WEBVTT - Episode 843: Dr. Eric Topol on “Super Agers” 0:00:04.720 --> 0:00:07.800 On this episode of Newts World. Ninety five percent of 0:00:07.800 --> 0:00:11.719 Americans over sixty have at least one chronic disease, and 0:00:11.800 --> 0:00:17.880 almost as many have two chronic killers. Diabetes, obesity, heart disease, cancer, 0:00:18.280 --> 0:00:22.440 and neurodegeneration are all diseases that need treatments to begin 0:00:22.920 --> 0:00:26.360 long before middle age. In thirty years, will have five 0:00:26.480 --> 0:00:29.200 times as many people at least one hundred years old, 0:00:29.520 --> 0:00:32.000 and they will be healthier than ever because of new 0:00:32.200 --> 0:00:37.159 medical breakthroughs. In his new book, super Agers and Evidence 0:00:37.159 --> 0:00:41.520 Based Approach to Longevity, doctor Eric Topol provides a detailed 0:00:41.560 --> 0:00:45.239 guide to a revolution transforming human longevity. And let me 0:00:45.280 --> 0:00:48.280 say I've been through several briefings and meetings over the 0:00:48.360 --> 0:00:51.120 years that doctor Topel is one of the most brilliant 0:00:51.640 --> 0:00:55.280 and extraordinary people I've ever had the privilege of learning from, 0:00:55.320 --> 0:00:59.000 and I'm thrilled that he's here. His unprecedented evidence based 0:00:59.000 --> 0:01:01.920 guide is about how you and your family and friends 0:01:02.320 --> 0:01:05.560 can benefit from new treatments coming available at a faster 0:01:05.680 --> 0:01:08.920 rate than ever. From his unique position as a leader 0:01:08.959 --> 0:01:13.479 overseeing millions in research funding, Doctor Topel also explains the 0:01:13.520 --> 0:01:18.399 fundamental reasons from semaglutides to artificial intelligence that we can 0:01:18.440 --> 0:01:22.200 be confident these breakthroughs will continue. I'm really pleased to 0:01:22.240 --> 0:01:25.360 welcome my guest, doctor Eric tople. He is the executive 0:01:25.480 --> 0:01:29.680 vice president and a professor of molecular Medicine at SCRIPTS Research, 0:01:30.080 --> 0:01:34.120 the largest nonprofit biomedical institute of the United States. He 0:01:34.200 --> 0:01:38.720 is also founder and director of the Script's Research Translational Institute, 0:01:38.840 --> 0:01:41.880 and a practicing cardiologist. He is one of the top 0:01:42.000 --> 0:01:45.960 ten most cited researchers in medicine, known for his groundbreaking 0:01:46.000 --> 0:01:50.960 studies in AI in medicine, genomics, and digitized clinical trials. 0:01:51.200 --> 0:01:53.560 He was named the Time one hundred list of the 0:01:53.560 --> 0:02:09.000 most Influential People in Health in twenty twenty four. Doctor Topel, 0:02:09.520 --> 0:02:11.639 thank you very much for joining us. 0:02:12.040 --> 0:02:14.800 Oh, thank you. It's wonderful to be with you and 0:02:14.840 --> 0:02:17.480 to have a chance to have another conversation. 0:02:17.080 --> 0:02:21.200 In well in super agers, you expand the definition of 0:02:21.280 --> 0:02:26.080 healthy lifestyle into what you call lifestyle plus. Why is 0:02:26.120 --> 0:02:30.400 this broader approach factoring in things like pollution, loneliness, posture, 0:02:30.760 --> 0:02:35.160 and even social connection so important to living longer and better? 0:02:36.160 --> 0:02:41.000 Right, So, we have been traditionally just thinking of diet, exercise, 0:02:41.720 --> 0:02:44.440 and in more recent years sleep health as the big 0:02:44.960 --> 0:02:48.600 lifestyle factors, but we've learned so much about these other 0:02:48.840 --> 0:02:53.600 layers of data and factors, as you mentioned, the environmental 0:02:54.000 --> 0:02:59.960 burden of air pollution, microplastics and nanoplastics, the forever chemicals, 0:03:00.440 --> 0:03:04.160 the consumption of ultra processed foods, but the good things 0:03:04.200 --> 0:03:09.160 about social interactions, avoiding isolation, being out in nature. I mean, 0:03:09.160 --> 0:03:11.800 there's so many different things now that add to the mix, 0:03:12.400 --> 0:03:13.679 and that's why I try to come up with a 0:03:13.800 --> 0:03:17.520 term to encompass it all. Because lifestyle factors was the 0:03:17.560 --> 0:03:19.720 best one I could come up with, and they are 0:03:19.800 --> 0:03:23.600 really important as part of our path to prevention. We 0:03:23.639 --> 0:03:26.880 are in a position now to prevent the three major 0:03:27.000 --> 0:03:33.000 age related diseases cancer, cardiovascler neurodegenerative. We've never been able 0:03:33.000 --> 0:03:36.440 to do that. It's been a fantasy for millennia in medicine. 