Accessible Longevity For All - with Sergey Young | The Empowering Neurologist EP. 112

Well, hello everyone. I'm Dr. David Perlmutter. Welcome to The Empowering Neurologist. Today we're going to talk about longevity. We'll be talking with my good friend Sergey Young. Sergey, let me tell you a little bit about him. He is the founder of the Longevity Vision Fund. He's a longevity investor and visionary with a mission to extend healthy lifespans of at least 1 billion people. He is the founder of the $100 million Longevity Vision Fund, which we're going to be talking about today. And the purpose of that fund is to accelerate life extension technological breakthroughs and to make longevity affordable and basically accessible to all. He is on the board of directors of the American Federation of Aging Research and is the development sponsor of Age Reversal XPRIZE Global Competition, which is basically designed to cure a disease. The disease is called aging. He's also one of the top 100 longevity leaders and a Forbes Tech Council member. He created a wonderful monograph that we're going to be talking about today called The Future of Longevity. I had the opportunity to connect with Sergey at the organizational meeting of this XPRIZE committee about a year and a half ago. So let's jump right into our interview. Well, hello, Sergey. It is great to see you again. The last time we saw each other, I think, was New York City, wasn't it?

Yeah, yeah, it was. I think it was a big conference. I really enjoyed it. Hi, David. Hi, everyone.

It seems like an awful long time ago. I mean, I think that might have been the last, the last time I was at a conference, face-to-face conference.

Yeah, I think it was January last year.

Yeah.

We haven't realized it's going to be completely different year in comparison to what we used to have, right?

Yeah. But that's all right. You know, change is not necessarily a bad thing. So, we'll adapt. You know, in the intro, I talked about the Longevity Vision Fund, which you created. And if you can just— we'll just jump in. Let's talk about what is the Longevity Vision Fund and why did you do it?

Okay. So, as you know, David, and probably part of your audience, my big passion is longevity, like extending healthy and happy portion of our life. This is what drives me on a really large scale and in affordable and accessible version of that. And when I started to feel this passion just a few years ago, I thought, you know, I've been doing investment for 20-plus years. So, I should probably, to support the space, I should probably set up a small fund. And $100 million fund by financial industry is really insignificant. And this is not my money, right? I'm just— other people, investors trust me to manage their money, right, for the good of the planet and their own income. So, I set up this $100 million Longevity Vision Fund with the purpose to support entrepreneurs. And different scientific organizations and startups which create different healthy life extension technologies and interventions. So, that's the idea. Well, we started to work 2 years ago. We invested in more than 15 companies in the last 2 years. And, it's been amazing journey because what we're doing every year to invest in 7 or 10 companies. We look at 200 companies from this sector. So, I have a pleasure of speaking to amazing scientists, amazing entrepreneurs with a similar passion like we have to create and support healthy and happy living on the planet through the means of technology and sometimes lifestyle changes.

Well, the Beyond that, you were certainly involved in the creation of an XPRIZE as well. And let's talk about that for just a moment, an XPRIZE that is dedicated, actually, to similar goals.

