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054: Maintaining Brain Health For Men and For Women, with Dr. Sarah McKay

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As we age we don’t have to lose our cognitive function, but is maintaining brain health for men different than it is for women? Our guest for today’s Awesome Health explains some of the keys to cognitive fitness, and if differences in genders are social, behavioral or biological.

Dr Sarah McKay is a neuroscientist and science communicator. She’s also the author of The Women’s Brain Book and is the director of The Neuroscience Academy. She is exceptional at translating brain science research into simple, actionable strategies for peak performance, creativity, health and wellbeing for men and for women.

On this episode of Awesome Health Podcast, Dr. Sarah tells us how she got into the field of neuroscience, whether nature or nurture more strongly influences us (answer: it’s both) and the overlap in biohacking concepts and ways to fend off cognitive decline. Dr. Sarah explains the role neuroplasticity plays in these two seemingly disparate areas, and why we need social connection for enriching our brains.

Interacting with others is incredibly challenging and stimulating for our brains, this type of experience is considered an “enriched environment” by science. These enriched environments help maintain brain health, even in the face of genetic disorders like Huntington’s Disease. Huntington’s is a degenerative disease that people can be pre-disposed to, and at one time it was accepted that if you had the genetics for it you would develop it no matter what. But Dr. Sarah explains how research done by a colleague of hers showed enriched environments could actually alter the trajectory of this disease. She gives more details on today’s show.

We then segue into other topics, including the ideal frequency for exercising is 3-4x a week, and anything beyond that offers no additional benefits. We also talk about how science has shown us that building muscle mass throughout our lives protects against cognitive decline; we can even take up weight lifting later in life (like 75 or 80!) and still see tremendous benefits from doing so.

We wrap up the show with a look at male and female genders and what she offers in her book, and the areas she sees as most promising in the world of cognitive health, brain function, and social engineering.

Join us to hear those topics and more on this thought-provoking and stimulating episode of Awesome Health with Dr. Sarah McKay.

Episode Resources:

Read The Episode Transcript:

Wade Lightheart: Good morning, good afternoon and good evening wherever you are. It's Wade T Lightheart from BiOptimizers on the Awesome Health Podcast, and I am delighted today because we are with Dr. Sarah McKay and she's a neuroscientist and a science communicator. You might've seen her TedX talk videos - she talks a lot about women's health, neuroscience, hormones, happiness, all these things that everybody wants to know about, but a lot of people don't know how to sort through the research in a way that you can communicate the salient points that you can effectively integrate into your life each and every day. She's joining us, I believe, from Northern Australia, but you're a new Zealander?

Sarah McKay: I'm living in Sydney, Australia, yeah. I live in the Northern beaches of Sydney, so that kind of the North, the North shore of Sydney along. I'm looking at my window and I have a Manly beach at the moment, so if anyone's ever been to Sydney, they'll know Manly, but I'm a new Zealander, I grew up in New Zealand.

Wade Lightheart: Right on. Super gorgeous. Well, thank you for joining us today. It's so exciting. Welcome to the Awesome Health show. I'm excited to dive into this.

Sarah McKay: I'm delighted to be here too.

Wade Lightheart: Okay, first question, neuroscientists. It's kind of like, you know, it's kind of like this mystique area, where world of super geniuses and neurons and neurochemicals, and I have this vision of beakers and labs and people staring into books late into the night and figuring things out. Tell me how did you get into it? Is that true? What's been your experience and what drew you into this field that is really exploding today in the world? It's come into its own that people are becoming fascinated with how their brains work. So give us a little background of how you got there, maybe your history and then how you got into this.

Sarah McKay: Yeah, for sure. So it is probably a little bit like what you say there. There are bakers and microscopes and passionate neuroscientists reading books and discussing all things brain. And I for one could not be more delighted that everyone else is becoming as curious and as interested in this sort of discipline that I've spent my entire career working on. And I often say there's a real seductive allure around in neuroscience. I was seduced into neuroscience, I was one of those kids - I loved school, I loved learning, I was always reading, had quite a broad academic interest but really did love biology and health. And my very first year of university I was in a psychology lecture and I was divided by human behavior and thoughts and feelings and emotions.

Sarah McKay: And we were doing a lesson on sort of the biology of psychology in a way. And I was like 'this is pretty interesting.' And we were recommended by the lecturer to read a book called "The man who mistook his wife for a hat", which is by a neurologist which some of your listeners may be familiar with. And he was a wonderful writer and wrote up these case studies and all of the kind of curious things that go wrong when the brain malfunctions. And I was actually captivated. So that was in my first year of university at that time, within that year. Another unit - I grew up in Christchurch, New Zealand. At the same time Otago university in New Zealand, which is about four hours down the road in Dunedin, this is in the South Island of New Zealand,

Sarah McKay: had started a brand new degree discipline of neuroscience, pulling together the neuro and brain components from psychology and pharmacology, physiology, psychiatry, anatomy, and to this new degree this was back in the early nineties, which probably ages me somewhat. That was it - that was, you know, one of those moments in my life that set the path leading in front of me. And that was kind of 25 years ago now. And I've really followed that path since I was incredibly fortunate to win a four year scholarship to Oxford university in the UK. And I studied neuroscience there and then I was looking at brain development and I was very interested in this kind of question about how does the brain wire up during development, had neurons make their decisions? Is it nature? Is it nurture?

Sarah McKay: Well, my research showed it was a bit of both, which is really what we know now that nature nurture very intertwined. But it was really around that time we started the first use of this very new word plasticity or neuroplasticity. And I remember the very first time I heard that when I was in the research lab, probably around the year 1999-2000, and we only just started using it in the research lab. The met concept had been around for a while, but we were just sort of starting to use it. And, you know, fast forward 20 years and now everyone uses this word. I think it gets misused in a lot of ways as well. But I mean, you can say I've kind of been fascinated and deeply engaged in this discipline. And for me, the thing I love the most about it, it's just some incredibly broad and deep and complex that it seems to answer for a lot of people so many questions about who we are as humans, how and why we think, feel and behave the way we do. There's a lot more we don't know than what we do know for now. And I think for me as someone who, you know, I just love learning. I love books. I love finding out, I love research. So it's a great discipline to devote your career to it because there's always something new to find out.
Wade Lightheart: Yeah, totally. It's fascinating. What do you think has caused this explosion of interest in the last maybe 5 or 10 years in the public domain? Do you think it's because of digital technology, because we're getting applicable models that we can change, you know, some of the things, or understand how some people operate? What would you say?

Sarah McKay: I think there's still lots of cases, particularly in the hard sciences like neuroscience, there's still a bit of a gap between, you know, what we know and the way the science says, and kind of where people want it to be. But the gap is narrowing and perhaps as a sense that the gap is narrowing what I see now, and this may be because I'm not working in the research lab anymore, I've got a little bit of a big picture view - that we are starting to be able to connect the dots between disciplines. And that probably has come about because of the internet age and the fact that scientists, institutions, researchers, we can now connect the dots more easily because we have more access to each other. So people in a way have to almost be in a silo.

Sarah McKay: You have to become by the virtue of a nature, of science, you become an expert in a very narrow area because there's so much to find out. So I think it may be that we're starting to connect the dots between different ideas and a lot of the sciences, the psychological sciences. We've seen a move towards, the positive psychology movement, which I think has been really important. How can we live better? How can we live better, healthier lives, just not be sick but be well. And we're starting to see that science can inform that. And so I think that that's perhaps part of that. I'm delighted that people are interested. What I do is - I try to keep up with feet on the ground cause there's so many cool ideas. We don't want to get too carried away and overreach. What we do now. I mean there's still plenty of things that we can learn from.

Wade Lightheart: So from your, obviously, decades of work and research and stuff, and I know there's kind of two different camps that I see happening in the world, and that is the areas where they're looking at reversing or treating cognitive decline, whether that's, you know, Parkinson's, dementia, these type of neurological conditions that can be Alzheimer's, that can be so devastating to people. And then there's the other side, which is what would quote unquote the biohackers side, which is, you know, going down the area of nootropics and plant medicines, kind of like accentuate or accelerate or expand or hit a new level of performance. I'd like to see here what your commentary is, maybe your experience in either one of those areas or both, or a little bit of overarching perspective of these kinds of two opposing branches that seem to be emerging. What's your thoughts?

