#177 – Alzheimer’s & dementia: Optimizing metabolic health to boost brain health | Emily Stong & Ben Grynol

Having good metabolic health can help you develop positive brain health and reduce your risk of developing Alzheimer’s or dementia. Emily Stong talks with Ben Grynol about how to take care of your brain and how using a CGM helped her throughout her pregnancy while living with gestational diabetes. Look for multiple new shows per week on A Whole New Level, where we have in-depth conversations about metabolic health and how the Levels startup team builds a wellness movement from the ground up in the health and wellness tech industry.

00:45 – Emily’s gestational diabetes diagnosis

Ben introduces Emily Stong and her experience with being diagnosed with gestational diabetes during her first pregnancy.

When Emily Stong was 36, she was pregnant with her first child. She walked into her doctor’s office and was notified of gestational diabetes. She had been given a diagnosis that she wasn’t sure what to do with. Well, the information she got from her doctor wasn’t that thorough. It was a piece of paper that said, “Hey, here’s how you should think about things like diet. Here are some ways you should make different lifestyle choices given how you manage gestational diabetes.”

04:31 – What Emily learned from her past pregnancies

Emily recounts her experience with her past pregnancies, noting how unprepared she was for the diagnosis during her first pregnancy.

Sure. Well, with my first pregnancy, I just wasn’t as educated. I got pregnant. I was having a baby. Great. I didn’t overthink it. And I was shocked when I was diagnosed with gestational diabetes. I had heard anecdotally from many people, “Oh, it’s no big deal.” But still, when you get that diagnosis, weirdly, it feels like a failure. I consider myself reasonably health literate. But the instructions I got from the doctor were very formulaic. And I was reeling a little bit from the diagnosis, which is funny to think back on because it’s common. But I didn’t feel equipped at all the first time. And I don’t think I did it well.

08:53 – Feeling defeated despite your best efforts

Emily describes the feeling of failure that she experienced as she realized that her best to take care of herself was not enough.

But it feels like a failure. You think you’re doing everything well up until then. You’re healthy. You’re taking your prenatal supplements. You’re trying to stay active. And then, you start looking up gestational diabetes and the impact it might have on your baby. And then you also read that you could be predisposed to diabetes after the pregnancy, later in life. None of its good news. With the dots the first time around it, I didn’t think the doctor’s office connected for me. I think they just told me to eat like a person with diabetes. I guess I was instructed to limit my carb intake. I even forget. I think I got a handout. I think it was a printed sheet of paper. I know it was a printed sheet of paper with a sample meal plan. And I didn’t know how to extrapolate that into my everyday life for the next couple of months. And it was defeating.

14:16 – The threat of belittling gestational diabetes

Emily explains the danger of reassuring other expecting mothers not to worry about gestational diabetes, which can also affect their babies in the long run.

But what is eating healthy? For some people, eating healthy is still avoiding a lot of fat. For some people, eating healthy is, I mean, picking your diet. I mean, we can all become a little draconian, too. So it’s just across the board. But I think the general message is reassuring the other expectant mother and saying, “Don’t worry about it,” which is risky because there are health impacts from gestational diabetes. And I can’t quote the statistics. But your child could be more likely to suffer from Type 2 diabetes later in life or more prone to obesity. I mean, there are health implications. If not managed, you’re more likely to develop Type 2 diabetes later in life. I don’t know the statistic for the number of women who have gestational diabetes and transition to Type 2, but it was alarmingly high when I read about it. And I wish I’d looked that up in advance of this call.

17:50 – Emily on sharing her learnings based on her health

Ben asks Emily about her experience sharing the information she learned with other women in a similar place.

Yes. This is something I think about a lot. I have this information now because I can take advantage of this technology. In the message boards, I’m less flag-waving in the way you might think. I was more general. I encourage women to take it seriously. Eat for… I would say things… I’m trying to think back. But I would say something like, probably, “Don’t listen to people who tell you not to worry about it. There’s a reason you were diagnosed with it. But it doesn’t have to be a huge deal if you know how to manage it.” And things like, “Make sure you’re eating plenty of greens, fiber, and protein.” Go to this place for… I would direct them to other resources. I wouldn’t give the same advice I received: don’t worry about it. I would say, “Do worry about it. There’s a reason you got the diagnosis, but it’s manageable. Don’t worry.”

22:24 – Taking your lifestyle choices seriously

Ben talks about how it can be daunting for other people to learn more about the importance of taking care of their metabolic health through the right lifestyle choices.

But it’s so funny, though, because in these cases, when anyone is on the edge or frontier of anything, so CGM frontier, it doesn’t matter what, any technology or what anything is, when people are trying to spread specific messages, it can feel a bit sometimes isolating, because you’re almost an outlier where people are like, “What are you talking about?” I mean, even when educating people about metabolic health and why it matters, it’s even though the views might be balanced. It’s just objectively stating things, here’s some science, and here are some findings, which is why it matters. People can look at those views as being so extreme. The message is not to avoid everything in the world at all times. But you might say, “Hey, we should think long and hard about our lifestyle choices, specifically around things like diet.”

