Interview with Alvaro Fernandez

Alvaro Fernandez, co-author of The SharpBrains Guide to Brain Fitness: How to Optimize Brain Health and Performance at Any Age was the featured guest in Episode 100 of the Brain Science Podcast. Below is the transcript of his interview. The full episode transcript is also available for download

Originally aired 08/23/2013

Dr. Campbell:  My guest today is Alvaro Fernandez.  Welcome to the Brain Science Podcast, Alvaro.

Fernandez:  Thank you very much, Ginger, for giving me the opportunity to be with you and your listeners on the 100th podcast—which is a big accomplishment.

Dr. Campbell:  I've been enjoying the SharpBrains website since I learned about it from your colleague, Elkhonon Goldberg back in 2007. [Note: Dr. Goldberg’s books were featured in BSP 16 and BSP 17. He was interviewed in BSP 18So, I'm really pleased to have you on the Brain Science Podcast today to talk about the second edition of The SharpBrains Guide to Brain Fitness

Before we start talking about the book, would you just tell us a little bit about yourself, and then tell us about how SharpBrains came about?

Fernandez:   Great plan!  So, myself: As your listeners can detect, I am not originally from the U.S.  I was born in the Basque country, north of Spain.  I came to the U.S. in 1999 to do a dual degree at Stanford.  I did a Master's in business administration, and also a Master's in education; because I love learning, myself, and I also want and I love to see other people learn.

That interest led me to an interest in neuroscience; because, of course, the brain is the organ that learns.  And then, when I graduated, I thought, Well, what career am I most passionate about, and interested in, and I can add some value to it?  I started with distance learning—how students, and also employees, in small and big organizations can use technology to learn at faster rates. 

But I kept reading more books about the brain—how the brain works.  Through Stanford, I attended many lectures.  And there was a book by Elkhonon Goldberg—the book is titled The Executive Brain—that talks about the role of the prefrontal cortex, and the frontal lobes overall, in what makes us uniquely human.  That book really inspired me.

I thought, even if half of what I am reading is true, many things in society will have to change: the way we educate our children, the way we train our work force, the way we stay healthy and productive until our seventies, eighties, nineties.  So, I just wrote a letter, out of the blue, to Dr. Goldberg, after I read his book, trying to propose why don't we partner in doing something meaningful to bring that knowledge, and that new mindset, and take it to everyone worldwide who is interested in enhancing our brain health.

And we partnered to create SharpBrains.  What SharpBrains is, just in summary, is an independent market research company and clearinghouse, where we track what is new in science, what is new in technology, what is new in the marketplace; which means what people are buying, liking, or not liking.  And with all that information and analysis, we shared that through conferences, through reports, and through books, like the one you just mentioned.

Dr. Campbell: I have to apologize, because I know you sent me the First Edition, and I think I failed to read it.  But I actually did really enjoy the new version.  It even shifted my attitudes about a few things—and I will come to that in a few minutes.

What is the goal of this book?

Fernandez:   First of all, we had many discussions, even, about how to title it.  And I think that reflects the goal.  The title is, "The SharpBrains Guide to Brain Fitness."  And there are two key concepts there:

One is 'Guide.'  Many books on the topic, they title 'Prescription;' and they adopt a more medical tone—like someone is the expert; the reader is clueless, and just wants someone with a lot of authority to tell them exactly what to do, exactly what not to do.

In our view, the science is not there right now—in terms of brain health, cognitive function—so, what we want to do is to explain what is the science, and to guide the reader to identify, maybe what is more relevant to his or her own life, and how to apply it.  So, we see ourselves more as guides, or as coaches, and we want to empower every single reader to then become their own coach, their own guide.

The other key concept is 'Brain Fitness.'  The analogy, of course, is physical fitness.  Sixty years ago, there was no awareness, no culture about physical fitness.  There were no personal trainers, no health clubs, no anything. 

And now, that already exists.  People know that we need to stay physically active.  We know that we can go to health clubs.  We know that it is different to prepare yourself to run for a marathon than to play tennis or soccer, or just to stay physically active and healthy on a daily basis.

So, brain fitness, we think is a new mindset; which is, it's not just the absence of disease— it is not just the absence of Alzheimer's disease, or depression, or cognitive impairment—it is how do we maintain and enhance the fitness of our brain; all the functions that we need, in order to adapt to our environment. 