Sarah McKay: I don't see them at all as opposing. I mean just from the beginning, when you say that I don't see them as opposing or dichotomous or one to one group over there. I mean, I just see there's this world of researchers and people out there trying to understand how the brain works and grows and changes and ages. And what's an area we can focus in, not that there's aging and then there's not aging. I do often note with a little tongue and cheek to myself that the biohacking world does tend to be made up of younger blokes, a lot of whom live in Silicon Valley. And, you know, they probably won't get old and die.

Sarah McKay: And the people, you know, researching dementia, probably working with people who are over 80, who probably are a little bit closer to the end of their life. I do think there's a little bit of perspective needed there, about the kind of 'the reality versus what we would kind of hope'. So I don't see them as different. I do think that aging probably for most of us is inevitable. However, there are aspects of that we can influence with lifestyle. But as everyone going to live to 200 in the next 50 or so years? I doubt it. Wouldn't that be wonderful? What I see is that the people who are working within sort of the Alzheimer's, dementia, degenerative diseases, dealing with people, perhaps you're looking at people in the eighties and nineties, we're now starting to show signs of Alzheimer's disease.

Sarah McKay: What happens is life does get under your skin and we've got people in their 80s who are now saying kind of things rolled out and their health that may have been factors that influenced how they lived when they're in their 20s and 30s. And life was very, very, very different back in the 1930s and 40s for people who are now in their 80s and 90s today. So I think that it's really useful if we take a long lived and we look at the life span and look at the people who are the oldest - who are the people who are doing incredibly well, who are the people who are doing this well and what can we unpack? We go back through their lifespans and then what we tend to see - it's not that if you do everything right, you'll live forever.

Sarah McKay: We just see the scale kind of tip sometimes in your favor and sometimes not. I think we have to be very careful not to look at large population studies or groups of people and go, right, there's a thousand people. Let's look at the research and then try and apply that to me individually. I do think that if you're trying to get at the biohackers - what are they looking at? They're looking at ways to optimize and live well and healthy and use information. Not hack longevity, but use a lot of that biological data and information. One of them said to me - I was over in Silicon Valley last year filming a documentary on brain aging and longevity. And we met, when I look at these, as I call them, the kind of the Silicon Valley bros, the biohacking bros, because they're usually young, wealthy, white dudes who are in this space.

Sarah McKay: You know, they're really interested in data and information and what they can learn about themselves to optimize their health. I think that's great, but if you're in your twenties or your thirties or your forties, it's probably easier to hack yourself than if you're, you know, an elderly lady who's in her late 70s, early 80s who just doesn't have that information and that knowledge and that education at hand. So I don't, I didn't see them as opposing, cause I think that also means that the people who are at the other end of the non-biohacking scale or miss out, and that's fundamentally unfair.

Wade Lightheart: One of the things that's a good - integration, because I've seen both sides of that fence. And what I do find is - the younger generation and the biohacking group is me-centric. I want to be all you can be, be a superhero optimized, live forever, and then kick butt and take names as we do it. And then the other side is very often group centric, kind of whether it's the pharmaceutical kind of perspective or developer and have a thousand, like you would say, an experimental stuff and these broad based applications. What do you think are the contributing factors that allow, from your observation, to age or have our brains aging in a healthy way or gives us the best chance? Maybe the do's and the don'ts around those areas?

Sarah McKay: I don't think that there's really anything new under the sun that's apart from what our moms told us as well. So I think if you look at this, there's a couple of different ways we can look at it. We can look at our evolutionary past. How did we get to where we are now? Let's look at those people who have already lived the longest, not the 20 year olds who are trying, but let's look at the 80s and 90 year olds who are really doing incredibly well. And if we take a combination of those and take a look at what we understand from large population based studies because we have to look at what a lot of people have done, not what just one or two people have done to be able to figure that out.

Sarah McKay: And we see all of those things that they do, it doesn't mean we necessarily do them. I mean, I like to put the brain in the middle and take what some people would say by soccer social view or look at your bottom up biology, the outside world and your top down thoughts and feelings. So, you know, we just need to move our bodies. We need to exercise, we need to nourish our bodies well. And most of us just need to quite frankly eat more vegetables than what we do and perhaps eat a little less crap. We need to make sure that we get enough sleep. We need to respect the light, dark cycle, sleep when it's dark, perhaps try and see a sunrise or set to help regulate your biochemical shifts.
Sarah McKay: So they'd be factors such as a diet, you know, eat well, move well and sleep well. I think from the outside and if we take a look at the people who are the oldest and who's showing the resilience to aging in terms of a brain perspective, what we see is if we look back on the lifespan, we see people who stayed in education the longest or who worked in the most intellectually demanding and rigorous jobs, they appear to be somewhat protected to a lot of the diseases of brain aging. So almost as if you've used your brain a lot to think a lot and challenge it a lot. It's a bit like a muscle, but that kind of an analogy actually plays out. Taking a look at how we manage stress, that's pretty fundamental and important.

Sarah McKay: It's a very stressful world in 2020 for many people. So what's your place or your way of reducing stress? Because we know increased stress, increases inflammation increases a whole lot of, sits off a whole lot of aging cascades in the body. So again, nothing new there I think. And also if we look to the outside world, it's about other people who are the people that we're interacting with. Do we feel loved and cared for? Do we feel we've got people to call on? And our social connections are probably one of the key indicators of a healthy long lifespan. Now, if we look at top down factors, we can look at, as I said, we've got things like education, but we've also got curiosity I would notice, we can use the word curiosity there. I was filming this documentary last year on brain aging and part of that we went and met some people in Australia who have been part of a longer study of aging who are all in the 80s and 90s, and they don't show the typical signs of aging.

Sarah McKay: And we kind of pulled them into a place in Melbourne and we kind of got them to run the way through a hedge maze police, all of these cognitive challenges along the way. And then they raced some of their younger family members who are in their 30s and 40s, we kind of pitched them against each other. They came out slightly, I call them the outers, they were slightly slower on foot, but they may listen to steaks, which is really interesting. The young ones always could run down, shake up, it was the wrong way or not, and then come back. The elders were far more methodical. But the thing that struck me the most, and this is the top down thing, was they were the most curious, interested

Sarah McKay: in the world around them. Interesting chatty social people, everything about you can imagine they were spending a day filming a documentary, film crew and sound guys and you know, I was the science presenter. They would just, all four of them just, were drinking up every moment of that day. And then the offspring were pretty similar as well. Super engaged, interested people. And I think that's another key there, is to sort of stay optimistic and engaged and curious about life. And we also see that you can go and you quantify and measure that population of people and you'll see that there is another protective factor. So I think what we see is, you know, it's a bit like building a wall. You see a lot of bricks that you can kind of build up to that resilience.

Sarah McKay: It doesn't mean that a disease can't come and swap it all away. But there's lots of what we would call in science risk factors of public health and risk factors that kind of help build up. And so there's nothing new in there under the sun, quite frankly. I guess it's being able to implement that and do that. Do you personally have the information, do you live in a society, do you live in a culture? Do you have a healthcare system that enables you to be able to do all of those things? And then, you know, you would hope that scales might slowly start to come in your favor.

Wade Lightheart: I know, it's always dangerous to speculate, but do you feel that the curiosity factor, the social factor and the intellectual rigorous, what challenges do you think that just creates more neurological connections? And so therefore if you lose some of them or they start to grade, you just have a bigger deck to play with than someone who's kind of in this kind of rigid calcified routine that's kind of small?

Sarah McKay: Yes, we think so. And if we can kind of back that up, if we go and look at animals studies and we provide, for example, we would call, living in it, you know, that kind of environment where you're constantly stimulated and engaged with other people. Cause social cognition, thinking about other people and interacting them is actually incredibly intellectually challenging for your brain. We would call it enriched environment and we could go and do, an animal study and we could have a bunch of mice and grow them up in a beer cage with just a bit of food and water and they would stay alive versus a group of mice we could put in an enriched environment with wheels and tunnels and lots of things to play and do and engage themselves with, so they physically and mentally stimulated and active.

