How Daily Choices Affect Aging - with Dr. Frank Lipman | The Empowering Neurologist EP. 106

Well, hello everyone. I'm Dr. David Perlmutter. Welcome again to The Empowering Neurologist. Our guest today is Dr. Frank Lippmann. Many of you probably know Dr. Lippmann. He's been on our program before. He has a new book out called Aging Well: The New Rules of Aging Well. And I want to just touch upon this whole notion that, you know, these days we're hearing about certain things that can happen to us as we age chronologically, and I think it's really important that we differentiate between the number of birthdays we have and how our bodies are actually looked upon in terms of are they aging well or not. My point is that you can be 70 years old in terms of your birthdays, but you could be 60 years old in terms of your biological age. Or 80 years old for that matter. And the point is that Dr. Lipman brings out to us today is that many of our choices, our lifestyle choices, factor in, play a big role in determining how we are aging. How is our biological age? How is our immune system functioning? How are we quenching free radicals? How are our telomeres? Are they remaining healthy? And we're going to have another interview coming up very soon about the whole idea of keeping our telomeres happy and healthy. But let me tell you a little bit about about my good friend, Dr. Frank Lippmann. He received his initial medical training in South Africa and then came to the US in 1984. He then became board certified in internal medicine. He did serve as chief resident at the Lincoln Hospital in New York. And over time, he became more and more aware of both the strengths and weaknesses of his training, as have we all. And as such, he broadened his horizons, began looking at alternatives, studying things like acupuncture, Chinese medicine, functional medicine, certainly looking at nutrition, how important that is, herbal medicine, meditation, yoga, and as he talks about in the new book, tai chi as well. He is recognized as a vocal advocate and pioneer, if you will, in integrative and functional medicine, or what he calls good medicine. He is the founder of Eleven Eleven Wellness Center. And the Chief Medical Officer at The Well. And he is certainly well sought after in terms of speaking engagements. He's the author of 6 bestselling books, several of which we've talked about before on this program: How to Be Well, The New Health Rules, Young and Slim for Life, Revive, and Total Renewal. And his latest book, The New Rules of Aging Well, that we are going to talk about today. So let's— jump into talking to my good friend, Dr. Frank Lippmann. Well, Frank, it is so good to see you.

And likewise, absolutely wonderful to see you.

Yeah, albeit virtual. I'm sure the time will come when we'll go to dinner in New York again, and it'll be great. But meanwhile, you've put out this wonderful new book called The New Rules of Aging Well. So right off the bat, I mean, we have a number of birthdays that we have, we have our chronological age, but your book is clearly not dealing with that, it's dealing with our biological age. And I think, you know, your main thesis is that ordinary choices that we make can have extraordinary benefit in terms of our outcome. So where do we begin?

Well, I think that's a great point. And, you know, as much as I believe, as you believe, the importance of diet and sleep and exercise, It's these ordinary choices we make on a daily basis that probably have as much, if not more, effect on our longevity and on our health. Whether it's having some gratitude, having some purpose in life, being kind to others, spending time in nature, listening to music. You know, a lot of these activities that we don't really classify as medicine. Actually have extraordinary healing effects on us. And we unfortunately have— we don't accept it, or we've compartmentalized medicine into the doctor's office. And, you know, these things are as much medicine as any particular drug or supplement or exercise.

Well, early on in the book, you talk about these and other lifestyle options, choices, in the context of activating, for lack of a better term, longevity genes.

Yeah.

We do know that conserved from, you know, from very small organisms up through— up to mammals and primates and humans, there are some gene pathways that seem to be associated when activated with extension of our lifespan. So tell us what that means, that we have the ability to, to some degree, control these genes, and maybe we can walk through what they are.

