Young Forever: The Secrets To Living Your Longest, Healthiest Life

Hi, Doctors Pharmacy listeners. It's Dr. Mark here. If you've been following me, you know that I'm obsessed with understanding the latest research on longevity and how we can apply it to our daily lives. So I wrote a book about it. Think of it as a roadmap to optimal aging. It's called Young Forever. It's never too early or too late to take control of your health. And this book will show you how. Visit youngforeverbook.com to learn more and order now.

Coming up on this episode of the.

Doctors Pharmacy, What are the fundamental drivers of disease, which essentially comes down to two things. You're dying of too much of the things that cause disease and dysfunction, and not enough of the things that cause you to thrive and optimize function. And it's really that simple. Hey everyone, it's Dr. Mark. One of the most important tools I have for helping my patients optimize their health is testing. And that is why I love what Rupa Health is doing. Functional medicine testing can require placing orders with lots of different labs, and it can kind of get really complicated for doctors and their patients to easily access results and keep track of everything. But Rupa Health has totally streamlined that process. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to health and healing. I'm really excited about that now and I can finally take advantage of these tests without the hassle of the confusion of going through so many multiple labs. Rupa Health is the place for functional medicine practitioners to access more than two thousand specialty lab tests from over 20 labs like Dutch vibrant America, Genova, Great Plains and more. It's 90% faster, letting you simplify the process of getting you the functional tests that you need and giving you more time to focus on your patients. This is really a much needed option in the functional medicine space and it means better service for you and your patients. You can check it out with a free live demo with a Q&A or create an account at rupahealth.com that's R-U-P-A-Health.com I'm all about streamlining my daily health routine to be as powerful and yet simple as possible. And that's why I love AG1 from Athletic Greens. Because when it comes to my health, I want it all. I want my gut to function great, my brain to feel sharp, my immune system to be strong, my body to feel energized and able. And being in my line of work, I know that means I need optimal levels of nutrients. Which is one scoop of AG1, I get 75 high quality vitamins, minerals, whole food source superfoods, probiotics and adaptogens to support my entire body, even with a really healthy diet, is hard to hit the mark for all our nutrient needs. So I feel better knowing that I have some extra help from AG1. Unlike other supplements and powders out there, AG1 is third party tested and made without GMOs, nasty chemicals, or artificial anything, and it tastes great, kind of like a tropical green drink. I like it on its own mixed with water, but it also works really well in most smoothies. If you're curious about trying AG1 from Athletic Greens for yourself right now, They're offering my community 10 free travel packs with your first purchase. All you have to do is visit athleticgreens.com/hymen. Again, that's athleticgreens.com/hymen to take ownership over your health and pick up the ultimate daily nutritional insurance. Now let's get back to this week's episode of the Doctor's Pharmacy.

Hi, this is Lauren, one of the producers of the Doctor's Pharmacy podcast. Today we're bringing you a special episode where Dr. Hymen is interviewed by his good friend, business partner, and host of the Drew Proett podcast, ask Drew Proett. Please enjoy.

Dr. Mark Hyman, welcome to the podcast. Pleasure to have you here. I'm gonna jump right in and your book, Young Forever, is all about how to basically age backwards. That's right. Before we unpack that and also what's going on today that is really causing so much inflamaging, abnormal aging that we see in the world, I wanna talk about how do we get an accurate assessment of how old we truly are today. What are the tools, the techniques that are out there that are available today that we never really had access to before to see how actually old we are on a biological level?

Absolutely Drew, it's so great to be with you on the podcast again. You know, most people think of their age based on their birthday, right? Their birthday is what it is and their age is what it is and there's no changing that and that's your chronological age. But the science of longevity has now helped us to unpack a very different view of aging, which is the difference between our biological age and our chronological age. And now we have tools, metrics to measure our biological age, which we never had before, based on emerging science, looking at DNA methylation, looking at immune age, and I think other ways through the lens of functional medicine, looking at the array of biomarkers that we can collectively assess someone's state of health. so I use all these metrics to come up with a sense of what's going on with someone's body. But the key one that's being used to assess any kind of intervention. So how do you know if you do some type of dietary change, like intermittent fasting, or you do some type of exercise, like strength training, or you take this supplement and, like, course of tendon, what is it doing? Is it working to affect your biological age? Well, now we have a metric based on DNA methylation, which is essentially this process. that marks your DNA with little tags to determine which genes are expressed or not. So you can't change your genome. Your genome is fixed. You've got 20,000 genes. That's it. Maybe there'll be gene editing and super fancy robotic techniques through nanorobots to change your genes at some point. We're not really there yet. But we can change the epigenome, which it means epigenome means above. So above your genes is this control mechanism. So your genes are like, the piano keys on piano. The Epigenome is like the piano player. And the piano player can play jazz or rock or reggae, whatever the heck you want. So you can change the Epigenome by how you live. So everything you do, every bite of food you take, every thought you have, every time you exercise, how your sleep is, what toxins you're exposed to, what's going on in your microbiome, everything that washes over you throughout your life, the sum total of all the experiences, what we call the exposome, controls the epigenome and you have control over all of that. Well, most of it, you can't control the toxins in your environment as much as we'd like, but you can limit them. You can restrict your access to certain foods that may have more toxins like pesticides or heavy metals. But for the most part, we can regulate our epigenome and we can reverse our biological age using the strategies that I talk about in my book, Young Forever, which is about how do we take the science of longevity, pair it with the science of functional medicine, and come up with a roadmap for how people can activate their longevity switches to reverse their biological age? So I did my epigenetic test, which is a blood test which looks at these DNA methylation patterns, and I found my biological age was 43. Now I'm gonna turn 63 in a week, but I'm 43 biologically, which is cool. I'm trying to get to 25.

I don't know if I'll get there, but I'm working on it. That's great. And before we talk about your central thesis that really the whole book is about and it sets up the book, is there one or two of those that is pretty easily available for folks? You mentioned a whole slew of different tests that are there. But if there was one test that people wanted to do to get a good sense of sort of their biological age, would you pick from that list that you have?

Yeah, I think the DNA methylation test is right now being used primarily to look at interventions for longevity. And it's available through various commercial labs that are you can buy and get through various online programs and tests. So it's pretty easy to get. The lab that I used was True Diagnostic. I don't have any affiliation with them, but they do a good job in terms of DNA methylation. There's a lot of other groups doing it from people at Elysium and Yale and other groups are looking at how do we sort of commercialize these tests. So there's a lot of companies commercializing them and I actually did all of them and I found there was a lot of variation. So I still think this is being tweaked, but through looking at the evidence of many of the studies that have done interventions to see if they can reverse biological age, the reality is that we can sort of track these things. So that's what I would recommend for people to track.

And the example of like DNA methylation, like the one you mentioned, how often might somebody want to check in on that after they've made some major changes in their lifestyle or they're following your program and they wanted to check back in on it?

