DO THIS DAILY To Increase Lifespan & REVERSE AGING! | Mark Hyman

I can't stress this enough, recovering from injuries, recuperating, don't let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently.

Welcome to Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. If you want to learn how to age well, if you want to learn how to avoid the ravages of diseases that we get when we age and also be vibrant and healthy and live well, you better listen to this podcast because it's with my longtime friend, functional medicine colleague, leader in the field of functional medicine, Dr. Frank Lipman. And we have been buddies for a long time. We've been running this road for a long time. And then we were just joking at how old we're getting. We used to be young whippersnappers in our 30s and 40s, and now we're 60 and 65. So we're doing okay. We're doing okay. Now, Frank He's really an incredible pioneer in the field of functional medicine, integrative medicine, and what he likes to call good medicine. It's just good medicine. He's the founder of 11:11 Wellness Center and the Chief Medical Officer at the well in New York City. He's a sought-after speaker and author of six best-selling books, How to Be well, the New Health Rules, which is awesome, Young and Slim for Life, Revive, and Total Renewal. His newest book, which we're talking about today, is called the New Rules of Aging well, A Simple Program for immune resilience, strength and vitality. Well, thank you, Frank, for writing that book so I don't have to. And I really appreciate your digging into this topic of aging because it's something that's interesting me more and more every day as I get older, as we all are. So welcome to the podcast.

Thank you. Thanks for having me on. Yeah, we are getting older, but thank God for functional medicine and what we've been doing. It just, it helps a lot. Makes it easier.

You're right. Functional medicine isn't about treating disease. It's about optimizing function and creating health. When you do that, you're learning how to turn on all the systems in the body that regulate everything that matters as we age in a positive way, and that allows disease to not have a place to hang out. It's a very different approach to disease and to aging. We're going to get really deep into it today because there's so much research on longevity. There's been so much research on healthy aging lately, far more than even 10, 15 years ago. It's just astounding. The goal really isn't necessarily to live as long as possible, although I want to live a long time. I'm going for another 60 years. The real goal is to live well, to be vibrant, energetic. My definition of health is basically being able to wake up in the morning and do whatever you want. If you want to go for a horseback ride, you want to climb a mountain, you want to sit and read a book in a rocking chair, whatever it is that makes you happy, that's what healthy aging is. So how do we get there, Frank? How do we do this?

Well, as you said, I agree 100%. It's about getting up every day and enjoying your life and doing what you want to do and being able to do what you want to do without struggling. The whole concept of functional medicine or optimizing function or optimizing the human condition is really how you age well. I think there are little tweaks you make. So you're 60, I'm 66, and we've been doing certain things for many years. And as you get to a certain age, as you get into your 60s, I think you need to tweak a little bit more to actually affect these longevity genes or these nutrient sensors or whatever you want to call them, which actually affect your aging and help you just increases health span as you're talking about, or optimize your health span as you increase your lifespan. And you know what I find interesting, and I've always found this with functional medicine, is a lot of this ancient wisdom is there. It's how do we tap into this ancient wisdom? And now, as well as you pointed out, there's more and more research. So it's how do we, you know, use this modern research and tap into this ancient wisdom and combine the two and that's how you age well.

That's right. It is pretty simple. I think to emphasize what you just said, there's a difference between your health span and your lifespan. Your lifespan is how many years are alive. Your health span is how many years of your life are healthy. So you could live to be 90 and your health span could be 60, meaning you start to go downhill and you become decrepit and end up in a nursing home for 20 years. That is not the way we want to live. You basically want to live fully until the day you die and then drop dead of nothing. And I think that's what I'm looking forward to.

Yeah, exactly. And that's, you know, I think that was the impetus of the book, especially, you know, I now have a grandchild and I want to, you know, enjoy my grandchild growing up and be healthy and vibrant and be able to play. And that was sort of the impetus of, you know, what else can I do? I mean, yes, you know, I eat well, I exercise, I meditate. sleep is very important. So I started getting into the research and what are these little tweaks that I can do as I get older. And so that was why I wrote the book. Because in a way, a selfish journey. I wanted to help me. And then as I do with my books, I try and make it simple for people. Because I think a lot of this research is very complicated. When you talk about the mTOR and the AMK, A and PK and a lot of these complicated concepts. My modus operandi is always how do I make it simple for people to understand so they can take these nuggets and make changes in their lives. They don't have to understand what mTOR is, although we can talk about it. They don't have to understand that you have these longevity genes that may be affected by certain, you know, of what you do. People just want to know what to do. and how to do it. And that's sort of what I try to do in the book.

Your books are very good because they're very clear. They're simple but not too simple. They're very practical and they're laid out in ways that are indigestible chunks that allow you to just absorb the information. And I'm actually a little jealous because I love those books and I think they're laid out so beautifully and you parse it down to just the essential things. And I like to write way too long books. So much I want to explain, but this is such a practical set of tools for living, not just aging well, but living well. So it's the same thing. Do you want to age well or be healthy now or live well and get rid of disease? It's all the same. So what do you think the biggest factor is when it comes to aging that controls our aging process?