Sure. I mean, I don't particularly care for the term longevity genes, but I sort of named them as such because that's sort of what's getting out there in the culture. And I agree with you. I think, you know, the term you use, longevity pathways, or these pathways, That we can affect by how we live our life, and yes, we born with a certain set of genes, but how how those genes are expressed is is determined by how we live. For instance, I have terrible genes. I just you know a couple of months ago did my genetic pathways with this actually wonderful new genetic group, the 3x4 gene genetic. Pathways, which is actually a functional medicine-oriented genetic test. And I have terrible genes, which I knew, you know, for heart disease, I have the ApoE3/4 gene, for vascular health, heart disease, inflammation, you name it, my genes look terrible. So you can take it one way and say, oh shit, that's it, I'm doomed. And my father died when he was 54, my brother had a heart attack when He was 50. I'm 66, and I think I'm still thriving. And you know what? What that those tests did for me showed me that you know my propensity is for this metabolic ill health, but I can change it, and I have changed it by how I live my life. And that is you know with diet and with exercise and with stress reduction and how I sleep. But as we said at the beginning, I think even more important is having a passion for life. Both of us are passionate about changing the medical system. You can be passionate about your kids. Volunteering can be your thing. But there are all these little things that one can do that are going to affect how these genes are expressed. And in particular, the couple of gene pathways, the mTOR, the mechanistic the mechanistic target of rapamycin and the cyclic AMPK pathways, which I know you've spoken about for years. I mean, I've been in some of your talks where you and Rob Roundtree, a couple of you guys, have shown these pathways and, you know, how these pathways are affected. And it's interesting that a lot of the same things affect these longevity genes or these pathways. And They turn out to be very similar lifestyle changes.

It's really quite remarkable that almost no matter how you slice it, it always comes down to the same usual suspects of exercise, diet, sleep, stress, gratitude. It's— no matter who you talk to these days, it seems like it's all ending up in the same place, and that should tell us something.

Right, absolutely, and then there are a couple of hacks which I put in the book that we all are doing now, and fasting, for instance, is a really important hack, and I remember Jeff Bland talking about hormesis probably, what, 20 years ago? This concept that a little bit of stress actually makes you stronger, you know, a little bit of the idea that a little bit of stress is good for you. Chronic stress is bad for you, but a little bit of stress is good for you. Jeff was talking about this many, many years ago, the hormetic effects on plants, why organic plants actually probably are better for you for many reasons. But that stress that plants go under make them have more phytonutrients, so they put They're protective of themselves to the outside world, but they're also better for you, for the humans to eat, because they have more phytonutrients. But you can extrapolate those hormetic effects onto our body too, and fasting is one of the classic ways that we can stress our body in a small way, which have very powerful effects on our health and on our longevity genes. And that's just one way of doing that. Yeah.

You know, um, again, it's, uh, we're having a discussion right now that we are talking about changing our genetic expression. And I will submit to you that, you know, years ago, uh, this would have been thought to be really way out there, almost heretical, that, uh, we could, uh, take actions that would change our genetic expression. And yet You know, now we talk about it day in and day out about the notion of epigenetics. And it's, yeah, it's for some, I think, even for many of us, it's still kind of difficult to get your arms around it after we were just inculcated with this dogma that genes were one-way pathway and fully determinant. Whereas you said something earlier on that now that you're aware of this perhaps maladaptive genetic predisposition that you carry, that we all carry. I mean, I have a bunch of MTHFR polymorphisms that I'm not happy about, but the fact is it's empowering because I do know that. What you talk about at the end of the book, which I think is exceedingly valuable, are ways of testing the downstream possible manifestations of those altered genes that you may have, these unique genes that make Frank Littman, who he is, that you can look at C-reactive protein, interleukin-6, tumor necrosis factor alpha, homocysteine, for example. Look at your various hormone levels, vitamin D levels, etc., which are downstream manifestations of some of these gene pathways, and therefore give you some powerful information as to, well, yeah, I carry the genes, but have I personally chosen to override what those genes are capable of doing in a positive way. And I think what you talk about towards the end of the book in terms of that list of laboratory studies that anybody can get when they go to their doctor, I think is exceedingly, exceedingly valuable. And I want to get back to— you alluded momentarily a moment ago to these longevity gene pathways, for lack of, again, a better term. But you talked about something called AMP kinase and the mTOR pathway. I think more and more of our listeners are hearing these terms. We've interviewed several other authors who've talked about them. But I wonder if you could just— let's just talk about this AMP kinase and a measure, a marker of energy availability in the human body, and how it regulates genes downstream, but also, more importantly, I think, what can we do as it relates to this pathway to take full advantage of it in terms of longevity?