Well, we have a number of studies. Six months? Yeah, yeah, yeah. That's a great question. We have a number of studies that reflect the changes in biological age with certain interventions. So some of them are a year long, like vitamin D might reverse biological age by a year. Some certain changes in diet may reverse biological age, some interventions like quercetin and dasatinib, which was done at Mayo Clinic, reverse biological age by over a year. in a sort of an intermediate term study, which is weeks. But the most impressive was the one done by Cara Fitzgerald in her group, which looked at a more aggressive dietary intervention, what I would call a functional medicine dietary intervention, which is an anti-inflammatory, detoxifying phytochemical-rich DNA methylation supporting diet, along with a number of other lifestyle interventions. And in eight weeks, they reversed biological age by three years. So it's not like you have to do this forever. to get a result. You have to do interventions for a short time to see really remarkable changes in biological age. So I think we're still figuring this out, but the good news is that you can see changes relatively soon. So I wouldn't say you do this all the time, but maybe every six months, 12 months, depending on what you're.

Doing with your lifestyle changes. Amazing. All right, let's set up the idea of the book, Aging is a Disease.

Talk about that. You know, in medical school, I certainly didn't learn that aging was a disease and we don't think about treating aging as a disease. And in fact, it's considered kind of wrong to think about aging as a bad thing. It's called ageism.

And- so people get very triggered by that.

Yeah, be very triggered by that.

But- Do you think that some of that is warranted?

Yeah, I mean, I think we don't wanna stigmatize people getting older, but that's different than biological aging. so you can get older and yes, you're gonna change your body and things are gonna happen and you're gonna get wrinkles, but the reality is that we can maintain our young biological age for a long, long time. And we've seen this in study after study. So I think when we talk about biological aging and aging as a disease, we're talking about these fundamental dysfunctions that happen as we get older that are not inevitable. So getting older is inevitable. but disease is not inevitable. And most of the things we see in our culture as people get older are phenomena that relate to underlying biological dysfunctions we call the hallmarks of aging that result in the diseases of aging, heart disease, cancer, diabetes, dementia. And what was remarkable as I was sort of researching the book was discovering that if we completely eliminated heart disease and cancer from the face of the earth, that we would maybe extend life by three to five years. which is insane. When you think about these are the two biggest killers on the planet, why wouldn't we lend life to be 120? It's because we're not addressing the other biological mechanisms underlying aging. And so if we do that, we might see a life extension, not of five to seven years, but of 20, 30, 40, 50 years. So maybe we can see us living to 120 or 130 or 150, which is not beyond the realm of possibility once we understand these mechanisms. And I see this, I see patients who are in their 30s and 40s who have a biological age of 70, and I've seen people who who are 70 or 80, we have a biological age of 50 or 40. So we have the potential to do this if we take advantage of the science of longevity and apply the principles that are addressing the hallmarks of aging and the causes of the hallmarks of aging.

So there's been a lot of books written on the topic of longevity, and it's a hot sort of area that people want to explore. What is unique about your approach with this book is sort of the functional medicine approach to aging. Can you chat a little bit about that? For sure. How is that lens shape how you look at this world of aging?

One of the exciting things for me is I began to research deep into longevity research is this framework of the hallmarks of aging, which are nine. I added one, 10, which is the microbiome. We can talk about those in detail. But these are the phenomena that go wrong. Damage to our DNA, changes in our immune system and inflammation, nutrient sensing pathways, telomere shortening, epigenetic changes. And, you know, there's a whole list of these problems that we now have identified that go wrong in the body that then result in the things we see as aging, all the diseases of aging. But, you know, it's sort of like the blind men and the elephant. Everybody's talking about these things. Let's take a drug to fix our mitochondria or to suppress mTOR or to increase telomere length or to kill zombie cells or all these different things that could be treatments for these hallmarks of aging. But from a functional medicine perspective, the question is always is what's the cause? So if the hallmarks of aging cause the disease of aging, what causes the hallmarks of aging? So let's go way upstream to look at the cause of the cause of the cause. So that's where functional medicine comes in, which is looking at what are the fundamental drivers of disease, which essentially comes down to two things. You're dying of too much of something or too little of something. You're dying of too much of the bad stuff and not enough of the good stuff. You're dying of too much of the things that cause disease and dysfunction and not enough of the things that cause you to thrive and optimize function. And it's really that simple. So from the lens of functional medicine, we look at the causes of the hallmarks, which are our diet, toxins, stress, physical and psychological stress, our microbiome and microbes, and various kinds of allergens and other insults that the body has, as well as the deficiency of things that we need to function right. We need the right food. And this is really important. And there's an array of phytochemicals that aren't considered essential, but that I believe are truly essential for biological health. So they may not be like nutrients or vitamin or mineral, but if you get a a lack of it, you get a deficiency disease like rickets or scurvy. But if you don't have these over the long time, you get what we call a long latency deficiency disease. In other words, if you don't have enough of the right phytonutrients over time, your biology can't function optimally and you age faster. So we need the right nutrients, we need the right types of exercise, sleep, rest, community purpose, meaning there's a whole list of these ingredients for health. So we have to remove the impediments for health and add the ingredients for health and that allows the body to thrive. So functional medicine is the science of creating health. not treating problems, it's actually the opposite. It's actually giving the body a chance for its own innate healing system to be activated, which then will naturally create health and reverse biological age.

So let's just do a little quick teaser on some of those. You said functional medicine is looking at what are we not having enough of and what is also getting in the way, right? Like what do we need to add more of and what do we potentially need to remove? So in the category of removal, what are like three of the top things that you see today, right? There's a whole list of them, but what are three of the top things that you see today that are creating an accelerated aging for most people? In fact, it's so accelerated that you have to really go far and wide and you talk about some stories inside of the book, which we'll chat about here. You have to really go far and wide and maybe travel to some foreign countries to really find groups and communities who are actually maybe aging in a more normal way. But yeah, what are three things you think today that are going on that are accelerating aging.

Well, clearly far and above everything else is our diet.

You put that as number one.

For sure.

Sometimes people talk about thoughts, sometimes people talk about toxins, but you're saying number one you really feel is diet.

