top two tend to be heart health and brain health, which heart health and brain health are highly connected to one another.
Dr. Krystal Culler, DBH, MA:Well, on surveys say we are highly concerned about our brain health, but yet we don't necessarily prioritize it or we report, we don't know what the steps are. So it's still kind of this area outside of health and well-being sometimes that it's probably to your point, it's ambiguous to us. We might not necessarily know the meaning. We might not know the elements, but really putting in as a staple and priority to our health and our well-being and our brain is an important part of that.
Jackson Nguyen:Yeah. Because I really love how you mentioned like the heart is so interconnected with the brain because by taking care of your heart, you also, at the same time, taking care of your brain. Because the Alzheimer's Association, they, like, they release this, like, top 10 habits for your brain. And some of those habits are, like, you know, like, healthy diet or, like, you know, getting your steps in, which is obviously very good for your health, your heart, but like at the same time, it's also really excellent for your brain.
Dr. Krystal Culler, DBH, MA:Yes. And that's one of the easiest guidelines to follow for brain health is if you're following anything that's heart healthy or a heart healthy diet, you're already doing the things that are brain healthy. American Heart Association's like lifestyle eight model falls right into brain health. And they have this brain health initiative and call out to where it's there. The synergies are so aligned.
Dr. Krystal Culler, DBH, MA:And like you mentioned, the Alzheimer's association, their 10 tips, they mirror one another. And so that's really a great starting point for people because we've spent two decades advocating for heart health. And so now we can build off of that for brain health.
Jackson Nguyen:Yeah. And now I'd love to talk a bit more about these lifestyle and prevention techniques, like what it looks like in practice, in our everyday routines. And so in your nearly two decades of working with people, like what are some small daily choices that make a big difference in terms of like long term brain health? And like, what are some of the things you do regularly to take care of your own brain?
Dr. Krystal Culler, DBH, MA:I love this question because it is not a straightforward answer around brain health and it's hard to answer it for folks, but we, one of the things we've done at the Virtual Brain Health Center is we've made a few different infographics for people and to try our best to go to what does the science say where these are these intervals and the American way is we want the bang for a buck. Where can we get the highest investment for our shortest amount of time? And we've gone to the science to try to answer some of those. I will give you those intervals, but I will also like to say with the caveat for a lot of this is around brain health is it's so individualized. The nice part is, is we can give these global recommendations on lifestyle, but it all comes down to multimodal interventions is it's not just one area of brain health.
Dr. Krystal Culler, DBH, MA:So one area for me would look very different for you. Jackson will look very different for another listener in terms of priority, but we do see these broad bucket areas that are good for an investment. So on our website, we have one that says, if you only have thirty minutes a day, where should you start to invest your time? So we did our best to go to the science and say, what are the baseline intervals of where you could go? So there are four main areas where we recommend, and then there's a one minute bonus.
Dr. Krystal Culler, DBH, MA:So I'll start there. The first one is to put five minutes into some type of restfulness based activity. So that could be meditation or breath work. And then you put ten minutes into brain fitness. So something that's going to stimulate your mind, lifelong learning or something that's new, novel, and challenging, something that makes your brain think that doesn't come to you automatically.
Dr. Krystal Culler, DBH, MA:Also at the same time, you're going to put ten minutes into your physical fitness. So moving the body, the CDC even shows that just five minutes of movement cause benefits for your health. It will show reduction in symptoms of anxiety and depression, but try to start there. And then you want to put five minutes into some type of a brain break as well. So the idea that you unplug and rest, whatever that looks like in some type of short interval throughout your day, we focus so much on needing that stimulation and we forget we need that balance of the restfulness in order to be able to stimulate our mind.
Dr. Krystal Culler, DBH, MA:So that gives you the thirty minutes. And then if you want to get your bonus practice gratitude. So I always say, that with something. If you're washing your hands, focus on your day. What's gone well.
Dr. Krystal Culler, DBH, MA:What are you thankful for at that moment in time? There's a lot of research that shows how adopting an attitude of gratitude will show you lots of benefits for your brain. There's a lot of other ones, but these are kind of the bare minimum. So five minutes of breath work, ten minutes on your brain fitness, ten minutes on your physical fitness, five minute brain break, top it off with a little bit of gratitude. And that's a good base start of thirty minutes.