I don't know if there's one biggest factor, but the things that I've changed, we probably live very similar lives. The things that I've changed now in the last couple of years have been one, I eat less and I do that mainly by fasting a lot. I mainly do time restricted eating, which in a way forces me to eat less. I have two meals a day instead of three meals a day. So I eat less. I rarely pay attention to my sleep, like more attention than ever. which I think is important. Sorry, just to go back to what I eat. The big change, the other big change I made in my diet, as well as eating less and time-restricted eating, I eat a little bit less animal protein, which we can talk about, which I think is important. But as we get to my age, also sarcopenia, losing muscle mass becomes important. As much as you need to decrease animal protein, you need to be careful about decreasing protein too much because you don't want to lose muscle mass, which is a big issue with what people suffer with as they get older. There's all this fine tuning that needs to be done. It's not you've got to do X, Y, and Z. You've got to alter it according to your needs and are you coping with the aging process? And then the last thing I think is you've got to be able to have a sense of humor. You've got to be able to laugh about it. I just can't do some of the things I used to do and it is what it is. You can't fight it and you've got to do the best you can, but you have to have a sense of humor about it. Otherwise, that's not a good thing if you can't laugh about it.

Yeah, if we take life too seriously, it definitely creates aging. And it's interesting when you look at the studies on aging, the defining characteristics of a lot of centenarians, people who are to be 100 years old, is their resilience, is their ability to bounce back from life's punches. We all get knocked to our knees by loss, by divorce, by illness, by this, by that. The difference is how do we respond to those challenges? And are we resilient or do we end up going into a downward spiral of depression and despair and dysfunction? And to me, that's a really interesting thing. It's your mindset. It's your belief. It's your sense of optimism. Optimists live longer, even if they're wrong.

Yeah, it's 100% correct. And that concept, as I said earlier, it's about mixing this ancient wisdom with modern science. One of the first things I got taught by my Chinese medicine teacher, Ephram Kongold and Harriet Beinfield, was health is about resilience. How do you build someone's resilience? You know, it's not about how well you are, but how well you respond to the knocks in life to diseases, etc. And they always stress this concept of resilience. I agree 100% with you. It is about being more resilient, healthy aging well is about being resilient. You may not be, you know, I can't run, for instance. I don't jog anymore because I got a gammy knee. but I walk and I cycle. So you adapt. And that's with everything in life. And I think your attitude is important too.

So food is a big deal in terms of health and in terms of aging. So what is the biggest mistake people make in terms of food when they eat if they want to live a long healthy life?

Well, I think people eat too much, especially as you get older. I think people eat too frequently. I think there's more and more studies showing that time-restricted eating or fasting, whatever you want to call it, has very positive effects on our metabolism. There was a study that just came out that said it doesn't help you lose weight. Well, that's maybe the case. I think, and I've been monitoring this lately in our practice, we're doing more longevity stuff. We've been monitoring markers, biomarkers for health and aging with people who are doing whether it's time restricted eating or doing fasting, mimicking diets or fasting, whatever way they're fasting. But we've been finding that their metabolic markers change positively, which is very interesting. Most people do lose a bit of weight but for the most part Time restricted eating or only eating in certain periods of fasting definitely has a positive effect on aging. So I think eating less is important. Low carbohydrate diet, I mean, you came up with this brilliant term called the Pegan diet, which I think is absolutely brilliant. So thank you for that.

Well, Frank, for people listening, the way I came up with that was I was on a panel with Frank. and another doctor was a vegan cardiologist. Frank was more focused on paleo at the time. They were arguing and fighting. I was in the middle like a ping pong ball and back and forth. I'm like, if you're paleo and you're vegan, then I must be Pegan. I sort of laughed as a joke. Then I realized it really made a lot of sense because they have far more in common with each other than the traditional American diet. The only difference is where you are.

Your protein, which is animals or beans and grains. That's it. Everything else is the same. Exactly. So I think if we want to look at a diet that was probably the best would be some type of Pegan diet. I'm not against animal protein, but as you get older, I think you need to eat a little bit less animal protein. Probably, I mean, this is what the research is showing, that the amino acid composition of animal proteins, in particular meat, is such that inhibits one of the, or stimulates one of these biomarkers that you don't, you know, these nutrient sensors or longevity genes that you don't want to stimulate as you get older. When you're young, when you're up to 40 or so, and you want to get stronger and build muscle, then eating animal protein is good. But as you get older, it may be a problem.

Hasn't this research shown that actually as you get older, that you need more protein to improve your muscle synthesis, which is really this thing that makes us age faster. We were talking about it before, but sarcopenia, this loss of muscle, results in a whole series of consequences including inflammation and pre-diabetes and abnormal cholesterol and all kinds of issues that lower hormones and increase cortisol and decrease testosterone. So losing muscle is a very dangerous thing as you get older and it's really why people end up in nursing homes. So how do we actually have enough but not too much?