Absolutely. I mean, the single biggest input to your biology every day are the pounds of food you eat every day. And the information in that food is in real time changing your biology and regulating everything that's going on. In fact, I call them the longevity switches, which is kind of a term I made up in the book. But essentially, there's these four nutrient sensing pathways that regulate biological aging. And these pathways are one of the hallmarks of aging. So one of the hallmarks is called deregulated nutrient sensing. It's a big mumbo jumbo of medical language, but essentially it means your body and food are not working together to create health. And so these pathways, when they're not properly tuned up will drive all the other hallmarks. So for example, the amount of starch and sugar in our diet is driving increase in insulin signaling pathways. So insulin goes up and this insulin creates this cascade that drives all the disease of aging. So insulin resistance and poor metabolic health, which affects now over 93% of the population, according to a new study, is the biggest driver of heart disease, of cancer, of diabetes, and dementia. And not to mention all the other problems like depression, and infertility and so many other problems that occur from insulin resistance. So this is the biggest phenomena that's happening globally, which is caused by our ultra-processed diet, which is about 60% of our calories in America. Processed food could be sardines in a can or a can of tomatoes. That's not necessarily bad, but ultra-processed food means that they take these raw materials from industrial agriculture, corn and soy and wheat, and they highly process them into components that you wouldn't have in your kitchen and they recombine them into things that are food like substances. And I've written about this. I've written many more books than I probably should have on food and nutrition.

So a lot of the fast food that's out there, a lot of the grocery store in the sort of inner aisles that are like highly packaged foods.

Yeah, all of that. Yeah, all of that is so bad for you. And if you look at the label of ingredients and you can't recognize what it is with covering the front of the package, you shouldn't eat it. And, you know, whether it's a corn dog or a Pop-Tart, you may not be able to tell the difference looking at just the ingredients on the label. So that's the biggest driver of so many of these deregulated nutrient sensing pathways. The other is just the constant influx of food. So we eat all day long, we snack, we eat before bed, and then we eat when we wake up. And this doesn't give our body a rest. And so that activates this pathway called mTOR. mTOR is really important. one of the four longevity switches. First is insulin signaling, then it's mTOR. mTOR is activated by protein and also by sugar. And when it's overactivated, it actually can drive cancer and prevent your body from repairing and healing itself. So you need to give your body a break from eating and inhibit mTOR, which then allows this process called autophagy, which essentially means self-cannibalism. so what's really exciting is our body has these innate repair mechanisms. We have the ability to clean up waste, we have the ability to rebuild new tissues, we have this, I can think of it, you cut your skin and all of a sudden your body then makes new skin, which is kind of a miracle, right? This is going on inside your body too, but we don't allow that to happen. Imagine if you had a cut in your skin, you kept scraping it and digging at it and it would never heal. That's exactly what we do with this constant influx of food. So we have to give our bodies a break so we can activate this process of self-cleaning, recycling and repair. And this is called autophagy. Now, you can't do that all the time because if you weren't eating all the time, you're going to starve to death. So you need to sort of have this Goldilocks balance between stimulating mTOR to create protein synthesis to build muscle, but also inhibit it at times by not eating. We call it time restricted eating, intermittent fasting. There's a lot of ways to do it that activates autophagy, which then creates this self-cleaning process. So think about, like, It's basically this cleanup crew that comes in and cleans up all the garbage and gets rid of all proteins and old, you know, inflammatory stuff and then builds new stuff. So it's like you've got this build building construction crew and this demolition crew and you need both to actually maintain your health and create longevity. Hey everyone, it's Dr. Mark here. Now you guys know how seriously I take my health routine and one of my non-negotiables is getting a daily dose of red light therapy. 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And that lack of exercise creates this horrible set of consequences that drives disease across the whole spectrum of illness, whether it's dementia or diabetes or heart disease or cancer and many, many other problems. So exercise, the right kind of exercise, strength training and cardiovascular fitness, are medicines, just like food is medicine, exercise is medicine, that activates also these longevity switches and pathways. And it also works through these four longevity switches, mTOR, insulin signaling, another one called sirtuins, which we can talk about, and AMPK, which is regulated also by regulated by sugar and so forth. So we have all these redundant pathways that are designed to work together to repair DNA, to shut off inflammation, to clean up old parts, to build muscle, to all these great things that our body needs to do so we can maintain our health. And what's so exciting now is we know how to turn the dials on these switches. You know, it's like a jet plane. You go in the jet plane and it's like a little overwhelming and you see the cockpit, man, that guy's gonna fly this thing. It's got 4,000 dials. I hope we can take off and land. But your body's the same way. And then the beautiful thing is though, learning a few simple principles, you can.

Keep the thing running without a whole lot of effort if you just know what to do. so you covered two, you covered food, which is eating too much and also not also taking a break from food. Autophagy, you covered also the category of not moving. Do you want to throw in a third bone?

For sure. And this is a little bit of a kind of outside left field thing, which I added as one of the 10 Hallmarks of Aging, not just nine, which is the microbiome. And I add the microbiome because it is such a key part of our health and it degrades as we age, and our diet does not feed the microbiome properly with the right types of fiber and phyto chemicals and polyphenols, and we do so many things to disturb our gut. And when we have a disturbed microbiome, it's a huge generator of inflammation in the body. And as we can talk about later, inflammation is also one of the hallmarks of aging, but it's also one of the most important hallmarks of aging because it drives dysfunction in all the other hallmarks of aging. So if you were to call out one hallmark of aging that's both the cause and the result of all the other hallmarks, it's inflammation. And the gut is a huge source of inflammation for so many people because most of us to one degree or another have a disturbed gut microbiome and leaky gut and that causes inflammation, obesity and aging at a rapid level. And we see this from the data. If you actually look at the data on aging, you see that as people get older, their microbiome is worse. And when they're older and sicker, their microbiome is even worse. So we can learn how to repair and heal and rebuild our microbiome. through the lens of functional medicine. It's one of the greatest contributions, I think, of functional medicine to the field.

Of medicine is understanding how to fix our gut. I love it. So, I think it's just worthwhile to just repeat maybe, and if you don't have it in front of you, I think I have the list right over here.

Just the 10 hallmarks of aging.

Again, you already covered one of them.

Which is the microbiome, right? Sure. I'll give you a bullet point. And a little bullet point for each one. I think that'd be super helpful.

So, a lot of things go wrong.

In no particular order. We have damage to our DNA. Every every day we get 100,000 little hits, death by a thousand cuts.

And what would be examples of things that would be...

