How to Improve Your Brain Health and Stay Sharp as You Age with Dr. Ryan Williamson

Ashish Kothari:  

Hi, Ryan. It is so wonderful to have you on our podcast. Thank you for joining us this Friday morning.

Ryan Williamson:

 Thank you, Ashish. I'm happy to be here. Seriously.

Ashish Kothari:

 Ryan, your background is really fascinating. When Amber, a dear friend of ours, connected us, you were a neurologist, a Navy veteran, and then you founded Transcend Health. You've also done some work at corporate as a consultant. I'm curious—on your journey, what’s drawn you to the intersection of brain health, longevity, and performance optimization?

Ryan Williamson:

That's a great question, Ashish. Like a lot of people who end up in healthcare, I’ve got a similar story to many others who feel called into the service of helping people—whether they’re nurses, doctors, or providers. I watched a lot of people suffer when I was younger.

I had a lot of family members dealing with medical issues growing up, and that inspired me to go into medicine. That was the original impetus. Once I got there, I had some great mentorship and found neurology, which I just loved.

Other than my sheer fascination with the human brain—which is still very near and dear to me—it seemed like an exciting field to be a part of over a career. And so far, that has proven true because of everything we’re constantly learning about how the brain works and how to optimize performance and health.

When you're trained as a neurologist, you can certainly help younger patients with things like migraines or peripheral nerve injuries and inflammatory conditions. But a good chunk of the work involves problems that happen in later years—things like Alzheimer's, strokes, and Parkinson's. These are issues that affect millions of people.

When I was in the military, I was helping younger people. That was very motivating—working with young, healthy, driven individuals whose mission was to get back on the battlefield and help. If that's not the most motivating work environment, I don't know what is. That's what got me out of bed every morning.

ut when I left the service in: 2022

That might sound strange, and yes, it is gratifying to help someone through an emergency or provide answers, but I kept seeing the same story play out time and again—where decades of untreated high blood pressure, poor lifestyle, or a bad diet had brought someone to this point.

They're likely going to continue dealing with those same issues, or an event has occurred that’s set them down an irreversible path. It’s very sad to watch that happen over and over again. So I started asking myself: is there a better answer? How can I help more people?

I dove into the longevity literature, which has exploded in recent years. It turns out a lot of these issues are actually quite preventable. That got me fired up. I wanted to help people live healthier lives, start earlier, and reach more people.

As much as I love doing podcasts and seeing people one-on-one in a clinic, it’s not the most efficient way to reach the maximum number of people. If no one watched the podcast and I just kept talking to patients one-on-one, it wouldn’t scale. I can only see maybe 10, 20, maybe 30 people a day in a clinic or hospital.

So I had the idea to write a book. I reached out to our friend Amber, who helped me with that. We ended up creating a business and scaling that idea—helping as many people as I possibly can understand that they are largely in control of their health outcomes.

If you’re listening to this and part of Ashish's audience, I really want you to know that. You are. Seventy to ninety percent of all your health outcomes—your mental performance, how you feel—is well within your control.

I've found that a lot of people just don’t know that. They feel like it’s an inevitable thing they’ll have to deal with. They fear that because their grandmother or grandfather had Alzheimer’s or a stroke, they’re destined to experience the same. That’s probably not the case.

Ashish Kothari:

There’s so much resonance from the work we’ve been doing and the research, Ryan. First, I think it’s amazing to see how many high-achieving professionals are essentially spending out of their health account to accumulate wealth. Then, as they reach retirement, they start spending from that wealth account to try to override some of these health outcomes—and sometimes, it’s too late.

I loved Outlive by Peter Attia. Friends, if you haven’t read it, I highly recommend it. It talks about how, frankly, our medical profession—at least in the West—is so focused on fixing and treating symptoms rather than addressing root causes.

One thing that was especially eye-opening for me—and honestly both infuriating and empowering—was this: around November last year, my A1C officially went above 6.5. So, I was diabetic.

But here’s the thing: when I started reading Outlive back in October or November, I realized that for the last two to three years, I’d been at 5.1, then 5.7, then 5.9. And the doctors only said, “Yeah, you should watch for it.”

But if you’re at 5.1, you are predestined to get there—unless you make some pretty dramatic changes to your diet, your exercise, and your sleep. If you do that, you never need to get there. You don’t need to end up on pills.

To share how dramatic some of these shifts can be: on December 24, I decided to make a change. By March, my A1C had dropped significantly. I’ve lost 15 pounds, and it’s all been through diet and exercise. I didn’t get on metformin or any diabetic medication.

