Live Longer Regardless of Your Biological Age with Kara Fitzgerald

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Good night. Older Smolder: How taking control of your biological age can help you live longer, better. In this show, this episode is going to have something for everyone in your life, from younger to older. From the food you eat and the daily habits you have, you will find out how to reverse your old age before it ever happens. My guest is none other than Dr. Kara Fitzgerald. If that name's not familiar, the title of her book, Younger You, may be. You've seen it, the gold cover. And if it's not already on your shelf, you may want to run out and get it. Dr. Kara Fitzgerald is an award-winning clinical researcher of bioidentical age reversal. Yes, you heard me right, using a diet and lifestyle intervention developed in her virtual and in-person functional medicine clinic. She's the author of the book Younger You and program based on her groundbreaking 8-week clinical study, and you are going to want to tune in to hear what they found, and follow-up case series that resulted in a 3-year and a 4.6-year average reversal of biological aging respectively. She also has a Younger You companion cookbook, Better Broths and Healing Tonics. Dr. Fitzgerald is an educator at the Institute for Functional Medicine and is an Institute of Functional Medicine certified practitioner. She regularly lectures internationally and hosts the podcast New Frontiers in Functional Medicine. I cannot wait to have you meet my guest today. I'm Debra Atkinson. You're listening to Flipping 50. I started this podcast over a decade ago to answer questions about fitness in menopause and beyond before you knew to ask them. The goal? To help accelerate your results with science and the practical application of proven protocols while living your best life. There's no more powerful health influencer in the world than a midlife woman, and it's not just about you, but the 3 generations that you influence. My unique 40-year career career, including being a university senior lecturer in kinesiology, an industry subject matter expert, and an international speaker, to founder of the first and the only exclusively made-for-menopause and beyond fitness membership in the world. Every week I interview experts behind the scenes and the science of optimal hormone-balancing fitness and longevity and share answers to our community's questions so you can have the vitality and the energy that you want, need, and deserve. Dr. Kara Fitzgerald, thank you so much for joining us.

Yeah, it's great to be here. Thanks for having me.

Well, yes, and somebody who looks like they must have started doing this when they were in kindergarten, we all have to know what prompted you to write this book?

Yeah, that's a great question. I mean, it's an interesting story to me because I wasn't directly entering into the conversation around bioage reversal. Bioage reversal, when we first started to look at epigenetics, was thought to be not possible. So I really want to underline that we entered into thinking around this and building our program before we thought that biological age could be reversed in humans. I mean, we could see in like worms and in mice to some extent that you could slow the aging process down., but it really wasn't thought to be able to translate. So we started to think about epi above genetics or genes. So epigenetics is the science of how genes are expressed, what genes are on, what genes are off. And that is at the behest of the environment, the way we live our lives, what we eat, how we're feeling, if we're moving our bodies, if we're stressed out, you know, the toxins we're exposed to, the relationships we engage in, basically everything that we're doing. Actually some of this information is inherited. So we get some of this from mom and dad and even generations previous. It's an extraordinarily interesting field of science. So I entered into thinking about how functional medicine, which I am a practitioner of, influences epigenetics in about 2016, or actually really even earlier. That's when we released our program because there was a lot of science on it. Regarding cancer, the tumor microenvironment will change gene expression for its own nefarious end. So in, in cancer, the— that microenvironment will turn genes on for its own survival. It will turn genes off that inhibit survival. And I became extremely interested in how we as clinicians in functional medicine, how our treatments how our prescriptions, how our diet and lifestyle prescriptions could influence this gene expression potential. And, you know, long story short, me and the director of our nutrition programs, Romilly Hodges, decided that we could build a diet and lifestyle program based on science that would specifically influence gene expression and epigenetics and a specific type of epigenetics called DNA methylation. So there's many ways that our genes are switched on and off, and one of the best researched and sort of the strongest or most resilient way we regulate gene expression is something called DNA methylation. And so we set out to build a diet and lifestyle program to sweet-talk, to optimize DNA methylation. But one thing we knew was that some of these patterns that we see in gene expression, like again, going to cancer, you see certain genes on, certain genes off that push cancer forward. Well, that mimics what we see in aging. I mean, isn't that crazy? And that's one of the reasons aging is the biggest risk factor for all of these chronic diseases. The older we get, the more vulnerable we are. And one of the, the ways that we see this is through the lens of epigenetics. Like, as we age, changes to gene expression really look a lot like these diseases. So we didn't really appreciate how we were looking at biological age in the design of our program until we researched it. So flash forward to 2019, we were in the middle of our research study looking at DNA methylation, and we weren't done with our study. It was being conducted at the time, and the first study in humans was published showing biological biological age reversal. And, you know, the scientist who figured out how to measure biological age by looking at patterns of gene expression was an author on this study. I think time stood still in that moment when I read that first study. And we knew because we were looking at gene expression that when our study was done, we would be able to look at biological age as well. And we didn't know what we would find, but we, of course, were, you know, just giddy. Like, just, it was a breathtaking moment for us to see that as compared to our control group who didn't have our intervention, the individuals who underwent our 8-week diet and lifestyle program reversed their biological age by over 3 years. So we were—