25:46 – Brain health and its relationship with common glucose spikes

Emily explains how brain health can be affected by common glucose spikes. She explains how Type 3 Diabetes and Alzheimer’s can correlate during the later stages of life.

But like you said, sometimes it’s referred to now as Type 3 diabetes. And the idea is that the western diet, and these common glucose spikes, contribute to dementia or Alzheimer’s later in life. I’m sure a lot of Levels listeners are familiar with, I believe, Dr. Lisa Mosconi, who explains that the impacts of Alzheimer’s are seen maybe in your 60s. But what’s leading up to that is happening during menopause or premenopause for women in their 30s and 40s. And that’s me. I’m right in that target area. And now I have two little girls. And I’m thinking about protecting my brain health when they’re older. I didn’t have kids when I was in my 20s. I had daughters at 36 and 39. I can’t afford to be casual about my brain health and lose it in my 60s.

30:14 – Weight gain and its relationship with brain health

Emily talks about how weight can affect your brain health and how weight management focuses more on image than health.

And that makes you sit back and think because, for most of my adult life, I’ve viewed food as I think most people do. Sometimes my enemy. Occasionally it contributes to weight gain. Or it was always considered a weight struggle. That’s what I equated unhealthy food with. Not so much, not my brain. Not my actual health. But undesirable weight gain. But our brain is, I mean, you can’t replace your brain. You can’t diet off the damage you do to your brain. So that made me connect preventative care and eating for preventive care, like the CGM has, in a way that nothing else did. Because I mean, sure, there’s a lot of messaging in society about losing weight. I mean, we all know that. We’re a very image-conscious society. But that didn’t make me a healthy eater. But the fear of compounding damage to my brain did.

36:01 – Type 2 Diabetes in children

Ben talks about how unhealthy food choices for children have been affecting their brain health at a cellular level, causing the development of Type 2 diabetes at earlier stages of life.

Not to be too hyperbolic about it, but you start to realize, when talking from a pediatric standpoint, the effects of children developing Type 2 diabetes earlier and earlier. And you go, “Oh, that’s driven by the… What’s it? The cranberry apple juice, the Ocean Spray stuff.” It’s like you see kids that are drinking that every single day. And having just too many sweets and too many highly-processed carbohydrates. And you go, “This is impacting health at such a young age.” What do you expect will happen on the cellular level as kids develop their brain health? That is not going to help anyone at any age. So it’s the earlier that we can set these foundations for our kids, you being a mom, and the more that we can instill this education at a young age, the more that we can generate awareness within our circle so that that can start to spread.

40:03 – The importance of food education in school systems

Soon after discussing the prevalence of Type 2 diabetes in children, Ben and Emily move on to food education in school systems.

So if you’re bringing that back to what you’re saying about the school system, let’s remove the meals in the school system, just the foundation. A child starts their day off and might have some breakfast that isn’t providing them with an excellent foundation to have as balanced emotions as young kids can have. How are we supposed to expect them to learn and retain information when you’re setting them up in a deficit to begin with? It’s wild to think about.

Emily Stong (00:06):

Most of my adult life, I viewed food as most people do. Sometimes my enemy. It might contribute to weight gain. Or it was always viewed as a weight struggle. That’s what I equated unhealthy food with. But our brain is just, I mean, you can’t replace your brain. You can’t diet off the damage you do to your brain. So that made me connect preventative care and eating for preventative care, in a way that nothing else did. Because, I mean, sure there’s a lot of messaging in society about losing weight. I mean, we all know that. We’re a very image conscious society. But that didn’t really make me a healthy eater. The fear of compounding damage to my brain did.

Ben Grynol (00:45):

I’m Ben Grynol, part of the early startup team here at Levels. We’re building tech that helps people to understand their metabolic health. And this is your front row seat to everything we do. This is A Whole New Level. When Emily Stong was 36 years old, she was pregnant with her first child. She walked into her doctor’s office and she was notified of gestational diabetes. She had been given a diagnosis that she wasn’t really sure what to do with. Well, the information that she got from her doctor wasn’t that thorough. It was basically a piece of paper that said, “Hey, here’s how you should think about things like diet. Here’s some of the ways that you should make different lifestyle choices given the way that you should manage gestational diabetes.”

Ben Grynol (01:46):

And so Emily turned to things like forums, things like message boards. She found other women who were pregnant and going through a similar experience on Reddit. And a lot of this information was helpful, but also not helpful in some respects. She would find some women that would say, “Hey, you should take this seriously.” And other women, sometimes even in her inner circle, those she would work with would say, “Ah, it’s not that big of a deal.” Well, the further along that Emily got in her exploration of things like metabolic health, glucose regulation and understanding the implications of having certain foods, especially while pregnant, well, the more she learned, the more that she became concerned about spreading this education and awareness. And so Emily came across Levels and started to monitor her glucose levels so that she could understand what was happening in her body in real time.

