#126 - Optimizing Health Span: Longevity, Inflammation, and Immune Resilience with Dr. Robert Silverman

Welcome to The Factor Podcast, where we talk about the stuff they didn't teach you in school, how to grow your practice, refine your clinical skills, and get better results for your patients. We're here to help you navigate the real-world challenges of being a healthcare provider, from delivering top-notch patient care to running a business that doesn't run you into the ground. Whether you're fresh out of school or scaling your practice, we're diving into effective cutting-edge treatments to get patients better faster. We'll also talk about business strategies and tactics to help you work smarter and not harder, and the mindset shifts required to thrive as a top performer in your field so you can build a career you love without burning out. If you're ready to learn what works and what doesn't from leading experts, industry innovators, and respected clinicians across a wide range of specialties, you're in the right place, my friend. Let's dive in. Hi there. Happy Friday. Welcome to The Factor Podcast. I'm your host, Jessica Riddle. Thanks for tuning in. Today we're doing something a little different. We're taking a look back at a conversation we originally recorded in October of 2023 with Dr. Robert Silverman. He's a leading voice in functional nutrition, immune health, and gut health, and he's also the lead instructor for our Functional Nutrition Certification Program, which is now in its second year. At the time of this recording, the healthcare profession at large was still actively sorting through the long-tail clinical impacts of COVID Many of you were seeing cases of long COVID symptoms that were unexplainable. You had patients dealing with inflammation, immune resilience, and you were learning more about the role of gut health in recovery. While some of these statistics and references in this conversation reflect that particular moment in time, the bigger ideas still matter today. Maybe even more now than they did. In this first part of the conversation, Dr. Silverman lays the foundation for what healthspan really means, why chronic disease remains such a major challenge, and which systems and biomarkers deserve more attention if we want patients not just living longer, but living better. Whether you're listening as a healthcare provider today, a student, or someone simply interested in the connection between nutrition, inflammation, immunity, and recovery, This is a conversation definitely worth revisiting. Let's dive into part 1 of our look-back conversation with Dr. Robert Silverman.

