The State of Science for Sex, Aging and Regenerative Medicine

Over the last 15 years that I'm actually doing this kind of medicine, preventative medicine, I have so many patients who come to see me, 30 pounds overweight, doing everything wrong on five or six medications. Six months later, they're off all their medications. Their body fat is down, their lean muscle mass is up, they're sleeping eight hours, they feel amazing energy, they're doing better in business, they're excelling at work, excelling at home, they're just feeling Tremendous drive and motivation.

Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's Pharmacy with an F, F-A-R-M-A-C-Y. It's a place for conversations that matter, and I think all of us care about how we can age well, how we can increase the longevity and vitality. And we're gonna have that conversation today with Dr. George Sapio. Welcome, George.

Welcome.

Now, George is a great guy, know him as a personal doctor for me. I've gone to seeing him for myself. We'll talk about that. And I was very interested as I'm turning 60 this year, how to age well. And everybody's talking about aging and aging well, but he's actually doing it. He's been doing it for decades. He's been a doctor for 30 years. He specializes in internal medicine, cardiovascular disease, and age management. He graduated from New York Medical College. He did residency at Albert Einstein College of Medicine and did his fellowship at Columbia. in cardiovascular disease management, including CHF or congestive heart failure and heart transplantation. He's received many awards. He's been cited for his excellence in age management medicine. I've learned a lot from George. He's doing innovative things around regenerative medicine, improving longevity, the genomics of heart disease and heart failure. And he's trying to answer the question which we all wanna know, which is how do I look to be 120 and still be vital, energetic, and sexually active, right? Right? I'm hoping to be sexually active when I'm 110, right? How about you? Same. So I was very curious about your work because as I said, I'm turning 60 this year and I wanna live well and I wanna live fit and I wanna understand what we know and don't know about the science of aging. And I've studied on my own, but you put me through a very comprehensive evaluation. which taught me a lot about where I stand and where I'm at and where I still have areas to work on in terms of my health. And you're part of a company called Cenegenics, which is focused on the science of healthy aging and age management. I think there's been a lot of evolution in the thinking in that organization. And I think you're at the cutting edge using really innovative therapies around regenerative medicine, around things like exosomes, peptides, diet, various kinds of therapies that can be very, very powerful hormonal therapy. We're gonna get into all that today. But first, you know, what was your incentive for starting this path towards age management and longevity and regenerative medicine and moving away from treating heart disease and congestive heart failure?

So Mark, thank you for inviting me to your podcast. Some of the things that we're gonna talk about are personal. Is that okay?

Yes, personal. I'm going to share my personal numbers. You can share whatever you want to share. It's very good.

So I'll just tell you a little bit about myself and my story. I went to the Olympics when I was a junior in judo. I competed from age 13 to maybe 21. And I was also a national racketball champion. I focused my younger years on just staying fit. Most of my parents wanted me to stay fit. around my 40s when I was basically in the midst of, you know, the cardiac training program and being a physician and working at, you know, Columbia Presbyterian in New York, I started to get tired and didn't understand why at, in my mid 40s, I was fatigued. When I'd wake up in the morning, my joints would hurt. I felt like an old man, believe it or not. And then other issues, you know, that happened to men in their 40s, they started having some sexual dysfunction issues. So I went to investigate various companies and organizations that dealt with aging. And for me, it was very important that I picked a company that was focused in on evidence-based medicine. Actually, all their protocols based on medical research that's actually presented in peer-reviewed medical journals and written, you know, by experts. So for me, that was extremely important. I did a lot of research when I was going through my training at New York Medical College. I published some papers as well. I also worked with some research project in Columbia. So I went to Cenegenics because of their protocols being focused in on evidence-based medicine. And some of the interesting things that I did was the same evaluation that I did on you a few weeks ago, I did myself as a patient 15 years ago. And I found out I was eating the wrong foods, the wrong times, the wrong portions, the wrong combinations. I was exercising aerobically, not anaerobically or high intensity interval training. So I was exercising the wrong way. in, and all kinds of exercise is.

Good, but there's better kinds of exercise, right?

Correct. And, you know, the endocrine system is very important. Unfortunately, as we get older, the endocrine system degenerates. It's your hormones. And your hormones and your metabolism. So my hormone levels were at the bottom end of normal range. So there's a whole controversy in the guidelines today regarding hormone levels. Unfortunately, it's a physician for a guy. not only testosterone, thyroid hormone, adrenal hormone, about nine different hormones, there's a wide range. And for patients and for other physicians who aren't familiar with some of the new innovations and new therapies, they just look at a lab value and say, okay, you're in the normal range.

Dr. Yeah, you could be 200 to 1000 and that's normal on testosterone, but is it optimal?

Right, but this kind of leads to personalized medicine. Everyone's different. You can't treat one patient the same. And we find out some patients at the low end may be perfect. Some patients at the low end may be abnormal. Most patients in their 40s who I see, and same thing happened to me, they're tired. They wake up, their joints are aching. Stress is a big producer of body fat increasing. And lowers testosterone too. Their muscle mass gets reduced. They don't sleep well. They're not motivated. They get depressed. They see their psyche psychiatrist, they may be put on an antidepressant or they'll see their internist and he may right away put them on a statin or a blood pressure pill or a blood sugar pill. Whereas now, you know, that sort of changed. The American College of Cardiology has revised their guidelines for statin use. We're actually putting people on an aggressive nutrition campaign and an exercise campaign for.

Six months before we actually start a statin drug. That's what they say. How many times does that actually happen in practice?

You know, I actually gave a lecture on a community on statin therapy and it turns out that 65% of people in this community stopped their statins because of side effects and did not even tell their doctor. And some of the side effects are diffuse muscle aches and pains, constipation, pasty stools and that's a big issue.

I mean, it's a mitochondrial toxin just to stop on statins for a while. the reporting in the literature of the side effects by the industry studies is very low. And when you look at the reporting by independent researchers on the side effects, it's pretty high. It's about one in five, 20% of people have some type of side effect, whether it's fatigue or sexual dysfunction, cognitive dysfunction, whether it's muscle pain, aching, soreness. All these things are really due to not the side effects, but the actual effects of the drug, which affects the mitochondria, which is the energy producing organs in your cell. And that's really the issue. And, you know, I think it's great to hear that they're revising guidelines to put people on statins less, but it's still a big problem.

While we're on the statin story. Yeah, I'm an aggressive traditional cardiologist, very aggressive when it comes to coronary disease. It's the number one killer in men and women, especially women after they go through their postmenopausal changes. But it turns out that, There's new evidence and new data to show that we have mutations in our body and there's specific mutations that basically control the level of cholesterol in your bloodstream. One is SLOCO1B1. It's a mutation that's an easy blood test to do. Soon it's gonna be mandatory before we put a patient on statins. If you have this mutation, you're not able to get rid of your LDL cholesterol in the bloodstream basically. it stays in the system, it stays in there and it gets into toxic amounts. It's not cleared by your system. There's other mutations, PCS2K9 mutations that have a reduction in the receptors of LDL so you can't clear out your cholesterol. So it's sitting in the bloodstream longer. The more it sits, the more toxic you get. And toxicity is significant. You know, I have a family history of hyperlipidemia. I even checked my genetics and I have an enzyme that's unable to metabolize statins. So it just sits around and I get toxic side effects. I can't take a statin drug. Most people can't take a statin drug. There was a recent article that was-.