So yes, there’s so much resonance here. If we can educate people more about our own thinking, and help them recognize that they can be in control, they can stop sowing the seeds of their illness, they can avoid prolonging their suffering. Because science is advancing every day. We’re going to live longer. Kids born today are going to live into their 90s.

The real question is: do you want to spend the last 30 years of your life suffering? Today, one in every person over 60 has at least one chronic ailment they’re struggling with. Do you want to live that way—or do you want to live a healthier life?

Decline is not a given. And I’m really curious to learn from your research. So many people just take it for granted that as they age, their brain, memory, and thinking will decline. But you talk about proactive cognitive optimization—the idea that we don’t have to be prey to that.

Talk to us a little about what you’ve learned. What’s been missing? And what are some ways you’re helping people?

Ryan Williamson:

 Ashish, first off—this is gold. Thank you for the courage and transparency to share your journey. It’s not easy to open up about personal struggles, and a lot of people stay guarded. So thank you for using your voice to help others. There’s real power in that.

I think Dr. Attia is a fantastic resource—probably one of the most rigorous MDs I know who’s public-facing and shares this kind of information. I’m also grateful for the Andrew Hubermans of the world. If you’re familiar with Professor Huberman’s work, you’ll know what I mean.

Where to start... You covered so much. It all comes down to lifestyle. And I think we’re all just so busy. We’re trying to get to work, make our spouses happy, get the kids to practice, care for aging parents—it’s a constant cycle of “gotta, gotta, gotta.” That’s the world we live in.

So even if people read a great book like Outlive by Dr. Attia, or hear about needing to get their A1C in check or whatever it is, it just feels like one more thing to do. And that can be really defeating. People are already overwhelmed just trying to make it through the day. The idea of adding one more habit or metric or responsibility feels impossible.

But I think that’s where we miss the mark. It’s not about adding one more thing. The real question is: what’s really important to you? What’s your “why”? What’s your purpose? What gets you out of bed in the morning? What makes you happy? Happiness Squad, right?

Where’s that center point for you? It could be as simple as wanting to watch your grandchildren graduate. It could be your business, your legacy—anything. It’s different for everyone, but I help people get that one thing in focus and in their mind.

Once you find your purpose—your why—then you naturally want to move toward it. You have your target. And from there, you can reverse engineer a plan, a lifestyle that brings you closer to that goal, or allows you to do more of what you love.

As you said, children born today have this incredible opportunity. With technology, AI, and the exponential curve of innovation, lifespans are increasing. Some projections even suggest we could live into triple digits.

But then the question becomes: how do you get there? How do you do that? And that’s when the “I have to” turns into “I get to.” I get to live a healthy, integrated life. I get to be intentional with what I eat.

By the way, I don’t love the word “diet.” It sounds restrictive and temporary. People go on diets, maybe lose some weight or reset their metabolism, and then go right back—if not worse. So instead, it’s about a sustainable nutrition plan. I get to move my body with purpose. I get to be intentional about my exercise.

And when you start thinking that way, you just feel better. You have more energy. You sleep better. You see the world through a completely different lens. I can tell you—I’ve done it both ways. And I choose this path all day, every day. It’s so empowering. That’s my general framework. And we can definitely dive into specifics.

Ashish Kothari:

 Yes, I’d love to. I want to highlight something for our listeners. That’s exactly why I looked into what you’ve started—and I want you to talk a bit about Transcend Health. There are certain aspects of it that I think are so powerful in helping people shift.

Even when we know what’s good for us, it’s hard to stay on the path. So talk a little bit about Transcend Health and what you’re trying to do there.

Ryan Williamson:

Thank you, Ashish. The whole idea of Transcend Health started with me just wanting to write a book to help more people because I was tired of seeing the same heartbreaking patterns over and over.

Along the way, my team and I started thinking: how do we get this message out to more people, sooner? So we began using social media, where I share short snippets that can help people. But I also started a membership program with group coaching sessions—bi-weekly Zoom calls.

Each session covers what I call “wellness protocols.” For example, we’ll do one on sleep. I’ll give a quick 15- to 20-minute overview on how sleep works in the body and why it matters. Then we spend another 30 to 40 minutes on how to optimize it. People can access these protocols, watch past recordings, and download resources through a private membership portal.