Sarah McKay: And we do see very, very clear differences in terms of what their structure and their function is like. And interestingly in some of this was done by a colleague of mine from Oxford who now works in Melbourne, is known as Tony Hannan, and many years ago, back at 1999-2000, he didn't think that type of study and mice who had a gene that predispose them for Huntington's disease, which is a degenerative disease, which causes a lot of motor and cognitive deficits and people, up until that point, we thought it was a hundred percent genetically determined. You got the gene where you've got various repeats of the gene, you ended up with the disease. They were able to alter the trajectory of the disease and mice that had environmentally enriched conditions versus those that weren't.

Sarah McKay: And that was kind of seen as one of these early indications that we can, you know, with the way that we live, our lives influence the outcome of degenerative disease. So certainly we know that living that way does what we would say build up more connections, build up more signups, you might not necessarily get more neurons themselves, but you're going to get neurons with far more connection networks which are more active and activated. And that builds up what we call resilience. We call that kind of cognitive reserve. And your brain slightly say you've got more cards and your debt to play with through life.

Wade Lightheart: Beautifully said. So if someone came to you at any age, doesn't really matter. Cause it seems like the principles are sound. What would you say on an allotment for brain health as a force, time, effort and energy. So I'm the bloke, let's say I'm the bloke, the 20 year old biohacking bloke over here in San Francisco. What are the things that that person needs to integrate now - do they need to exercise an hour a day, two hours a day? Do they need to challenge himself with something new every month? Is there any common elements or minimums, the minimum effective dosage of these components cause everybody kind of says those things but what's enough to actually create a difference?

Sarah McKay: That's really interesting cause I think we are now getting to the point of can we look at it? Is there a dose response in terms of that now I think if you're in your 20s and you work in Silicon Valley, you're clearly intellectually stimulated, engaged, you're probably freaked over your diet and you're either probably eating steak 24/7 on some kind of weird meat only diet and then you switch eating green juices and who knows what you're doing. I think that they are a bit of an extreme kind of case. If you've just to look at average women in their 40s and living around where I do, perhaps that would maybe slightly realistic, but I think you've got to wait. I don't think we're quite yet at the point of being able to say this dose of exercise, this dose of sleep, this dose of stress reduction because we can't predict what's going to happen 2030, 40 years down the track.

Sarah McKay: We can only look in retrospect if we're going to make any clear predictions like that. Now there has been some work done looking at more short term outcomes in terms of dose response for things like exercise and mood and exercise and mental health outcomes. Cause we typically see it as a bit of a shorter lead time until we're going to get the data from there. And there has been some work done. Looking at what type of exercise for how long and how often over the course of a week perhaps is going to help lift people out of depression for example. And this has been done on it and it's quite lovely and it's reasonably doable. It's kind of about three or four times a week.

Sarah McKay: Once you're kind of hitting five, six, or seven times a week, that the benefits tab sort of flatten out and then sort of start to dip a bit. So maybe exercising seven days a week might might be too much, but for most people, it was looking at the type of exercise. I mean personally I think that the type of exercise should be something that you stick at and enjoy. But there was a slight tendency towards group exercise and team sports versus perhaps going for an individual tennis. And that's probably because it's a whole lot more fun playing game of tennis for someone then for many people running might be solitary. So there was a little bit of that social engagement in there, but again, that varied quite widely. I think that you've got to do what kind of wags your tail?

Sarah McKay: I love ocean swimming. I spend lots of times swimming in the ocean of Manly beach and around the rocks and looking at the fish, walking my dog and I run a little bit, but not a lot. And that's what I enjoy. So I think you got to do what you enjoy. I mean, in terms of the amount of time it was under an hour and that was when they sit, we saw, you know, if you did it for 10 minutes or you did it for two hours, you didn't see the same kind of sweet spot. So that sweet spot for mental health at least is kind of three or four times a week for about 30 or 40 minutes doing something that you enjoy maybe with other people. So again, it's not like there's some startling secret in there.

Sarah McKay: It's kind of what's doable and what can you integrate into your life and a real way that works with you rather than being, you know, you've got to do CrossFit and then do it for so many hours a week and lift so much weight. What we do see is if we look towards older people, go look at people of 60s and 80s, they still want to live healthy lives at that point. Interestingly, what we see is we do need to start integrating things like resistance training. And we do see some very, very clear around - if you build up muscle mass, not only does it protect you against frailty and muscle degeneration, but if you have stronger muscles, more muscle mass when you're getting older, then that helps sort of slow down the cognitive decline. So there's definitely a link between the muscles and the brain. And in particular that is getting much more important for people who are losing muscle mass as they get older.
Wade Lightheart: That's great. So all us muscle heads have been going to the gym for years are actually proven to be neurologically protected?

Sarah McKay: So as long as you spend doing it by lifting the weights. Not sneaky, but you've got to keep on doing it when you're older as well. And that's the thing. And you can start, you know, you can start when you're 75 or 80. And I think that that's really important. That's a really important message as well as you don't need to have been a bodybuilder for your lifespan to lift weights to see the benefit.

Wade Lightheart: Yeah, I looked at the research about people in their eighties and nineties and the effects of an eight to 12 week training program are just absolutely remarkable what it can do for them.

Sarah McKay: Yeah, they really are. But there's a bit of a mindset shift. I mean, my mom's in her 70s or my inlaws are in their early 80s and to try and say to them 'Hey, you should start doing resistance training and lift weights.' It's just so out of them, It's just not anything that they would ever consider doing and to work with people and those situations to not only teach them how important it is to get them to actually have a go and to make sure that they're doing it safely and it's done in the right way, as something that's difficult. And especially right now, I mean, we're recording this in early 2020. I think this is a lot of neglected populations of people out there that we need to be very mindful of.

Wade Lightheart: Well, let's talk about a topic I think, cause I want to get to your book "The woman's brain" and amendment before I go there. I think, I'm actually during the quarantine I'm staying in a rented little apartment adjacent to one of our researchers and she has a lovely little boy who's five years old. And it's fascinating to be around. I've had the good fortune to be able to play Legos and drive bikes and do all kinds of things that I haven't done a long time. And it's activating a certain point.

Sarah McKay: Lego is fantastic. I've got two boys, so I've been playing Lego for a few years now.

Wade Lightheart: I know, I built this great spaceship the other day that absolutely blew myself away. It was like I literally sat in a room for like eight hours building a Lego spaceship. It was really fine and found it a very Zen moment. But what would you say are some, cause I do know that in early years this is a very formative component, four children. And is there any common elements that can assist in the development of the child's brain in those early formative years? And are some things that you've seen in research that are definite things that parents want to incorporate in their lives or things that they need to avoid?

Sarah McKay: Yeah, look, I think there's probably three key elements in there in terms of what we can do to help support and help build that grey matter infrastructure with young kids from the they're born. And particularly those kinds of first 5, 10 years of life, childhood as this amazing time of wonderful brain plasticity. The brain is going through this huge extra sort of fast growth phase and it's incredibly plastic and that's great because whatever happens to those children's brains, we'll shape and sculpt them. We need to make sure that the experiences that they have are healthy experiences. So there's probably three types of key things that we can look at. And the one is that social interactions, one of the greatest things we can do to build brain architecture, is make sure that social engagement and interactions at the right kinds of engagements mean babies need attachment.

Sarah McKay: They need to be nurtured and loved by a caregiver from the moment they're born. So engaging, interacting face to face with kids, what we would call these serve-turn interactions. A vitally important. The second is perhaps what should we not do? I think that we need to teach children how to be resilient and how to manage stress. Now, I'm not talking about the stress of starting school for the first time with the stress of separating from a caregiver for the first time. But that way of mitigating toxic or otherwise damaging stress, perhaps, you know, violence in the home, perhaps a natural disaster like an earthquake, perhaps some kind of incredibly toxic stress can have very long lasting damaging effects on little people brains and minds and in their growth and development going forward. The best things we can do is to buffer that with other people modeling how to relieve and reduce stress.

Wade Lightheart: How would you do that? Those little interrupts for a child, that kind of anxiety, something that happened, a traumatic event or something. How do you go about doing that?