So toxins, poor diet, stress, the microbiome insults, all these things create little nicks on our DNA. And we have a whole repair system that goes in and fixes it. And so that has to happen well. So problems with DNA repair, epigenetic changes, we talked a little bit about the exposome, washing of our DNA and marking our genes and regulating which genes get turned on or off. degradation in our P genome. There's also the development of what we call senescent cells. Senescent cells are cells that don't die. And most of the time when your cells are done doing their job, you have this process called apoptosis. They die, they get recycled and all is good. But sometimes, like zombies, they don't die. And there's many reasons for it. Again, the too much of something that we don't need and not enough of the things that we do need accelerates this process. and you get these zombie cells which produce this whole inflammatory cascade that accelerates inflammation, accelerates aging, and also causes other cells to become zombie cells, right? So they don't die and they just keep going. We also have the deregulated nutrient sensing pathways that I talked about, mTOR, AMPK, SIRT1s, and insulin signaling, these four pathways that are really key and really are importantly regulated by food, which is why it's so important. there's mitochondrial dysfunction. So degradation of our mitochondria and how they work, which is our energy factories. So our ability to produce energy, have energy, make energy, all gets degraded. And there's many ways to improve and enhance the function of your mitochondria, which we go through in the book. And there's telomere shortening. Telomeres are the little end caps, like the end of your shoelace things, a little thing on the shoelace and front, some unraveling every time your DNA. has replicated, you have to replicate cells all the time, that it has to open up and then it has to close up, and the telomeres are part of that regulation. And as we age, our telomeres shorten, and when they get too short, you die and you can't replicate anymore. So that's bad news. And then there's the microbiome. I added that one, so that was mine. But I think other people are also adding this too and thinking about this, but degradation of the microbiome, the dysbiosis that results in inflammation throughout the body and leaky gut, that's a huge factor in accelerated aging. The also next one is the inflammaging. Inflammaging is one of the most important ones because we have, you know, the phenomena of inflammation as the key driver of almost all age-related disease. So if you look at heart disease, cancer, diabetes, dementia, these are all diseases of inflammation. And so is depression and autism and obviously autoimmune diseases and so many things that go wrong are diseases of inflammation. So inflammation is both an accelerator of all the other hallmarks and is caused by dysfunction in all the other hallmarks. So for example, if you eat too much sugar, it dysregulates the nutrient sensing pathways in such a way that accelerates inflammation. But also if you have inflammation, it accelerates insulin resistance. So it's like it's kind of like all one big web like kind of mishmash of things. And the hallmarks are not separate. They all are dynamically interacting and affecting each other. Was that 10 or did I miss one?

I think that was 10.

Okay. I wasn't counting, but I think that's all of them.

I want to zoom out for a second. There's a lot of really smart people that are working in this space. Many of them are your peers, your colleagues, your friends, people that you know.

And.

How would you contrast sort of what you're bringing to the table with this lens and view compared to a lot of what has been talked about in the space of longevity, right? Just using a compare and contrast because I think it's a nice opportunity to contextualize what you're talking about because some of the things that you're saying, they kind of feel like no-brainers to people. But in another way, when you really zoom out, there's a sense when you're reading this book that this is actually kind of like a fundamentally different approach.

It really is different because What I think is unique about my approach is two things. One or three things. One is I see the world through the lens of systems biology and zoom out to see the interconnections between everything. And I'm able to sort of see the patterns in the emerging research based on this overarching paradigm shift in medicine called systems biology, network medicine, functional medicine. Two, I've had 30 years of experience of treating patients using functional medicine. And I've had the unique ability and the rare opportunity to have a really deep dive on people's biology because of the nature of the places I worked at Canyon Ranch, my own practice, where people came and they could do, you know, thousands of biomarkers. So I literally have thousands of biomarkers on tens of thousands of patients over decades. And that gives me a unique lens into what happens when you change different variables, diet, exercise, stress, supplements, whatever you're doing. to optimize people's biology. So I've seen remarkable things that would seem like miracles that I know work because we've done them and they're repeatable. And I think taking that experience and overlaying it with the science of longevity, it helps me to understand things a little bit differently and a little bit in more depth and, and then provide a clinical roadmap of how people can take advantage of the science step by step, how they can identify what's going on in their bodies, their biological age, their imbalances, what's going on with the hallmarks, and then give very prescriptive strategies and a roadmap to correct these problems and to optimize their health. So I'm coming at it from a doctor's perspective. There are a lot of scientists who've written books who are researchers, and they're great, and I've learned a lot from them, but they haven't seen a patient. and they haven't treated a patient. They're treating mice or they're treating monkeys or whatever, which is helpful to understand the biology. But it really is very different than putting together a comprehensive strategy for people to assess and optimize their biology. So that I think that's what's quite different.

Are there any hacks, prescriptions, supplements that you feel before we get to kind of your list of recommendations that you have and you've already talked about food, you've talked about some lifestyle things. We'll tease out a few others. Do you think that there's anything that you see out there right now that is getting a little bit too much weight as a solo intervention for longevity and aging?

For sure. So Drew, everybody wants a quick fix. Everybody's looking for the magic pill to extend their life because they don't want to take on the other changes. And there's a lot of people out there prescribing and taking metformin, which is a drug that was discovered in 1957 it's been most widely used for the treatment of diabetes. And it helps improve insulin sensitivity and insulin resistance, and it works on one of the key longevity pathways called AMPK, which is really important. And it can help in ways that other diabetes drugs don't, which often in a way make it worse by increasing insulin. So this is actually a relatively good drug for diabetes. However, looking at the data from the functional medicine perspective, it's important to look at how does it work, how good does it work, and how is it compared to other interventions that may work better. So the, the, the, right now there's a lot of research going on. There's a big trial right now called the TAME trial treating aging with metformin or targeting aging with metformin, which is, it's important because they're doing a clinical trial. to determine whether or not this really has an impact. But there's a study that was done many years ago called the Diabetes Prevention Trial. And this diabetes prevention trial was about 1,000 people who were pre-diabetic, and they gave them either nothing, lifestyle changes, or metformin. And the metformin group had a reduction in the progression of diabetes by about 31%. The Lifestyle Group had a reduction in the progression of inform and to diabetes by 58%. And the diet and the lifestyle program was not optimized for diabetes because it was done in the days when we thought a low-fat diet was the cure for diabetes.

1990, right?

It was when they started the study. So, if you look at the data, for example, from Sarah Hallberg and others that I talk about in the book, they used a ketogenic diet. for treating not just pre-diabetes but for advanced type 2 diabetes. And we're able to completely reverse type 2 diabetes in advanced diabetics with a ketogenic diet. And they were able to get 100% of people off the main diabetes drugs and about 90 plus percent off insulin and have a weight loss of 12% and improve all the cardiovascular biomarkers, which you would expect may got worse on a high fat diet. So it's kind of like, well, If you did the diabetes prevention trial with a ketogenic diet and compared to metformin, it would probably be like 100% versus prevention of diabetes to compared to 58% or 31%. So, I'm dubious about it. I'm not prescribing metformin for longevity at this point. I think lifestyle works far better. Now, there may be people I might use it in who have diabetes, we're working on an interim strategy, but I share a story in the book, I've shared it before, but it's just such a remarkable story of this woman, Janice, who shows the power of what food can do to reverse biological aging and to cure, not just prevent, not just treat, but to cure. And I'm saying that deliberately, many chronic diseases of aging. So this woman was 66, she came to Cleveland Clinic and joined our Functioning for Life program, was a group program. not even a one-on-one doctor's visit. And it was based on the 10 day detox diet, which essentially is a very low glycemic 50% fat, not keto, but higher fat, phytochemical rich, high fiber, anti-inflammatory detoxifying diet in three days. By the way, she was had a BMI of 43. So that's huge. Obesity is 30, severe obesity is 40, and she was very, very overweight. She had type 2 diabetes for 10 years on insulin. She had heart failure. She has kidneys were failing. Her liver was fatty. She had high blood pressure. She was on a pile of meds. $20,000 copay a year. In three days, she was off her insulin. In three months, her A1C, which is your average blood sugar going from 11, which is probably an average of 300, almost needed to be in the hospital with that number, to perfectly normal at 5.5 off of all her medications and her heart failure reversed and her kidneys normalized and her liver normalized and her blood pressure normalized. And then in a year, she lost 116 pounds. and all her diseases went away and she reversed her biological age and she got off all her medications. Now, I could have given her all the metformin in the world and none of that would have happened. And she was already on all that stuff and it wasn't working. Those managed diseases, I don't want to manage disease, I want to reverse them by creating health. We didn't treat any one of her diseases, I just optimized her health and created health and as a side effect the diseases went away. So that's the beauty of functional medicine. I don't have to know anything about the diseases that I'm treating, but I do obviously because I'm a doctor. All I have to do is use the science of creating health, AKA functional medicine, and the diseases go away as a side effect.