And when I am sixteen, in high school, my environment is different from when I am twenty-three, in college, when I am thirty, in the workplace, when I am maybe sixty, starting to be retired.  So, we wanted to describe—based on neuropsychology, cognitive neuroscience; those are the core scientific disciplines—how can we enhance our daily living, based on that new knowledge.

And the work of brain fitness was to create that sense of optimism.  It's not just about disease—Alzheimer's—it is about how to enhance functionality.

Dr. Campbell:  Right.  I mean brain plasticity is so exciting.  For one thing, it offers so much hope for people who do have problems.  But it also means that those of us who are healthy have something we can do to, like you say, have brain fitness.  I really love that phrase.  I think your analogy to physical fitness is right on.

Early on in the book, you talked about two studies that were published within a few weeks of each other in 2010.  And I appreciate the way these studies demonstrate the hazards of learning neuroscience from the mainstream media.  Would you spend a few minutes talking about those?

Fernandez:  Yes, sure.  Even before I answer the question directly, to me and to everyone involved in SharpBrains—we work with dozens of scientists, and doctors, and people in different disciplines—we really are amazed how the media, often with good intentions, but often they confuse readers more than they enlighten readers.  And this is one of those examples.

Also, it is worth noting that there has been a lot of coverage on neuroplasticity in the U.S. and Canada; not so much in Europe.  I'm from Europe originally, and we do a lot of work with Europe, so we know that.  And then, the Nintendo game, Brain Age, or Brain Training—it was called differently in different places—was extremely successful in the U.K.  They sold millions of units there.

So then, the BBC—a TV program that is on in the BBC—tried to set up the question: Well, do games, like these Nintendo ones, work or not?  And they created a test that involved thousands of volunteers, from their homes, all across the U.K.  And just to summarize, the study conclusions were that, no, the brain training program that they had created did not work. 

Then, they published the study as a scientific study—which was pretty surprising—in Nature, a very well-respected, also a U.K. based, publication.  And that created a whole global media coverage around the concept that brain training of any kind does not work.

So, that's what happened.  Then, three or four weeks later, in the U.S., the NIH released the most comprehensive systematic review of all the evidence of high-quality—meaning not just observational studies, but actual randomized clinical trials—that had measured, credibly, long-term results of different interventions.  And they had two key outcomes: either it helps delay or prevent Alzheimer's disease, or it helps delay or prevent cognitive decline.

And with those two key outcomes in mind, they reviewed every single intervention you could imagine—from all kinds of drugs, all kinds of lifestyle interventions, all kinds of supplements, meditation, anything you can imagine.  Two main factors were found to be protective, both against Alzheimer's disease and, more clearly, against cognitive decline.  One was physical exercise, and the other was cognitive training—which basically is the opposite of what the BBC study had claimed three weeks before.

So, what we spent a whole chapter in the book trying to do was to analyze what those two studies actually did, what kind of studies they were, and to explain why they seemed to contradict themselves, and what a reader can do, in two ways: First, to take away from this message, which is, of course, we would like these to work better than they do; but we already have things that seem to work, or at least, to be more likely to help us than not.  And second, how can the average person be better equipped tomorrow—when we read a new headline, next week; when we read something that seems to contradict what we read today? 

So, we need to build that framework of interpreting scientific data, which the average reader doesn't have right now.  And it's not that complex; meaning, people already do very complex things every day.  We have to buy a car: buying a car is complex.  We buy or rent a house: in which neighborhood?  What kind of fridge are we going to buy for our kitchen? 

We are always making complex decisions.  So, everyone can make complex decisions, if we have the basic information, and the basic frameworks to process that information and to make intelligent decisions.  And that's how we wanted to start the book.

Dr. Campbell: Yes.  And it is challenging to figure out what works and what doesn't.  But, like you say, a good place to start is to look at what we do know in the real science.

Fernandez:   Let me maybe augment my answer; because the NIH study, itself, also was very interesting.  There was a disconnect between the NIH findings, themselves, and how they were portrayed in the media.