0:03:36.720 --> 0:03:39.840 But we now, not just because of the lifestyle factors 0:03:39.880 --> 0:03:42.960 that we understand at a much more granular level, but 0:03:43.440 --> 0:03:46.640 because of other ways that we'll be discussing. This is 0:03:46.640 --> 0:03:50.200 a really propitious moment in medicine now. 0:03:50.280 --> 0:03:53.040 You suggestin I found those fascinating good The idea of 0:03:53.040 --> 0:03:56.840 a one size fits all healthy diet is fundamentally flawed. 0:03:57.320 --> 0:03:59.320 Why is it flawed and should we be looking at 0:03:59.360 --> 0:04:01.760 a more personalized focus on nutrition. 0:04:02.520 --> 0:04:06.480 Well, everything about us is unique. I mean even identical 0:04:06.520 --> 0:04:09.920 twins are unique. So the fact that we would prescribe 0:04:10.360 --> 0:04:14.840 a diet or anything for all people is really a miscue. 0:04:15.120 --> 0:04:17.800 So a lot of work being done right now for 0:04:17.920 --> 0:04:21.920 this whole concept of personalized nutrition for certain foods that 0:04:21.960 --> 0:04:27.120 are really exacerbating the health of people because of promoting inflammation, 0:04:27.440 --> 0:04:30.800 whereas others it doesn't have that effect. So in the 0:04:30.880 --> 0:04:34.080 years ahead, a lot is being done to understand what 0:04:34.240 --> 0:04:36.599 is the best diet at the individual level. 0:04:37.160 --> 0:04:39.720 By recently going through a series of briefings on the 0:04:39.760 --> 0:04:42.840 whole concept of making America healthy again, and they keep 0:04:42.960 --> 0:04:47.560 talking about ultraprocessed food, and you make a case that 0:04:47.760 --> 0:04:51.800 clearly ultra processed food has a huge impact on cardiovascular 0:04:51.880 --> 0:04:55.920 metabolic diseases. I'm absolutely fascinated by the degree to which 0:04:56.000 --> 0:04:59.040 ultra processed food is a major problem. 0:04:59.520 --> 0:05:02.520 It is in the United States is the worst defender 0:05:02.560 --> 0:05:05.599 in the world. The problem here is that we have 0:05:05.720 --> 0:05:10.320 allowed a big food to spike their foods with all 0:05:10.360 --> 0:05:13.680 sorts of things that are alien. If you look at 0:05:13.680 --> 0:05:18.559 the ingredients on packages. You'll see things will never seen 0:05:18.600 --> 0:05:21.840 before that aren't in our kitchen. And it turns out, 0:05:21.960 --> 0:05:25.320 whether it's to promote texture, whether it's to get a 0:05:25.600 --> 0:05:29.039 rush of the food that is absorbed more quickly, these 0:05:29.080 --> 0:05:33.120 are things that are in a classification. There's a classification 0:05:33.200 --> 0:05:36.760 called Nova Nova four. These are things that are really 0:05:37.200 --> 0:05:41.840 promoting inflammation throughout the body and in the brain, and 0:05:41.880 --> 0:05:44.919 it's really bringing on a much higher risk of these 0:05:45.240 --> 0:05:49.200 age related diseases. So we have to get arms around this, 0:05:49.480 --> 0:05:52.600 and very little has been done because the food industry, 0:05:52.640 --> 0:05:55.760 of course, as opposed to it. What's really interesting is 0:05:55.760 --> 0:05:58.839 that when people are taking these DLP one drugs like 0:05:58.880 --> 0:06:04.360 ozembic and when jarrow, it changes their reward circuits and 0:06:04.400 --> 0:06:07.880 they eat less ultra processed foods. They shift to healthy food. 0:06:08.080 --> 0:06:10.400 It's amazing, you know. It isn't just using a way, 0:06:10.720 --> 0:06:13.680 It isn't just about less inflammation and their body and 0:06:13.720 --> 0:06:17.440 their brain. But they actually, somehow or other, they don't 0:06:17.480 --> 0:06:21.520 get rewarded like they did previously by these I would 0:06:21.520 --> 0:06:24.760 say contaminate or alien foods that are really bad for 0:06:24.839 --> 0:06:25.320 our health. 