That'S gonna be the future really is getting your genes tested for a cardiovascular risk and actually seeing which people will do well with statins, which people do poorly, which people tolerate saturated fat, which people don't, right?

So how about this? How about curing cardiovascular disease? I gave a talk two years ago on is there a cure for cardiovascular disease? And it turns out a lot of the research, and some was done at the Cleveland Clinic, I know you're there, by Eric Topol. And he did a lot of stuff with PCS K9 inhibitors and vaccines. So if we can basically start giving a vaccine to children when they're five years old, along with the measles, mumps, rubella vaccine or polio vaccine, you give them a PCS K9 inhibitor vaccine and follow them Now you may not develop cholesterol plaques, you may not need to even worry about statins. That's the whole focus of Cenegenics basically, preventing, we're preventing the problem. So there's physicians who take care of the disease, which I still do, taking care of the heart attack, the hypertension, the diabetic, and then the other half of me is a preventative medicine doctor. I'm preventing the problem. So we basically, you know, so getting-.

Preventing illness is not the same as, creating health or actually increasing longevity or vitality, right? So that's a great point.

I want to read some statistics that I brought with me. This is from the National Center for Health Statistics. In quote, Americans are living longer, not necessarily healthier. From the Billy Guyton, who was distinguished professor and chairman of the Department of Medicine at University of Mississippi, quoted, Population studies show that we have increased the length of life, but made no progress in decreasing the length of disability at the end of life. And the time has come to abandon disease as the focus of medical care. Medical care that is centered on the diagnosis and treatment of diseases at best is out of date and at worst harmful. And this was published in the American Journal of Medicine, the end of the disease era.

So-- and what do they say we should be doing?

Basically treating the patient when they're younger preventing the problem by educating them on proper nutrition, proper exercise, and basically restoring their endocrine system. The endocrine system degenerates as we get older. And as a result, the thyroid gland that controls our metabolism slows down. We have subclinical hypothyroidism. There was a great article written by Dr. Gaby, he's a nutritionist. He wrote a book on nutrition. Dr. Gaby, yeah. And it was about, you know, treating.

With, you know, Armour thyroid and subclinical hypothyroidism. which is a risk for heart disease and depression and sexual dysfunction and cognitive decline and memory issues.

Right, and most of it comes from where? The source, toxic belly fat. Barry Sears wrote a great book on toxic fat. Fat is very inflammatory, visceral fat around the organs we measure when we did your evaluation. You were actually pretty healthy compared to most of our clients.

You said I had 6.2% body fat.

We'll go into the details, but you actually did, I was very impressed. I was very impressed. But it turns out that fat in the belly is very inflammatory and it's the main cause of chronic disease. And some of the chronic diseases that we're attacking are heart attack, stroke, cancer, diabetes, Alzheimer's disease. Yes. And you wanna slow that down.

If you look down at your belly.

That'S what's driving it all. So over the last 15 years that I'm actually doing this kind of medicine, preventative medicine. I have so many patients who come to see me, 30 pounds overweight, doing everything wrong on five or six medications. Six months later, they're off all their medications. Their body fat is down, their lean muscle mass is up, they're sleeping eight hours, they feel amazing energy, they're doing better in business, they're excelling at work, excelling at home, they're just feeling tremendous drive and motivation, which is important as you get older. Their bones aren't getting soft, their height is remaining stable, they're not getting frail. Frailty is a big problem. Sarcopenia, loss of muscle mass, a big problem. These are some of the things that we're really focused in on, preventing the problem, making you feel better.

But you're actually talking about people who are already down the road, who are already 30 pounds overweight, already have the visceral fat, already have the diseases going.

On in their system, and you're talking about actually reversing that. Correct, that's half my patient profile. The other half are patients who come in like yourself, healthy but want to stay healthy.

Yeah.

Yeah. And that was your case. Your levels came back amazing, you're very healthy, but you want to remain healthy. And you see from taking care of patients, as you're getting older, people get sicker and you want to prevent that from happening.

Yeah, I don't want to live a long time and I want to be vital and healthy and I was very curious about what my numbers were because I didn't really know all my numbers and the evaluation you put people through gives them a benchmark to understand where they are in the spectrum of health or disease or aging and you give them the tools to reverse that. So, you know, you do something that is really not done and I used to do it all the time at Canyon Ranch when I worked there over 20 years ago, which was body composition. Now, when was the last time you went to your doctor and he checked your body composition? You might get a skin caliper thing if you go to the gym and see what your body fat is. That's not very accurate. This is a special machine that you have there at Cenegenics, which is like a bone density machine, the same machine used for that. But you also check your body fat. Where is the fat? How much do you have? How much muscle do you have? And, and, you know, I was kind of shocked. I thought the machine was broken. It said I had 6.2 body fat, which you said was like an Olympic level athlete. I'm like, well, I'm not that. But the key is food, you know? And I, I talked to a friend of mine the other day who spends two hours a day in the gym, and he's a good 20 pounds overweight in his gut. and I'm like, you could spend two hours in the gym, but if you're not eating right, and I do the opposite. I eat right and I spend far less in the gym, which I, than I'd like to. I mean, I like to exercise two hours a day, but I just don't have the time now. It's what I want to do when I grow up. And, and, and he was actually struggling. And I feel like my body composition.

Was good because of the input that I use food to change my, my biology. You make a great point. No matter how much you exercise or how good you eat, unless your metabolism is age 18 to 20. As you're aging and your hormones are degenerated and declined, you're not going to be able to achieve those goals like you achieving. So for you, you know, your levels are excellent and we'll go over those in detail, but you're doing all the right things. You're exercising, you're eating correctly and your hormones are at the right level and metabolism at the right level and you're taking some good supplements. Yeah. There was a great article that just came out on probiotics and the gut. And it turns out that probiotics, the microbiome, the gut function is extremely important. And I know that part of what you do is a lot of gut function. It turns out that there's new peptides that are produced in the intestine and these peptides cause changes in appetite, changes in fat deposition. So, I'll send you the article but it's a great new article on peptides. like again, everything's changing in medicine on a weekly basis.

Yeah. Well, the big things that are really focuses of your work are, you know, hormonal therapy when appropriate, like testosterone or thyroid or adrenal support or even, you know, treatment with growth hormones sometimes you use, but less and less. Right.