So, the main message in the media was nothing prevents Alzheimer's disease.  That was very pessimistic.  And many people took away, Well, if nothing prevents Alzheimer's disease, why should I even care, or try to do anything?  The tragedy is that the study, itself, that's not what it showed.  So, it is true that there was no magic pill; there was no single intervention that could be shown to prevent or delay the onset of the pathology—meaning the accumulation of Alzheimer's plaques and tangles, nothing could stop that.

However, that's not what most people care about.  What I care about is how long can I remain independent.  How long can I remain vital?  How long can I retain good attention and good memory?  And what this means is, how long can I delay the onset of the symptoms? 

There is a very important disconnect, that people often are not aware of, between the pathology of Alzheimer's and the actual symptoms of Alzheimer's.  And I will say that, when we interview people, what people really want is to delay the symptoms.  If we can delay three years, five years, ten years, the symptoms, that's an extremely meaningful outcome. 

And according to that outcome, there were interventions shown in the NIH study that can either increase the risk or reduce the risk of symptoms.  So, for example, I mentioned physical exercise and cognitive stimulation in general—but cognitive training in particular—can reduce the risk of those symptoms.  They delay the onset of those symptoms.  On the other hand, diabetes or depression can increase the risk. 

So, of course, there are many, many things that we can do in our daily lives to enhance our functionality and to delay symptoms—which is what truly we care about.  And whether or not it stops the pathology is a very interesting question for research, for more biomedical studies.  But people were very confused; and the media didn't differentiate those two frameworks very well. 

Dr. Campbell:  One of the things that stimulated me to start the Brain Science Podcast way back in 2006, was this very problem; the fact that you're constantly hearing stuff that, if you're like you and me, you've been reading about it, and you say, That's not right!  You don't even have to be a neuroscientist, you can just be somebody that's been reading the actual science, and you know that the media is doing a bad job.

I mean National Geographic actually put out a special issue about the brain a few months ago, in which they had "100 Secrets About the Brain You Don't Know."  And, would you believe it?  At least 10 of them are wrong.  One of them was that old one: you only use 10% of your brain. 

Fernandez:  That's amazing!

Dr. Campbell: Can you believe that a reputable magazine—at least, I thought of National Geographic as reputable—would publish something that outdated?  On the other hand, it means there's no shortage of material for you or me to share with people.

Dr. Campbell: Alvaro, in the book, you talk about what you call the "pillars of brain fitness."  You've sort of alluded to those; but would you like to just mention what those are?

Fernandez:   We try to do many things with the book.  One is to educate readers, but in a fun way; because it's not a textbook, so we have to also engage people.  We also have to move people, a lot, across a journey of discovery, and even of self-reflection.  So, we had to think very hard how to sequence different chapters; and in the last chapter, we help integrate everything.

So, I think the best way to answer the question is to explain, at the high level, how we structure the book.  First, it's how does the brain and the mind work.  Because we thought that understanding is very different than understanding the role of the pillars.  So, for example, if we say, how does stress impact on decision-making and on attention; we need to understand that, in order to understand the pillar of stress management, and why that is so important, for example. 

So, the first two chapters are about the brain—the mind—and how to read the new scientific data to really understand what is going on.  We have a section titled, "Don't Outsource Your Brain," basically making the point you just made; which is that all of us, we shouldn't outsource our brains to the media to tell us what to do, because that's not their role.

So then, after people understand the basics, we go to the pillars—the most important components of a healthy lifestyle that can promote functionality and delay disease.  And the four critical key pillars are:

Aerobic exercise.  That can contribute to many things; for example, the creation of new neurons.  Which is something that people don't know today; that not only every day we are creating new neurons, no matter our age, but there are things we can do, such as aerobic exercise, that can even enhance that rate of neurogenesis.  So, that is very important. 

The second one is nutrition—healthy nutrition.  But in fact, that has proven to be a bit controversial, because many people on the radio, or in other places, are always promoting supplements: take this supplement, or that supplement, or that supplement.  And that's not at all what the science showed.  Healthy, balanced nutrition is a very important component, because a lot of those nutrients end up in the brain.  But it is about a healthy diet.  And people rarely know what that means; it is not about supplements.

In fact, one of the most maybe surprising things that happened in that NIH study—the evidence that you mentioned before—was that ginkgo biloba, which is the main thing many people take, was shown not to work.  Still, people are taking supplements, and ginkgo.  Anyway, nutrition is the second pillar; but that means a well-balanced nutrition.  The model there is the Mediterranean diet: fruits, vegetables, Omega-3—through fish, not through supplements.  So, nutrition is number two.