Right. So I mentioned, to me, one of the powerful, most powerful hacks— I mean, I don't particularly like the term hacks, but it is, in a way, a hack— is fasting. I think fasting affects these longevity pathways, these longevity genes, in a really positive way by inhibiting the mTOR, which is what we want to do, and stimulating the AMPK. Dietary changes, you know, I remember first hearing, it was you, I always remember this so clearly, when you started talking about a keto diet, I don't know how many years ago, and I was like rolling my eyes and I said, this guy's lost it. And you're right. But I remember, this is a long time ago. So, you know, these dietary changes, particularly low carbohydrate diets, can do that. There's certain nutrients that seem to come up in these pathways all the time, you know, whether it's curcumin, whether it's resveratrol, quercetin. Quercetin is one of, you know, I've become a huge fan of quercetin, and I think You know, and I had this aha moment once listening to a lecture by Bob Roundtree, and he was going through all these longevity pathways, and you see all the same nutrients coming up as affecting these longevity pathways in a positive way. And, you know, and it's the same thing, it's that low-carb diet, it's the fasting, it's the exercise, it's bringing down the blood sugar, whether it's sometimes with berberine, but also the curcumin, the resveratrol, the quercetin, all seem to come up. And as you said, it's a lot of the same things which affect these different pathways and getting the same results downstream. And what we do now, you're not practicing much anymore, but I do a lot of clinical Patients still, and you know I'm doing a lot of longevity stuff, and we now measuring all these markers. So we do a lot of these markers. We often do a genetic test as well, and we just mix that with lifestyle. And it's very interesting how simple lifestyle changes make huge effects on these biomarkers, and relatively quickly. So you know within you know we'll do a set of bloods within two or three months. Three months we usually. We'll repeat it, and within 3 months, when people start making changes— for some people, it's stress reduction. For some people, it's sleep. Most people, it's diet. Some people, it's more supplements. It's remarkable how efficient our body is to change and how quickly it can make changes. It always— It bothers me that we have these 2 epidemics going on at the moment. We have the epidemic of COVID and at the same time we have this epidemic of metabolic ill health that no one's talking about— not no one, but not many people are talking about. And it's actually fairly easy to affect this epidemic of metabolic ill health with lifestyle changes, and that would probably have such a huge effect. Yeah. On, you know, the poor outcomes we're having with COVID and I just wish we could get this message out there. I mean, it would happen before vaccinations already.

Well, you just brought about a really important connection that I'm hoping all the viewers of this podcast got, and that is this relationship then between the epidemic of metabolic issues and including things like coronary artery disease, hypertension, type 2 diabetes, obesity, and risk for bad outcome as it relates to COVID. So if, in fact, our lifestyle choices relate to the former, in other words, the chronic degenerative conditions, and there's a relationship then between those conditions and bad outcome with COVID then it's fair to say by transitivity that our lifestyle choices should be playing a role in terms of our outcome as it relates to getting this infection. So, you know, I think I would probably like to explore that a little bit further. But I want to get back to something we were talking about in terms of gene expression and the notion of small stress or hormesis that turns out to be positive. You know, it's important to recognize why would stress in an isolated event somehow be a positive for us, lead to better— or gene expression of genes that can help keep us alive. And I think if we put it into historical context, for example, fasting is telling our bodies in our hunter-gatherer days, if you will, that we better make some changes right now in our energy utilization, the liberation of calories, etc. Because we're starving, there's no food around, and we've got to do something right now to make sure that we're able to persevere. So that is the impetus, if you will, probably not a good word, but the impetus for your genes to light up in a certain area that says, we're in preservation mode right now. And more importantly, or at least importantly, we've got to do everything we can to preserve our muscles so that we can get food, but even most importantly, we've got to make sure that we have fuel for the brain because it's the brain that determines our ability to get back on the gravy train and find some food. So, we are activating— when we stress our genome, we're activating highly conserved genetic pathways that allow us to ultimately survive. and reproduce. So that's the power of what it is that you wonderfully brought to our attention in your book, and that is that these small stresses, when they're positive, we call it hormetic response, are activating these pathways that are ancient and that are designed to keep us alive and keep us healthy so that we can continue on with our Our species. That's how deep and immutable these pathways really are.

Right. And they're actually relatively easy to stimulate or to activate. You know, my favorite is extreme temperatures, going from— you know, I'm a big fan of saunas, and I'm, you know, I go from a sauna into either cold plunge or a cold shower and sometimes not enough, go back into the sauna. But that change, going from the extreme heat to the extreme cold, is a very powerful mechanism. And people can do it. You don't have to have a sauna. You can go from a hot shower to, you know, do half a minute of an ice-cold shower, or cold, you know, end off with a cold shower. You know, that change in temperature does the same thing, as does high-intensity interval training. You know, when you're exercising, it's just as easy to just put a little bit of a spurt of extra energy into whether you're cycling or running. But these little spurts are extremely powerful too, for the same reason, stimulating those genetic pathways.

Well, I'm going to be interviewing, 2 days from now, Wim Hof. And so we'll be exploring—

Oh, that's exactly it.

Cold exposure and breathing exercises.

Yeah.