8 weeks. 8 weeks. And that's pretty impressive. Thank you. And when you talk about immediate gratification, I mean, that's all of us. Yesterday's yesterday. Please, that's when I'd like it. Yeah. Yeah. So amazing.

I've been practicing for many years, and in Connecticut, I teach other professionals functional medicine. Our paper was the third to come out in the world to show this, and it was the first controlled study. So it was the first with a control group, and it was the first with a multimodal diet and lifestyle intervention. So here we are, this little clinic in Connecticut, and the phone is ringing and the internet is humming, and we're, you know, it was just, it was pretty crazy. And so from there, obviously, you know, people wanted to know how to do this program, and that just bled right into us doing the book.

For listeners who maybe got lost in the science or the definitions. Let's go back to the ABCs. Define DNA methylation.

So again, the rubber meets the road with how genes are expressed. Our genes are our DNA and the way that we live, you know, the foods we eat, et cetera, et cetera, will influence what genes are on and what genes are off. The DNA that we inherited from mom and dad is not our destiny. We've got a lot of control over the patterns of what's on and off. This is the field of epigenetics, the study of what's on and off. And a chief way we regulate what's on and off is something called DNA methylation. So if you can go back to high school and just sort of remember a strand of a double-stranded double helix DNA, we can inhibit genes if we put these methyl groups on them in specific areas, in specific regions. So in science, some papers will denote a methyl group. It looks like a red lollipop. And so if you just envision on this DNA, you know, dots of these red lollipops, when they're grouped together, that DNA is sort of not— it's not available to be transcribed, to be turned on.

So cool. Just to reiterate for everybody, so twice weekly strength training. Can influence 179 genes associated with aging, right? So I don't know what, what you're all doing, but get to it.

That's right. Well, and what's actually really exciting too, that even one exercise session was so shown, and one yoga session, one meditation, like, it doesn't take a lot for us to begin the favorable influence, but to actually have the lasting changes. So we can see beginnings with ONE, but it's those patterns, it's the habits, you know, it's adopting them and taking them on really over time, you know, that can bring us these lasting changes. But to your point earlier, we did show some pretty profound stuff in just 8 weeks.

So cool. So within the book, I know you're teasing out, you've got like recipes, meal plans, and you could start from the very beginning, we could have been optimizing the way that we age all along the way. So if you're 50, obviously we can't go back and retroactively turn that on, but hint at a couple of things. I mean, what would we have done differently as 20-somethings or 30-somethings that would have changed very much what's happening when we're 60 or 70?