Sarah McKay: I think we need to be mindful of the impact that it will have on them for the first case. Cause a lot of people kind of think when we talk about resilience, what doesn't kill you make you stronger, you know? And that's not necessarily the case and people should understand that there's a difference between a good little bit of stress, it'll help build them up and teach them how to be resilient. You know, we people freak out about children doing tests or exams at school. I think men, that's a good way to sort of stress them out in a really safe, peaceful environment where they're going to be. Versus, you know, a child in a natural disaster. What are we going to do to help make sure that they still feel safe and loved and cared for despite the fact that there may be chaos around them.

Sarah McKay: So there's no easy answer for that, but it's just being mindful and understanding how important it is to protect them from that extreme toxic stress or deprivation. Because we do see plays out through the rest of their life span of that. If that happens, sometimes it may require intervention from outside. And then I think give them the opportunities and the space and environments in which to have enriched learning. So give them opportunities to play and to be curious and to learn and to be able to kind of experience all of that, all of the things that the world has to offer and children are naturally active, engaged, curious explorers, a bit like those older people I talked about. Kids naturally want to learn and to provide them with the right types of opportunities in which they can, I call it freedom within a framework.

Sarah McKay: I mean obviously we're all in quarantine at the moment. My kids aren't at school. They're doing online school in the morning, bit 10 and 12. So thankfully they're pretty engaged. Kids who like learning like their mom. So they smash out their online school and then in the afternoon off they go on their bikes. One of them's out in a reserve near me building bike jumps. A couple of the neighbors have complained to council, but the parents are all supporting the kids cause they should be building bike jumps with shovels and spades and mounds of dirt when they're 10 years old. And just kind of playing out in the natural world and environment. And my oldest son spends a lot of time in the surf, body boarding and surfing and just lots of people might not leave a 12 year old boy go and do that.

Sarah McKay: But I think they almost kind of know what they need and I wanted to give them the flexibility to learn and grow within within a framework. You know, we don't want them to be unsafe, but we want them to be challenged. And for me those would be the key elements, you know, that kind of supporting their curiosity, helping reduce toxic stress and interacting and engaging with them socially. So that number three is the enriched learning environment. And kids right now who are in lockdown need to be going out digging in a park, and building a bike jumps, they don't need to be seen inside by the neighbors who are disapproving and saying that they should, you know, I'm not sure what some of the neighbors around here around think, but I think, you know, we need to be flexible, especially right now in many parts of the world, with kids being locked up. And that's for the greater health of all of us. We need to give them space to still be children and to just miss themselves in nature and play in the way that children are meant to play.

Wade Lightheart: Beautifully said. So we're going to go to the next piece, which I really wanted to talk about and I think every woman wants to know about it and every man needs to know about it. And that's your latest book. I believe it's called "The woman's brain"?

Sarah McKay: In Australia and I think the US it's called "The woman's brain book.", neuroscience of health hormones and happiness. In the UK and Europe and Ireland, it's called "Demystifying the female brain.", and then in other countries.

Wade Lightheart: Probably some places they're just burning the book upon arrival. But I mean it's based on neuroscience so you can learn it if you don't like stuff like that. But so tell me first and foremost, how did it come to an idea of yours to take what you've learned and put this all into a book?

Sarah McKay: The woman's brain? Well, I didn't want to call it the women's brain book. I should say that I wanted to call it in her head, something like the nature, nurture and neuroplasticity of the female brain. But in her head, the publishers thought sounded too much like one of those sort of modern day domestic psychological book. They might think it's fiction. So I call it if I'm ever speaking or giving a presentation, I always call my title "In her head" because that's what I wanted to call it. Unfortunately, it's called "The woman's brain book" in Australia. So I actually didn't really want to write a book cause I once wrote a PhD thesis and lots of research papers and articles and blogs and things for newspapers. And I was neither really want to write, but I was run by very charismatic publisher,

Sarah McKay: a charismatic woman saying 'would you like to write a book?' And I said not really. She said 'let's meet over coffee.' And she was so engaging, I thought, well, I'll meet her. She sounds good, I've been run a few times by the publishers and I was not interested. And so we met over coffee and she's a pretty funny woman. And I said "I don't have any ideas for books. I don't see the point of writing a book." And they say have the idea. And she said 'let me ask you a question - what have you ever written for an audience that has resonated with them?' And that was easy because a few years earlier I'd written an article for the ABC here in Australia on menopause and brain fog.

Sarah McKay: And pointing out that it's very common and lots of women freak out. Cause I think it was the first signs of dementia, that kind of fogginess and it's not. And so that article went on and we had this huge outpouring of woman going 'Oh my God, I thought it was just me. I was too scared to say anything in case I really did have dementia. Thank goodness it's just menopause', et cetera. And so they said to me, well, there's your book idea. And I was like 'I'm not writing the book about menopause' because at the time I was 40, I was like, that's something for old ladies. I'm 45 now, I have a little bit of a different opinion. But anyway, then she said, well, what about baby brain? Is that a thing? Which has that kind of foggy fuzziness that lots of women experience when they're pregnant.

Sarah McKay: And I grew up in New Zealand. Your listeners may be familiar with our wonderful prime minister as well, who's had a baby while well. And she's been hidden up the country. And I grew up in a part of the world that didn't know things about the baby, I'd never even heard about it. And so I was like, I think that's a lot of rubbish. I don't think there's any scientific evidence to back that up. But then I realized I've been neuroscientist for 25 years, owned and operated a female body and brain my entire life because neuroscience, there's so much that you could think about. I had never thought about various aspects of my life as a female through that lens of neurobiology.

Sarah McKay: And I could write about puberty and I could write about the menstrual cycle, I could write about the pill and I could write about pregnancy and menopause and why a girl was a woman, more likely to be diagnosed with anxiety and depression and why a woman more likely to be diagnosed with Alzheimer's. And I thought Hey, I could look at like the entire female lifespan, a womb to tomb. And within kind of half an hour we knew there's a book idea in this. So the agency said go home, write down a chapter outline, a kind of summary and we'll see where it goes. And it honestly took me an hour or two to do that because there were so many questions I realized. I hadn't even thought about that before, but that I thought, wow, this would be fascinating to explore as a neuroscientist to explore all of these things.

Sarah McKay: And that was really kind of how the book came about. So I didn't go in with a lot of background knowledge about some things. I did have background knowledge and for example, brain development and aging, but not about neuroendocrinology. In whole minds influenced the brain that was a field. Neuroendocrinology was a field I hadn't researched, I didn't know anything about. But I know enough neuroscientists and I know how to understand research enough that I'd went on this curious, fantastic journey, unpacking all these different aspects of the female lifespan and women's health through the lens of neurobiology. However, I have decided when I was talking about the book, people would say, what have you been doing? And then they would go the female brain and people kind of hone in thinking there is a female brain which is pink, which is very different from a male brain, which is obviously blue. And we are, you know, our brains are a little bit like genitals. They are just so fundamentally different than that determines everything about these gender stereotypes about women versus men. Which is really not what the book was about as I said, I was just writing a book about the pill and the menstrual cycle. Like I'm not writing about Mars, Venus brains, but obviously asked that question a lot at the beginning, which is probably your next question there?

Wade Lightheart: Well, actually, I want to kind of dive into what are some of the discoveries that you found in your research putting this book together that can improve or be sign posts for women as they go through the various stages of human development or the challenges that come with it that, that are maybe unique to two women essentially.

Sarah McKay: So I guess I went in and it was probably a little bit like the way I went into my PhD research. It's a nature nurture versus type question. And so I thought well, if we look at puberty, we look at the menstrual cycle, we look at pregnancy, we look at menopause. These significant life transitions in the lives of girls and women and which hormones play a huge role. And you know, when you go through puberty, you've moved from being a girl to a woman. You have a month. If you have a monthly menstrual cycle between puberty and menopause, when you're not pregnant or you're not on the pill, for example, you've kind of got a monthly neuroscience experiment going on. Pregnancy is obviously a dramatic shift. And then at the other end of the reproductive life, so as menopause and I very much thought, well this is all going to be around hormones.