Because it seems like we need more as we get older. Right, so this is probably the most complicated issue as we get older. How much? Because I agree 100%. I do think we need to increase animal protein, but as you get older, you actually need to increase protein. How do you increase plant proteins, if possible, without increasing too much carbohydrates? Because you want to still keep your carbohydrates down. The way I get around it, I actually use, I have a protein shake and I use pea protein and I put collagen in. Collagen actually has the amino acid profile, it doesn't have as much leucine and methionine, so it's less of a problem. I won't have as much steak. It's not that I don't have steak, tonight we're having steak. It's not that I don't have animal protein, but I have cut it back a bit and maybe eat a little bit more fish. and a little bit, I have collagen a lot of the time. I have collagen almost every day. So I think that is a fine balance and it's not, there's no simple answer here and I don't, I think it's a big problem not having enough protein as one gets older. But it also seems to be a problem of eating too much animal protein as one gets older. For sure.

For sure. And what's enough? You know, we have these giant steaks and big hunks of meat and what we really need is about 30 grams to stimulate muscle synthesis, which is about the size of your palm. Now, if you're Shaquille O'Neal, it's a bigger piece. If you're five years old, it's a smaller piece. You can use your own body as a measure of how much protein you need.

I think that's a very simple. That's why your Pegan diet, I think, is brilliant. I love that concept.

I think that sums it up. Yeah, exactly. Actually, it's funny you mentioned the Pegan diet because I created something called the Pegan Shake, which is essentially pea protein, pumpkin seed protein, and collagen, grass-fed collagen protein. So, it's exactly what you're talking about.

Right. And, that's what I do. I think that's a way of getting around it, to be quite honest. So, that's brilliant.

Yeah.

Fantastic.

So, let's talk about this idea of time-restricted eating. And, there are many ways to quote fast. There's what we call intermittent fasting, which is maybe not eating for a whole day or three days or a week sometimes. There's time-restricted eating, which is only eating with a certain time window. There's fasting-mimicking diets, which are eating less calories for a number of days to stimulate the same pathways. There's ketogenic diets. They all do a very similar thing. What is the biology of how this works? We know that these things do work. looking at animal studies, human studies in terms of improving metabolism and the longevity biomarkers. But what are we seeing in how these methods actually work and what is the most effective? What should people be doing in order to take advantage of this new science?

Right. So what they're doing, I mean, the way I explain to patients is, which I think is, I mean, they're doing a number of things. It's triggering your body's own self-cleansing mechanisms. After you haven't been eating for a certain amount of time, 14, probably more 16 hours, your body's self-cleansing mechanisms kick in, which is very important with the aging process because one of the factors in aging is your body, once it goes back to functional medicine, the functioning of these systems don't work as well. so the fasting actually starts putting that autophagy system into play. So I think that's probably one of the most important aspects. It also will improve mitochondrial function, which also decreases as we get older. So the consequences of fasting or what happens in your body are often the opposite of what happens as you get older. So that's why I think it's so important. which way of fasting is best is the way that you'll do. I mean, whatever works easiest for a person is what I encourage. And I think the easiest one for most people is to eat dinner earlier and eat breakfast later, which is what I do and what I recommend. Now, if people want to do a day of just water fasting or three days or even more, that's great. That's a little bit more complicated and and most people won't do that, but if you can do that, that's fine. There's also this fasting mimicking diet where you do five days a month of very low calories and no animal protein and low carbs. We've actually created some shakes or my health coach has some recipes for people. If they want to do it themselves, you can buy the Prolon shakes as well. You should bring out some shake. I mean, it's a no-brainer to bring out a five-day program of, because it works. I mean, we've done it on patients that actually there's no question you get the same results whether you do fasting, mimicking diet for five days, you do intermittent fasting. We're seeing positive results across the board with biomarkers and different types of fasting. So I don't think there's one way. I think the way is to find the way that you will do and that works easiest for your lifestyle.

Dr. Yeah, you know, people say, Dr. Hyman, what do you eat for snacks? and I'm like, I don't. I think snacking is the worst invention. Snack foods are typically really unhealthy and they're a modern invention and we used to not have to be eating all the time and that's the problem, we're eating all the time. And I think, you know, just to underscore what you said about these different approaches to time restricted eating, intermittent fasting, fasting and making diets is they activate a set of mechanisms in the body that improve blood sugar control, that get rid of belly fat, that increase muscle synthesis, that build your bone density. that increase testosterone, that increase brain function and cognitive function, that improve your stem cell function, that help your immune system, and they clean up all the debris in your cells. It's called autophagy, which is the same sort of self-cleaning mechanisms. There's mitophagy as well that comes from the same process. So these are things that we actually can take advantage about without actually changing what we eat. Now, if you change what you eat, you get a double benefit. But these are very powerful things that we should be paying attention to in the science. And I think you just feel better. You feel more energetic rather than being sluggish from eating food all the time.

Right. And you know that. Thank you. All those mechanisms are what actually start their function decreases as we get older. It becomes harder to keep your blood sugar under control. The muscle synthesis, brain cognition and brain function. So fasting is like a magic pill. Or eating less is a magical. So to me, that's probably the most important thing you can do.