What really makes it powerful, though, is the community and accountability. Members share their wins. Someone might say, “Hey, I started wearing an Oura Ring”—which is my preferred tracker, though there’s also Apple Watch, WHOOP, whatever. They’ll share how their sleep score was terrible because they were staying up late, reading on their phones, drinking to fall asleep, eating too late—all the wrong things.

But then they start dialing it in. Their sleep data improves. They feel better. They perform better. And they share their progress with the group. It becomes this contagious, positive effect. There’s that idea—you’re a reflection of the five people you spend the most time with.

When you’re in a community of like-minded people, all interested in supporting one another and improving their health and performance, it’s one of the most gratifying things I get to be part of. That’s the heart of the community.

I also offer shorter, prescriptive courses people can take as a one-time thing. And I have a smaller cohort where I guide people through the book, chapter by chapter, as a primer on all of this. There’s also one-on-one coaching for those who are interested.

Ashish Kothari:

Ryan, there were a couple of aspects of Transcend Health that really stood out to me.

First and foremost is this notion of community. We’ve created a community as part of Happiness Squad as well, because today, the reality is—we have more knowledge than ever before. Not just a little more—like, a thousand times more access to knowledge.

We know what to do. I knew sleep was important. I knew meditation was good for me. I knew alcohol wasn’t. That information is everywhere. The problem isn’t knowing. The problem is we don’t have the space for practice.

So knowledge becomes noise. That’s why I love the community aspect of what you’ve built. When you connect to your “why”—and all the research validates this—a positive why is far more motivating than a negative one. Saying “I want to be there for my grandkids” is a much stronger motivator than “I don’t want to die.” Research confirms that.

Even when you know your why, staying on the path is hard. That’s where community matters. Every wisdom tradition includes this concept of a Sangha—a group that comes together. We go to church once a week not just to pray, but to be with people who remind us to walk the path.

Muslims go to the mosque. Hindus to temples. Buddhists have their Sanghas. Community is a built-in support system. So creating a space where people can learn from one another, inspire each other, and hold one another accountable—over time, that’s how real transformation happens.

At first, the habits we’re trying to form are things we do. But eventually, they become who we are. I think that’s such a beautiful foundation, and I’m so glad you started Transcend Health with that vision, Ryan.

Ryan Williamson:

Thank you, Ashish. Like I said, it’s truly a beautiful and gratifying thing to experience. You mentioned something that really resonates with me and that’s creating the space to intentionally think about these things and practice them.

That ties into how I help people manage stress. Leaving space for yourself is so important, yet most people don’t even think to do it. We get swept up in the pace of modern life.

The technology curve is a double-edged sword. Here we are, having this amazing conversation—you’re in Colorado, I’m in Georgia—we’re using Zoom or Riverside through a video screen. It’s virtual. We have high-speed internet.

This would’ve been unthinkable 30 or 40 years ago, or maybe just in its infancy. Now it’s mainstream. With that, we’ve also got the advent of the internet, supercomputers, quantum computing, AI—all these incredible tools.

So yes, we have more access to information than ever before. But we’re also living at a higher pace, with higher expectations. We’re constantly bouncing from task to task—getting the kids ready, going to work, answering emails, checking notifications. All of this creates a massive amount of cognitive stress. There’s actually a term for it: techno-stress, which I love.

Ashish Kothari:

I love that term—techno-stress. Tell me more.

Ryan Williamson:

Techno-stress is the stress that technology puts on our brains.

And again, this comes back to the idea of community. We evolved in tribes and groups. Our neurobiology is centered around relationships, feeling safe, and being part of a group. But there wasn’t this level of technology when our brains evolved.

Our social and technological evolution has far outpaced our biological evolution. We’re constantly taking in too much information, without giving ourselves time to process it. That’s why we feel overwhelmed.

We’re designed to ebb and flow. The brain works optimally in about 90-minute bursts. After that, it really needs a break—otherwise, performance drops off a cliff. So I tell people: every 90 minutes, take a break. Step away from your desk. Stand, stretch, move, go outside, breathe. Meditate, do breathwork—whatever works for you.

Just step away from the screen and the information overload. That should be a daily rhythm. And if your boss has a problem with that, I’d be happy to send them data showing how much more productive you’ll be.

Ashish Kothari:

It’s crazy, right? We know this. It’s something we reinforce in our programs too. We know that after 90 minutes, our ability to focus drops significantly. We accumulate stress.

There’s that Microsoft study that shows, using brain sensors, how your brain can literally go red after too much activity. But just five-minute breaks can keep your brain functioning optimally. And yet, most executives I work with are in back-to-back meetings all day long.