0:06:25.600 --> 0:06:27.400 I've probably gotten into this recently. I've been sort of 0:06:27.440 --> 0:06:32.039 startled as you talk about the big food spends so 0:06:32.200 --> 0:06:35.359 much on lobbying and such a huge impact that it 0:06:35.400 --> 0:06:39.080 has been able to basically block efforts to get nutrition 0:06:39.760 --> 0:06:42.320 in a serious way back into the core of the 0:06:42.320 --> 0:06:43.359 decisions of the government. 0:06:44.279 --> 0:06:47.640 Absolutely. You know, one of my colleagues in the UK 0:06:48.080 --> 0:06:51.320 as a great physician scientist named Christan Tellican. He wrote 0:06:51.360 --> 0:06:55.240 a book called Ultra process People. And in that book 0:06:55.360 --> 0:06:58.720 he did an experiment on himself which is representative. I mean, 0:06:58.839 --> 0:07:03.520 a healthy guy who is not overweight. For thirty days, 0:07:03.720 --> 0:07:06.560 he took as much ultra processed food as he could. 0:07:07.040 --> 0:07:09.560 Before he started, he took a brain scan and all 0:07:09.560 --> 0:07:13.760 these blood has for inflammation, and by thirty days his 0:07:13.880 --> 0:07:18.400 brain structures showed mark inflammation. All his blood tested he 0:07:18.440 --> 0:07:22.280 gained twenty pounds. So this is a huge problem in 0:07:22.280 --> 0:07:25.440 this country because we are way out in front of 0:07:25.480 --> 0:07:28.400 the rest of the world on our consumption of ultra 0:07:28.400 --> 0:07:32.000 processed foods, and that's going to really impede our ability 0:07:32.480 --> 0:07:34.880 to prevent diseases. I mean, we have a path now 0:07:34.920 --> 0:07:37.560 to do that, but the fact that our food supply 0:07:38.160 --> 0:07:41.440 is so poor, particularly it's consumption of these food it's 0:07:41.440 --> 0:07:44.560 because they're made to help people want to eat more 0:07:44.600 --> 0:07:47.600 of them and not be satiated, and so we have 0:07:47.680 --> 0:07:48.720 to do something about it. 0:07:49.120 --> 0:07:51.760 I haven't sort of thinking this may be goofy that 0:07:52.160 --> 0:07:54.360 you almost need to have an end factor for nutrition, 0:07:55.240 --> 0:08:00.240 because the same tomato, depending on where it's grown, be 0:08:00.360 --> 0:08:04.000 radically different in how much nutrition it has, And there 0:08:04.080 --> 0:08:06.320 has to be some way for an average normal person 0:08:06.640 --> 0:08:08.240 in the same way you could pick up a package 0:08:08.240 --> 0:08:10.200 and look at calories, you ought to be able to see, 0:08:10.280 --> 0:08:12.920 you know, is this one hundred percent nutrition or twenty 0:08:12.920 --> 0:08:15.520 percent or ten percent? Because a lot of the stuff 0:08:15.600 --> 0:08:18.800 that we buy, this inexpensive is mass produced in a 0:08:18.800 --> 0:08:21.200 way that actually makes it less healthy. 0:08:22.200 --> 0:08:24.560 That's right. I mean, I think if we stick to 0:08:25.120 --> 0:08:28.640 fruits and vegetables, whole grains. There was a really big 0:08:28.680 --> 0:08:31.280 study of over one hundred and five thousand people followed 0:08:31.280 --> 0:08:33.880 for thirty years, and only nine percent of them made 0:08:33.920 --> 0:08:38.679 it to this super agor status without the age related diseases. 0:08:38.920 --> 0:08:42.520 And what did they eat. They ate this diet, you know, 0:08:42.559 --> 0:08:46.600 a Mediterranean like diet low in red meat, not necessarily 0:08:46.679 --> 0:08:51.120 you know, absent, but mainly concentrating on a plant based diet. 0:08:51.160 --> 0:08:55.160 That is what correlated with their ability adjusting for all 0:08:55.200 --> 0:08:58.680 other factors of how they could go to their seventy 0:08:58.679 --> 0:09:01.800 eight seventy five and not have these diseases. 