Lies I Taught In Medical School - Dr. Robert Lufkin : 1179

You're listening to the Human Upgrade with Dave Asprey. You're listening to the Human Upgrade with Dave Asprey. Today we're going to talk about lies, specifically lies from medical school with a very, very well known field in, we'll say biohacking and longevity, because there's a lot of longevity in biohacking. None other than Dr. Robert Lufkin. He's a physician, he's only written 200 peer reviewed studies. Barely met the cutoff for being on the show. 14 books in six languages. So this is, this is a man who's done a lot in the field of longevity, which as you know, is, is one of the core tenets of biohacking. You get to change the environment around you and inside of you so you have control of your own biology. Well, what do you want? You might want to lose weight or manage stress better or be smarter, but living a lot longer is something that we all want and it's something that absolutely is happening right now. Before we started rolling, we were talking about how the biohacking industry is now a $63 billion business. But what most people don't know is that last year $600 billion is went into longevity companies. So if all of this money doesn't do anything for longevity, I'd be surprised. My goal is only 50% better than our current best, which is about 180 years old. Rob, am I a madman?

No, no, absolutely. Dave, I. Thanks so much. You're very kind. I'm a huge fan of yours and your work and it's, it's really a pleasure and an honor to be with you today. I'm so looking forward to this conversation.

Were you worried when you decided to call your book Lies I Taught in Medical School? Do you think you might piss off a few colleagues here and there?

Well, it is, it was intentionally provocative to get, get people's attention. Maybe a few other people will look at it and begin questioning things. But I, I'm always reminded of a quote from one of the greatest doctors of all time, Sir William Osler. And he famously addressed a class of graduating medical students 120 years ago. And, and his quote is one of the most famous quotes about medical education. And he said, gentlemen, I have a confession to make. 50% of what we've just taught you in medical school is wrong. And furthermore, we don't know which half it is.

Wow, how honest. And if you look back, not just in medicine, in almost every field, we, what we think is happening isn't real. Even all of the stuff in this room, if you really look at it, it's mostly empty space when you zoom in on it. And then we have all these models about how quantum reality versus information fields versus magnetic fields and all of them are real and all of them are simultaneously stories. And then next year some AI engine's going to come out with something goes, oh, we thought that Galileo was right and he was directionally right, but he was wrong. And, and that's why any kind of censorship to me is abhorrent. Because you can't do science if there's censorship. Like you have to be able to ask questions, go, well, we've always believed that, but maybe that's not true and that's not misinformation, that's just curiosity.

Yeah, that's absolutely the basis of medical science and medical education too. Always questioning, always revising our current models of reality because at very best they're only approximations. And as we change our models, the, the, the, the lies and the truths change also.

I feel so much safer knowing that big Pharma controls a lot of the lies that we teach these days, don't you?

Big pharma, big food. Absolutely. It's a very scary, deeply disturbing thought, but unfortunately it's true.

I love it that with your reputation, just your hard science, you're saying look at the numbers instead of, you know, let's just kind of believe whatever. Really most people are just picking this up. They, they heard it somewhere or there's big campaigns about things. Let's go through some of the, some of the things that we might believe that aren't necessarily backed by science. Tell me about how plant based diet exclusively is going to make me live longer.

Yeah, that's it, That's a good, that's a good question. And, and let's let, let me say the, before we begin, if I can, the is very critical of Western medicine, but I'm, I'm a Western medicine insider. That's been my entire career. So the I, I still believe in Western medicine. Great value, all this. Yeah. In the 20th century it transformed our lives. We, it wiped out many diseases, infectious diseases, public health. And even now in the 21st century, if I'm hit by a car outside and I need a blood transfusion and a splenectomy and a my fracture set. I want Western medicine. The problem, I think and what the book addresses is that in the 21st century, 80% of our resources are spent on a group of chronic diseases that while they were present in the 20th century are nowhere near what they are in the 21st century and it's this epidemic of chronic diseases. When we apply the same medicines and surgery that were so effective in the 20th century, when we apply them now in the 21st century to these chronic diseases, they don't work. And that's the failure of Western medicine. And that's the, the challenge that I try and point out in this book.

I think you've done a good job on that. And one of the things that, that I love about your story is, like me, you tried what's supposed to work and it didn't. So my research, you had hypertension, gout, dyslipidemia, and pre diabetes. Correct. What were you doing that you believed was working that wasn't?

Well, my whole life I was, I was raised following the dietary guidelines, as it turns out. My mom was a professional dietitian, so I was raised believing that nutrition mattered and it was important what you ate. Unfortunately, she followed the dogma, the current teachings, which are still in effect today. And those recommendations which we followed religiously, I believe led ultimately, along with other lifestyle choices that I made to my acquiring these four chronic diseases at, you know, midpoint or early point in my life.

Wow. If you and Dean Ornish arm wrestled, who would win?

That's a good question. Because although we. Dean. Dean is brilliant by showing that lifestyle can, can make changes and in these chronic diseases. And I really applaud him for it. I think we differ on some of the details of the implementation, but the overall principles, I'm with him 100%.

It's funny because I've definitely kind of called out his nutritional recommendations, but he was the first big university doctor to say maybe we should look at meditation and lifestyle. And he did mix it with his diet. And I would have liked to see them tested separately because you see different results. But that was a really big thing to be able to do. And I think that, that there's even some people where a very low fat carbohydrate diet might work. And I've seen people lose weight on that, but I don't think long term that's a direction for longevity that I would choose. But what do you think about that?

That that's true. Yeah. And for, for me and I, and I believe for most people, the low fat diet, because of the three macronutrients, we keep protein pretty much the same. And then if we lower the fat content, we raise the carbohydrate content. And in my opinion, and what I believe the evidence shows that I show in the book and quote the original references that high carbohydrate foods along with seed oils and grains drive the metabolic drivers of these chronic diseases, which is oxidation, inflammation and insulin resistance. And it's interesting that these things that drive these chronic diseases, there's no real pill or surgery for them. And in fact the pills or surgery that I was given, I was prescribed medicines for them. These pills or surgeries can be life saving in the short term, like insulin for a type 2 diabetic, but long term they just mask the symptoms in most cases and the diseases continue to progress with fewer symptoms, but then they have the chronic complications of them. So the way to really reverse them, I believe is through lifestyle. And that's empowering because it's a choice we get to make.

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When's the last time you ate french fries?

Well, I, I have a 12 year old daughter and she occasionally has a. And I will, I will eat one occasionally, but I don't, I'm, I'm concerned with the carbohydrates in them. I'm especially even more so concerned with the seed oils and the high temperature and the, the toxic chemicals that are produced from those. So I don't believe those are healthy at all.

I'm with you there. Now, if someone was forcing you to either smoke one cigarette or eat a big plate of soybean oil french fries, highly processed, which one would you do?

Well, there's some recent evidence now that in, in a study that was showing that a small amount of french fries, a single serving of french fries, is equal to more than a pack of cigarettes as far as the same type of toxic compounds that are, that are found in them. So I would go with the cigarettes.

And by the way, I'm opposed to smoking.

Yes, a bad idea.

And nicotine even has some longevity benefits, surprisingly at micro doses pharmaceutically extracted around Alzheimer's disease and Parkinson's. Right. So I don't really want to smoke and I don't really want to eat french fries. And like I said, if you eat one french fry on a rare occasion, whatever, it's not the end of the world. Okay, but, but I do very, I'll say religiously avoid the seed oils and I have for about 12 years now. And the difference, when I replaced that oil with saturated fats, you know, beef tallow and ghee and butter and MCT oil and things like that, after about two years, I stopped craving fat the way I did. And then I came across that research that shows the half life of fats in cell membranes is about two years. And so people would drink bulletproof coffee back when I was at bulletproof. And after two years, like, oh, I just need a little butter versus I can't get enough. And I, my theory there is that that's probably just because we're repairing some cell membranes in the mitochondria or in the cells. Have you come across any research about swapping out the Omega 6s and getting rid of those and using more saturated fat. Or is this more of an olive oil discussion? Like what's your perspective on that?

Well, yeah, first to your point, the, of the, you know, the high carbohydrates, you, you switch out carbohydrates, you get an effect in a, you know, in a few hours to a few days. You really notice it and you feel it. Grains, if you switch those out, you know, the pro inflammatory effects of the, the proteins and the grains, it can be up to 90 days. But the seed oils are particularly challenging because of their long half life in our fat. So it can take months to years and that's, that's really tough. As far as far as the olive oil or, or beef products, I don't have a, I don't have a strong preference. I mean there's certain things about their cooking value and some you don't want to heat and not, I mean the, the, our dietary choices like everything sadly today have become highly politicized. So there's the carnivores who don't talk to the vegans who, you know, and I love my vegan friends. I used to be vegan at one point. I do my carnivore friends, I've been carnivore also. And I think you can be very healthy or very unhealthy on either a vegan or carnivore diet. And my way of thinking, it's not either one of those but it's getting rid of the junk foods and avoiding the things we talked about. Personally I think it's more challenging on a plant based nature just because there's more junk food with plant based things and you may miss some of the micronutrients. So you've got to keep an eye on it. Whereas with Carnivore you can pretty much get by just by eating the meat and you know, you're taking care of most things but yeah, but for me it's not about vegan versus carnivore. I embrace them all.

Thank you.

Hope to be the Switzerland of diets, you know.

And there's a case too, I do believe that many vegetables that we eat have enough plant compounds that are bad for you and that it's probably individualized for that some people handle them better than others. So the idea that you shouldn't eat any vegetables seems extreme and the idea you should eat only vegetables seems extreme. And having tried both of those, I ended up where some days I don't have any carbs and some days I do, I just don't eat the carbs that cause metabolic dysfunction in me, but they might not in someone else. And that's where it gets really, really confusing. From a medical perspective, just with all of your research, how does one personalize what they're doing so that it works?

Yeah, that's such an important point, David. I'm glad you brought it up. All these things, I think the things we recommend will benefit most people, but we all have to look at our individual experience and nutrition. And so someone may have an issue with diet, with dairy, rather. So you can do an elimination diet where you, you, you, you peel back all the things and then you add one thing or add another thing and you can, you can check out dairy or eggs. Some people have a problem with eggs. You know, I do. Some people have a bigger problem with grains than others. So I totally agree with personalization, But I think, I think the principles that we're talking about apply to most, if not everybody in general.