So. So Cenegenics started in the late 90s, 1996, 1997. At that time, Alan Mintz, who, who was basically head of the at the company, he was a radiologist. He was a big advocate of HGH and human growth hormone. Over the years, because of strict guidelines with the federal government, because of hard for physicians to prescribe growth hormone, and because of a lot of the abuse on certain athletes using growth hormone, we kind of shifted our focus. We're not really a growth hormone company. People think of Cenegenics as HGH. That's not true. Right now, we're focusing in on natural peptides, which are proteins. that tell your body to make growth hormone on its own. So it's a natural protein telling your body to make your own growth hormone instead of giving you HGH. We're not a big testosterone. It's not just about testosterone HGH. It's about a whole complex of four things: nutrition, exercise, hormone optimization, and basically supplementation with certain nutrients that we can't get enough foods today. And as you know, certain foods, for instance, foods from a farm that's not organic, they're injecting the livestock with steroids, antibiotics. They're feeding it corn. I never knew this, but corn is toxic to cows. Yeah, it's not their natural food. Because it's so toxic, you need antibiotics.

They load it up with antibiotics. Everyone thinks- Stomachs will explode from fermenting all the corn. It turns into gas and they explode. They get bloat.

And they literally have to stick a giant hose down their throat to relieve the pressure. And we're eating that meat. And guess what happens? We're getting all the steroids. steroids. It turns out that by a lot of my patients who are seeing with large belly fat, men and women who have a high diet in not organic foods, they're getting a lot of the steroids from eating all these foods and that's inhibiting pituitary release of certain hormones, slowing down the thyroid gland, slowing down the adrenal gland, affecting the pancreas with insulin and cortisol production and they have high levels of those holding on to fat and affecting your sex hormone production.

So all the endocrine disruptors, right, in our all endocrine disruptors are basically pesticides and herbicides. These things actually are shown to alter your hormone levels and interfere with your natural hormones. They actually can be much more potent and cause infertility, hormonal disruption. I mean, I, I was shocked. I mean, I try to eat organic whenever possible, grass, whenever possible, always at home. When I go out to eat, I can't always guarantee that I try to pick the better restaurants. I travel. I'm at airports. You can't have complete control. And I thought, you know, I'm going to pretty low levels of these things and I just wanted to check. So I checked my glyphosate level, which is Roundup. It wasn't super high, but I had a moderate level of Roundup in my urine, which I shouldn't have any because I don't eat GMO soybeans and I must be eating other products that have that in it. I found I had high levels of organophosphate pesticides. I mean, high levels. And so even someone who's conscious trying to reduce their exposures, we all have that and it's all affecting us. Are you drinking red wine? I don't. You don't. I'm a tequila man.

Tequila is a plant. It's a good alcohol. A lot of red. So I, as a hobby, I make wine. A lot of the wine I get from the grapes from California. There are a lot of glyphosate in those wines. Yeah. You know, there's a lot of studies.

Looking at leaky gut, interleukin 2 from, from glyphosate. Do you believe in all that? Yes.

Yeah. Yeah.

And the other thing, you know, it's interesting about testosterone, for example, and guys, you're, you know, as bigger your belly, the lower your testosterone. and men grow breasts because they get more estrogen, they eat a lot of starch and sugar and carbs, alcohol, beer bellies, that all makes your testosterone go down and stress makes it go down. So if you cut out the starch and sugar and you do weight training.

Your testosterone would naturally go up, right? I just saw a patient last week, his testosterone was 1000 on nothing. But his free testosterone was 100. So a good range of free testosterone is about 220, depending on your laboratory. So something was binding his testosterone. it was estrogen. He had a big conversion from testosterone to estrogen because he had a lot of adipose fat in his belly, a lot of adiposity. Adipose tissue will increase the conversion of testosterone to estrogen through an enzyme aromatase.

So he was a big aromatizer. So the more fat you have, the.

More estrogen you have as a guy. And you know what? And men think estrogen's a bad thing. Estrogen's a very important compound for men and women. Women just need more than men. We like to keep our estrogen levels in women around 100 to 150, men about 25 to 50. Estrogen is a vasodilator. It increases blood flow. It's also your libido hormone. Estrogen gives you your sex drive and your libido. Dr. Justin no, testosterone. Well, testosterone will convert to estrogen, but estrogen is the main hormone for your sex drive and libido. Estrogen is very important for your bones. When the WHI trial was going in the 1990s. Dr. Justin It's a women's health initiative. and before they added the new clinical arm, once they stopped estrogen in women, the amount of hip fractures increased 1000%. And there's a lot to talk about with women and hormones and heart disease. I gave a big lecture a year ago on, Can you give HRT to women who are at risk of heart disease or who have heart disease? And while we're on the subject, it turns out that Women were getting estrogen from horses. They were getting equine estrogen, not bio-identical.

Which means pregnant mare's urine, Premarin.

And, you know, so the studies were done on this. I'm saying, okay, we don't use that on women. But the problem was they were giving women Premarin who were above the age of 70, 10 years after their changes. It turns out if you look at the basic science and look at a blood vessel wall, the biology of the estrogen receptors which are in the blood vessel wall change from a protector if estrogen is present to a monster. The plaque just increases significantly when there's no estrogen around. So women who get early hysterectomy or go through their changes nine to nine years after menopause, that's the new window timing hypothesis, six to nine years after menopause, now their receptors change from a protective to a monster. And if you give a woman Estrogen, you can increase their risk of MI.

Any estrogen or only the Premarin?

I mean, would it occur with bioidentical hormones? Unfortunately, that's what's in the data. There was recent studies from the Mayo Clinic, Cleveland Clinic. I mean, all the big institutions looked at this timing hypothesis. So now the guidelines are if a woman is within six to nine years, that's their window of their changes to give estrogen replacement.

It's great for their bones, it's great for their skin, it's great for their hair.

It keeps them young. Because according to the Women's Health Initiative, it increased the risk of heart attack, stroke, cancer, if you give it after nine years after menopause. And that's why it was a roller coaster ride for women. So I actually did research on all the papers from, you know, and every time I give a talk, I need to do that to make sure that I know what I'm talking about in front of a large group of Physicians. Between 1950 and 2018, it was a roller coaster ride for estrogen and, and hormones for women. And it turns out now it's, it's all about the biology of the estrogen receptor. and you want to be able to give women estrogen, but you have to do it at the right time. Yeah.

And the right form, right? Because Premarin will increase CRP, inflammation.

We never use Premarin. I've never used it ever.

Well, it's still women are on it and they take it.

And it's because doctors need continuing medical education. A lot of physicians are so busy today because of the insurance issues in the office, they have to see a lot of patients and don't have time to look at all the new data. As part of what I do with Cenegenics, I'm Chief of Innovations for that company, and I go out to two big meetings a year. One is the AMMG, Age Management Medicine Group. It's a great conference. It's all about science and aging. If you go to agemed.org, you can get a good look at our upcoming conference on this. The other one is the A4M conference. You've heard of that, American Academy of Anti-Aging Medicine. but these conferences, we present, you know, not me myself, but I speak at some of these, too, but they present all the new hot things on aging and new hot innovations like genomics, metabolomics, microbiomics, brain age testing. So, you know, this is what's important out there, all these new, new things. And, you know, unfortunately, a lot of these doctors don't understand, and they have no time to do it. So when we start putting patients on some of these medications, they'll say, why are you doing that? Just give them a statin. Just give them a blood pressure. pill.

