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

Hello, boys and girls, ladies and germs—Tim Ferriss here. Today I’m chasing ultra‑practical playbooks for brain performance with Dr. Tommy Wood, a pediatrician and neuroscientist at the University of Washington, head scientist for F1 drivers, co‑host of Better Brain Fitness, and author of The Stimulated Mind.

We’ll range from newborn brain injury to adult cognition, flag what’s solid science versus thin ice, and stack the best low‑risk moves you can actually use. Quick teaser: yes, I’m chewing xylitol gum and eyeing air purifiers, but first—why are human babies so plump?

Human newborns are uniquely fat because that stored fat fuels ketone production and delivers DHA to a rapidly growing brain. Ketones support brain construction and energy during early development and likely help during recovery later in life.

You study newborn brain injury—what’s state of the art right now?

Two big injuries dominate: prematurity and a birth event that cuts blood and oxygen to the brain. For the latter, cooling to about thirty‑three and a half degrees Celsius within hours for three days reduces death and disability; prematurity is different—cooling can harm, but caffeine for breathing issues surprisingly improves later cognition, and the home environment after discharge carries huge weight for long‑term outcomes.

Jumping to adults: if I smash my head and get a bad concussion, what would you actually do?

Keep temperature down and avoid fevers, steady blood sugar and skip big glucose spikes, and don’t slam sports drinks right after the hit. I’d add creatine, omega‑3s, possibly exogenous ketones, riboflavin and branched‑chain amino acids to help sleep, melatonin if needed, avoid caffeine early, and return to light aerobic activity as soon as symptoms allow, building up without aggravating them.

Why does that early movement help?

Better blood flow, beneficial myokines, and improved sleep likely drive it, with strongest evidence in youth sports concussions, so long as intensity doesn’t worsen symptoms.

Side quest: what did you weigh for your off‑road Ironman and for Strongest Man?

I raced the off‑road Ironman around one‑eighty‑five pounds, and cut to just under one‑ninety‑eight for middleweight Strongest Man, though I sit heavier in daily life.

Back to DHA—why is it so central, and how should people get it?

DHA clusters at synapses and inside mitochondria, supporting signal release and energy capacity, and it also feeds anti‑inflammatory, pro‑resolving molecules that help shut off runaway immune responses after injury. One to two grams of DHA daily or two to three seafood meals a week is a practical target, and the body can store extra in fat tissue for later release.

Where do omega‑3s meet homocysteine and B vitamins for brain health?

Omega‑3 benefits show up when methylation is sufficient; trials found B‑vitamin therapy helped only in people with adequate omega‑3 status, and omega‑3s helped when homocysteine was low enough. Methylation is needed to anchor DHA into brain cell membranes, so both pieces matter.

Let’s ground this in Alzheimer’s—who was Auguste Deter, and why does she matter?

She was Alois Alzheimer’s index patient—her brain revealed plaques and tangles—but her case was early and unusual, and she might not match today’s late‑onset Alzheimer’s. Early‑onset forms are often single‑gene; the common late‑onset version is heavily shaped by lifestyle and environment, even for those with genetic risk.

I’ve seen claims that nearly half to most dementia is preventable—how real is that?

The Lancet Commission attributes about forty‑five percent to modifiable risks across education, hearing, blood pressure, activity, smoking, alcohol, and more, with sleep and late‑life exercise likely adding further. With broad societal change it could approach seventy‑plus percent, but it’s probability, not a guarantee—still, you can tilt the odds hard in your favor.

Here’s my n‑of‑1: intermittent fasting, keto and ketone esters sparingly, CGM, omega‑3s, B vitamins for methylation, zone work, daily walking, and strength training; MRI suggests a young brain age, tests look great—what else should I emphasize?

Ketones look promising as therapy, but for prevention I’d focus more on demand than supply—underuse may explain low glucose uptake early on, not just blocked fuel. Push the brain to ask for energy by engaging complex, skill‑heavy activities.

Which activities best drive that demand?

Open‑skill, coordinative movement beats steady‑state for brain benefits—dance stands out, and team ball sports or non‑head‑contact martial arts are great too. The mix of skill learning, reaction, navigation, social input, and sometimes music seems to amplify the effect.

You flagged brutal VO2‑style work changing the hippocampus—how much is enough?

Months of Norwegian four‑by‑four training improved hippocampal structure and the gains lasted years, likely via lactate‑driven BDNF signaling; you don’t need that exact protocol, but you do need frequent efforts that generate serious lactate.

Any simple way to gauge that intensity, and should we measure lactate?

It should feel miserable during hard repeats—short all‑out efforts with long rests or high‑rep sets with blood‑flow restriction will get you there; continuous monitors are coming, but you don’t need them to reap the benefits.

Beyond the usual suspects, what supplements actually move the needle—CDP‑choline, xylitol?

Cover fundamentals first: omega‑3s, B‑vitamins for methylation, vitamin D, iron if low, magnesium, and polyphenol‑rich foods. CDP‑choline in the five‑hundred to one‑thousand milligram range has evidence in mild decline and TBI, and I take ten grams of creatine daily—quality monohydrate—since it reliably supports cognition and recovery for me.