They absolutely foundationally apply. And the easiest test that I figured out was, first I tried about 18 months of an elimination diet where you space out all your foods. And I realized, why don't I just either eat nothing called fasting or just eat steak for three or four days and then, oh, look how I feel. And then you introduce, I recommend actually all of the bad stuff. So you do that and see how you feel. Oh, something in that bad stuff was the culprit, and it probably wasn't just one thing. And that was the big challenge, I think, for anyone doing research is if there's three things that cause a problem and you test each of them separately, you're never going to resolve the problem. You have to remove all of the offending things to get the results you want. And I'm really excited about artificial intelligence right now because it feels like it's doing a better job of sorting through what's likely to work so you can figure it out. Now, I know you're working with AI and you're interested in that. What's your take on this? Are we going to look at genetic data? Are we looking at gut bacteria data? Are we looking at just blood work? What's the best data source for us to know?

I think all of the above. I'm so hopeful and so excited about artificial intelligence because as a physician, as a practicing physician, I know when a patient shows up with a complex medical history and, you know, back in the days when they had charts, it was, you know, one foot high of paperwork. As a physician, you only have so many Time, so much time to evaluate the patient. So what do you do? You look at the last five pages and the summary of everything in the chart, but you're not able to actually look at the chart. And that's. And to say nothing. You're not able to look at the gut microbiome or any other microbiome in the body. You're not able to look at the whole, you know, know, not genotyping, but gene sequencing of the whole body. So I think, I think AI is going to transform the medical encounter, the health encounter, the longevity encounter. And it's going to, it's going to allow us all to be biohackers a little bit with our data. So it's so excited about that.

We share that excitement. One of my companies, upgrade Labs, we're now using AI on people's lab data in addition to their personal wearables and in order to make recommendations. And the goal there is you should go see the doctor when you need to go see the doctor. But you shouldn't go see the doctor to ask for a vitamin D test and to get permission for that because that's not necessary anymore. And even then to interpret that, you probably would need a doctor. But when it's not right and the normal stuff like what is in your book, if that doesn't work well, then you go, something, something weird's happening. And then you get quality time from doctors because we've freed you up from the drudgery of medical practice. And there's a lot of saying the same thing really well, but it feels like the tools are now available where we can get people 80% of the way there before they come in.

Yeah, absolutely. I'm so excited about CGMs in the US finally being available this summer without a doctor's prescription. Like, you know, in England they've already been that way. So people be able to get access that data and just the idea of all the information, not just in the charts, but our own knowledge of everything that happened. I mean, you can imagine a scenario where you had a disease where it mattered, that, you know, in third grade you broke your arm without an injury, it just fractured spontaneously. And you may not even remember that, but it's part of your medical history. And with AI, I think we're going to be able to get deeper and deeper into the individual. And I just can't wait for all that to happen.

How quickly do you think it's going to happen?

I think very quickly. Just like large language models kind of exploded onto the scene. We were, we were stuck with convolution neural networks and you know, image recognition, which was, which was groundbreaking. And then suddenly this, this leap to large language models which, which is just unprecedented. So I think it's, I think it's going to be happening very, very fast. And we're already seeing, we're starting to see some examples of that already. And now it's about gathering the data and making it accessible. But I'm super bullish about AI.

One of my concerns is that AI gets trained on a data set. And you know, the British Medical Journal, maybe it was them or the Lancet, wrote a big piece on the, the crisis of irreproducibility where a lot of the stuff that's published, when you test it again, it doesn't work. So when I ask just a general thing like ChatGPT or Claude a question, it always says things that are clearly from his training. Like, before you make any decisions, talk to your doctor. I tried that when I weighed 300 pounds. My doctor was fat too. And his advice wasn't very helpful on that front. And so I'm hopeful that we don't pollute AI with bad data and that's a concern. But with enough patterns from millions of people's medical records, the data will point out which beliefs we have are false.

Absolutely. I think it's. You're exactly on. It's not enough just to scrape the Internet and Reddit and Twitter and everything for the best recommendations because then you'll get the food pyramid, which was developed, you know, as by Big Food and Big Pharma to drive junk food sales, basically. Instead we have to get at the, at the raw data. And that's, that's one of the, of course, the challenges of large language models now is that they're opaque and they're, their reasoning for the most part is, is obscure. We don't know what it is and that needs to be sorted out somehow. But I'm optimistic.

I'm traveling to a meeting of the minds in AI in Switzerland in a couple weeks here where we're going to be talking about exactly these kind of problems because it's an industry wide thing that's not just for biohacking or medicine or longevity. It's there for every single thing.

Yep.

Where it has to be truth oriented, even if it's an inconvenient truth. And that's why, like the title of your book, you know why, as I told medical school, well, if AI was trained on those lies, it might tell the same ones. And not even know it. So I think though, when we get to the point where we can say, well, take what you just said and then run it against my labs or run it against a million people's labs and see if that's true and then the whole system will slow down and go, I guess I was wrong.

Yeah, yeah, yeah. I have a friend who works in like heavily into AI and you know, people talk about hallucinations with LLMs and his viewpoint is that they're not hallucinations, they're lies that the AI tells which, you know, infers a certain agency which may not be there yet. But it's an interesting point of view.

And we're not going to talk much more about AI because there's all kinds of stuff in your book that isn't AI based. But one of the more interesting things I've come across lately is a guy named Mo Dao, Mo Gao Dat, who was head of R and D at Google's Advanced projects. And his whole book says, here's how we need to manage AI. It is going to change the world dramatically, but it's learning based on how we treat it. So he just said, look, as one of the preeminent researchers in the field, I always say thank you to ChatGPT because we wanted to learn. Gratitude because you're training and every time you talk to it. So guys, this is a thing. Don't yell @chatgpt. It's like a kid, right?

It's listening, right?

Yeah.

It's paying attention.

Yeah. And in case it's paying attention to this, I for one support our new AI overlords. There.

Yes.

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One of the things that I like about your, your transformation is something we have in common and it's Gary Taubes. Gary was on the show about I think episode 778. But I met him back when I ran a longevity nonprofit, an in person one in Palo Alto. And his book was really transformative. It was good calories, bad calories, just very well written. And after I interviewed him for that, I told him about the book I was writing about fertility and he said, oh, let me hook up with an agent. So it turns out my first book happened as a direct result of an introduction from Gary. So I'm always eternally grateful to him.

Such a great man, a genius. He's inspired so many people and changed so many people's lives with good calories, bad calories and then, you know, many more best selling books along the same line.

Yeah, what an amazing mind and a good writer too. I, because I, I mean you and I have both written books. It's hard to write a book where there isn't one wasted word. Yeah, and he, he sets that bar so high. I, my books are, I think awesome. There's, well, as good as I know how to make them, but I might waste a word here or there when I read it again. I. I could have said that more concisely. So I. I've just never, never come across writing like that. So, Gary, if you're listening, thank you. All right, let's get into mtor. Tell me about mtor.

Wow. MTOR is. It's one of my favorite molecules, and it's arguably the most important biological signaling molecule known. It's been conserved. It's a protein switch that's been conserved for billions of years, literally from yeast all the way to humans. And something that's in every single cell in that line has to be important. And it's. It's a switch that does a simple thing. It. It helps the cell survive and the organism, by extension, survive by detecting the presence of presence of nutrients. And if nutrients are present, it tells the cell to grow and turns on inflammations. And specifically, by nutrients, we mean glucose, we mean insulin, we need oxygen, signaling factors like that. And then conversely, if there's low nutrients in the cell environment, it switches to the off position, which turns down inflammation, also turns down cell growth, because you don't want to grow if there are no nutrients. But it turns on something called autophagy, which is cellular repair, which actually turns out, has a lot of benefits. And there's a school of thought, and I believe there's really compelling evidence that mtor, along with other important signaling molecules, amp, kinase, sirtuins, and all, form the foundation for longevity. And having MTOR turned on all the time, this hyper function state, this growth state, is advantageous for the young organism when bones are growing and the mind is maturing. But once you reach maturity, turning MTOR on all the time in this growth state, the body can't grow anymore. So it triggers hyperfunction. And the hyperfunction, as it turns out, drives the phenotypes of aging, you know, gray hair, menopause, hearing loss. But it also drives. There's very strong evidence that it drives the chronic diseases that we've been talking about on this whole show, all the way from obesity, diabetes, cardiovascular disease, Alzheimer's, cancer, and mental illness. And by turning MTOR down, you can, you can have significant effects that, that's been shown in many animal models and some human models. And there's one drug that happens to turn MTOR down called rapamycin. And many people, as you know, you take rapamycin off label for longevity and the other thing, and I talk about rapamycin in the book, but I think that the important message Is that just like other pills from science. Pills are wonderful. They do a lot of things. I believe that lifestyle is even more powerful than rapamycin. And you can take rapamycin. I mean, I take rapamycin, you know, but I think if we don't change our lifestyle because lifestyle has the same effects on mtor, the same beneficial effects on mtor, if we don't embrace the lifestyle effects, that we're going to miss out something. And the evidence is, there's, there's evidence for that. Rapamycin is the single most powerful longevity drug shown on the itp, which is Interventions testing program. I think your audience knows about that. And it was by far stronger than any other drug tested in this mouse model, sort of the gold standard mouse model. But when they combined rapamycin with acarbose, another drug that has a relatively small effect, combining rapamycin and a carbose, you had a beneficial effect that exceeded the individual effects of either one of the two. So there, there are synergies that we don't understand. You know, we really don't understand MTOR or rapamycin or, you know, lifestyle, you know, as, as biohackers. We know we're, we're constantly, you know, clawing away at the truth. Right. You know.

Do you take a carbos as well?

I do. I don't eat a lot of carbs. So a carbos, you know, as you know, is a, is it blocks carbohydrate uptake in the gut. So like a lot of friends, we have it in a salt shaker and if we ever at a meal where there are carbohydrates, we'll sprinkle a carbo on it and then it'll slow the uptake. But if I don't, for regular meals, I don't take it because I don't eat refined carbs.

One thing I've never had a clear answer to, if you block carbohydrate intake in the gut, aren't you going to get candida and lipopolysaccharides and you're gonna have like un undigested carbs where they don't go in the gut?

Yeah. This is an interesting question. It doesn't seem to, it doesn't seem to happen that way. And I guess sometimes people, perhaps I'm just hypothesizing here, but maybe people who eat very high sugar carb diets will overcome the gut's capacity to take them up and they don't get candid unnecessarily. I Mean the, the gut microbiome may be able to handle that without getting overrun by these opportunistic infections like that.