Dr. Krystal Culler, DBH, MA:And of course you can build on those intervals.
Jackson Nguyen:Yeah. Because it's interesting because I remember, I don't know where, I heard this from, but one person told me, was like, if you don't have time to meditate, they're never telling me you need to meditate because it shows how, you know, we I feel like our brain is constantly so stimulated, whether, you know, we're so busy. A lot of times you don't take that rest thing period. And rest is so, like, obviously really good for our brain, but a lot of times we're so, like, charged with, like, doing a million things and always running around, like, find that time to rest. And so I completely agree with you, and I feel like I definitely need to take some of those strategies that you mentioned for myself as well.
Dr. Krystal Culler, DBH, MA:I'm honestly so glad you shared that. And to be completely transparent with you, this is exactly why we wrote our kid's book about brain health is at the time my niece was about to go into kindergarten and she walked in and she said, I want some quiet time. And she walked into the other room and my husband came in and he goes, I want some quiet time. And I'm like, you're an adult. You can take quiet time wherever you want.
Dr. Krystal Culler, DBH, MA:And in that moment, it got me thinking what happens from the time when we're little and we acknowledge our needs. And even with young children language, we express our needs and we go and do what we need. Right. But something happens, but when we're an adult and we have free will and the full ability to do it, that we stop ourselves and we no longer do it. And I thought, but the way we answer children is very different as adults.
Dr. Krystal Culler, DBH, MA:And I thought, well, look at these little kids, their brain health catalyst of change. They know what they need. They're expressing themselves. They're doing these things. How can we start to use them to reinforce the brain health skills they're having?
Dr. Krystal Culler, DBH, MA:And then how can we use them to have those conversations? Cause when they're younger, they're not necessarily reading on their own. They're reading with parents or older siblings or grandparents. And then how do we have everyone have these little conversations around brain health? So I thought my little niece was my little catalyst of the idea of we're going to have these conversations differently.
Dr. Krystal Culler, DBH, MA:And it all started because she was like, I want quiet time. And I thought, and I watched these all adults around her say they all wanted quiet time, but no one else wanted to take it. And I'm like, interesting. Something happens as we get older that we start to put these restrictions in of these basic things. But when they're little, if you watch little kids, they just go take a nap.
Dr. Krystal Culler, DBH, MA:If they want a snack, they get a snack, you know, that they follow these things. And then, and we get older and then we scramble to put all these basic things back in place, like needing rest, remembering to take snacks because we lose track of our Workday, all of these things. I'm like, what do we do that we can put these habits into place? So we really have these strong foundational pillars of our brain healthy lifestyle. And that then our energy can go towards other things that, you know, bring us the joy, bring us the fuel, that bring us the energy and not us having to just constantly have to recorrect or as we think about constantly having to reset on the rest piece because we have gotten so overly exhausted.
Jackson Nguyen:Moving on, I want to ask you because there's a lot of buzz around, you know, like brain health supplements, there's apps, miracle cures and such like that. Especially, I feel like with the age of AI that we're in right now, there's definitely a lot of deepfakes now that people are obviously trying to impersonate real doctors, trying to sell different supplements, these brain supplements. And they may work, they may not work, and such as a form of predatory capitalism. And so I was wondering, what's your advice to our audience to find these trustworthy resources to actually best take care of their brain health?
Dr. Krystal Culler, DBH, MA:Yeah, this is a really hot topic in brain health. And I would say, I wish I would have pulled the numbers, but the brain health supplement industry grows by the millions every year. And unfortunately it has happened over time that they have just changed the labels on some of the supplements. They all have pink or silver sparkly brains, or they have called out, air quote, what the cognitive or proclaimed cognitive benefits of a supplement may be. And they lack the rigor of a scientific study to really back up the marketing claims.
Dr. Krystal Culler, DBH, MA:And some of the supplements that had been under scrutiny by the federal trade commission has been over the marketing, the misleading marketing, because they lack that. I have no, what do I want to say? Conflict of interest with this company, but I recommend people check out a company called Supco. It's a free app. And what they do is they have no affiliations with any of the supplement companies, but they basically look at the market and they look and they do third party testing on some of the supplements and they put out reports to say, do they actually have the amount of the supplement that's in there?
