WEBVTT - Kopi Time E149 - Longevity with Brian Kennedy 0:00:06.019 --> 0:00:08.699 Hi, this is Kopi Time podcast series on markets and 0:00:08.699 --> 0:00:12.310 economies from DBS Group Research. I'm Taiu Bei, chief economist, 0:00:12.449 --> 0:00:15.350 welcoming you to our 149th episode. 0:00:16.110 --> 0:00:19.819 Today we will discuss longevity with the foremost expert in 0:00:19.819 --> 0:00:23.559 the field. Brian Kennedy is distinguished professor of biochemistry and 0:00:23.559 --> 0:00:27.180 physiology at Yong Lu Lin School of Medicine at National 0:00:27.180 --> 0:00:30.170 University of Singapore. He's also the director of the Center 0:00:30.170 --> 0:00:35.060 for Healthy Longevity National University Health System. Professor Brian Kennedy, 0:00:35.220 --> 0:00:36.129 welcome to Kobe time. 0:00:37.040 --> 0:00:37.958 Thanks, pleasure to be 0:00:37.959 --> 0:00:38.430 here. 0:00:38.799 --> 0:00:41.348 It's great to have you. This is a subject close 0:00:41.348 --> 0:00:43.759 to my heart. I was just telling you right before 0:00:43.759 --> 0:00:47.520 this recording that all the 40-somethings and 50-somethings I know they're, 0:00:47.560 --> 0:00:49.799 they're deep into this. So I will have a lot 0:00:49.799 --> 0:00:53.720 of eager friends listening into this podcast. Uh prof, let's 0:00:53.720 --> 0:00:56.240 begin by defining senescence. 0:00:57.860 --> 0:01:01.159 Yeah, senescence is a, a term that gets used for 0:01:01.159 --> 0:01:04.260 multiple meanings, and I think that's one of the reasons 0:01:04.260 --> 0:01:07.459 that it's complicated for people to understand. So for instance, 0:01:07.540 --> 0:01:11.699 when a uh salmon comes back into the fresh water 0:01:11.699 --> 0:01:16.139 and dies, that's called senescence. Um, but I think most 0:01:16.139 --> 0:01:16.910 people 0:01:17.589 --> 0:01:21.529 In in today's discussion would refer to it as the 0:01:22.089 --> 0:01:27.000 uh cessation of division of cells in your body, uh, so, uh, 0:01:27.010 --> 0:01:30.690 cells can for a variety of different reasons, stop dividing 0:01:30.690 --> 0:01:34.599 and enter into a senescent state. Uh, and in that 0:01:34.599 --> 0:01:39.250 senescent state, they're no longer able to support regeneration of tissues, 0:01:39.330 --> 0:01:42.089 but they still are live cells and they can secrete 0:01:42.089 --> 0:01:45.089 factors that are pro-inflammatory. 0:01:46.050 --> 0:01:46.059 No 0:01:47.889 --> 0:01:48.730 Go ahead, please. No, 0:01:49.089 --> 0:01:50.730 go ahead, no, no, I'm, I'm listening. Yeah, 0:01:50.889 --> 0:01:54.010 so 11 thing senescence is therefore is to keep cells 0:01:54.010 --> 0:01:56.769 from becoming cancer cells. So when something goes wrong in 0:01:56.769 --> 0:01:58.260 a cell and it may be on its way to 0:01:58.260 --> 0:02:02.169 being a tumor cell, the senescence pathway can be invoked 0:02:02.169 --> 0:02:04.610 and that stops the cell from being able to divide. 0:02:04.650 --> 0:02:06.730 So in a sense, it's anti-cancer. 0:02:07.500 --> 0:02:12.360 On the other hand, these, these cells secrete pro-inflammatory factors 0:02:12.360 --> 0:02:15.820 that influence cells around them and maybe even throughout the 0:02:15.820 --> 0:02:19.100 body in some cases, if there's enough senescence and so 0:02:19.100 --> 0:02:21.859 that can actually stimulate aging and cancer, so it's kind 0:02:21.860 --> 0:02:22.660 of a trade-off. 0:02:23.889 --> 0:02:26.470 Right, OK, so that's exactly where I was to jump into. 0:02:26.669 --> 0:02:28.809 So the question I guess is, you know, so what 0:02:28.809 --> 0:02:32.500 are the molecular hallmarks of aging? Is it, is it 0:02:32.500 --> 0:02:35.919 the what you just described that the cells stop dividing 0:02:35.919 --> 0:02:39.820 and then they may be secreting inflammatory material? 