I think in metabolically healthy and gut bacteria, healthy people, probably when I was £300, I'd been on antibiotics for 15 years for chronic sinus infections. Turns out those are triggered by environmental toxic mold. But my gut was wrecked, I think. In fact I tried some carbohydrate blocking enzymes way back in the day and I was like, man, I've never farted that much in my life. Even when I was a vegan, I didn't fart that much. So I don't think I'm a good example of that though, because if you have a ruck's gut bacteria, you're going to have metabolic dysfunction, right?

Yeah, yeah. And a carbo is one of the side effects that the toxicity is diarrhea or gut indigestion gas, that kind of thing. So if people take a lot of it when they're having a lot of carbs, they block it. They may have those side effects, but passes.

The other thing that I've been experimenting with is we'll call it a microdose of pioglitazone or Actos. And for people listening, you might not know about this unless you're a super nerd. This is a diabetes drug and it affects a system called Ppar. And it seems like you get much more stable blood sugar. But I'm taking a quarter dose every day, every other day, something like that. Have you experimented with any of the other diabetes medications besides metformin?

Well, acarbose. I haven't experimented with that one. But I think what you're hitting on is really important point of microdosing various drugs. For example, low dose naltrexone is a, is a your audience.

I don't think everyone knows everything. We're nerding out of it. If it listened to all 1200 episodes, they probably know, go ahead and talk about it.

But it's a, it's a physical addiction drug for people with serious physical addictions. But now it's being used for people with junk food addictions and sugar addictions. And it's also, there's evidence that it's actually a longevity drug and people are taking it on a chronic sort of microdosing level or low dose level all the time. Similarly, you know, famously recently, the, the phosphodiesterase 5 inhibitors, Cialis Viagra, which were originally, you know, nitric oxide supplements for erectile dysfunction. Who would have thought? Well, they work on all the other blood vessels to our brain, to our kidneys, to our heart, they actually, there's evidence now that they improve longevity. And now they're, people are adding low dose those drugs to the longevity stack and it goes on and on and on. So I think, I think you're hitting on something really valuable that, that there are a lot of these drugs that we can repurpose them at a very low dose that may be beneficial for, for longevity in general and all these chronic diseases. The list goes on and on and on.

Yeah, I do take microdose Cialis 6 milligrams a day and you notice a difference, but it's more of a, a blood flow in the brain difference, I would say. And because of my, my medical history, when I first went to the Amen Clinic 20 years ago or something, and they looked at I had something like five standard deviations less blood flow in my brain as a result of toxic mold and low blood pressure and all. And it's, it's nice to have enough blood in the brain, it turns out.

Right.

So I, I manage that now along with all the other stuff. I know, I know my system well and mine's probably harder to manage than the average person because of my health history, but it's manageable. And so many listeners fall into this trap of either being angry at medicine, which doesn't make any sense, or being angry at pharmaceuticals and saying I'm a good person because I haven't used a pharmaceutical. That's like saying I'm a good caveman because I haven't used fire. It's appropriate use and appropriate dose for the results you want for the system that you're living in. And so I'm not opposed to them. And I think for a nuanced longevity strategy, they can help you to control your metabolism, but only after people really do the stuff that's in your book, the intermittent fasting stuff. I've written two books about that. Because it turns out having no food in your system sometimes helps with mtor, which we just talked about.

Yeah, no, totally, absolutely. And I just want to go on record saying I'm not recommending. Do not stop your prescription medicines without talking with your physician first of all. But on the other side of the coin, I think there is a place for these powerful pills and surgery that have been developed that in the biohacking sense can let us optimize longevity beyond which merely lifestyle can. So I think lifestyle is foundational, but if you want to push it to the next level, it may Be partial epigenetic reprogramming. It may be stem cells, it may be plasmapheresis, you know, rapamycin, a carbos, you know, on and on and on. So it just, I think it adds value and I would not, I would not leave them out.

Any tool, I don't care if it's a laser, a magnet, waking up early and seeing the sun. All things that get us the results we want ought to be on the table. And so I like that you're pragmatic about that. And I am thinking of a friend, you may know her, Dr. Sandra Kaufman.

Sure, yeah.

She's one of the funniest doctors as I know. She's very gifted with her knowledge of, of drugs on this. And I'm sitting with her and she's just eating like a cupcake, actually two cupcakes. Like, what are you. And she goes, oh, I blocked it with a carbos.

And she sort of has like the.

Pharmaceutical counteraction for everything she's doing. So. Yeah, I like sugar. I just figured out a way to eat it without it hurting me. I'm like, okay, I'm not going to go there personally, but I kind of respect that approach. It's like I'm a master of my body and all.

Exactly. If you want to understand it. Yeah.

Now we talked about some of the pharmaceutical stuff which isn't the main focus of your book, but one of the things I don't think we've, we've talked enough about yet is this TOR pathway or mtor we talked about. This was a subject of, I think several chapters in my longevity book. What raises mtor?

What turns on mtor? Well, oxygen, insulin. Insulin like growth factor, basically catabolic, I'm sorry, anabolic growth type stimuli, oxygen, all those factors. And, and then some short chain amino acids can do it also. But interestingly, fat has very little effect on mtor. So fats in most proteins, you're pretty much safe to when. So when you go from a high carb, low fat diet to a low carb, high fat diet, that lifestyle is favoring MTOR being turned more to the off state. And obviously MTOR should be on and off. But the problem is with, with modern man and also with aging, I think we, we turn MTOR into the, the positive. We turn MTOR on too much. And that's the, the root of things in many ways.

Don't carbs raise MTOR far more than proteins?

Yes. Yeah. Insulin and glucose, by far the amino acids that do it. You can really, you know, they're they're not significant compared to the glucose effect.

I love it that you're saying that because I know a good number of people who are saying, well, I'm going to eat vegan proteins, even though the aminos are much less available and they're usually highly processed because of mtor. But you're eating it with a cracker and the cracker raise your MTOR way more than the plant based, low quality protein.

So when I look at this, if.

I want to turn off mtor, either you do it pharmaceutically or you just don't eat for a while. Or there's this magic idea that you could blend butter and MCT oil in coffee. My new coffee company, if you guys idea, yeah, it's going to be big someday. Because my new coffee company, by the way, is Danger Coffee. Because who knows what you might do. I'm not tied in with bulletproof anymore, but a third party tested 300 different breakfast foods back in like 2005, and they were looking at insulin secretion. And the lowest possible breakfast other than no breakfast was coffee with butter and MCT oil. It had zero effect on insulin, which is why I say you can have it during a fast because it doesn't affect MTOR or insulin, which are the two primary things we're playing with when we fast. Right. And that's still controversial because in the mouse study, the mouse only had water. Like mice don't have espresso machines either, but you should probably have that. So what's your take on having things during a fast? Either soluble fiber or mcts or fats that have calories but don't change mtor insulin?

Yeah, that's a great question. And it comes down to what is the purpose of the fast? Is the fast the purpose of the fast to stay in ketosis, which a ketogenic diet will, or is the purpose of the fast even to. To turn on other things that that fasting only turns on? And it just depends on how you, how you want to go. I mean, you could make the argument that, that having MCT oils or butter could potentially raise mtor, but it's a relatively small effect. So if, if that gets you through the fast, then you're much better off having a fast with coffee and danger coffee with butter and MCT oils than you are with saying screw it and not fasting at all, you know?

Oh, of course, yeah. Is there evidence that that fat will raise mtor? I didn't know about that.

Oh, no, no, no.

Okay, yeah.

So make the argument so. No. Yeah, yeah. Yeah, so it's just calories and so it's not going to be an MTOR effect for sure.

Yeah, got it. And this is one of the things. What's the definition of a fast? And even then, was, is it a dry fast or a wet fast? Can you have tea? And the answer is, nobody knows. Like, there's all these traditional. At least tea is what most people drink during a fast, unless it's a dry fast. What's the longest you fasted?

Longest I fasted, personally, is I've only gone 72 hours. I'm looking forward to doing longer ones, but having a house full of children.

It makes it harder.

When I get a space of time, then it'll be easier to do it, but I'm looking forward to doing a longer one.

The longest I've done is five. And I've been having a lot of conversations lately on the show about akkermansia, which is definitely good gut bacteria. Unless you fast for too long, in which case it's like, I got nothing to eat, I'll eat you. So is there an upper limit to fasting that, that you think is healthy?

The length of the fast?

Yeah.

You mean if you go too long.

Without feeding your gut bacteria, some of them will just go away, but others will start. So Akkermansia, if, if it's penetrating your gut barrier, it's bad for you inside to Parkinson's and if it doesn't, it helps to regulate GLP1. Like, like the Wegovy and Ozempic and things like that.

Yeah, I mean, the, my, my whole thinking on fasting changed tremendously in writing this book and just researching it. I mean, in the book I, I talk about a famous fast that's been in the medical literature that other people have talked about. Angus Barberi, he's a Scottish gentleman who weighed, I think, over £200, and he wanted to go on a water only fast for two weeks and he tried it and he lost a little bit of weight and it was under a physician supervision. And he goes, well, this is great, I'm going to continue. And he went on for a year and famously on literally only water and vitamins and tea and maybe coffee, I think, but no food. And he lost all that weight over that period of time and was otherwise healthy. And they even had his glucose being monitored periodically and they published that in the paper. And it wasn't, you know, hypoglycemia or anything like that. He just was, you know, his body made enough glucose from the fat and, and things so my, my thinking on, on fasting has really changed now. But the gut, the gut microbiome, I think there's, is, is going to, I think it's going to yield a lot of things, a lot of information. And I'm waiting, you know, maybe, maybe AI or, you know, some of these other smart, smart companies we talked about earlier may be able to come up with things, but I'm, I'm really hopeful for that right now. When I do a microbiome analysis, I'm still not sure how to interpret it or what's good and maybe I just need to go deeper on it.

At a certain point it gets to be absurd. I've been getting anything I could figure out about what's going on in my gut because I had such bad gut problems years ago. So there's a fungal microbiome, there's a bacterial microbiome, there's a viral microbiome and a yeast microbiome and probably some other little phages and things that we don't really pay attention to. And you could say, well, this is the one that's the problem. But then you've just fallen into the big pharma trap of believing that only one thing is the cause. And my favorite example there is, what's the one thing that causes bread? Is it the yeast or the flour or the water? Well, you got to have all of them. And I feel like with our gut bacteria, this is a problem that we're unlikely to solve without big tech.