Sarah McKay: What I guess for me was the surprise that every one of these true life transition hormones opened a window or door. But the experiences that women have very widely, and a lot of the time thoughts and our feelings and our behaviors and experiences and expectations and these points in time aren't necessarily driven by hormones themselves as almost as if we think hormones are the loudest voice in the crowd. And they're not always, and in particular, depending on where you grow up in the world as well. And the stories you've been told, we have a very, very strong tendency to have a very negative perspective around the influence of hormones. So I suppose if I could try and be very brief and give an example of each of these. So puberty, you know, young people, it's quite an emotional time of a lot of emotional turmoil and change, but a lot of things are changing.

Sarah McKay: Your body's changing, your social groups changing, picture moving from primary school to high school, elementary to middle to high school as you would say in the US, so there's a lot of shifts happening. But if we look at the social context in which children experienced puberty, children go through puberty the same time as their friends, do not have the same negative emotional outcomes as children who go through puberty much earlier, much later than the friends we've got hormones, children's bodies, and brain's experiencing pubertal hormones for the very first time in the seconds of boys and girls. But the social context is the greater determinant of whether they will struggle with emotionally at school and socially. So it's not the hormones, the hormones are causing the changes, but it's the social context. Am I changing at the same time as my friends?

Sarah McKay: What's happening to people around me, relationship to me. So that I think is very interesting. We see this again and now when we tend to blame, especially women, our hormones, we talk about this premenstrual syndrome or pre-menstrual tension. And I was really interested in this, because you know, it's almost as if we're on this emotional roller coaster - we can't get off driven by hormones. And I thought I wonder how many women in the world have put their hands up and say 'yes, I have PMS'. This particular research blew my mind. There was a meta analysis, which is a way of polling together. Lots of different research studies and one kind of pot because there's power in numbers. Like the more biohackers have noticed, the more data you've got, the more certainty you can make for a client because there's value in there.
Sarah McKay: And I was looking at rates of reported PMS around the world and they vary between about 10% and about 90% depending on which country you're in. And it was even within region Sweden, within Europe, 10 to 15% of French and Swiss women. So they suffer from PMS compared to 75% of Spanish women just over the border. You go over to the middle East, it was around 50% of women in the UAE versus around 90% in Iran and similar variations seen globally. So I was like how can hormones be the sole provider of PMS if it varies between 10 and 90% depending on which country, society, culture you live in - there must be some other influence in there. So I went to talk to a women's health psychiatrist and researcher in New Zealand called Sarah Romans. Now this kiwi Sarah who was really curious about this too and has done a lot of studies looking at how hormones and day of the menstrual cycle impact mood.

Sarah McKay: And in studies where women are taught to, we're looking at PMS, there's a very strong tendency for negative mood to be recorded. Day out and that week before the period and the week before they began to bleed. But when you do studies that we're not telling women that we're looking at PMS, we're just looking at mood and daily life, daily menstrual cycle. What else has going on, you know, do you feel what's your physical health, what your stress levels, what your social interactions. And we don't see most women. But the majority of women, there's not a strong propensity for hormones to be the sole provider of emotions when you don't prime women into thinking that that's what you're going to find. And fact, mood is far more likely to be influenced by physical health, by stress and by her socially supported.

Sarah McKay: So again, we've got this strong tendency to think that hormones are the sole provider of emotions. But if studies are done very carefully, we don't see that. I think we'd see something similar when we look at pregnancy. Women might feel fuzzy and forgetful, feel like they kind of have lost their minds somewhat during pregnancy, although I think about the kiwi Prime minister - she did quite a cracking job leading a country despite carrying a baby. If we go in and we look at the very careful studies that are done, these studies have been repeated a lot because it's quite easy to get pregnant women to come into a research lab and do cognitive testing on them. The vast majority of studies show that pregnant women are not more forgetful. They're not showing cognitive decline during pregnancy.

Sarah McKay: In fact, we're also seeing many women are smarter and sharper during the pregnancy then before or in comparison to women who are not pregnant. And this is exactly what we see in the animal kingdom. So you can go and you can do run a rep through a maze and you know, get do various memory tests on lots of mammals and you can do it with pregnant mammals and non-pregnant mammals. They don't read books on what to expect when they're expecting. We see cognitive enhancement during pregnancy in the mammalian kingdom. So again, we see very different outcomes than we are told by this kind of cultural narrative we often are immersed. And menopause again, you know, hormones kind of go up and down. You can have hot flashes, you can have bad sleep, et cetera. We have a lot of windows for the difficult times opening during perimenopause and menopause, but by large women's experiences, dependent on her physically, well how good they are at reducing stress and again, how socially supported they feel.

Sarah McKay: So for me I guess that was the message that came through quite surprisingly in the book - that hormones aren't the sole provider of negative emotions. And we sincerely do a lot about how hormones tick away through the lifespan if we focus on them. It removes any agency we have over thinking and feeling and behaving in a positive way because we can do stuff about our physical health, our stress, and our social connections. But we can't necessarily do anything about the fact that we may have a menstrual period for 40 years of our life.

Wade Lightheart: This is a really interesting, because I see a couple patterns emerging in the social connections, whether it's elderly, whether it's going through the various stages of life or whether it's a child learning to play with their friends and stuff. Which leads me to my next question, which I've been doing a lot of thinking about and I don't have the answers for it, and maybe you might be able to enlighten me. And I was sharing, you know, of course the social structure of male, female relationships has been radically altered and challenged. And I think there's a lot of positivity that's come out of that, particularly for women's options. But as I was sharing with some of my friends recently, we were talking in a group of this and I said - to me this feels like the most radical biological experiment that's ever happened on this planet is that for the first time ever, females have control of their reproductive cycle.

Wade Lightheart: In other words, they can go on a pill and not first off. I think nowadays the average woman's probably having more menstrual cycles. As someone said, a sperm is cheap and eggs are expensive. So you only have so many of those produced. And one of the things that I found interesting is that now since the advent of widespread birth control for women, that all of a sudden the social structure of possibilities or social opportunities has radically shifted. And now we're a couple of generations into this and there seems to be an incredible debate about what are the social responsibilities or social connections or what patterns need to be challenged or broken because it was pretty straight and narrow before and now it's completely different. The options have called up. And so men don't know how to add a couple choices.

Sarah McKay: The woman had none. And now suddenly women have choices too.

Wade Lightheart: Correct. And this is creating a radical impact on social status, economic status, structure of society, all of these things. What are your thoughts about this? Have you explored this? Are you looking at this? Because to me this is an area that's really fascinating. The planet has been around for billions of years that all the species on the planet and this is the first species that we know of that has complete control of that for the first time. And I always believe if you alter the social behavior of a species, you actually change the species and we may actually be engaging in some sort of mutation. What's your thoughts around that? Or have you thought about it?

Sarah McKay: I guess all we're doing with the pill is we're giving women more choice over when we choose to reproduce. So you know, you can go off the pill, you can get pregnant the next month. You're not producing a child that would be in any way different than if the woman hadn't been on the pill. So I don't think that there's any kind of switch and evolution that we're going to see there. If anything, you know, we've got really smart, well-educated woman who can go out and get educated, have a career, be happy and fulfilled, decide when they wish to become parents and hopefully make a choice about when the right time is for those children to be bought up. My parents have made a choice, a really well informed choice about when to have children, have bigger family to have and I can see that so many benefits in terms of it.

Sarah McKay: I've been able to choose when to have my children at that age. At a time of my picking and my early thirties have just two boys and then me and my husband, we've been able to devote our time to raising them instead of me having to start having kids. You know, when I first became sexually active in my early twenties - I got educated, didn't miss out on university. Maybe I could have 15 children by the end. That would be just awful. We'd certainly not be living the life that we do now. So I guess in that respect, giving women the choice over when they have children, how many children they have, and the timing can only benefit if you want to talk about it in terms of evolution. I think that the children, those women choose to have, if you want to take a bigger picture, look at a society.

Sarah McKay: I mean, we could look at plenty of stories going around right now, at what's happening in this global pandemic. And let's take a look at which countries are being helmed by women. Who are the political leaders, who are the countries have done particularly well. In terms of handling this global pandemic, narrow Australia, we do have a male prime minister, but we also have two women state premiers in Australia, and New Zealand has a female prime minister who have seen great success with dealing with the pandemic in some countries, for example, Iceland throughout Scandinavia, maybe not so much Sweden. And if we do have a look at that, we can say, well, what's been the impact of having female, you know, women as leaders do this?