It's true. Hi everyone. Hope you're enjoying the episode. Before we continue, we have a quick message from Dr. Mark Hyman about his new company, Farmacy, and their first product, the 10-Day Reset. Hey, it's Dr. Hyman. Do you have FLC? What's FLC? It's when you feel like crap. It's a problem that so many people suffer from and often have no idea that it's not normal or that you can fix it. I mean, you know the feeling. It's when you're super sluggish, your digestion's off, you can't think clearly, or you have brain fog, or you just feel run down. Can you relate? I know most people can. But the real question is, what the heck do we do about it? Well, I hate to break the news, but there's no magic bullet. FLC isn't caused by one single thing, so there's not one single solution. However, there is a systems-based approach, a way to tackle the multiple root factors that contribute to FLC, and I call that system the 10-Day Reset. The 10-Day Reset combines food, key lifestyle habits, and targeted supplements to address FLC straight on. It's a protocol that I've used with thousands of my community members to help them get their health back on track. It's not a magic bullet. It's not a quick fix. It's a system that works. if you want to learn more and get your health back on track, click on the button below or visit getpharmacy.com that's getpharmacy with an F, F-A-R-M-A-C-Y.com Now back to this week's episode. And, you know, you mentioned the meat thing and I think it's still, to me, it's still, the science is still controversial. You know, I talked to my friend, Valter Longo, who's one of the leading longevity scientists and he's from Italy and he's the guy who developed the fasting mimicking diet. He's been on the podcast. And he said, he knew this woman, Emma Morano, who lived to be 117 years old. And she was anemic when she was young lady and her doctor told her to eat three eggs a day, which she did for 100 years, literally. And then when she was in her 90s, I think she was getting frail and weak. And her doctor told her to eat a pound of meat a day. And she did. And she lived from 90 to 117. So I wonder, you know, how How true is this? And if your other lifestyle factors are good, if you're eating animal protein and getting adequate muscle benefit from it as you age, where is that fine line in terms of animal protein?

Well, I think this is the dilemma, not really a dilemma, but I think we all need to find what works for our bodies. But I think it also points out a factor that in Western medicine we always try and look for the one thing that works and everything works together. We have this complicated system and the mTOR issue may be one small part of it. I think you've got to find that balance. I agree. I don't think... I mean, I know vegetarians who get cancer, the idea of animal protein causing cancer. Vegetarians get cancer. Vegetarians don't do well. You've got to find out what works for you. And once again, I'm not trying to blow smoke up here, but the Pegan concept, the Pegan diet, I think, and finding your own type of Pegan diet, I think, is if we're looking for a solution, not that there's a solution, the Pegan diet in terms of... Thank you, Frank. Intermittent fasting, eating within that content of time-restricted eating, a Pegan diet, is the way we all should be eating.

Yeah. And, you know, I think the other thing that is important, I've noticed for aging, is muscle. And, you know, I think we have a neglected organ, which is our muscle that we don't pay much attention to. And this condition that we get as we age, it's inexorable. Like, if you don't do something to stop it aggressively, you will lose muscle. So, you could be the same weight at 65 than you are at 25. but your body be twice as fat. It literally looks like a ribeye marble steak as opposed to a filet mignon, which is what you want for your muscle with no fat rippling through it. That's all related to our diet and the lack of exercise. The two things I want you to talk about is the other side of the coin because protein you need and you want to get enough but not too much, but it's actually sugar and starch that drive this aging process. and that combined with muscle strengthening and building as you get older seems to be some of the most important factors. Can you talk about those and how they relate to aging? Sure.

Well, sugar and starches are the devil. It's not even a debate. You've got to get as much of that out of your diet as possible. The protein is a harder one, how much protein you eat. As you get older, maybe decreasing animal protein, increasing a bit of plant protein, but still keeping those carbohydrates as low as possible, or the sugars and the starches. I think the muscle issue is interesting. Because I've been doing acupuncture for so long, and I really got into the functioning of the muscles. It's not just about building muscle. You want those muscles to work efficiently. What I see a lot of, especially as we get older and we have injuries, certain muscle groups tighten up. When certain muscles tighten up and they don't fire, your body compensates and starts using other muscles. Let's say you have a tight hip or you have an ankle problem. Your back muscles have to work more and then you start getting back pains and then maybe it goes up to your shoulder. Not only do you have to improve muscle mass or watch the loss of muscle as you get older, you've got to watch that functioning because as we get older, muscles tighten and the fascia tightens that thin layer that surrounds the muscles. When you cut open a chicken and there's this fascia around the muscles, that surrounds all our muscles in our body. That, as an acupuncturist and paying a lot of attention to that for the last 30 years, I've seen it becomes a problem, especially as we get older and as we injure ourselves, and especially as we get older and we injure ourselves, we don't tend to recover as well. So it's really important when you do injure yourself to get some bodywork, to get some acupuncture, to get those muscles working efficiently again, and not just letting injuries sit there and not treat them. So I think It's not only building muscle mass and not losing or not losing muscle mass, but it's improving the muscle efficiency and that's keeping those muscles long and limber and watching that the fascia doesn't tighten.