Travel training hack—what’s in your gym bag, and how do you use BFR?

I pack BFR cuffs and sturdy bands, then run ten to fifteen minutes of high‑rep sets with short rests for legs, push, and pull; it maintains size and strength shockingly well and is rehab‑friendly. You’re restricting venous return, not arterial inflow, and the burn is real without heavy loads.

Last one—music and languages for brain health worth the time?

Yes—dance, language learning, musicianship, art, and even strategy video games tighten aging‑sensitive brain networks on EEG, and bilinguals show stronger executive control and delayed dementia. Even app‑based language practice in older adults improves key cognitive functions when you truly engage with it.

I’ve always bombed the one‑second number span tests, but I crush response inhibition tasks like the Stroop, which might tie to juggling languages. Same with tango back in Argentina—hours a day, fully improvised, listening hard, reading the music in real time—so I’m curious if careful listening alone, not just making music, can reshape the brain.

I’m the same: average on most cognitive tests, oddly strong on response inhibition, and I grew up multilingual. Studies suggest engaged listening and music theory training can deliver brain benefits close to playing an instrument, so focused, active listening matters.

With tango you can’t fake it—you’re tracking the band and remembering patterns on the fly. Switching gears, I want to flag two things tied to brain aging: act fast on hearing or vision loss, and make sure your training creates errors so the brain adapts.

Losing hearing or sight raises dementia risk, and that bump drops after cataract surgery or using hearing aids. Trials support hearing aids especially in higher‑risk folks. Mechanistically, less input shrinks function and people pull back from life, which compounds decline; congenital loss is different because the brain builds other routes. For plasticity, you need a gap between what you can do and what you’re trying to do—mistakes signal the system to rewire, like lifting to failure for your cortex.

Okay, non‑negotiables. I love climbing for the moving puzzle it is, but if people can’t do 47 brain hacks, what actually sticks for you?

Sleep. It’s the pillar I won’t trade. I used to psyche myself out with trackers; now I treat a rough night as a mood hit more than a performance disaster. Short runs of poor sleep mostly slow processing, not accuracy. Aim for any bump you can sustain. Practical stuff helps: stop work before dinner so rumination dies down; use a simple shutdown cue like blue‑blocking glasses; read fiction; keep it cool—I use an Eight Sleep; wear an eye mask, which even beat a face‑only “Zorro” mask in a summer study. Keep alcohol low, don’t smoke. Air quality counts too—filters like HealthMate, JASPR, Blueair sized to the room, or a Coway Airmega can lower blood pressure. High blood sugar and blood pressure are the big metabolic risks, so manage those. Oral health is huge: gum disease links to dementia via inflammation and bacteria that show up in plaques. Treat it, and consider xylitol gum or rinse to shift the mouth microbiome. And ventilate rooms—high carbon dioxide wrecks sleep quality.

Ketones also fascinate me for their anti‑inflammatory punch. Thanks for the purifier list—I’ve seen scary carbon‑dioxide data in hotels. Quick one on supplements: do you take vitamin K2?

I take a small dose with vitamin D in the dark months, and I’ll get some from fermented foods like natto when I feel brave. It’s optional if your diet covers it.

Speaking of brave, we tried fermented shark in Iceland—like ammonia punching your sinuses. My brother’s face was priceless.

That’s how it’s made edible—the urea breaks down to ammonia. I can handle it, but Swedish surströmming in a can? Open it and you’ll see why the internet gags.

Back to sleep science: what’s your take on dual orexin receptor antagonists possibly aiding amyloid clearance and long‑term brain health?

More and better sleep lowers amyloid burden over time, but amyloid is just one part of the story and a proxy for waste clearance. DORAs improve sleep in insomnia and sleep apnea and look like our best pharmacologic option now when CBT‑I and basics fail and other causes are ruled out. If you already sleep well, I wouldn’t add them just to prevent dementia. Cognitive stimulation and exercise can boost sleep quality too, which supports the clearance you want.

You wrote The Stimulated Mind—why take that on, and who’s it for?

It’s for anyone with a brain. The subtitle is about preventing dementia, but it’s equally about getting your mind to work better now. I focus on the big levers with evidence in humans and cut out the endless lab‑test laundry lists. It’s deeply referenced so you can check every claim. And I lay out a model for real life: change one area and the whole network shifts. Sleep better and you’re more social, more cognitively engaged, with better blood sugar and pressure. Small moves compound.

Find it wherever you buy books. Online, DRTommyWood.com is home base, and Instagram is @drtommywood. The old X handle is @DrRagnar, but you’re not really posting there. Anything you want to leave folks with?

If you read the book and disagree with any interpretation, tell me. Every point is cited so you can dig in, and I’m happy to learn.

Tommy, thanks—so many takeaways I’ll use. Show notes are at tim.blog/podcast. Until next time, be a touch kinder than necessary to others and to yourself. As Jack Kornfield reminds us, compassion that excludes you isn’t complete. Thanks for listening.