# Katie Couric and Eric Topol: On the State of US Life Science and Extending Healthspan

An episode of [Ground Truths](https://invisiblenetwork.ai/podcast/1728526108), 12 Jun 2025, 55 min.

Audio: https://api.substack.com/feed/podcast/165726942/8f6b650862936179bc0f0984adc349ae.mp3

Thank you Richard DeWald, Michael Mann, Dr Avneesh Khare, Maud Pasturaud, Lower Dementia Risk, and many others for tuning into my live video with Katie Couric! Join me for my next live video in the app. Get full access to Ground Truths at erictopol.substack.com/subscribe

## Transcript

[0:00] SPEAKER_00: But anyway, you guys, welcome to the Substack Live.
[0:04] SPEAKER_00: I'm thrilled to be talking to Dr. Eric Topol.
[0:07] SPEAKER_00: I'm going to give you a little background on Dr. Topol.
[0:10] He's a renowned cardiologist and founder and director of the
[0:13] Scripps Research
[0:15] SPEAKER_00: Translational Institute,
[0:17] SPEAKER_00: and he's got a new book out.
[0:18] SPEAKER_00: That is getting a lot of attention.
[0:20] SPEAKER_00: And he's going to teach us all how to live to 100 plus,
[0:24] SPEAKER_00: but also live well,
[0:26] SPEAKER_00: which is the most important part.
[0:28] And his book is called Super Agers,
[0:30] an evidence-based approach to longevity.
[0:33] SPEAKER_00: And it cuts through the hype around biohacking and anti-aging fads.
[0:39] to offer a clear science-driven path to living longer and,
[0:43] as I mentioned,
[0:44] living well.
[0:45] SPEAKER_00: Hey,
[0:45] before we talk about how you're going to help us all live to be
[0:50] a 100-plus,
[0:51] SPEAKER_00: I wanted to ask you if I could,
[0:52] SPEAKER_00: Dr.
[0:53] SPEAKER_00: Topol,
[0:53] a little bit about this assault on science that we've seen that
[0:58] happened really,
[0:58] SPEAKER_00: I think,
[1:00] SPEAKER_00: it was happening before COVID.
[1:01] SPEAKER_00: I think it was kind of
[1:04] SPEAKER_00: supercharged during COVID and after COVID.
[1:08] SPEAKER_00: And now with RFK Jr.
[1:10] SPEAKER_00: in charge, I think we're seeing it on steroids.
[1:14] And I'm curious if you can comment on that as somebody who has
[1:20] so much expertise in
[1:22] SPEAKER_00: science and medicine about some of the things that have been happening.
[1:26] SPEAKER_00: For example, I know he dismissed the entire CDC report
[1:30] SPEAKER_00: vaccine panel, Sean O'Leary.
[1:33] SPEAKER_00: I don't know if you know Sean O'Leary,
[1:36] SPEAKER_00: but he's a pediatrician and infectious disease researcher.
[1:40] SPEAKER_00: He described it as an unmitigated public health disaster.
[1:45] SPEAKER_00: We've seen massive cuts to NIH.
[1:48] And as a result,
[1:49] these massive cuts to NIH mean massive cuts to research
[1:53] universities.
[1:56] SPEAKER_00: What do you think about everything that's going on?
[2:00] SPEAKER_01: Well, it's horrifying, Katie.
[2:02] The NIH part is especially a problem because we're seeing a
[2:07] budget being dropped
[2:08] SPEAKER_01: down from $47 billion
[2:11] SPEAKER_01: by 40%, almost $20 billion less.
[2:14] And one could argue that it would be good to have made it more
[2:17] efficient and take
[2:18] SPEAKER_01: some of the cost of doing biomedical research in this country,
[2:21] SPEAKER_01: the crown jewel of the world,
[2:24] SPEAKER_01: sure,
[2:24] SPEAKER_01: but not in a reckless,
[2:25] SPEAKER_01: indiscriminate,
[2:26] SPEAKER_01: and profound way.
[2:28] SPEAKER_01: So this is one of the big devastating parts.
[2:32] SPEAKER_01: But as you say, it cuts across all parts of the HHS, RFK Jr.
[2:38] SPEAKER_01: 's
[2:40] SPEAKER_01: stewardship.
[2:41] SPEAKER_01: And the vaccine panel is just one more.
[2:44] It seems like every day there's something else to add to this
[2:48] that's challenging,
[2:50] SPEAKER_01: the ongoing science research in this country.
[2:54] SPEAKER_01: And there doesn't appear to be any good rationale, reason,
[2:59] SPEAKER_01: Methods are being used here.
[3:01] SPEAKER_01: So it's horrible.
[3:03] SPEAKER_01: The main question,
[3:03] SPEAKER_01: of course,
[3:04] is will we still be able to go forward or are we going to
[3:07] basically go even
[3:09] SPEAKER_01: backwards in terms of all the advances?
[3:11] SPEAKER_01: I mean, this is such a momentous time in medicine.
[3:14] SPEAKER_00: Right.
[3:14] SPEAKER_01: I think of all times for this to occur,
[3:17] SPEAKER_01: we're making such remarkable strides and it's going to set us back.
[3:22] It's also going to give advantage to other countries around the
[3:25] world who are not
[3:25] SPEAKER_01: going through this.
[3:27] SPEAKER_00: That's right, Dr. Tobel.
[3:28] SPEAKER_00: And we, you know, I interviewed Francis Collins.
[3:30] SPEAKER_00: I've talked to,
[3:31] SPEAKER_00: you know,
[3:31] SPEAKER_00: I'm very,
[3:32] I have so much respect for people who are scientists and in the
[3:36] medical community
[3:37] SPEAKER_00: through my cancer advocacy work.
[3:41] SPEAKER_00: And Francis Collins was saying how
[3:44] SPEAKER_00: incredibly devastating this is.
[3:47] SPEAKER_00: And as you said, we're at such a critical time.
[3:50] SPEAKER_00: And I think for people who don't follow this regularly,
[3:54] SPEAKER_00: it's this confluence of artificial intelligence and technology,
[4:01] SPEAKER_00: engineering,
[4:02] SPEAKER_00: kind of bringing all these disciplines together,
[4:04] SPEAKER_00: but particularly AI in terms of what it can do
[4:09] SPEAKER_00: in science and medical research.
[4:12] SPEAKER_00: You're the expert.
[4:13] What does AI promise in terms of scientific breakthroughs and
[4:18] why is it so critical
[4:20] SPEAKER_00: to marshal the power of it right now?
[4:23] SPEAKER_01: Yeah,
[4:23] so this is really the reason why we're moving into this
[4:28] hyper-accelerated phase of
[4:29] SPEAKER_01: discovery and transforming medicine.
[4:32] SPEAKER_01: For one, we're seeing the discovery of new drugs.
[4:35] SPEAKER_01: In fact,
[4:37] a drug for a very severe lung condition that we don't have a
[4:40] good treatment for,
[4:40] SPEAKER_01: idiopathic pulmonary fibrosis.
[4:43] SPEAKER_01: This is the first AI discovered drug that is now
[4:46] passed a phase two trial,
[4:47] so it's pretty far along and it looks great,
[4:50] discovered by AI.
[4:51] SPEAKER_01: So that's one part of the story.
[4:54] Another is that the way we practice in medicine is getting so
[4:58] much more efficient
[5:00] by just having our conversations made into synthetic notes that
[5:05] are far better than
[5:06] SPEAKER_01: the notes that are in our...
[5:08] SPEAKER_01: This is freeing up two, three, four hours a day for clinicians.
[5:13] SPEAKER_01: And it just keeps getting better.
[5:14] SPEAKER_01: And it's not just a note.
[5:16] That whole AI product is being used to order the tests and do
[5:21] the coding and for
[5:24] SPEAKER_01: future appointments,
[5:25] SPEAKER_01: prescriptions,
[5:25] SPEAKER_01: pre-authorizations.
[5:26] SPEAKER_01: I mean, all the things that occupy physicians.
[5:30] SPEAKER_00: And keep them away from their patients.
[5:32] SPEAKER_00: Yeah.
[5:33] SPEAKER_01: Exactly.
[5:34] So that restoration of the patient-doctor relationship is
[5:37] starting to really take
[5:39] SPEAKER_01: hold,
[5:39] SPEAKER_01: which is great.
[5:40] SPEAKER_01: And of course,
[5:41] SPEAKER_01: what I think is the biggest,
[5:43] SPEAKER_01: most exciting frontier is using AI to extend our health span.
[5:48] SPEAKER_01: And this is something I think that up until now,
[5:51] SPEAKER_01: we didn't realize how we have this truly remarkable opportunity.
[5:55] SPEAKER_01: And that's why I put so much work into this for agers thing,
[5:59] SPEAKER_01: just because we're going to do this.
[6:02] SPEAKER_00: I want to talk about super agers in a second,
[6:05] but the one thing I also wanted to mention that I think is so
[6:08] exciting about AI,
[6:10] SPEAKER_00: Dr.
[6:10] SPEAKER_00: Topol,
[6:10] SPEAKER_00: and I wonder if you think this as well,
[6:14] SPEAKER_00: is in terms of diagnostics.
[6:16] SPEAKER_00: You know, I know there's a woman, I always mention her at Dana-Farberg.
[6:23] SPEAKER_00: And she's a doctor, but also she herself got breast cancer.
[6:27] SPEAKER_00: And I think she was working with an engineer on AI diagnostic tools.
[6:33] And I read,
[6:35] and this was a while ago,
[6:36] so I need to update my reading,
[6:38] that
[6:39] SPEAKER_00: not only will AI allow you to be better at diagnosis,
[6:45] SPEAKER_00: you know,
[6:45] SPEAKER_00: very early,
[6:46] SPEAKER_00: but it can be predictive.
[6:48] SPEAKER_00: And it can look at certain people and say,
[6:51] there's a high likelihood you will get breast cancer in the
[6:55] next five years.