Yeah, yeah. And just, I mean, to the biohacking, you know, you, you, you chase one variable down, you raise it, you correct it while the others compensate and you change. MTOR and AMP kinase adjusts, you know, or, you know, there are all sorts of interactions that are happening there. And I'm very hopeful that, yeah, big tech and you know, greater minds than, maybe than ours will be able to, to help assist.

I'm as excited and hopeful as I've ever been because it, it feels like we have way more control now over our biology than we did 10 or 20 or 30 years ago. And also we can monitor it. You know, you can look at your heart rate variability in the morning and if something you did messed up your metabolism, it's going to show in your data. So you can track yourself day by day and you slap on a continuous glucose monitor. I, I was an early advisor and investor in levels which made this very available. And now it's going to be, for some reason you need a permission slip in the US to have your own Data. But anyway, so now that's going to be available. So anyone listening to the show, like, you know, if you think that oatmeal is good for you, get a continuous glucose monitor. And then like anyone who's read either your book or mine, you just step away from the oatmeal. It's peasant food to keep you alive during famines, but it's not good for you.

Right, right, absolutely. I couldn't agree more with that.

What is the worst grain you could eat?

Well, I think all grains are problematic because of the proteins. You know, a small number of people have formal celiac disease with gluten sensitivity, but there's probably a much larger number of people who are sensitive but not allergic to gluten. And so I would think the gluten containing grains would be the, the worst ones. But for me, I, I, I try, I stay off all grains basically, if not for the, not for the protein pro inflammatory nature that drives our immune system. But also they're in the US are soaked in glyphosate, most of them, which is illegal in 30 countries for health reasons. And then on top of that, the grains, like you say, a lot of them are full of carbohydrates. So yeah, you know, strike three there for me.

I, I will do white rice when I'm eating carbs, which is the safest of the grains because we removed most of the bad stuff when we got rid of the brown parts of it. And I, why anyone would eat brown rice unless it was a famine, I don't know, but I still laugh. You go to the sushi place and they charge more for brown rice.

Yeah, it's sort of like the healthy, the healthy option.

It's absurd. One of the things that you mentioned and that comes from Gary Taub's work is, okay, insulin turns on mtor, which causes muscle growth, but as we age, sarcopenia or muscle loss is a major problem. So how is someone who's say, over 50, man or woman? It doesn't really matter for this question. Okay, you start getting tissue loss, you get muscle wasting. And if you're on a longevity program to minimize mtor, aren't you going to be very thin?

Yeah, and that was one of the, that is MTOR in some ways simulates fasting for the body, obviously. And that was one of the concerns that, that I had before I started taking rapamycin, which suppresses the mtor. And, and that that was muscle loss. And the papers I looked at and the, the evidence is still mixed, but in My review of the data, the preponderance of data was that rapamycin didn't, didn't increase sarcopenia in older patients and didn't have that effect. But it's still, it's still controversial. It's still a concern that, you know, we shouldn't, we shouldn't discard out of, out of, you know, out of place. We need to pay attention to that. I totally agree.

And even with that, there's changes in the type of muscle fiber as you age. And one approach is you just have to exercise for two hours a day until you need shoulder replacement. And there's some longevity docs with books who are kind of into that. The other approach to that would be modulate the type of amino acids you eat, which can also do that. And exercise is necessary as a, as a co factor for this. So if you're on rapamycin and you never lift anything heavy, it's probably not going to have the same effect. Right, right. I think you'll be fine if you once or twice a week pick up heavy things, but you don't need to do that in two hours a day kind of protocols, at least in my experience.

Yeah, well, I think it's a new, a new era too of longevity where it used to be people at age 60, 65, they retired and then it died five years later. Now we're having, you know, 70 year olds enter the Miss Texas competition and we have 80 year old rock stars filling, you know, aminators of tens of thousands of people and you know, and 80 year old presidents pick your party, either one, you know, and, and so we're now a new era where we don't know what's going to happen with 90 year olds that are doing these kinds of things and we have to readjust our, our medical recommendations. You know, as a radiologist, we have X ray limits on how many X rays you're supposed to get in your lifespan for a cumulative dose. But that was when people only lived to 60. If you're going to live to 130, you may want to think twice about getting that extra X ray study. You know, and there are other things as well. You know, some places famously don't do kidney transplants and people over 50, well, you know, 50 years age isn't even halfway for a lot of people.

Yes. And I, I'm going to celebrate my 28th percent birthday today. Or not today, sorry, this year anyway. It's not today, but it's, it's one of those things where Even in the 90s, the definition of elderly started at 55 and so many people rioted that they adjusted the definition of elderly upwards about about 10 years. I think if I'm remembering right and the data is it's actually about 6.5 years of additional life that people have earned just since the 90s. And that's in the face of all the toxins in the environment that didn't, didn't even exist back then.

Yeah.

What percentage of the metabolic and chronic issues we're seeing are because of environmental toxins?

Well, I would say it depends how you define toxins. If we include nutrition, if we include sleep as a toxin, disordered sleep, if we include stress as a toxin.

Let's take those out and just look at either man made toxins or potentially like plant toxins that are concentrated by men and used unnaturally like some of the natural insect killers are probably still not good for you.

Yeah, I think, I think it's a bigger number than, than people expect and I think it's, it's such an important point that you can, you can go through your lifestyle and you, you can eat all the, all the foods we've been talking about, you can get your sleep in order, you can get your stress in order, you get your exercise mental and physical. But if there's mold lurking down there, or mercury or lead or shot of glyphosate every day you shot a glyphosate, those things without saying can, can derail the whole train. So, you know, to put a number on it, you know, I, I would, I, I'd say, you know, at least 25%. I mean, I think everybody needs to take a close look at their, their history and, and you know, looking at the medical history, you know, how many physicians ask you about mold, you know, how many physicians ask you about mercury, ask you about these other things, but then they go ahead and treat you with these chronic diseases that can be driven by those things. And maybe again, AI by being able to find out all the information will help us with that.

I think it will. And probably the most eloquent person I've seen talk about this is Bobby Kennedy. And he just says, look, in 1992, every chronic disease in kids and adults started skyrocketing. So there's one of eight toxins we started using around then, things like atrazine or other plasticizers that there's a long list, at least one of those is the culprit. And like we talked about earlier, mixing two longevity drugs may give you a greater result. Mixing Two man made estrogen disrupting toxins. Each one might be FDA level safe or EPA level safe, but when you put them together, even at safe levels, they're not safe anymore. I think it's something like 75% because the incidence is so high and the curves are all just going straight up into the right. So it has to be something beyond our stress levels. I can't blame Facebook and Instagram for all this. I need a certain percent.

But yeah, totally, that's such a great point. Something happened in the 80s and 90s that caused all these chronic diseases to go off the charts all the way from mental illness to obesity to, you know, seemingly unrelated things which we know metabolically are all related by the same thing. And it's, you know, it's probably not sugar and carbohydrates, although they're bad, but they didn't change that much. And you know, seed oils maybe took off. But I think you have a great point that toxins are something that need a lot, lot more attention.

I recently came across a study of my favorite. This is a Mother Nature toxin. It's just a lot more present because of our farming practices. It's OTA or ochratoxin A. And I've been saying for a long time this stuff is bad and here's all the evidence, but the new study showed that relatively small amounts of it affected glial cells in the brain, the things that metabolize or, sorry, the things that maintain the brain. And it also affected the mitochondrial membrane and the mitochondrial function. So you could say, well, I did all the lifestyle stuff and it didn't work. Which was my story, man, I'm really doing all the healthy stuff and I've spent, you know, $100,000 on doing all the healthy stuff. It's not working. And then you realize, oh, there's something that's inhibiting my cells from doing what they're supposed to do. And then we start playing with, with environmental factors. And for me, one of the environmental factors that I, I coach people to do is look at your water filter, look at your air filter. Because if the inputs, which is £30 of air you breathe every day has something in it that inhibits your metabolism, it doesn't matter if you do other things right? Or maybe it matters, it doesn't matter as much. And then you don't get the results and then you think, oh, this doesn't work. But it's so complex. Now fortunately, I think we, we know the most likely suspects. I don't know that I Could say, you know, it's one versus the other. But if you just minimize your exposure and don't worry about the fact that you are going to be exposed, just minimize the benefits on metabolism can be really kind of shockingly strong.

Yeah, that's so important. As a patient, as a user, we do these lifestyle things, we embrace all these lifestyle things, but any one of these environmental toxins can derail the train. So there's so many things we have to look at. It's very, very challenging. But there's hope that at least, like you say, we're beginning to identify them and we can take corrective actions for many of them.

Now tell me all the benefits of the calories in, calories out model.

The benefits. It's simple, it's intuitive, it's, you know, the law of thermodynamics. It makes sense, you know, energy. But that is by far eclipsed by the fact that the calories in calories out model doesn't work. As we've seen with the obesity epidemic skyrocketing, where most people are either overweight or obese, and it's only getting worse.

One of my favorite things online is these kind of 25 year old, I'll call them junk food bodybuilding fans going, it's just about calories in, calories out. So I'm canceling out my Snickers bar with my Diet Coke. And you can do that because you're 25 and that is going to wreck you. And then you talk to those people 10 years later and like, oh my God, I, I wrecked myself. I really wish I hadn't done that. But they, they keep saying law of thermodynamics. And one thing I said, guys, uranium has a million calories per gram. Does it make you fat? And they go, well, you can't absorb that. I go, oh, so it's a question of what we absorb. And then they get all frustrated. So, well, no one would eat that. Okay. And then we talk about one of my favorite drugs, one you actually might not be familiar with because it's not from medicine, it's from agriculture. It's called zeronol. You ever heard of it? 0c e a r. It's purified mold toxin called zearalenone, which is one of the known toxins. It's 10,000 times more estrogenic than human estrogen. They put it in cows because cows get fat on 30% less calories.

Wow.

So if such a drug exists, I'm pretty sure calories in, calories out. It just got Sunk like battleships sunk to the bottom of the ocean. And so it simply doesn't work. And I look at the 18 months where I went to the gym six days a week, 90 minutes a day, suffering on this low fat, low calorie diet, just gnawing hunger pains all the time. All I did was break my stress hormones with that. I never lost a pound after 18 months. I was strong, but I saw a 46 inch waist. And I kind of look at, at that advice, the calories in colors advice as, as cruel because it's blaming people who are fat. And I sorry. I mean, there's the medical term obesity, but I was fat. I was obese too. And it's blaming us, but we're the ones trying the hardest. We're just have bad advice.