At our house, we actually use his name as a verb when we go into the cold pool and all that. We say, we're going— I'm going to go Wim Hof now. So,

yeah, yeah,

I look forward to interviewing him. But again, you know, it gets to this notion that we can make simple changes in our lifestyle choices that can have huge effects on activating gene pathways. In your discussion of these gene pathways, you quickly began talking about what many people have heard of now, telomeres or telomeres, which are these protective end caps, if you will, on our chromosomes. And there does seem to be a relationship between disease resistance and longer, healthier telomeres. What do we do to take advantage of that information?

The same thing that we do for all the other things. You know, meditation has been found to lengthen telomeres. exercise, sleep. Now, you know, this is the boring thing, you know, as my daughter says, Dad, you're just saying the same thing over and over again. But that, unfortunately, or fortunately, is a reality. A lot of these mechanisms, the underlying lifestyle changes, affect all these different mechanisms in a positive way. So we can talk about longevity genes, we can talk about telomeres, you know, we can talk about these markers, but ultimately it's about getting good sleep, dealing with your stress, eating a low-carb diet, probably eating less, you know, fasting, exercising, and then, as we both always come back to, those ordinary things you can do on a daily basis, having gratitude, being kind, volunteering, having purpose in life, all You know, things that we take for granted, being in nature. I mean, you've just spent 5 months on a boat. That's probably more powerful than any drug you'll ever be able to take.

Well, you know, your comments about sleep and activity, you know, these days there are so many ways that people can track that and get informed in terms of reaching goals. I wear this and I have it on right now, Oura Ring. Me too.

There you go.

So there's a plug for Oura Rings. So I have a pretty good sense I get a sense as to the quality of my sleep. Yeah. Importantly, I get feedback. If I ate dinner too late or if I had chocolate or whatever it may be—

Yeah, absolutely.

—that affects my sleep, I know moving forward that's not going to be my choice. I'm going to continue to refine the program until I'm always getting a 94 to a 97. That's my goal, and at least an hour and 20 minutes of deep sleep for activation of the glymphatic system. Hopefully cleaning out the detritus from my brain.

Exactly. And I think there's the Oura Ring, and I was actually just speaking to a young woman who actually told me to send her regards, Casey from Levels Health.

I'm waiting. I just finished doing that, filling out my—

I'm also going to do it. She's a friend of your son. You see, they're doing this continuous blood glucose monitoring, which I think is Just another way of monitoring and getting the feedback from the changes we make. I think that's the future.

That's great. It's a lot of information. All right. Our listeners, our viewers know that we're going to tell them eat less sugar, that the type of dietary fat they consume is important, when they eat is important, how late they eat in reference to going to sleep is important. Sleep's important. Getting outside, hot and cold, they know all these things. But in your book, you have a few other outliers that many people may not be familiar with. And the first has to do with how do we treat our fascia? So maybe you can tell us what that is and then why we specifically want to target that.

Right. So I've been obsessed with fascia for many, many years, being, you know, studying acupuncture. And trying to understand how acupuncture works from a Western perspective. Because when you go to acupuncture school, you learn about meridians and this energy, and I always was struggling to understand it from a Western perspective. And in fact, the first time I heard Jeff Bland speak in the late '80s, mid-'80s, whenever it was, about functional medicine, that was my first aha experience of someone talking Chinese medicine from a Western perspective. So I was always trying to, you know, understand what is this mechanism of meridians. And so as I started studying more and more acupuncture, I got interested in what the fascia is. The fascia is this thin connective tissue-like substance that surrounds all your muscles all your organs. It's connected from head to toe. And I started thinking that the fascia may have something to do with acupuncture because when I started practicing and messing around with needles and releasing this tight fascia, I actually realized that there's some connection between meridians and fascia. And now I believe that the fascia is actually the medium that the acupuncture meridians run in. So from a Western perspective, this fascia, which is this thin tissue that surrounds all your tissues and your muscles, is this in a way a protective medium. And when you injure yourself, your body protects itself by the fascia sort of thickening or protecting that area that you've injured. And when that gets tight, what happens is your muscles don't function as optimally. So you get certain— let's say you injure your ankle, the fascia will tighten around your ankle, and that will lead to less firing of certain muscles that insert into the ankle. So when your muscles in your leg aren't firing properly, then it's going to put more strain on your hip muscles. When your hip muscles get overloaded, then you're going to get some back pain. So it's really important to free up the fascia to optimize the movement of these muscles and the tendons. Otherwise, your body starts compensating. And as we get older, our ability to repair from injury decreases somewhat. And often you'll get an injury and the fascia will tighten. And if you don't sort of deal with that fascia, you're going to— your body's going to compensate and you're going to get some disability and over time can lead to problems. And I think, you know, we old farts now, David, so it becomes more and more important to treat these injuries earlier so your body doesn't tighten and compensate because, you know, as you get older, you want to still stay limber and you want to move around, you want to enjoy your grandchildren, you want to enjoy the sports you do. So it's really important to take the fascia seriously. Even in functional medicine, I've always felt the musculoskeletal system has been sort of put to the side and the importance is not— now we're understanding that muscles have a metabolic function too and they're important for metabolic health. But I think it goes beyond that. I think just the movement of the muscles over each other and the movement of the muscles with each other and with You know, with the joints is really important, and the fascia is key in that.