I love it. I want to take a little quick pause and actually go through something that you've put together in your book, which is a great resource for folks, and it's your approach to the food pyramid. And I kind of want to walk through it really quickly.

Okay, sure.

Because people are so interested, you're the Food is Medicine doctor, and they're so interested about how you think about food and what to prioritize. And I think a thing that a lot of people don't necessarily know about your work is like you really encourage people to get to a place where they have metabolic flexibility.

Yeah, for sure.

Where they can enjoy a lot of different types of foods, but when their foundation is solid, that makes them able to do that. You're not the guy that's saying don't ever eat sugar. You're not the guy that's saying don't ever eat, you know, any particular category of things that are there. You're the guy that's like, hey, when we have it dialed in, then we can have a lot more flexibility. But first we've got to dial it in a little bit. So this is a little bit different than your ten day detox style. This is your Pegan diet, right? So I have the food pyramid here. Maybe Patrick, for those on YouTube, we can throw it on the screen. And for those in the listening on audio, you know, we can link to it as well. So walk us through the top of this food pyramid and we're going to start off with the top of the pyramid, the little triangle at the top, and help us understand each one of the categories as you walk through.

Yeah. Well, first of all, I want to say that there's really two approaches. One is if you have a disease or a problem, then we take a slightly different approach, which is we personalize the approach. So for example, if you are an advanced type two diabetic, you know, there's zero tolerance for deviation from a certain type of way of eating if you want to reverse the diabetes until you are metabolically flexible or metabolically resilient. So the key is not to be restrictive, but to optimize your biology, tune your body up so it can run 200 miles an hour and not go at three miles an hour like most people's metabolic processes go. So how do we tune up your biology? That's really key. And how do we personalize it based on what's going on with you? But for the general population, you can achieve metabolic resilience without having to be too extreme. But it really means understanding what is information in food and how to use food to upgrade your biology. So, at the top of the pyramid is recreational treats, things like alcohol, sugar, and so forth. And, I would just say that, not on the pyramid and not included in recreational treats, are ultra processed food. They're just zero. Like I will never eat an ultra processed food no matter what. Like if I'm in an airport and starving, I'm not going to eat anything with high fructose corn syrup, trans fats, a thousand ingredients that are weird because they're not food. So it would be like eating a rock. Why would I eat a rock? So I just don't. And I think nobody should really eat those foods because they're extremely harmful and they create all sorts of downstream consequences that drive aging and disease and also make us eat more of them. cause they're designed to be addictive. So that's just a no, no. But if you start, you can't stop. Yeah. So those are foods we know, like all the snacks and candies and processed foods. The things that are okay are things like sugar in small amounts. They're recreational treats. So, for example, I like to drink tequila. I'm not going to have it for breakfast, lunch and dinner. I'm not going to have a bottle every day, but I might have a shot a couple of times a week or maybe a couple of times a month is probably how much I actually have. Sugar, same thing. It's not you never have it. Like on Thanksgiving, I'm going to have a, you know, a nice gathering, and I'm gonna have pecan pie because I love pecan pie, but I don't really eat pecan pie except on Thanksgiving, right? But I know I'm exercising, I'm eating well, my insulin levels are low, my lipids are good, my hormones are balanced, so I can actually tolerate more stress, more biological stress from the food because it is a stress to eat these foods. Alcohol, the same thing. So I think recreational treats are fine, but they should be seen as, you know, like a special, special kind of thing that you don't do on a regular or daily basis. And then the next category is, you know, things that we can use that are designed to upgrade our health. And these can sort of be mixed with all the other foods, but spices and herbs are really important because they, they contain so many phytochemicals. So I was in Sardinia and in Korea researching my book on longevity, and I went to Korea and they had this incredible tea they serve me. It's just because they have so much of this wild sage growing everywhere. And, you know, they don't have a lot of money, but they live in this abundant world where they harvest all these greens. They have summer greens, winter greens, all these wild herbs. And wild food has way more phytochemicals. So they make this wild sage tea that is yummy and tasty and turns out has as many of the powerful phytochemicals that are in green tea, these catechins, which we know increase longevity through many of these longevity pathways. So, I'm drinking this wild sage tea and that's really helpful. Or, you can use Indian food, for example, it's full of spices like curcumin and pepper and all sorts of these wonderful spices that upgrade your biology and improve inflammation and are antioxidants and help your microbiome. So, I include a lot of herbs and spices. And then, I think the next is eating Grains and beans. Now, grains and beans are not part of our diet from an evolutionary point of view. We really didn't have them in our diet. But I do think there are certain grains and beans that can be part of a healthy diet. And this is very personal. If you're metabolically healthy, you can tolerate more of them. If you have insulin resistance or diabetes, you have to be careful how you're eating them, what you're eating them with and so forth. And you can now measure what's going on. You don't have to guess anymore. There's companies like Levels that have these continuous glucose monitors. and you can track what's happening in real time to your biology. So say, I'm gonna have a, you know, a cup of brown rice, 'cause that seems like a healthy food. Okay, great. Do it. See what happens. If your blood sugar goes through the roof, you know it's not working for you. And it also depends on your microbiome too. We know from studies from Israel and other places that the microbiome will affect how any particular food affects your blood sugar. That's a whole other conversation, but our microbiome plays a role as well. So you need to track your own numbers, and I think part of the exciting thing about longevity research is these biosensors that are emerging. And we have them, we wear them, or a ring or an Apple Watch or a Fitbit or whoop or these implantable ones that are coming that may detect over a thousand biomarkers, the continuous glucose monitors, which are available now, which are pretty fun to track and see what's actually happening. So I think there are certain ways to eat beans and grains. And I say eat weird grains, eat weird beans. You want the more heirloom kind, you want the kinds that are not super high in starch. So, for example, we were with our friend Jeff Bland the other day who's the father of functional medicine, and he's started producing this ancient grain from 100-year-old seeds. Which is really a fruit. It's really a fruit, right? It's a flower. It's a flower. I think it's a flower. Yeah. And, it's a Himalayan tartary buckwheat. And, I don't know why they call it wheat because it has nothing to do with wheat, but it's basically this ancient grain-like substance compound. that's grown in the Himalayas that is full of 132 phytochemicals. It's very high in protein, very high in microbiome beneficial fibers and phytochemicals. It has compounds that are found nowhere else in nature. And you can make pancakes with it, or you can make noodles with it, or you can make bread with it. And that might be actually a very healthful food. So there are weird things like black rice or forbidden rice, the emperor's rice, like the blueberries of rice. And that's full of, again, phytochemicals. or certain types of quinoa, these can be fine. And I think it's important that people want to include these, that's fine. But again, watch what happens to your biology. Look at what happens to your numbers. Track your numbers is so important because most of us don't track what's going on inside. And that's what's so exciting to me for really, you know, we look at the sort of accelerating pace of technology and the accelerating pace of scientific advance. And, you know, we used to, like, my first computer had four megabytes of hard drive and one megabyte of RAM, and it cost 3, 500. And now I have a supercomputer in my pocket for a couple hundred bucks, right? So that's what's happening in terms of testing, diagnostics.