Ryan Williamson:

Exactly. Learning how to structure your day is critical. And for busy entrepreneurs or business owners, the instinct is to fill any open space on the calendar. That’s just a habit. But we need to create a protected space—time to think, time to reset, time to be with your family, and even time to just be alone with your thoughts. These are essential practices.

And it’s not just about your performance—though that alone should be a good enough reason. Chronic stress leads to very real physical consequences. Stress isn’t just in your head—it shows up in your body.

When you’re chronically stressed, your body produces elevated stress hormones, like cortisol. Over time, cortisol contributes to impaired fasting glucose, which raises your risk of diabetes. It can make you more metabolically unhealthy, increasing insulin resistance.

So even if you’re eating right and exercising, if your tissues are insulin resistant, your metabolism slows down. It’s harder to lose weight, harder to see results. Sleep helps with that. Taking breaks helps with that.

Cortisol also raises blood pressure over time, which can lead to heart attacks and strokes. There’s even growing discussion around Alzheimer’s being referred to as “Type 3 diabetes.” It’s more complex than that, of course, but there’s no denying the link between metabolic health and brain health.

If you want to reduce your risk of dementia, focusing on metabolic health is essential. It’s all interconnected. And these foundational pillars—sleep, nutrition, exercise, stress management—are often overlooked because they’re so basic. But they’re where the bulk of the data lies. Dr. Attia and others talk about this as well.

In today’s world, though, people are so busy that they’re constantly looking for a shortcut—a quick fix or a biohack. They say, “Just shoot me up with stem cells,” or “Give me this pill,” or maybe, “I’ll try Ozempic.”

But Ozempic, without proper dosing, strength training, and protein intake, can actually cause you to lose more lean mass than fat mass. So when you come off it, you’re even more insulin resistant.

I mean, people just...

Ashish Kothari:

 There’s a lot there. So let’s get into that, Ryan. Obviously, all of your research and training over the years has centered around brain longevity. You also talk a lot about brain resilience—this ability to protect and even enhance cognitive function.

So talk to me a little bit about what you’ve found to be the key drivers behind brain longevity.

Ryan Williamson:

Yeah—back to those core four pillars. That’s really it.

Ashish Kothari:

Your four: sleep, nutrition, stress management, and exercise.

Ryan Williamson:

That’s it. It sounds so simple, but it’s actually incredibly profound. These four pillars are not just easy to understand and integrate into a lifestyle—they’re also where the data lies. This is what moves the needle on a cellular level.

There’s a whole categorization of disease we refer to as the hallmarks of aging. These are molecular and chemical changes that happen at the cellular level. When you break it down, sure—your brain cells are neurons, your liver has hepatocytes, your heart has cardiac myocytes. But fundamentally, the machinery of each cell is very similar.

Every cell in your body has the complete DNA to make your entire body—it just ends up doing a specific job. But they all run on the same basic operating system, and those cells can age faster or slower, depending on your lifestyle.

Take someone like Bryan Johnson—he’s become a prominent figure in longevity and slowing aging. He’s been experimenting with many interventions. But the most important concept I want people to understand is the difference between chronological age and biological age.

Chronological age is how many candles are on your birthday cake. Biological age reflects how fast your cells are aging. The tests aren’t perfect yet, but we do have fairly accurate metrics—like DNA methylation patterns.

Methyl groups are small chemical markers that tag onto your DNA to regulate what parts get expressed. These patterns shift with age, and when you analyze large data sets, you can see trends that correlate with biological aging.

So let’s say I’m 37—if you swab my cheek and my methylation pattern looks more like a 50-year-old’s, that probably means my cells are aging too quickly. Maybe I’m chronically stressed, pre-diabetic, smoking, or sedentary.

On the flip side, if I’m doing all the right things—sleep, nutrition, exercise, stress management—my pattern might resemble someone younger.

In my own tests, I’ve had biological age results come back anywhere between 28 and 33. Now, I don’t get hung up on the number—I don’t walk around saying I’m “biologically 28.” But the idea is: you want to slow your rate of aging. That impacts not just how long you live, but how well you live—how long you can do the things you love with the people you love.

That’s the goal. That’s the impact I want to help people create in their lives.

Ashish Kothari:

It’s a given—we’re going to live longer than our ancestors. But friends, I’ll make this bold statement:

It’s also a given that your healthspan—the number of years you live in good health—is going to bring more suffering in your later years unless you make significant changes. We’re on track to die miserably if we don’t do something about it. Both those truths coexist.