Yeah. We call it Age-Reversal XPRIZE. At some point of time, we should talk about the perception that we have in society of the term longevity, the life extension options that we all have. But so, we changed the name from Longevity XPRIZE to Age-Reversal reversal XPRIZE. So for some of you who are not familiar with XPRIZE, this is nonprofit foundation based in California created by Peter Diamandis. And there's many great people were behind that, like Ray Kurzweil was an inspiration for that. And the whole notion of XPRIZE, you take $10, $15, $20 million of nonprofit money Sometimes from guys like Elon Musk. We actually, a year ago, we just finished Global Learning XPRIZE, which was funded by Elon Musk for $15 million. So you take this money from a company like Google, Facebook, or Elon Musk, other great people. You go to the world and you say, the first team from any country with any technology which would solve this world global problem, will get this money. So what is immediately happening after that? If you design your competition, technological competition correctly, 300, 400, 500 teams from usually 50+ countries are trying to compete on what is the best way to solve this problem. So we have XPRIZE like Global Learning, how we help people in prison, people in poor families in US, kids in Africa to learn English or Swahili on their free laptops or any other notepads with zero help from adults. Or we can now talk about Age-Reversal XPRIZE. So the idea of Age-Reversal XPRIZE is for team or different teams to bring technologies or interventions which in the current regulatory regime will help you to turn back your biological clocks. Probably in the course of, say, 12 months, you should be 12 months younger rather than 12 months older. I mean, it's obviously— it's approximation, right? Because we're measuring biological age by a set of biomarkers. So, we team up with Steve Horvath, the inventor of one of the most famous biological clocks with Terry Grossman, who was actually co-author of the book Transcended, one of the first books on longevity written by Ray Kurzweil and Terry, and with Peter Diamandis. So, this is what we're doing. We just finalized design stage and we're looking for sponsor. We have 2 interests. One is one of the governments who want to fund this and for the benefit of the planet. and one wealthy person with good intentions. We're looking for up to $50 million so we can then bring this prize to the table and then start a competition among hundreds of teams to help us to invent and scale age reversal technology and make people healthier and happier.

Well, healthier and happier. Let's look at that question. Why should we do this? Why should we be interested in considering aging to be a disease that we should be targeting just as we target coronary artery disease and Alzheimer's? What's the payoff here? Why should we do it? And then, after that, we should ask ourselves, should we do it?

Yeah, yeah, that's a great question. And, you know, I'm a super optimistic person, and I tend to think that the whole planet thinks exactly the same positive things about the longevity or any other ideas that we, or that I embrace. So, and it was pretty shocking to me. Then I realized, I was just looking at this study, I think it was done back in 2015, and people in the US and in the UK, in Great Britain, has been asked, if you would have an option to extend your life, by moderate 10, 20 years, would you take it? And we had only 35% positive response rate. So, 2/3 of the citizens just say no to, you know, probably any life extension opportunity, even if you put there healthy and happy years caveat. Our mental model is that when we hear a term life extension, and I think we are, you know, people who are who embrace that haven't done a great job with communicating this in a proper way. People think, okay, they're going to extend, they're going to add like 5, 10, 15 years right in the end of my life, where I am in the most risky, fragile stage of my life, when I require a lot of support, right, and where I'm powerless. So that's the mental framework that we all use for that. And obviously we just need to change it because my dream and And our intention is to help people to extend the most productive stage of their life. I mean, from my current 49, I think it's between 25 and 45, but obviously when I'm going to be 69, it's going to be probably somewhere around 25 and 65-ish, right? So that's the whole idea of that. And I do agree with you. It's not completely obvious for everyone. that adding this, even healthy and happy years, will be good for them. But my job is to create this option, and then I think that for the rest of the public, the rest of the people, it's really up to them whether to take it or not. But what I do know that, I mean, if you look at, well, all disease that we call— I call them killer monsters, which would create the major mortality risk after age of 50, like, be it heart disease, cancer, diabetes, and probably even neuro— well, obviously neurodegenerative disease. They all— you have exponentially increased risk of getting them after— with age, right? So, that's why I think aging is— there's a lot of disagreement whether aging is disease or a risk factor, but it's either or for sure. So, that's why— We're looking actively at this. And personally, I just want to have more time on this planet. As a father of 4 kids, I would like— they give me the reason to, you know, wanting to live more.