Ben Grynol (02:34):

One of the things that she’s really focused on, too, is this idea of longevity. How can she create positive brain health for the long term? And so Emily’s currently doing her doctorate. She’s based in Atlanta. And she’s doing her doctorate in public health education. And she’s very focused on the idea of brain health. How can she optimize for the long term? And how can she help to provide more education for those around her? She’s very much driven to spread this message far and wide, especially starting at the foundational level, that being her kids, surrounding them with the right support systems and the right conditions so that they can learn early on and optimize their help. Anyway, this is a very important conversation to have with Emily. Here’s where we dug in.

Ben Grynol (03:21):

So let’s kick this one off. This is what we know. We know that you are based in Atlanta and you are a mom of two. You had your first daughter at 36. And some of the interesting things that were uncovered, your member story is on our blog, but you talked about gestational diabetes and your experience going through that. So why don’t we go back and get into some of your background.

Emily Stong (03:49):

I’m from southwest Florida. And I bounced across the country for a while. And then I went into the Peace Corps. And then I moved to Austin. And then I got a job at the CDC in Atlanta. So now I’ve been here about 10, 12 years.

Ben Grynol (04:08):

And so you ended up having your first daughter in Atlanta by the sounds of it.

Emily Stong (04:11):

Yes. Yes. Both my girls are Atlanta born.

Ben Grynol (04:15):

So when you were going through your pregnancy, what did that look like as far as your health and wellness journey? I know you had highlighted that gestational diabetes was something that was on your radar and something that you were experiencing. And so why don’t you walk us through that.

Emily Stong (04:31):

Sure. Well, with my first pregnancy, I just wasn’t as educated. I got pregnant. I was having a baby. Great. I didn’t think too much about it. And I was really surprised when I was diagnosed with gestational diabetes. I had heard anecdotally from a lot of people, “Oh, it’s no big deal.” But still, when you get that diagnosis, weirdly, it feels like a failure. I consider myself reasonably health literate. But the instructions I got from the doctor were very formulaic. And I was reeling a little bit from the diagnosis, I think, which is funny to think back on, because it’s common. But I really just didn’t feel equipped at all the first time. And I don’t think I really did it well. I think I listened more to people who were like, “Don’t worry about it.” When I tried to follow the directions, I just didn’t have the information. I wasn’t as empowered.

Emily Stong (05:40):

And so the second time, I started paying more attention to influencers. I think so many of us do. And I started to pay more attention when people spoke about gestational diabetes. And I researched it a little, even though I was past my first pregnancy. And I really started, because I became a mom, I started to pay attention to brain health. And that was the big thing that really led me to Levels and CGMs in general. And so I had been using a CGM for about three months. I mean, I’d been using Levels for about three months before I got pregnant the second time. And I was perfectly prepared this time to be diagnosed with gestational diabetes. And yet I wasn’t, even though I think I should have been. I think that was a mix up with the lab results. But I treated my body. Now, I just, in general, treat my body like I should have with the diagnosis. I now eat for blood sugar, to keep it level.

Emily Stong (06:47):

And I mean, this isn’t like a rabbit hole you would go down. But if you’re on a subreddit for pregnant or expectant moms, so many women are lost. They’re like, “I just got a gestational diabetes diagnosis. I don’t know what to do,” or, “I got these instructions from the doctor. It just seems impossible.” And if you approach it a different way, it’s much more manageable. And it’s not inconvenient. So this second time around with my second, I just felt so much more empowered and equipped. And I had a much healthier pregnancy. I looked better. I felt better. And it was reflected in my blood sugar. And it was an easier birth, too, but I don’t know if that’s related at all.

Ben Grynol (07:40):

So when you got that first news, what was it like as far as, “Hey, here’s something to consider,” and you walk out? What did it look like? Were you armed with any tools? And we have to paint the picture, too, because your background, you highlighted a bit, but your background’s in public health education. So you’ve got a lens on health and wellness, at least a foundation.

Emily Stong (08:06):

Yes. I mean, I should be clear, nothing I talk about is related to my job at all. But I work in a different field. But I do have a public health background. I’m getting my doctorate in public health now. And health literacy is some of what we study. And I did my coursework on gestational diabetes, because you’re excited all through your pregnancy. And you go in for all these tests. And you know that you have your gestational diabetes test, which is just a miserable one. They give you the most foul liquid to just chug down. And you’re trying not to throw it up. And then they take a blood test. And you go home and you hope for the best. And then the doctor calls you and tells you, “Oh, hey, you failed. You have gestational diabetes.” And I think you have to go in again for another control test. I forget. It might depend on the practice.

Emily Stong (08:53):

But it feels like a failure. You think you’re doing everything well up until then. You’re healthy. You’re taking your prenatals. You’re trying to stay active. And then you start looking up gestational diabetes and the impact it might have on your baby. And then you also read that you could be predisposed to diabetes after the pregnancy, later in life. None of it’s good news. With the dots the first time around it, I didn’t think the doctor’s office really connected for me. I think they just told me to eat like I was a diabetic. I think I was instructed to limit my carb intake. I even forget. I think I got a handout. I think it was a printed sheet of paper. I know it was a printed sheet of paper, with a sample meal plan. And I didn’t know how to extrapolate that into my everyday life for the next couple months. And it was really defeating.