Medicine today keeps people alive far longer than nature ever intended. Twenty thousand years ago, if you lived in a tribe of 35 people and couldn’t walk, you simply wouldn’t survive. There weren’t enough people to carry you.

Fast forward to today—we have people kept alive on machines for two, even three years in a coma. That’s how far we’ve come. So yes, we already know we’re going to live longer.

But here’s the real question:

Are we going to live healthier?

Are we going to add life to the years we’ve been given?

That’s not a question anymore. It’s a necessity.

Look at the workplace. I consistently see 40 to 60% of people experiencing chronic stress. Look at burnout rates—they’re soaring. So it’s no surprise that the second half of life is often filled with misery, not meaning.

And that’s why a lot of the work we’re doing, Ryan, is focused on helping people become more aware—more aware of how their own beliefs about success and happiness are actually making them unhappy in the long run.

Unless we have a paradigm shift—in how we define success, how we find joy and fulfillment—we’re going to keep chasing something out there, when the answer is actually in here.

We have to learn how to add life not just to our later years, but to every moment. From now until then.

Ryan Williamson:

That’s beautiful, Ashish. You hit the nail on the head. I wish there was more alignment on this. And you’re right—happiness is internal. It’s not something external.

Ashish Kothari:

Exactly. It’s not an external thing.

And if you’re not well, it’s hard to be happy. If you’re struggling to sleep, if you’re in pain, if your joints hurt when you walk, if you’re taking pills like they’re food—rather than using food as medicine—then life just isn’t good.

So let’s dig into sleep. Because in my view, we’re a sleep-deprived nation. There’s no question about that.

Let’s go deep there, Ryan—what have you learned from your research and coaching? What are three or four simple actions you recommend to help people improve their sleep?

Ryan Williamson:

 Absolutely. So, consider this. I try to look at things through a design or evolutionary lens. We sleep for about a third of our lives. Think about the massive opportunity cost that represents—not just from a productivity standpoint (forget about being an entrepreneur and how many more phone calls or sales you could make), but from a safety perspective.

If we were living in tribes, and a lion came up and grabbed a group member while they were asleep, or an invading tribe attacked, or there was a natural disaster like a flood—being unconscious for a third of your life would be a huge risk. You’re literally rolling the dice. So why would something like sleep evolve and persist for so long?

Because it's that important.

Sleep is non-negotiable. And I want people to really understand that—not just for brain health, but for the health of the entire body. Sleep is the only time your body repairs itself. If you’re sick, or just had a hard workout—CrossFit, strength training, running a marathon—your muscles only repair themselves during sleep.

Sleep is also the only time you consolidate and form new memories. If you’re a student, learning something new, or taking an online class, you can absorb all the information you want—but it won’t stick as a long-term memory until you get quality sleep.

Your immune function, metabolism, blood pressure—the list goes on. Sleep is essential for all of it. That’s the baseline.

Ashish Kothari:

What’s the optimal amount of sleep you’ve found for most people?

Ryan Williamson:

That’s an interesting one. It really varies from person to person, but the optimal range seems to be somewhere between seven and nine hours.

Most people have a general sense of what works best for them. But honestly, this is where a sleep tracker can be super helpful. You can start to learn when your sleep is truly optimal—not just how long you're sleeping, but how consistent your sleep is.

And that brings me to a key point: sleep regularity may actually be more important than sleep duration.

What I mean by that is keeping a consistent bedtime and wake-up time. Let’s say you go to bed at 10 p.m. one night and then stay up until 3 a.m. the next night—that inconsistency really throws off your system.

And culturally, this is a big issue. Monday to Friday, we set alarms and grind through our 9-to-5 routine. Then Friday afternoon hits—it’s happy hour, time to blow off steam. One drink turns into four, four turns into who knows how many, and next thing you know, it’s 4 or 5 a.m. and you're eating pizza. You sleep all day Saturday, you're hungover, maybe do it again Sunday, and then Monday rolls around—and you're back at square one.

That cycle completely disrupts sleep regularity. Not only does it hurt your performance Monday through Wednesday, but long-term, it’s associated with shortened lifespan and increased risk for chronic disease.

is. Based on data from around: 2013

They found that on the Monday after daylight saving time, there was a 24–25% increase in admissions for heart-related conditions.