[6:57] SPEAKER_00: And it will...
[6:59] SPEAKER_00: impact how a particular individual is monitored.
[7:03] I can't talk for some reason anymore,
[7:06] you guys,
[7:06] so I apologize if I'm being inarticulate.
[7:09] SPEAKER_00: But are you seeing progress in that area, too?
[7:12] SPEAKER_01: Yeah, I'm so glad you mentioned that.
[7:14] SPEAKER_01: And actually, you articulated it quite well.
[7:17] The story here is that there was the largest ever randomized
[7:20] trial of AI in medicine.
[7:22] SPEAKER_01: It was done in Sweden with over 100,000 women.
[7:26] And the women who got randomly assigned with the mammogram to
[7:30] have AI plus the
[7:31] SPEAKER_01: radiologist had 25% more cancers diagnosed.
[7:36] And this should be part of every woman's mammogram assessment
[7:40] now in this country.
[7:41] SPEAKER_01: And of course, it isn't.
[7:43] SPEAKER_01: And we're far from that.
[7:44] And then the other thing that you touched on is that from a
[7:47] normal mammogram,
[7:50] SPEAKER_01: the AI can figure out the risk very accurately over the next five years.
[7:55] SPEAKER_01: And in fact, a company just got FDA approval for that last week here.
[7:59] This is all part of that ability to predict our liabilities of
[8:05] our health,
[8:05] SPEAKER_01: major,
[8:06] SPEAKER_01: whether it's cancer,
[8:08] SPEAKER_01: heart disease, neurodegenerative disease, AI is having a big effect.
[8:12] SPEAKER_01: So the mammogram is just one example,
[8:14] but the retina is one of the most extraordinary ones because
[8:17] from the retina in
[8:19] SPEAKER_01: people who are healthy,
[8:20] SPEAKER_01: you can determine if they have risks for heart disease,
[8:23] SPEAKER_01: for a stroke,
[8:24] SPEAKER_01: for liver disease,
[8:26] SPEAKER_01: kidney disease,
[8:28] SPEAKER_01: for Parkinson's and Alzheimer's five years before they have any symptoms.
[8:32] SPEAKER_01: The retina, we can't see these things, but AI can.
[8:36] SPEAKER_01: And that's what's so extraordinary.
[8:38] SPEAKER_00: When is that going to be available, do you think, to the general public?
[8:43] And I don't know if I'd want to know if I was going to get
[8:46] Alzheimer's or Parkinson's.
[8:49] I guess there are some new medications that can stave off
[8:52] Alzheimer's,
[8:53] I think.
[8:54] SPEAKER_00: I'm not sure what can be done for—my dad had Parkinson's.
[8:57] I don't know what else could be—what could be done in terms of
[9:01] preventative
[9:02] SPEAKER_00: measures if you find out early enough about that.
[9:06] SPEAKER_00: But, you know, these retina scans, when will they be available?
[9:10] SPEAKER_00: By the way,
[9:11] SPEAKER_00: everyone who's just joining,
[9:12] SPEAKER_00: I'm talking to Dr.
[9:14] SPEAKER_00: Eric Topol,
[9:14] SPEAKER_00: and we're right now going to get to his book in two seconds.
[9:18] SPEAKER_00: But tell me about the retina scans.
[9:21] SPEAKER_00: Yeah.
[9:22] SPEAKER_01: So the retina isn't commercially available yet,
[9:25] but the multiplicity of exceptional research reports have shown
[9:30] that it's the case
[9:32] SPEAKER_01: with all medical images,
[9:33] SPEAKER_01: as we were talking about with the mammogram,
[9:35] SPEAKER_01: but the retina is just rich.
[9:37] SPEAKER_01: We thought it was a gateway just perhaps to the brain,
[9:40] SPEAKER_01: but it's to almost every organ in the body.
[9:43] SPEAKER_00: That's so crazy.
[9:44] SPEAKER_01: Yeah.
[9:44] SPEAKER_01: So someday,
[9:45] SPEAKER_01: Katie,
[9:46] SPEAKER_01: we'll be doing our,
[9:47] SPEAKER_01: you know,
[9:47] SPEAKER_01: retina selfies and then having AI analyze it and giving us now,
[9:52] SPEAKER_01: you're bringing up,
[9:53] SPEAKER_01: well,
[9:54] SPEAKER_01: you don't want to know if there's not a way to prevent,
[9:56] SPEAKER_01: but we do have ways to prevent,
[9:58] SPEAKER_01: particularly Alzheimer's,
[10:01] SPEAKER_01: but also Alzheimer's.
[10:02] SPEAKER_01: the heart and the cancer diagnosis.
[10:06] SPEAKER_01: So, and we're gonna just keep getting better.
[10:09] SPEAKER_01: That's what's really,
[10:11] SPEAKER_01: so for people who are young now to know in advance,
[10:14] SPEAKER_01: they're gonna be having a great opportunity to truly prevent.
[10:18] SPEAKER_01: This is one thing to emphasize that all these years,
[10:22] we're talking about millennia that medicine's talked about
[10:25] primary prevention of
[10:26] SPEAKER_01: major age-related diseases.
[10:29] SPEAKER_01: We've never done it before.
[10:31] SPEAKER_01: But we actually can't do that now.
[10:34] SPEAKER_00: That's so exciting.
[10:35] SPEAKER_00: Well,
[10:35] SPEAKER_00: let's move on to your book,
[10:37] SPEAKER_00: Super Agers,
[10:39] SPEAKER_00: because people are really interested in longevity.
[10:44] SPEAKER_00: So interested, there's a lot of pseudoscience out there.
[10:47] SPEAKER_00: So before we talk about what works, let's talk about what doesn't.
[10:52] SPEAKER_00: And I know you take on biohacking, pseudoscience, anti-science movements,
[10:57] SPEAKER_00: And all these things,
[10:59] SPEAKER_00: you know,
[11:00] all this malarkey that's out there that is telling people
[11:06] certain things that just
[11:07] SPEAKER_00: have no basis in science.
[11:09] SPEAKER_00: Why do you think,
[11:11] what has fueled these movements and what can we do about all
[11:16] this misinformation?
[11:18] SPEAKER_01: Yeah, it's a great question.
[11:19] So there's a few reasons why we're seeing this longevity moment
[11:24] right now.
[11:25] SPEAKER_01: There's never been more intense interest.
[11:28] SPEAKER_01: One is that we have had
[11:30] SPEAKER_01: big investments in science and biotech to reverse aging.
[11:37] And this is a lot of billionaires who,
[11:39] when they were young,
[11:40] they wanted to be rich.
[11:42] SPEAKER_01: And now that they're rich, they want to be young.
[11:43] SPEAKER_01: And they put a lot of resources into these companies.
[11:46] SPEAKER_01: And some of them are doing really elegant science and
[11:50] We can say that you can make a mouse or a rat that's old make
[11:56] it truly young.
[11:57] I mean,
[11:57] yeah,
[11:58] it's extraordinary,
[11:58] but we're not in any data in people,
[12:01] right?
[12:01] SPEAKER_01: So that's one area that's really been moving quickly.
[12:06] SPEAKER_01: And maybe someday we will have a way to reverse aging.
[12:10] SPEAKER_01: But right now we don't.
[12:11] SPEAKER_01: We're not even close.
[12:13] SPEAKER_01: And we also know that these various shots on goal each have
[12:18] SPEAKER_01: liabilities and risks.
[12:19] Like,
[12:20] for example,
[12:21] the cellular reprogramming,
[12:22] we've seen tumors show up in mice and rodents.
[12:26] SPEAKER_01: So it's not a, you know, kind of a clear-cut path to people.
[12:32] Now,
[12:32] the second bucket is what you are getting at is the longevity
[12:37] marketing.
[12:38] SPEAKER_01: All these companies are
[12:40] SPEAKER_01: There's clinics that charge up to $250,000,
[12:42] and you can get plasmapheresis and hyperbaric oxygen chambers
[12:48] and stem cells,
[12:48] SPEAKER_01: all these unproven things.
[12:50] SPEAKER_01: No less all these anti-aging supplements that have absolutely no data,
[12:54] SPEAKER_01: to make these claims.
[12:56] And so there's companies that are doing every test under the
[12:59] sun,
[12:59] total body,
[13:00] MRI.
[13:01] SPEAKER_01: And so this is yet another category which is fueling the interest.
[13:05] SPEAKER_01: And then finally, there's actually real stuff that we can do now
[13:10] SPEAKER_01: that we should be doing.
[13:11] SPEAKER_01: And especially,
[13:12] SPEAKER_01: you know,
[13:12] SPEAKER_01: when we were talking about,
[13:13] SPEAKER_01: you know,
[13:14] SPEAKER_01: this make America healthy again,
[13:16] SPEAKER_01: or whatever you want to call Maha,
[13:17] SPEAKER_01: we could do this.
[13:18] SPEAKER_01: We have the tools to do this now, but we're not doing it.
[13:21] SPEAKER_01: So that's what I think is the real opportunity for today.
[13:26] SPEAKER_00: Well,
[13:26] SPEAKER_00: let's talk about the tools because I know,
[13:28] SPEAKER_00: uh,
[13:29] SPEAKER_00: the,
[13:30] SPEAKER_00: the new concept of health span versus lifespan has come into play and,
[13:35] SPEAKER_00: and you write about that,
[13:37] SPEAKER_00: but,
[13:37] but talk about particularly selfishly about women because women
[13:43] do live generally
[13:44] SPEAKER_00: longer than men,
[13:45] SPEAKER_00: but it doesn't mean that they're living well.
[13:48] SPEAKER_00: Um, but can you talk about this idea of health span?
[13:51] SPEAKER_01: Yeah, this is of course what we're after.
[13:54] SPEAKER_01: And, uh,
[13:55] SPEAKER_01: Longevity,
[13:56] SPEAKER_01: if you have dementia or other horribly debilitating diseases,
[14:00] SPEAKER_01: no one really wants that.