Well, let me say again, you know, just to clarify, what you're saying is that you're not trying to tag on 5 or 10 years on the end when people are debilitated. What we're looking at here is an effort to increase the healthspan, the period of time when we are engaged and we are productive. You used a term in another of your books called morbidity compression, which has become an adopted term as well, that we're trying to really extend the time where we're really able to participate in life. Yeah. But there are some pushbacks even with the notion of that, that, for example, If we reduce aging to the extent that people are able to engage longer, then we might have more people on the planet, we might strain our resources, and, you know, there is probably the sense that this is tinkering with things that we shouldn't, you know, that there is some law that we must age in order to pave the way for the so-called younger generation. How do you respond to that? I'm sure that's a mentality. How do you

respond to that? Yeah, that's a great question. I mean, if you think just being fact base here. In terms of our overpopulation, if you look at any reliable model of the world population figure, the growth stops around figure of 10 billion or 11 billion, somewhere between year 2050 and 2080. Our current reproduction rates in 20 most developed countries on Earth Below two, so if like for family, so that means that we're gonna have less people on the planet after if we continue to to live the way we do now. After year 2050, we're gonna have less people. So that's that's that's the thing. And even if you look at China figure, China today has like 1.4 billion people. China figure for the end of the century is. 800 million. So, that's an example of that. Well, the other thing which I'm always bringing here, these concerns actually have— well, resonates a lot with my own heart and mind. Because look at the way we live on the planet today. There's so many things that we need to fix in this world before we embrace the idea of living much, much longer. And that's partly the reason why 2/3 of people don't want to live longer, because if you look at the current version of the world that we created, well, inequality in US and in the world is just increasing, right? And that's a very sad thing. Or, well, think about the implication of extreme longevity on dictators like North Korea. They're going to have their beloved leader for 200, 500 years. Is it good or bad for them? I'm not sure. Or think about our social constructs like marriage. 2/3 of the marriages go into divorce stage, depending on the country, in the first 3, 5, or 7 years. Well, that means that our social construct of marriage should evolve in a way to support diversity of the choices that people have today. And then finally, just the whole collective responsibility notion for our planet and our relationship with Mother Nature. Hopefully, if we're going to live longer, we're going to be much more responsible for our actions. People will not be throwing the plastic because they would— them, not their next generation, would need to solve this problem as well. So, I agree with skeptics. We need to change the world, change the planet, make it a better place so we can— more and more of us will be comfortable with the idea of living longer. So, in a way, I'm developing this talk for TEDx right now. It started from the idea of, oh my goodness, radical life extension is great. to my quick realization that— and I call it actually morality of immortality. So this— I'm not a big fan of immortality anyway, it's just a phrase. But the moral side, the ethical side of it is super important for us to fix, for us to enjoy these extra years on the planet.

That said, should a technology become available, be it a drug intervention, a mechanical intervention, a genetic editing intervention, An epigenomic tweak, if you will. How do we ensure that we can democratize that sort of new technology so that it's not an elitist sort of intervention for just the selected few?

Yeah. Well, it's— I've been thinking about this for a while, and it's an extremely important question. Remember, part of my mission is is affordability and accessibility aspect. Well, partly it's solved by much more technological way that we use to solve this problem, right? Because the cost of technologies is always, even the new one, is always exponentially decreasing. Think about mobile phones. 20, 25 years ago, it was like $10,000 and only rich can have it. Right now, You go to China, Shenzhen, and you buy smartphone, proper smartphone, much more powerful than we had even like 10 years ago for $9, right? So, that's the technological answer to that. The other thing is obviously this is highly regulated area. And so, we have FDA, we have government and governments around the world which are looking at this space. And because it's related to human health, I'm pretty sure that regulations will be helpful here and will be developed to make sure there is a fair distribution of what is created, even for the first 10 years when it's protected. Some of these solutions are really cheap, if I can use this word. Think about it. We have very few candidates, like generic drug candidates for longevity pill, right? Obviously, you should not take them now, right? And we are in the beginning of the trials, like to test metformin or test rapamycin, whether they have positive side effect of increasing your healthy lifespan, right? But in the end of the day, I was just speaking to Nir Barzilai, good friend of mine, the man behind TAME trial. This is a trial of metformin. for 5,000+ people that, you know, we're planning to do in the US. And metformin is a generic drug. It has been known to us for 60 years, I think. And obviously— and the funny fact about this thing, so if you do a trial, you need to have placebo and you need to have metformin. In fact—

There are certainly plenty of retrospective studies that look at all-cause mortality that have validated metformin in terms of— Oh, yeah, exactly.