Well, let me say it goes back to in utero. Wow. I mean, yeah. The way that we define the pluripotent stem cells that we build a human from, when an egg is fertilized, the way we build a human is through DNA methylation and demethylation. We're defining what genes are on and off. This is why we think we know we need folate in pregnancy. This is certainly one of the reasons. So I would say that we need to be eating for gene expression forever, like even before then. So always this kind of information, healthy gene expression patterns are being established from in utero really on. But to your point, things kind of slow down. So there's early, there's rapid development in utero. We're growing a baby, you know, early infancy, childhood, obviously things are just busting out. We're developing radically until probably somewhere in our 30s. We used to say 40s. It seems like that number is getting a little bit younger. And there's this switch that happens from, you know, radical development to almost the beginning of decline. And this is when we really want to get in there and be committed to our habits. So to your point, what would we have done differently, you know, if we adapted these early on? And people are actually, as the science comes forward, I see younger and younger people really embracing these things. I mean, we want to be mindful about eating the perimeter of the grocery. I mean, a lot of those things that we already know— fresh veg and a lot of vegetables, greens, yes, colorful fruit and veg, but primarily vegetables, going organic if we can. We do need the protein that comes from animals. That's what we researched in our study. If you're vegetarian, we have a vegetarian version in the book, and we talk about how to get protein from beans and other sources. Spices are really smart. Rosemary, one of my favorites. Thyme, oregano, turmeric, and what else? Garlic, ginger, and on and on and on. Adequate hydration. Mushrooms are wonderments. They're beautiful for gene expression. Maitake, shiitake. What else?

Eggs. You know, that question right there, sorry to interrupt, but mushrooms are coming up in our community. I mean, people are curious. Is there anything more that you want to say about mushrooms?

Well, I mean, a lot more could be said about mushrooms. There's a variety of them and they do, you know, really important work. They're packed with these beta glucans that are just important players. They've got choline. Some of them have folate. I mean, they just have a complement of extremely important nutrients. Something in science we say pleiotrophic, meaning they've got a lot of different effects on the body. But one of them for sure is helping with gene regulation and helping with epigenetics. So I encourage people to be consuming them on a daily basis, eating, ideally eating mushrooms and consuming them, you know, in a whole foods diet. There are supplements that we can purchase as well. And when you buy supplements, I would just tell folks to make sure that they're fruiting bodies, you know, make sure that that's what you're getting.

Okay. Hey, this is Debra Atkinson, and there is one thing you can't do in the gym at your age, and that's get all the protein that you need. You've got to do that in the kitchen. To make it easy for myself, not only to get the protein but the fiber, the fruits and vegetables I want daily, I started drinking a smoothie a day 30 years ago. But when I realized all the junk the sugar and the extras that you don't want, that I don't want, hiding in most protein powders. That's when I finally caved in after years of saying I will never ever ever sell supplements. Stop skipping, skimping, and sabotaging yourself in the morning after workouts by always being prepared. Look, yep, I agree, real food first, but it's just not convenient to carry a turkey cookie sandwich. Sometimes the protein and don't forget the fiber, they kill cravings and they boost satiety. And you've gotta make it easy to do the right thing. You can use code PODCAST for 10% off your first order at flipping50.com today. Okay. So I do wanna back up one step and ask you again about protein to clarify. In your studies and what you found, is there an advantage for biological age looking at animal versus plants?

That's a great question. And it's being hotly pursued, the answer to that. I would say that the protein consumed in animal-based product is advantageous for us for building muscle, for providing some of the nutrients that we need for DNA methylation. Liver, something that we include in our program that one can take in capsules. I am absolutely of the mind that an animal protein-based diet is incredibly important and can be incredibly nutrient dense when done correctly. So can a vegetarian or even a vegan diet. For sure. But I will say, as a clinician who's worked with vegetarians and vegans for the entire length of my career, it's got to be done with care. And I cover that. I cover it really carefully in the book. How do you enact a vegan diet that's nutritionally sufficient? Yeah. There was a study that came out recently looking at biological age in twins and comparing— actually, it was a Netflix documentary. We're writing about this. We're going to put a blog out about it. We interviewed a scientist, she's a friend and colleague of mine, Lucia Aronica out of Stanford, who was one of the authors on the paper that this Netflix documentary was based on. So they, they were looking at twins. One group followed a vegan diet. The other group followed an omnivore diet. They gave them some basic guidelines and they showed that the vegan pattern resulted in a younger biological age over the duration of the intervention. But we need to be really, really careful to jump to conclusions around that. They lost some weight as well. It was a lower caloric eating pattern, as vegan diet often is. So that would be one, obviously one thing that would result in a, you know, in a beneficial shift as far as weight goes, which could influence biological age. But the thing that Dr. Aronica really kind of hit home is that long-term veganism will, when not done really correctly result in actually a biological age acceleration associated with the various nutrient insufficiencies that are really common. So I'm not convinced that a vegan dietary pattern in the long term would result in a lower biological age. I think a well-designed nutrient-dense dietary pattern is layering in a, a gentle time-restricted eating structure, layering in exercise. I think that that is what the optimal pattern is. And in my opinion, and what we've shown in our research so far, is that animal-based, you know, just makes it a little bit easier to achieve a certain level of nutrient density. If one is committed to a vegan dietary pattern, it can be done in a nutrient-dense way that is, you know, likely to support a really robust and young bioage. So I don't want to dismiss it. It needs to be done correctly. It can be done smartly and be beneficial. It may not be a pattern that's beneficial for all of us. So we just, we need to look at nuance around it.