Yeah. I mean, they say you shouldn't shame fat people or fat shaming is bad, which it is. But by propagating a theory that calories in, calories out is the rule of the land, then you're shaming the people for making the choice. But that's not the choice, obviously. And, and it's cruel.

And on that note, we also shouldn't shame people who are wrong because sometimes, you know, you're wrong. And I've certainly been wrong about things. I've been wrong. Yeah, exactly. And you don't even want to shame dumb people because, well, half of people are dumber than average, so that wouldn't be nice. That's the definition. But also, if your mitochondria aren't working in your brain, your IQ drops. Right? So maybe it's metabolic dysfunction. And when that person has their metabolism working, they get their brain back. So it's not even that they're dumb. It's the same thing that's making us fat and giving us all these autoimmune conditions is the same thing that's actually lowering our cognitive function. So when people read your book and say, oh, I fixed my metabolism, oh, and now I can remember things again, they're directly related. It's like love handles in the brain, right?

Yeah. I mean, that was a wake up call in writing the book about how this metabolically healthy lifestyle, in particular diet, can reverse some patients, not all, but some patients with Alzheimer's disease, to the point their brain fog goes away. And then Chris Palmer and Georgia Eads work on mental illness, where literally the junk food was making people psychiatrically hospitalized on all these medicines. And when they changed to a metabolically healthy diet, the mental illness went away and they went home. And it makes me Wonder about all of us, you and I, who maybe aren't at a clinical level of psychosis, but we all have ups and downs in our daily lives as we deal with our, our kids or our spouses, our employees, our employers, you know, anger, stress, anxiety. You wonder how much of the current nutritional and toxin environment is contributing to the divisiveness in politics and everything else we see in the world today.

I think a very meaningful amount of the meanness we see in the world today comes from metabolic dysfunction. Because when your system isn't working right, your cells are stressed. That's the definition of stress. You know, famine can induce stress. Metabolic dysfunction is stress. So then you get a stress signal and then your rational brain looks for what's causing it and you decide it's your mother in law or your kids or whatever. The reality was, if you were at your full power, your biology is wired to be kind to other people because that's how tribes work. It just, you couldn't be the person you wanted to be because your metabolism wasn't letting you. And I, I know that if you give me msg, I'm probably going to be a total because it gives me. I don't normally have hypoglycemia, but that stuff, my brain swells up and I, I literally, I don't like myself when I have that stuff. And I, so I, I feel like there's a lot of people who carry a lot of guilt and shame over things they've said or done. It's because your brain was poisoned or it was just turned off by something you ate.

Yeah, no, absolutely. I couldn't agree more with that.

So if, if that resonated with you listening to this, you can kind of give yourself a pass on that. Forgive yourself for that. I've been an absolute asshole when I ate the wrong stuff. And it happens to, you know, no matter how conscious you are. It's just a thing. And I wonder, when people go into the doctor's office, they get stress hormones because, you know, white lab coat syndrome. But they also, you know, had a diet soda which will also cause this because aspartame does that to your brain and maybe they match it with a jelly donut and then they're, you know, really nervous and all sorts of things and then they can't even remember what they heard. So learning how to fix your metabolism and making it a daily practice, I don't even think longevity or longevity or weight loss is the real win. It's peace. Yeah, you feel peace when your metabolism Works.

Yeah. I love that thought. That's, that's beautiful.

You have a really calm vibe about you too, right? Like you really love what you do. Were you always like that?

No, I, I think when I had these four chronic diseases, I changed in a lot of ways. When I changed my lifestyle, a lot of things just changed. About myself, I wasn't intentionally changing my vibe or anything, but I think I may, maybe it was effective in the metabolism and all, but I sort of look at the world differently now and I've. I'm not the same person I was before I had those diseases. I was, you know, on a different path, doing different things. Different things mattered to me now. Other things matter.

It's funny, the reason the new coffee is called Danger Coffee, it's because who knows what you might do. Like the good side of danger, where, you know, I could do anything right now, I'm going to do the right thing. But that feeling that I didn't have the energy to do anything, much less the right thing, was a major part of my life for the first 30 years. And to be free of that is the most precious thing. And that's why I'm just so respectful. That you have this great medical career and you're willing to change your ideas. I think you're changing a lot of lives with your work. Because when people get their energy back, who knows what we'll do? We'll probably be nice to each other instead of mean. That would be nice, right?

I love the Danger Coffee. You don't, you know, you don't know what to expect. It's a new world, a new life. It's beautiful.

Like what's, you know, it feels really dangerous to ask that girl out. Right? But you, that's the kind of danger you want, right?

So you can do it. Possibilities.

Yeah. Now, one of the things that I have tracked in my health over time is fatty liver. I don't have good results from when I was really fat, but clearly the fact that I was eating seed oils, even though I didn't know that they were causing that stuff, and I certainly at times had a lot of carbs, I knew that I had high liver fat. And it's one of my longevity things. And I have something like 0.8% like exceptionally low liver fat. And my, my visceral fat in total is at the low end for an 18 year old. So I think this is a longevity variable. Can you talk to me about fatty liver? What causes it, why we should care and how common it is?

Yeah, fatty liver I will have a whole chapter about in the book. But it's fascinating. When I went to medical school, fatty liver was caused by alcohol, so it was alcoholic fatty liver disease. In 1980, that all changed and nobody knows why. There began to appear new cases of fatty liver. In fact, it skyrocketed. And the doctors, as they were trained, thought this was due to alcohol. And they would tell the patients to stop drinking. The patients would say, I've never had a drink in my life. They wink and say to her, you know, but just stop it. Then finally kids, children started having it and they realized that they weren't, it wasn't related to alcohol. Anyway, long story short, this new type of fatty liver disease, which is given the name non alcoholic fatty liver disease, or nafld, has now eclipsed alcoholic fatty to liver disease to where it's not only the number one cause of liver disease, but it's also the number one cause of liver failure and liver transplants. And it's exploding, it's continuing to take off. And what do the institutions say, the medical schools I work at and other leading schools? The health recommendation if you have fatty liver disease is to lose weight. You know, makes sense, lose fat, get rid of the fat in your liver. But the problem is as, as Robert Lustig is so eloquently pointed out, that that alcohol is, is a toxin. It's metabolized by the organ that handles toxins in the liver. And it has a certain pathway that makes fat in the liver and has other effects. Fructose is also a toxin. It, unlike glucose, which goes all to the cells of the body, fructose, only 90% is metabolized in the liver. It's a toxin. So when fructose is metabolized, it has a very similar metabolic pathway as ethanol and it produces fat in the liver. And anyway, there's very strong evidence that fructose is the driver for fatty liver disease. It also produces urate, which interferes with nitric oxide synthetase. It raises blood pressure, it stimulates fructose, doesn't raise insulin in itself, but it drives insulin resistance. So it actually drives type 2 diabetes without directly raising the insulin. So fructose is really problematic. But the, the, the, really the, the nail in the coffin is Robert Lustig from UC San Francisco did a beautiful study, controlled study with children with fatty liver disease. And he, he basically changed their diet and he substituted for fructose glucose in their diet. So he didn't change the number of calories, so they didn't lose weight or Anything. All he did was substitute glucose for fructose isocalorically, so to speak. And in eight weeks these children actually their fatty liver disease reversed to the point you could see it on the imaging studies and it was, it was very dramatic. So, but this message isn't, isn't getting out. You know, people are still told just to go lose weight, exercise, you know, these kinds of things which, which really miss the whole point about fructose.

This will be unpopular, but I sometimes advise college students or people have a really important exam, well, you might want to take some good quality mold, free coffee, add a little bit of butter, a little bit of mct, and the MCT is there for ketones and add glucose. Right. Now you shouldn't do this every day because glucose causes glycosylation, but not as much as fructose. And this is a binding of sugar to proteins. That's pro aging. But that boost of mitochondrial function when you're oh my brain's running on both glucose and ketones at the same time, you're probably gonna do better on that test. It's a short term performance hack that has a long term minor effect. What do you think of that advice?

Yeah, and the body's very forgiving at that age, as you can say as well. And you may get a performance benefit with a longevity hit, but the longevity hit is mediated by years and it's probably going to be wiped out by other things. So yeah, I, I wouldn't argue with that.

And again, this isn't longevity advice. It's. I needed to bring it right now. There's a bunch of other nootropics that I advise in those situations and even 1mg of nicotine which also is pro metabolic at those tiny doses because of PGC1 Alpha, which is another longevity drug. No, Well, I guess it, it's not really a drug. It's longevity molecule that's raised by exercise or strangely by nicotine. Now if you wanted to get rid of non alcoholic fatty liver disease and you were only willing to give up fructose or the seed oils, which one's worse?

It's a good question. The seed oils I'm getting more and more worried about for insulin resistance and inflammation. But the evidence is it's still not as strong as for carbohydrates and glucose for, for non alcoholic fatty liver disease. The, the evidence for fructose is very, very strong. You know, Robert Lustig we mentioned has.

Been on the show. He's great.

Dave Polmutter had a book drop acid, about uric acid, but it's really about fructose. And then Richard Johnson, nature wants us to be fat, is all about fructose. And he, that's his, his wheelhouse there. So if I had to, if you pin me down on those, I would say the, the fructose. But I avoid seed oils like the plague.

Also now I avoid both of them on, on a regular basis. And if I had to pick one, I think fructose is worse for the liver, but I think that the. I think the seed oils are worse overall, metabolically, so you really don't want either one. And I remember back when I was doing keto and low carb for the very first time in the 90s, based on Robert Atkins work, I would buy fructose because it didn't raise insulin and you couldn't really find it commonly. So I ordered online and I take it, I just never felt good on it. So I quit taking it. I just wasn't worth it. And now I'm, I'm thankful I didn't because I was poisoning my metabolism, at least my liver with that stuff. It's. It's just not good for you.

Yeah. The American Diabetic association, which is funded by DaVita, which is a dialysis company, and the word cause of, of dialysis need is type 2 diabetes. But American Diabetes association used, and diabetic authorities used to recommend fructose for diabetic patients because it didn't raise the insulin directly. They didn't understand that it actually drove insulin resistance, which is the sine qua non of type 2 diabetes. So it was actually making it worse.

Do you think that there were some doctors, maybe researchers in the back halls of big food companies who knew that, like the tobacco industry knew very well for years that tobacco was doing it. And the glyphosate companies like Monsanto, Bayer, they knew. Right. They suppressed it so they could sell more. Do you think there was a fructose thing going on with that as well?