Dr. Krystal Culler, DBH, MA:And they kind of start to hold some of them accountable for it. They have an app where you can screen your supplements on the bottle and you can start to see, you know, is the quality there is the value there. Have over 30 different checkpoints that they look at to kind of look at, do they have scientific studies? Can you access the scientific studies on their website? Are they credible?
Dr. Krystal Culler, DBH, MA:Are they reliable? Do you have good value? So all of those things, they're kind of, they sit side of the supplement market. So you can look at that. That's where I go when I look, I also look at people's website, but the golden rule of thumb, if it sounds too good to be true, it probably is too good to be true.
Dr. Krystal Culler, DBH, MA:There is no miracle bullet or a supplement. I think just a couple months ago, there was this huge splash about creatine and Alzheimer's disease. And it's like, when you got to the study, there was less than 20 people in the study. It was a pilot and the headlines ran frantically with it. And it was like, you get to the researchers and they're like, that's never what the intent of it was.
Dr. Krystal Culler, DBH, MA:It was a small pilot study in mainstream media, like took off with it and it was everywhere. And so unfortunately that tends to be what happens. And, you know, researchers don't get a say of how someone takes their study and may then relabel it and it goes mainstream media, but to really be careful. And when you start to see those flashy headlines, worst case, ask someone about it and And your local pharmacist is sometimes a really great resource to go into to your pharmacy. Your pharm techs are great resources that are local there, or your healthcare providers can sometimes answer those questions, but pharmacists they're right there.
Dr. Krystal Culler, DBH, MA:They're all the time, wherever you could go and to access and to ask them.
Jackson Nguyen:I see. I'm wondering, do you personally take any like brain health supplements at all?
Dr. Krystal Culler, DBH, MA:Personally for brain health, I do not. I work with my healthcare providers. I do take some for migraines, so magnesium and where I live, we're up in the cold Northeast. I take vitamin D because we're vitamin D deficient in some of those, but I have not tinkered around with any in terms of brain performance for that.
Jackson Nguyen:Yeah, because I don't know personally on TV, I see so many ads on these various supplements and it's like myself, I'm like, do they actually even work?
Dr. Krystal Culler, DBH, MA:And you know, know people that have tried different ones I can share for, I was going to write a blog a couple of years ago. I was on Namenda, which is an Alzheimer's drug a couple of summers ago because a secondary use of that is for migraine treatment. And so I spent the summer seeing if it would help with my headache prevention med. It did not, but I had joked. I said, this is going to be really interesting to explain to insurance a few years because it took a while to get approval and then go, but then since it wasn't effective for me personally, there are some small trials that showed it was helpful for other people.
Dr. Krystal Culler, DBH, MA:I had titrated off, but I was like, this is going to be really interesting to be in my medical record a few years down the road. So all these trade offs, right. But as to be middle age, 36 and be on an Alzheimer's drug. And I remember when my neurologist approached me, she's like, keep an open mind. And I'm like, okay.
Dr. Krystal Culler, DBH, MA:And I went and I read the studies and I said, things are worth a try and you have trial periods, but you know, you gotta work with your providers for where you're at and make some decisions.
Jackson Nguyen:Yeah. And now moving back to our conversation of brain health, what's one thing that you wish people would stop doing for their brain and one thing you'd wish they start?
Dr. Krystal Culler, DBH, MA:I think one thing I wish they would stop doing is neglecting it because it always seems to be an afterthought. And so I think, and the one thing I think they would start doing is prioritizing it. And I really think for most of it is this conversation is we've never really had to make decisions with our brain in mind. And I would say for the average person, you don't, unless you live with a brain based condition. If you live with a mental health diagnosis, the conversation may look different because you think, or you make decisions differently about your brain or unless you maybe have a diagnosis of a chronic health condition, then you start to realize how certain things then impact your brain.
Dr. Krystal Culler, DBH, MA:But I would welcome more people to not neglect their brain and to start to prioritize it. Even when you start to think just one more Netflix show, you have a consequence the next day from that one more Netflix show. And we all know that, right? We, we know that when we do these trade offs, but to have a little bit more awareness, because it's very easy to fall into that trap of when you start to make those decisions a couple more times each day that we get into this bad loop of habits that are detrimental to our brain versus, you know, there there's always trade offs, but how can you start to make those decisions better in interest for your brain and start to collect on those dividends so you are feeling how you wanna feel and more productive throughout your day?