Emily Stong (09:54):

And I still see that, because sometimes I’ll go on to message boards just out of curiosity. And I [inaudible 00:10:02] in the second pregnancy. And it’s defeating. It’s scary. None of it’s good news. And it’s bewildering, because you don’t wake up knowing how to eat as if you have diabetes. And you don’t get that education. It’s literally a handout. And now that I’ve looked into it more, the handout you get isn’t really that good. So starting on my Levels journey, or my CGM journey, I learned what to prioritize instead of what to avoid. And I’m just going to say, in my first pregnancy, and I think I said this in my question and answer, you get so defeated that you just kind of throw your hands up in the air and you’re like, “I’m just going to go have a Snickers bar, because I’m pregnant. I’m hungry.” And everybody says, “You can eat everything you want,” until you get diagnosed with gestational diabetes.

Emily Stong (10:49):

And then you have to be really careful, but you don’t really understand what you’re supposed to do. And a lot of it is just women educating women, because again, the instructions from the doctors are, it’s just not that great. I think we should really revisit that, how we speak to expectant mothers and the education that we give them on diet. And what’s important to prioritize, just in general. And I mean, I’ve learned a lot more. I wish I’d been told to eat a ton more eggs and sardines in my first pregnancy. But I knew more the second time around. So the second time around, I ate how I had been eating. And I prioritized nutrition over fearing that I was going to slip up, if that makes sense. Because I think everybody who uses Levels, you learn what works for you. And that’s the beauty of it. You’re getting this real time feedback on how your body’s reacting to a certain meal.

Emily Stong (11:53):

So if it was a traditional diet, you’d be evaluating yourself on how much weight you lost after a month, or after a week, or however frequently you diet. But it’s not for weight loss. It’s for eating for health. And you’re looking and you’re examining how you feel as you put food in your body. And then you’re looking at your blood test, or your blood sugar levels, and connecting that to how you choose to eat. So it really, it’s beautiful for behavior change in a way that following a meal plan on a piece of paper isn’t.

Ben Grynol (12:31):

And when you were reaching out to some of the, whether it was Reddit or different message boards, was the sentiment around support where everyone was trying to figure it out together and share things like, “Hey, I’ve figured out eating these certain foods have worked for me”? What does that look like from, we’ll call it, a micro community perspective where everyone… I mean, paint the picture. Everyone’s going through, regardless of where they are in their pregnancy, everyone is going through the experience together of being pregnant. So what did that look like as far as trying to figure out how to best navigate this diagnosis that maybe people had different levels of understanding of what it actually meant and what they could do about it?

Emily Stong (13:15):

Actually, an even smaller micro community, I can think of my office at work. My first pregnancy, when I had gestational diabetes, three of my coworkers were like, “Oh, I’ve had that.” And their advice was, “Don’t worry about it. It’s not that big of a deal. Just eat how you normally would.” Because anybody who gets a foundational diabetes diagnosis, they’re told to do the finger prick test. And I think that is really hard for people to adhere to, especially if you’re getting conflicting advice from other pregnant women saying, “Eh, it’s not that big of a deal,” or, “I kept forgetting to do it.” And so it was almost like my fellow coworkers, it was almost like, “Eh, just ignore the diagnosis. My baby was fine.” And you can’t take three other babies and draw any health conclusions, as we all know. And I kind of see that reflected on the mother’s message boards. Don’t worry about it so much. Just eat in a way that makes you feel good. Try to eat healthy.

Emily Stong (14:16):

But what is eating healthy? For some people, eating healthy is still avoiding a lot of fat. For some people, eating healthy is, I mean, pick your diet. I mean, we can all become a little draconian, too. So it’s just across the board. But I think the general message is reassuring the other expectant mother and saying, “Don’t worry about it,” which is risky, because there really are health impacts from gestational diabetes. And I can’t quote the statistics. But your child could be more likely to suffer from Type 2 diabetes later in life or more prone to obesity. I mean, there are health implications. If not managed, you’re more likely to develop Type 2 diabetes later in life. I don’t know what the statistic is for the number of women who have gestational diabetes and transition to Type 2, but it was alarmingly high when I read about it. And I wish I’d looked that up in advance of this call.

Emily Stong (15:24):

But mothers reassure other mothers. Or expectant mothers commonly reassure other expectant mothers not to worry about it. And that’s really dangerous advice, or it can be, because it is serious. And it should be taken seriously. But it doesn’t have to dominate your life. But when you get a bewildering diet plan or you get bewildering health information that you really just don’t know how to translate into everyday life, it almost feels like it’s too much to manage.

Ben Grynol (15:53):

Do you think it’s harder when you have, so we’ll make an assumption. It’s that someone that you’ve never met and is a digital avatar online has a lower level of trust until that trust is built up, because it’s like you don’t know who that person is. But somebody that you interact with, let’s say, in the office on a daily basis, or maybe friends and family that are part of a support group, the trust level is going to be immensely higher because you have history. Is it harder when people that you trust are saying things that you might disagree with? But then do you start to question it yourself, where you’re like, “Should I listen to… It doesn’t feel right, but they’re saying don’t worry about it.”