That's a really good point, Frank, because I've had back issues my whole life from back surgery when I was 30 and recently had another back surgery. And now I'm getting treated by this physical therapist who's going into the fascia and re wiring things and then giving me exercise to do that compensate for the inactive muscles, exactly what you were talking about. And, it's been only three days of working with this person and I feel like a different human being. My body feels limber, lighter, opener. It's pretty amazing. So, I mean, not everybody can access that, but there's ways you can do it yourself with foam rollers and other things to really help. Okay, so let's talk about something that is...

In the book, I talk about foam rolling. I think I just have to mention foam rolling because I think that is a lot of people can't afford going to some bodywork who does deep tissue work, but foam rolling is sort of the closest you'll get to going to someone who can do that. I really can't stress this enough. Recovering from injuries, recuperating, don't let those muscles tighten. because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently. It's one area of functional medicine that we didn't really get into in functional medicine. We talked about most of the other organs, but we didn't really talk about the functioning of the muscular skeletal system. I think that is really important. Dr.

It's definitely one of the nodes on the matrix which is structural, but if we don't get into it enough, I agree, and actually we're talking about building a whole course on structural modules. So, I think that's very important. Let's talk about something that is a little abstract, but is really central to aging, and that is impacted by our diet, light, by exercise, by environmental toxins, and it's something called our mitochondria. And we've talked about that on the show a little bit before, but it's really important. So, what are mitochondria? Why are they so important in aging and disease? and how do we improve them? Because it seems to be the central feature of aging is the dysfunction and the loss of mitochondria.

Right. So the mitochondria are just the energy powerhouses in the cells, and you have many in all our cells. And as we get older, their number decreases and their function decreases. So optimizing their function and trying to increase their number is one of the most important things you can do for aging. And interestingly enough, most of the things we've been talking about improve mitochondrial function or increase the number. We'll mention it. Yes. Others we haven't. But it's a low carbohydrate diet or fats are what the mitochondria thrive on. Fasting is particularly good for mitochondria. Exercise, in particularly High intensity interval training is really good for it. Strength training as well. So sleep, a lot of the lifestyle changes, to me the mitochondria are what we in Chinese medicine talk about chi. We talk about the energy and how do you boost chi. To me the mitochondria are the western equivalent to chi. That's your body's energy. All these changes we talk about actually work with the mitochondria. One of the things we haven't talked about and which actually seems to work well or stimulate the mitochondria is this concept called homesis, which is...

I love that concept. What does that mean? What does that mean? I love that concept.

Homesis means sort of what doesn't kill you makes you stronger, basically.

Ah, that's perfect definition. That's the best definition I've ever heard.

That's a little bit of stress is actually good for the body. Chronic stress we know is a problem and creates all these problems and it will help, won't help you age well, but a little bit of stress, homeostasis is good. And that's what fasting is. Fasting is physical homeostasis. It's a stress, a little bit of mild stress on the body and your body's response to that, and we talked about resilience, but your body's response to that is a positive response which stimulates all these factors that are good for aging. So we talk about fasting, we talk about a little bit of interval training where you push yourself a little bit more than usual. Going from hot to cold, so even just having an ice cold shower after a hot shower, I love going from a sauna, I've become obsessed with my sauna, going from my sauna jumping into some freezing cold water. Temperature extremes are another way of stimulating hormesis.

I love that. I love going from my steam or sauna right into an ice bath.

That's good for aging. That's hormesis. Anything that's a little bit of stress on the body is good. Actually, what's interesting, I remember years ago at Jeff Blan talking about this or someone at one of the functional medicine conferences with phytonutrients, a lot of the homesis is really good for plants. So plants develop more antioxidants and protective phytonutrients to protect themselves from whatever they have to deal with to survive. So spraying them with herbicides and that doesn't actually help them develop these phytonutrients to protect themselves, which actually end up being good for us too. The first time I heard about homesis was years and years ago at one of the functional medicine conferences with someone, I think it was Jeff who talked about the importance of homesis on plants and developing you know, fatty nutrients that would then benefit us.

Yeah, you know, it's really important to understand this idea because when you look at, for example, organic versus conventional plants or even wild plants, even versus organic plants, the wild plants have way more by hundreds to thousands of times more antioxidant potential, phytonutrient compound, and they also taste better. And what's interesting is that flavor goes along with phytonutrients. So the flavor profile of a food is directly related to the nutrient density. and to the phytochemical content. So, if you go to a garden, which I did the other day to a friend of mine's garden, and you pick a really ripe tomato that's just ripened on the vine, you stick it in your mouth, and it's an explosion of taste and flavor and phytochemicals that is so different than these cardboard store-bought tomatoes that don't taste like anything. So, that's really the power of the little stresses. And, I think the strength training, the HIIT interval training, the fasting, the phytochemicals. These are all ways to actually improve this. I want to get into some tweaks that you have in your book that are really, really great. But before I want to talk about this idea called our epigenome and how that plays a role in our cells age and how we deteriorate. So what is an epigenome? What is its relevance to aging? How do we deal with it? What can we do to help fix it? Right.