0:09:02.360 --> 0:09:06.040 Do you bring a lifetime of study and I'm really 0:09:06.040 --> 0:09:09.360 regard you as one of the leading students of human health. 0:09:09.840 --> 0:09:13.080 What are the practical steps listeners to this podcast could 0:09:13.120 --> 0:09:15.280 take to ensure healthy agent. 0:09:16.280 --> 0:09:19.080 Yeah, so it isn't just the lifestyle factors as we've 0:09:19.080 --> 0:09:23.600 been discussing. You know, ways to improve deep sleep because 0:09:23.640 --> 0:09:27.320 that gets reduced during our aging as we get older, 0:09:27.679 --> 0:09:31.720 and exercise being paramount and not just aerobic, but you 0:09:31.720 --> 0:09:37.360 know resistance, strength, core, exercise, balance, positive, all that. But 0:09:37.440 --> 0:09:40.040 what we really need to do is to define the 0:09:40.200 --> 0:09:44.199 risk of people because we have twenty years before any 0:09:44.200 --> 0:09:47.520 of these diseases actually take hold in our body and 0:09:47.720 --> 0:09:51.800 show up. So with twenty years and inflammation being in 0:09:51.840 --> 0:09:56.679 the common thread, we have a way partly using lifestyle factors, 0:09:56.720 --> 0:09:59.680 but first we have to identify so we have to say, what, 0:10:00.240 --> 0:10:03.000 if any disease are you at risk for in your 0:10:03.040 --> 0:10:06.800 forties and fifties ideally, and then how are we going 0:10:06.840 --> 0:10:10.120 to prevent that from ever occurring in your lifetime. We 0:10:10.240 --> 0:10:13.040 have a way to do that now because what's happened. 0:10:13.080 --> 0:10:17.079 You know, there's this amazing science of aging progress. Some 0:10:17.120 --> 0:10:20.160 of it, of course, is being directed to the private 0:10:20.200 --> 0:10:25.640 sector startup companies to try to reverse aging. Now that's exciting, 0:10:25.679 --> 0:10:27.920 but we're not there yet. We're good at that in mice, 0:10:28.520 --> 0:10:31.520 but not in people, right, and it carries risk. The 0:10:31.640 --> 0:10:34.160 other part of the science of aging, which is extraordinary 0:10:34.240 --> 0:10:38.920 that most people don't know about, are these clocks organ clocks. 0:10:39.320 --> 0:10:41.600 So if I could draw a tube of your blood, 0:10:41.640 --> 0:10:44.160 I could say, you know what, I got eight organs 0:10:44.320 --> 0:10:48.319 on tracking and your immune system from these plasma proteins 0:10:48.400 --> 0:10:51.760 up to eleven thousand plasma proteins in your body, and 0:10:51.800 --> 0:10:54.000 I can say, you know, you check out well, all 0:10:54.080 --> 0:10:57.560 your clocks are at your real age, your chronologic age, 0:10:57.640 --> 0:11:00.439 or one of them. Let's say your heart is out 0:11:00.440 --> 0:11:04.640 of sync and it's accelerating of aging. That gives me 0:11:04.880 --> 0:11:07.080 a clue as to what I need to zoom in 0:11:07.120 --> 0:11:09.840 on and find out are you at risks for let's say, 0:11:09.840 --> 0:11:13.400 heart disease and get all over it long before you 0:11:13.480 --> 0:11:17.600 ever would have a significant artery problem. So this is 0:11:17.640 --> 0:11:20.440 a capability we have right now. We have markers for 0:11:20.600 --> 0:11:25.600 Alzheimer's that show up more than twenty years before a 0:11:25.640 --> 0:11:29.880 person would have mild cognitive impairment. We have a capability 0:11:29.920 --> 0:11:33.560 now to really make a huge den in these big 0:11:33.600 --> 0:11:37.199 three age related diseases, and we're not taking advantage of it. 0:11:37.480 --> 0:11:39.680 One of the points you make is that strength training 0:11:40.160 --> 0:11:42.880 is really important at a level you had not understood before. 0:11:43.200 --> 0:11:44.040 Tell us about that. 0:11:44.600 --> 0:11:47.920 Yeah, so what's interesting. As a cardiologist, I was always 0:11:48.040 --> 0:11:51.360 big on only aerobic and when I had patients come 0:11:51.400 --> 0:11:54.240 in with these big beach muscles, I'd say, well, wait 0:11:54.280 --> 0:11:57.200 a minute, now, what about the aerobic exercise. Well, it 0:11:57.240 --> 0:12:02.960 turns out strength training is equally important and its association 0:12:03.160 --> 0:12:07.600 with healthy aging is vital. As we get older, we 0:12:07.800 --> 0:12:12.360 lose muscle mass and we also have a propensity for falls, 0:12:12.400 --> 0:12:16.600 and this is not good for longevity, particularly healthy agent. 