Sarah McKay: Some really pretty good outcomes in terms of how the pandemic's been managed. And here in Australia, we haven't even had a hundred deaths yet. So you know, I think that's quite a good thing and they can only be benefits that come from having women and men, and seeing kind of parity there in terms of leadership, both for, how decisions are made and also for what is the next generation of young people, boys and girls growing up to think that they can be in now. I was fortunate growing up in New Zealand because I'm in my mid forties now, but even when I was a teenager, when I was at high school, we had a female prime minister, Helen Clark. I grew up in a country where being a prime minister could be something that I could aspire to if I wanted to start anything I would, I would be in a decision, in position.

Sarah McKay: We had made certain decisions like that right now. But I think having women in these roles is just so beneficial for young people, whether they be boys or girls, just to see what they could possibly contribute as well. So it may be an experiment, but I haven't seen too many negative outcomes of it. Just yet. I think that there's a few men who find it quite discomforting that perhaps the gender roles that they were brought up to believe, you know, maybe they feel slightly uncomfortable. But I think any man who's kind of well educated, open-minded, kind and thoughtful, it's not going to be in any way challenged by having women standing next to them, making decisions and why I think my husband definitely in that.

Sarah McKay: I know I've had a few really great things happen in my career recently and there is a dad of some children that we know said to my husband - is it weird for you to see your wife be so successful? And he was kinda like, dude, we met when we were both at Oxford. I'd won a scholarship to do a PhD at Oxford. That was how we met. I was successful and had already done things when I met my husband. So I think I certainly never be with anyone who wouldn't stand by my side. And that way I think of it as an experiment. I think so far the outcomes are looking pretty good.

Wade Lightheart: And one of the things that I think is important, cause I want to dive into this because people don't want to talk about these things and I think it's important to bring this to light because now for example, a woman who maybe gone down the career path and decided to have children later in life than say what was typical, you know, if I look at my parents' age, a lot of people were having children when they were 20 years old, 18, 19, 20, 21, 22, and you see now people are having children 30, 35 even 40 before they're entering in this. And all of a sudden you have developed an identity around a career, around a profession and you have a child and you're with a partner that also has that. And now the responsibility factors of that career are still going to go on whether you have a child or not, and then your other partner has to kind of step in as well in a role that I think a lot of men haven't fully considered because of these traditions. How do you suggest, cause obviously you've done this and they're doing this. What are some things that you've learned personally from that component? Because I think it's something that everything's just been so politicized and everything. And I'm just curious what is that look like? What are the things that you learned and how do you have those conversations and take the responsibilities that you know were previously just designated as a woman's thing?

Sarah McKay: I think that's really interesting because I guess I feel like I've grown up with a different perspective on all of it. So my best friend all the way through high school, she's a psychiatrist, husband's always been at home. They've got three teenagers now, and her husband's always been the one at home. Well, she went out to work. My step dad raised five kids by himself without their mother. And for me and my husband, we made a decision that I wouldn't be in the research lab. I would be running a science communications business from home. Well, he went out to work so that I could, you know, someone would raise the kids. I think someone has to be there to raise the kids. But for me, whether it's the man or the woman has never been certainly part of the decision making process.

Sarah McKay: It's more a matter of who does it make most sense for. But I've grown up in a part of the world where that's kind of normal. I've got quite a few friends where the woman's worked, the dad's been the ones at home. I do think that, and I certainly know when I had my boys, they were easy babies, I was incredibly fortunate with the two of them, but I struggled with my identity going from being scientist to mother. And that was a massive struggle for me. We didn't have any family support cause I live in Australia, my husband's Irish and my family's in New Zealand so we didn't have any family support. In those first few years it's bloody hard work raising babies without family physically helping you out.

Sarah McKay: So I burned out as lots of new parents do, I struggled not so much looking after the kids but with the identity shift into motherhood. And I always say I loved my babies, but being a mother I think is a part of that as perhaps I thought it was going to be this beautiful golden kind of lovely time, a little babies and happiness and it was just like kind of bloody hard work. Cause there's a lot of groundhog days, a lot of drudgery. And I guess I wasn't expecting that or maybe I'd pretend to that wasn't the reality. And I think for a lot of women when we have babies, because we've had so many wonderful life experiences, and then suddenly you kind of have to focus and again, there's a massive struggle with that identity shift and there's some really lovely work done by lots of people who work in this space saying that the transition into motherhood is a little bit like the transition through adolescence and that you don't suddenly become a mother.

Sarah McKay: There's a process and there's a journey of exploration and discovery and self identity that women go through. Maybe that was a different journey for women back in the fifties or sixties who didn't have as many enriched life experiences prior to having kids as what some women do now. But I don't think that that's necessarily a bad thing to have. Have something happened to you, even if it's something that you desperately want, that challenges your sense of identity and who you are and kind of gives you a bit of pause to think and to reassess what your priorities are. And for many women I think of my friend who's a psychiatrist cause she had to go back to work quite soon after having her kids, I think she was actually doing some medical school exams for her first one and that's kind of kept her on the emotional level in a way because she wasn't solely, you know, the moose in herself in this new world. You know, she reckons it kept her on an emotional level. So yeah, I think that many women face challenges, but I don't think facing a challenge is necessarily a bad thing and if it's one that has emerged because you have more options now. That's also is something that we should all be kind of facing as a society cause it's about raising kids to be healthy, happy contributors to society when they grow up.

Wade Lightheart: So now I'm even more curious as I keep diving into this topic. Do you feel quote unquote the men are from Mars, women are from Venus, characterizations are actually more of socially reinforced positions or is there some sort of biochemical reality?

Sarah McKay: I think largely societal behavioral. I think that there's perhaps when baby boys and baby girls, you've got a newborn baby boy and girl, there may be tiny, tiny differences that may be present, but they're largely reinforced by how children are raised. There's a very interesting study that I do that looks at this, looks at children at the age of five, six and seven. It was published in the general science that's looking at this propensity men have and lots of different cultures and societies around the world kind of think that they put their hands up and are the ones asking for the promotions, there's a real kind of male hubris and belief in their innate intelligence. Whereas girls, a woman, um, had to be kind of encouraged to that space more.

Sarah McKay: Now if you go in and look at five-year-olds have just started primary school, and you say there's various ways that you can taste this. You can go in and you can say 'Hey, we have developed a game for really, really smart kids, who wants to play the game'. All five-year-old boys and a little five year old girls will go 'yeah'. You go and talk to seven year olds and say 'who wants to play the game that's being designed for smart kids'. The boys will give a go. Me and the girls will have a tendency to go 'Aaaaw, that's a game for the boys'. Cause that's just not kids. You can tell them a story that's kind of resonates with, a gender neutral story about a scientist is going to save the world or you know, something that's going to help.

Sarah McKay: It's like climate change for example. And then you say to the five-year-olds 'is that a man or a woman scientist or could you grow up to be that scientist?' And all the boys would go 'maybe he's going to be a man' and a little five year old girls are going 'me, it's going to be a woman'. You go and talk to the seven-year-olds. Two years of primary education, the boys, the seven year old boys are gone. I could be a scientist and I grew up, the girls are more likely to say that's what the boys will do. So there's something shifting there. Within those first couple of years of primary school, there's no bias. There's no biological switch that depends on and five-year of six or seven year olds. You know, even the kind of the very various early stages of puberty is still well and truly a couple of years down the track and healthy children.

Sarah McKay: So we're seeing this tendency for girls to think that it's the boys who have the intelligence and the boys to go 'I am intelligent'. I will grow up to be that way. The only thing that could be happening is that they're somehow picking that up, whether it be from each other, whether from wherever they are learning it from TV, from parents, from other kids, from the school, playground, from teachers, society culture in general - it's teaching. And then this study was done in the US so it hasn't been replicated in other countries in the world. And it would be interesting to see, Sheryl Sandberg's always there telling women to lean in and encouraging women to have more confidence in themselves. Because we do see that there's this kind of divergent attitude towards your capabilities.