Ben Grynol (16:36):

How did you think about that, where it’s like, let’s say, there were people in the support group that are saying, “No, this matters. Pay attention to it,” and then you’re getting conflicting advice from this inner circle? How did you sort of think about that?

Emily Stong (16:51):

Wow, that’s a really good point you bring up when you think about trust and advice and people’s impact on you. I think the people I know, I have a higher trust level for them. And so it was more reassuring to hear, in my first pregnancy it was more reassuring from them to hear, “Don’t worry about it.” Now, my doctor, I should have the highest level of trust for my doctor. But my doctor didn’t give me that much information. So it really was other women who were reassuring me in the online support groups. I only really found that in my second pregnancy. And I didn’t need it that time, because I was using Levels. It was more like I was an observer there and occasionally weighing in. But I didn’t need the support the second time around, because by that time I was empowered to manage my blood sugar on my own.

Ben Grynol (17:50):

So were you starting to share some of this knowledge, where it’s almost like you’re waving this flag to a group of women and saying, “I have anecdotes. I have data. I’ve seen this. This is what you should be thinking about,” because you’re armed with new education, new information. Sure, the data, I mean, if we’re being objective about it, everyone’s data is very personalized. And what works for one person might not work as well for another. And there are so many lifestyle factors that play into glucose regulation and variability and all these great things. But there are other principles. Bring it back to the Snickers bar. There are other principles where you can now say, “Don’t just go and have a Snickers bar. That is just not going to be good for you, no matter what.”

Ben Grynol (18:40):

Were you being a little bit more vocal in trying to spread this education and message that you’d now, you’ve got this foundation and you’re like, “I’ve been through this once and here’s how we can think about it now”?

Emily Stong (18:52):

Yes. This is something I think about a lot, because I have this information now, because I’m able to take advantage of this technology. In the message boards, I’m less flag waving in the way you might think. I was more general. I encourage women to take it seriously. Eat for… I would say things… I’m trying to think back. But I would say something like, probably, “Don’t listen to people who tell you not to worry about it. There’s a reason you were diagnosed with it. But it doesn’t have to be a huge deal if you know how to manage it.” And things like, “Make sure you’re eating plenty of greens, fiber and protein.” Go to this place for… I would direct them to other resources. I wouldn’t give the same advice that I received, which was don’t worry about it. I would definitely say, “Do worry about it. There’s a reason you got the diagnosis, but it’s totally manageable. Don’t worry.”

Emily Stong (20:09):

I think maybe a couple times I probably brought up the CGM, but most people don’t have access to this technology. Until it’s more widespread, until it’s a lower price point, I think that might be hard for someone to hear, “Hey, this taught me how to do this. It’s great. You should go try it.” And then they’re like, “Well, shoot, I’m saving it for my non-existent maternity leave.” Because it can be a sensitive topic. In America, a lot of the women on the message boards, when they say they’re in the US, and most women are, people in Canada say, “Hey, you have my sympathies,” because of our maternity leave, our healthcare coverage. No, I don’t know that a CGMs free in Canada. But no, I don’t think I would talk about the CGM so much, because I felt really lucky I had it. But I know that pregnancy’s such a sensitive time. I didn’t want to bring something up that somebody couldn’t access.

Ben Grynol (21:16):

Were people receptive when you were, just from an education perspective, not necessarily about the CGM, but just when you were saying, “Hey, this does matter”? Were people receptive to it? Or, what was the general response?

Emily Stong (21:31):

Yeah, people were receptive to it, because pregnant women, and I think across the board, they want to do the best they possibly can for their baby. Even if you’re a slacker in other areas of your life, when you’re pregnant you want to do the absolute best for your unborn child. And so I think people really are receptive. I think when people told me not to worry about it, I think I listened because I wanted to be reassured. But if somebody in the office had taken me aside and said, “No, Emily, here, this is important…” I mean, I did take gestational diabetes seriously the first time. I just felt bewildered a lot of the time with it. But not even related to gestational diabetes, I’ve kind of become a blood sugar evangelist. I tell everybody about it. In fact, after listening to me for a year and a half, my husband finally signed on. He was the most resistant.

Ben Grynol (22:24):

But it’s so funny though, because in these cases, when anyone is on the edge or frontier of anything, so CGM frontier, it doesn’t matter what, any technology or what anything is, when people are trying to spread certain messages, it can feel a bit isolating sometimes, because you’re almost an outlier where people are like, “What are you talking about?” I mean, even when educating people about metabolic health and why it matters, it’s even though the views might be balanced and it’s just stating things in an objective way, here’s some science, here are some findings, this is why it matters, people can look at those views as being so extreme. The message is not always avoid everything in the world at all times. But you might just say, “Hey, we should think long and hard about the lifestyle choices we make, specifically around things like diet.”

Ben Grynol (23:17):

And people can sometimes misinterpret the intent of those views as being positive and helpful. And they’re misinterpreted as being sort this extreme position of pontification. So it is challenging, because after a while, if people come around, they’re like, “Oh wow, this took me a while to realize.” Whereas, other people might be anchored more on the position of going back to the specifically with gestational diabetes with a “Oh, I’ll just downplay it. It doesn’t matter that much,” because that’s the general sentiment that is floating. People might care, but the general sentiment is like, “It’s not as big a deal as you think it is.”