Let's move right in. Let's talk about the protocols for longevity, optimizing healthspan and human performance. Longevity is without question the conversation piece, and I do believe That we're really gonna still be talking about in 2025, 'cause it really incorporates all that we do, or at least a lot of what we do, in the idea of nutrition, functional nutrition, also functional medicine. I believe that the key to longevity is turning on the health switches, and I'll go into a little more detail with that. But without question, the master switch is having a robust and resilient Immune system. People always ask the question, what is longevity? Can we have a definition? Well, we talk about lifespan versus healthspan, and what is truly the difference? Well, the difference between lifespan and healthspan, interestingly enough, is that lifespan is how long you live, and healthspan is how long you live without a chronic disease. Even longevity is based on chronic disease. I'm not real happy about that. Now, most people have a chronic disease in America by the time that they're 65. Actually, almost 70% of Americans have a chronic disease by that point. 4 out of 10 Americans have 2 chronic diseases. So the World Health Organization put together some stats, and the reason they did was COVID was driving a lot of conversation about age of death. And what they found out was that our generation, this generation right now, is the first generation where people's ages rescinded. So the American mantra, or one of the American mantras when it comes to health, is always to leave the place in better shape for the generation after us because of what everybody did before us. Unfortunately, that isn't the case. So in the US, we are now expected to live 77.5 years. My goal is 120, but that's for another day and another dollar, if you will. People are expected to live in full health in America to 66 years. So there's an 11.5, almost a 12-year difference between lifespan and healthspan. That correlates to about 18% of our life we are gonna live in chronic unhealthy disease. We are not doing a good job. And the first thing I'm gonna say is not enough people are seeing alternative practitioners. Not enough people are seeking lifestyle health. Not enough people are seeking out nutraceuticals, changes in diets, etc. Globally, lifespan is at 73.3 years, and the healthy lifespan is about 63.7 years. There's about a 10-year difference. Again, you're looking at about that 16 to 18%. We all globally, nationally, locally need to do a better job. So a couple of things that we got was, number one, Reducing caloric intake by 12% improved the cell senescence, the ability for the cells to die appropriately, and slowed the pace of aging. Now, the attempt in that study, interesting, was to decrease caloric intake by 25%. They only got to 12%, but that 12% decrease in calories really dramatically affected longevity, healthspan, lifespan, and what I like to refer to in vitality. Now, is intermittent fasting all about caloric restriction? Not gonna really have the opportunity to get into that. I'd love to come back and do a webinar on intermittent fasting, how women are affected by it, and what effects other than caloric restriction do you have. Maintaining the levels of taurine found aging and improved health and lifespan. Taurine is really without question the secret sauce. It's an amino acid that helps with bile flow. It decreases excitotoxicity. Toxicity. I would have to venture to guess that if I quizzed many people, most people don't take taurine, but they will take other amino acids. So distinct longevity mechanisms. This is interesting. I was just on a podcast with a longevity expert, and he disagreed wholeheartedly with this in that reduced activity of growth hormone IGF-1 was found to extend lifespan across species. He thinks upping growth hormone. Again, it's the debate, but in this study, that's what they found. And essentially, the last 2 bullets are mitochondria. I believe that the one thing that we should all start to consider, test for, and look at is mitochondrial dysfunction. So here's what we call the hallmarks of aging. This was from a 2013 study. I took a little creative license and moved it around. Number 1, immune reboot. I believe we all have to reboot our immune system. It was the name of my 2022 bestselling book. I think we all need immune health, but the biggest thing is we need immune resilience. We need our immune system to be resilient versus multiple variants of pathogens. Inflammation, or now what we like to refer as inflammaging, burning ourselves up from the inside. Inflammation, my mantra is to manage and modulate it. Microbiome. Well, I mean, if you want to talk about your microbiome, your number one microbiome is in your gut. We are made up of 10 to 1 bacteria cells to human cells. Our second microbiome is our gums, and our third microbiome is our skin. Our microbiome, or within our microbiota, is really something that we should want to positively affect. Just look at our gut. I don't know if Jessica told you I'm from New York. So I had the honor for many years of taking the New York City subway. If you've ever seen a picture of a New York City subway, it's a bunch of sardines in a tight little can. So there's always this one stop, it's 125th Street, where everybody comes in and squeezes together. They literally squeeze some people out. People want to get out. That whole idea of the people coming in is good bacteria. Pushing out all the bad bacteria in your microbiome. Mitochondria dysfunction. Mitochondria dysfunction, as I said before, is a major player. Big believer in mitochondria dysfunction and being a conversation piece. Mitochondria dysfunction is the cause for fatigue, which is the number one reason that we go to the doctor, believe it or not. Also, mitochondria dysfunction has been implicated now in neurodegenerative diseases. Fascial injuries. Nothing better to help fascial injuries than What I like to refer to as the gold medal winner for instrument-assisted soft tissue mobilization factor. Fascia, the Saran Wrap of the body. It envelopes everything going around the body. It leads to a theme called tensegrity. Vagus nerve tone. And each one of these hallmarks, there'll be a few slides, we'll get into a little bit more detail. We will get a little granular, if you will. Vagus nerve, cranial nerve number 10, goes from the brainstem, the medulla oblongata, down through the transverse colon. It is the key communicator between the gut to brain and the brain to the gut. What I like to refer to when the vagus nerve is functioning well, it is the superhighway to health. Telomere shortening, the shorter the telomere, the closer we are to death. Loss of muscle mass. Muscle mass has been coined a phrase by Dr. Gabriella Lyons as the longevity organ. I think it is without question the longevity organ, but it's the first step In that stepladder of health, those next steps would be muscle-to-fat ratios, and the top layer would also be grip strength, VO2 max, and power. Disrupted nutrient insulin signaling, mTOR pathway, AMPK, and sirtuins. And lastly, compromised autophagy, our body's ability to break down old cells, use the debris to make new cells. If it's compromised, we're really stuck with a lot of old Dying or dead, but inflammatory cells. And that's why they call them senescent cells, or we like to refer to them in our parlance as zombie cells. So 2023, a follow-up 10 years later, all the hallmarks are interconnected. Thanks for the memo. The body's all interconnected. So whatever you do to one part of the body, you do to the whole part. So you have localized that ultimately affects systemic. Dysbiosis was a newly added hallmark. It's the unleveling of good and bad bacteria. You need about 85.1% good bacteria not to have dysbiosis. So there are no days off when you're thinking about gut health. I like to ask a lot of my patients, what have you done for your guts lately? Do you have the guts to be healthy? Getting back to the Hallmarks of Aging, along with now chronic inflammation as opposed to just inflammation, disabled macroautophagy. There's 3 types of autophagy. This type of autophagy signified as being the key to the inability to perform autophagy efficiently. Dr. Peter Attia, who wrote the book Outlive, said one of the most important things to understand when you're using some sort of intervention is, do you have a biomarker to know if you're doing it correctly? So here are some of my biomarkers for longevity: interleukin-1 beta, interleukin-6, interleukin-8, and TNF-alpha. These are all inflammatory markers. Now, interesting, interleukin-6, I like to refer to as the girl with the curl because sometimes it's good and sometimes it's bad. But this set of interleukins should be taken on everybody if— for me, as a baseline to see if they're inflamed. Interleukin-6, interleukin-1 beta, and interleukin-8 can predict the incidence of lower back pain. I think it was at 92% accuracy. So I use these on all my musculoskeletal patients. C-reactive protein is tissue inflammation marker. How inflamed is your tissue? Hemoglobin A1c is your diabetic marker. So it takes the average of your blood sugar over 90 to 120 days with an emphasis on the last 30 days or the most recent 30 days to the tune of about 50% of your test. ApoE. I'm gonna ask everybody there. So here it is in a nutshell. There's 3 variants of the ApoE test. There's ApoE2, less than 1% of the people have that. If you have ApoE2, you ain't gonna see Alzheimer's. You are lucky. 75% of America has ApoE3. That means your car is in neutral, and if you have a good lifestyle, car goes into drive. Your car is in neutral and you have a bad lifestyle, you're going to reverse. You can get Alzheimer's. ApoE4 increases your incidence, having 2 ApoE4s, by 80% towards Alzheimer's. It's an Alzheimer's predictor. It portends Alzheimer's. So who wouldn't wanna know that they do not have a genetic marker for Alzheimer's? ApoE4 is critical. And last but not least, on the left side, LPS, lipopolysaccharide. LPS is an endotoxin. That holds gram-negative bacteria on the inside of the intestinal wall. When it's expressed through leaky gut or damage to tight junctions, LPS is a direct minder, leads you down a slippery slope on a lot of health conditions, even lower testosterone, estrogen, brain damage, musculoskeletal damage. LPS will allow you to understand that— Better yet, the expression of LPS increases the incidence of heart disease By 3 times. Lp, less than 1% of the population has the test. It is your genetic marker for heart disease. Less than 1% of Americans have taken it. 25% of Americans have it, and 40% of their relatives have it. So for me, I made sure to take it so I could tell my sister, I could tell my parents even. I have no children, my niece, my nephew, etc. How many people out there know their Lp marker? I'm real curious to see how that chat is lighting up. I can't see it. Blood pressure, body composition, as we talked about before, telomere length, VO2 max. VO2 max, the number one marker probably for overall fitness. It's how well you utilize oxygen when you try and perform cardiorespiratory exercise. Maximum grip strength right there at the top tier for me. Mitochondrial dysfunction. And last but not least, zonulin. Zonulin is a protein enzyme that talks about the pulling of junctions in epithelial cells. So when zonulin is elevated, it pulls apart the tight junctions. Also, an elevation to zonulin is an everyday marker in that people who have elevated levels of zonulin have bigger waist circumference, higher blood pressure, blood sugar metabolism, and body composition issues.