Yeah, love that. And I think this is a really good time to throw in, and I don't want us to get distracted with not coming back to exactly the bioidentical age or bioage, but I think there's some conflict with all of our listeners about animal versus plant and what they're hearing is fasting and longevity conversations come up that, you know, experts are saying some prior to the age of 65 plant-based is better. After 65, then everybody needs animal. And I find myself conflicted with that, wondering, okay, if we know we're going to need it as soon as we're 65, you know, don't we want it ahead of time, or at least to be monitoring our muscle mass and insulin sensitivity because that might be a decision, would it not, in whether plants work for us or not.

Well, a lot of plants work for us. There's no doubt about it. Whatever dietary pattern we're doing, we want it to be, you know, very plant dominant. We, in fact, we think the polyphenol density of our program, we're starting to tease out maybe what were the pieces that moved the needle for us so strongly, and it's possible the polyphenol density which kind of dwarfs other dietary patterns, even the Mediterranean, even like dense polyphenol Mediterraneans. Ours was, you know, that much more higher in polyphenols. So we need that plant information, but yeah, the nutrient density of animal protein and the ratio of amino acids in animal protein is really advantageous to building and maintaining muscle mass. So, I mean, honestly, I wrote a blog and we can link to it if you want to. It's on my website about using our Younger You program and toggling it with a high protein intervention when somebody's really focused on building muscle mass and resistance training. So we would still hit our targets on most days. And then on the resistance training days, you know, just turn the volume up that much more. On some specific proteins. So yeah, to your point, we need muscle now regardless of our age. You know, we just need it. We need to be engaging in resistance training. All of those things are important. And individualization. I think that there are too many definitive responses. We all need to be doing X. We all need to be doing Y. Your X, you know, what gets your bio age the lowest, what builds muscle, you know, fabulously for you. Leads to insulin responsiveness and metabolic flexibility in you is going to be a little bit different than what's in me. And people— so the Younger You dietary pattern, there's a kind of a— there's room within it to lean a little bit one way or the other, you know. So some people are going to use the Younger You information and maybe go a little bit lower carb, a little bit higher protein. Other people can use this foundational information and be a little bit higher plant-based. Yeah, you know, maybe a little bit lower fat. I mean, we can kind of play within the general guidelines, but I think the fundamental information that we put together to influence epigenetics, you know, should be core for all of us and then, you know, tweaked a little bit, you know, individualized for you. And then if you can work with a functional doc and get your biological age and get the other pieces of information so you can individualize and find your best is what I would recommend for all of us.

Gold. Talk to me a little bit about exercise. So what did you find was key? I'm just going to guess it's neither extreme.

Yeah, that's right. So in our program, we need, you know, when you're doing a research study, you've got one program basically needs to fit everyone, which isn't real life. But the most important thing when it comes to exercise, the absolute bottom line is to do it.

You know, and so I think somebody has that line, but just do it.