[14:03] But the whole idea is how can we extend healthspan where you're
[14:07] free of these
[14:08] SPEAKER_01: age-related diseases.
[14:09] SPEAKER_01: You actually have a very high quality of life.
[14:12] SPEAKER_01: And to be at 85 plus and not have any cancer is
[14:18] SPEAKER_01: not have any neurodegenerative disease, and have no heart disease.
[14:23] SPEAKER_01: That's really the goal we can achieve now.
[14:26] SPEAKER_01: I don't know about 100, but we certainly can get to 85 plus.
[14:31] SPEAKER_01: And the patients who I present in the book
[14:33] particularly Leigh Bruce Hall,
[14:35] who's 98,
[14:36] who's just entirely intact in every possible way.
[14:40] SPEAKER_01: She's kind of prototypic of the future.
[14:42] SPEAKER_01: We're going to see a lot more of these super agers or welderly.
[14:46] SPEAKER_01: And we used to think it was tied to our genes, but it isn't.
[14:51] SPEAKER_00: Well,
[14:51] SPEAKER_00: I was going to ask you about that because,
[14:54] SPEAKER_00: you know,
[14:55] SPEAKER_00: aren't there some genetic components like you just are lucky in terms of
[15:03] you know,
[15:04] your DNA and your genetic makeup that predispose you to living
[15:10] healthier.
[15:10] It's like those people who chain smoke all their lives and yet
[15:14] they live to be like
[15:16] SPEAKER_00: 95 years old.
[15:18] SPEAKER_01: Yeah, no, we've seen some of that.
[15:19] SPEAKER_01: When we did this Welderly study,
[15:21] SPEAKER_01: Welderly was our term for super agers,
[15:25] SPEAKER_01: they had to be over 85 and never been sick,
[15:28] SPEAKER_01: no medications.
[15:29] And so we even saw some people,
[15:31] like you said,
[15:32] Katie,
[15:33] 99,
[15:33] two packs of cigarettes a day still.
[15:35] SPEAKER_01: I mean, but what we learned when we did whole genome sequencing
[15:39] SPEAKER_01: is that these people,
[15:41] they didn't have anything in their DNA that was different from
[15:46] the elderly,
[15:47] SPEAKER_01: the people that had the typical disease pattern.
[15:49] SPEAKER_01: In addition, they didn't have in their family story.
[15:53] SPEAKER_01: So like,
[15:54] SPEAKER_01: for example,
[15:55] SPEAKER_01: Lee,
[15:55] SPEAKER_01: the patient 98,
[15:56] SPEAKER_01: her parents died when they were in their 50s and 60s,
[16:00] SPEAKER_01: and her brothers died.
[16:02] SPEAKER_01: 40 years earlier than her.
[16:04] SPEAKER_01: So the question is,
[16:05] why are these people in the elderly often the last person
[16:08] standing in their family?
[16:10] SPEAKER_01: And it's not mostly genes.
[16:12] SPEAKER_01: It turns out it could be luck, but that's probably a very small percent.
[16:18] SPEAKER_01: It's probably everything that points to the immune system.
[16:21] SPEAKER_01: You get to 85-plus
[16:24] SPEAKER_01: when you have a resilient, intact immune system.
[16:28] SPEAKER_01: But as it turns out,
[16:29] SPEAKER_01: once we start getting into our late 50s and 60s,
[16:32] our immune system in many of us starts to really lose its
[16:36] protection and goes
[16:37] SPEAKER_01: haywire and stimulates a lot of inflammation.
[16:41] SPEAKER_01: And that's when we get into trouble.
[16:43] SPEAKER_01: So you don't see that in the DNA.
[16:45] SPEAKER_01: You only can see that by doing specific immune system testing,
[16:49] SPEAKER_01: which we don't do in the clinic yet.
[16:53] SPEAKER_00: So I guess the key is keeping your immune system strong, right?
[16:57] And I always thought inflammation was cause,
[17:02] Dr.
[17:02] Topol,
[17:03] when the immune system goes crazy.
[17:06] That's why immunotherapy is so tricky,
[17:11] because it's your own immune system fighting cancer.
[17:15] SPEAKER_00: But the question is,
[17:16] can you get the right balance where it fights the cancer but
[17:19] doesn't hurt the
[17:20] SPEAKER_00: healthy cells and organs?
[17:22] SPEAKER_00: at the same time.
[17:23] SPEAKER_00: So what can you do to keep your immune system, I would say, in balance?
[17:31] And someone's asking,
[17:32] Ira's asking about the microbiome,
[17:34] and Ira,
[17:35] we'll get to that in a second.
[17:37] SPEAKER_00: By the way,
[17:37] SPEAKER_00: someone asked how you felt about the CDC vaccine panel getting chicanned,
[17:43] SPEAKER_00: excuse my French,
[17:44] SPEAKER_00: Dr.
[17:44] SPEAKER_00: Topol.
[17:45] SPEAKER_00: And Dr. Topol said he, well, you say what you said earlier.
[17:49] SPEAKER_01: No,
[17:49] SPEAKER_01: I mean,
[17:50] SPEAKER_01: it's a travesty because these are very experienced people,
[17:53] SPEAKER_01: years of vaccine expertise,
[17:57] SPEAKER_01: and who knows who's going to replace them.
[17:59] SPEAKER_01: And it was just unjustified, unnecessary.
[18:02] SPEAKER_01: And it's just all part of this anti-vax story that we're seeing.
[18:06] It's just there's nothing that's been shown to be more helpful
[18:10] in promoting health
[18:12] SPEAKER_01: than vaccines.
[18:13] SPEAKER_00: And think of all the lives vaccines have saved, right, Dr. Topolman?
[18:17] SPEAKER_01: tens of millions of lives.
[18:18] SPEAKER_01: And there's no perfect vaccine.
[18:21] SPEAKER_01: We'll acknowledge that.
[18:22] SPEAKER_01: But whenever we have anything in medicine,
[18:24] SPEAKER_01: whether it's a drug or a vaccine or anything,
[18:27] SPEAKER_01: it's always the risk versus the benefit ratio.
[18:30] SPEAKER_01: And here the benefit is just so exponentially important.
[18:33] So it's terrible to see this getting negated and overridden and
[18:38] challenged.
[18:40] Okay,
[18:40] but anyway,
[18:41] but getting back to longevity,
[18:42] thank you for doing that.
[18:43] I just wanted that person to know that we had talked about that
[18:47] early in our conversation.
[18:49] SPEAKER_00: I think I was asking you,
[18:50] so if the immune system gets weakened and it's really important
[18:54] for us to keep our
[18:55] SPEAKER_00: immune system strong,
[18:57] SPEAKER_00: right?
[18:59] SPEAKER_00: Is that the key to aging well?
[19:01] SPEAKER_00: And what can you do to bolster your immune system?
[19:06] SPEAKER_01: Well, quite a bit, actually.
[19:07] SPEAKER_01: Now, some of it is lifestyle factors.
[19:10] SPEAKER_01: So if you have a diet, an optimal diet that doesn't promote inflammation,
[19:16] SPEAKER_01: And that would be a plant-based diet largely.
[19:19] It would be avoiding as much as possible the bad
[19:24] ultra-processed foods that
[19:25] SPEAKER_01: stimulate inflammation,
[19:28] SPEAKER_01: avoiding too high a protein diet,
[19:30] SPEAKER_01: which has been linked to promoting inflammation and atherosclerosis.
[19:34] SPEAKER_01: So a diet that's healthy is one thing.
[19:37] The second is exercise is incredibly important for keeping our
[19:42] immune system intact.
[19:44] SPEAKER_01: and blocking untoward inflammation.
[19:48] SPEAKER_01: And then sleep, really important, deep sleep.
[19:51] SPEAKER_00: I'm good at that, Dr. Topol.
[19:53] SPEAKER_01: Oh, it's good.
[19:54] SPEAKER_01: Wow, that's great.
[19:56] SPEAKER_01: If you get deep sleep,
[19:58] this is the ticket for getting those waste products out of your
[20:02] brain each night.
[20:03] SPEAKER_01: And as we get older,
[20:05] SPEAKER_01: we tend to get much less deep sleep,
[20:07] SPEAKER_01: that slow-wave sleep,
[20:09] SPEAKER_01: usually in the beginning of the night.
[20:11] So getting that,
[20:13] and you can work on that,
[20:14] but it's much more than just these lifestyle factors.
[20:18] SPEAKER_01: We've now learned that the immune system degradation with age,
[20:23] SPEAKER_01: so-called immunosenescence,
[20:26] SPEAKER_01: and inflammation,
[20:27] SPEAKER_01: our propensity for that as we get older,
[20:29] SPEAKER_01: inflammaging,
[20:31] SPEAKER_01: These are the drivers of age-related diseases, and we can suppress them.
[20:36] SPEAKER_01: Like, for example, we talked about what can you do about Alzheimer's.
[20:41] SPEAKER_01: There have been three huge studies of the shingles vaccine,
[20:44] SPEAKER_01: so-called natural experiments,
[20:46] SPEAKER_01: in three different countries around the world.
[20:49] SPEAKER_01: Australia, Wales, and the U.S.
[20:51] And what we saw from that was the shingles vaccine not only
[20:55] protects against
[20:56] SPEAKER_01: getting shingles,
[20:57] SPEAKER_01: which is bad enough,
[20:58] SPEAKER_01: but it brought down dementia and Alzheimer's by 25%.
[21:02] SPEAKER_01: If that was a drug, that'd be extraordinary.
[21:06] SPEAKER_01: These data certainly convinced me of,
[21:09] SPEAKER_01: you know,
[21:09] SPEAKER_01: getting the shingles vaccines,
[21:11] SPEAKER_01: which is...
[21:11] SPEAKER_00: Well,
[21:11] SPEAKER_00: I hope you were going to get it anyway,
[21:13] SPEAKER_00: Dr.