Sarah McKay: And it starts really, really young and it's not biological. So we can go in and we can very carefully look at lots of aspects of how males and females think or feel or behave. And I think we need to be very, very careful to ask questions in the right way. What is the specific feature or difference that we're looking at and how different is that difference? Because by large, there's far more similarities, if you look at normal distribution curves, they're far more likely to be overlapped to be completely separate. And I think if we do see differences, we often tend to assume that they're at an age, they're biological, that we're there from the womb. We are often not seeing that emerge at different points through the lifespan.

Sarah McKay: In America you have this - gender reveal parties that people have, because gender is how you feel. It's sex reveal parties, but no one's going to call them that. You know, is it a boy or a girl before they're even born? So children are born into this gendered world. And that's okay. So long as we don't see these outcomes, that little girls who are seven years old suddenly think that they're not as smart as little boys who are seven years old. So we need to be so careful about where we can, where we attribute some of these differences too because the results, what we see, the outcomes of seven year old girls sitting saying they're not as smart as seven year old boys. There is something seriously wrong and that is damaging and has negative outcomes.

Wade Lightheart: Beautifully said. I got another question that's kind of emerged out of this too because I can remember going through puberty and the rise of testosterone that came into my life and thankfully I've made it past the age of 30. Which is if you look historically, as a man, if you can get past 30, you've done very, very well. Cause most men didn't live past 30, testosterone got up. And especially now as I'm getting older and I see testosterone diminishing, how it's offered me perspective and I can kind of see younger men go through that. Growing up, going through that testosterone and rage madness, how do you see when puberty hits for females and you know, this flood of these hormones for lack of a better word, feminizing hormones start to happen? What happens to the brain, I mean I just kinda went kind crazy.

Sarah McKay: Oh the crazy things and the feelings that you had when you were a guy and you know, of course testosterone kind of kick that off. But it's interesting cause it's been a lot of work done on this. And I didn't look into testosterone, but there has been a lot of work done in that space going - can we see a direct correlation between level of testosterone someone has in a behavioral outcome? And in terms of things like aggression or throw seeking - there's actually not a straight line relationship between levels of testosterone and that outcome we can see. So I think we need to be quite careful about attributing the hormone is the sole provider of the outcome because sometimes we say it opens a window and then we see a lot of other influences kind of coming in and coming into play like dopamine addicted or whatever.

Sarah McKay: You know, the group of people that you choose that you end up hanging out with may be a large influence on what kinds of activities you partake in. So I talk about it in the book, and I'm speaking here from the perspective of girls who in some ways need to be encouraged to be a bit more of a thrill seeker and environments where it's useful for them, like in the classroom or something. But what we see is that the large influence on the dumb stuff or the not so dumb stuff you do is around tribe approval. What are the other people around you wanting you to do? And this the craziest, silliest thing I did as a teenager, and I was a pretty good teenager, I broke into my high school with one of my best friends at the weekend.

Sarah McKay: We found a window and we climbed in. Now why do we break into the school school at the weekend? Cause she had forgotten one of homework folders. And for us the thought that one of us could go to school without having done our homework on Monday was so mortified that we thought that was just good. Breaking into the schools are justified act cause for us we saw getting your homework done - that was where the approval came from. Right now, other kids, the approval may have come from, you know, getting massively smashed on drinking vodka or something in that classroom that they broke into. So what we see is a lot of these acts are around peer approval. So, you know, choose your friends wisely, don't break into the classroom cause you're getting behind. It's called that story.

Sarah McKay: Since I've written, my book has become quite well known in my old high school. To the entertainment of the principal. But what we say - kind of go back a bit, when boys and girls enter puberty, we do see that the pubertal hormones and what we see is testosterone in the male gets converted into estrogen in the brain. And then that kind of triggers a lot of the effects. So mother nature kind of had last laugh if you do, but what we see is that we see the adolescent brain development kind of kickstart. So, not only are we seeing pubertal hormones, we're seeing changes in brain development and we say that on average girls kind of into that phase of brain development a year or two before boys do and much the same way that goes into puberty slightly before boys.

Sarah McKay: But the boys eventually catch up. Most of the changes we see, kind of an early puberty around maturation of the regions of the brain involved with things like emotion. And we could, you know, the reward pathways and we could kind of extrapolate that into switch just to sort of throw seeking and emotions and feelings and they almost kind of develop and go through there and the adult maturation slightly before more cortical areas in particular the prefrontal cortex and here, which is that very growing up part of your brain which is involved in things like judgment and planning and decision making and reasoning. Also being able to regulate emotions and resist impulses and also engage and interact with other people, that the parts of the brain are involved in what we would call social cognition. Now what I think is under not well understood about the sort of the teenage brain as it's a little bit like a toddler's brain and that it's not half developed and is kind of really rubbish at doing the things that it does.

Sarah McKay: It's more like a toddler's brain where it's going through this massive shift and plasticity and which experience is a very, very important to helping it wire up and develop in the right way. So much the same way or one or two year old's brain fundamentally requires language to learn, to hear, to be engaged in the process of learning language, to wire up the language parts of the brain. So to all of those functions that teenagers brains are that sort of shift that we're seeing in development. They require the right kinds of experiences in which to wire up. So when we see a young person, like a 12-13 year olds shift from, from the kind of family to be friends being more important, that is because that's social cognition part of the brain requires what? A degree of appropriate social experiences to learn the appropriate social responses.

Sarah McKay: When we say, you know, all this planning and judgment and thinking and raising and decision making, what's quite useful at their will at high school and they're learning, you know, physics and they're learning maths and they're learning how to write essays so they're being challenged in the right kind of way to help those parts of the brain develop. So I think we need to sort of see it as this wonderful time in which we put the right experiences, you know, we enriched children, child's young person's environment and the right way, then we're going to see the appropriate brain development rather than deprivate or kind of maybe influence it with the wrong environment. So that's sort of what we see in young people. I think a large part of unrecognized brain development as I see it around the sort of social cognition and we see young people or think everyone's looking at me in this imaginary crowd, this absolute desire for peer acceptance, tribe approval, finding out who you are within a new set of people. And that's a really massive and important part of development. And we say that very neatly playing out in terms of development of the brain in these areas too.

Wade Lightheart: What's your opinion on digital technology and its impact on brain development? So we've got a couple areas that people are talking about, especially in the areas of using these digital machines at early ages. Also the proliferation of pornography and the potential to thing. And then also just social media in general where people are interacting through a digital medium where you're not in that physical residence. So some of the communication styles tend to change if you dove into that as a research center.

Sarah McKay: Porn always been around, probably all just wish we could go back to the day when all you'd find was your teenager with a few little innocent Playboys sort of stuck under the bed. Not the kind of full on stuff that they can access these days. But there's lots of bits to kind of unpack there. I'm very much in the camp of 'it's here to stay.' They've grown up with it. We have to teach them how to use it wisely and not to just as hopeless as young people. Putting phones down, having a bit of stepping away and having a bit of time away. I think right now we're in a very different situation because the only way we often can connect is as using digital technology. And you know, we're having this great conversation because of that.

Sarah McKay: I think we need to think about it in terms of what are we using it for and why, rather than the fact that we're just on a screen. Are we using it to zoom your mom who lives in another country like my mom does, you know, it's a grandchild reading a little kid. A book over zoom is they go to bed at night as a child using online technology to engage with their teacher cause it's the pandemics or they're in lockdown or if a kid reading a Kendall book, my sons play Fortnite, particularly my oldest son who's 12 during this pandemic because he hasn't been able to see his friends. Now things are changing here in Australia and he can kind of go to the beach and have a surf with his mates.

Sarah McKay: But at the beginning he couldn't see his friends. And it's so important when you're that age to connect with your friends. It's been smashing hours on Fortnight and he's been laughing and he's been engaged in teamwork and there's engagement and they're all kind of working together. So I'm a fan of what are they using it for, what are the outcomes and why rather than screen time. I do think it's adults and it's so important that we sit boundaries that are reasonable and evidence based. It's doable. So my son, I thought it was just absolutely wonderful. A couple of weeks ago we were kind of at one of the harbors near here and he dropped us off phone off and it sent to the bottom of the ocean.