Why does that matter? Because a one-hour shift in sleep caused a population-level change in heart rate, blood pressure, and autonomic nervous system function. That’s enough to increase inflammation and trigger serious cardiovascular events—especially in people with pre-existing conditions like diabetes or high cholesterol.

Now, this isn’t about the healthy 20-year-old athlete—it’s more relevant for the general population, particularly older adults—but it shows how powerful sleep regularity really is.

And look, we all live in different time zones, we travel, we have unique schedules. So it’s tough to gather perfect data—but this kind of evidence really drives the point home.

So, what can people do?

There’s a lot, but one of my favorite things to say is:

“Excellent sleep starts in the morning.”

People usually respond with, “What in the world does that mean?”

Well, there’s actually strong research showing that your circadian rhythm—your body’s internal clock—is one of the key regulators of sleep. It acts like a natural pacemaker. It tells your body when to be alert during the day and when it’s time to wind down at night.

This rhythm is primarily set by light. Back before artificial lighting, we woke up with the sun, and when it got dark, we felt sleepy and went to bed. That’s how our biology evolved.

Now, here I am sitting in my home office surrounded by artificial light, trying to make a studio look “lit”—and it’s not the healthiest thing for your brain.

What does help is getting natural light exposure early in the morning. You only need about 10 to 15 minutes, and the best time to do it is when the sun is still low in the sky, when the light is orange or red.

One thing I love that Andrew Huberman talks about is how this low-angle sunlight helps prime your circadian rhythm. You want to avoid doing this midday when the UV index is too high—midday light can actually harm your eyes.

But that early sunlight does two important things:

It helps you feel more alert during the day

It helps you fall asleep more easily at night

And that same light also stimulates a different part of the brain that regulates mood, which means it can actually help improve symptoms of anxiety and depression. So, getting sunlight early in the day is not only great for sleep—it’s also great for your emotional health.

That’s one easy and free way to improve sleep quality.

Another one, which ties into the movement pillar, is getting morning exercise. A solid morning workout has been shown to improve the quality of deep sleep later that night.

Why? Because when your body goes through a physically demanding workout, it needs to repair itself—and that reparative process primarily happens during deep sleep. So the better your workout, the better your body pushes for deeper rest.

Those are two really effective, simple things people can start doing in the morning to help optimize sleep.

I’m happy to keep going if you’d like.

Ashish Kothari:

 No, this is great. These are simple, right? One thing I’m curious about—and I always talk about—is the role of caffeine.

Ryan Williamson:

Yes! I love that topic.

Ashish Kothari:

Right? People don’t realize how long its half-life is. We’re caffeinating until 4 p.m. and then wondering why we can’t fall asleep.

Ryan Williamson:

Bingo. So, you nailed it. I tend to tell people about noon-ish—you could probably get away with maybe 2 or 3 p.m., depending on how quickly or slowly you metabolize. I mean, some people know if they have two sips of coffee and they're just wired all day. Like, you may be a slower metabolizer.

Whereas if you're a two or three cup person and it takes you a while to turn the engine on, so to speak, maybe you're a faster metabolizer.

But yes, caffeine has a very long half-life, and this actually plays into the second kind of system that helps keep us awake or alert. And that's the adenosine system, or the sleep pressure system. Process S is another way that's sort of stated for sleep pressure.

Throughout the day, you have this neurotransmitter—this chemical in your brain—that slowly releases and rises called adenosine. And when it crosses a threshold in the evening, you start to feel sleepy.

So in addition to the light regulating the day-night, dark-light cycle, the sleep pressure that rises helps initiate that feeling of sleepiness.

And the reason I bring this up is that caffeine is an adenosine receptor antagonist, meaning it blocks the binding of adenosine to that receptor. So you're not slowing down the release of adenosine—you're just minimizing its effects.

That's part of why people are caffeine, caffeine, caffeine—and then they stop or they have that crash afterward. It’s because the adenosine comes kind of binding back. And there are some other mechanisms at play there, but that’s sort of grossly oversimplified.

But the half-life of caffeine is very long. It's about ten hours. So to your point, Ashish, if you're drinking a cup of espresso at 4 or 5 p.m.—or even, like I did for a long time, because I enjoyed it—a little espresso after dinner, right? This is common in European culture. That is horrific for your sleep, and not the thing you do.

But again, we as a culture—these are just things that people do. And they just don’t know, or it’s just a habit.

Ashish Kothari:

You know, and what's curious about it, Ryan, was when people drink—let's say, it's again a habit, right? Talk about habits.