0:02:41.029 --> 0:02:44.130 Yeah, I, I think we can list several different things 0:02:44.130 --> 0:02:46.889 that are driving the aging process. Cells in essence is 0:02:46.889 --> 0:02:50.449 certainly one of them. Um, the inability of your adult 0:02:50.449 --> 0:02:54.410 stem cells to replenish their tissues, levels of inflammation in 0:02:54.410 --> 0:02:57.690 the body, your telomeres, DNA damage, all of these things 0:02:57.690 --> 0:03:00.008 probably contribute to the aging process. 0:03:00.508 --> 0:03:04.669 Um, and, uh, it's still somewhat of a mystery to 0:03:05.199 --> 0:03:08.198 put them in order and talk about how they contribute, 0:03:08.279 --> 0:03:11.038 what percentage each of, each of them contributes. So I 0:03:11.038 --> 0:03:13.449 think a better way of thinking about it is that 0:03:14.020 --> 0:03:16.549 You have a a network in your body that maintains 0:03:16.550 --> 0:03:20.779 health and it's kind of a homeostatic network, uh, and 0:03:21.029 --> 0:03:23.949 this network can respond to things that happen in your body. You, 0:03:24.110 --> 0:03:25.710 you know, you get out in the sun, you get 0:03:25.710 --> 0:03:29.339 skin damage, you start eating a lot of fast food, 0:03:29.429 --> 0:03:31.989 you know, your body adapts to that and it keeps 0:03:31.990 --> 0:03:35.020 you healthy for the most part. But over time that 0:03:35.020 --> 0:03:37.179 network breaks down, and when it breaks down, 0:03:37.750 --> 0:03:40.699 These hallmarks of what you see, high levels of inflammation, 0:03:40.789 --> 0:03:42.630 your stem cells don't work as well, so all of 0:03:42.630 --> 0:03:47.029 a sudden the senescent burden goes way up. Um, and 0:03:47.029 --> 0:03:49.929 so they're, they're telling you that aging is happening, but 0:03:49.929 --> 0:03:52.389 I think preserving the network is really what we want 0:03:52.389 --> 0:03:55.270 to do to keep people young, not, you know, treat 0:03:55.270 --> 0:03:58.229 each hallmark separately. I think that that so far hasn't 0:03:58.229 --> 0:03:59.100 worked very well. 0:04:00.250 --> 0:04:04.539 And when does it begin? My son is 11 years old. 0:04:04.630 --> 0:04:07.509 Clearly he is not going through the process of aging yet, 0:04:07.589 --> 0:04:09.990 but would he at the age of 18, at 25, 0:04:10.070 --> 0:04:12.300 is it hard to put a marker around that? 0:04:12.710 --> 0:04:15.270 Well, I, I may even disagree with you. I think 0:04:15.270 --> 0:04:19.350 we we recently did a biomarker study using DNA methylation 0:04:19.350 --> 0:04:21.059 of 10,000 Singaporeans. 0:04:21.570 --> 0:04:24.380 And we happened to have a birth cohort in that study, 0:04:24.540 --> 0:04:27.940 so we were looking at newborn babies, and already we 0:04:27.940 --> 0:04:31.808 can detect that baby boys were older than baby girls. Uh, 0:04:31.829 --> 0:04:34.859 and so that suggests that maybe aging starts in the womb, 0:04:35.100 --> 0:04:38.380 you know, and that already there's something happening that's different 0:04:38.380 --> 0:04:40.140 between boys and girls. 0:04:40.630 --> 0:04:46.220 Um, so, certainly during development, you don't see manifestations of aging, 0:04:47.149 --> 0:04:49.760 you know, kids are getting stronger, they're getting smarter, their, 0:04:49.829 --> 0:04:53.720 their brain is, is developing, um, and so, you know, 0:04:53.790 --> 0:04:56.869 you begin to see the decline in aging in adulthood, 0:04:57.070 --> 0:04:57.980 you know, maybe. 0:04:59.269 --> 0:05:02.269 You know, starting around 30 maybe, but 0:05:03.109 --> 0:05:05.988 And there may be parameters that are driving that aging 0:05:05.988 --> 0:05:09.070 process that are not detectable, but happening throughout life. 0:05:10.220 --> 0:05:14.470 And is the manifestation of aging first in cognition or 0:05:14.470 --> 0:05:18.708 is it more physiological developments that you pick up as 0:05:18.709 --> 0:05:19.700 signs of aging? 