Jackson Nguyen:I I feel like I totally resonate with that because a lot of times, you know, as a student, I know sleep is really important, and I definitely want to get more sleep. But sometimes, you know, when assignments come in and then before I realize that it's, like, 2AM. And I definitely know that it's not good for your brain. And then so, like and so, like, sometimes me pulling an all nighter or, like, only a few hours of sleep, and then me the next day, I look like a zombie because I my brain is not able to think at all. And so, like, some of these decisions that we make, really affects our brain health.
Jackson Nguyen:Because a lot of times, I feel like we really wait until we get diagnosed with some sort of brain health related condition in order to actually make the decision to take better care of our brain. And so I am really inspired by it's important to start taking care of your brain health starting today, by resting, by sleeping, and taking good care of your heart. That would translate to good care of your brain, etcetera.
Dr. Krystal Culler, DBH, MA:Yeah. And I hope people do get inspired to do that. I think of years ago when they did the genetic testing became available on like Ancestry and 23andMe, and they did the APOE4 testing and I'm like, might as well, it's part of the kit. And I'm sitting there waiting for my results thinking there was already Alzheimer's and dementia in my family. And then I kept telling myself, what would it matter if it's positive or negative?
Dr. Krystal Culler, DBH, MA:It's not necessarily indicative that yes, I won't get Alzheimer's or dementia. It just means you are at a higher risk profile. I already know slightly at a higher risk profile because it is in my family anyways. But I was sitting there like, I know the information. I know more than the average person because I read these research articles for fun.
Dr. Krystal Culler, DBH, MA:This is what I do in my leisure time. I read these books. I read these articles, but the honest conversation I had of myself is like, what would I do differently either way, based on the results? And it came back to, I know there are lifestyle things I can do now. Would I be perfect?
Dr. Krystal Culler, DBH, MA:Likely not. I could always exercise more. I could always eat better, but I can make these small improvements in these gains. And that's what I started to do. Slowly yet surely made different swaps in the kitchen, did some things around my office.
Dr. Krystal Culler, DBH, MA:So my desk is a little more comfortable and I have a standing desk and a walking treadmill. I can add in movement throughout the day now that I work from home and just started to make those changes now. Cause I thought I don't have to wait on this test result. I don't have to wait for if it's positive or negative to say, I don't need to worry now. I can still wait a few more years or a few more decades.
Dr. Krystal Culler, DBH, MA:It's like, no, I could do these things now. And overall I can start to feel better.
Jackson Nguyen:I personally think of the brain as sort of like a diary where everyday choices you make are recorded over time, whether that's for better or worse. But habits, especially bad ones, can be really, really hard to change. And so I'm wondering, what's your recommendation for people to make these changes effectively to better take care of their brain health?
Dr. Krystal Culler, DBH, MA:Yeah, I'm so glad you shared that. It's to honor that behavioral change is not easy. If it was easy, everyone would be out there healthy all the time. And I mean, I think we see this reflected in any type of the list of chronic health conditions we see impacting Americans or neurodegenerative diseases. It's not to just blame someone for the lifestyle or the choices that they have.
Dr. Krystal Culler, DBH, MA:There's a genetic component. There's a lifestyle component. There's an environmental component. And you know, their lifestyle that we do see is we can modify some of these things. And it's a little bit over time.
Dr. Krystal Culler, DBH, MA:I mean, it's not that we're going to eat one salad and all of a sudden be healthier. Unfortunately, that's what we like to see as Americans. We want like these quick wins and we want these fast results, but it is these small, steady, changes. And that's what we see overall in brain health. And I think that's what these latest studies are just showing.
Dr. Krystal Culler, DBH, MA:We just had the one that came out that it's not the 10,000 steps that you have to do. Three to 5,000 steps is enough on exercise. We were just seeing some studies that even just show twenty five minutes of moderate movement, meaning gentle exercise, your yoga, Tai Chi, Qigong is enough per week for people to get benefits of movement. And so there's all these different intervals that people can aim for and mobility looks different for all of us, but it's the notions of to keep moving, to focus on your breathing, to wind down, to eat better. And we all have improvements that look different.