Number three is mental stimulation, overall—the famous use it or lose it.  What is new—and people don't understand, often—is that if we do something that feels too easy, that's not use it.  We need to do something beyond our comfort level; we need to truly stretch our minds, to feel a little bit of an effort, for it to truly be beneficial.  Otherwise, we don't need a brain to just do something for the twenty-millionth time. 

I often tell people, when they ask, 'Are crossword puzzles very good?' I answer, 'Well, it depends on how many you have done.'  The first ten probably are wonderful, because they force you to really pay attention, to break your mind thinking different strategies, to pay a lot of attention, to problem-solve.  After one million, the marginal value of one is probably worthless.   Because, it is like a robot; you already know what to do. 

At that moment, maybe you should play a videogame, or do something completely different.  And vice versa; if I'm talking to a child who is playing videogames all the time, I would tell him, 'Stop doing that, and do more crossword puzzles.'  Right?  The value of novelty, and variety, and challenge is the third pillar in our framework.

And now, the fourth one is stress management.  It is how we need to regulate stress in systematic ways.  In today's society that changes very quickly, where things are often very, very complex, we can either decide to live on the top of the mountain in a very quiet, calm environment, or we have to decide to really learn how to understand and recognize our own emotions, our own levels of stress, and how to self-regulate those—which can be through exercises like breathing, like Yoga, like meditation; there are some technology tools based on biofeedback that can be very efficient.  But the role of really learning about stress, stress management, and what scientists call emotional self-regulation, is a critical pillar of brain health.

But those pillars are like the fundamentals.  We need to start there, because that's most likely where is the low-hanging fruit for most of us.  We just have to think, Well, in which of these pillars maybe I'm weaker?  If I'm always eating fast food, maybe my opportunity is to reduce fast food or soda consumption.  If I am completely sedentary, maybe moving from sedentary to two hours—or even an-hour-and-a-half—of some cardio activity per week would be my key opportunity.  If I am working in a very boring, repetitive job, maybe I need to change and to do a new career, or try to find more stimulating things to do in my free time.

So, those are the pillars.  But then, the last two chapters, that's where I think we cover more new ground.  Beyond those pillars, what are the tools that people can use?  If I have, let's say twenty hours next year that I want to devote to enhance my brain health, my brain fitness, what could I do?  So now, through technology, there is a variety of options that people can benefit from.  There are programs that enhance working memory, or information processing, or stress management. 

So, what we try to do in the end is, what are those tools that are becoming available now?  And there is a sort of controversy around those; because, of course, the developers of those tools claim they are wonderful for everyone in the universe, and for everything you can dream of.  And some scientists will say they are worthless, forget them, don't spend money there. 

The reality is in the middle; it's like Aristotle's virtue is the middle point of two vices.  So, we try to explain what is the value and limitation of many, many new tools that are becoming available; and which groups of readers may find some more useful or not.

And then, the last chapter is how you integrate all these pillars and all these tools into a plan, or into something specific that you, the reader—no matter if you are a consumer or a professional—can benefit from.  So, in fact, I was very curious about what you, Ginger, said in the beginning—that a couple of things have shifted your attitudes, maybe even your behaviors.  But that's what we wanted to do in the last chapter, is how do you integrate all this knowledge into your daily life and daily work, so that it truly creates an improvement.  Because just a book, per se, is pretty useless, unless it moves to your real life

Dr. Campbell:  Well, there were two things that really stood out for me.  One was the chapter about social engagement.  Because, although I, as a physician, am well-aware of the importance of social engagement for older people, I had never really thought about it in terms of its effect on our brain function.  So, that was an eye-opening chapter for me.

And the other thing was, in your chapter—that I think you called, "Cross-Training"—which was sort of an analysis of some of the available cognitive training regimens, I liked the fact that you focused on this idea of cross-training.  Because it really made me think about cognitive training from a different perspective—more like the way I think about going to the gym as only being one piece of my physical fitness regimen; it's not the only thing I do.  So, that really changed my attitude toward the cognitive training thing.  And I want to ask you about that in just a second.   