Sarah McKay: It's very upstate as you can imagine. So you didn't have a phone for about waking up? It was good. He's got a new one since, but we have set quite strict boundaries around his use of that and he's 12 and I pay for the phone. So we've just, you do not go on it before school. You come down, you engage and you interact with us. You've got to do online school at the moment. So that doesn't count as screen time. If you're going to play Fortnite with your friends after school, that's fine. But you've got a limited amount of time and the rest of it, we've just had to put those restrictions in place because I think it's important that he finds ways to engage and interact with his friends. So important, but not at the expense of, as we would say, green time or screen time, but then he could go and he could spend like two and a half hours out in the ocean surfing.

Sarah McKay: So I think it's finding that balance and finding ways to teach kids how do you use the stuff wisely but not give them confusing messages. Because right now if they're on a screen 6.5 hours a day, I have my choice cause they're stuck at home and they're doing online school. Our schools have been amazing at engaging the kids. I just think we need to be more thoughtful about demonizing versus nauseous devices. And I think the adults are just as terrible. My mother can't put her phone down and she's in her seventies. So it's so hard not to have your phone in your hand all the time, isn't it?

Wade Lightheart: It really, it really, isn't it. It's an emerging trend, I mean I don't think anybody anticipated 10 years ago when we got mobile devices that people would be texting and driving, and drinking and driving. I never would have imagined that. How addictive is one of those devices? So I love the idea that you've created some sort of dialogue and conversation about what the expectations are of young people

Sarah McKay: I think right now we need to be giving our young people so much grace and so much kindness. It's a bit like letting the kids go and build jumps in council land. I mean the council was kind of against council. Were you a whole, it can be refilled up within three minutes. We need to just give them a bit of understanding cause they're the ones that have almost given up more than anyone. You know, kids have given up school, they've given up sport, they've given up friendships that are time when all of that is just core to who they are. And so that's why we've been pretty relaxed around Fortnite for example. Because my son, he's laughing and he's with his friends and he's engaging and he's not lonely. And I think that right now is more important than screen time. We're not leaving them play it as a day. But you know, the outcome for that is mental health and wellbeing and social connection. It says digital skate park right now because the skate parks are closed. So we need to be quite thoughtful about, you know, the decisions we make around it. And certainly that's what me and my husband have tried really hard to do.

Wade Lightheart: Beautiful. I think you've given some great thoughts to think about. I want to be mindful of the time and I want to provide you a platform to talk a little bit about the woman's brain cause we've gone all over the place, which has been so much fun. I love it. I absolutely love, I have 5 million more questions, but I want you to know, so the book that you've written, the women's brain,
Wade Lightheart: who's it for? What's it about and what's the outcome that you were hoping that the readers would maybe be drawn to it and take away from that book when they read this book?

Sarah McKay: Look, I joke it's for women and the man who loves them. It's not written for scientists. And I'm a scientist. I just spoke to lots of scientists. I just want people to read it and be curious and to question the expectations about their own health outcomes and perhaps your own thoughts and feelings instead of defaulting to a lot of what they may have learned. And also just to find it, curious to explore a little bit of the basic neuroscience that I think I have revealed in the book. I think that there's, you know, as I said, it looks at childhood and puberty and the menstrual cycle and the teenage years and there's all of these, you know, just such common events to all of us. And I think that there's a little bit of something for everyone, no matter which point in the life span they're at, lots of my friends dive straight into the menopause chapter cause it's kind of right on the horizon for many of us right now in our sort of mid to late forties.

Sarah McKay: I just want people to read it and just be curious and maybe what I've kind of spoken about quite a bit already, come away from it. Not just hanging your head on your hormones as being the sole provider of everything, but realize that they're just one little voice in the crowd and the loudest voice in the crowd is other people. And I think it doesn't matter which researcher, doctor, scientist expert, paper - I read about any point in the lifespan from the moment someone's born to a teenager, you'd be a new mom to someone or aged care. I always said what's kind of the key thing we can do to support someone at this point in the lifespan or what's the key indicator for health? Every single one of them always said 'other people' and I think that we just maybe at this point in 2020 everyone we kind of knew that, but we dismissed it.

Sarah McKay: Why is everyone's struggling with staying right now - because we can't connect naturally and the way that we really want to, so many people are suffering so much because of that desire to connect, that natural way that we just run into people on the street and see them and chat to them. We can't do that anymore. And it really is. Hopefully this is a short term thing right now, but I want people to consider that for other people when they're at different points in the lifespan. And to realize that if you're thinking about someone else and that way you might be the key indicator for the health outcome at that point in the lifespan.

Wade Lightheart: Very beautiful. And another question I have before we wrap everything up and that is where do you see the most promising research or the breakthroughs that are going to come in, you know, cognitive health, brain function, social engineering in a way that's going to positively influence society? Do you have any ideas or guesses of where we're going in this whole field or what might emerge out of it?

Sarah McKay: That's really, that's really interesting. I haven't really kind of thought about that. I guess for me, what I see as a lot of these concepts that I was dragged into, the things that your mom told you, and this more holistic, connecting the dots between different disciplines and ideas. What we're sort of seeing now as a lot of the science to support a lot of what we kind of know. But what is most important about that is that can help determine where things like political decision making. And money should be focused towards where are the greatest gains. I mean, we understand a lot of the time we had a lot of the greatest gains can be made, and the people who perhaps need the most support within a society. So we're now not just seeing things, it's really important that children aren't raised with severe neglect and poverty.

Sarah McKay: We understand that it has negative outcomes in their brain health and development. How can governments and how can policy and how can society in general go. Right now we have the evidence. It's pretty clear. That's where we need to be focusing our resources. I think that for me is where I think we need to be. You're using the evidence to support the right kinds of decisions and policies. All of this, tweak this heck that, take this supplement, do this, do that. It's very odd that it's quite selfish and individualistic and lots of ways because the people that have the capacity to do that don't really need the extra support. We need to be looking at how can we implement a lot of the new evidence and the new sites into the evidence based policies and platforms to help the people in the world who need it the most.

Wade Lightheart: Dr. Sarah McKay, what a fantastic interview. We covered a whole gamut and hopefully we can get you back again cause I've got a million other questions. I'm going to take some of these thoughts and research based things that you've shared with me and I'm going to put it into the conversation field that I like to have with my friends and researchers and stuff and see what comes back from them so I can have another load of questions for you as we move forward.

Sarah McKay: Let me know how those conversations go.
Wade Lightheart: Well, I think today what's really beautiful is, there's never been a better time to be exposed to a vast array of information, as I would say, get out of the algorithm prison and not just live in an echo chamber that you can actually explore other people's ideas, other people's research, people that have dedicated maybe a lifetime to a particular field and have some key insights that could really transform your entire life. And so I'm super grateful that you joined us today and shared your insights. I'm encouraging everybody to get your book. We've got it in the show notes to connect. If you can share with where can people reach you, where can we connect? I know you have some cool things that you can download from your website. It's all about that.

Sarah McKay: So my website, which has newly set big facelift, which I'm very excited about, drsarahmckay.com/toolkit, there's a nice little brain health. Sort of seven healthy habits that we can engage in to promote brain health through the lifetime. And as I say, there's nothing new under the sun. It's just we've now got the evidence base behind that. So where should we be focusing towards? And I play around a bit on Instagram. I also run professional development online trainings for people who work within the health professions. So therapists, counselors, psychologists, healthcare providers who are in learning a little bit more about neurobiology and what can we take from the lab and help to improve the lives of their clients and their patients. So using your science and professional health setting.

Wade Lightheart: Super awesome. We're going to put all the notes and links inside the show notes so everybody can just dive in there and grab them. And what a delightful conversation. Thank you so much for joining me. I just love, you know, diving into this and finding an ask these curious questions that I have. Cause I know your listeners are really going to love it.

Sarah McKay: That's what gets me up every day. I don't often know the answers, but I have fun, joy and fun and finding them out and talking to the people who know more than me. So I've thoroughly enjoyed this chat too, it's been a privilege to be part of it.

Wade Lightheart: Well, thank you very much and thank you again and everybody for listening. It's another day on the Awesome Health Podcast for BiOptimizers. Make sure you check out Dr. Sarah's book because you just never know - you might learn something about your brain that could transform your life, your family, your relationships, your kids. This is an important area and it's just a real pleasure to have you join us today. Thanks for listening and we'll see you again on the next episode.
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