So we wanted it to be accessible and have evidence behind it as being enough to tweak gene expression, to tweak epigenetics, because exercise is like the best vegetable. It's such a powerful gene regulator. It's extraordinary. In fact, we can even, if we're preconception, so if we're going to have kids, we can hand down the information around our exercise patterns to our offspring. Exercise. I talked about cancer in the beginning. Exercise is one of the most important anti-cancer interventions in changing gene expression. So cancer will go in and turn genes on and off in this pro-aging, awful way. And exercise is an elixir to that. Exercise will change it. Actually, so will these polyphenol veggies, you know, greens, colorful veg, mushrooms. Some of the things that we've been talking about. So they, they can all behave similarly when it comes to gene expression. It's so interesting. It's so cool. So in our study, we wanted people to exercise a minimum of 30 minutes, 5 days a week. We wanted them to do whatever they wanted, no control around that, except that we wanted them to achieve a perceived exertion of 60 to 80% of their maximum. So if you're at 60% of your max, might be lightly sweating, you're breathing a little more intensely, but you could still have some kind of conversation. And it's up to our participants to determine what that is. And research suggests that we know, like, we're able to accurately perceive our own 60 to 80%. Now, in the book that— and that's what we do in our study. And if you do the program with us, that's what we adhere to. In the book, we know. So again, going back to the idea that we need muscle mass and longevity is associated with decent muscle and just You know, being limber, et cetera, et cetera. So yeah, resistance training is important. High-intensity interval training is important. Getting our heart rate up, keeping our heart strong, et cetera. So these more granular details in our exercise pattern are all important. But to your point, in our study, you know, we started with something really accessible to all of us. And to your second point, yeah, when we overdo it, that is a pro-aging phenomenon. And we can see it, like athletes have experienced this. In fact, we test athletes, you know, we can see that something called secretory IgA, which is kind of a first-line immune defense in our nasopharynx, in our mucous membranes, is always depleted in athletes at the end of the season. So we can, we can see that the push, that the intense push will have a negative fallout. And as far as biological age goes, they have actually studied that in certain athletes, and we've seen it to be sort of pro-aging in certain settings.

I want to ask you one more question, a little bit off, you know, either of these very tangible things. How important is joy? Was this a part?

So yeah, so we know that community connection, you know, those things that raise the love hormone oxytocin, they're incredibly important. You know, as I mentioned to you, I think we weren't recording, that I'm here in Mexico, and Mexico is something that really kind of brings out the oxytocin in me. And my family and just kind of lights us up. And there's a lot of community here. There's just like a— just there's a juiciness here that I actually see reflected in my Oura Ring. You know, I see my heart rate variability just rise and my sleep, my resilience, my stress response, all of those numbers just get better being in this environment. Yeah, huge, incredibly important. I don't know how we would exactly We wouldn't really be able to study it in a research study. I mean, that would have to be thought through carefully, but, you know, we can see, you know, depression associated with certain kinds of gene expression patterns or PTSD or adverse childhood events and how they can influence the life stages and be pro-aging. We can see not only presenting with mental health challenges, but the chronic diseases of aging can be informed By a lack of community and connection and so forth, you can see sort of inflammatory patterns increased when we look at different gene expression patterns. So yeah, to your point, all of these things are associated with longevity. One of the things that will be important for us to study and hasn't been is what resiliency looks like on, on the epigenome. What do resilience patterns look like in DNA methylation. And I think we will get there and we will be able to use that information to probably diagnose and correct imbalances before they even show up. I mean, it's really kind of extraordinary where we're at. Yeah. So we can look at who's vulnerable to PTSD or some of the— even autism, you know, early on, even potentially in utero and be able to change those patterns and to understand what, yeah, what resiliency looks like and how to tweak it and how to actually achieve that. So the science of epigenetics and DNA methylation specifically, the ability, the diagnostic potential is, you know, is just massive and interesting. It goes way beyond biological age, which is also just in its own corner, extraordinary and very, very exciting. But the promise of this whole field of study of epigenetics is, it's just, you know, it keeps me going. It keeps me really excited about, you know, about my field, about my work.

Love it. Oh, and I love the work that you're bringing. I think we could probably go on for another half an hour, but I'm going to ask you one more question. So how valuable for someone who wants to look at what are the effects of my habits on my longevity for tracking tools? What do you like and how much would you lean into those?