Just give them a sugar pill.

Aspirin. You know, it's, you know, it's, it's so. It's more about educating a patient. Most people don't know how to eat. If you go to a restaurant, and for instance, let's say Capitol Grill right next to my office in down on Wall Street. I mean, the martinis are double, which are, which are okay. Everyone likes a martini here or there. But you can't have the martini and the bread and the dessert. You have to pick your poison, which one you're gonna have. You know what I'm saying? Yeah. You know, a nice, nice piece of fish that's. that's wild. Maybe a vegetable, a salad. So far everything is good, some nice water and, you know, maybe a couple of cocktails, but you can't have the dessert and the bread with all that. So that's what we kind of teach is, is a lot of combinations. We teach how to eat on an airplane, how to eat when you're at.

A rest on vacation. I eat an airplane. I bring in days worth of food.

In my bag, and I don't touch.

Anything that's served on airplane. No, that's a, that's a good thing. So, so let's talk about some of this Innovative stuff, because you we just touched on the hormone issue, which some people do need hormone replacement and some people will benefit from it. And I think it's a lot of the great work you do. But there's also these innovations around regenerative medicine, whether it's stem cells, exosomes, peptides, things probably people have never really heard of. And they're relatively new in medicine and not practiced by many people, but you've been innovating around some of these areas around these things. So talk about the whole kind of regenerative medicine piece around exosomes, peptides, stem cells. Where are we at with that? What are you finding works? what is the literature show and what should people be thinking about and how do they figure out what to do?

So, let's talk about regenerative medicine. Okay. I've been working with Dr. Bob Hariri of Cellularity for about four to five years right now. You probably know Bob. He does a lot of work with Peter D'Amondis and Craig Venter, Human Longevity Institute in La Jolla. So, Bob basically was one of the early pioneers in the field of placental stem cells and formed a company called Cellularity. And the Cellularity, basically their vision is to take the placental stem cells that used the placentas are usually from full-term pregnancies in women who are screened of all viruses and diseases who are pretty healthy, eat well, lean, and basically they used to throw these placentas out. Now we're finding out that if we take these placentas, look inside, there's cells in the placental tissue that basically are the mesenchymal stem cells. They take these cells and now we can put them into, you know, anywhere in the body. If we put them into a knee, it's gonna reduce inflammation in the knee and maybe prevent knee replacement in the shoulder, hips.

Aren't those sort of identified by the DNA of the mother where the placenta came from? Isn't that a risk?

So, a lot of the placental stem cells are what we call immune tolerant. They're safe because, you know, the babies, it gets protected. So these stem cells, you know, are excellent source. Now, they've done a lot of research, even with cancers, using what we call P and K cells, natural killer cells, flump present in tissue that can actually cure multiple myeloma in, like, four cases already. So there's a lot of research with that. The only issue in this, in the US, is it's very regulated by the FDA. So you need a specific protocol, an IND or IRB protocol, and those are difficult to get. And right now, a lot of these stem cell facilities are outside the United States. Yeah. Recently, another company, OrganCell, has developed- There.

Are also other stem cells before you get into the exosomes, like from your own fat tissue, your bone marrow tissue.

That are being- so, you know, there's- and also at some of these conferences, they do a lot of stuff with adipose tissue.

Promisize, 6.2% body fat.

You ain't finding any stem cells in my fat. There isn't any fat. Well, what's been shown now, you're taking out adipose fat tissue from yourself. You know, let's say you're in their 50s, that's 50-year-old adipose tissue compared to placental tissue which is day zero. So now your body's accumulated environmental toxins, glyphosate, all these other toxins, and these stem cells are kind of tainted, right? It's been shown now fat-derived stem cells are increasing tumor growth in patients. So I'm not recommending adipose-derived stem cells. Bone marrow-derived stem cells are good, but who wants to get a bone marrow biopsy? There's a company called OrganCell that's using something called exosomes. And about six months ago, I had no idea what exosomes were, but these are nanoparticles, nanobiology. It's small vesicles that were once thought to remove waste from the cell. Remember the Golgi apparatus? And exosomes secrete waste, they go to the cell membrane. Turns out that these exosomes communicate with other exosomes and they communicate by micro RNA, DNA and messenger RNA. And what it does is if it finds a cell that's old, it makes it young. If it finds a cell that's inflamed, it makes it un-inflamed. There's been a lot of patients and clinical studies done in doctors' offices with Lyme disease. Now, Lyme disease is difficult to treat. A lot of people have chronic Lyme, chronic arthritis, pain, and it turns out that these patients are getting IV drips of exosomes resolved inflammation. One particular patient had prostate cancer. and he got laser ablation of the prostate, which a lot of urologists don't believe in that yet, but they basically had laser therapy of the prostate. The PSA in this patient was 14. Usually it takes about six months for the PSA to drop. He got exosome infusions three days a week for a month and then once a week for three months. His PSA in six weeks went from 14 down to one and remained one. So if you do a Google search on exosomes let's say in breast cancer, exosomes and lung cancer.

Exosomes. This research is being done in major.

Medical centers in the U.S. and also, you know, internationally.

Yeah.

So exosomes are, they're the brains of stem cells. It's, it's a really a hot area.

Right now at the. So the exosomes are taken from amniotic fluid, placental tissue. Correct. That are from the stem cells. But you remove these bioactive vesicles, in a sense, these little bubbles within the cell, like little sacks that contain these special molecules that can communicate and reset diseased tissue. Correct.

That's the basic science mechanism for exosomes. The particles.

You just inject them?

You can do it as an injection with the, you know, under the skin, you can do it in the joint, you can do it, you know, in the scalp for hair. You can, you know, we do for, when we talk about sexual dysfunction, I'll tell you some of the things we do for sexual dysfunction regarding exosomes. we're giving exosomes to patients who have neurological diseases, diseases like Parkinson's disease.

Is it FDA approved?

So exosomes right now are under a specific regulation where the FDA approves it for use under, you know, because they're proteins, they're not cells. So, you know, so they're not looking at this as a cell. So there's a basically, it's the, it's.

The brains of the cell that directs everything else without having the DNA in there, which gives you a lot of matter.

You're not using the cell parts, a cell or it's a protein. They're proteins. So what's really interesting is the field is changing rapidly. A lot of people are getting interested in exosomes. I'm very excited about exosomes. I've already used it in several patients and we're getting amazing results. So I think exosomes are the next hottest. It's the next biggest, smallest thing. Yeah. The size of an exosome is 1 million times smaller than the diameter of a hair follicle.

Wow. So it's pretty little.

It's powerful. Think about when you get sick with the flu, chills, rashes, shaking in bed. These are viruses. This is small. These particles that are small are very powerful. So each milliliter, 1 mL of exosomes has, I mean, 1 mL of this flu, amniotic fluid that they're getting has 100 billion exosomes in it, which is significant.

Dr. That's unbelievable. and peptides are also something you mentioned which are related, right? Peptides are proteins.