0:05:20.109 --> 0:05:20.190 Well, 0:05:20.250 --> 0:05:22.229 I, I think that a lot of people would say 0:05:22.230 --> 0:05:25.109 that the ovarian aging is the first thing you really 0:05:25.109 --> 0:05:27.709 see in women, so you, you know, you have a 0:05:27.709 --> 0:05:30.549 decline in fertility starting in your 30s and 0:05:30.820 --> 0:05:35.519 Uh, menopause somewhere in your 40s and 50s, um, that's 0:05:35.519 --> 0:05:39.510 indicating that ovaries are, are aging, I think. Uh, also, 0:05:39.559 --> 0:05:44.399 your thymus tends to undergo what's called involution, which leads 0:05:44.399 --> 0:05:48.220 to a dramatic reduction in production of immune cells. So 0:05:48.480 --> 0:05:51.320 those are two things that happen relatively early during the 0:05:51.320 --> 0:05:53.519 aging process, um. 0:05:54.178 --> 0:05:57.380 Muscle loss, you know, starts usually around 40 and people 0:05:57.380 --> 0:06:00.659 say you, the average person loses about 1% muscle mass 0:06:00.660 --> 0:06:05.140 a year after that. Um, cognitive decline, and, and actually 0:06:05.140 --> 0:06:07.988 physical decline, it depends on how you measure it, you know, 0:06:08.100 --> 0:06:11.489 you don't see a whole lot of 40 year old 0:06:11.488 --> 0:06:14.058 athletes right at the top level. 0:06:14.510 --> 0:06:18.920 Um, and already when you're measuring how fast like neurons 0:06:18.920 --> 0:06:21.600 fire and connect, you know, it's already slowing down at 0:06:21.600 --> 0:06:24.880 that point, but it's hard to measure because your body's, 0:06:25.079 --> 0:06:28.040 like I said, is good at compensating, you know, so 0:06:28.040 --> 0:06:30.839 it finds other ways to adapt to to to things 0:06:30.839 --> 0:06:32.440 that are going a little bit slower and you don't 0:06:32.440 --> 0:06:35.269 really notice that in your daily life. So, if you 0:06:35.269 --> 0:06:37.799 really want to take really deep measures, you can already 0:06:37.799 --> 0:06:40.410 start to see things in 30s and 40s, but 0:06:40.790 --> 0:06:44.149 You know, in terms of actual functioning disease-free health, you know, 0:06:44.269 --> 0:06:48.070 that's usually not until 50s and 60s where you begin 0:06:48.070 --> 0:06:49.630 to see a significant decline. 0:06:50.500 --> 0:06:54.630 I recall reading somewhere that in terms of physics and 0:06:54.630 --> 0:06:59.350 pure mathematics, the pathbreaking discoveries come from scientists who are 0:06:59.350 --> 0:07:02.019 in their late 20s, early 30s. They even the Nobel 0:07:02.019 --> 0:07:05.070 laureates don't necessarily go through pathbreaking discoveries in the late 0:07:05.070 --> 0:07:10.070 30s and 40s. I've heard about musicians that the really 0:07:10.070 --> 0:07:12.470 brilliant musicians are much younger than the older ones. 0:07:13.290 --> 0:07:16.309 Yeah, I think that that's certainly, it's certainly been well 0:07:16.309 --> 0:07:20.709 uh defined for math and physics. Um, you know, biology 0:07:20.709 --> 0:07:22.540 research is a little bit different because I have a 0:07:22.540 --> 0:07:25.459 whole team of people working with me and so it's not. 0:07:26.399 --> 0:07:28.429 You know, we may have a great discovery, I hope 0:07:28.429 --> 0:07:30.440 we do, but whether it comes from my brain or 0:07:30.440 --> 0:07:33.109 one of the young people's brains is debatable. 0:07:34.799 --> 0:07:38.839 Um, Proff Kennedy, I have heard you talk, ah, in, 0:07:38.880 --> 0:07:43.200 in public forum in, in terms of the distinction between 0:07:43.200 --> 0:07:46.829 lifespan and health span, and really that I've also heard 0:07:46.829 --> 0:07:50.200 you talk about this phrase, uh, compressed morbidity. So could 0:07:50.200 --> 0:07:52.750 you help us sort of walk through these three things? 