So yes, you might have over time gotten into a habit of drinking a hot beverage. It just so happened to be tea or coffee, and you might take a couple of them.

So think about—what if you just shifted after the first cup to a decaf? You can still get the taste. You're still getting the habit. But all of a sudden, you're not putting caffeine into your body.

And caffeine addiction is real, right? Just like anything else. If you don’t believe me, try giving up caffeine for two weeks and see what happens to your mood and your energy levels. Also see what happens after two weeks.

But really, I think it’s—you know, we live into this. The environment we create and actions we do unconsciously start to shape, and take away from even the most powerful one ingredient that is really, I think, the foundation—which is sleep—to almost all of our health.

And yet today, most people are not sleeping seven to nine hours. They’re sleeping less than six. They are sleeping in all different kinds of time zones, right? They’re not sleeping at the same time. And that’s a big issue.

Ryan Williamson:

100%. And before we beat caffeine users up too much—because I am a fan of caffeine.

As I mentioned, I think it's a great tool when used appropriately. So, if you have, I don’t know, one to two cups—I think my favorite would be freshly ground black coffee.

Again, I would stay away from the processed and refined sugars to put in the coffee for a lot of reasons—because processed sugar turns out not to be great for us. Creams, again, in a moderate amount, probably okay. But that can contribute to an excess amount of saturated fat, which can lead to blood vessel problems, like in the heart and the brain.

But freshly ground coffee—not only does it taste great, in my opinion—it contains compounds called polyphenols that can help act as antioxidants in the body.

Number one, it can actually be good for kind of an anti-inflammatory effect, which is great. But caffeine actually appears to be neuroprotective—so against Alzheimer’s, Parkinson’s, conditions like this.

There’s some data that support that it either delays the progression of or the initiation of either of those conditions. So there seems to be some help there too, which is very interesting—when used appropriately.

Ashish Kothari:

When used appropriately, in the right dosage...

Ryan Williamson:

...and at the right time. Not drinking a whole pot at midnight.

Ashish Kothari:

Exactly. So, there’s a lot here. You’ve shared your four pillars—sleep, nutrition, stress, and exercise—that you’ve built your programs around.

We’ve already gone deep on sleep. If there’s one other area you’d point to and say, “People really don’t realize how much this affects longevity and brain health,” what would it be?

Ryan Williamson:

Probably supplementation of some sort. You could say that could be a sub-pillar of nutrition, but I really made it its own chapter in my book that's coming out in September, because I think it's that important—and because it can be difficult to get the right supplementation, even in a healthy nutrition plan.

So, if I had to pick a top four or five that are all over-the-counter, that have quality evidence, that most people probably could do more of or more with—this is in no particular order.

A funny one—creatine monohydrate.

Creatine is a powder that a lot of bodybuilders and athletes use to gain muscle, and it in fact does that. It’s one of the most well-studied molecules across time on the planet. The safety profile is excellent, in my opinion. It does improve athletic performance, but there’s actually newer data that’s emerged on brain health—and its ability to help the brain's resilience around oxidative stress, energy production, and probably decreased risk of cognitive disorders and decline like Alzheimer’s down the road.

There’s even some emerging data on other organ systems too. And this all gets back down to that idea of the hallmarks of aging and the cellular machinery that we all kind of share between organ systems.

You can get creatine naturally from the diet—it’s present largely in red meat. To be clear, I’m not like a carnivore diet person. My general nutrition take is something like a whole food, plant-based and/or Mediterranean diet.

Don’t get me wrong—I love, I really do try steaks, but a good filet or ribeye maybe once a month tops, I think is fine. But I wouldn’t do that three, four, five times a week. That’s way too much saturated fat, in my opinion—without fiber and other things that you need.

But my point is that there is creatine in red meat, but in order to get the recommended dose, which is about five grams a day, you'd have to eat an inordinate amount. Like, you wouldn’t even be able to do it. It would be pounds and pounds of meat to actually get that into your diet. Hence, supplementation can be helpful.

So, five grams a day. Again, there are some studies that are looking at higher doses—like, for example, in post-traumatic brain injury recovery, this would be like a really bad concussion—up to about 20 grams a day for a short term. Seems like it can be safe and helpful. The jury’s still out on whether larger doses for a long time...

Ashish Kothari:

Okay.

Ryan Williamson:

So that’s a great one that I take every day, that I think—again, people may be surprised that they notice a little boost in performance, but also...

There are two big distinctions I want to make just overall with any kind of healthy lifestyle.