So this is, you know, once again, one of the basic concepts that's come out of Well, that hasn't come out of functional medicine, but what functional medicine treats that, you know, most of our genes we can change or we can manipulate in a way or upregulate or downregulate. So, for instance, you know, I actually just did a whole genetic test. I've got terrible genes. I knew I had terrible genes. You know, I have the genes, I have the APOE, I have the gene for Alzheimer's, I have heart disease genes. I mean, my genetic profile is terrible. But whether I get Alzheimer's and heart disease and all these diseases of aging is determined by how I live my life. These lifestyle factors, how I sleep, how I think, how kind I am to other people, how optimistic I am, what I eat, how I move my body, all are going to affect most of those other genes or the genes that we can affect to or upregulate or downregulate to affect our aging. So aging is probably less than 20% genetic. I mean, there's obviously a genetic component where you can't change those genes. I've got those genes. Oh, no, I don't know about those genes, but I've got enough genes that I know that I can change. Just because I have the APOE4 gene, just because I have some of these heart genes, doesn't mean I'm going to get it. Yeah, I'm probably losing it a little bit.

You seem all right. You seem all right, Frank. You're doing okay.

My heart may not be as good, but that sort of makes me want to just be more careful because you can change how you age. You can change the progression of these diseases. I think it just all comes back down to these lifestyle changes that we all have to make. Sleeping is one of those things that I think is really, really important. And we don't talk enough about it, although more and more people are starting to realize the importance of sleep. But how you move, how you sleep, how you think, how you eat, when you eat, all these factors affect this epigenome, these malleable genes that actually can be upregulated or downregulated and affect how well we feel. and how we age.

I think that's really an important point, Frank, because you mentioned you have these predisposing genes, but they're not predestined.

Exactly.

They're not predestined to get these conditions. And what most people don't realize is that 80 to 90% of our chronic disease issues are not driven by genetics. They're driven by what we call the exposome, what our genes are exposed to and how those genes are expressed. And so if you're exposed to environmental toxins, if your microbiome is not healthy, if your diet's crappy, if you're not exercising, if your mental set, your mindset is not optimistic and focused and positive, it literally can change the expression of your genes by all these factors. And that's the beautiful thing about functional medicine. It teaches you how to optimize the function and the expression of your genes to improve their functioning and also to reduce the ravages of aging. I'm very optimistic about you, Frank, because I didn't realize you were 66. I thought you were like 56. I mean, I know you're kind of older than me, but you don't look it. So, something's working. And I think for two old dudes, we're doing all right. I'm 60 or 66. It's working. And I think that people don't understand that what we see often as aging in America is abnormal aging. It's not really how we need to age, that we can age vibrantly. healthfully and be alert and focused and energetic even right up to the end. And I've seen this in many people. I met this guy who was 95 years old the other day. He had a girlfriend that was 20 years younger than him. She was a young spring chicken at 75. And he was just running around the room. And I'm like, what's up with you? How do you do this? He says, Whatever I did yesterday, I just do it today. If I played single sentence yesterday, I do it today. And, I think he just kept living his life and not mentally succumb to the idea of aging. And, I think you have to be more cautious, careful, you have to be more alert to what you need to take care of yourself. But, I think we have so much potential to stop and even reverse the ravages of aging. And, I noticed this to myself. Because of COVID I was locked at home like everybody else. I'm like, well, I'm not going to not exercise. got a zoom trainer and I really never had done weights before because I was, you know, I was running around on the road. I was, I didn't, I don't like it. I don't like it hurts. It's uncomfortable. I'd rather go for a bike ride, you know, play tennis. And, and I got, I got serious about it. And within a very short time, I noticed my body started to change. I literally put on 10 pounds of muscle. My, my, it was like, I, I was an incredible transformation, and it was just in a very short time. So I think we have the potential at any age to stop and even reverse these effects. and what I love about your book, Frank, is that you have very simple tweaks that have a profound impact on healthy aging. So, talk about some of these tweaks and I can trigger you if you need to, but I just think it's really—Dr.

Yeah, I'm really old.

I mean, you talk about things like physical intensity, cold showers we talked about, rolling out your fascia, magnesium, saunas, mushrooms, sunshine, sleeping, sort of very various kinds of simple tweaks or tricks. They're not really tricks, they're just science-based interventions that if we stack them have accumulative benefit.