0:07:53.579 --> 0:07:56.500 So, so healthspan is, it's a little bit hard to define, 0:07:56.519 --> 0:07:58.760 but I think you can understand that. It's the period 0:07:58.760 --> 0:08:02.480 of time that you're largely disease-free and that you're highly 0:08:02.480 --> 0:08:03.929 functional in life, um. 0:08:04.829 --> 0:08:08.760 And you typically that if the average lifespan in Singapore 0:08:08.760 --> 0:08:13.579 is 85, the average health span would be around low 70s. Um, 0:08:13.589 --> 0:08:16.260 and so there's a period of time, maybe a decade 0:08:16.609 --> 0:08:20.029 on average, where people are alive, but they're not in 0:08:20.029 --> 0:08:23.350 good health, or they're not functioning well, uh, and that 0:08:23.350 --> 0:08:26.269 would be, that's where all the healthcare costs are and 0:08:26.269 --> 0:08:29.059 that's where quality of life diminishes dramatically. 0:08:29.510 --> 0:08:33.169 So if you have an intervention that uh compresses morbidity, 0:08:33.210 --> 0:08:37.080 and we've published that with alphakitic glittering in mice, uh, 0:08:37.159 --> 0:08:39.809 what you see is that the health span goes up 0:08:39.809 --> 0:08:42.890 more than the lifespan. So it's, it causes a small 0:08:42.890 --> 0:08:45.809 increase in lifespan, but a big increase in health span. 0:08:46.169 --> 0:08:48.929 And so that period of time when you're sick and 0:08:48.929 --> 0:08:52.289 have multi morbidity gets diminished, and so that's what compressed 0:08:52.289 --> 0:08:55.569 morbidity is. And that's really what we would like to see, right? 0:08:55.719 --> 0:08:56.659 Are you, you. 0:08:57.039 --> 0:08:59.979 You know, jokingly, you'd like to be totally healthy and 0:08:59.979 --> 0:09:02.090 then eventually get hit by a bus. I mean, there's, 0:09:03.659 --> 0:09:06.169 I mean, maybe not, but you get the idea. 0:09:07.140 --> 0:09:09.579 Yeah, I think, uh, Atul Goanes being mortal in the 0:09:09.580 --> 0:09:12.340 very first chapter has something about like that his grandfather, 0:09:12.460 --> 0:09:15.210 who was a lawyer till his 90s, basically, you know, 0:09:15.460 --> 0:09:17.299 was healthy till the day he died because he got 0:09:17.299 --> 0:09:18.299 hit by something like that. 0:09:18.780 --> 0:09:24.190 Um, but, uh, I, you know, in WHO they have this, uh, 0:09:24.200 --> 0:09:30.190 life expectancy adjusted marker called HAL, HALE Health adjusted life expectancy. 0:09:30.320 --> 0:09:32.359 So is that the way to look at it then 0:09:32.359 --> 0:09:33.500 that instead of looking at 0:09:33.500 --> 0:09:36.159 that's one parameter you can use to try to measure 0:09:36.159 --> 0:09:38.030 health span. I think there are different ways to look 0:09:38.030 --> 0:09:40.880 at it, but, um, and like I said, it's there 0:09:40.880 --> 0:09:43.390 I don't know if there's consensus on how to measure it, 0:09:43.429 --> 0:09:44.848 but um. 0:09:45.450 --> 0:09:47.840 That would be one parameter you could think of, yes. 0:09:48.210 --> 0:09:50.369 I, I just like the fact that Singapore ranks number 0:09:50.369 --> 0:09:52.849 one in the health adjusted life expectancy metric. 0:09:53.859 --> 0:09:56.119 Yeah, I mean, Singapore is doing quite well, and you know, 0:09:56.289 --> 0:09:58.569 what I hope is that they really make a commitment 0:09:58.570 --> 0:10:02.289 to healthy longevity because the the time is right to 0:10:02.289 --> 0:10:05.770 do that and this island could be the, the model 0:10:05.770 --> 0:10:09.949 case for really extending health span because uh there's a 0:10:09.950 --> 0:10:15.718 lot of things going in advantage for Singapore, uh, it's small, manageable, um, 0:10:15.770 --> 0:10:17.319 already have good healthcare system. 