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So blood levels and longevity, glucose, creatinine, and uric acid. All these people who lived to 100 had lower levels and good blood markers. Interestingly enough, look at the first bullet: lowest of 5 groups for levels of cholesterol and iron had a lower chance of reaching 100. Wait a minute, what are you saying? WTF? Whiskey Tango Foxtrot? What is going on? Well, you know what's going on. The bottom line is they're telling you that a low cholesterol marker is a good thing. It's not. It's not. If you— if they're not taking particle size, if they're not taking ApoE status, if they're not taking Lp, direct LDL, your cholesterol markers are virtually useless. And by the way, cholesterol, 15 to 20% is based on the ingestion of cholesterol. 80% or more cholesterol numbers are based on consumption of sugar. So even the discussion that I see traditionally is really archaic and inaccurate at this point. I love taking an omega-3 index. It shows the percentage of EPA/DHA in your blood. 8% or higher is ideal. Most people in the US are 4% or lower. It's the highest risk zone. People with high omega-3 levels live 5 years longer. And people of high omega-3 levels hold off Alzheimer's for 5 years as well. So you're buying 5 years of healthy life by just taking omega-3s every day. And this just really wanted to go into detail. If you look at the right side, the baseline 300 milligrams going up with the big percentage is 1,800 milligrams. And I suggest 4 grams a day or 4,000 milligrams. I believe you're only as young as your immune system. So if someone would ask me a longevity test, biological versus chronological, I would definitely do markers to see how functioning and how resilient your immune system is. Immunity is the key to longevity. Tufts University, Boston U Medical School helped answer the question. People who lived to 100 had a highly functioning immune System. Immune resilience, talked about it before. Here it is. It's a term that represents the ability to withstand and bounce back from infections and inflammatory stressors. You look at the people again who lived to over 100, there was one thing that they all had in common. They had beneficial bacteria. They were populated with a large amount of beneficial bacteria, and they did not suffer from dysbiosis. 80% of your immune cells are in your gut. It's where your macro and micronutrients are absorbed.