Right, so there's so many simple things we can do. I think actually just to get back to what you said, you know, I'm also starting to do some weights now. I've always resisted weights too, you know, I love riding my bike outside and doing yoga and stretching, but I sort of always resisted weights. I'm starting to do a little bit of weight training now and I also find it actually quite helpful. So, I concur there. I think I'm going to start back to the fascia and watching injuries because what I've seen so often in so many people, because I see so many patients, many times people are exercising a lot and something happens, they injure themselves. and then they don't recover properly and then they stop exercising or they don't exercise as much. So, you know, I encourage everyone when you do hurt yourself, just take care of that injury. So it doesn't limit, it may change the way you exercise in future. Now I can't run because of my knee but I ride a bike. So, you know, you do want to continue exercising but don't let that injury Just stick around or don't let it fester. You need to treat injuries. So if you can't get bodywork, a foam roller can be really helpful. I think getting outside early in the morning, getting some fresh air and some natural light first thing in the morning is a really good thing. I find it helps people sleep at night. In other words, getting your body into some type of rhythm I'm also obsessed with rhythm, you know, maybe because I saw when I first started doing medicine in South Africa, when I worked in the bush and there was no electricity and I saw how people lived with the rhythms and cycles of life. They got up when it was light, they went to bed when it was dark, they ate whatever was local and grown locally. And they didn't seem to have a lot of the chronic diseases I was seeing in the city. Trying to keep a rhythm is important. If you can try keep it with the seasons and with day and night, it's important. So if you go to bed, try to wake up early and get outside and try to go to bed at the same time every night. Try to create some type of regular schedule. I think that's really helpful. I'm boring now. Me and my wife go to bed pretty early. It's been great with a little grandchild because he goes to bed even earlier than us, probably the only person who does. But if you can get into some type of rhythm, going to bed at the same time, waking up at the same time in the morning, and getting outside and getting some fresh air and some natural light, that's really helpful. I do think trying to incorporate some form of time-restricted eating is helpful for most people, especially as you get older than 50. It's a good idea. Keeping active during the day so you don't have to go to the gym, you don't have to ride your bike, but get up and move around. Move your body. You just want to move your body.

It's amazing how inactive we are. When you look at an average day, I've got a ring. It's called an Oura ring, and it tells you how many hours of inactivity you you have and I'm like, holy crap. I've had eight hours of doing nothing and sitting on my doing podcasts or reading a book or working on my computer. And it just, you know, it's really important to move.

Right. And, you know, I found that since COVID I've made that much more, you know, especially doing more virtual sessions with patients and not in the office. I'm actually getting up in between and going out, which is good. So I think that's important. And I think the little things we talk about, don't take yourself so seriously, have a sense of humor about aging, being optimistic, being kind to others and yourself. I think kindness, compassion, I think these are all really important factors in aging. And then finally, having a sense of purpose and some meaning. And that sense of purpose may be your job, it may be your family, whatever it is, find something that's meaningful to you. It could be volunteering at a nonprofit. But I think getting involved in something that's important to you is really important. And then finally, find a tribe or a community that you relate to that supports you and that you can support. I think, yes, obviously eating, we talked about eating and sleeping and exercising. all important, but it's these non-tangible things that are important. And it's the little things we do on a daily basis, the ordinary things we do on a daily basis that have an extraordinary effect on our health and our aging. And that's these little things we talk about, you know, having passion for life and having meaning and having a community. So, you know, don't just think it's all about diet and exercise and sleep, which is Really important.

It's a lot about what's going on up here.

Yeah, absolutely.

In your mind.

Yeah, these things are key and there's so much bad stuff going on. There's so much negative, it's so easy to get caught up in the negativity of today.

Well, you know, Frank, you were talking earlier, I just reminded me of this study I read in the Journal of the American Medical Association this year, which was very amazing, which showed that Longevity was related to your sense of meaning and purpose. So even the science is showing that just being connected to something bigger than yourself is so, so important and having meaning and purpose is so key. So Frank, let's talk a little bit about supplements. Is there a role for supplements? Do they really work? There's all these longevity supplements out there. Is it a waste of money? Is it a good idea? Tell us, what's the deal on supplements?

Well, I think they work. I take a load of myself. Yeah, I do think they work. I mean, look, I'm not going to, I think it's a bonus rather than essential because they tend to become expensive, but I do think supplements are helpful to optimize function. I really do. And, you know, I am, I take the, you know, the regular supplements that, that I will take with it vitamin D, which I think is essential for everyone. I'll take my fish oils. But there are supplements which I think do affect the mitochondria and do affect the aging process. Am I sure about that? No, I'm not sure. But I'm not going to wait for the science to confirm to make sure it's happening. I'm going to take it.

The thing is, with their lower risk, there is a cost to it, but the benefit potential is there. and I think that there is good evidence that these things do affect some of the biology of aging.

Yeah, me too. I take now coenzyme Q10, I take nicotinamide riboside, nucleotide riboside, which is like the hot one.

NAD, right?

NAD, NAD, and NMR, everyone's pushing their supplements, but I actually do think I mean, I take it. It's hard to say if it's making a big difference because I'm doing all these other things too, but I take it. Particularly as we get older, it makes a big difference.

I see people who are more nutritionally deficient as they age, their diets aren't as good, the absorption is not good, and there's really good data that shows even a multivitamin in an older patient reduces the risk of disease and hospitalizations, infections, and a whole host of things. Particularly in the time of COVID we all need to upregulate our nutrient levels. What about testing? Are there tests you can do in functional medicine that are different that help you determine longevity? What do you recommend?

Well, I don't know if they're different. I just do a few more biomarkers. We do like the Boston Heart or Cleveland Clinic has one, too. We do an advanced lipid panel. which I think can be helpful. And then we do insulin growth factor, we do interleukin-6, we do a couple of other inflammatory markers. But for the most part, we're doing most of the markers we've always done. We've added maybe a couple more. We're doing more obviously hormones, measuring hormones. And then there's a wonderful genetic test that we've started doing, the 3x4 genetics, which I find by far the best genetic test started by a woman, actually a South African woman who is a functional medicine.

