The Neurosurgeon's Guide to Protecting Your Brain Health in Your 20s
What a brain surgeon actually does to keep his mind sharp - and why you should care
By
Josh Felgoise
May 30, 2025
Your brain is basically "a big mushy piece of yellow tofu," according to Dr. Randy D'Amico, a neurosurgeon at Lenox Hill Hospital. "If it was exposed and there was a strong rainstorm, it would be injured."
That might sound terrifying, but here's the thing: this delicate three-pound organ controls everything you think, feel, and do. And unlike what you might assume, protecting it doesn't require expensive supplements or complicated biohacking protocols.
Dr. D'Amico, who spends his days literally operating on brains, has a surprisingly simple approach to brain health. Here's what someone who sees the brain up close every day actually does to protect his own.
The Foundation: Use It or Lose It
"You got to use it or lose it without a doubt - challenge yourself," Dr. D'Amico explains. But his definition of "using your brain" might surprise you.
Read Books (Yes, Actual Books)
"Read a book. Reading a book expands your ideas, right? Everything we do is based on our beliefs and our beliefs are built on our experiences. The best way to increase your experiences is to read a goddamn book because it takes you to a place that you are not in."
Dr. D'Amico's current reading list includes everything from Marcus Aurelius' "Meditations" to "The Great Nerve" by Kevin Tracy (a book about the vagus nerve and longevity). The key isn't what you read - it's that you're actively engaging your brain with new ideas and perspectives.
Listen to Music Thoughtfully
"Listen to music. Think about the music that you're listening to, right? Why is this, why do I like this or why don't I like this? Go listen to something else."
This isn't passive consumption. It's active engagement. Dr. D'Amico has curated a Spotify playlist called "Great Songs" with five days of music spanning decades. The criteria? Only songs he deems truly great make the cut. This kind of critical thinking and curation exercises your brain's analytical abilities.
Look at Art and Think
"Look at art. Try to understand more. It's not about like, I don't understand art. It's look at it and just think and think about why you're looking at it and why someone made it and what's going on."
The pattern here is clear: brain health isn't about doing brain training games on your phone. It's about genuine curiosity and critical thinking applied to the world around you.
The Nutrition Strategy: Keep It Simple and Natural
Dr. D'Amico's approach to eating for brain health is refreshingly straightforward, especially coming from someone with deep medical knowledge.
His Daily Eating Pattern
Morning: Avocado toast on seedy, low-glycemic bread with hot sauce Mid-Morning: Two Greek yogurts with chia seeds and hemp seeds Lunch: Often skipped due to busy schedule, replaced with green tea Afternoon: Peanut butter on quality toast for sustained energy Dinner: Low-glycemic pasta with vegetables, focusing on natural, whole foods
The Philosophy Behind the Choices
"I became obsessed with a glucometer for a period of time. I was just watching my glucose trends and trying to flatten the curve."
His goal isn't complicated: maintain stable blood sugar levels throughout the day. This supports sustained energy and cognitive function, which is crucial when you're making life-and-death decisions.
The bigger principle? "What is natural is probably not wrong because nature is perfect."
Supplements: The Minimalist Approach
In a world of endless supplement marketing, Dr. D'Amico keeps it incredibly simple:
Creatine: The Only Must-Have
"The only thing I take is creatine... There's enough scientific backing on it. There's the brain health component and the muscle recovery component."
Creatine isn't just for gym bros. Research shows it can improve cognitive function, especially in tasks requiring quick thinking and mental energy.
Magnesium: For Better Sleep
After discovering that melatonin made him groggy with strange dreams, Dr. D'Amico switched to magnesium for sleep support. "I noticed that my heart rate variability... was low and I was like, shit, am I dying or is it coffee related?"
Everything Else: Proceed with Caution
"Supplements are tricky because they're not FDA regulated. You have to be really really careful."
His advice? Don't get caught up in the latest supplement trends. Stick to what has solid research behind it.