0:12:17.040 --> 0:12:20.800 So now the data show unequivocally that we should be 0:12:20.840 --> 0:12:24.240 doing some resistance strength training at least a couple of 0:12:24.280 --> 0:12:27.559 sessions a week, and that is a really important part 0:12:27.640 --> 0:12:29.920 of the story to promote healthy aging. 0:12:48.520 --> 0:12:51.120 One of the things you talk about is the importance 0:12:51.160 --> 0:12:54.280 of deep sleep. I have sleep appness, so I actually 0:12:54.400 --> 0:12:57.800 use a seatpap machine and I've been sort of surprised 0:12:58.120 --> 0:13:01.280 that the machine has trained me. So I actually go 0:13:01.360 --> 0:13:04.880 to sleep faster with my machine than I would if 0:13:04.880 --> 0:13:06.520 I were, say at a hotel and did not have a 0:13:06.640 --> 0:13:11.000 with me, And presumably it's really helpful over the long one. 0:13:11.400 --> 0:13:14.080 I can report now as a witness that it seems 0:13:14.120 --> 0:13:16.199 to have a very positive effect. 0:13:17.080 --> 0:13:20.000 Yeah, so there's two things there that's really important. First, 0:13:20.120 --> 0:13:22.240 there is a lot of sleep apnue that needs to 0:13:22.280 --> 0:13:25.240 be treated, and a lot of people aren't aware of that. 0:13:25.520 --> 0:13:28.920 But secondly, even if you are not having these spells 0:13:28.920 --> 0:13:33.080 of slowed or stopping breathing, there's another part of the 0:13:33.120 --> 0:13:36.600 deep sleep, so that during our sleep, particularly in the 0:13:36.640 --> 0:13:39.679 early part of the night, we need to slow wate 0:13:39.720 --> 0:13:44.079 sleep because it's during that where we clear our metabolites 0:13:44.080 --> 0:13:47.600 from our brain, our waste products through a system that 0:13:47.679 --> 0:13:51.520 we now know of as glim fattics, not limphatics, but 0:13:51.679 --> 0:13:55.319 glim fatics, And so these glimpatics, these channels in our brain, 0:13:55.640 --> 0:13:59.640 they basically get rid of all this toxic waste on 0:13:59.640 --> 0:14:03.960 any basis. Now, what's amazing is we've learned now that 0:14:04.080 --> 0:14:07.440 drugs like ambient you may feel like you slept, but 0:14:07.520 --> 0:14:10.559 as it turns out, it actually backs up these metabolizes, 0:14:10.720 --> 0:14:13.480 it prevents them from getting out of the brain. This 0:14:13.559 --> 0:14:17.000 is one of the biggest risk factors for Alzheimer's disease. 0:14:17.040 --> 0:14:19.160 So what we have to do is if we knew 0:14:19.160 --> 0:14:21.640 that somebody had a risk for that, which we could 0:14:21.720 --> 0:14:25.200 know decades in advance, we would really work on their sleep. 0:14:25.320 --> 0:14:28.600 In fact, everyone should because as we get older, you know, 0:14:28.680 --> 0:14:32.720 our deep sleep could get down to just single digit minutes, 0:14:32.760 --> 0:14:35.160 which is really bad, and we want to get it 0:14:35.240 --> 0:14:38.280 up to as high as we can, ideally close to 0:14:38.320 --> 0:14:42.720 an hour people seventy and older. And so with tracking it, 0:14:43.120 --> 0:14:46.000 that is you can either ring or smart watch, you 0:14:46.040 --> 0:14:48.440 can find out exactly how many minutes each night you're 0:14:48.480 --> 0:14:51.160 getting in deep sleep. It's pretty accurate, and then you 0:14:51.200 --> 0:14:53.440 can work on it, like what is it that you're 0:14:53.440 --> 0:14:55.960 doing in exercise or lack of it, What is it 0:14:56.080 --> 0:14:58.720 you're eating, how late in the evening are you eating? 0:14:59.000 --> 0:15:02.800 How do you handle? All these things will affect it. 0:15:02.840 --> 0:15:05.880 And one of the biggest thing is regularity is sleep. 0:15:05.960 --> 0:15:08.280 Our body wants to go to sleep at the same 0:15:08.360 --> 0:15:11.120 time every night, but we don't let it. And sleep 0:15:11.160 --> 0:15:14.560 regularity has a big association with all three of the 0:15:14.600 --> 0:15:15.800 age related diseases. 