[21:13] SPEAKER_00: Tobey.
[21:13] SPEAKER_01: Yeah, you know, I was, but it really took it over the, you know...
[21:18] I get sick whenever I get these shots,
[21:20] you know,
[21:21] whether it's a COVID booster.
[21:22] SPEAKER_01: And I've had colleagues that got the,
[21:24] SPEAKER_01: particularly the second shingles shot,
[21:26] SPEAKER_01: and they really got ill.
[21:27] SPEAKER_01: And I said, oh, gee, when am I gonna do this?
[21:29] You know,
[21:30] it was like,
[21:31] I don't have a two or three day hiatus here that I can just get
[21:34] sick.
[21:35] SPEAKER_01: But finally I said, well, the data here are really compelling.
[21:38] SPEAKER_01: But that's just,
[21:39] SPEAKER_01: we don't,
[21:40] the shingles vaccine is an example of revving up the immune
[21:43] system in older adults.
[21:46] SPEAKER_01: And that's what we're,
[21:47] SPEAKER_01: you know,
[21:47] SPEAKER_01: in the future,
[21:48] we're going to be using vaccines just to bring the immune
[21:51] system up at a higher
[21:52] SPEAKER_01: level to maintain its integrity.
[21:55] SPEAKER_01: And we're going to use anti-inflammatory drugs.
[21:58] SPEAKER_01: So these drugs like Ozempic and Munjaro, they're real actions.
[22:03] SPEAKER_01: is not just about weight loss or helping diabetes.
[22:07] SPEAKER_01: It's about inflammation.
[22:09] SPEAKER_01: They are potent blockers of brain inflammation,
[22:13] SPEAKER_01: testing now in Alzheimer's,
[22:15] SPEAKER_01: in big trials,
[22:16] SPEAKER_01: and also body-wide inflammation,
[22:18] SPEAKER_01: which is critical in cancer and in heart disease.
[22:22] SPEAKER_01: So we're going to be using these drugs in the future in pill form
[22:27] SPEAKER_01: to block inflammation.
[22:28] And if those trials are coming out in early next year for
[22:31] Alzheimer's work,
[22:33] SPEAKER_01: for these,
[22:34] SPEAKER_01: you know,
[22:34] SPEAKER_01: Ozempic-like drugs,
[22:35] SPEAKER_01: that's going to be one of the biggest changes in the history of medicine.
[22:39] SPEAKER_01: We've not had a really potent and safe anti-inflammatory drug,
[22:44] SPEAKER_01: especially that gets its effects through the brain.
[22:48] I've been reading all about how GLP-1s are very effective for
[22:53] all kinds of issues,
[22:54] SPEAKER_00: brain health,
[22:56] SPEAKER_00: with Alzheimer's and all.
[22:57] SPEAKER_00: Do you see a point in time where everyone will be on a GLP-1 or anyone,
[23:04] SPEAKER_00: I mean,
[23:05] just for their overall health and to prevent a lot of these
[23:08] aging diseases?
[23:11] You know,
[23:11] I speculated that in super ages because that's where it looks
[23:15] like we're headed.
[23:17] SPEAKER_01: And remember, we're still in the early days.
[23:20] SPEAKER_01: We have these two gut hormone mimetics,
[23:24] SPEAKER_01: basically,
[23:25] SPEAKER_01: that look like the hormones that we have naturally in our body.
[23:29] SPEAKER_01: There's another 15 more that have been discovered.
[23:32] that are gonna be made into pills like these are,
[23:35] and all kinds of combinations.
[23:37] And what we've learned is that the gut speaks to the brain and
[23:41] the immune system
[23:41] SPEAKER_01: through these hormones.
[23:43] So,
[23:44] you know,
[23:44] it used to be thought that a way to a man's heart was through
[23:47] his gut.
[23:48] SPEAKER_01: Well, now it's the way to a human's health.
[23:51] SPEAKER_01: Immune health is through their gut hormones.
[23:55] SPEAKER_01: So we're going to see an explosion of this whole.
[23:57] SPEAKER_01: It's not just the ones we have today.
[24:00] SPEAKER_01: There's just so many combinations.
[24:02] SPEAKER_01: They're so potent.
[24:03] SPEAKER_01: Some of them get in the brain so much better than ones we have right now.
[24:06] SPEAKER_01: So we can look forward to much better tools for prevention.
[24:12] SPEAKER_01: on top of the lifestyle factors.
[24:15] SPEAKER_01: And then the other thing,
[24:16] SPEAKER_01: to go back,
[24:16] SPEAKER_01: Katie,
[24:17] SPEAKER_01: to a point you asked about earlier,
[24:19] SPEAKER_01: it's the AI that's so critical to tell us about the risk in each of us.
[24:25] SPEAKER_01: So are you at high risk for one of these three major age-related diseases
[24:31] SPEAKER_01: And when.
[24:32] SPEAKER_01: We can never do that before.
[24:33] SPEAKER_01: We can not only say accurately if you're at high risk, but also when.
[24:38] SPEAKER_01: And we have 20 plus years for these diseases to take hold.
[24:43] SPEAKER_01: 20 plus years.
[24:44] If we can't do something in a 20-year time span with all these
[24:48] tools and with the
[24:49] SPEAKER_01: ability to have such remarkable analytics,
[24:53] SPEAKER_01: we must be pretty dumb.
[24:55] SPEAKER_00: Yeah.
[24:56] SPEAKER_00: Well,
[24:57] SPEAKER_00: and by the way,
[24:58] SPEAKER_00: everyone,
[24:58] SPEAKER_00: I'm talking to Dr.
[24:59] SPEAKER_00: Eric Topol,
[25:01] SPEAKER_00: who wrote a book called Super Agers,
[25:05] and he is the director of the Scripps Research Translational
[25:09] Institute and a
[25:11] SPEAKER_00: renowned cardiologist.
[25:12] So he's talking,
[25:13] telling us what we can do to live longer,
[25:16] healthier lives.
[25:17] And we have talked about sort of the anti-science trend in this
[25:20] Trump administration and
[25:22] SPEAKER_00: and RFK's move to not only, you know, get rid of super...
[25:29] SPEAKER_00: you know,
[25:30] SPEAKER_00: qualified people from like the CDC Vaccine Advisory Board,
[25:35] SPEAKER_00: but also these huge cuts to the NIH,
[25:38] SPEAKER_00: which are,
[25:38] SPEAKER_00: you know,
[25:39] really trying for research universities and for the great work
[25:43] that is done at the
[25:45] SPEAKER_00: NIH.
[25:45] But if you all have questions,
[25:46] I want you to put them in the chat and I'll try to get to them.
[25:51] SPEAKER_00: But I wanted to also kind of dig into those three areas.
[25:55] SPEAKER_00: You talked about Dr. Topol, you talked about
[25:59] SPEAKER_00: You know, diet, exercise, and sleep.
[26:02] So,
[26:03] you know,
[26:03] exercise,
[26:04] there are a lot of definitions of exercise,
[26:06] you know.
[26:07] And I read something different every day that I should get into
[26:11] level two and get
[26:12] SPEAKER_00: my heart so I'm moving at least three times a week for 20 minutes,
[26:16] SPEAKER_00: but even longer than that.
[26:18] SPEAKER_00: where I can talk, but I'm not talking very easily.
[26:21] SPEAKER_00: It sort of hurts to talk.
[26:23] SPEAKER_00: And then I hear like 10,000 steps, no, 7,000 steps.
[26:26] SPEAKER_00: And then,
[26:27] SPEAKER_00: you know,
[26:28] and so I think it's really hard to be practical and incorporate
[26:32] this in your
[26:33] SPEAKER_00: everyday life.
[26:33] SPEAKER_00: So when it comes to exercise,
[26:36] SPEAKER_00: Help us or help me.
[26:38] I don't know if you all watching this have the same issue,
[26:40] but what should we be doing?
[26:43] SPEAKER_00: And why is there so much different information out there?
[26:47] SPEAKER_00: It's so hard to keep up with.
[26:50] SPEAKER_01: Well, you're right.
[26:50] SPEAKER_01: There's a lot of confusion.
[26:52] SPEAKER_01: But let me be clear, any sustained physical activity is good.
[26:56] SPEAKER_01: Any.
[26:57] SPEAKER_01: So,
[26:57] SPEAKER_01: you know,
[26:58] SPEAKER_01: even if it's,
[26:59] SPEAKER_01: you know,
[26:59] SPEAKER_01: a walk that's relatively brief without any fast heart rate or sweating,
[27:05] SPEAKER_01: that's good.
[27:06] SPEAKER_01: But the more the better to a certain point.
[27:09] SPEAKER_01: It doesn't have to be extreme.
[27:10] But we're talking about at least five times a week,
[27:13] ideally 30 minutes of aerobic activity.
[27:16] SPEAKER_01: That would be brisk walks or cycling or elliptical or treadmill,
[27:22] SPEAKER_01: running,
[27:23] SPEAKER_01: jogging,
[27:23] SPEAKER_01: all these sorts of swimming.
[27:25] SPEAKER_01: 30 minutes five times a week, that's to strive for.
[27:28] SPEAKER_01: It doesn't have to be with a heart rate monitor.
[27:31] SPEAKER_01: It doesn't have to be where you're working up torrential amount of sweat.
[27:36] SPEAKER_01: The extreme isn't really proven,
[27:38] SPEAKER_01: as I review in the book,
[27:40] SPEAKER_01: about how far,
[27:41] SPEAKER_01: how nuts you have to go with this.
[27:43] But as long as you're getting a good workout and having some
[27:46] sweat is an indicator
[27:48] without having to worry about your heart rate or whether you
[27:50] can talk or not,
[27:52] SPEAKER_01: So that's one thing.
[27:53] But the big change in recent years is the new data about
[27:57] resistance training and
[27:59] SPEAKER_01: balance training.
[28:01] So as we get older,
[28:02] we lose muscle mass,
[28:04] and that's not good for healthspan.