We're going to get there pretty soon. So one clarification just as you're going through this list, spices and herbs is listed above beans and legumes, but you want spices and herbs to be frequent in our diet. It's just that the quantity, you're not.

Going to really eat that much spices and herbs. It's based on volume too. Yeah, based on volume. And then down next is the sort of fruit and starchy vegetables. So again, depending on what's going on with you, if you're a type two diabetic, you might not tolerate a lot of fruit, or you might only tolerate certain foods like berries, but not bananas, or you might, you know, tolerate, you know, certain types of potatoes, like purple peruvian potatoes, but not Yukon big starchy potatoes. So I encourage people to track what's going on. But I, I personally find that if I don't eat them, that, that I, I don't function well. So I need some degree of starchy vegetables. So I have, like, Japanese purple sweet potatoes. I have kind of weird veg, I call them weird. ugly vegetables because they're again more heirloom, they're more richer in phytochemicals. And the beautiful thing about phytochemicals and food as medicine is that the flavor of the food comes from the phytochemicals in the food. I mean, if you look at processed food, the flavor comes from the additives and chemicals and sugar and starch, sugar and salt and fat that's in the food. When you look at these natural foods that are rich in phytochemicals, flavor always is resulting from the phytochemical richness of a food. So the more flavorful a food is, the better it is for you. And Dan Barber figured this out as a chef. He's like, oh God, this butternut squash looks good, but it's sort of tasteless. So how do we get a really yummy tasting squash? So he created the honey nut squash, which was in a way kind of reverse engineering and hybridizing foods to create new varieties that actually are more like heirloom varieties to increase the flavor. But that is only because they're increasing the phytochemical richness of the food. That's really, really important. So I think, again, track what you're doing, watch what you're doing in terms of foods, but track your numbers. The next layer down is protein. And I think this is a very controversial subject and it's a very confusing subject for people because many longevity researchers are saying, Be a vegan. Don't eat any animal protein.

Minimize animal protein.

Minimize or eliminate it. as the solution to longevity. And I think a lot of these, just to be honest, these are very smart guys, PhDs, Nobel Prize winners. I mean, I, I, they're way smarter than I am, but they also haven't treated patients. So, and, and, and so I think it's important to understand that, that when you look at the science of protein and aging, it's really a Goldilocks problem. Too much is not good, but not enough is also not good. So all the centers around this pathway of mTOR Mtor, like I said, when it's stimulated, builds muscle, which is the currency of longevity. What happens as we age is we lose muscle. It's called sarcopenia. Our muscle becomes like marbled fat, kind of like a ribeye instead of a Wagyu steak instead of a filet mignon. And when that happens, our age aging phenomena accelerate. So we become more insulin resistant. we become more inflamed, our hormones dysregulate, our cortisol goes up, our growth hormone goes down, basically just creates a disaster, plus all the frailty and disability and weakness that comes with it. So you have to activate mTOR in the right way at the right time to maintain your muscle mass. And that's one of the most important things you can do as you age, is maintain your muscle mass. So you need to have the right type, quantity and timing of protein to do that. And I talk about this in the book, but there was a large survey of all the scientific literature by all the world's leading protein experts. Well, maybe not all of them, but most of them called the proteage study. The proteage study really looked at what, what, what do people need as they age in terms of protein? And, and it turns out that we need a lot more and we need a lot higher quality protein than most people are getting as we age. And high quality means has the right amount of the muscle stimulating amino acids, which are the branch chain amino acids, particularly one called leucine, which it happens to be very low in plant proteins. Now, you can get enough of it in plant proteins, but you have to eat large volumes or you have to eat high amounts of highly processed plant protein powders, which is another way to do it if you really are committed to being a vegan. Or adding branched-chain amino acid supplements or adding, for example, certain things like amino acid complex, which is a research product that came out of Europe that has high levels of leucine and all the amino acids to stimulate muscle synthesis and is used in treating sarcopenia. There's ways to hack this, but you need to have at least not 0.8 grams per kilo, which is the minimum amount to not get a protein deficiency disease. So we say, oh, you need 0.8, that's most people are getting more than that. You need actually probably 1.2, 1.5, even two grams per kilo as you age, depending on your activity level and exercise level to maintain muscle mass. And part of the problem is that as you age, you get something called anabolic resistance. When you're younger, you can put on muscle a lot easier. When you're older, you can't, which means you can't anabolic means to build, to build muscle. So you get resistance to building muscle because of the phenomenon of aging, but you can overcome that by the type of exercise you do and the right amounts of protein. So I would say most people need at least a palm size piece of protein, which is not that much for most people. It's like a four ounce piece of chicken or fish. So we have that or grass fed or regenerative steaks. those can be very effective in maintaining and building muscle as we age. So that's important to get adequate amounts of protein. And then the bottom, which is the most abundant and the most important, I think, layer of the pyramid is the source of all the phytochemicals. And these are all the colorful fruits and vegetables which are rich in medicinal compounds that have been shown through many mechanisms to regulate so many of these hallmarks of aging and longevity pathways. And they're being studied, whether it's quercetin that reverses biological age or resveratrol, or things like physeteran, which is from strawberries that kill zombie cells. So many of these longevity pathways are regulated by these phytochemicals. You want a rich array of phytochemicals. And the best way to do that is to eat as many wild foods as you can, which is hard for most people. And that was what I found in Korea. They actually ate a lot of wild foods. They ate wild mushrooms. They had wild tea. They had lots of greens, wild greens, summer greens, winter greens. So they had every day as part of their diet. Even if you go to a restaurant, you get wild greens on the menu. It was amazing. And so wild Mice are rich in these compounds and they also eat animals that eat wild foods. So the animals actually take these compounds up from the food they're eating and these phytochemicals end up in the meat and the milk of these animals. In Sardinia, they had a lot of goat cheese and sheep cheese and products and they were very rich in these phytochemicals, which I believe helps enhance their longevity. So that's really key and that should be probably 80% of your diet by volume. I call this a plant rich diet as opposed to plant based diet. or plant forward diet, you can do whatever you want. But I think it's very different than just being 100% vegan. Now, you can do it, but it's very tough. And I can say after treating thousands of patients and many vegans over long periods of time, and also looking at the scientific literature, it's very hard to build and maintain the type of muscle you need as a vegan unless you are really proactive and understand the science of it. and complement your diet with extra amino acids and extra types of plant proteins that are jacked up proteins. So I think it's possible, but it's.