0:15:16.560 --> 0:15:19.600 We've noticed that we tend to go to bed earlier 0:15:20.600 --> 0:15:23.520 then we used to, and I think it's probably helped us. 0:15:23.960 --> 0:15:25.920 I notice you have a ring on your finger. Do 0:15:25.960 --> 0:15:27.880 you believe in wearables and are they helpful? 0:15:28.800 --> 0:15:31.320 I am using this R A ring. There are several 0:15:31.360 --> 0:15:34.360 other rings like this, but what I found with it, 0:15:34.360 --> 0:15:36.960 it helped me quite a bit to get deep sleep 0:15:37.000 --> 0:15:41.360 more deep sleep. So basically a smart watch and a 0:15:41.520 --> 0:15:43.760 R ring and I wear them every night just because 0:15:44.000 --> 0:15:47.720 now I'm tracking how many minutes of deep sleep, knowing 0:15:47.720 --> 0:15:50.600 how important that is to prevent Alzheimer's, which is something 0:15:50.600 --> 0:15:52.920 I don't want to get. I was a poor sleeper. 0:15:53.160 --> 0:15:55.920 I started with less than fifteen minutes a night, and 0:15:56.040 --> 0:15:59.760 just by learning about all these things like sleep regularity, 0:16:00.360 --> 0:16:03.200 like the interactions with what I was eating when I 0:16:03.280 --> 0:16:06.320 was eating, what exercise when I was exercised, all these things, 0:16:06.880 --> 0:16:08.840 I was able to get it up to over forty 0:16:08.840 --> 0:16:12.000 five minutes tonight on average. For me at least, it 0:16:12.040 --> 0:16:14.600 has help. And I think this is something that people 0:16:14.640 --> 0:16:17.800 should think about, particularly as we get older, because that's 0:16:17.800 --> 0:16:20.360 when the deep sleep becomes a big issue. We want 0:16:20.400 --> 0:16:23.160 to get that stuff out of our brain those waste products, 0:16:23.360 --> 0:16:25.480 and the only way we can do it is with 0:16:25.600 --> 0:16:29.760 these glim fatics during deep sleep. That is the restoration 0:16:29.840 --> 0:16:32.360 of sleep, the magic that we need. You know, you 0:16:32.360 --> 0:16:35.720 could sleep maybe just six hours or even less, but 0:16:35.800 --> 0:16:38.200 if you have forty five minutes to an hour of 0:16:38.240 --> 0:16:40.560 deep sleep, that's a golden From. 0:16:40.440 --> 0:16:43.800 A mental health standpoint, just having thirty minutes a week 0:16:43.840 --> 0:16:47.840 in outdoor green spaces leads to lower rates of depression 0:16:47.880 --> 0:16:49.120 and less high blood pressure. 0:16:49.760 --> 0:16:53.400 It's true. That is the data for being out in 0:16:53.560 --> 0:16:57.200 nature is striking. I was not aware of this until 0:16:57.200 --> 0:17:00.200 I went in deep on this research and reviewed all 0:17:00.200 --> 0:17:03.000 the papers. I have really struck by it. And now 0:17:03.040 --> 0:17:06.359 we're talking about nature prescriptions for patients. We never talked 0:17:06.359 --> 0:17:09.960 about that. This is another part of that lifestyle factors 0:17:10.000 --> 0:17:13.520 that we have to acknowledge that it's really great when 0:17:13.560 --> 0:17:17.600 you're with other people. That's even a double benefit because 0:17:17.840 --> 0:17:21.320 social interactions and being out of nature are quite important. 0:17:21.560 --> 0:17:24.800 This reminds me we currently have a sick care system 0:17:25.200 --> 0:17:28.240 when what we actually want is a healthcare system that 0:17:28.440 --> 0:17:31.920 simple breakpoint. This is a good example. If I can 0:17:31.960 --> 0:17:34.919 get you to go out for thirty minutes or more 0:17:34.960 --> 0:17:38.760 a week, and that actually lowers the likelihood of depression 0:17:39.440 --> 0:17:42.240 as opposed to taking a drug for it. Some of 0:17:42.240 --> 0:17:44.640 the stuff that you've put together is I assume it's 0:17:44.640 --> 0:17:46.280 all true, but it sure is astonishing. 