Oh, yeah.

What's her name again? But anyway, Yale. I find that we've been finding, because it's the only genetic test that I've seen that actually sort of works in the functional medicine perspective and puts a lot of how these genes work together. and what you can do to help these combination of genes. So it's actually a pretty helpful test that we've been doing as well. Then, you know, the other tests, you know, measuring your biologic clock and telomeres, I don't know about those tests. I mean, they've been promoted and, you know, we're starting to play around with it. I don't know how important that is. I think some people like to see these things, which is fine. But, you know, my philosophy hasn't changed from that perspective. It's more about making these lifestyle changes and, and, you know, whether you want to do this extensive testing is fine. My experience has been that these lifestyle, these factors we're talking about have been changing people's markers.

I mean, we can measure the changes over time.

So you can, and people like that, so. If you want to actually do a test and then measure it three to six months later, you see the changes, which is actually that's quite encouraging for people. From that perspective, I think it can be helpful. These things aren't necessary. The things that are necessary are the Pegan diet and then looking after your sleep and moving your body. And having meaning, all the things we talked about. Now, whether you want to measure all these factors can be helpful because it can help you fine tune things like the genetic test can say, okay, your liver function, you may need some more of these nutrients because the way you're processing hormones or toxins is not so good, or you have more propensity for inflammation or or your brain health may not be as good to take this. I do think the markers can be helpful in sort of taking it to the next level, but not essential.

Yeah, I think I agree. They're supplements, not replacements for everything else. So, you know, foundationally, all the things we talked about are really important: lifestyle, diet, sleep, exercise, maybe a little supplements. But there's new things on the horizon that are for healthy aging that people are researching, talking about. Can you share some of the promising things that are ahead that you might be focused on? Sure.

As embarrassed I am to say is there's a drug called metformin, which is a popular, it's used in diabetes a lot, which seems to be showing positive effects for aging too. which go beyond just keeping your blood sugar down. It seems to be affecting this mTOR, one of these longevity genes or these nutrient sensors, seems to have some positive effect on aging. My concern with any drug, metformin included, is what are the side effects? Metformin seems to have a relatively low profile of side effects that can affect absorption of some nutrients, B12 in particular can affect gas, also can affect your response to exercise, but it's sort of relatively benign. So that's one that I find interesting. There's a drug called rapamycin, which I'm definitely not recommending yet, which some people are taking, but because that Grappa mycin shuts down mTOR. Yeah, mTOR. Those are the two drugs. Then some people are using peptides. I don't really know enough about peptides to recommend them. I find them quite intriguing and interesting. I just don't know enough about them yet. I think there's so much research going on to there's going to be products coming out. At this stage, it's really what we've been talking about Metformin, especially if you tend to be pre-diabetic as you get older, is something interesting. I'm going to explore it a little bit further. I'm a little bit hesitant at the moment.

Yeah, I'm cautious about it.

Berberine is the natural equivalent of metformin. I've been starting to take berberine now because that has similar effects to metformin. But that's as far as, you know, I don't do the crazy stuff. the biohacking, you know, the biohacking world has been very interesting because that's a very masculine approach to aging, but I think we've got some good stuff there. I mean, some of the biohacking guys, I think go a bit too far. I'm a little bit more on the sort of more gentle side of the pushing it.

Yeah, yeah. But there's a lot of wild west out there and people should be cautious. People using stem cells, exosomes, very sensitive.

Yes, cells is the other.

Exactly. So, I think there are promising things. They're not quite ready for prime time yet. And, I need to say, Metformin is, you know, I believe that if you focus on the lifestyle and the dietary things, you can probably achieve most of the same benefits. And, what I worry about is like people say, oh, I'll take a statin and I can eat a McDonald's. It'll be fine for my cholesterol. That is just a bad idea. So, Frank, your book is just fantastic. I encourage everybody to get a copy. It's out. It's called the New Rules of Aging well, a Simple Program for Immune Resilience, Strength and Vitality. That's what it looks like. It's a fabulous book. I just think it's also a beautiful book. It's digestible. And there's so many brilliant little snippets of wisdom that are easily applied to your life every day and it will help you not only live longer, live better, but also even if you're not old, it's a great book for just optimizing your health, whether you're 20, 30, 40, 50, 60. It is a good manual for your life. So I encourage you, Frank, to keep doing what you're doing. We've been on this road a long time, and as functional medicine practitioners, we do see the power of these methods to really transform people's lives when nothing really else does. So I'm planning to be 120. I don't know where you're going, Frank, but I'm really interested in this. You're right. We're both getting older, so we're way more interested in aging. So you're going to hear a lot more about it.

And thank you so much for everything you do.

Frank.

And thank you, Mark. Thank you.

And you can learn more about Frank's book. Go to Dr. Frank Lippman. That's drfranklippman with one P.com/books and learn more about Frank and his work. It's really tremendous. And if you love this podcast, please share it with your friends and family on social media. Leave a comment. Tell us about how you've figured out ways to age well and push off the ravages of aging. which we're trying to do. And subscribe wherever you get your podcast and we'll see you next week on the Doctor's Pharmacy.