But, for example, I've been tending, on my show, to tell people that—as my personal opinion—they should be spending their time doing something real, like learning a new language, or learning to play an instrument, rather than playing a brain game on the computer.  But from your book, I realized that those are not mutually exclusive choices.

Fernandez:   You've made me very happy!

Dr. Campbell:  So, what is brain training?

Fernandez:   Exactly; that's the key question that, from a science perspective, is

the most fascinating.  And the media has not gotten there yet.  They will get there in a few years; but we are now covering new ground.

So, in our view, brain training is any structured set of exercises proving to enhance a particular circuit of neurons that support a particular brain function—that can be more cognitive, or emotional, or executive.   I know that I used many, many words in that description; but what are some key ingredients?

One is that the training has a bit of difficulty and effort.  If it's just playing around some random games in some website, that's entertainment; that's not training.  And that was one of the criticisms against the BBC study we mentioned before, in that they designed a protocol that truly was a joke; it was not brain training, it was an average of three hours total training per person.  So, in the physical context, how could you call physical training something that the whole intervention was three hours?  Well, that's not credible.

So, in one of the chapters, we also talk about what are the minimum conditions for brain training to even be called 'brain training?'  And we said, based on all the literature we have analyzed, where there are clear benefits, the minimum is fifteen hours of training per targeted brain function. 

Also, it is important, again, it's not that the brain has one function; attention is different from memory, is different from processing speed, is different from regulating stress and emotions.  So, it has to feel like training; it has to be adaptive; it has to become more difficult.  Because if it's the same, it's like going to the gym and, imagine you want to enhance and build bigger biceps: Well, everyone knows that you have to increase the weight of the machine, over time, to build biceps.  If you always go to the machine at the same difficulty level, that's not training. 

But the problem with many programs in the market is that they are not designed properly to train anything relevant.  It has to be something that—for example, I mentioned the word 'working memory' earlier; or 'emotional regulation;' or 'processing speed.'  So, there is a variety of functions that already has been shown to be important in daily life—for different reasons; either to be able to learn new information, to make good decisions, to manage stress; even for driving safety. 

I mean driving, itself, is a very complex perceptual and cognitive activity—that people often are not aware of.  So, how do we enhance and maintain that capacity, so we can maintain and be safe drivers until our fifties, sixties, seventies, eighties, nineties—which in the U.S., especially, driving is very important for life.

So, brain training—to summarize—has to be about two things: an element of effort and improved practice (some psychologists call it 'deliberate practice') on brain circuits that really make a difference in daily life.  Otherwise, it's just an exercise in vanity. 

And what I think also is going to happen, in the next maybe five or ten years, is that we will have better assessments.  So, imagine that you can go to a website, or through a doctor, or just yourself in your home through a website, and maybe after a thirty-minute in-depth assessment—like a computerized neuropsychological assessment—you will identify your strengths, your weaknesses.

You will say, maybe, this is my life, this is my work, what are the areas I should work on more?  And then, you will have a more personalized plan, that tells you these are the specific brain functions you need to improve on, and this is the best combination of lifestyle and these brain training tools that can be efficient in helping you.  And then, you will be able to have the perfect model.  And right now, that doesn't exist.

So, it's more about some guidelines and some tools for people to understand.  And I am extremely happy about what you said.  We talk also about learning how to play a musical instrument, or learning a second language.  But, as you say, they are not exclusive.  Learning how to play a piano takes thousands of hours, and can be extremely expensive.  Some scientists say, 'Don't buy this brain training program, because it costs $100, and instead, it is better for you to learn the piano.'  Well, learning the piano probably is going to cost you $5,000, $10,000, $20,000.

So, people need to understand, first of all, what is my objective; and then, based on my objective, I can work backwards, and think what is the best combination of these different options that can help me the most.  It's like the Swiss knife.  You know the Swiss knife, where you have different tools; you have either a scissor, or you have a knife, or you have a screwdriver.  People need to understand, those are different tools in the toolbox—how to use them. 

That's the new mindset—versus the old one, which is, this is the magic pill.  We're just waiting for the magic pill to cure Alzheimer's.  That would be excellent news.  I don't see any progress there.

Dr. Campbell: Yes.  It's like in the early days of the physical fitness movement, when they were selling things like bands that vibrated around people's waists, and were supposed to make their fat go away.  I mean we're kind of in that stage in the brain fitness movement, where there's a lot of stuff out there; it's easy to make claims that people don't judge critically. 