0:17:46.680 --> 0:17:48.840 Well, I'll tell you another thing related to that, which 0:17:48.880 --> 0:17:52.040 is astonishing. There's a graph and a book and also 0:17:52.560 --> 0:17:57.119 texts associated with it. There's a study so striking on 0:17:57.280 --> 0:18:00.520 people with depression taking these ssri I drs which are 0:18:00.800 --> 0:18:04.840 pervasive like prozac and all the others, and every form 0:18:04.880 --> 0:18:09.800 of exercise was better than the drugs, whether it's dancing 0:18:09.920 --> 0:18:12.800 or walking or you name, it was better than the 0:18:12.880 --> 0:18:14.879 drugs for reducing depression. 0:18:15.200 --> 0:18:19.359 So a doctor who prescribed physical activity as opposed to 0:18:19.400 --> 0:18:20.240 giving you a drug. 0:18:20.560 --> 0:18:23.800 It's such an extraordinary study. And now one of the 0:18:23.800 --> 0:18:27.040 biggest things it isn't that we don't know about these 0:18:27.040 --> 0:18:30.640 lifestyle factors, but we in the US. You know, we're 0:18:30.680 --> 0:18:34.200 great with technology. We're a leader, we're a leader in AI, 0:18:34.960 --> 0:18:37.520 and what we want to do instead of trying to 0:18:37.560 --> 0:18:41.920 treat diseases is truly prevent them. We couldn't do that before, 0:18:42.240 --> 0:18:45.760 we couldn't do it. But now the combination of lifestyle 0:18:45.840 --> 0:18:48.560 factors with AI, you know, we couldn't do this without AI. 0:18:48.680 --> 0:18:51.560 You have to assemble billions of data points on each 0:18:51.600 --> 0:18:55.840 person to say this is your risk and this is 0:18:55.840 --> 0:18:58.040 what we're going to do about it. And so it 0:18:58.080 --> 0:19:00.560 isn't just the lifestyle factors. We got to use all 0:19:00.600 --> 0:19:03.679 the layers of data the AI to give us the 0:19:04.400 --> 0:19:07.879 accurate and temporal So used to be let's say you 0:19:07.920 --> 0:19:10.840 did a gene sequence and you say, oh, you're at 0:19:10.920 --> 0:19:14.560 risk for Alzheimer's disease. Well, we didn't know from that 0:19:14.640 --> 0:19:17.520 whether it's at age ninety eight or sixty eight. Now 0:19:17.520 --> 0:19:21.119 we can pinpoint the time, not just the risk, and 0:19:21.520 --> 0:19:24.800 it's very precise. So the whole idea is that we're 0:19:24.840 --> 0:19:28.560 in a different time right now when prevention, which is 0:19:28.560 --> 0:19:31.439 so attractive for its potential, right now, we need to 0:19:31.480 --> 0:19:33.960 go after this and we're the perfect place to lead 0:19:34.000 --> 0:19:34.320 the way. 0:19:35.240 --> 0:19:39.840 I'm a big believer that artificial intelligence is going to 0:19:39.880 --> 0:19:43.480 empower us both in efficiency and in the ability to 0:19:43.520 --> 0:19:47.240 aggregate huge volumes of data and pinpoint things that you 0:19:47.280 --> 0:19:50.000 just literally couldn't have done before. How do you see 0:19:50.000 --> 0:19:53.600 that getting applied to the system, right. 0:19:53.800 --> 0:19:56.840 So what we want to do now is to prove 0:19:57.359 --> 0:20:00.680 that when you have all these layers of data. Obviously, 0:20:00.720 --> 0:20:03.360 things like the Electronic Health rugty of all that, labs 0:20:03.359 --> 0:20:06.800 and whatever skins AI can pick up things that we 0:20:06.880 --> 0:20:10.720 never see, for example, normal labs. You've had normal labs 0:20:10.720 --> 0:20:13.720 throughout your life, but it sees trends. We just look 0:20:13.760 --> 0:20:16.359 at it normal or not. But this so called set 0:20:16.359 --> 0:20:20.879 points for you. Then we add things like apologenic risk score, 0:20:21.000 --> 0:20:24.560 which we have that for all common diseases, the common cancers, 0:20:24.640 --> 0:20:28.600 heart disease, Alzheimer's, so we have that. And then we 0:20:28.680 --> 0:20:32.600 have these clocks body wide clock it's called a methylation 0:20:33.000 --> 0:20:36.240 epigenetic clock. We have organ clocks. We have all these 0:20:36.240 --> 0:20:40.760 biomarker proteins. All these are inexpensive. When you put it 0:20:40.800 --> 0:20:45.120 all together, along with a person's current lifestyle, you can 0:20:45.200 --> 0:20:48.200 say this is your risk, whether it's a particular type 0:20:48.200 --> 0:20:52.920 of cancer, heart disease, or neurodegenerate. And that's what we're 0:20:52.960 --> 0:20:55.960 not doing. We're not doing these well before a person 0:20:56.000 --> 0:21:01.040 ever has a disease. For example, the marker for Alzheimer's 0:21:01.320 --> 0:21:05.600 it's called p COW two seventeen, that has been available 0:21:05.600 --> 0:21:08.920 in the US for two years. Nobody knows about it, 0:21:09.200 --> 0:21:13.359 but it's as good as a cerebral spinal fluid assessment. 