I love my Oura Ring, and I think they're doing a really good job in staying ahead of the curve as far as their science goes. They're always bettering themselves, and I can see that it's gotten better and better, and they publish on their data and they compare their data to the standard measurements used in the research and clinical settings, and they're doing well. As far as it can motivate us, I just think it can be an incredibly useful tool. Yeah, I love it. Combine it with actually getting biological age testing done, or I know you're going to give your listeners the information to access our biological age quiz. It's free. So you can get some nice free tools on our website. Yeah, it's where we're headed. Yeah, no doubt about it. It can help motivate us. We just, again, want to be mindful. Like, there's probably a time for some of us to just either take it off or stop. Don't look at the app. I mean, I'll speak for myself and say that last year had some really stressful time points in my business and some things that I was called to do. Like, I know there's an end to this and I just didn't want to obsess on it. I was in a tough time and it was something that I couldn't immediately stop. I just had to kind of muddle through to the best of my ability.

And, and in some level, do you think there's any, any truth to this?

Okay.

So that period of time you were going through a really hard time, is there any equivalent to that to We go to a gym, we do a hard workout, we put ourselves through overload, but we do that because then we have more resilience. We get stronger, we supercompensate. So what about resilience in life itself? Because we've been through trauma or hard times, sometimes it raises the bar for, well, that's not a big deal.

Yes. And as I was saying earlier, yeah, we need to understand what those resiliency patterns look like. For example, people who survived the Holocaust with a kind of perspective that suggests, like, logotherapy. His name is escaping me, the scientist who developed that whole form of therapy. But people have gone through incredible, unspeakable hardship and come out with their ego, their self intact. And stronger and perhaps some kind of peace about— and that is information that is housed at least in part on our epigenome. So the more that we can study that, the better. Plenty of us though can experience toxic stress, which is damaging and draining, and it's pro-aging. And that's been measured. That's been demonstrated. So Yeah, there's a way that we can sort of do the stress dance that can help preserve us, but we may experience things that are just simply pro-aging for a period of time. I mean, this has been looked at. Acute stress can be pro-aging, but when it's resolved and when we come out the other side of it, we can bounce back to where we were and hopefully even younger. Awesome.

And good to know. So good to know. Yeah. Okay. So much good here. And I know we're going to send them to the quiz, so everybody loves a good quiz anyway. But I mean, one that could get you younger, I think. Yes. Okay, everybody, we'll put that in the show notes.

It's easy. It's not that many questions. It's cool. You can take it again. You know, it'll give you insight into your own patterns. Yeah.

And where's— if somebody wants to follow you on social, do you hang out there at all? Where's the best place to catch you?

Yeah, I think Instagram is probably the best, and it's just my name, Dr. Kara Fitzgerald. We're active in that space. We're active on Facebook. We're active on Twitter.

Thank you so much, and thank you for the work you're doing on behalf of all of our listeners and myself. And listeners, now it's up to you. So if you have a question you wish I would have asked, I did my best. I had your back. And you can leave comments or questions at show notes, catch me on a DM, but flipping50.com forward slash live longer. And what are you waiting for? Let's start Flipping 50 today. Thank you for listening. To listen to a decade of episodes and to get the show notes, visit flipping50.com where you'll be able to find all the previous episodes. And I made it super easy to make the most of your listening. Time and get exactly what you want to listen to as top priority by getting the top 10 episodes in the areas you most care about, like how much protein do you need, weight loss, and other 3 ultra-important topics we've identified as our community's top 5. There's no more powerful health influencer in the world than you, Midlife Woman. So go and listen right now. So in this episode, we really gave you a lot of working definitions of DNA methylation, of epigenetics. And I know you've heard that word before, but I think it bears hearing what we talked about today and what effects are and it's not your genetics. You cannot blame mom and dad on this one. But the shocking thing is we talk about exactly where you can start. So pre-utero, excuse me, some of us wanna go back and make that retroactive, and yet we can't, but we can pass this along. Never you forget, you influence 3 generations. You, my friend, are leaving a legacy. Here's how we did it in this episode. If you need to go back and replay this one, you're going to love it. Do you have a question for a podcast? A question you'd love to ask, or maybe a story you want to tell? Did you know we have a special group just for podcast question roundups and the answers? My community coaches and I provide answers daily inside of this group, but it's also where I go when I occasionally say, okay, open call for podcast questions or tell your story. Would you like to be a guest? So if you're looking for a community of women who are also interested in optimizing their health, strengthening their mindset, and looking forward to every new year, join the Flipping 50 Insiders group. Flipping 50 Insiders on Facebook.