I'm not MD, so that's why I'm phrasing this in words of people.

Yeah, but you're a geek.

Yeah, yeah, yeah, I'm geek a little bit, yeah. So people don't rush to pharmacies.

I wear my geek badge with honor.

That's true. So people don't run to pharmacies to ask for metformin after our discussion. But the funny— the interesting fact about this TAME trial of metformin, the metformin supply for this trial is actually cheaper And the

placebo might well be a sugar pill, which might not necessarily be a true placebo.

Exactly.

But what you're talking about now is the idea of giving somebody a drug who does not have an illness, per se, is not sick. So, what does it take for people to begin to get their arms around the whole notion of this, you know, reducing the rate of aging? of biological aging by, even in this case, a drug intervention when they don't have any underlying illness. I mean, we live in a world of cause and effect, of kind of live your life however, and then when you have a problem, then you'll take whatever the drug may be. So, it does seem to be a bit of a paradigm shift that needs to evolve.

Exactly. I think healthcare system would not even evolve, should be radically transformed in this way. Because what we have today, and we shouldn't be, I mean, we shouldn't be super critical about healthcare system or moreover about people who work on them. I'm super grateful to them. And actually, the negative sides of today's healthcare system is just continuation of the positive side. So, this amazing specialization of different doctor specialties. It was great in the last 100 years because all of them developed the special unique knowledge in their own areas. But the problem is on the road to this specialization within medical profession, we lost the integral, the comprehensive view of the human body. And so that's one. The other thing for many, many years, well, like centuries, The only diagnostic tool that you have is when disease manifests itself. So, that's why we developed this very symptomatic reactive version of medicine because without diagnostic devices, like the first time you can discuss a problem with your doctor when it manifests itself, when it's stage 4 cancer. But, we just need to realize the world is completely different. We just invested in a company called Freenom. And, what they do, They use blood test sample with a lot of data from 100,000 people to develop toolkits for early diagnostic of colon cancer. They have portfolio of cancers to watch that, but then today, to make sure you understand whether you have or you don't have colon cancer is you need to do colonoscopy. every 5 years, well, depending on the protocol and the country, and it's invasive procedure. Even, you know, I'm like this super longevity enthusiast. I was delaying my colonoscopy for like 2 years. I was so afraid of it. So, what these guys do, because artificial intelligence can analyze all these biomarkers and they take a lot of— not 10, not 20 from a sample of the blood. There's very good proxy if you do— if you analyze this whole big data, you know, This diagnostic tool can tell you on stage 1 whether you have this risk of cancer or not. And depending on the cancer type, I was just looking at the statistics, if you detected cancer on stage 1, you've been really proactive about this whole thing, the recovery rates can be up to 90, 100% this year. 20 years ago, cancer was kiss of death. Well, not anymore. I mean, it's still pretty difficult disease. Cancer is still probably number 2 reason for death after age of 50+, but we're right in the middle of fighting against cancer. So, this is how shift from reactive stage 4 treatment of this disease and trying to save lives and how we can proactively address and look at the diagnostic of that and decrease the cost of healthcare by 10, 20 times. Wow. So, that's— this is what's happening in this space. It's just an example.

Yeah. I think that, you know, bringing up the whole cancer discussion, you know, we are probably now in longevity and aging where we were in the '70s, when prior to that, you know, cancer was pretty much luck of the draw, well, come what may, you got it or you don't. Then we saw the development, the understanding of oncogenes, and began to be in a place where we were a little bit more able to understand both mechanisms and be a little bit predictive by looking at those—

Yeah.