[28:07] SPEAKER_01: And so the ideal thing is some resistance training,
[28:10] SPEAKER_01: and that could be with bands or push-ups and sit-ups and
[28:14] SPEAKER_01: you know, planks and lunges and that sort of thing.
[28:16] SPEAKER_01: It doesn't require, it's free.
[28:18] SPEAKER_01: I mean, it doesn't require any expensive equipment.
[28:20] SPEAKER_00: Where you're using your own body weight oftentimes to like,
[28:24] SPEAKER_00: you know,
[28:25] SPEAKER_00: to do planks or,
[28:26] SPEAKER_00: you know,
[28:28] SPEAKER_00: using bands and all that jazz.
[28:30] SPEAKER_01: Exactly.
[28:31] SPEAKER_01: And,
[28:31] SPEAKER_01: you know,
[28:31] doing that at least two or three times a week is really
[28:35] important to maintain your
[28:36] SPEAKER_01: muscle strength.
[28:37] SPEAKER_01: And that's why hand grip strength is a big determinant of health span.
[28:41] SPEAKER_01: It's not just because your hand is strong,
[28:44] SPEAKER_01: it's that you've got your upper body,
[28:45] SPEAKER_01: which is pretty much neglected with most of the aerobic activities.
[28:50] SPEAKER_01: You get your upper body strong and balance training,
[28:52] SPEAKER_01: you know,
[28:53] standing on one foot for a minute or longer and being able to
[28:58] do some touchdowns
[28:59] SPEAKER_01: and that sort of thing.
[29:00] That's really good for people as we get older because we lose
[29:03] some of our balance
[29:05] SPEAKER_01: capabilities,
[29:05] SPEAKER_01: our proprioception.
[29:07] SPEAKER_01: So these are really important.
[29:09] SPEAKER_01: They can't be emphasized enough.
[29:11] And unlike these longevity clinics and these predatory things
[29:15] out there,
[29:15] these are free.
[29:17] SPEAKER_01: Okay.
[29:17] SPEAKER_01: Anybody can do this stuff and you don't have to go nuts with it.
[29:21] SPEAKER_01: You don't have to,
[29:21] SPEAKER_01: you know,
[29:22] if you spend a short amount of time every day doing one of the
[29:26] aerobic or the
[29:29] SPEAKER_01: resistance training,
[29:30] SPEAKER_01: that's terrific.
[29:32] SPEAKER_00: You know, it's funny.
[29:33] SPEAKER_00: I've been trying to stand on one foot with my eyes closed to see.
[29:38] SPEAKER_00: It's really hard.
[29:39] SPEAKER_01: It is hard.
[29:40] SPEAKER_01: It's hard.
[29:42] SPEAKER_01: You get better as you do it more.
[29:44] SPEAKER_01: And you can keep your eyes open, but that'll make it a little easier.
[29:49] But if you do it on a foam pad or something that makes it more
[29:52] challenging,
[29:53] you can keep stepping it up to get your balance better and
[29:56] better with these
[29:56] SPEAKER_01: different simple techniques.
[30:00] SPEAKER_00: Nancy is asking the name of the book.
[30:02] SPEAKER_00: Nancy, it's called Super Agers, and it's by Dr. Eric Topol.
[30:06] SPEAKER_00: So we covered exercise.
[30:08] SPEAKER_00: And,
[30:08] SPEAKER_00: you know,
[30:09] SPEAKER_00: of course,
[30:09] SPEAKER_00: we know with diet,
[30:13] SPEAKER_00: you avoid ultra processed foods and stuff in,
[30:17] SPEAKER_00: you know,
[30:18] SPEAKER_00: packaging.
[30:18] SPEAKER_00: And when you can't
[30:20] You can't pronounce the ingredients,
[30:22] you know,
[30:22] stay away from them and things like that.
[30:24] SPEAKER_00: But are there other things?
[30:26] SPEAKER_00: Someone was asking about turmeric, for example.
[30:29] SPEAKER_00: Someone else was asked, I think that same person mentioned cloves.
[30:33] SPEAKER_00: Are there herbal things that,
[30:35] SPEAKER_00: you know,
[30:36] that people have been doing in certain cultures for centuries
[30:40] that we should be
[30:41] SPEAKER_00: taking advantage of that are,
[30:43] SPEAKER_00: in fact,
[30:43] SPEAKER_00: anti-inflammatory?
[30:46] SPEAKER_01: Well, it's a really good question.
[30:47] SPEAKER_01: We don't know.
[30:48] There's not been any good studies to bring any of these
[30:51] candidate supplements or
[30:53] SPEAKER_01: herbs or any of them.
[30:55] SPEAKER_01: You know,
[30:56] SPEAKER_01: last week,
[30:57] SPEAKER_01: we have been keen that maybe taurine,
[30:59] SPEAKER_01: which is an amino acid,
[31:01] SPEAKER_01: maybe that would be worthwhile.
[31:02] SPEAKER_01: And then new data came out to
[31:04] SPEAKER_01: really question that.
[31:05] SPEAKER_01: So these herbs that you mentioned,
[31:09] SPEAKER_01: it's possible,
[31:10] but we just don't have any evidence that they are helpful to
[31:14] promote healthspan to
[31:15] SPEAKER_01: reduce the toll of these important age-related diseases.
[31:20] SPEAKER_00: Somebody named Christopher said, be careful of turmeric.
[31:23] I think he said it might have metal in it,
[31:25] but I get fresh turmeric actually.
[31:27] SPEAKER_00: And I put it in like,
[31:30] SPEAKER_00: anyway,
[31:30] SPEAKER_00: nobody cares,
[31:31] but ginger and turmeric and a little cayenne pepper and oranges
[31:36] and lemons and make
[31:37] SPEAKER_00: my own kind of,
[31:38] SPEAKER_00: uh,
[31:41] SPEAKER_00: shots that I try to take, and I think they really help.
[31:46] SPEAKER_00: You also mentioned to not do too much protein,
[31:49] but all I see on social media is that protein should almost eat
[31:57] your weight in
[31:58] SPEAKER_00: protein.
[31:59] SPEAKER_00: And I'm curious,
[32:01] I know it's part of this trend to keep your muscle mass strong
[32:05] and healthy,
[32:07] SPEAKER_00: and I'm just curious if
[32:09] SPEAKER_00: Is that dangerous?
[32:10] SPEAKER_01: It is dangerous.
[32:11] SPEAKER_01: And this is that bro science,
[32:14] SPEAKER_01: you know,
[32:14] SPEAKER_01: that as you get,
[32:15] SPEAKER_01: you touched on it,
[32:16] SPEAKER_01: the one gram per pound per day,
[32:19] SPEAKER_01: which is an overdose.
[32:20] SPEAKER_01: There's no data to support that.
[32:22] SPEAKER_01: I've scoured all the literature.
[32:25] And the most you could get to if you're getting older and you
[32:28] want to increase your
[32:28] SPEAKER_01: protein,
[32:29] SPEAKER_01: you're worried about muscle mass,
[32:31] SPEAKER_01: you know,
[32:31] SPEAKER_01: you would go to,
[32:32] SPEAKER_01: let's say,
[32:32] SPEAKER_01: 1.2 per kilogram,
[32:33] SPEAKER_01: 1.4
[32:37] SPEAKER_01: grams of protein per kilogram.
[32:39] SPEAKER_01: So this is half of that one gram per pound approximately.
[32:44] But what you see are data that we get to this crazy
[32:49] recommendation by some people without data
[32:51] SPEAKER_01: that you should take that much protein per day.
[32:53] SPEAKER_01: First of all, it's very hard to do that.
[32:55] SPEAKER_01: But more importantly, the data all suggests that it could be harmful.
[32:59] SPEAKER_01: So I really advise it against that.
[33:01] And if people are gonna say,
[33:04] I wanna have one gram protein per day,
[33:08] they better provide the data
[33:11] SPEAKER_01: to back it up.
[33:12] SPEAKER_01: And I don't see any.
[33:13] SPEAKER_01: And that's,
[33:14] SPEAKER_01: we're talking about,
[33:14] SPEAKER_01: you know,
[33:15] some of these people that are really working out heavy for
[33:18] muscle training and
[33:20] SPEAKER_01: strength training.
[33:22] SPEAKER_01: They're very keen on this, but there's no data to support it.
[33:27] SPEAKER_00: Okay, that's good to know.
[33:28] Well,
[33:29] if you see the data,
[33:30] let us know,
[33:31] because I think a lot of people are confused about that.
[33:33] SPEAKER_00: Now, kind of the trend is moving away from protein and into fiber.
[33:39] SPEAKER_00: And fiber is,
[33:41] SPEAKER_00: is really important.
[33:43] And a lot of Americans or people even around the world don't
[33:46] get enough fiber,
[33:47] do they?
[33:48] SPEAKER_01: That's really true.
[33:49] SPEAKER_01: And getting 25 to 30 grams of fiber a day is challenging.
[33:54] SPEAKER_01: You got to go after it.
[33:55] SPEAKER_01: But that is a recommendation.
[33:57] SPEAKER_01: And it does help.
[33:58] SPEAKER_01: There's been strong linkage of that to reducing cancer,
[34:01] SPEAKER_01: particularly colon cancer,
[34:03] SPEAKER_01: but also improving reduction of heart disease.
[34:07] SPEAKER_01: So fiber is an essential
[34:11] SPEAKER_01: anti-inflammatory part of our diet.
[34:14] SPEAKER_01: And that is something you don't need to worry about getting too much.
[34:18] SPEAKER_01: Our biggest problem is, as you said, Katie, too little.
[34:21] SPEAKER_00: You know,
[34:21] SPEAKER_00: you mentioned colon cancer,
[34:23] and I've been really obsessed with the fact that so many people
[34:27] under the age of 50
[34:28] SPEAKER_00: are being diagnosed,
[34:30] SPEAKER_00: Dr.