So peptides are proteins. Peptides are, you know, I started using peptides when I didn't feel like using, you know, HGH anymore because it was just getting too controversial and was getting too difficult to even prescribe it to patients. So peptides basically are short chain amino acids under 50. If they're greater than 50 amino acids.

In length, they're considered proteins.

It's like a mini, it's like a mini protein, a protein fragment. A mini protein. So there's different peptides for different things. There's peptides to stimulate the thymus gland to increase your immune system, to increase your T-cells. There's peptides that repair. So, if you have inflammation in a joint or muscle, you can actually see within two weeks, you can see a muscle that's abnormal and disarray from steroids, let's say, to a muscle that's perfectly lined up with one peptide called BPC-157. CJC-1295 is another peptide that stimulates the release of growth hormone from the brain.

Where do they come from? Are they extracted from other humans?

So, a lot of these peptides are basically made in a laboratory. Some of them are made with plants, some of them are not.

In terms of the decision on who should get them, how do you figure out which one to use? How do you sort that out? Because there's so many of these things.

So for an example, let's say I'll see a patient and they tried everything to lose weight. There's a peptide called AOD. It stands for anti-obesity drug. But it works in the body by stimulating different mechanisms to increase weight loss. There's other peptides to increase hair. There's peptides to increase muscle. There's peptides to increase the burning of fat. Certain peptides can give you better sleep. Now, one of the main- Is there.

A good data on all this stuff?

Oh, there's a lot of research, a lot of data. I actually provide that with you. You can send it to your followers. But it turns out that slow wave sleep is a deep sleep. That's very important. That's when our brain gets increased growth hormone. So, there's a peptide that we give six to eight at night, so it peaks at 1:00 a.m. when the amount of growth hormone gets released from your brain. And that, you know, growth hormone is what keeps us young. It keeps our bone strong, it keeps our muscle mass normal. It makes us have energy. So, you know, sleep is a big problem today. We see a lot of sleep apnea, a lot of people have that, which is at risk, you know, that puts them at risk for a lot of different diseases. But, you know, one of the things that is important is these peptides increase slow-wave sleep, increasing growth hormone more than usual.

So that's incredible. how do we get our hands on that? So these are prescribed through a doctor.

Correct.

And, and can you get them in a regular Pharmacy?

There's a pharmacy called Taylor Made Pharmacy. And, and Taylor Made basically has, they've really started with the peptide business early on. There's other pharmacies that are starting to, to come on board with making some of these peptides, but I can give you a link to, to their, their, their Pharmacy. That's excellent. Amazing.

So exosomes, peptides, stem cells, regenerative medicine, this is really the future and it's a big movement. It's not just on the fringe. There's a lot going on globally around this. There's restrictions in the United States but increasingly we're learning about how to use these substances that are actually designed to promote health and regeneration and repair and healing as opposed to medications which often tend to suppress or block or interfere with some biological process. These actually optimize your natural biological systems and processes, which is amazing. It's a real shift in our thinking about how we help people regain health and vitality. So stay tuned. You guys are all going to hear more about exosomes, peptides, you're hearing about stem cells, the microbiome and more. It's pretty, pretty exciting. Now, the next, the next topic I want to get into is people's often challenging subject for people to talk about, which is sexual dysfunction. and it's a pretty big problem across the board for men and women. And it's something people really don't talk about that much. We had the little blue pill Viagra, everybody was happy, but there's more to it than that. And I want to talk about some of the approaches you have. But first, can you share some of the scope of this problem and who it affects and what kinds of things you are doing to help people solve this issue? Because I have this patient who's like 75 and I mean, all she does is talk about sex and all her partners. So, people can stay sexually active for a long time. I have 80-year-old patients who are like, I want to keep being engaged. And, I think we often say, oh, I'm 50, I'm over it. I had met another guy who was like 58 and he's like, I'm done. I'm like, wait a minute, you're done? It's like, you don't have to be done. And so, I think, what are you finding in terms of the scope of the problem? And then, one of the kinds of.

Things that are really working. Scope of the problem is significant and it just is not in the older population. We're seeing problems age 30. Age 30, 40, 50. Men and women. 80% of erections in men is vasculogenic, is due to blood flow. 20% is hormones. So a lot of the younger patients come in and say, listen, my testosterone must be low because I can't get an erection. that's not the case. It's other things that are involved. Vessels, blood vessel flow. Blood flow is a big problem. Now, why do people have lack of blood flow? It turns out that atherosclerosis starts at age five. You can start having plaque in your arteries. Yeah, and the first sign of erectile dysfunction is endothelial dysfunction. The endothelium is the inside lining of blood vessels. We have 60,000 miles of blood vessels in our body.

Ho many miles in your penis?

Well, so it turns out that it's one organ, not multiple organs, the endothelial system. So people often ask, you know, as a cardiologist, why are you dealing with erectile dysfunction? Because the first sign of endothelal dysfunction is erectile dysfunction. The first presentation that someone has a blockage in an artery is lack of early morning erections or ectil dysfunction.

So when we say that disase absolutely.

Diabetes is a big thing. Hypertension is a big problem. Alcohol is a huge problem. When you have alcohol, you have an acute inflammatory reaction in the blood vessel wall. But the most that we see is sugar. Sugar. Sugar is extremely inflammatory. If you have a Coca-Cola.

So basically the donut or a coke or an erection, you gotta choose, right?

Within two hours, right? Within two hours of having sugar. we can actually measure in the urine an inflammatory mediator. We can actually measure your blood vessel by looking at endothelial function testing to see that it's vasoconstricted after sugar. Sugar could precipitate a heart attack. There was a good video.

So you don't have dessert if you want to have sex, is that the idea?

You gotta pick what you want. So sugar is a big problem, but what we're finding out is blood flow is huge. And like you said, to see the diseases or, or, you know, what we're eating, and that can affect us a lot.

I want people to really get that. What Dr. Shapiro just said is that sugar is one of the biggest causes of sexual dysfunction.

Well, sugar is the biggest cause of inflammation inside the blood vessel lining, which is a big, which is a reducer of blood flow. It's all about blood flow. So what are some of the things that we can do to increase blood flow? A technology that I recently started using about a year ago is called GainsWave. GainsWave uses low intensity, extracorporeal shockwave therapy and it basically can optimize men's health, it can optimize performance. What it does, it creates a small injury. Injury then sends a message to the brain. The brain releases mediators, mesenchymal stem cells, to go to that site and increase blood flow by causing what was called angiogenesis. So actually the Gains Wave treatment, which has been very popular lately and it's available all over the US. We do it in New York City and my Westchester location, but it's involved everywhere. But it's for two things. It basically helps increase blood flow and it does that by angiogenesis.

And angiogenesis means growing new blood vessels.