—the influences of oncogenes on the development and propagation of cancer. You have your finger on the pulse of the leading-edge technologies across multiple areas. Maybe we can walk through what you see are some of the promising candidates, and I know there are plenty of them right now. But where are we going with this right now? Who's leading the pack? And maybe we can unpack a few of these.

Yeah. So, when people ask me what is the most thing that I'm excited about, and I call it Horizon 2. So, this is technologies which will be available for us in 5, 10, 20 years, which will radically extend our ability to expand healthspan, right, to increase the healthspan for each of us. And then Horizon 1 is what you can do now. Is it diet? Is it your lifestyle choices? Is it early diagnostic, et cetera? We'll come back to that. So, then, Horizon 2 technologies are technologies that we're investing, that we're supporting through Longevity Vision Fund. So, what is the most exciting? We see just an amazing spike in gene editing and gene therapies. And, obviously, this is not the area of my biggest specialty, and it's not the area of my focus, but I think we have enormous inflow of capital into this thing. And, if you think about this, this is— If we will have an ability to alter genes to prevent specific disease, like we call it orphan disease or disease through— that we all like, of genetic origin, right, in some specific cases, we'll be able to save so many lives and increase the quality of life of people who are suffering from that. So, we call it orphan disease, right? If you look at FDA, regulatory framework. But, you know, they're not that orphan. 400 million people on the planet are suffering from these rare diseases, right? So, they have genetic nature. So, that's why— what I also like about gene therapy is it's also changing the definition of the drug itself, right? So, just, you know, what we used to have is is a white pill or just different color of pill, but that's basically you take it orally and that's it. Right now, you use— you can have gene therapy in specific encapsulated technology which do slow release in your body, right? And, some of the drugs, I mean, still pretty early, it has their own specific transmitting device which would help you to close feedback loop. Are you on the right track in terms of release of particular substance in your body? So, this is obviously pretty futuristic. So, this is 5, 10 years from now, but we just invested in a company. It was founded by— we call him Edison of medicine— by Bob Langer from MIT. And this is the man who was one of the founders of Moderna, right? So, this is where we're changing not only our ability to alter genes, but also the definition of what we call a treatment, what we call a drug. Obviously, there's just a lot of ethical implication here. So, I don't want to create perception that since we've done the discovery, it's all going to be automatically available. But yeah, I know that with this, we'll be able to help so many people who are in desperate need or who are dying earlier, who has or has genetic disease. So, that's one exciting place. The other exciting place is in organ transplantation and organ regeneration. This is part of regenerative medicine. Like a year ago, I think we invested in a company. They're Pittsburgh-based and it's called LightGenesis. And, what they do is their technology allows to use our lymph nodes as a place to regrow artificial organs inside our body. So, think about liver transplantation. As far as I know, you need to wait for donor for liver transplantation, and it's a matter of months, sometimes year plus. It's $100,000 procedure in US. So, that's just a lot of money. And, a lot of people just die by waiting for donor transplant, liver transplant. So, what they do in their technologies, and they've done it successfully with mice, With pigs, with dogs. And actually, this quarter, they're starting human trial. They just got FDA approval for that. So, they take donor liver, they split it in 50 to 70 pieces, and each of these, they use as a nucleus through simple operation. They put it in the lymph node. It's here, the one in our— just in our lower stomach. And, in the course of 3 to 6 months, our body, it regrows from this nucleus like Plan B, like ectopic liver inside our body, which takes part of the functions of our liver, right? So, this is how it works. Obviously, they're at early stage of development. They need to go a long way for this to be available to public, but results are super promising. That's why they were so fast to get FDA approval on that. And instead of matching one donor with one recipient and spending $800,000 on that and let people die in the course of waiting for 6 or 12 months, so we're going to save 60, 70 lives from that. And obviously the cost of it is just decreasing exponentially. So that's for me an example of how technology and science can can bring affordable and accessible solution to our current problems. And funny enough, probably the third piece that I— there's so many of them. There's just a lot of things that we— just happening in the world is I'm still hopeful about longevity in a pill. I'm still hopeful that it's going to be generic drug which would have a positive side effect that we already know, like metformin, rapamycin, you know, some drugs, which we will test and do a trial in the next 5 to 10 years, and which would, you know, be helpful in adding at least 2, 4 healthy and happy years, and insert it within our lifespan. So, that might be great. It might be generic. It can be a new drug developed with the use of, you know, human knowledge, experience, and a bit of artificial intelligence. But we obviously, we so get used to this concept of taking drugs, so I would not be surprised that right now, it's not going to be disease-specific, but it's going to be addressing aging at its core. So, I'm really hopeful with that one.