What's Actually Bad for Your Brain
Alcohol: The Uncomfortable Truth
"If you look at people who have one [drink] the day after they drink and their readiness score just plummet. It really fucks with you."
Dr. D'Amico acknowledges the recent surgeon general's warning about alcohol being a leading cause of cancer. While he's not saying never drink, he's clear about the impact: "Chronic alcohol use is definitely something not good for you."
Excessive Stimulants
Even coffee, which has many health benefits, can be problematic in excess. Dr. D'Amico switched from multiple cups of coffee to mostly green tea after noticing it affected his heart rate variability and kept him "ramped up."
Social Media: The Subtle Brain Drain
While he doesn't advocate for completely avoiding social media, Dr. D'Amico emphasizes awareness: "Just when you look at it, pull back a little bit and be like, is this making me feel good or bad or why? That's not a judgment. That's just identify how it makes you feel."
He's particularly concerned about the impact on young people: "Happiness score of children has gone down... And I guarantee it is somehow related to social media."
The Sleep Connection
"Sleep is super important. Everyone has proven that."
Dr. D'Amico goes to bed at 9:30-10:00 PM and wakes up at 4:30 AM naturally. His evening routine is simple: reading until he falls asleep (his TV has been broken for weeks and he hasn't bothered to fix it).
The lesson? Prioritize sleep over entertainment. Your brain literally cleans itself during sleep, clearing out toxins that accumulate during the day.
The Evolutionary Perspective
Here's where Dr. D'Amico's advice gets really interesting. He advocates for aligning our modern lives with what humans evolved to do:
"Think about how humans evolved from nomadic tribes wandering and what they were eating and how they were sleeping and what their communities or social structures looked like. Anything anti that is probably wrong because nature is perfect."
This means:
Natural sleep patterns (early to bed, early to rise)
Whole food nutrition (avoiding processed foods)
Regular physical activity (as our ancestors required for survival)
Strong social connections (tribal community structures)
The Mental Health Component
"Mental health is hard," Dr. D'Amico acknowledges. But his approach is holistic: "Exercise, sleep, eating healthy and using your brain are the things that you can do every single day to make yourself better."
He's particularly focused on young men: "Young men in particular right now are in a really tough time... Shut up and listen to the other opinions and look at the other viewpoint."
His advice? Stay open-minded, challenge yourself intellectually, and don't get caught up in manufactured masculine ideals that don't serve your actual wellbeing.
The Stress Management Secret
Remember, this is advice from someone who performs brain surgery under extreme pressure. His approach to stress management is surprisingly simple:
"There's no race, there's no rush, there's no timeline. The only thing you're racing towards is death."
That's not morbid - it's liberating. It means most of your daily stresses are temporary and manageable. The key is maintaining perspective.
Your Brain Health Action Plan
Based on Dr. D'Amico's approach, here's what you can start doing today:
Immediate Changes
Start reading - Pick up an actual book, not just articles on your phone
Stabilize your blood sugar - Focus on whole foods and avoid glucose spikes
Consider creatine - It's one of the few supplements with solid research
Prioritize sleep - Aim for consistent sleep and wake times
Limit alcohol - Be honest about how it affects your recovery and performance
Long-term Habits
Exercise regularly - Both cardio and strength training support brain health
Stay curious - Engage with art, music, and ideas that challenge you
Build real connections - Social media isn't a substitute for genuine relationships
Practice stress management - Remember that most problems are temporary
Stay natural - Choose whole foods and natural sleep patterns when possible
The Bottom Line
Your brain health doesn't require expensive protocols or complicated routines. According to someone who literally operates on brains for a living, it comes down to timeless principles: challenge yourself intellectually, eat natural foods, get good sleep, exercise regularly, and maintain perspective on what actually matters.
"If you're using your brain, you're using your brain. That's a good thing."
It's that simple. And that powerful.
Want more practical advice for optimizing your health and performance in your twenties? Subscribe to Guyset for weekly insights on what actually matters for young men.