Correct. So anytime you have an injury, your bet, your body is trying to repair that injury. And now natural repair mechanism is stem cells. so you have a cut on your finger or a shave, you're shaving and you have a cut. What happens in two days? It's healed. Why does it heal so fast? We have a self-repairing mechanism. So, this low-intensity shockwave therapy, GainsWave basically gives you this small injury and we're all familiar with shockwave therapy for lithotripsy, right? Lithotripsy is higher intensity for kidney stones. So, this is low intensity. so the Gains Wave therapy basically works by angiogenesis, new blood vessel growth and growth factors, bringing new growth factors to the area. Usually we do a treatment once a week or twice a week. It's about six sessions. It doesn't hurt. It's not painful, it's non-surgical it's non-invasive patients see results, you know, significant. We're getting great responses. And usually we do six treatments or 12. Some people have Peyronie's disease, which is a plaque. of fibrous plaque and injury to the penis. This has been curing it in patients. Incredible. That's incredible. And, and I mean, and these are young patients that we're seeing, you know, 30s and 40s, some 50s and 60s. But, you know, we're seeing, we're seeing some great results with, with Gainswave therapy.

It's, you know, so does it, does it when you get, like, six to.

12 treatments, is it a temporary result or does effects are longer lasting?

We're seeing results lasting up to two years. It's sort of like having a cardiac bypass in a sense, right?

You get new vessels. Well, yeah, not exactly. I mean, that's the mechanism of it. Let's say you exercised your whole life compared to someone who was sedentary their whole life and you both had a heart attack. From the books, remember some of these studies, the person who exercises is going to have a smaller heart attack. The person who doesn't exercise will have a larger heart attack. What does exercise do? Grows new blood vessels. so, you know, if someone who exercises a lot, who has some blood vessel growth but, you know, sort of like is having a lot of ED issues because they change their diet, they have some inflammation and their blood vessels are kind of like constricted, this will help knock off some of the calcium inside the vessel wall, it'll increase dilation of blood flow, bring in more growth factors and basically- Dr.

It's like regenerative medicine for the penis basically.

Correct.

And it may allow you to throw away your Viagra or Cialis, right?

So, you know, Cialis and Viagra work locally on the penis by phosphodiesterase type 5 receptor inhibitors. And what this is doing is you're inhibiting constriction so you're dilating. But there's other side effects with some of these medications. It reduces blood flow to the eye. Sometimes you can have increase.

Yeah.

You have visual changes. You're gonna have increased reflux by reducing lower esophageal sphincter pressure in the esophagus. I mean, you know, sometimes they're great. Like, stasis, five milligrams daily is great for people with bph because it reduces pressure on the prostate and, and able, you know, allows you to urinate better. That's been a help with a lot of patients. But sometimes combination therapies help.

Yeah.

Like we mentioned exosomes before. So now we're taking exosomes and we're, and we're doing what's called an XX shot or an XY shot. And basically what that does.

I'll call it a P shot.

So, I actually trained with Dr. Rannels and learned PRP and did a lot of PRP, the P shot, the O shot, which helps a lot of women and men, but that's with their own blood. We spin it down and we re-inject it back into them. So, we're getting some growth factors. But, if you compare PRP with some of the new therapy exosomes, exosomes, you're talking about a tremendous increase in growth factors that basically make the results so much more powerful. So, I'm doing some PRP now, not as much. I'm doing a lot more exosomes. I think exosomes will be the future. I know a lot of people injected.

Directly into the penis or sexual organs.

You go right into the penis, you numb up the area, sometimes you can do a nerve block, it's no pain at all. and it takes about 15 minutes. And the response is significant. Patients with prostate cancer who have decreased sensitivity, who got radiation, who now can't get an erection, now suddenly can get an erection after an exosome injection.

That's amazing. Yeah. So how's, how's Gainsway different from other P treatments for erectile dysfunction or performance enhancing drugs?

Well, because Gainsway is the only therapy that's, that's basically using low intensity shockwave therapy.

It's not pharmacologic, it's not invasive.

It's drug free, not invasive, surgery free. It improves blood flow, gives a better erection quality, you have harder erections, more full erections, sexual performance is improved. And actually a lot of patients will come who are younger who want to increase performance. They have good erections but they want performance, they want to be able to last longer. So they come in for performance issues, not ED issues. And then we have maintenance. Once the patient goes through their six or 12 sessions, they'll come back once a season and get a maintenance treatment. But the combination thing of exosomes, PRP or- Diet, exercise, all of that. And Gainswave, exercise, so important. Diet, eating less sugar, keeping those vessels dilated, very important. And we're seeing, you know, it's a safe procedure too. Everyone's concerned about, you know, surgery. I mean, we used to, I used to send a lot of patients for bypass, coronary artery bypass graft surgery. It's, you know, if you need it, you get it. But, I mean, right now we're trying to do multi-vessel stenting. And, I can speak for hours on just cardiology and traditional, you know, disease management. But, I mean, here we're talking about, you know, more natural ways to stay.

Younger and healthier and live longer. It's great. It's really great. And, I think the thinking about aging as a process that's not necessarily inevitable. We can, with a little effort, work in intelligence, use lifestyle plus various innovative treatments that are regenerative to actually optimize, maintain our health and even reverse some of the things related to aging. And I look at myself, the more I've understood about diet and exercise, the more I've implemented it, the better I am. I can tell you my bone density and my body composition was better than even just three years ago. even though I'm getting older, I'm getting healthier.

So you want to talk about your results?

Yeah, let's do that. So before we go, where can people get Gains Wave? How do they find out about it? If they're trying to be curious, what do they do?

So we have an office at 40 Wall Street in New York City and we have an office in Westchester for Westchester Park Drive. That's our main office in Westchester County where they can get Gains Wave. But we have Gains Wave centers you know, in other places all over the US. It's not just here in New York. So they go to a website. There's actually a few places in New York, but I'd rather them come to me as a cardiologist.

Because they're not from New York.

You're listening and maybe you're in. Yeah, so there's a website. I'll provide you with the websites of all these companies. Well, there's, yeah, there's a couple of different websites, but I'll send you the main website for Gainswave. I'll send you the website for, for the peptides tailor-made. I can give you some websites to the Exosome Company as well.

And we'll share that in the email that goes along with the podcast. If you haven't subscribed to the podcast.

Subscribe and you'll get all the information you need. Yeah, but these are some of the best. I mean, that's what I really do is get the best of the best and give them to my patients and.

I'll be happy to share them with your followers on the podcast.

Yes. So my results, how did I do, Doc? So basically, you know, so here's what we do. A patient comes into the center. and we'll do a blood test. A blood test is done about two weeks before the visit. And it's not a typical blood test that you get in a doctor's office. It's about 90 different tests. It looks at biomarkers, it looks at new advanced, you know, genetic markers, metabolism markers, things that you normally don't see in a typical insurance based practice. It's a concierge practice. So you're going to see some some some interesting labs. The good part about this is the labs are done before we see you. so when you come in, we have those results and it makes the day so much easier. It's a very private, you know, location. It's, it's, it's one patient a day. It's not a, a mill where we see 50 patients a day. So it's, it's very nice and quiet. You'll come in there and we'll give you what's called a special suite.

It took me, like, six hours or.