Very hard to do. That's super helpful, Mark. If we were to create almost like a pyramid for the things that are not dietary related. Yeah. That you want people to be thinking about. Yeah.

I know.

Number one at the top, you've already mentioned it before.

Exercise.

Yeah. Would be right up there. Yeah. Right. What would you put next? in that category.

Hormesis. What's that? You're asking.

I know what it is, but talk about it for the audience. And by the way, if we're thinking about it in terms of the triangle and kind of building up from there, would you even say that exercise is, you know, obviously all these things go together, but in terms of prioritization, when you look at the world, there's been a lot more conversation about sleep. But do you think that most of your patients that come in that you still see today, they need to dial in exercise more than they need to dial in sleep? Or is it pretty similar?

I mean, listen, we all seven, eight hours of sleep. And if you're not getting good quality sleep, you, you can't be well.

You can't.

So let's say exercise and sleep right up there on the. Yeah, exercise sleep and then, you know, stress reduction, the basic foundational lifestyle stuff, I think is all key. And our, our mindset, our thoughts, our beliefs also regulate our biological aging. So all those are key and we could talk about that for hours, but I think something unique that people don't know about is this idea of hormesis, which is a stress that doesn't kill you, that makes you stronger.

So exercise is a form of hormesis we're all familiar with. You lift weights, you tear muscle, you build more muscle, you get bigger, stronger.

And fitter.

Right. Which also creates extra mTOR in the body. Right. But it's just a temporary situation.

Temporary. Right.

Kind of like people eating protein.

Right.

And the fears around that is that, well, it's just a temporary situation.

Right. And your body re-regulates. Exactly. Like I was saying, oh, mTOR, you don't want to activate mTOR, so you shouldn't exercise. Well, that's ridiculous. Right. So it's really the Goldilocks problem. What's the right amount of activation of mTOR and right about of inhibit inhibition of mTOR? But hormesis is a beautiful concept that can be applied across a broad range of therapies, and you use some of them that are super easy and accessible, and others that are maybe a little more difficult to get now but will be part of medical care. So obviously diet can be a hormetic phenomena. If you restrict calories, it's a form of starvation. So if you don't eat for 12 or 14 or 16 hours a day, which is called time restricted eating, your body sees that as a little bit of a stress. oh, there's no food. Let me activate all my healing systems to compensate for that. So we have so many genes that are designed to protect us from starvation and help us live in periods of scarcity. We don't have many genes that help us deal with too much in abundance and excess, which we have now. So different kinds of modifications of the timing of eating, whether it's calorie restriction, which is a little harder for people. I don't think most people can do that. time-restricted eating, intermittent fasting, which could be a 24-36 hour fast a week, longer fasts, there's all kinds of ways of doing it. Fasting, mimicking diets, keto diets, all do the same thing, which is they mimic starvation, and that's a stress. And that is the stress we know extends life more than any other known intervention. So if you restrict calories by 30%, you'll live 30% longer, meaning if you restrict calories by 30%, you'll live to 120 years old. in based on animal studies. So this is a really a very important part of hormesis. The second is exercise, obviously, which we talked about. A third would be phytohormesis, which is including kind of these plant chemicals, which are not designed for human health. They're designed to protect the plant. They're their defenses. So there kind of can be little stresses that activate the body into a healing response. So a lot of phytochemicals is also an important phenomenon, we call that phytohormesis. And then there's other things which we can do, like I did this morning, which was take an ice cold shower, which sounds like a horrible thing to do in the morning, but it's better than a cup of coffee. And it really works to activate longevity switches. So hot and cold therapies. And I talk a lot about hormesis in the book, but saunas, hot baths, cold plunge, cold shower, these things are very activating for many different mechanisms. For example, a sauna will activate these things called heat shock proteins, which are designed to repair. Oh, I didn't, one of the hallmarks I didn't talk about was, was damaged protein. So that's the one I missed. So you have a lot of damaged proteins as you age, and these misfolded, dysfunctional proteins gum up your system. Right. So sauna has actually helped to repair these proteins and help to either get rid of them or repair them. And they all, it also activates your innate immune system. And in one series of studies that was done in Finland, they found that if you took a couple of saunas a week, and this, by the way, their control group was once a week because everybody in Finland takes sauna once a week. So, it wasn't even no saunas. It was more than once a week, like two or three times a week. Like a 24% reduction in mortality. If you did it four or five times a week, it was a 40-something.

Percent reduction in mortality.

Specifically sauna, not necessarily cold. The cold plunge is different, but that activates a lot of neural pathways that enhance dopamine that activate brown fat. that improve your mitochondrial function, bed repair. I mean, I, and cryotherapy, I did this cryotherapy when I was at this hotel in Europe, and I had so much energy. I felt so good. I was like, wow, this is like, you know, taking cocaine without all the bad side effects. So I think it was pretty impressive. So cryotherapy is easy, and most people can do it by taking a cold shower. I have a little steam shower at my house, and I do fill up the bath with cold water. I jump in there, go back and forth, and that's something that most people can access, whether it's a hot bath or a cold shower. Most people have that. And you can get saunas, you can get cold plunges, you can go all the way. Then there's other hormetic therapies that are also important. One of them is, for example, hyperbaric oxygen therapy, which is a stress to the body because you're putting your body in a basically a container that increases the pressure on you to two atmospheres, which is like being 66 feet underwater, and then pumps in 100% oxygen, which is not normal. that's kind of a stress. And that activates all these healing pathways. And in one really interesting study in Israel, they found that more than any other intervention to date, it kills zombie cells more than any other intervention, and it actually lengthens telomeres more than any other intervention. So that's kind of cool. And then there's other therapies like ozone therapy, which is an oxidative therapy. We think, well, oxidation's bad, but a little bit of oxidation activates your body to respond stronger and turns on all these longevity pathways, improves your mitochondrial function, stem cell production. Oh, yeah, stem cell exhaustion was another hallmark that I forgot. So our stem cells die out. So I, so sorry I forgot those, but now I'm remembering. And, and so our stem cells kind of poop out and that activates them. It, it turns off inflammation and helps you, you increase your antioxidant enzymes. There's so many things. So ozone's another one. Hypoxia, that's another one. So low oxygen States, another kind of stress. there's machines that actually you can put on your face called a cell gym that will take you up to Mount Everest for a little while and then bring you back down and then give you more oxygen. And, that hypoxia state is a stress to the body and it helps to clean up old mitochondria and repair mitochondria and increase mitochondrial function. So, that's another one. You can also get a $50 hypoxia mask which restricts air and you can sit at your desk work on your computer and be hypoxic or exercising. A lot of athletes use these when they're training.