Well, I think that point well taken on muscles and metabolic health. I mean, it's really quite clear that muscle tissue plays a really important role in the whole insulin resistance-diabetes continuum. We know that, you know, the ability of muscles to absorb glucose is really fundamental to maintaining adequate glucose levels, and subsequently, of course, in the liver as well. And, you know, that this failure is what characterizes, you know, insulin resistance and ultimately diabetes and all of the downstream manifestations. And we now recognize that it's probably this, at least in muscle cells, this GLUT4 transporter that is really the, the focus of, of much of the issues as it relates to the development of our inability to bring glucose into the muscles and make glycogen. And what's the best thing we can do to target that, even to perhaps bypass the, the functionality of insulin? And that is through AMP kinase via exercise. Who knew? So exercise is a powerful way through activating this AMP kinase to help us with our blood sugar making glycogen in, you know, both the GLUT4 transporter and the GLUT2 transporter in the liver. So exercise, I mean, maybe people don't necessarily understand or choose to understand all the biochemistry that's involved here. The bottom line is exercise is good for you, helps keep your blood sugar where it needs to be, and as such reduces this primary mechanism that is so fundamentally related to aging, And that is inflammation.

Right. And what I see a lot in my practice is people get injured and they don't treat the injury properly. And then it leads to, you know, not being able to exercise properly. And that, you know, just leads to all sorts of, you know, as you were saying, metabolic problems. So it's really important to Try either avoid injury if you can, so don't push yourself too much as you get older, but when you do get injured, just be very aggressive about treating it quickly and properly.

I think that you bring up a very good point, and that is exercise is what we call a U-shaped curve, that if you don't get enough exercise, you're going to have problems. If you get the right amount, sweet spot, Goldilocks zone, that's good for you. But if you overdo it, like you were just alluding to just now, then there— when you exceed, for example, your ability to deal with the high level of oxidative stress or the free radicals that you create, if we could use that parlance, then damage occurs to mitochondria, to DNA, etc. So that there is a sweet spot, like there is for blood sugar, like there is for insulin levels, like there is for vitamin D levels. that you don't want too little, you don't want too much, you want to be in the just-right zone as it relates to sleep, for example. We know that Alzheimer's— Right. —is correlated with not enough restorative sleep and actually too much sleep as well. So I think it's about understanding and defining what are those sweet spots, and once you get that, to ask yourself, what metrics do you have to define The sweet spot as it relates to you as an individual, perhaps based upon your genomic testing that you may have, or even your metabolomic testing that you may have. And perhaps someday, or some people are claiming they're able to do it now, even your microbiome information could give you a better tell in terms of what you should be— what your goals should be in terms of these lifestyle issues, what you should eat. how much exercise, sleep, etc., you should get. You know, there's one area that I'm having a tough time trying to make the hormetic discussion real, and that is as it relates to sleep. You know, if you don't get one good night's sleep, just one night, you activate your amygdala, your part of your brain, the fear center of your brain, if you will. By as much as 60% from just one night of non-restorative sleep. So I'm trying to figure out what is the level of lack of sleep that's going to be good for you if we want to go with that model. The only thing I've been able to come up with is, oddly enough, as fate would have it, I'm not sure how to explain this, why it would be good for us, but if you get a bad night's sleep, you actually... Okay. turn on the production of BDNF, brain-derived neurotrophic factor, that allows you to grow more brain cells. Now, that doesn't continue, but one night of crappy sleep actually augments BDNF. So, um, I guess maybe that's a hormetic effect of not getting a good night's sleep.

That's interesting. I never even thought of sleep and hormesis. That's really interesting. Yeah.