Seven hours to go through the whole thing. It's a full day. It's, and, you know, and it's not like the Prince of Longevity, where they just do testing. we actually treat, follow, supervise. So we make sure you're doing right. So you'll come in the center and then, you know, you saw the room, you have Wi-Fi access, you're able to relax, and then we start bringing you for certain testing. And we're gonna test different body systems. We wanna find out how old you are in your brain, your brain age. How old are your bones? Do you have good bones? How is your muscle mass? Do you have good muscle mass? How about your lung function, your heart.

Function, your various strength, your fitness activity, your nutrition activity? So we did all this on you. How many push-ups can I do? How many sit-ups can I do? how much, how's my grip strength? You know, how fit am I using a special machine where I get on a bike and you basically exercise that you want to throw up and they measure oxygen consumption, your carbon dioxide production. Look at your, something called VO2 max, which is essentially a measure of your fitness level. And the higher it is, the better you are. And I think I did okay. And I, I think, you know, the number of Mets I did, which is also okay, probably was better when I was younger, but. I want to improve that. I can see, okay, I start here, but I can get better.

Exactly. So we did about an hour and a half to two hours of testing. Then you spend about an hour or two with our nutritionist and then our advanced nutritionist looking at more detail nutrition for the gut function. So now we're kind of mixing traditional medicine with functional medicine. And then you spend about two hours with me going over all the results and then we come up with a plan going forward. and you've been on the program now for about two months or months, one or two months, and speaking with you, you feel a lot better, right? I mean, how do you feel after you just in a month, I think it was about a month ago we started, right?

Yeah, no, I feel better and better. I think I'm always trying to find the edge, improve things, stay fitter, healthier. So, I'm very curious about the follow-up results. how I do. I got an exercise program for the exercise physiologist there, which is great. And, my goal is really to keep getting younger. I had my telomeres done, which are a measure of the end caps of your chromosomes, and they shorten as you get older. But, we know from research that through diet, through various vitamins, through exercise, stress reduction, meditation, you can actually lengthen your telomeres. It's not a one-way street. 59, but my Telomere says I'm 39, which is pretty awesome.

Correct. Telomeres are big. It's a big part of our program. We've been using Telomeres for many years. But you're right, just walking 60 minutes. Walking 60 minutes a day will lengthen your Telomeres and increase your lifespan by 25 years. Just walking 60 minutes a day. That's something that easy.

Yeah.

So we can give you a supplement to increase your Telomere astragalus root product that makes your telomeres longer. But there's a lot of things that shorten the telomeres: smoking, lack of sleep, stress, death of a parent, not exercising, diabetes, hypertension, alcohol, all these shortened telomeres. So a lot of things we can do that's simple and a lot of people just don't do those. So let's go into detail about some of the tests. So one of the tests we did was something called a VO2 max, a cardiopulmonary test. So I used to use this at, when I was in Columbia looking at patients to see if they're, you know, candidates for heart transplant. And what we looked at is something called the VO2 max under 14. And if it was under 14, then you were a candidate. If you had, you know, God forbid, you know, a bad heart, weak heart, that you can get it. So Olympic athletes have, you know, VO2 maxes between 40 and 60. So we really look at, you know, the level. of your fitness. And that's really what this test is measuring. One measure is how fit you are. So we measure, we look at fitness in METs. So the range is 5.9 to 12.2. You were 11.6, almost perfect. Your VO2 max was 40.7. And you did excellent. But the most important part of this for you was how good did your heart function at peak exercise? So if you think about an echocardiogram, a sonogram of the heart, whether you get in a doctor's office, that's at rest. This is an echocardiogram, basically like a stress echo. It's your functional cardiac output. How is your heart functioning at maximum stress? And we look at your oxygen level. It's called the oxygen pulse and we can see how well you're oxygenating. People who have coronary artery disease or blockages who are at risk have oxygen pulse of 8 to 10.

Your oxygen pulse was 41, amazing. So my pumps are working good. Your heart is working.

Pipes are clean. Excellent. Another thing that this test gives us is your tidal volume, your pulmonary function, how good are your lungs functioning. And yours was excellent in the upper range of normal. What was really interesting was we can find out at what heart rate are you burning fat 10 times faster and gaining muscle 10 times quicker. In other words, what heart rate do you exercise at so it's basically more efficient.

Yeah, I don't want to lose any more body fat.

Well, no, you don't want to lose muscle either.

No.

You know, you don't want to lose muscle. So some people exercise at the wrong heart rate and they're burning muscle and they're getting thin and cachectic and wasting. You want to gain muscle and lose fat so you're more leaner. So your, your, your, your, your, what we call this, your anaerobic heart rate, we found out, and that was excellent.

So you can see a lot of merit.

You're able to customize an exercise program based on that heart rate. And that's what this test does. so the VO2 max test came out phenomenal. And we repeat this in a year and see how much you progressed. A lot of patients on the Cenegenics program will start off at the bottom and then they work a year after the program, they're like functioning excellent.

Well, it's interesting is we know from the research that your VO2 max, that's how much oxygen you can burn per minute, is directly related to longevity.

So the higher your VO2 max, the longer you live. And that's an excellent question. There's a, there's a, I think I showed this to you during your evaluation. It's a hazard ratio. it's called a death ratio and measures the people who are less active and less fit have higher mortality, the people more active and more fit have an increased mortality. Based on your test extrapolating this to a survival curve, you've increased your lifespan by 25 years compared to someone who's not exercising.

Dr. Wow. Okay. All right. So I'm going to believe to be at least 105, right?

Dr. And I'll give you the link to that paper. Yeah.

Okay.

So another thing we looked at is your bone density. How strong are your bones? Do you have thinning of the bones, osteopenia? Do you have very thin bones, osteoporosis? And we measure in hips and we measure in your spine. So you had excellent bone strength in hips and spine. Now, what makes bones thinner? What harms them? What makes them more osteoporotic? Smoking is the number one thing. Smoking is no good for bones. soft drinks. Soft drinks have phosphoric acid. So part of what I do for the community, I'm on the hazmat team for Westchester County Special Operations. And one of the things that we look at are hazmat symbols on trucks that go on the highways. So if they roll over, they're at risk. If a Coca-Cola truck rolls over, there's a hazmat symbol on some of these trucks because that phosphoric acid, it's bad for the environment. They call a hazmat team. if you took a nail for that you build a house with and put it in a Coca-Cola can. Yes. The nail will melt in three days.

Yeah, it's a good way to clean.

Your car engine, right? It's. I mean, a lot of people drink Coke.

It's just, you know, look, I'm.

It's the real thing. If everybody, you know, if you want, you can look at something called Katie Kirk did a whole thing, a video webinar on. It's called fed up. There's also forks and knives.

I'm sure you heard it. Fed up. I was in fed up. Were you? I was one of the main characters. I consulted on that film.

Oh, I like that film.

That's a great film, Fettke.

It's on Netflix. That's great. Now, vegetables are great for making bones strong. Hormones, estrogen, progesterone, growth hormone are all important. Testosterone and DHEA for bone strength. Nutrients, calcium, magnesium, vitamin D, CK, boron, manganese, zinc, and copper are very important for bones.