Emily Stong (23:55):

Right. No, I completely agree. And I find when I talk to people about it, I focus more on the brain health aspect, because that is speaking about the future and preventative care. And that has resonated more for me. Because otherwise, anything that’s scary or terrible, if you hear about it enough, it kind of loses its impact. But the fact that a large number of people who get gestational diabetes can develop Type 2 diabetes, that should be really scary. And it should make anybody sit up and pay attention. But I don’t know if it’s because diabetes is just so common now or if there’s a futility to it. I’m not sure. I don’t know if a doctor doesn’t want to say that in a doctor’s office, because it’s fear mongering. I don’t know.

Emily Stong (24:58):

But for me, I feel like people listen more when I talk about brain health. And for me, I have an aunt who’s diagnosed with Alzheimer’s. And so I am really trying to eat for my future brain health as well. And other people, I feel like women, because two-thirds of Alzheimer’s patients are women, I feel like when I share that statistic, I feel like people may pay more attention. Because a lot of people see it on my arm and kind of ask about it. And I’m always happy to talk about it. But occasionally, I get the eye roll, like, “Emily, calm down.” I’m like, “No, no, this is important. Did you know?” And so, I forget what your original question was, but yeah, I feel like people can kind of dismiss it.

Ben Grynol (25:46):

Why don’t we go into all of the research and work you’re doing as it pertains to brain health and Alzheimer’s? Because Alzheimer’s is now discussed as being Type 3 diabetes, where it is prevalent. There is a connection. And people are becoming more aware of the significance of managing and maintaining good metabolic health, so that long term they can develop good and positive brain health. So why don’t we dig into that a little bit more, because it is such an important topic?

Emily Stong (26:23):

This is not my professional job. This is something I’m exploring more for my coursework at Georgia State. But this idea that, sorry, I’m stuttering here. But like you said, sometimes it’s referred to now as Type 3 diabetes. And the idea that the western diet, these common glucose spikes, are contributing to dementia, or Alzheimer’s later in life. I’m sure a lot of Levels listeners are familiar with, I believe, Dr. Lisa Mosconi, who explains that the impacts of Alzheimer’s are seen maybe in your 60s. But what’s leading up to that is happening during menopause or premenopause for women in the 30s and 40s. And that’s me. I’m right in that target area. And now I have two little girls. And I’m thinking about protecting my brain health when they’re older. I didn’t have kids when I was in my 20s. I had daughters at 36 and 39. I can’t afford to be casual about my brain health and lose it in my 60s.

Emily Stong (27:31):

And so there’s this idea that, or not idea, there is, we’re starting to understand that when you have these significant glucose spikes, which we used to think only happened to people who were diabetic, but actually everybody can have them, that these glucose spikes are contributors in affecting brain health and is contributing to a later diagnosis of Alzheimer’s or dementia. And I can’t speak intelligently about the link here on the podcast, frankly. I’d like to look at my notes or look back at some things I’ve turned in for school. But my takeaway from that as a layman is that if I want to maintain my mental acuity, if I want to maintain my mental health later in life, and I’m not talking about just depression, I’m talking about my sharpness and my ability to participate in society and be a present mother and a present, hopefully, maybe a present grandmother one day, I need to be paying attention to my diet now.

Emily Stong (28:33):

And not paying attention to just how much I weigh or strength training, which is also really important, but what it’s doing to my actual brain and the brain chemistry. And a glucose spike is not something to be avoided because I just ate a bunch of junk and I’m worried about an expanding waistline. It’s something to be avoided, because I’m actually damaging my health or my brain. And I’m going to see the effect later in life. And it took me a long time to understand that. Or you might hear it. But to really accept it and apply it to how I live behaviorally, and I wasn’t able to do that until I adopted the CGM and the Levels Health, because it’s so easy. Food is, I mean, talk to any yo-yo dieter or any dieter. Everybody’s been a yo-yo dieter at some point, I’m convinced. But you might regret that meal that you binged on last night, but you’re like, “Eh, I’m going to be healthier for the next few days,” or, “I’m going to be stricter with myself.”

Emily Stong (29:38):

Well, it doesn’t work like that if you’re worried about your brain health. You did the damage with that meal. And of course, it’s cumulative. I mean, it’s not like that one meal’s going to, you know, you’re doomed. But you want to avoid that trend. So for me, it’s almost been don’t think about calories. Don’t think about junk food as it affects my appearance. It’s how internally, what it’s doing to my mind, my brain. And it took me a long time in life to make that connection. And I think it’s hearing the science and the research that they’re doing now.

Ben Grynol (30:14):

The compounding is key. I mean, that over time, that is what causes these chronic conditions. It’s not acute, where it’s something took place once. And that’s exactly what you’re saying. It’s you don’t want to instill the sense of fear of avoid everything at all times. We’re all human. But it’s understanding the long-term implications of some of these lifestyle choices and considerations. Over time, compounding, it’s like anything. Compounding in life is exponential. And that just leads to poor downstream effects.