0:21:13.600 --> 0:21:17.639 It's as good as a PET scan. And this marker 0:21:18.200 --> 0:21:22.280 is lowered by exercise and by healthy lifestyle, So it's 0:21:22.320 --> 0:21:25.560 like an LDL cholesterol for heart disease. So why aren't 0:21:25.600 --> 0:21:28.280 we using this? Why aren't we preventing Alzheimer's? You know 0:21:28.440 --> 0:21:30.879 very well how much it costs to care for a 0:21:30.880 --> 0:21:33.560 person with Alzheimer's who would want to get that dread 0:21:33.560 --> 0:21:37.399 of disease. And that's why lifespan is not what we're after. 0:21:37.880 --> 0:21:41.760 It's health span free of these diseases. We can do this, 0:21:41.880 --> 0:21:45.080 but we haven't set our minds yet on our priorities, 0:21:45.080 --> 0:21:48.120 our resources to do it. And we have the tools, 0:21:48.600 --> 0:21:51.800 and the immune system is the common thread, and we 0:21:51.920 --> 0:21:54.880 now have an immune system clock that we can use. 0:21:55.440 --> 0:21:57.760 So why aren't we doing this? That's really what the 0:21:57.800 --> 0:22:01.600 book is about, reviewing the lifestyle actors, but providing a 0:22:01.680 --> 0:22:05.239 blueprint for how we can change the face of what 0:22:05.280 --> 0:22:08.360 we call the elderly. That you started with, how many 0:22:08.359 --> 0:22:11.479 people are sick to the welderly, which is the study 0:22:11.520 --> 0:22:14.919 we did of fourteen hundred people with whole genomes, and 0:22:15.000 --> 0:22:18.360 we didn't find anything these people, it's not their genes 0:22:18.400 --> 0:22:21.480 that are doing it. It's their lifestyle, their immune system, 0:22:22.000 --> 0:22:24.240 not in your DNA. For the most part. 0:22:43.560 --> 0:22:45.760 You make the comment in your book that we're stuck 0:22:45.800 --> 0:22:48.399 in the nineteen sixties in our approach to cancer. But 0:22:48.920 --> 0:22:51.320 that's true almost across the border. I mean, we have 0:22:51.480 --> 0:22:56.720 somehow culturally in the medical professions, financially, in these big companies, 0:22:57.280 --> 0:23:01.359 including the insurance companies in the hospitals, have gotten locked 0:23:01.359 --> 0:23:05.119 into a model which we objectively now know makes you 0:23:05.240 --> 0:23:07.879 less likely to live longer and less likely to be healthy. 0:23:08.720 --> 0:23:12.200 How do we get the transference to get the average 0:23:12.200 --> 0:23:15.840 doctor to decide they can offer you a prescription to 0:23:15.880 --> 0:23:20.439 go exercise instead of giving you an antidepressant. That's a 0:23:20.560 --> 0:23:23.800 revolution that will be culturally very challenging. 0:23:24.680 --> 0:23:29.320 It will be because we have such reliance on antidepressant 0:23:29.480 --> 0:23:32.840 medications that don't work very well and can be superseded 0:23:32.880 --> 0:23:37.240 by things like exercise. But I think the bigger problem, 0:23:37.320 --> 0:23:40.080 and you allude to this with the cancer. You know, 0:23:40.160 --> 0:23:44.160 this reactive rut that we're in. We stream for cancer 0:23:44.720 --> 0:23:48.000 based on only age, you know, So if you're a 0:23:48.080 --> 0:23:50.119 only in age forty or forty five, you're just to 0:23:50.160 --> 0:23:53.840 have mammograms on a frequent basis. Well, eighty eight percent 0:23:53.880 --> 0:23:57.520 of women, eighty eight percent will never have breast cancer 0:23:57.520 --> 0:23:59.879 in their lifetime. Why do we put all these women 0:24:00.200 --> 0:24:03.840 through all the waste? We can determine a person's risk 0:24:03.920 --> 0:24:07.560 and partition the screening, but we don't do it. We 0:24:07.600 --> 0:24:11.199