[34:30] SPEAKER_00: Topol,
[34:30] SPEAKER_00: with colon cancer.
[34:31] And I just read yesterday that the number of people under the
[34:34] age of 50 diagnosed
[34:36] SPEAKER_00: with colon cancer is going to double by 2030.
[34:40] And I know there are a lot of theories people are talking
[34:43] about,
[34:44] are talking about
[34:46] SPEAKER_00: microplastics.
[34:47] They're talking about the microbiome,
[34:50] which is sort of your overall digestive and gut health.
[34:53] SPEAKER_00: But there are theories about the overprescription of antibiotics.
[34:57] SPEAKER_00: And, you know, we mentioned protein.
[34:59] SPEAKER_00: I talked to one doctor
[35:00] SPEAKER_00: who's looking at these ultra-processed protein bar supplements,
[35:05] SPEAKER_00: food replacement,
[35:06] because she was seeing so many healthy people in their 30s and
[35:10] 40s who were like
[35:11] marathon runners who were being diagnosed with stage 3 and 4
[35:15] colon cancer.
[35:16] SPEAKER_00: Oh,
[35:16] SPEAKER_00: and Paula Dunn is asking about alcohol,
[35:19] SPEAKER_00: too,
[35:19] SPEAKER_00: and that's something that people are looking at.
[35:21] SPEAKER_00: I mean, there are all kinds of theories that
[35:24] SPEAKER_00: Do you have any idea about why we're seeing this?
[35:30] SPEAKER_00: Because it is,
[35:31] SPEAKER_00: you know,
[35:32] SPEAKER_00: as someone whose husband died at 42 of colon cancer,
[35:35] SPEAKER_00: it is so distressing to see this.
[35:39] SPEAKER_01: Totally.
[35:40] SPEAKER_01: And it's even people in their 20s getting.
[35:43] SPEAKER_00: I know.
[35:43] SPEAKER_01: Olin cancer, breast cancer.
[35:46] And,
[35:46] you know,
[35:47] these are spikes we've never seen before that are cropped up.
[35:51] It started well before COVID,
[35:52] but it just keeps going,
[35:54] as you say,
[35:54] and projected to double.
[35:57] SPEAKER_01: The only thing that I think we can say is,
[35:59] SPEAKER_01: you know,
[36:00] SPEAKER_01: in that whole idea about the immune system and inflammation,
[36:05] SPEAKER_01: our environmental toxins,
[36:07] SPEAKER_01: like ultra-processed foods and microplastic,
[36:12] SPEAKER_01: nanoplastics,
[36:13] SPEAKER_01: forever chemicals,
[36:14] SPEAKER_01: our exposure to that just keeps growing.
[36:18] We aren't doing anything with all these non-degradable plastics
[36:22] that are getting
[36:22] distributed throughout our body and have been shown to
[36:26] accelerate heart disease and
[36:27] SPEAKER_01: be linked to dementia and everything else.
[36:30] SPEAKER_00: There was a study.
[36:31] SPEAKER_00: They were even finding it in people's brains.
[36:34] SPEAKER_01: Yeah, a spoonful of plastics in our brains.
[36:37] SPEAKER_01: I mean, this is just so concerning.
[36:40] SPEAKER_01: We're doing nothing about it.
[36:42] And this is where,
[36:43] you know,
[36:44] going back to RFK Jr.,
[36:45] he talked about doing this stuff.
[36:46] But at the same time,
[36:48] we're getting rid of the EPA and doing everything we can to
[36:52] take a
[36:53] any chances to get on top of this,
[36:56] whether it's with big food or with the environment.
[36:59] SPEAKER_01: But,
[36:59] SPEAKER_01: you know,
[37:00] SPEAKER_01: it's hard to come up with another explanation,
[37:03] SPEAKER_01: at least as far as I can see,
[37:04] SPEAKER_01: for these young people getting cancer,
[37:07] SPEAKER_01: diverse types of cancer,
[37:09] SPEAKER_01: without somehow invoking one of these environmental triggers.
[37:15] SPEAKER_00: I wanted to, yeah.
[37:17] SPEAKER_00: Well, hopefully, you know, these epidemiological studies can continue.
[37:22] SPEAKER_00: It just, it takes so long to do them.
[37:26] SPEAKER_00: And unfortunately,
[37:27] SPEAKER_00: you know,
[37:27] I wish I had the answer so I could tell people stop doing this
[37:32] or that and prevent
[37:34] SPEAKER_00: them from getting colon cancer.
[37:36] It's just very,
[37:36] very frustrating how long it takes to make a determination.
[37:41] SPEAKER_00: I wanted to ask, somebody asked about
[37:44] inflammation,
[37:45] which is something that you were talking about as a major
[37:48] driver of aging,
[37:49] right?
[37:50] So are there things that we should or shouldn't be eating to
[37:54] decrease inflammation?
[37:56] SPEAKER_00: You know, we've seen a lot about probiotics.
[37:58] SPEAKER_00: Somebody mentioned prebiotics.
[38:01] SPEAKER_00: Is that part of sort of the pseudoscience?
[38:05] Or tell us,
[38:06] how can we separate fat from fiction in terms of probiotics and
[38:10] prebiotics,
[38:11] etc.?
[38:11] ?
[38:12] SPEAKER_01: I mean, that's a kind of a new frontier that we don't know enough about.
[38:16] So whether we can manipulate the bacteria in our gut or their
[38:21] metabolites,
[38:22] SPEAKER_01: the stuff that they make while they're in our gut,
[38:25] SPEAKER_01: residents in our body,
[38:29] SPEAKER_01: We don't know how to do that yet.
[38:30] SPEAKER_01: There's a lot of work being done.
[38:32] SPEAKER_01: We only have one disease that they can help with,
[38:35] that manipulation with prebiotics and basically changing our
[38:43] constituents.
[38:44] And that's this pseudomembranous colitis,
[38:47] bacteria caused by Clostridium difficile.
[38:51] SPEAKER_01: But other than that, we are in the dark.
[38:54] SPEAKER_01: And so we don't know.
[38:55] SPEAKER_01: I do think that's going to be another.
[38:58] SPEAKER_01: We were talking earlier about the gut hormones talking to the brain.
[39:02] But the gut microbiome is another way that is central to our
[39:05] immune system.
[39:06] SPEAKER_01: So we're learning how to engineer that.
[39:09] SPEAKER_01: I mean, you know, Jennifer Doudna is trying to do editing of our gut.
[39:14] SPEAKER_00: Right.
[39:14] SPEAKER_00: We're talking about CRISPR.
[39:16] SPEAKER_01: Yeah, CRISPR to prevent asthma.
[39:19] SPEAKER_01: Wouldn't that be something?
[39:20] But our gut microbiome and the things it makes are critical to
[39:25] our immune system
[39:26] SPEAKER_01: and inflammation.
[39:27] SPEAKER_01: We just don't know how to control it yet.
[39:29] SPEAKER_01: And so the things that are out there now that,
[39:31] SPEAKER_01: you know,
[39:32] SPEAKER_01: call it prebiotics and antibiotics,
[39:35] SPEAKER_01: we don't know how they work.
[39:37] And they don't have any data evidence that they're really doing
[39:41] anything yet.
[39:42] SPEAKER_00: What about, though, some foods?
[39:45] SPEAKER_00: You know, we talked about diet.
[39:48] SPEAKER_00: Are there foods, I looked this up once, that reduce inflammation?
[39:53] SPEAKER_00: And are there foods that increase inflammation?
[39:56] SPEAKER_00: Yeah.
[39:57] SPEAKER_01: Well,
[39:57] SPEAKER_01: plant-based foods,
[40:00] SPEAKER_01: fruits and vegetables,
[40:03] SPEAKER_01: nuts,
[40:04] SPEAKER_01: legumes,
[40:06] SPEAKER_01: fiber,
[40:07] SPEAKER_01: these are all anti-inflammatory.
[40:09] SPEAKER_01: I mean, they're great.
[40:10] SPEAKER_01: I can't get enough of them.
[40:13] SPEAKER_01: Omega-3 rich foods like salmon and other seafood.
[40:19] Very good anti-inflammatory without having to take pills or
[40:24] supplements that we
[40:25] SPEAKER_01: don't know work as well.
[40:27] SPEAKER_00: Let's say you don't get enough of that.
[40:30] SPEAKER_00: Can you take supplements like omega-3 supplements?
[40:34] SPEAKER_00: Aren't those the ones that make you burp and you smell like fish?
[40:39] SPEAKER_01: If you take enough of it.
[40:40] SPEAKER_01: If you take enough of the icosopentanoic acid.
[40:44] SPEAKER_01: Yeah.
[40:45] SPEAKER_01: You burp and your breath is like a fish, yes.
[40:49] SPEAKER_01: But most people,
[40:49] SPEAKER_01: when they're taking that,
[40:50] SPEAKER_01: they're not taking such high doses so they don't have to worry about it.
[40:54] SPEAKER_01: But yeah,
[40:54] SPEAKER_01: if you can't get some seafood in your diet or you have...
[40:58] SPEAKER_00: Or let's say you don't get enough seafood in your diet.
[41:00] SPEAKER_00: Yeah.
[41:01] It's not a bad idea if that's,
[41:03] I mean,
[41:03] that's one thing that you can do that is certainly safe.
[41:08] It's just that it's probably better,
[41:10] the data to support it comes from the diet.
[41:13] SPEAKER_01: We don't have nearly as much from taking the supplements.
[41:16] Yeah,
[41:17] somebody had a good question and it went down and I wanted to
[41:20] ask you about,
[41:21] oh,
[41:21] kimchi.
[41:22] SPEAKER_00: Yeah,
[41:22] you hear like kimchi and sauerkraut and sort of pickled foods
[41:28] are actually really
[41:29] SPEAKER_00: good for your gut.
[41:30] I was watching some woman on Instagram who every morning she
[41:33] eats sauerkraut.