But there might well be some implication for just making some dietary changes in terms of what we eat, how often we eat. How much we eat? Where are we on on that understanding?

Yeah, look, and and probably because you know my longevity and healthy journey started from Brain Grain, the book of yours. I probably have it here. Yeah, yes, that's the revised

edition. I'll have you know.

Oh, really? Yeah. So I'm still I'm so proud. I mean, you gave me the the latest one last January. And my wife is reading this now. So, where we are on that, obviously, let's come back to Horizon 1, right, as I call it, what we can do today to live healthier and happier version of our life. And obviously, dietary choices is a great area to start. In fact, it's so important that I even wrote a small book called— I can show it to you. Like 10 Simple Principles of a Healthy Diet. It's a 100-page book, very simple.

It's a wonderful book. It's well illustrated. You know, it got my— I was very impressed with that book. And we're going to have a link to that book if you go, viewers, if you look back at the blog post for this episode.

Thank you. Thank you very much, David. And in fact, so when people ask me, what are the things that I need to change to increase my the quality of my life today and provide the platform for the future healthy living, I'm always starting like, do your annual checkup because early diagnostic of cancer, heart disease, diabetic is super important. And then, the most important choice that you can do on a daily basis, not on annual basis, is your diet, right? And, if this is heavily plant-based, You take out the processed food and there's so many principles that you can apply to that. And that's— so I took, after reading your book, I just take out this whole kind of gluten thing. And I think it was the second book called China Study. I decided not to be so heavy and focused on dairy. And well, that's just completely changed the quality of my life. I mean, my skin, my level of energy that I have. And frankly speaking, plants, they have such a low caloric intensity. So even if I would have like a full table of plants, you know, I'm still going to be fine in terms of calories. And obviously plants is much more healthier for us rather than just relying or over-relying on the protein. I'm for balanced diet, but unfortunately the food choices that we have in a restaurant, in fast food, or in our supermarkets So, you need to take these balancing decisions on your own.

Well, balance, I think, is really very important to get back to a couple of things that you brought up earlier, and that is this AMP kinase pathway and the mTOR pathway. You were talking about things like metformin, and we certainly know that our dietary choices, both in terms of what we eat and how much we eat, influence both of those pathways. We've had on the program the author of this book, James Clement. The book is called The Switch, and that really talks about how we can cycle through back and forth between building tissue and breaking tissue down, which happens to be a good thing. Autophagy is extremely important in terms of recycling damaged cellular material, cellular debris. We've learned a lot from— we had on the program recently author of this book, Dr. David Sinclair from Harvard, who really makes a very similar argument to what you, you just said. And— Oh, I'm sure it's there somewhere.

Yeah, there's somewhere. David is a good friend. We actually invested in his company called Life Biosciences, and I'm visiting him in Harvard Medical School right before lockdown. Amazing man and beautiful book.

Yeah, it's a terrific book. So, And he emphasizes that not just what you eat, but how frequently you eat and how much you eat. And I think that, you know, looking, for example, at the Okinawan study where there was 20% less calories and how their longevity was impacted positively by that, and it really brings up the notion of low-level stress by not eating, by intermittent fasting.

Yeah.