So we make sure we test those. What's interesting, the minerals, minerals in our food have gone way down. In 100 years, we've had a 90% decrease in minerals in the soil. And the way we get minerals in.

Our food is from the soil. And vitamins, minerals and vitamins. You're right. So we have patients who see us with you had a great vitamin K level. I mean, vitamin D level, by the way. You had a great vitamin D level. But what we find is vitamin D needs vitamin K2 to get absorbed.

Right.

Foods used to have high levels of vitamin K2.

No more based on what you just mentioned. Yeah, and also it's made in your gut flora too. And so a lot of people have messed up gut flora and they don't.

Make vitamin K. Exactly. So we now give our patients, we recommend vitamin D with K2, not just regular vitamin D. Also, resistance exercise is very good for bones and you do that.

Let's talk about my body fat because that's what I love to talk about.

I'm saving that best for last.

The best for last. So I actually thought the machine was broken. and he's like, no, no, we just did somebody before you and it was bad. So I think it's right.

So we look at different types of body fat. We look at your, your visceral fat and your body fat total.

Fat, right?

You know, was 6.2, which was, which was really good. Olympic athletes have between five and ten. So you're in the Olympic athlete range for body fat.

Androids, senior Olympics.

Android fat, also known as belly fat, was 7.2. Another remarkable level. So, you know, for the, you know, we haven't seen, we've seen this in patients who are on our program for a year or two, not initially when they come in.

You said, I'm the best one you ever had.

Hundreds and hundreds of patients.

That we've seen in Santa Ana, New York City.

Functional medicine works, guys. Now, just so you know, lean muscle mass in NFL football players are greater than 75,000 grams. You're 75,233 grams. So you have the muscle of an NFL player. That doesn't make sense.

And the body fat of Olympic athletes. How could that be? I mean, I don't have that much muscle. Lean, you have lean muscle.

It's a ratio of your muscle to your fat. You have, yeah. So for me, it's all those upward.

Dogs and downward dogs. Yoga is important for this, but you.

Have a lot of muscle. I've been doing yoga for 40 years.

And I think that it does help maintain your strength. It uses body weight. I don't do much weights. I want to do more, but it's fascinating to see that. that just by obviously focusing on diet, you can change your muscle mass. In fact, I wrote this book called Eat Fat, Get Thin, and a lot of the research that I uncovered during that was that if you actually eat more fat and less sugar and starch, it drives increased muscle mass. So I've seen my body composition change over the last 30 years being much better than it was, even at the same weight that I was when I was 30. My muscles are more defined, I have less less belly fat, I have much more muscle at 60 than I did when I was 30.

That's very important because as you get older, you get frail. What prevents frailty is muscles. So we don't want to get sarcopenia. So sarcopenia is a big, big, big problem. Unfortunately, our body has regulatory mechanisms. And what occurs is we secrete a factor called GDF-8. also known as myostatin. The job of myostatin is to break down muscle as we build it to keep you balanced. Aging upregulates myostatin. Diabetes upregulates myostatin.

Stress does.

Everything.

Yeah, in fact, you're right. I mean, I think this is what happens as we age. Our bodies do go through a process if we don't do anything to counteract it, right? When you're three years old, you get a cold, you bounce back. If you're 80 years old, you get a cold, dragging for weeks, right? So same thing, if you're in bed for a week as a kid, nothing happens. If you're in bed for a week when you're 80 years old, you lose a year's worth of bone density, you use tons of muscle mass, you have months to get recovery from just that simple thing. So we actually have to work harder as we get older to actually change the force of entropy that make us age, but it's doable. In fact, I saw this study recently where they looked at older athletes, they were as fit as 30 year olds if they maintained their fitness level over their life. And I think probably most 30 year olds don't have VO2 maxes of 40, right?

That's true. That's true. But between you and me, that's also not true because I see a lot of patients who are younger who don't exercise and they have poor VO2 maxes. But you mentioned something interesting when you get older. So we did a study, our own little trial in New York City with football players who retired. it was called the Optimal Wellness Challenge. And basically, we took a retired New York Giants football players, and we took some from the Redskins. And basically, we, we saw them. This was like 20 years after they retired. Not pretty. They were overweight, diabetics, hypertensives. They were on some, were on pain meds. They were, they were multiple joint issues, broken bones, you know, multiple fractures. They were just in pain. And, and basically what we found was they were a mess. We put them through the Cenegenics type program. Nutrition, exercise. I even went to the supermarket with them and watched how they shop and saw what foods they were picking off the shelves.

Frightening.

Whole milk with steroids in it instead of organic milk, food that was not from food that was GMO, food that was not organic and so on. And then we put them through the exercise program. and hormone optimization program. Within six months, we've noticed cholesterol got reduced, blood pressure got reduced, sugar reduced, body weight down, muscle mass up, fat down, cognition improved, motivation drive improved. And we were just about to do a TV show on all this. I actually closed the bell for the New York Stock Exchange for this. It was great. It was a lot of fun. you know, but, I mean, this is what happens in this, this population. Not only the sports population, all population.

Yeah.

And, and if we start fixing the problem before it happens, okay? So we can fix it when they have disease or, like yourself, you were, you're very healthy. Keep you very healthy. So there's two types of patients that we, that we basically treat, but, but, you know, there's nothing more exciting than, than getting a patient and keeping them healthy. or getting a patient who's sick and making them healthy off meds.

Yeah, powerful. So there is hope for all of us who are aging because that's the fastest growing segment of the population and the baby boomers are all heading there. And even if you're young, it's important to start young if you're listening because what you invest early pays off later. I've been taking care of myself my whole life. I've never really been overweight. I've exercised and as you see, I'm almost 60 and basically as fit as a 30-year-old or younger. and I think that's possible for everybody. I just want everybody to have hope and believe that if they understand the basic workings of their biology, if they understand how to create health, that that it's available to them at any time. And it doesn't take a long time. You're talking about really months or weeks for people to start to see massive changes. So it's great the work you're doing, George. It's been an amazing conversation. Check out Cenegenics and Dr. George Zuber in New York and also Gains Wave, if you're interested in that treatment. It's available. in many areas around the country and check it out online. And thank you for this really important conversation about healthy aging that really matters.

Thanks, Mark. I want to leave you with one fact I just read today. Currently, there's over 2 billion obese people in the world.

Yes, there are.

The first time that that number is higher than the amount of people who are nutritionally depleted.

Yeah, it's terrible. It's depressing. In fact, this is the third year in a row we've seen life expectancy go down. It's never happened before in human history.

And, we can change it.

Yes, we can change it. We can affect it. And, I think that's the work you're doing, which is so great. Thank you for doing what you do. And, you've been listening to the Doctor's Pharmacy. This is Dr. Mark Hyman, a place for conversations that matter. If you like this podcast, please share with your friends and family on social media. Leave a comment, we'd love to hear from you and sign up for the podcast and subscribe wherever you get your podcasts, iTunes, Google Play, wherever and we'll see you next week on the Doctor's Pharmacy. I see.