But one of the things I liked about the book was—and we're not going to get into this, but I'm just going to mention it to my listeners—you did talk about some of the programs that are out there with strict criteria.  You discussed only a few.  And there are now several programs out there that are very affordable. 

I know that USAA—because I have USAA insurance—now, if you're over fifty-five, you can do the Posit Science driving program for free.  It's very similar to the other Posit Science stuff—because I've done some of their stuff.  And you've got advice in your book; the kinds of questions that a person should ask, if they're thinking about using a particular program.


But is there anything else you want to share before we close today, that I've left out?

Fernandez:   In a sense, there has been so much progress, in science, technology; just with respect to how, as you say, insurance companies, hospitals, schools, retirement communities use these new technologies, I think the average person really has to learn a lot of new things to not stay behind the new times. 

And that way, we thought people needed a good book to say, This is the guide; this is not the prescription.  This is the beginning of a journey—of a path.  But to start on the right path, I have to start somewhere; and this book can help me start in the right place.  Again, I hope readers will appreciate that. 

But, again, I see it as a journey.  It is a path.  It is like—back to physical fitness, where it was fifty years ago and where it is now—this brain fitness field is going to move way faster than physical fitness.  Because the science is happening faster, and the technology.  As you say, the things that used to be expensive, now are becoming very inexpensive.  There are many things happening.

The other key thing I wanted to mention—I took a note earlier, when you were talking about neuroplasticity as a very exciting concept.  People don't realize, though, that neuroplasticity can be good or bad. 

So, what 'neuroplasticity' means is the property of our brains to adapt—to evolve, based on experience.  That was a very clever asset that evolution gave us; that we are not perfectly hardwired, but we have a lot of leeway.  So, we can adapt to our environments.  And neuroplasticity is what enables that. 

But what we know today is that happens at every age.  So, the rate of neuroplasticity, it is true that it slows down after our twenties, but people of any age can still change—in a sense—their brains.  The question is how to change them in a good direction vs. a bad direction.

Often we talk about many things that work, that don't work, and we ignore the elephant in the room.  Which is what is the biggest waste of collective time?  Is it videogames?  I would say perhaps; but an even bigger waste of collective time, I would say—in most cases—is watching TV.  The average American watches four hours of TV a day; and that increases as people get older. 

That is, in a sense, implicit to brain training.  We are training our brains to be passive observers of what someone else has programmed for us.  That's brain training that is not helping us.  And in fact, in some areas of the book, we also talk about that; about how one of the few leisure activities that has been correlated with lower cognitive function is precisely watching TV.  And that's a correlation, it's not causative.

So, if the brain is plastic at any age, how can I offer it—how can I offer myself—the kind of environment, the kind of activities, that are going to improve that trajectory, not just for today, but for the next ten, twenty, thirty, forty years; thinking of our own brains as the most important, precious asset we have, without which we have nothing, we have not even personhood. 

So, how can we introduce elements of novelty, of talent, of joy, of curiosity into our lives, into our work, into our personal lives, into our families, into our relationships with people around us?  And that's, I think, a key message of the book, and the whole promise of neuroplasticity; which is how do we architect, organize, a life that truly enhances our future, more than makes us be stuck or in decline.

Dr. Campbell:  I still remember, when I interviewed Dr. Goldberg, he talked about how one of the things he did (I assume he probably still does this) was he made it a point of learning how to use the new software and various tools in his office and lab, rather than just letting one of his students do the stuff for him.

Fernandez:   Yes!

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Dr. Campbell:  That's a very important principle: we always have opportunities to learn new things and meet new people.  I think younger people just take this for granted, and don't realize that they're going to reach a time in their life where the temptation to just do the familiar becomes strong. 

I know people my age, and older, who still have the attitude, Well, I'm too old to learn anything new.  Well, that's ridiculous.  You may be too lazy to learn something new, but you're never too old to learn something new.

Fernandez:   Exactly!  But also, people need to understand what is the true active ingredient—or the true value? 

So, for example, I had an interview with a reporter from Fortune a few weeks ago.  And she said, 'Well, after this conversation, now I understand I have to start learning Mandarin Chinese tomorrow.'  And then, I asked a few questions: is that the best route, or not?  And it happened that this person had been living in France for many years.  So, I said, 'Well, maybe the best thing for you would be to start writing, maybe for some French publication.  That would still make you bilingual, and practice.' 