That we call hormesis. And when we stress our bodies in certain ways, we activate certain pathways and even some genetic pathways. So, in a real sense, we are cultivating better gene expression without having to, you know, have CRISPR technology available to us to edit our genes. Through changes in the epigenome that we can induce, we can change gene expression, and that's a pretty empowering concept. I think, you know, you've talked about the notion of how we can change this modulator of gene expression, this epigenome, as being really one of the central players also in what you see moving forward in terms of technology.

Yeah, I agree. I think we sometimes, you know, we have this notion, oh, you know, I've been unlucky in genetic lottery. This is why I have extra weight or I could not do this, this, and this. But, what I learned through investing in longevity and just being overall part of this space that, well, yes, probably 1/3 of your choices and how healthy and long you're going to live is predetermined by genes, but 2/3 is your own choice. And then, The other thing which I think pretty important that you just touched on that you can actually create the reverse feedback loop, right? By your lifestyle choices, you actually modify genetic expression and your epigenome. And I've seen so many people changing their lives through dietary, physical exercise choices. And then this is even before we speak about peace of mind. Yeah. you know, the importance of the mental health is also— is the current focus of the world, and it's very complementary to your physical health as well.

Yeah, and as a matter of fact, I do have an interesting interview coming up with Elissa Epel, who writes The Telomere Effect, and she's a psychologist, and she talks at great length in this book, which I haven't finished yet, About exactly what you said, the effects of our state of mind, our mental health, on directly how that affects our telomere length, and as such, how it might impact aging and longevity. So, you're right, especially these days when our world is very stressful. Oh, yeah. The world has, as you and I were talking about before we went on, has become very stressful. Interestingly, though, there's an interesting interplay between some of the pathways that are getting a lot of attention as they relate to aging and longevity and immune function as it might relate to our response to COVID-19.

Yeah.

For example, we know that NAD levels play a very significant role in the action of certain enzymes in the body that are called sirtuins. That regulate things like immune response, inflammation, and DNA repair, that lower levels of NAD lead to less functional sirtuins, shorter telomeres, I might add, and less functional immune system. We see lower levels of NAD in people who are chronologically older, who have type 2 diabetes, obesity, coronary artery disease, other chronic degenerative conditions. So even via the notion of amplifying their NAD availability via supplementation, or we know that exercise, for example, and caloric restriction amplify NAD levels as well, amplifying these pathways that are intimately involved in longevity and slowing the aging process, but may have a real important role to play these days as it even relates to immune function. I think it really brings up this interesting interplay between immune capability, immune balance, if you will, and aging. I mean, I think so much of the work focuses on the notion of senescence of our immune cells, how these senescent immune cells ultimately amp up the process of inflammation, and how widespread is the damage and the downstream effects of inflammation from that cardinal event of the senescence of our immune cells. And you've talked about, and, you know, you did this wonderful monograph, which is The Future of Longevity, that you were kind enough to give to me. Oh, yeah. You talk about, you know, the notion of cellular senescence and senolytic therapy and what we can look for there. So, but, you know, there's a lot to be said about lifestyle. I remember at the XPRIZE, that first meeting, I was speaking to the individual who wrote the foreword to your book, Aubrey de Grey. Yeah. And he said quite categorically— we were talking about lifestyle, about getting enough sleep, intermittent fasting, the type of diet, etc. And he said, going to be technology, meaning, you know, some form of technological/pharmaceutical sort of intervention. And, you know, no one's taking anything off the table, that's for sure. But if If our viewers want to know, okay, you know, I watched the interview now with Sergei Young, and what a great last name, Young. What can I take home today? And I think the first thing would be take home your book. I mean, in your book, you'll learn about, and there'll be a link in the blog, learn about, you know, what you've discovered about food. But, you know, let's not downplay the importance of some really important lifestyle choices, things that our viewers might want to implement today. So maybe we can just give a short list about some of the things that people can implement starting today that may, we don't have to promise, but that may have an impact.