Dr. Krystal Culler, DBH, MA:I think that's the one that we will probably uniformly agree to disagree on what a healthy diet looks like, because there are so many individual factors, but fortunately all of the brain health diets, whether it's the MIND diet, the Mediterranean diet, the MIND DASH diet, they all have the overarching components of basically eating the rainbow, healthy fats, less red meats, limiting your sweets, but you know, following these general guidelines and making the slower incremental changes. And I think when it comes to that is you have to find what works for you and then finding the professionals or healthcare supports or professional supports that will help you work. It's just like, if someone gave me an exercise program, it was like, you have to go do CrossFit. It would never work for me because with migraine high intensity and like getting my head below my knees a lot does not work for me and like my health conditions. If it went to you, maybe you would love it, but other people it's like, you know, one type of prescriptive thing doesn't work, but it's like, find what works for you and something you enjoy and build on it.
Dr. Krystal Culler, DBH, MA:And then what we know in brain health is being open to trying something a few times and then maybe say that's not for me, but Hey, you try something new with a friend that, you know, that this idea with adults and learning is being open to new experiences, trying something a few times. The first couple of times is to like get over our fear in the first place of something new, being around new people and, you know, keeping that open mind because our preferences and our lifestyle is going to change over time. That fitness routine we may have in our twenties will look different from 40 to 60 and 80, and it's going to have to involve. And unfortunately that's what a brain healthy lifestyle looks like. It's chronic iteration.
Dr. Krystal Culler, DBH, MA:And so to just encourage us all those little tiny, little tiny improvements, but to keep it consistent and don't try it all at once. Pick one little thing and start there.
Jackson Nguyen:I'm actually wondering, do you think we're like lowering the bar in some way where I feel like, because initially, you know, the American Heart Association, they were recommending like 10,000 steps a day, and now it's 5,000 or 3,000 steps is enough. But I feel like back then, let's say back to the hunters and gatherers, I feel like they've definitely walked a lot. And I feel like humans, we have evolved to become so sedentary in a way. And so now we have to be much more proactive to take good care of our health, the brain health. Because I feel like back then, let's say back before when phones or stuff were invented, humans were much more socially connected with each other.
Jackson Nguyen:And now with phones, at the same time, technology can be helpful, but at the same time, it could also be harmful. And so now it's making us more in our own bubble and isolated from each other, even though you might be connected through Facebook or Instagram and stuff. But sometimes people, even though interacting with those social media, you can still feel lonely. And obviously that could be really detrimental to your brain health. And so I'm just wondering, I don't know, as a society, are we getting worse at taking care of our brain health?
Jackson Nguyen:And now we have to be much more proactive in order to actually take care of it.
Dr. Krystal Culler, DBH, MA:I think you highlighted all of the struggles and conversations that we have in the broader brain health space. And a lot of it is, you know, our world and technology has evolved so quickly and our brain and our biology has not. And, you know, we weren't designed to technically navigate this world that we are in, especially the brain and the body in this technology and the demands that we are in. And it's almost like you said, we're going backwards. We're going back to these basic practices and it almost sounds silly in some ways where we go back to brain health and it seems counterintuitive where I feel like when I do presentations and I have up the slide and it's like the brain health basics are to breathe, to move, to nourish, to connect.
Dr. Krystal Culler, DBH, MA:And we've lost track of those things through the hustle and bustle of lifestyle and culture and the pace of life. And of course this looks different globally. You know, a lot of this is US imposed. If you go to other countries, there's different layers of what brain health looks like. So the global conversation looks different in certain areas of the world as well.
Dr. Krystal Culler, DBH, MA:And to acknowledge that, but I think so much of it is going back to these basics. And when you've read so many of the different books or when you hear other experts speak, it's like, we have lost sight of that. But if you also think about it, has anyone actually ever taught you how to breathe intentionally? You may have learned it if you've played a musical instrument or if you've been a vocal swimmer, I mean, vocal singer or a swimmer, or if you've played sports for elite athlete or a long distance runner, you may have learned it in the context of that, but to actually just learn to sit and breathe, or it's counterintuitive. If someone tells you to just sit and be by yourself for a few minutes, how awkward that feels to so many of us, let alone little kids that are growing up on technology.