0:10:17.650 --> 0:10:20.770 Uh, and I think there's also a population that believes 0:10:20.770 --> 0:10:23.049 in the government. So when the government takes the lead 0:10:23.049 --> 0:10:26.250 on something, people will follow, you know, you, you could 0:10:26.250 --> 0:10:29.840 say anything in the US you could say. 0:10:30.229 --> 0:10:32.679 You know, drink 3 cups of water a day or 0:10:32.679 --> 0:10:35.080 more and then half the population would disagree with you 0:10:35.080 --> 0:10:36.710 on my definitions 0:10:37.929 --> 0:10:40.919 for sure, absolutely, uh, I want to talk in greater 0:10:40.919 --> 0:10:44.440 detail about Singapore uh later. I just want to cover 0:10:44.440 --> 0:10:46.760 a couple of things first with you. Uh, when I 0:10:46.760 --> 0:10:48.000 told my wife that, you know, I was gonna 0:10:48.114 --> 0:10:52.314 Discuss with you this this health span lifespan issue. She 0:10:52.315 --> 0:10:55.924 basically said, well, it's largely genetics. So is it largely 0:10:55.924 --> 0:10:59.455 genetics or and she's a polysci PhD, so let's not 0:10:59.455 --> 0:11:02.034 necessarily give her full credence. You, the expert, tell me 0:11:02.034 --> 0:11:05.864 whether the genetics versus environment, how much do these things matter? 0:11:06.674 --> 0:11:08.395 How much trouble am I going to get if I 0:11:08.395 --> 0:11:13.965 disagree with her she has a very old you get. 0:11:16.049 --> 0:11:20.020 Um, there's certainly a genetic component, but most research suggests 0:11:20.020 --> 0:11:25.580 that it's relatively small, maybe 30% of the, of the equation, 0:11:25.710 --> 0:11:28.619 and the rest of it is sort of lifestyle environment, 0:11:28.789 --> 0:11:30.340 where you live, how you live. 0:11:30.710 --> 0:11:34.159 Um, and that it is very important. Now, there's an 0:11:34.159 --> 0:11:36.840 exception to that though. There are people that live to 0:11:36.840 --> 0:11:41.520 be centenarians. Um, they chose, they got there by choosing 0:11:41.520 --> 0:11:45.200 the right parents. Uh, that's very genetic when, so people 0:11:45.200 --> 0:11:49.119 with exceptional longevity have the right genetics, but this is 0:11:49.119 --> 0:11:53.939 extremely rare. The, the vast majority of us, um, uh, 0:11:53.950 --> 0:11:56.150 environment and lifestyle are probably more important. 0:11:57.400 --> 0:11:57.840 But this, 0:11:57.849 --> 0:12:01.619 this genetic lottery fascinates me. I'll give you my personal example. 0:12:01.750 --> 0:12:05.189 My mom, she's no longer with us. She had all 0:12:05.190 --> 0:12:08.030 sorts of morbidities, even at a fairly young age, diabetes 0:12:08.030 --> 0:12:11.989 related morbidity and so on in her 60s. My dad 0:12:11.989 --> 0:12:15.219 still around 90+. We had his 90th birthday last year. 0:12:15.320 --> 0:12:18.669 Fingers crossed, he lives longer, and he has never really 0:12:18.669 --> 0:12:21.119 stressed out about, you know, the right diet or the 0:12:21.119 --> 0:12:24.270 right pills, whereas my mom who did pass away, actually 0:12:24.270 --> 0:12:25.349 was far more worried about her 0:12:25.349 --> 0:12:26.228 health. Yeah. 0:12:26.729 --> 0:12:28.530 Well, there's two things I would say to that. One 0:12:28.530 --> 0:12:32.210 is that, uh, centenarians don't typically live well, that they 0:12:32.210 --> 0:12:35.130 have the genetics, right? So they, if you look at them, 0:12:35.169 --> 0:12:37.250 they were more likely to be a little bit overweight. Now, 0:12:37.289 --> 0:12:39.729 they weren't like crazy obese, but they were more likely 0:12:39.729 --> 0:12:43.169 to be a little bit overweight. Uh, and near Barzilai's 0:12:43.169 --> 0:12:46.569 study of Ashkenazi Jews, they're slightly more likely to be 0:12:46.570 --> 0:12:50.000 smoking than than the po you know, so they have 0:12:50.000 --> 0:12:52.320 the right genetics, they're resistant, um. 0:12:53.000 --> 0:12:54.510 I would also say that. 0:12:55.559 --> 0:12:59.209 I, I think it's great to be uh very alert 0:12:59.210 --> 0:13:01.900 to a healthy lifestyle and doing your best to live 0:13:01.900 --> 0:13:04.380 a healthy life, but I don't think worrying about it 0:13:04.380 --> 0:13:06.940 constantly is a good thing. And so, you know, I, 0:13:07.020 --> 0:13:10.539 I think that sometimes people forget the, the, the level 0:13:10.539 --> 0:13:14.059 that stress plays in their aging, uh, and trying to 0:13:14.059 --> 0:13:17.299 manage your stress, um, is, is critical. It's hard for 0:13:17.299 --> 0:13:20.700 us to study that in animals, but I'm convinced it's 0:13:20.700 --> 0:13:23.940 a critical component of aging, the mindset, you know. 0:13:24.299 --> 0:13:26.929 And so you said father, not worrying, and he seems 0:13:26.929 --> 0:13:29.330 to like go through life and take things kind of 0:13:29.330 --> 0:13:32.369 as they come, maybe yeah, your father's worried that could 0:13:32.369 --> 0:13:33.330 have been a factor. 