It's not about one big effort—that is going to frustrate people; to feel overwhelming, and then never go back to that—but something that truly also is an effort, but also it makes sense in one's life, and brings an element of joy.  In the case of Elkhonon, he still uses a lot of new software and likes to experiment with new things.  And that works.

When I asked him what was the best thing I could do, myself, he said, 'Well, exactly what you are doing.'  Right?  To run a new organization, in a completely new field, where every day we have to figure out what we are going to do next year. 

Right now, we're creating the agenda.  We have an online conference every year—this will be in mid September.  What is the agenda?  And it's going to look very, very different from last year, reflecting the advances in science and technology.   

So, all of us have those opportunities.  I think often the bottlenecks are two: one is, as you say, laziness.  I mean sometimes it feels easier just to do what we know we can do well.  And second is stress.  And that's why, in the book, we pay a lot of attention to what are emotions, what is stress; how too much stress can be bad for the brain at the structural level—how it can contribute to the death of neurons, and even to a smaller hippocampus—and also, bad from a functional perspective—how it can lower working memory or attention. 

So, how can we truly learn how to deal with stress.  The problems is that there are millions of workshops and millions of books on stress.  And everyone knows stress is bad.  But few people have really taken the time to know, based on the best science right there, what is the most efficient way to learn how to master that new capacity to regulate stress. 

In my personal case—just one human being, one anecdote, but that reflected what I think is the science—what helped me a lot was two things:  One was to learn how to breathe, and how to meditate.  So, the right pattern of breathing, in a mindfulness setting, made a huge difference. 

But then, I also saw technology.  And we didn't have time to talk about biofeedback.  There are different metrics, but one that is very grounded in research is called heart rate variability—what is the pattern, the rate of change of heart rate.  And there are systems—that are pretty expensive; sometimes they come with games—that help you self-monitor your own level of stress.

So, you can apply that breathing, those meditation techniques you have learned—maybe in a class, or in a retreat.  And you cannot fool the system.  So, you can really see if you are getting more stressed or less stressed.  That really helped me regulate my own stress extremely well, in more efficient ways than many, many weeks I had spent before in other kinds of activities.  And that's brain training.  Not only is it about cognition, also it is about the role of stress and emotions.

It's a new mindset.  It's a new, I think, very fascinating opportunity that we have ahead of us; that, of course, is going to be evolving very quickly, because of this new science, this new technology, these new best practices.  But we thought the book would be a great way to just start making some progress.

Dr. Campbell:  Well, I think that the SharpBrains Guide to Brain Fitness makes a great contribution to this area.  And I'm definitely going to recommend it to my listeners.

Fernandez:   Excellent!




I want to thank Alvaro Fernandez for being my guest for Episode 100 of the Brain Science Podcast.  I would like to mention that the book, The SharpBrains Guide to Brain Fitness, has been written with a diverse audience in mind.  As Alvaro mentioned, they were trying to write a book that would be accessible to regular people. 

But, for those of you who are interested in the research ends of things, the book contains ample references, including that NIH study that he mentioned—which you can download from the Internet; and it's actually over seven hundred pages long.  There are also lots of interviews with scientists embedded into the book.  So, it's a really meaty, but easy-to-read book.  And, of course, I will have a link to it in the show notes at

I also want to take a moment to mention the work of Elkhonon Goldberg, who we mentioned during the podcast.  I, early on, did two podcasts—actually, three podcasts—about Dr. Goldberg's work.  His book, The Executive Brain, was featured in Episode 16 of the Brain Science Podcast.  Another book about brain aging by him, called, The Wisdom Paradox, was featured in Episode 17.  And then, I actually interviewed Dr. Goldberg in Episode 18

So, it's been a while since we talked, but he did make a valuable contribution to the early days of the podcast.  So, it seemed appropriate to bring his colleague, Alvaro Fernandez, on for this episode.

Click here to download the complete episode transcript.

The Brain Science Podcast is copyright 2013, Virginia Campbell, MD.   You may copy this podcast to share it with others, but for any other uses or derivatives please contact me at

Special thanks to  Lori Wolfson for transcribing the Brain Science Podcast.