Dr. Krystal Culler, DBH, MA:The idea when they're like, I'm bored and it's like being bored is not a bad thing. It's actually a really great thing for our brain. And we have to encourage those moments and create these spaces where we're bored and we're tinkered. It's like you said, we're going almost backwards and then we're also having to reteach ourselves and let us know, like break down these societal stigmas and the messaging we've had to be like, it's okay to sit and just be, it's okay. We're having to redo a lot of that, like you said, and then for the social connection piece, just reminding people that there's different types of connection, how important and vital that is for our health.
Dr. Krystal Culler, DBH, MA:That's kind of the next wave of the, I think health and well-being is that's been a part of the World Health Organization's definition since like the 90s. And yet we've missed that pillar of health and well-being, Angel piece of the brain health conversation as well.
Jackson Nguyen:Thank you so much for your insights on that. Next, I want to shift gears a bit into looking at Alzheimer's and dementia, but in the context of brain health. And I was wondering what does like dementia personally mean to you, Doctor. Color?
Dr. Krystal Culler, DBH, MA:Yeah, I think for me, for this conversation, it it's changed a lot over time. When we used to talk about brain health, it was separate from Alzheimer's disease. And I still think today a lot of people will go from brain health to memory to Alzheimer's. It's just like this, like a leapfrog. Like we just jumped these topics and not realize it's this whole continuum and you can have a dementia diagnosis, or you can have an Alzheimer's disease diagnosis or anything that's related to the brain and brain health is still a right to you.
Dr. Krystal Culler, DBH, MA:You can be brain healthy with dementia. You can be brain healthy with MS. You can be brain healthy with anxiety or depression. Brain health is a right to all of us, and you can still have this brain healthy lifestyle and do these elements of brain health. It may look different for where you are at somewhere on that continuum for you.
Dr. Krystal Culler, DBH, MA:And that's kind of been where my work has been is translating what brain health looks like for people with dementia. It's been from earlier stage, whether it's mild cognitive impairment up through about in the community, stage, and then into some in senior living across the continuum from independent living up to nursing home care. Translating what does brain health start to look like in terms of programming and environmental supports, but advocating that we all have a right to brain health. And what does that look like for care partners? What does that look like for staff?
Dr. Krystal Culler, DBH, MA:And I think that leads back to where we've talked before that brain cares for all of us. And it's been interesting to see that conversation shift and realize that brain health, this big broad brush stroke and everybody is under that. But before it was like separate, it was separate in its own area and Alzheimer's and dementia was its own field too, but realizing they're together now. It's more cohesive than once And
Jackson Nguyen:speaking of these like brain health, like interventions, because recently, The US POINTER study, which is a large scale two year randomized control trial that was by the Alzheimer's Association, their purpose was to assess the effect of these various lifestyle interventions, diet, exercise, heart health, cognition, and social engagement on cognition. And so results that they shared from the twenty twenty five Alzheimer's Association International Conference this year, they have shown that these numerous lifestyle interventions have shown incredible promise and helped older adults improve their cognition. And so I would love to hear your insight into some of these lifestyle interventions and how do these interventions align or not align with some of the brain health strategies that you advocate for.
Dr. Krystal Culler, DBH, MA:Yeah, and I think to summarize their results, they put out a US brain health pointer. They call it a brain health recipe, which summarize like their intervention and they put forward, you want a physical exercise for thirty to thirty five minutes, moderate to intense exercise, cognitive exercise, and they used brain HQ, brain training exercise for about thirty minutes plus regular engagement and lifelong learning. So intellectually stimulating activities. They did nutrition where people followed the MIND diet, which is one of the rigorously studied diets under the brain health umbrella. And then they encourage people to monitor their health.
Dr. Krystal Culler, DBH, MA:And so regular check ins with healthcare providers. So monitoring chronic health conditions that are common under the broader brain health space, like your blood pressure, weight management, and your annual lab results. And so those four things combined are the main part of their brain health recipe. So kind of similar to what I shared with you on our thirty minutes, the physical exercise, the cognitive exercise, focusing on nutrition and monitoring your health. And this really mirrors a lot of the other areas that we focus in on brain health.