0:13:33.950 --> 0:13:34.210 Right. 0:13:34.609 --> 0:13:36.549 Um, OK, so let's talk about the things that we 0:13:36.549 --> 0:13:40.119 can control, um, you know, diet, this issue has been 0:13:40.119 --> 0:13:42.340 around for maybe half a century, and there is my mother, 0:13:42.349 --> 0:13:48.340 so exactly. So since we can't control our father and mother, uh, 0:13:48.559 --> 0:13:50.119 the things that we can, let's talk a little bit 0:13:50.119 --> 0:13:53.819 about diet and exercise, the two things that, you know, 0:13:54.000 --> 0:13:57.039 a lot of people talk about, where do we stand 0:13:57.039 --> 0:13:59.950 in terms of scientific zeitgeist in these two areas? 0:14:00.440 --> 0:14:00.679 Let's 0:14:00.679 --> 0:14:02.919 start with exercise because I think it's a little bit 0:14:02.919 --> 0:14:04.280 of an easier discussion. 0:14:04.700 --> 0:14:10.630 Um, you do it. If some combination of resistance training 0:14:10.630 --> 0:14:15.030 and cardiovascular training is probably good for everybody. Um, it's 0:14:15.030 --> 0:14:17.150 important to try to do both, as as you get older, 0:14:17.190 --> 0:14:19.549 you wanna try to maintain that muscle mass. So one 0:14:19.549 --> 0:14:21.349 of the most important things you can do is keep 0:14:21.349 --> 0:14:26.109 your muscle mass. Um, but, you know, cardiovascular health is 0:14:26.109 --> 0:14:28.979 obviously good for your heart and your vascular system, and 0:14:29.260 --> 0:14:32.890 And a range of other systems as well. So, uh, the, 0:14:32.929 --> 0:14:36.650 the key to me is sustainability, you know, and trying 0:14:36.650 --> 0:14:40.570 to find exercise programs that fit your needs. If you're 0:14:40.570 --> 0:14:43.010 doing something and you don't like it, you're, you're gonna 0:14:43.010 --> 0:14:47.119 stop doing it. I just be honest, you know. So, um, 0:14:47.609 --> 0:14:50.090 for me, you know, I enjoy running. I, I kind 0:14:50.090 --> 0:14:52.059 of get my mindfulness from running. 0:14:52.559 --> 0:14:56.419 It's, it's meditative almost for me as well. Um, and 0:14:56.419 --> 0:14:58.659 so it's very good for me, and then I for 0:14:58.659 --> 0:15:02.119 I forced myself to go do weightlifting, and I've, I've 0:15:02.119 --> 0:15:03.900 learned to live with it. I don't love it, but 0:15:03.900 --> 0:15:06.260 I don't hate it either, and so, and I feel 0:15:06.260 --> 0:15:09.619 good after I, I complete it, so, uh, and I 0:15:09.619 --> 0:15:12.940 can see the benefit of doing it over the long term, so. 0:15:13.700 --> 0:15:16.090 You know, that that for me is what works, but if, 0:15:16.099 --> 0:15:18.890 if tennis works for you, that's great. The the key 0:15:18.890 --> 0:15:21.979 is find something that's sustainable. 0:15:24.729 --> 0:15:27.809 The um one point that I wanted, sorry, I, did 0:15:27.809 --> 0:15:30.929 I lose you? you can hear me, right? Yeah, um, 0:15:31.169 --> 0:15:32.489 we're going to get your diet for a second. I 0:15:32.489 --> 0:15:35.049 just want to share with you my personal slightly off-track 0:15:35.049 --> 0:15:37.369 observation on this issue. I also like to run. I 0:15:37.369 --> 0:15:39.789 also like the fact that during running all sorts 0:15:39.840 --> 0:15:42.460 A serendipitous thing can happen. I was in Dubai yesterday. 