Emily Stong (30:55):

And that makes you sit back and think, because most of my adult life, I’ve viewed food as I think most people do. Sometimes my enemy. Sometimes it contributes to weight gain. Or really, it was always viewed as a weight struggle. That’s what I equated unhealthy food with. Not so much, not my brain. Not my actual health. But undesirable weight gain. But our brain is just, I mean, you can’t replace your brain. You can’t diet off the damage you do to your brain. So that made me connect preventative care and eating for preventative care, like the CGM has, in a way that nothing else did. Because, I mean, sure, there’s a lot of messaging in society about losing weight. I mean, we all know that. We’re a very image conscious society. But that didn’t really make me a healthy eater. But the fear of compounding damage to my brain did.

Ben Grynol (32:09):

It’s wild too, because how much of this has to do with awareness, where there’s just not enough awareness of things like brain and health and Alzheimer’s? So we hear a lot. I think we hear there are these societal threads, if you want to call them that, these thematic things that we discuss within our, we’ll call it within sort our inner circles of friends and family, things like breast cancer in women. That is something that people have heard about. They might have people either in their immediate inner circle that have had breast cancer or been through various forms of different cancers. When it comes to Alzheimer’s, women in their 60s are more than twice as likely to develop Alzheimer’s over the rest of their lives as compared to breast cancer. And when you start to think about that, just as a statistic, it’s alarming where you go, “Wait, what?”

Ben Grynol (33:03):

This thing that we talk about all the time… We don’t even talk about Alzheimer’s. And now you’re telling me that that is more of a concern. There are a lot of women’s health issues I think that they’re integral to keep generating more and more awareness about, heart disease, Alzheimer’s, there are all of these things that have sort bypassed or been, they’ve flown under the radar for so long. And some of that has to do with maybe word-of-mouth conversations, maybe marketing, maybe things like campaigns where people say, “Oh, we’re raising money for X, Y, Z.” And it doesn’t mean that one cause is any more or less deserving of having support. That is not necessarily the message at all. It’s that when there are major implications associated with different conditions and diseases, it is integral that as a society we elevate these messages as high as possible so people can start to act on them.

Ben Grynol (34:02):

And so with things like Alzheimer’s, I mean, it’s incredible even to think of within my inner circle as I’ve learned more about the implications of Alzheimer’s in women, specifically women who are over 60, and you start to think about people that you know. And you go, “Oh wow, maybe the culture that person is part of has a diet that is more carbohydrate heavy and not as focused on things like fat, and fiber, and protein.” And that is where you start to have these links and you go, “Oh, that would be driven by compounding chronic metabolic syndrome over a long period of time.”

Emily Stong (34:43):

I mean, you brought up two interesting points. One, I mean, it’s hard to look at an individual and draw a conclusion, for my aunt, for instance. I mean, she lived a very, as far as I know, I mean, she ran marathons. Lived a very healthy life. Didn’t pay that much attention to her diet. But it’s a variety of lifestyle factors and genetic factors. The lifestyle they’re thinking is more important. But also the point you brought up about the determination of what gets funded for research, it’s really, that’s a rabbit hole. But Alzheimer’s has the potential to affect so many more women. And you just don’t hear about it as much. But I just think it’s so important. I mean, I just think so. That’s an understatement.

Emily Stong (35:35):

But I’m much more worried about Alzheimer’s than I am for developing breast cancer. And knock on wood, I mean, God forbid, I don’t want either. I don’t pay as much attention. I don’t know what we would tell a woman as far as avoiding breast cancer. What do you tell her to do differently? But I do know if you want to avoid Alzheimer’s, a good idea would be to eat for metabolic health.

Ben Grynol (36:01):

Not to be too hyperbolic about it, but you start to realize when talking from a pediatric standpoint, the effects of children who are developing Type 2 diabetes earlier and earlier. And you go, “Oh, that’s driven by the…” What’s it? The cranberry apple juice, the Ocean Spray stuff. It’s like you see kids that are drinking that every single day. And having just too many sweets and too many highly-processed carbohydrates. And you go, “This is making an impact on health at such a young age.” What do you expect is going to happen on the cellular level as kids develop, their brain health? That is not going to help anyone at any age. So it’s the earlier that we can set these foundations for our kids, you being a mom, and the more that we can instill this education at a young age, the more that we can generate awareness within our own circle so that that can start to spread.

Ben Grynol (37:04):

It is integral for this long-term health so we don’t get to the point where we go, “Oh, now somebody is N number of years old.” Let’s say it is, someone who’s 60 or older. And you go, “Oh, now we have to start thinking about these things.” It’s like, “No, let’s bring it back to the foundation, because that’s where it all starts.”

Emily Stong (37:25):

Oh, I could not agree more. This is one of my favorite topics. For example, I’m in Atlanta, the free breakfast that they offer in the school system. And I do not want to knock any free meals that are provided for children, by the way. I think that needs more funding. But sometimes I, for fun, I’ll go look at the, I mean, for fun, but I will look at the menu just out of curiosity. My children aren’t old enough for it. But it is fruit juice in the morning. It’s a blood sugar nightmare. And you give a child fruit juice in the morning and then they’re going to sit in a classroom. And that is not equipping them for a day of learning. That’s equipping them for a day of a blood sugar rollercoaster.