[41:34] SPEAKER_00: I was like, that sounds disgusting.
[41:36] SPEAKER_00: Yeah.
[41:37] SPEAKER_00: before or after you brush your teeth.
[41:39] SPEAKER_00: But what about these sort of fermented foods?
[41:44] SPEAKER_00: Aren't they shown to, I don't know, what do I know?
[41:47] SPEAKER_01: Yeah, it's possible.
[41:49] SPEAKER_01: But again, we scan data to support it.
[41:53] SPEAKER_01: So a lot of things are like a nice idea, but show me the data.
[41:58] SPEAKER_01: And, you know, we just don't have that.
[42:00] SPEAKER_01: And of course, you know, I'm talking about promoting healthspan.
[42:05] SPEAKER_01: Maybe some of these things could reduce inflammation a little bit and,
[42:09] SPEAKER_01: you know,
[42:09] SPEAKER_01: that may be a good thing.
[42:11] SPEAKER_01: But what we're really looking for is,
[42:13] SPEAKER_01: you know,
[42:13] SPEAKER_01: have an effect on people's health that you can prove.
[42:16] SPEAKER_01: And that's where we're really short for any of these things.
[42:20] I'm curious about just your views on supplements,
[42:23] because as we know,
[42:24] they're not regulated.
[42:26] SPEAKER_00: On the other hand, I mean, should you not take them at all?
[42:31] SPEAKER_00: Are there certain supplements?
[42:34] SPEAKER_00: Gosh, the supplement industry is a huge industry.
[42:38] I know that some people say you should get your vitamins
[42:42] through your food,
[42:43] SPEAKER_00: but other people,
[42:44] SPEAKER_00: we just mentioned omega-3s.
[42:46] SPEAKER_00: if you don't get enough omega fatty acids or whatever those are called.
[42:51] So are there supplements that you would feel comfortable if
[42:55] people took them?
[42:57] Yeah,
[42:57] I mean,
[42:58] I think the supplement story,
[43:00] the problem is the companies have made bold claims.
[43:03] SPEAKER_01: They have no data to support them.
[43:05] SPEAKER_01: And as you said, it's unregulated.
[43:08] So they basically convince people of their supplement's impact
[43:14] without anything to
[43:15] SPEAKER_01: back it up,
[43:16] SPEAKER_01: all right?
[43:16] SPEAKER_01: And
[43:17] SPEAKER_01: And there are many out there that are heavily marketing.
[43:20] SPEAKER_01: I mean, I'm seeing these vending machines in airports now.
[43:24] SPEAKER_01: And I mean, it's just crazy.
[43:26] SPEAKER_01: Now,
[43:26] SPEAKER_01: should anybody,
[43:28] SPEAKER_01: my patients,
[43:28] SPEAKER_01: they often come in and they have a long list of supplements,
[43:31] SPEAKER_01: you know,
[43:31] SPEAKER_01: that they take.
[43:32] SPEAKER_01: I say, you know, that's really good to enrich your urine.
[43:35] SPEAKER_01: but you don't need these things because you have a very healthy diet.
[43:39] SPEAKER_01: So for people who are healthy without a specific deficiency,
[43:44] SPEAKER_01: like a vitamin deficiency or something,
[43:46] SPEAKER_01: there's no benefit to taking any of these supplements.
[43:49] SPEAKER_01: There may be some specific reasons that certain people,
[43:52] SPEAKER_01: because of their dietary intolerance or a vitamin deficiency,
[43:57] SPEAKER_01: that's a different matter.
[43:59] SPEAKER_01: But otherwise, again, we just don't have evidence that they have benefit.
[44:02] SPEAKER_01: And we have people that are taking hundreds of these
[44:05] SPEAKER_01: like,
[44:05] SPEAKER_01: you know,
[44:05] SPEAKER_01: Brian Johnson and,
[44:08] SPEAKER_01: you know,
[44:09] SPEAKER_01: Ray Kurzweil and advocating that they're following followers.
[44:15] SPEAKER_01: And it's just crazy.
[44:19] I'm looking,
[44:20] Kathleen Mary is here and she's had some interesting comments.
[44:24] SPEAKER_00: But one thing I wanted to ask you, then I'll let you go.
[44:27] SPEAKER_00: But you all,
[44:27] SPEAKER_00: if you have questions for Dr.
[44:29] SPEAKER_00: Topol,
[44:30] SPEAKER_00: please like ask them because you don't,
[44:33] SPEAKER_00: you know,
[44:33] SPEAKER_00: we rarely...
[44:35] are able to have a face-to-face with somebody of his stature
[44:39] and knowledge.
[44:41] SPEAKER_00: But,
[44:41] SPEAKER_00: you know,
[44:41] SPEAKER_00: I think Kathleen Mary was talking about functional medicine,
[44:45] SPEAKER_00: and that is a real trend.
[44:47] SPEAKER_00: And,
[44:48] SPEAKER_00: you know,
[44:48] SPEAKER_00: I used to think it was a really great thing,
[44:51] SPEAKER_00: and now,
[44:51] SPEAKER_00: you know,
[44:52] SPEAKER_00: where you kind of look holistically at the patient.
[44:55] SPEAKER_00: But now I feel like the term is being used so broadly.
[44:59] And I'm curious what you think about this whole practice of
[45:02] functional medicine and
[45:04] SPEAKER_00: People who are in it who are watching, don't kill me.
[45:07] SPEAKER_00: I just am slightly confused about it.
[45:11] SPEAKER_01: Yeah,
[45:11] SPEAKER_01: I mean,
[45:11] SPEAKER_01: I like the holistic part of this,
[45:14] that when we see a person and trying to evaluate their health
[45:18] and promote their
[45:19] SPEAKER_01: health span,
[45:20] SPEAKER_01: we should be thinking about everything,
[45:22] SPEAKER_01: their mental health,
[45:24] SPEAKER_01: every organ.
[45:25] SPEAKER_01: I mean, that's what's exciting now is we actually have organ clocks.
[45:29] SPEAKER_01: We have specific protein markers.
[45:32] We even have a protein score for health span that just got
[45:35] published this past week.
[45:36] SPEAKER_01: I mean, we have new ways to get at
[45:41] SPEAKER_01: this total body brain, total body health.
[45:44] SPEAKER_01: And like,
[45:45] SPEAKER_01: for example,
[45:45] SPEAKER_01: a lot of people have no idea that there's a marker for Alzheimer's,
[45:49] which is incredibly accurate and can be picking up the risk two
[45:53] decades ahead.
[45:54] SPEAKER_00: That's really scary though.
[45:56] SPEAKER_00: Again, I don't know if I want to know.
[45:58] SPEAKER_01: Well, you know, if you have a family history of Alzheimer's,
[46:02] SPEAKER_01: and you have,
[46:02] SPEAKER_01: let's say,
[46:03] SPEAKER_01: an APOE4 allele,
[46:06] SPEAKER_01: you would want to know because if your P-Tau 217 is low,
[46:11] SPEAKER_01: that is liberating.
[46:12] SPEAKER_01: And if it's high,
[46:13] SPEAKER_01: if you exercise,
[46:16] SPEAKER_01: if you need to lose weight,
[46:17] SPEAKER_01: if you have a better diet and better sleep health,
[46:21] SPEAKER_01: it markedly lowers this marker.
[46:24] And it should greatly extend your health span without the worry
[46:28] of Alzheimer's.
[46:29] SPEAKER_01: So there's a whole notion of, I don't want to know.
[46:32] SPEAKER_01: That's old stuff, Katie.
[46:33] SPEAKER_00: Yeah, sorry.
[46:34] SPEAKER_01: No, that's okay.
[46:35] SPEAKER_01: The new thing is, I can do this.
[46:38] SPEAKER_01: I can prevent the three age-related diseases.
[46:43] SPEAKER_01: particularly Alzheimer's, heart disease, and cancer.
[46:45] SPEAKER_01: We're in a new day for this.
[46:48] SPEAKER_01: And people don't realize that we shouldn't have this defeatist attitude.
[46:52] SPEAKER_01: It's not necessarily in our genes at all.
[46:55] SPEAKER_01: And so I like holistic idea of feeding the person,
[47:00] SPEAKER_01: but using the tools,
[47:01] SPEAKER_01: the science we have today.
[47:04] SPEAKER_01: And that is changing quickly.
[47:06] SPEAKER_01: And it's a combination of,
[47:08] SPEAKER_01: you know,
[47:08] SPEAKER_01: what were the old things that,
[47:10] SPEAKER_01: you know,
[47:11] SPEAKER_01: a mother would tell us about like diet and exercise and sleep.
[47:15] SPEAKER_01: And it's all the new things that,
[47:17] SPEAKER_01: you know,
[47:17] sizing up a person's risk with AI and getting all over their
[47:22] risk and basically
[47:23] SPEAKER_01: preempting and preventing disease,
[47:26] SPEAKER_01: something we've never done before.
[47:28] SPEAKER_00: You know,
[47:29] SPEAKER_00: you talk about all these tests that are available now,
[47:31] SPEAKER_00: but those are pretty cost prohibitive for most people.
[47:36] SPEAKER_00: I guess those are things like the tech bros do and stuff like that.
[47:40] But when are some of these tests going to be widely available
[47:45] so people can really
[47:47] be proactive and staving off some of the things that appear
[47:52] when they are,
[47:53] SPEAKER_00: you know,
[47:54] SPEAKER_00: really carefully and closely monitored?
[47:57] SPEAKER_01: Yeah, I'm glad you asked that because the expense here is de minimis.
[48:02] SPEAKER_01: And the reason I say that is,
[48:03] SPEAKER_01: you know,
[48:04] to get a whole genome sequence now can be done for less than a
[48:07] couple hundred
[48:08] SPEAKER_01: dollars.
[48:08] SPEAKER_01: Polygenic risk score should be less than $50.
[48:11] SPEAKER_01: For the organ clocks, you know, it's going to be in the $100 ballpark.