0:15:42.669 --> 0:15:46.109 I went running and I saw two peacocks flexing their 0:15:46.109 --> 0:15:50.109 plumes in just all glory. If I were driving or biking, 0:15:50.150 --> 0:15:51.950 I would not have seen that, and that that delight, 0:15:52.030 --> 0:15:55.739 I think will sustain my running habit for years to come. Yeah, 0:15:55.869 --> 0:15:59.950 I run outside instead of treadmills almost I only run 0:15:59.950 --> 0:16:02.150 on a treadmill if there's no other choice because I 0:16:02.150 --> 0:16:04.849 think you're right, you experience the world being outside running 0:16:04.849 --> 0:16:05.229 and 0:16:05.640 --> 0:16:07.840 Although I did try to run in Dubai last summer 0:16:07.840 --> 0:16:09.520 and that was, that didn't go well. 0:16:12.010 --> 0:16:15.130 December, January, February is what you want to do. Yeah, absolutely. Um, 0:16:15.320 --> 0:16:18.700 you had mentioned about the muscle loss aspect, about 1% 0:16:18.700 --> 0:16:22.400 muscle loss in your 40s onward, uh, so resistance training 0:16:22.400 --> 0:16:23.679 is something that you would want. 0:16:23.765 --> 0:16:25.895 People in their 40s onward to focus on as well, 0:16:26.034 --> 0:16:28.234 yeah, for sure. And also it's good for your bones, 0:16:28.354 --> 0:16:30.635 you know, one of the things that maintains bone density 0:16:30.635 --> 0:16:33.955 is putting resistance on your bones, you know, putting load 0:16:33.955 --> 0:16:38.205 on your bones. And so, um, when you're doing uh 0:16:38.395 --> 0:16:40.914 resistance training, you're not only helping your muscle but your 0:16:40.914 --> 0:16:41.875 bones as well. 0:16:42.950 --> 0:16:46.349 Shouldn't dairy also help with respect to bone? Got lots 0:16:46.349 --> 0:16:47.059 of calcium? 0:16:47.789 --> 0:16:51.429 Uh, dairy is complicated. Um, you want to maintain the 0:16:51.429 --> 0:16:55.510 appropriate calcium levels for sure, uh, as you age. Um, 0:16:55.669 --> 0:17:01.099 a lot of studies suggest that very high dairy, accelerates aging. Um, 0:17:01.349 --> 0:17:04.390 there are a lot of, uh, observational studies in, in 0:17:04.390 --> 0:17:05.819 humans to suggest that. 0:17:06.189 --> 0:17:09.188 Uh, so I tend to, I keep to a very 0:17:09.189 --> 0:17:12.069 low dairy diet. I eat yogurt and I, I will 0:17:12.069 --> 0:17:17.629 eat cheese sometimes, but I don't drink milk, uh, at all. So, but, 0:17:18.030 --> 0:17:19.829 you know, how your body reacts to that and what 0:17:19.829 --> 0:17:22.420 happens to your calcium levels is something you should be measuring, 0:17:22.430 --> 0:17:25.270 and this is, this is one point I would like 0:17:25.270 --> 0:17:28.150 to make is that people ask me about supplements and 0:17:28.150 --> 0:17:30.459 vitamins and all of all of these things. 0:17:31.050 --> 0:17:33.290 Well, you need to know where you are on this equation. 0:17:33.410 --> 0:17:34.810 You need to be able to, you need to know 0:17:34.810 --> 0:17:38.489 your vitamin levels. You need to know your meta metabolic levels, and, 0:17:38.810 --> 0:17:41.050 you know, we, and now we have a clinical aging 0:17:41.050 --> 0:17:43.810 clock where we can measure your biologic age based on 0:17:43.810 --> 0:17:48.040 50 clinical variables that everybody should be getting anyway. You know, 0:17:48.089 --> 0:17:52.290 it's uh it's LDL and inflammatory factors and so if you're, 0:17:52.369 --> 0:17:55.000 if you're one of these people that likes to do interventions, 0:17:55.089 --> 0:17:57.869 whether it's lifestyle or supplements or drugs, a lot of 0:17:57.869 --> 0:17:59.280 people are taking rapamycin. 0:17:59.550 --> 0:18:03.819 You should be measuring outcomes as well and and trying 0:18:03.819 --> 0:18:06.649 to find the strategy that works best for you, uh, 0:18:06.699 --> 0:18:09.520 and I think a lot of people, uh, I think 0:18:09.520 --> 0:18:12.140 I always actually I think my my God, I don't 0:18:12.140 --> 0:18:12.520 know what your levels. 