There’s the performance aspect, right? That’s what we all feel. Meaning—you sleep poorly, we all know you feel groggy and tired the next day, you can’t perform. You eat the wrong thing, it doesn’t agree with you—that’s pretty intuitive.

But we don’t have a sensor for Alzheimer’s, or diabetes, or heart attack, right?

Once we get to a threshold where those things show up, that’s when we go, “Oh man,” like—there’s some clinical change. When in reality—A1C is a great example of this—when you go from 4.1 to... you don’t—you can’t detect that. There’s no way of knowing that unless you’re following a lab result.

So, to me, there’s the maintenance and longevity phase too. People don’t really get the immediate reward of “Oh, I feel better when I’m doing this.” When in reality, you’re likely doing yourself a massive favor by doing all of these things as part of your integrated lifestyle.

Again, that’s the longevity front. You’re going to notice a difference in performance, I am sure. But I just want people to have that distinction.

Ashish Kothari:

 What are the other four that you would recommend?

Ryan Williamson:

Yes—sorry, I tend to go down rabbit holes!

So, magnesium is another important one. Specifically, magnesium gluconate or glycinate—these are the two most bioavailable forms. Magnesium acts as a cofactor in over 300 enzymatic reactions throughout the body. It's hugely important, and most of us are deficient in it.

What makes it tricky is that magnesium levels are hard to detect accurately through blood tests. That’s because most magnesium is stored in the bones, not the bloodstream. So your blood levels might appear normal while you’re still quite deficient.

The recommended daily dose is about 400 mg for men and 300 mg for women, adjusted roughly based on body weight. It also helps with sleep. I take it at night and have personally noticed improvements—whether that’s placebo or real, I’m not sure—but there is evidence showing magnesium supports both sleep quality and general cellular health.

So that’s number two.

Number three: fish oil, specifically for its omega-3 fatty acids, DHA and EPA. These are incredibly important for cardiovascular and brain health.

Believe it or not, about 60% of your brain is made up of fat, and of that, approximately 40% is DHA. That’s how critical it is. I don’t have the exact number in front of me, but over 90%—possibly closer to 93–95%—of Americans are deficient in omega-3s. That’s because most people don’t eat much fish or nuts, which are primary dietary sources.

That’s where supplementation can be helpful.

Aim for 1,500 to 2,000 mg a day (combined DHA and EPA)

Some studies support doses up to 4,000 mg/day, which may further support vascular function and brain health

Fish oil is one of those “good fats” for your brain. And studies have shown that combining fish oil with vitamin D offers even greater long-term cognitive benefits.

Speaking of which, number four: vitamin D.

Most of us can get sufficient vitamin D from about 10–15 minutes of midday sunlight exposure. But here’s the catch:

If you have fair skin like me, you need to be cautious because sunburn is a real risk.

If you have darker skin, it takes longer to produce adequate vitamin D.

That, combined with the fact that most of us spend our days indoors, makes vitamin D supplementation a smart move. Again, when combined with fish oil, studies show it can have powerful cognitive benefits.

Number five: curcumin, the active compound in turmeric.

This one surprised me, but when I started digging into the research, the data was impressive. Curcumin has strong anti-inflammatory effects and is associated with lowering all-cause mortality by around 10 to 15%. That’s a significant drop in overall risk of dying from any cause.

So, those are five over-the-counter, non-prescription supplements that can really move the needle on health—what I might even call a fifth pillar in itself.

Ashish Kothari:

Yeah, I love that. Well, Ryan, this has been incredibly informative. I love what you're doing. And I truly wish more doctors and researchers would help shift medicine away from just treating symptoms toward prevention—encouraging people to start building these habits much earlier.

As we’ve said, we’re living in a time where we’re going to live longer, and we have the opportunity to avoid suffering in our later years. And most of it is in our control.

I go back to what you said at the start: 70 to 90% of our health outcomes are within our control. Even though knowledge is important, it’s not enough.

So thank you for the work you’re doing to help heal the population. Anything we can do to support you, we’re here. And we’ll definitely have you back when your book comes out to share more tips around the other pillars.

Thanks so much for joining us today.

Ryan Williamson:

I would love that, Ashish. It’s been my privilege, and I’d absolutely love to come back. I’d also love to stay in touch in the meantime—it’s been a joy, and I’m just here to help.

Thank you for having me.

Ashish Kothari:

Take care. Have a wonderful day.

Ryan Williamson:

You too, Ashish. Thank you.