Dr. Krystal Culler, DBH, MA:So those, I think areas of your health where you put in an investment gives you a high reward. And so I think that's a nice one for people to remember pretty easily. Physical fitness and brain fitness are huge. So engage the mind and engage the body to get a lot of an investment for your overall brain health and well-being.
Jackson Nguyen:Yeah. And in terms of these various numerous like brain disorders, like neurodegenerative ones, like Alzheimer's, dementia, ALS, and so forth, which are progressive. Unfortunately, they do not have care. So I feel like these various brain health strategies are really excellent for people who are still at the early stage, and those who have not you know, have that condition yet. And so they're making good choices right now so that ultimately that could delay the risk of some of these neurodegenerative diseases.
Jackson Nguyen:And so but for those with these conditions, like, what are some of your recommendations for them to take good care of their brain despite having the diagnosis?
Dr. Krystal Culler, DBH, MA:I think it leads back to a lot of these brain healthy lifestyle factors and it's multimodal, right? And so even if you are living with something with neurodegenerative, it's working with your providers to focus in on those lifestyle risk factors. So movement may look different if you're living with a neurodegenerative disease, but what type of movement are you able to engage in safely? And what is, what will your providers recommend? What may be the dietary recommendations that they may have you work with someone to be able to do and focusing too, I think when it comes to these areas or two areas of health that you recommended earlier was the social health and the spiritual health component tends to be very important for individuals navigating chronic health conditions.
Dr. Krystal Culler, DBH, MA:And so sometimes it may be getting involved with groups for additional support, being involved through still through volunteerism, whatever that looks like for you, but leaning in on those other areas of your health and well-being and making sure that those are still strong for you, because sometimes we may have the opportunities where we want to disengage from those areas of our health. And there's a time and a place where that may happen. But if that's still important to you, if your social health and your social butterfly in those things, finding those moments or looking at ways you can reengage into those groups to make sure that area of your health is still supported, even though it may look different and prioritizing that. So I think looking very broadly at what are those pillars of health and adjusting those goals to meet you where you are and working with the providers that can help you do that. Sometimes social workers can be a great resource, peer support.
Dr. Krystal Culler, DBH, MA:National organizations. If you have a specific diagnosis, like an MS society, ALS groups, Alzheimer's association has great resource groups and support groups and getting engaged in and meeting others that sometimes are navigating the same journey as you. I've seen great friendships spark from that. I've had the opportunity to support some individuals in those peer led groups where we've done educational groups and watched great friendships flourish from that.
Jackson Nguyen:That's incredible. And as we start wrapping up, if our listeners today could remember just one takeaway from this entire conversation we had, like, what would you want it to be?
Dr. Krystal Culler, DBH, MA:Do one thing each day that's better for your brain. Keep it simple. And if you're able to start to make those decisions to prioritize your brain, you're going to start building those habits, not realizing it. But I think if you start out with that intention of one thing a day better for your brain, you're gonna start seeing the success over time.
Jackson Nguyen:And if our audience would like to learn more about you, your podcast, and the Virtual Brain Health Center, how could they reach you?
Dr. Krystal Culler, DBH, MA:We keep it very simple. We're at virtualbrainhealthcenter.com and you can find everything easily on our website.
Jackson Nguyen:And I was wondering what's next for you in 2026? What's something that you're excited for that's coming up?
Dr. Krystal Culler, DBH, MA:We are in the midst of planning our large Brain Week event. So people, it's our sixth year doing brain week, which is crazy for me to say, but we plan that it will be March 9 through the thirteenth. And so we usually have 15 free programs for people to check out with experts from neuroscience all across the world. So people can check that out. The countdown will be up on our website soon, and you can register to see that they're all my favorite word.
Dr. Krystal Culler, DBH, MA:They're free and accessible for anyone to join in. That's our big give of the year where we collaborate with lots of partners and Jackson, we're going get you involved, so they'll see you and your podcast there too.
Jackson Nguyen:Awesome. Doctor. Kuller, it's been such a pleasure to be with you today. Thank you so much for sharing all your insights, your experience, and empathy with us on today's episode. I really appreciate you a lot.
Dr. Krystal Culler, DBH, MA:Thank you so much for having me.