Emily Stong (38:08):

Again, I am not being critical of the free meal programs. I love them. And I would like them to get more funding. I would also like there to be an eye on metabolic health for our children, because you’re right. I mean, Type 2 diabetes among children. How did we get there? And I think about this a lot, because I’m a mother to two young girls. And I want to teach them to eat in a healthy manner. But food in America is such a weird subject. Or maybe it’s food in the Western world. You’re afraid to talk about diet with your kids, because you don’t want to make them insecure about their bodies or give them an eating disorder. So you really want to speak about it in an empowering way. And it can feel like a minefield. But you want to talk about your kids in a way that they’re going to be eating for their future health, too.

Ben Grynol (39:08):

Without a doubt. This is the anecdotal, parental thing to say, but there has to be a direct correlation between treats and temper tantrums. That is true in every which way. It’s clear when any of my kids have some treat, they’ll have something, you let them have the treat. It’s like you can count down the clock until the temper tantrum comes. And it’s because of emotional regulation. What are they supposed to do? Of course, they’re going to feel terrible, because you just gave them something that you know is going to make them feel terrible. Let’s say it was some donut or something, where you’re like, “Well, that is highly-processed carbohydrates packed with sugar. What is going to happen?” Of course, they’re going to crash. Of course, they’re going to have a temper tantrum. I mean, it’s just not a good state to be in.

Ben Grynol (40:03):

So if you’re bringing that back to what you’re saying about the school system and let’s remove the meals in the school system, just the foundation. So a child starts their day off and they might have some breakfast that isn’t providing them with a good foundation to have as balanced emotions as young kids can have. How are we supposed to expect them to learn and retain information when you’re setting them up in a deficit to begin with? It’s wild to think about.

Emily Stong (40:38):

I wholeheartedly agree. I mean, there’s so much room for improvement there. At the same time, you don’t want to criticize the system in a way that they withdraw that aid, which is so needed. Because the only thing worse than the, I mean, no food. No breakfast, I think, is worse than the blood sugar rollercoaster that an unhealthy breakfast can set you up for. But in my house, it’s funny you mentioned food retreats. In my house, it’s a Saturday morning bagel that my husband will sometimes… And I used to partake in this, too. And maybe sometimes still do, with regret. But take my three year old out to get a bagel, because it’s their special thing to do together. It’s funny, because since he started wearing the CGM, there’s a lot less bagel runs. But I would notice it’s impossible to avoid. You can’t help but notice on the days that she had a bagel, it’s like, “Oh, our day is kind of shot now.”

Ben Grynol (41:33):

I mean, it oscillates. That’s the thing, too. It’s not a point in time where it’s like, oh, okay, that happened.” It really does oscillate where throughout the rest of the day and sometimes even assume that this leads to a day of maybe a child having different energy levels if we want to call it that. And then maybe that child gets poor sleep the next night. And then wakes up and sort of starts out in that state of having high variability as far as their glucose goes. And it’s just like, it’s harder to get that balance. So it is integral to make sure that as parents, we’re creating the conditions for our kids to have as much balance as possible. And it’s exactly what you said, where you don’t want to tiptoe around it as a minefield. But you want to make sure that you are introducing food so that they understand what is healthy and what is not without feeling like food is ever dangerous.

Ben Grynol (42:30):

Or food is something we should avoid, because everyone’s relationship with food will differ. And it is very, very important that we’re creating healthy, we’ll call it a healthy education, so that people can understand these are children, they’re trying to understand it as best as possible. But as long as they know that there are certain foods that they can have sometimes. And there are other foods that they should have more often, like having, if a child eats meat, having protein without all the sauce all over it and whatever else. That’s going to be a lot healthier than eating a hamburger from McDonald’s that is not protein. So it’s creating that understanding as much as possible. It is such a key factor.

Emily Stong (43:12):

No, I agree. I like the trajectory of this conversation. We started with the child in the womb.

Ben Grynol (43:17):

And always come back.

Emily Stong (43:18):

And then old age. And always come back to the early years.

Ben Grynol (43:23):

Exactly. No, I mean, there’s so many important things to unpack as parents and the work that you’re doing for your doctorate and everything around brain health and it is very important that we continue to elevate these messages, because change is going to happen. Or catalyst for change is going to happen from us telling one person close to us and then another person. And they tell two people, and four people, and it goes from there. That’s the people that we have the highest trust in our relationships with are the people that we can help to influence this behavior change over time. So it is so important to have these conversations.

Emily Stong (43:57):

Agreed. Like I told you, I’ve become an evangelist, a CGM evangelist.

Ben Grynol (44:02):

That’s what you got to do. Well, now your husband is using it. And it is great to see. And so having that foundation within your family is very, very cool.

Emily Stong (44:11):

We’re having fun with it, too. I mean, it’s actually fun. We kind of call out our scores to each other at the end of the night. He won’t link up with me on the app so that we can see each other’s scores. But, I don’t know. It’s become a geeky hobby in our household, in the healthiest of ways, I think.