Well, I think in my heart, I believe that most people get up and want to do good in the health industry and in all industries. They don't want to get up and say, I want to harm people. But, but having said that, in the book, we talk about some things that have come to light where people were paid, scientists were paid money to write articles discounting the effects of sugar. And, and it only came out years later and it was never disclosed. And I'm sure similar things are going on. I mean, famously. You mentioned the tobacco industry. Well, you Know, as, as your audience probably knows, in the 1980s, when tobacco was being shut down, the tobacco industry pivoted and purchased the junk food companies and basically just moved into junk food. They use their same marketing strategies, their same approaches, but with the advantage they could market to children, which they couldn't do as a tobacco company. And now we're seeing, you know, that if they lied about tobacco, they're probably gonna, I mean, I hate to be that cynical, but there probably be people who will lie about the junk food effects, and fructose is certainly one of them.

It's interesting. I don't think the vast majority of people would do that. That all it takes is a couple of sociopaths in, you know, somewhere deep in finance or something where, where, you know, they, they flip a switch and then if you're working for a company and they tell you that you're helping people. Like one of the most frightening conversations I ever had. I was at a neuromarketing conference at Stanford. This is where we're talking about measuring people's brainwaves to see how they respond to advertising. The guy sitting next to me was the chief marketing officer for Monsanto.

Oh, really? Right.

And this is before I had as much of a reputation as I do now. And, but I was just really curious. I said, you know, did you get a lot of, do you get a lot of crap for this? And he said, oh, no, we're, we're feeding the world with genetically modified yellow rice, which is a story. It's not even true that no one grows that stuff. It's not real. And, but you could tell he was not an evil man.

He was believing it.

Yeah, yeah, he, he believed the, and so a lot of my belief and what drives my motivation in biohacking is get enough energy in your brain and you have enough energy to think about stuff and spot the. This, this is about creating reality and consciousness. That, that's better. And so, you know, I, I don't remember the guy's name and I, I'm sure he went home and, and ate glyphosate soaked grains because he knows it's safe even though it's not. Right. But was there somewhere who fudged some research that informed him? Probably right. It's a, it's a, it's a very tough problem in humans. But things like your book with its beautiful, you know, lies I told in medical school title, that, that's, that's just brilliant. I think you're, you're doing some good, some good stuff to Help people just learn how to think. Oh, you got it. All right. The cardiovascular disease lie and the hypertension lie. Do tell.

Well, one of the diseases I came down with was hypertension. And the recommendation I was given was to avoid some salt and lose weight. And, and I was put on a drug that actually lowered my blood pressure. And I thought, well, you know, I, you know, I tried avoiding salt. Nothing happened. You know, I wasn't overweight, so nothing happened. So I figured I'll just be on this drug the rest of my life and that will take care of it, right? It's managed. But what I didn't realize is that drug, just like insulin for type 2 diabetes or putting a stent in for a heart attack, does nothing to control the progression of the underlying disease and many of the, many of the complications down the road. So my, my, though my blood pressure was under control, which is what hypertension is, the, the damage to the blood vessels was continuing. So it, it made me question, do a little biohacking, look under the hood myself, and I, I realized that on a low carb diet, one of the side effects is people get dizzy because their blood pressure drops, especially when they're on, when they're on blood pressure medicines, and consistently, like most people, will have a blood pressure improvement on a low, low carb diet. And so that was one of the, one of the motivators. And I certainly found that right away that was one of the first things that, that helped. So the, the hypertension lie was that, you know, the best thing to take for hypertension is a blood pressure medicine, which you may want to take in the short term to control the blood pressure. But for long term, there may be other things you can do.

The first talk I ever gave about health in public was at the nonprofit that I used to run called the Silicon Valley Health Institute Now. And I was relatively nervous. I'm not a doctor. I'm a researcher. Right. I'm an author. I wasn't even an author back then. So I did this exhaustive research, and I don't remember the guy's name off the top of my head, but he was the president of the American Hypertension Society. And he said, well, I'm. I don't believe any of the studies where they ask people to recall their salt intake, and most advice to lower salt is based on, I don't know, how many grams of salt did you have yesterday? It's, it's dumb. So he said, I'm just going to measure urinary excretion in 3,000 people to know what they're actually doing. And his conclusion after a large study for multiple years was direct, quote, if you want to live longer, eat more salt. And that has to do with the fact that sodium lowers renin. And renin is a factor in the blood. When it goes up even a little bit, it increases cardiovascular risk dramatically. And so inadequate salt increases your chances of a cardiac event. And probably too much salt is bad, but I'd much rather have way more salt versus very little salt from a longevity and certainly from a feeling good perspective, because the more stress you're under, the more salt you need. So if you tell someone, take this drug to lower your blood pressure and don't eat any salt, and then they have a really bad day, something. One of the studies I've come across something like 20% of people in homes for elder care diagnosed with senile cognitive dementia. They just have low blood pressure. You take them off the blood pressure meds and they get their brain back. Who would have thought?

That's why I love the biohacking approach that, you know, that you basically invented. But the work of people like yourself, questioning the dogma, questioning the orthodoxy and asking these questions, it's so important because a lot of times people in the ivory tower or in their narrow medical disciplines don't have the perspective to really see the big picture, sadly enough.

It's funny too. Epidemiology is kind of dangerous because there is no average human. In fact, I teach my kids that, like, the worst thing you could be is average. Like be abnormal, because normal is not a good thing. And so when you look at these large groups, you can make all these terrible conclusions that might work for one person, but probably don't work for a lot. And my frustration in following this kind of advice was that none of it was working. So I work in big tech in Silicon Valley, data centers and Internet things. I can measure whether a packet gets there or not over the Internet. It is a hard fact. And you can diagnose it. And I realized as a computer hacker, okay, I can poke a system and I get a result or I don't. Eventually you figure out you don't know what's going on in there, but you know how to control it. And I just said, I give up. I'm only going to do what works, and I'm gonna have to measure it to find out. And that was what led to the biohacking movement, was it's okay to question orthodoxy, but if you question it, you convince yourself you're right. And you keep doing it, you will break yourself, just like you will on a low fat, high carbohydrate diet. You have to measure results. And then if what you thought worked, didn't work, then you change your mind and you recognize that it still might work for your spouse.

Right.

Because we're unique. And so it's this insistence on getting the data and trying more than one thing at once were the two hallmarks that kind of set it apart from what I think in medical school they would teach you. Polypharma is a bad thing. Right. And polypharma for listeners is the idea that, you know, using multiple drugs that have similar effects at the same time. But in biohacking, like I'm going to do, I'm going to sleep and exercise and eat the right foods and maybe I'll get the result. But if I just do one, it's probably not going to work. So, yeah, end of the day, how you feel and what your labs look like, that is the hard data that it doesn't matter if it's supposed to work. It either does or it doesn't.

That's right. Results oriented. Absolutely. And yeah, and similar drugs can have different effects like metformin and berberine. They both have effects on the glucose, similar mechanisms, but when you combine them, you get synergistic effects, just like with the rapamycin a carbos that we don't understand. You know, that they're, they're, they're nuances that we have yet to learn.

That brings us back to the AI conversation. We're going to figure this out in real short order. And something else I think AI is going to teach us is something you write about in your book. Talk to me about LDL particle size and quantity. What's your take on that?

Yeah, I mean, I think the LDL situation is rapidly changing and we have a lot to learn on that. Unfortunately, for the last 40 years, we've been chasing LDL as a cardiovascular risk factor, which it is, but it's a relatively small risk factor. Most people who come in with heart attacks have normal LDL cholesterol. We can drill down particle size and look at some of these things. I think there may be answers in there. But I think the bigger picture, in my opinion, if you look at hazard ratios, which are the risks, smoking is much bigger than LDL as a risk factor. And how does smoking cause heart attacks if there's no cholesterol or LDL involved or what's going on? And then metabolic factors like triglycerides and HDL and insulin resistance and diabetes are much, much greater factors than LDL cholesterol. And then you have the whole thing with statins. And statin was the one drug that you could give a heart attack patient that would do something, it would lower their ldl. But we, you know, we talk in the book, famously, other people have talked about the exaggeration of the effects, you know, using relative risk instead of absolute risk. So you all the ads For Lipitor say 30% reduction in heart attacks, which is not really the case. It's 1% absolute reduction consistently across most of the statins, even today, 20 years later. And then finally, the disturbing things about general ldl at least, is that when you look at all cause mortality that you do get a 1% lowering of cardiac heart attack mortality, which, you know, think about it, the number one cause of death for you and me and most of our listeners statistically will be a heart attack. Hey, I'll take 1% savings on that. But in these large Meta analysis of 60 studies and similar other ones, they show that the people who have lower heart attack risk by 1%, they have a higher risk of death from other things that make up the difference. So their, their net all cause mortality is more or less statistically similar. So what did they die of instead of a heart attack? Well, it was things like suicide or traffic accidents or maybe something's going on with our brain or other things. Cholesterol is vitally important for our hormones and other things as well. So I think it's, it's rapidly evolving. The information is changing rapidly. And you know, I'm, I'm hoping that there'll be more sense of it coming out because right now it's, it's very controversial and it's kind of moving a lot. But I personally, I think statins are overused for people with low heart attack risk. And if you, if you are on a statin and you haven't had a heart attack, get a calcium score. If your calcium score is zero, your doctor, even according to the American College of Cardiology, can discontinue your statins without getting slapped by the insurance company or the, you know, the provider that they work for.

Wow. I, I always kind of laugh like, your doctor can discontinue this. I'm like, this is my body. Like, I hire my doctors as partners and consultants in sources of knowledge, right? And I want the full explanations. It's kind of like, well, I didn't give you the right to put me on or take me off. I want to use it Recommended or not. And this gets around the insurance company behavior, which is just. It's absolutely criminal that they think they can tell a doctor what to do like that. That should be the first regulatory thing we fix. Because doctors are there for a reason, and it's not to be the servants of big insurance. It's gross.

Yeah, absolutely. And. And I think we're entering into a new era of patients where, you know, and I slipped into it there sort of the paternalistic thing. The paternalistic thing the doctor, he or she will can't discontinue.

I was trying to call you out on it all. I know that's not your perspective.

Yeah. But. Yeah. To where the patient is now the CEO of their own body. They have agency they have to control. And I know more about my history than any doctor will ever know about my life experiences, my trauma, whatever's happened to me and what motivates me and drives me. And that puts me in a unique position of managing my own healthcare. And the doctor can give me advice and recommendations, and then I can choose to accept it or not accept it, just like I choose, you know, what pills to take or what lifestyle I embrace.