They even have these little whistles that you can get on Amazon that do the same thing. You blow out a certain amount of resistance, you breathe in a certain amount.

Of resistance, and that I think is like 12 bucks on Amazon. So also light therapy can be hormetic. So red light therapy actually activates mitochondria and repair healing and DNA repair. So there's a lot of therapies that we can start to include as part of our sort of suite of tools. And some of these again, like ozone therapy is a little bit hard to get or, you know, hyperbaric oxygen therapy is hard to get. But these are things that are going to become more part of our regular medical care.

In the future, do you see them as like they're going to be just part of your normal gym, the way.

That people have gym memberships? Absolutely. I mean, what's exciting is there's a lot of companies popping up that are providing these various therapies in the settings that are outside the healthcare system where people can go and pay join these kinds of experiences where they're getting a lot of these therapies like ozone and hyperbaric oxygen and, and, and mitochondrial stimulating things like cell gym. So it's out there. It's coming more.

Well, Mark, I know we only have you for a little bit more time, but what is the message around this book and the sense of Hope that you want to bring to people when it comes to this area of Aging, which can feel very scary, especially you know, people hit these milestone years, 40, 60, 80, whatever it is, there's a sense of you look around, a lot of people don't even want to actually get older. And you talk to most people like, I would never want to be 120 and sort of shriveled up in some nursing home and I'm not able to feed myself and I don't know who anybody is. So what do you want to say to those folks who think that that's their vision of aging?

Well, that's clearly what we see all around us, right? if you lived in Sardinia or Korea or Okinawa, you wouldn't think that, right? But if you live in Sweden, then every car is a Volvo, pretty much, right? If you live in Texas, maybe you don't see Volvos very often. It doesn't mean that Volvos don't exist, it just means it's not around. And so I think we have to reframe our conception of aging and realize that if we take care of ourselves properly, just like if we have a car from 1920, that'll still run if we take care of it. It takes a little more attention, a little more love, a little more maintenance. And, and that's true. Right. I, I can't do the same things and run myself the same way I did when I was 20. But I can still perform at a high level. I can still feel good. I can still, you know, often out perform my friends who are 30 or 40 years old because I've learned how to sort of hack longevity, if you will. And, and I think the, the message I want people to understand is that what we see around us is abnormal aging. Nobody wants that. But by using the tools and principles in Young Forever, by taking advantage of the science of functional medicine and the emerging science of longevity, we can reimagine aging to look very different. And so my imagination takes me to a place where I'm 120 years old. I go for a hike in the mountains with my partner, my love of my life. I swim in beautiful lake after, make a delicious dinner, have a bottle of wine, make love, and just drift off into the never world. And that's kind of how I want to go. And I think it's really quite possible. Jeff Bland, who we were just with yesterday, tells the story of his, I think his grandfather, who basically was the patriarch of the family, he was like 100 years old or something, and he had a beautiful dinner with everybody. He said his goodbyes and was kind of having a great meal and walked to bed and said, I'll see you, this is it. And he basically went to bed and never woke up. He was like checked out. I think that sounds pretty good to me. And I think I also want to just sort of lead people with this this notion that, you know, it's not about this sort of narcissistic hedonism of wanting to extend your life. And it's not about doing it for the purpose of just selfish sort of purposes, but it's really about harvesting the incredible wisdom and insights and experience that happens as we age. So at 62, I'm going to be 63 in a week, I feel like I understand life better. I understand myself better. I understand how to be a better person, to be a better friend, a better father, a better partner, to give my contributions to the world, to have better impact. And so imagine harvesting all that for our society, not having to take care of a bunch of decrepit old people, but people who are a vital part of society, who are adding wisdom and value to the world as they get older, and who need less and want less from the perspective of having to climb the ladder of success. They've done it, they've got there. now they can give back. And so that's a very different world. And just to kind of, you know, share a quick note about the economics of this because you go, oh my God, you know, what happens if we extend life and it's going to cost so much and the planet can't take it and it's going to be such a burden? And there's a lot of research actually looking at this, this kind of concept. And David Sinclair published a paper in Nature Aging talking about this. And I didn't understand half of it because it was this very complicated mathematical models that they use. But essentially what they said was if we extend life by one year because we're going to be improving health and reducing the burden on the healthcare system and we're going to be increasing productivity and value by adding one year of life, we will add about $37 trillion of value to the economy. And if we extend life by 10 years, it's over $360 trillion. Now, that's a lot of dough. I think that's more than the GDP of the entire world annually. So, that's pretty impressive. And if we if we see it as a value add rather than as a cost, if we see it as a way of enhancing the value to society through the wisdom and experience of elders, well, I think that's a win.

I love it. It's a hopeful message and it's a great place to end off. The book is out or on pre-order, depending on when this podcast comes out there. Young Forever, the Secrets to Living youg Longest healthiest life. Mark, what's one thing that you're gonna do today? You have a whole day of press, podcast, other stuff. You already took a cold shower, so you can't answer that. What's one other thing that you're gonna do to set your longevity up for success today?

Well, a couple of things. One, I got a green juice and a protein smoothie for breakfast, which is coming now. And then I'm gonna go have dinner with my team and celebrate life and myself and my birthday. and what turns out to be almost as important as anything else is community. I mean, if you're part of a knitting group or a bowling club, you're gonna live longer. And so being with people you love, you care about, who see you, who value you, who you add your value to is also medicine. Community is medicine, just as food and exercise are medicine.

I love it. Mark, thank you for coming on the podcast for sharing your wisdom. And I'm excited to catch up with you at dinner tonight. And I have a surprise for you. We have pecan pie.

Oh, no.

We have pecan pie. get five for you. I know it's your favorite. Mark, thank you for being on.

Thanks, Joe. Hey, everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter, and in it I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com/pix to sign up. That's drhyman.com/pix, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer.

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