0:18:15.609 --> 0:18:16.010 These are. 0:18:18.790 --> 0:18:21.959 Um, prof, we sort of lost you in the last 0:18:21.959 --> 0:18:24.569 30 seconds. Just let's just uh go back to that 0:18:24.569 --> 0:18:27.170 point of the, uh, after you talked about dairy, but 0:18:27.170 --> 0:18:29.689 the 30, 40 things that you can do to test 0:18:29.689 --> 0:18:32.209 your vitamin levels, that part, let's repeat that part. 0:18:33.579 --> 0:18:37.170 Yeah, so we recently generated a clinical chemistry clock that 0:18:37.170 --> 0:18:40.709 predicts your biologic age, and it does so from about 0:18:40.709 --> 0:18:44.599 40 or 50 analytes that you commonly get when you get, uh, 0:18:44.609 --> 0:18:47.649 go to a doctor's office or hospital. And these are 0:18:47.650 --> 0:18:50.569 things you should be doing all the time, measuring these factors. 0:18:50.930 --> 0:18:54.810 These things like HbA1C, LDL, inflammatory factors. 0:18:55.170 --> 0:18:58.899 Um, and you should know what those are, and if 0:18:58.900 --> 0:19:01.369 you have them, we can also tell you your biologic age, 0:19:01.800 --> 0:19:04.859 but you should also know your vitamin levels. Typically these 0:19:04.859 --> 0:19:08.500 things are not measured, um, and people ask me, should 0:19:08.500 --> 0:19:12.198 I take vitamin D or B complex, and I, I'm like, 0:19:12.260 --> 0:19:16.079 I don't know, what are your levels? And they don't know. So, uh, 0:19:16.260 --> 0:19:19.140 you should measure yourself and, and pay attention to how 0:19:19.140 --> 0:19:22.339 you're doing, uh, before you just start taking a bunch 0:19:22.339 --> 0:19:23.329 of different things. 0:19:24.050 --> 0:19:26.160 All right, let's go to the broader issue of diet, 0:19:26.239 --> 0:19:28.719 which you already have sort of foreshadowed that it's a 0:19:28.719 --> 0:19:31.599 bit complex. um, what should one be eating and what 0:19:31.599 --> 0:19:32.599 should one be avoiding? 0:19:33.260 --> 0:19:35.729 Yeah, I mean, this is still highly debated. You can 0:19:35.729 --> 0:19:38.510 find experts that will say just about anything. I think 0:19:38.510 --> 0:19:41.609 the two common diets that people talk about for aging 0:19:41.609 --> 0:19:46.160 are a vegetable rich diet, uh, that's low in, uh, 0:19:46.170 --> 0:19:51.939 red meat and dairy, uh, kind of a Mediterranean diet, um, and, uh, 0:19:51.959 --> 0:19:54.250 and that's the one I tend to believe in, uh, 0:19:54.339 --> 0:19:57.729 and then there is another group that are very keto-oriented, 0:19:57.810 --> 0:20:01.410 so they're like high protein, high fat, no carbs, um. 0:20:03.199 --> 0:20:07.170 I think that that keto diet probably makes people lose weight, 0:20:08.060 --> 0:20:13.859 but it also unbalances your uh uh nutrition such that 0:20:13.859 --> 0:20:18.260 your body has to make relatively serious adaptation to what 0:20:18.260 --> 0:20:21.380 it needs, and I think over the long term, most 0:20:21.380 --> 0:20:24.739 of the evidence suggests that having high amino acid levels 0:20:24.739 --> 0:20:29.260 accelerates aspects of aging, uh, whereas if you look at 0:20:29.260 --> 0:20:31.140 the animal models where you keep 0:20:31.680 --> 0:20:35.599 Uh, calorie and take uh isochlorine, so you're, we're not 0:20:35.599 --> 0:20:40.040 changing total calories, and then you change macronutrients, it's actually 0:20:40.040 --> 0:20:43.520 high carb, low protein that's associated with longer lifespan. 0:20:44.390 --> 0:20:46.589 But there are two caveats to that. One is that 0:20:46.589 --> 0:20:49.859 it's complex carbs, not simple sugars. I think those are, 0:20:49.989 --> 0:20:53.708 are not good for you. Um, the other is that 0:20:53.709 --> 0:20:56.989 for humans, if you say you're eating a diet rich 0:20:56.989 --> 0:21:00.959 in carbohydrates, you're probably getting way too many calories. Carbohydrates 0:21:00.959 --> 0:21:03.339 is the fastest way to over nutrition, and I think 0:21:03.339 --> 0:21:06.550 that's why people perceive it as bad. But if you're 0:21:06.550 --> 0:21:09.280