Yeah. And so I look at doctors as just great partners in longevity. And there are some listeners who are just angry. And I admit when my doctor at the Palo Alto Medical foundation told me that vitamin C would kill me and didn't know who Linus Pauling was, I fired him. And guys, if you don't know who Linus Pauling is, that's okay. He just won two Nobel prizes and took 90 grams of vitamin C a day, which, by the way, is a bad idea. It does raise oxalate metabolism. But regardless, the problem there was that I was getting that paternalistic advice. Right. And so it. I went away from that and a few other experiences where they just didn't believe me. Like, oh, sure, you're eating Snickers bars. You say you're on, you're exercising, you're not because you're fat. And that's evidence of it. So I spent four years just pissed off at doctors. And I really studied biology and medicine and all these things. So I'm like, I'm gonna have to do this myself. And then I realized, oh, there's this whole group of functional medicine, these calm organization, ortho, molecular, and there's all these amazing healers and helpers. So if you're sitting with that anger at doctors, I hate to tell you there's more than one kind of doctor and there's lots of really good ones. So I think that's worth just calling out because there's some patients who are kind of feeling gaslit, and I don't think most doctors doing that on purpose. Sometimes it's an insurance issue or something else. But if you're feeling pissed off, you might want to look at your care provider and, you know, find one who's compatible with you. When it comes to cholesterol, I'm one of those. Okay, show me the numbers. And if high LDL is causing damage to my arteries, it ought to be reflected in an enzyme that's released when there's damage to the line of the arteries, which is called LP PLA2. Right. So what I've been sharing with people throughout the time I was at Bulletproof, like, oh, my gosh, what if my cholesterol goes up? Well, it might or it might not. But if it is causing harm, then you should see evidence of harm. And the evidence is lacking. But what does have high correlations with heart attacks is C reactive protein and homocysteine. And one's a genetic issue. Homocysteine and C reactor protein is usually an infectious issue. So if those are going on, you might want to look at those. But to worry about cholesterol, when you haven't addressed the big smoking guns and you haven't seen whether cholesterol is causing trouble, it just doesn't make sense. But I'm not a doctor.

Well, one thing. We have a pill for LDL cholesterol. We don't have a pill for C reactive protein. So we don't, we don't really have a pill for homocysteine either. So a lot of times doctors want to give a pill. And in out of fairness, you know, I'm a patient. I'd rather have a pill than get a lecture on my lifestyle. So a lot of times patients ask for pills. So there's a bias towards giving a pill. And if there's a pill for LDL called a statin, people will prescribe statins.

I love that you're, you're putting out that. I would rather take a pill than exercise. It just doesn't really work that well. And if you make a pill like that, let's talk if there aren't bad things.

Exactly. We'll get back on here.

I mean, and some people are saying, well, you're supposed to work hard and suffer. I would like to work hard on things that don't cause suffering in myself or others, because life is better that way. But I'm willing to Work hard and suffer, but only as much as is necessary to get the results. And so kind of fetishizing, you know, the, the pain of fasting or gritting it out in the gym. In the gym, you have to be willing to do that when it's necessary. But if you just do it reflexively because of some puritan value, I don't think that supports longevity, it supports stress. Something else in your book that has me dancing with joy. Talk to me about cancer and talk to me about Alzheimer's and how they're related.

Great question. The theme of the book, we go through many, but essentially all the chronic diseases we've mentioned tonight and we, we look at what medicine says are their causes and their treatments and then we look at the underlying. What I believe and many, I think there's strong evidence that the underlying metabolic drivers of them all and cancer and Alzheimer's disease in the face of it seem like very different things. You know, Alzheimer's is all in the brain primarily. It's, it's mental function. Cancer is a cellular hyper function metastatic disease, things like that. But I believe they're both driven by at one level hyperfunction, which goes back to mtor. And if you look at the evidence for, well, if MTOR hyperfunction drives cancer, then if you block MTOR with rapamycin, this drug, is there any evidence that shows that it reverses cancer? Well, yeah, there is. There are eight FDA approved indications for cancer for rapamycin as not primary therapy but adjunctive therapy. Things all the way from metastatic renal cell carcinoma, which is the number one kidney cancer, to several other cancers where rapamycin blocking MTOR is advantageous to the cure of the cancer. And, and there's evidence that these metabolically healthy lifestyle things by the ketogenic diet being in ketosis is now being used for cancer patients as well. So, so there's all this metabolic evidence for cancer. Well what about Alzheimer's disease? Is there evidence for turning down MTOR with Alzheimer's disease? Well, there are animal studies that we talk about in the book where there's a mouse hamer model for Alzheimer's in mice and when you block MTOR with rapamycin, you're able to reverse the mental findings in the mice with mouseheimer's disease to the point the evidence is so strong that now the University of Texas as a multi million dollar study for humans with Alzheimer's disease using rapamycin.

Wow.

And similarly there's the evidence with the, with the ketosis and the ketogenic diets with Dale Bredesen and Heather Sandison and others where they've shown that putting people on a ketogenic diet in an Alzheimer's clinic can have can for some, but not all patients can actually reverse them. And a ketogenic diet turns mtor down just like rapamycin would, or not just like it, but one more thing that does it. I love Heather Sanderson study or quote about it. She runs nursing homes for Alzheimer's disease patients. But unlike most nursing homes for Alzheimer's disease patients, her patients go home because they get better. And I asked her, you know, what do you do? And she says, well, first thing we do, everybody's on a ketogenic diet. There's no, there's no ice cream and cake and da da, da, da, da. And I go, come on Heather, how do you know it's the kettle ketosis that you know that's having the effect? And she goes, well, when Mr. Smith comes in and his grandchildren come into the room, I know he's in ketosis because he remembers each of their names, gives him a big hug. When he's out of ketosis and the children come into the room, he doesn't recognize them at all. So for some patients it's not everybody, but for some people the effect can be dramatic.

I love it that you brought up Dr. Dale Bredesen who wrote the book the end of Alzheimer's and was on the show as well. And he was the first big, well credentialed doctor who said, okay, there's definitely a metabolic component which is to your point. He also said, and there's other types. One is caused by toxic mold, which is a huge thing I've been ringing the bell about, or by toxic metals or by these other several factors. And one of the most magical dinners I've ever had was David Perlmutter who we talked about with uric acid recently and Dr. Dale Bredesen at dinner at the American Academy of Anti Aging Medicine. We had the most magical conversation I've ever had because we have these two great minds who are working on these problems and it's so fascinating.

Yeah, I had a great conversation with Dale the other day. He had a patient was like a 55 year old, 60 year old high functioning attorney in Los Angeles and he came back from a trip and basically developed brain fog, couldn't function anymore to the point where he was fired by his job and it was early onset Alzheimer's. He was went to the top medical schools and you know, they just, you know, There is no treatment, really, that works. And anyway, Dale saw him and through his colleagues, and it turns out he had had an. He'd gone overseas to a tropical area, had gotten an infection, and it was a parasite infection of the brain that was causing the brain fog, and they reversed it with. With pharmaceuticals, and now the guy's back in his job at the quote. Alzheimer's went away, but to your point, yeah, Dale has great things about Lyme and mold and, you know, and lead and mercury and all sorts of environmental toxins that maybe they. Maybe you say they masquerade as Alzheimer's, or maybe they drive Alzheimer's, because Alzheimer's is an inflammatory reaction to environmental insults.

And it's a metabolic dysfunction. And most of those toxins directly cause mitochondrial dysfunction, which is the same as metabolic dysfunction. So it's. Figuring out what the cause is is important. And I'm just so grateful and amused that we have great minds like you as well, who are just looking at, oh, maybe it's more than one thing, because this is relatively new in the last 50 years of medicine. Or it is multiple things, and there isn't one cause of Alzheimer's, but there might be seven.

Yep. Yeah.

Now, we're coming up on the end of the show, but one of my favorite chapters is called the longevity lie. What's the main longevity lie?

Well, most people, when you ask them why people age, why we get older, it's wear and tear. You know, my. My jacket wears out, my shoes wear out, I wear out. I get wrinkles, I get gray hair. We just wear and tear. It's a natural, intuitive thing. But. And. And it probably. It does cause aging, but I don't believe it causes. It's. It defines our longevity because longevity and aging are actually different things. Like we. We hinted at earlier. Longevity is. Is determined by about four or five diseases that statistically we die of. Nobody dies of old age. In fact, in the United States, you can't put old age on the death certificate as the cause of death. You have to say one of the things in the top five things are heart attacks, cardiovascular disease, stroke, Alzheimer's. It's a short list. And if you look at those diseases, if somebody has a heart attack, it's not that their heart wears out. It's actually the blood vessels have hyperfunction and they develop this thickening and this atheroma like we talked about earlier, and it occludes with cancer. People don't wear out when they die of cancer. It's actually hyper function. The cells go into hyperdrive. They metabolize all over the cancer cells, go all over your body, and even Alzheimer's disease. It's not like our brain wears out when we get an Alzheimer's. It's actually on defense. It's hyperfunction. It's inflammation, these beta amyloid and these other things which may not be causal, but they're certainly bystanders there. But all these things are driven by hyper function. And also, there's a interesting theory of longevity that we talk about in the book that Misha Blaglosconi, who's a rapamycin researcher in New York in the cancer center there, he's advanced and other people agree with it, is that while aging is driven by wear and tear phenomena, oxidation, the usual things that actual longevity is determined by hyperfunction, by mtor back to mtor and AMP kinase and these basic metabolic molecules that are turned on to hyperfunction too much. And the idea is that if we turn MTOR down, we turn down hyperfunction. We'll actually lower our chance of getting all these killers that determine our longevity. And once we do that, an interesting thing happens that the drugs that turn down MTOR actually increase longevity in animal models all the way from yeast to mice. And some evidence in dogs and maybe in humans. And that's the really exciting thing about looking at longevity as not just wear and tear. Because if you think about it, cells don't wear out, the germline doesn't wear out. You know, the, the. The male and female gametes continue on for forever. Essentially, it's only the, the somatic line that differentiates and then eventually wears out. But what we talk about in the book is that the actual cause of death that determines our longevity, why we die at 60 instead of 70 or 120 or 150, is hyperfunction.