[48:16] SPEAKER_01: For PTA217, similar.
[48:19] SPEAKER_01: All these markers are relatively inexpensive.
[48:22] SPEAKER_01: The only one that's
[48:23] Up there,
[48:23] like $800,
[48:24] $900 are these cancer,
[48:26] multi-cancer early detection tests.
[48:29] SPEAKER_01: They're going to come down too.
[48:31] SPEAKER_01: The point being is,
[48:32] SPEAKER_01: if you prevent one of these diseases,
[48:36] SPEAKER_01: the difference in spending $100,
[48:39] SPEAKER_01: $200 versus the treatment for these diseases,
[48:41] SPEAKER_01: which are very expensive,
[48:43] SPEAKER_01: if not even ineffective,
[48:46] SPEAKER_01: case in point, Alzheimer's.
[48:49] SPEAKER_01: The trade-off here is something,
[48:51] SPEAKER_01: maybe not in the United States,
[48:52] SPEAKER_01: Katie,
[48:53] SPEAKER_01: but in most of the rich countries around the world,
[48:58] SPEAKER_01: and an example would be the UK,
[49:01] SPEAKER_01: but many others,
[49:02] they're going to be providing all these things because they're
[49:04] low cost to
[49:05] SPEAKER_01: everyone,
[49:06] because preventing these diseases and promoting health of the
[49:11] population is what we
[49:12] SPEAKER_01: want to do,
[49:13] SPEAKER_01: right?
[49:14] SPEAKER_01: Of course.
[49:15] SPEAKER_01: We have this crazy system here,
[49:16] SPEAKER_01: which is,
[49:17] SPEAKER_01: you know,
[49:18] SPEAKER_01: out of pocket and poor insurance coverage and inaccessibility.
[49:22] We're not positioned well to implement this new era of
[49:26] prevention,
[49:27] but other countries will.
[49:29] SPEAKER_00: Well,
[49:29] SPEAKER_00: that seems crazy with this emphasis on making America healthy again,
[49:34] that the emphasis isn't on that instead of gutting all these
[49:38] research institutions
[49:40] and the NIH and creating this brain drain where all these
[49:44] experts and young
[49:45] scientists are not going to stay in the United States where
[49:47] their research isn't
[49:48] SPEAKER_00: funded.
[49:49] But,
[49:50] you know,
[49:51] you say these are affordable and they are relatively
[49:54] affordable,
[49:55] but you
[49:55] SPEAKER_00: You know, I go to a really good internist.
[49:57] SPEAKER_00: I've never heard of any of these tests.
[50:00] SPEAKER_00: He's never mentioned any of them.
[50:01] SPEAKER_00: And I love my internist.
[50:03] He's an infectious disease specialist,
[50:06] pulmonologist,
[50:07] and internal medicine.
[50:08] SPEAKER_00: And yet, I've never heard of any of these tests.
[50:13] SPEAKER_01: Yeah,
[50:13] SPEAKER_01: that's kind of why I wrote the book,
[50:15] SPEAKER_01: Katie,
[50:15] SPEAKER_01: because the people should know about this stuff.
[50:18] SPEAKER_01: I mean, there's a revolution going on and it's very quiet.
[50:21] SPEAKER_01: You know,
[50:21] SPEAKER_01: nobody's heard of organ clocks,
[50:23] SPEAKER_01: you know,
[50:24] SPEAKER_01: or Ptow 217 or,
[50:26] SPEAKER_01: you know,
[50:27] SPEAKER_01: a lot of things that we're talking about,
[50:29] how inexpensive it is to get polygenic risk scores for all
[50:32] these conditions or even
[50:34] SPEAKER_01: a genome sequence.
[50:35] SPEAKER_01: So most doctors are unaware that
[50:39] SPEAKER_01: Maybe with AI, they'll be more aware as we go forward.
[50:43] SPEAKER_01: But we have a void of knowledge in the medical community.
[50:48] SPEAKER_01: And it's because everyone's busy and they just can't keep up with these.
[50:52] SPEAKER_01: You know, these are big discoveries that are being made.
[50:54] SPEAKER_00: Or they're getting all this misinformation, right?
[50:58] SPEAKER_01: Yeah, yeah, yeah.
[50:59] SPEAKER_01: But you nailed it, why aren't we doing this?
[51:03] SPEAKER_01: We should be investing in this,
[51:04] SPEAKER_01: not gutting the resources,
[51:06] because we've never had such a propitious time in medicine to
[51:09] change the whole arc
[51:12] SPEAKER_01: of these big diseases,
[51:14] SPEAKER_01: which by 65,
[51:17] SPEAKER_01: the majority of Americans have at least one of these diseases,
[51:20] SPEAKER_01: and it's just the elderly.
[51:22] SPEAKER_01: We have to flip the elderly to the elderly, and we can do it.
[51:26] SPEAKER_00: Well, I think this is such an exciting area of research.
[51:30] SPEAKER_00: I'm so happy, Dr. Tobel, you wrote this book.
[51:34] SPEAKER_00: I think it's well worth everyone's time to read it.
[51:39] SPEAKER_00: And thank you for your advice.
[51:41] SPEAKER_00: I'd love to come to your clinic sometime.
[51:43] SPEAKER_00: You can do all these tests on me.
[51:45] SPEAKER_00: I'll be your guinea pig.
[51:47] And then I'll share with everybody what I learned and what you
[51:50] can do to mitigate
[51:53] SPEAKER_00: the presence of some of these things.
[51:55] One last point is you don't have to do any of these tests if
[51:58] you do all the
[51:59] SPEAKER_01: lifestyle factors,
[52:01] SPEAKER_01: if you do that.
[52:01] The reason to do these tests is to motivate you to do the
[52:06] lifestyle factors.
[52:07] SPEAKER_01: Because,
[52:08] SPEAKER_01: you know,
[52:08] SPEAKER_01: so I'm not a big advocate of tests,
[52:11] but most people won't do all the good things that we know today
[52:15] until they know
[52:16] that they have a specific risk or a specific condition at a
[52:19] specific time,
[52:20] SPEAKER_01: which we can do now.
[52:21] That's the reason to do the test,
[52:23] because you just have to get people activated.
[52:26] SPEAKER_01: And once they know, a lot of people change their ways.
[52:29] And that's what we're looking for,
[52:31] is to adopt things that promote our health spans.
[52:34] SPEAKER_00: And again, everyone, Dr. Tobol is saying diet, exercise, and sleep.
[52:41] SPEAKER_00: And you can learn more about what to do in all those categories.
[52:45] SPEAKER_00: We've discussed it here today,
[52:47] SPEAKER_00: but how much exercise you need,
[52:50] SPEAKER_00: what kind of diet you should have,
[52:52] SPEAKER_00: and sleep.
[52:53] SPEAKER_00: You know, it's always easier said than done.
[52:56] SPEAKER_00: But I think when you think about this,
[52:58] especially because I had a really delicious chocolate souffle
[53:01] last night at dinner.
[53:02] SPEAKER_00: Am I not allowed to eat sugar, Dr. Topol?
[53:05] SPEAKER_01: No, everything is in moderation, right?
[53:08] SPEAKER_01: So, yeah, that's okay.
[53:10] SPEAKER_01: It's just you don't want to have that every day, right?
[53:12] SPEAKER_00: No, that's true.
[53:13] SPEAKER_00: That wouldn't be special.
[53:15] SPEAKER_01: And it's just also social engagement.
[53:18] SPEAKER_01: It's time in nature.
[53:20] SPEAKER_01: Lifestyle is expanded, too, not just the big three.
[53:23] SPEAKER_01: There's a whole bunch of other layers of that,
[53:25] SPEAKER_01: just so people don't think it's just the old ones.
[53:29] SPEAKER_00: Right.
[53:30] SPEAKER_00: Well, I think people can read more about it in your book, Super Agers.
[53:33] SPEAKER_00: Really enjoyed being with you, Dr. Tobel.
[53:36] SPEAKER_00: This is so nice because you and I talked for about an hour,
[53:39] SPEAKER_00: and I think the information you conveyed is invaluable.
[53:44] SPEAKER_00: So to all my Substack followers,
[53:46] SPEAKER_00: or even if you're not,
[53:47] SPEAKER_00: do you have to follow me in order to watch this interview,
[53:50] SPEAKER_00: you guys?
[53:52] SPEAKER_00: No.
[53:52] SPEAKER_00: Oh, well, anyway, subscribe to my Substack.
[53:55] SPEAKER_00: Are you on Substack, Dr. Tobol?
[53:56] SPEAKER_01: Yes, I'm really big on it.
[53:58] SPEAKER_01: I have a ground truth Substack.
[54:00] SPEAKER_01: I do newsletters.
[54:01] SPEAKER_00: I didn't know because you don't have to.
[54:03] SPEAKER_00: Yeah.
[54:03] SPEAKER_00: Okay, good.
[54:04] SPEAKER_00: Well, I'm going to start getting your newsletter.
[54:06] SPEAKER_00: I'm going to sign up for your Substack.
[54:08] SPEAKER_00: You sign up for mine.
[54:09] SPEAKER_00: I'll scratch your back.
[54:10] SPEAKER_00: You scratch mine.
[54:12] SPEAKER_00: And I'm still learning the ropes of this platform.
[54:15] SPEAKER_01: Great one.
[54:16] SPEAKER_01: I'm so glad you're on it.
[54:17] SPEAKER_01: That is a big, big plus to have you as part of Substack.
[54:21] SPEAKER_00: Oh, thank you.
[54:22] SPEAKER_00: That's a nice thing to say.
[54:23] SPEAKER_00: All right.
[54:24] SPEAKER_00: Thanks, everybody.
[54:25] SPEAKER_00: Hope this was useful.
[54:26] SPEAKER_00: And Dr. Topol, thanks again.
[54:27] SPEAKER_01: Thank you.
[54:29] SPEAKER_00: Okay, bye.

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