Yeah. I actually have on my website, it's sergeyyoung.com, there's an infographic that you can download. There's just a lot of free stuff. The whole longevity project for me is pro bono. This is me sharing my knowledge and passion with the world. So, it's called 10 Longevity Choices. And this is what we can do today. This is how we stay, as Ray Kurzweil say, on longevity bridge. Because in 10, 20 years, when all these technologies which we discussed today, David, and the audience, are going to be available for us, we want to have our body and mind in the best state. So, we need to stay on this longevity bridge. So, And then lifestyle choices, again, I call them 5 buckets of Horizon 1. There's 5 things that you can do today. And you obviously is an expert, there's so many of them. So, these annual checkups, the importance of early detection and diagnostic of some of the disease. So, that's super important. The second I call don't die stupid, right? So, it's just about bad habits. Yeah. Statistically, minus 10 years from your life. Or like in our family, we have a zero alcohol tolerance policy for car driving. In some of the states, you can actually have glass of wine and drive the car, but we just don't do that. And then the third piece is the most important piece is the diet, right? And if I would pick up like one thing to change, this is what I would do. And obviously, heavily plant-based, lower caloric restriction, making sure you know the sources of your meat and fish. So, make sure they're organic, less antibiotics, hormone growth, et cetera. And the 4th piece is physical activity. I love trackers, so I'm using Apple Watch, but you can use Fitbit, Halo, whatever you like, Oura Ring, et cetera, because it motivates me to do 10,000 steps a day. And this is where my foundation for physical activity, and I do a lot of calls when I'm walking. And then you just add stretching, some other form of exercise that you like. And number 5 is what we call peace of mind. This is your sleep, is your meditation, is a way to decrease cortisol level in your body, feel less stressful. And act of kindness. You would— the best longevity pill or the opportunity to live longer, healthier, and happier that you have is to have a mission in this life and share your best in this world. Think about some people like, I don't know, Dalai Lama or people whom you know who practice spirituality or doing something good for the planet or for for their community, etc. And they're all shining, and they live longer, they look younger. So, having a sense of purpose, being grateful, being kind is actually super important as well. So, that's the positive side effect of your desire to live longer and healthier and happier.

Well, the Dalai Lama said that if you want others to be happy, practice compassion. If you want to be happy, practice compassion. So, hey, it— maybe it's selfish to be compassionate and empathetic because it does you some good, as you just described, but that's for sure. Sure, but certainly does good to the recipient of that compassion as well, which might just be the planet. It's not just directed towards other people, but this shared planet that is so very kind to us. Sergey, thank you for spending time with us today. I know that our viewers have gotten a lot out of this. I think also it's very encouraging in terms of what the future could look like. You know, you're really helping us understand that and really facilitating moving the ball down the field in terms of where we could go. We certainly know that coming at this disease of aging from multiple perspectives is really going to pay off. And, you know, that is really the upstream issue as it relates to all the other chronic degenerative conditions that are, you know, crippling our planet. This is something that really stands at the headwaters. Good on you. I appreciate knowing you. I appreciate the fact that we got together out in California and connected thereafter. I very much look forward to what's next in your life. I'm hopeful to stay in touch and learn about that.

David, thank you very much. reciprocity. I just want to thank you for your support. Without knowledge, you know, by writing your books and spreading the kind of longevity and health news and principles, you helped me to change my life. And obviously, you know, when we got together a few years ago in California, thank you for your support for this, you know, amazing, uh, you know, seminars, webcasts, books, and everything you share with the world. Thank you. And to the audience— Thank you. Please stay healthy and happy.

What an incredible overview we've just had that looks at really the state of the art, where we are today, and certainly what the future looks like as relates to the actual treatment of aging. Considering aging a disease, we know that it's related to so many of our other chronic degenerative conditions, and really the future does look bright, especially when we have people like Sergei Young involved and dedicating themselves to exploring this incredibly fascinating universe. Thanks for joining us today. I'm Dr. David Perlmutter. We will see you soon. Bye-bye. Bye.