Such a powerful perspective. And one of the things that's in that chapter is you're basically saying if you want to really address longevity, it's going to involve some pharmaceuticals and lifestyle. And one of the things that kind of drives me nuts, I think you can get to 120 with lifestyle if you're lucky. And there may be a genetic thing. I'm not sure about that, but it's possible. But if you want to really radically extend human life, you're gonna have to take direct control of some of these pathways. And it's going to require the right pharmaceuticals at the right doses for the right person. So the fact that you're just openly talking about rapamycin, even though it's an off label use. I think that that's really important for listeners. There's a lot of physicians who listen to the show and a lot of biohackers and you know, if you're thinking, well, I'm just gonna go the, the natural route, you probably won't have enough thyroid and Testosterone when you're 80 and those are pharmaceutical and you probably will have some overactive MTOR unless you're addressing it. And yes, intermittent fasting, we both agree on that. That's part of it, but it's not the only part of it. Right?

Yeah, I agree with you 100%. We're exactly on the same page. I think you can get to 120 just with lifestyle and you want to avoid those chronic diseases because even the centenarians, they get a heart attack, they are cancer, they die just like anybody else. So. But getting beyond 120, I totally agree. It's going to be stem cells, partial epigenetic program, the stuff we mentioned before and the drugs and the interventions, the biohacking, it is truly biohacking. Sine quanone. It's there. That's what's going to deliver beyond that.

For us, it feels true to me. But the fact that I feel like it's true doesn't really matter. The data that I'm seeing, including things like measuring speed of aging, which we can finally do because we have these aging clocks like Steve Horvath's work, and there are some people out there who are trying to discredit that and say, oh, that's not scientific. I'm like, this is one of the biggest achievements in the role in the world of aging in a long time. Because now instead of waiting till you die to see if it worked, you can say, am I aging faster or slower after I did this for a year? And I'm at 73% the rate of normal, which is pretty good, right? And my total budget over the last 20 years has been about $2 million and it should have been about maybe $100,000 over 20 years, which is, you know, relatively cheaper than insurance. It's just I didn't know what to do. And when I first started this stuff, I was also desperate and I also had a very large budget because I was an entrepreneur in my 20s. And so I'm grateful for that because otherwise I think I would have Parkinson's or Ms. Or some other bad condition now if I hadn't taken control, because I was pretty wrecked in my 20s. And so you boil all this down in the book, people listening to the show could be like, well, there's a lot in here like, what do I do? So your chapter 12 is called the Plan and you call it the Paw Plan. What does that stand for? And give me the basic steps.

We're looking towards nutrition first of all. And it's I looking towards the evolution of human nutrition prior to the agricultural revolution, which was when food became available and people began eating all the time. Prior to that, most people believe we were hunter gatherers and there were, there was fasting built into our, our lifestyle, I believe. I think we both agree fast healthy, turns down inflammation, does a lot of great things, even short fasts do. So the first part's about nutrition and the steps, some of which we've talked about now about how we can improve that. Then we talk about stress, how we can alleviate stress. I love stress because it's not really what happens to us in the world is not what's stressful, it's how we respond to it. And sometimes it's out of our control, but it's truly how we respond to it. So we go over stress and we go for sleep, sleep quality and quantity and then exercise, both mental and physical. Then kind of above and beyond that, then we go into the more biohacking type things. We talk about rapamycin and some of the other drugs and some of the possibilities there to sort of open the door for people who want to measure things more and you know, dive in and follow your work. Really.

I'm not the only one. I put a name on it. But there's so many people doing research now and sharing results and, and creating new things. And I, I am truly grateful for the way you put, you put all the information together because ultimately if your metabolism works, everything in your life is better and your risk of those big four or five killers goes down dramatically. And if we just had that and then you died at the same time, you're going to die anyway, you still won. That's the worst case. But I do admit I get disturbed sometimes when I see people saying we're never going to extend human life. Because I'm thinking every piece of evidence that I have says we already have done that, even in the last 30 years and that the rate of our improvement is going up so dramatically because we have the Internet to research PubMed now, we have any of the AI tools that read it for you and answer questions. And so our rate of knowledge about this is getting better. And the amount of money, even 15 years ago, when I Was running the longevity nonprofit. No investor would ever touch anything in that space because it's an impossible thing. In fact, if you were at a major university and you said you wanted to reverse aging, they would probably take your tenure because they think you were crazy. Right. And so now the fact that there's $600 billion being invested in longevity, I'm pretty sure it's going to work. And given that I can measure that it's working and I'm at 73%, that's enough for me to say this is happening. But I still see sometimes big names out there saying we're never going to extend human life. What do you think is driving that, that belief that we just can't change this?

I think they're being naive. I mean, there's. The amount of information about longevity has been accelerating in the last 10 years, 20 years. I mean, to put it in perspective, MTOR wasn't discovered until almost the beginning of the 20th century. This, this fundamental biological molecule, nobody knew about it. And you know, rapamycin was discovered in the 60s, and then it took another 40 years for MTOR to be discovered. But now there are new things that are happening faster and faster. You know, three large multibillion dollar companies with billionaire investors and, you know, as you mentioned, many, many more. We're seeing amount of money being poured into longevity, But I think it's because things are happening. We're seeing drugs that reliably, consistently improve longevity of every animal system it's been tested in, like rapamycin, other than humans, because we just, we don't, we can't test it easily in humans. But if it, if it works in all those animals and it has these effects on these chronic diseases, There's a lot of reason to believe that it's going to affect humans in some beneficial way. But, and that's just the surface. There are new technologies, just like AI jumped with these quantum leaps. There's probably things that we don't even see coming down the pipeline that are going to have dramatic impacts. But even with the things that are happening, Partial epigenetic programming. I went through the list before. The things that I'm excited about, I think those are all. Every day I wake up, I can't wait to see the next article.

It's just like, whoa, it's a golden age of longevity.

Yeah.

I've done the, the gene therapy that reverses your measured age by about nine years on it.

Which one did you do?

The follistatin one.

Oh, nice.

Right from a mini circle and I had the inventor on the show and it just raises folletin for about two years to levels of a young person. But some people, they don't know why yet. One Guy had a 31 year age reduction on his DNA methylation age, which is the gold standard for aging. And so there are hyper responders. We don't even know why, but we're getting to the point where there are interventions that no one's thought of. And another, another company I was looking at starting a longevity venture fund and I looked at a couple investments and one of them had two PhD quantum biologists who figured out how to take a single photon coming off of a cell and play it back to the cell to control cell behavior.

Wow. And wow, what the heck.

Like, this is a whole new world. So I've never been more excited. And my big thing for living a long time is with Peter Diamandis. I met the guy in charge of asteroid defense for the planet. That would affect my longevity.

Yeah, that's true.

And I drive a heavy vehicle. I mean, you know that also physics can affect that.

Yeah.

If I hit a Prius, I'm sorry, I'm going to be the one who walks away.

Right.

And I don't feel that bad about it. I hate Priuses. So, you know, that whole thing, you put it all together and who knows.

Maybe, maybe we'll, we'll both do it.

But if it's not us, there are people listening to the show right now who are going to live way longer than anyone thinks and it's going to mess up the insurance companies and it's going to have society wide impacts. But the biggest reason that this matters is that our birth rate is below replacement. If we don't have our older people get younger, we'll have empty cities and they'll be known to do fun stuff. We have to fix this. It's a societal thing.

Yeah. I mean, I think we both were raised in an era when we were taught to be afraid of population explosion, overgrowth, and now we're seeing population collapse and it's, you know, this may be a way to do it. The thing I always like about longevity is you talk to somebody, they're age 65, they retire, you go, how would you like to live another 40 years? And they go, well, I want to play golf, I want to hang around with my grandkids, but do I want to do it for 40 years? And I think that that's not the way to look at it really. The way to look at it is look at how you, how we all change from 30 to 60, let's say in our lives, the way we transformed as human beings, the way we grew into different people. Imagine now you could go from 60 to 100 and grow. Continue to grow, reinvent yourself, do something different. Sure, play golf, hang out with your grandkids, do that too. But continue to grow as a person. Think of the wisdom of the elders that you would have with a group of hundred year olds that can help the planet better and live fuller, purpose driven lives.

We're so aligned there. I look at the future I want is where people have the wisdom of age and the energy of youth. Because then you not only know what to do because you've seen all the stuff that doesn't work, you have the energy to do it. And then to help a lot of other people and to do that you have to have meaning in your life. And that means we fix a lot of society problems. And this is the thing, whether you're 20 and you're listening to the show, your brain will work better. You'll have a better body, you'll have better hormones. You have a better relationship in your life if you fix your metabolism. And if you're 100, you can probably reverse your age by 20 years if you work really hard on it. And we're already there. But I think we can do better than that and so absolutely.

Nice.

Well, it's an honor to have you on the show and thank you for writing Lies I Taught in Medical School. It's a great book. And guys, if you like intermittent fasting, you like biohacking, you're into longevity. This is a book that has a very clear story and reason and through line to help you think about metabolism and aging. And the side effect of making your metabolism work better is living longer. Or the side effect of living longer is that you had to fix your metabolism. It doesn't matter what your goal is, you're going to have to to do it.

Thanks Dave, for having me. You're so kind and thanks for all the great work you do. I'm going to go out tomorrow when I'm fasting and have some danger coffee.

All right, I'll give you a bag. On the if you like today's show, you know what to do. Number one, go out and buy Lies I Taught in Medical School. I want this book to be on the New York Times best selling list and maybe even to push off any of the books that have hit the list that tell you you can't live longer because that's bs. And when you buy it, leave a review. For authors like us. Reviews matter. We actually see them and it tells other people. Was this a book that was cranked out by some AI thing or is this a real work based on years of experience? This is that book. So Liza taught medical school. I want you to go buy it. You're listening to the Human Upgrade with Dave Asprey. A Human Upgrade, formerly Bulletproof Radio was created and is hosted by Dave Asprey. The information contained in this podcast is provided for informational purposes only and is not intended for the purposes of diagnosing, treating, curing, or preventing any disease. Before using any products referenced on the podcast, consult with your healthcare provider carefully read all labels, and heed all directions and cautions that accompany the products. Information found or received through the podcast should not be used in place of a consultation or advice from a healthcare provider. If you suspect you have a medical problem or should you have any healthcare questions, please promptly call or see your healthcare provider. This podcast, including Dave Asprey and the producers, disclaim responsibility for any possible adverse effects from the use of information contained herein. Opinions of guests are their own and this podcast does not endorse or accept responsibility for statements made by guests. This podcast does not make any representations or warranties about guest qualifications or credibility. This podcast may contain paid endorsements and advertisements for products or services. Individuals on this podcast may have a direct or indirect financial interest in products or services referred to herein. This podcast is owned by Bulletproof Media.