I hate this terrible pun. These are the things that keep me up at night. Not really, I don't stay up at night. But another outlier that you bring to our attention in the book is you spend— you have a good discussion there about the importance of taking care of our feet. And I can't say that that's a topic that's gotten a lot of attention in, you know, the other books that people are putting out that reference our health.

Well, I got turned— you know, there's this lovely, wonderful, crazy woman in New York, which she actually is all over the world now, this Yamuna, who I was lucky enough to meet and work with. And she made me realize the importance of your feet. And when people have feet, you know, foot problems and the consequences and how we walk in these, we spend so much time in shoes that are not particularly good for the way we, you know, our structure and our mechanics. So I think I was going through a stage where I was just blown away by meeting her, working with her, and her pointing out the importance of feet that I put it in there because that's something new for me too. But I think she's, you know, it's spot on because, you know, I've seen over the years people come in with back pain or hip pain or all sorts of pains. And often it's because they have flat feet. It happened to me. My arches had collapsed. And as soon as I started supporting the arches, a lot of things changed. And when you think of it, we're spending most of our day on our feet. And if the mechanics and the structure are off, that is going to affect all sorts of mechanics in your body. So it just makes sense. And I had seen that, but I'd never really realized the real importance of it from her perspective. And she's probably right. You know, I always used to think about feet as when the mechanics are off, it's going to affect mechanics in your body generally, and you're going to have some aches and pains. But she's going further to say, and she actually has a book coming out, I should hook you up early next year. You should do a podcast with her. She's a very, very interesting woman. She's just been doing bodywork for the last 40-odd years. She talks about how, in her experience, how it actually affects your organs as well, which is very, very possible. So I've become much more intrigued by feet and people's shoes because if you look at especially women, unfortunately, they're forced to wear high heels for whatever reason and what we do to our feet is not particularly good for our health.

Well, you'll help me get set up. I'd be happy to have her on the podcast. Your co-author of your new book, Danielle Claro, tell us what she offered.

Well, you know, she did the other book with me, The New Health Rules. She's got a way of taking complicated information. I give her the information, she has a really nice way of simplifying it, simplifying maybe too much, because, you know, we had this back and forth when I used to say, well, that's just too simplistic. So You know, it's always this fine balance. I'm always wanting to take complicated information and make it accessible for people. So she just really helped take that information. You know, this is why we came up with longevity genes, because when I started talking about longevity pathways and more complicated information, she had a nice way of taking that information and simplifying it for and making it user-friendly for the mass audience. So that was her, you know, she was really helpful with that.

Well, I know that has incredible value because I know when I write my books, you know, I'll take— there'll be 15 pages there where I'm really getting into something after, you know, I end up— I don't type really well, I dictate. And I dictate, I just close my eyes and I start going. And then my writer, Kristen Loberg, will look at it and it'll come It'll be a page or maybe even a couple of paragraphs. And I say, what happened to all the rest of the information? Then she says, you want to try to simplify it. Yes, exactly. So, you're very blessed then to have that opportunity. I wanted to let our viewers know that beyond the content of your book, and you always do this, and I think it's really super, is the quality of your book is like no other. I don't know if people can see it, but this is high-gloss, wonderful coffee table kind of beautiful book. With great images. And gosh, you know, this is the kind of book you want to leave around the house just because people are going to pick it up. You always do this. And somehow or another, your publisher always manages to put out a beautiful book when Frank Lippmann writes a book. So that's super cool.

Yeah, we— Danielle's also very good at that. Her whole shtick is to make it— you've got to feel it. You've got to, you know, there's an aesthetic about a book.

Well, great. Frank, it's great to see you. My hope is that next time it won't be virtual, but if it is, it will be what it is. So I want to thank you for spending time with us today. Terrific information, terrific book, and I'm so excited for you.

Thank you. Thank you, David. Thank you for all that you do. And it's just been an absolute pleasure knowing you for so many years and watching what you put out. So thank you.

Thank you. We'll see each other soon. Bye.

Okay, bye.

Well, Dr. Lipman, thank you for joining us. And to everybody else who watched the program today, thank you for spending time with us. What wonderful information. How empowering it is to know that in fact we hold the keys to the kingdom, that we can make lifestyle changes that can in fact have a significant Positive effect on our rate of biological aging. Though we cannot turn back the hands of time, we can certainly affect how our bodies age and really can do some very powerful interventions at home based upon the choices that we make day in and day out. I'm Dr. David Perlmutter for the Empowering Neurologist program. Thank you for joining us. We'll be back soon. Bye-bye. Bye-bye.