Wow.

So it's all about that ecosystem once again. Time magazine did a study 20 years ago, March of 2004, and in the study it called inflammation the secret killer. As I said before, inflammaging is the inflammation that's causing internal aging and aging you before your time. As I— my credo is to manage and modulate Inflammation. And inflammaging will decrease hormones, metabolites, your ability to take away cellular debris, increase inflammatory cytokines, impair autophagy, cause mitochondrial dysfunction and dysbiosis, also increase cell senescence. Here you've got a beautiful slide where you've got healthy microbiota versus dysbiosis.

Healthy microbiota.

It has diversity and richness. It allows for oxidative and cognitive status. Whereas dysbiosis is a decrease in the variety of bacteria species and destruction of helpful bacteria. You need a biodiversity. You don't wanna take in a probiotic, the same one, the same species all the time. It's like a neighborhood. Diversity wins in your garden of your gut because the more diverse bacteria you have, The more health-promoting functions you can draw upon. How to get healthy aging in your gut and take care of your gut because it's your second brain. Your gut is not only necessarily your second brain, it has its own nervous system called the enteric nervous system. That nervous system is the largest nervous system in the body. Diet, supplements, and good exercise will help you towards taking care of your ecosystem.

Wow.

Ozempic and all these weight loss drugs. I'm not saying no one should take it. I'm just saying that I think it's being overprescribed, and I don't think people understand all the side effects that are associated with it. 40% of the weight loss is muscle mass. In addition, there's some more side effects that are very uncomfortable— diarrhea, vomiting, and the like. And also 3.7 times the increased size in your intestines. So you want your Ozempic? Take care of your gut microbiome. Here's your anti-Ozempic, if you will, protocol: berberine, alpha-lipoic acid. Said anything interesting so far? Pro-resolving mediators, pre- and probiotics. You got it. You take that and you're going to get an Ozempic moment. So some of the consequences of mitochondrial dysfunction. Dysfunctional mitochondria lead to oxidative stress, decreased ATP. A decreased ATP leads to an increased amount of sensation towards pain, altered mitochondrial biogenesis, calcium imbalance, and cell death. The diseases that can be affected by the mitochondrial dysfunction, neurological diseases, said that earlier, Dystrophy, aging, neurogenic disorders, cardiac disease, cancer, mitochondrial disease, metabolic disorders and diabetes, and skeletal muscle and movement disorders. Here's a slide that really illuminates the idea of what fascia can do. The skin pulling away from the chicken breast, that white film which is depicted right here, or—

Right here.

Right there, that is your fascia. Interestingly enough, you look at a filet of salmon, the white film on top, or when you open it up, that's fascia. So fascia's on top of the muscle, it's in between the muscle, and it's actually in between the muscle and the bone. Fascia is the longest and largest system in the body 'cause it attaches to the skin, and it's the only system that touches every other system. Fascia is living matrix. It's your full-body wetsuit. It's connective tissue. It's sheathing the body. It's below the skin and above the muscle. Lymph nodes and nerves live in fascia. It's a sensory organ and it accounts for 20% of our body mass. Vagus nerve. We could do a whole webinar and spend an hour and still need more time to cover all that the vagus nerve does. The basic vagus nerve, medulla oblongata, down through the transverse colon. It attaches to the transverse colon at a point called a neuropod. That neuropod is able to sense what's going inside the microbiota. So the microbiota communicates to the gut, that gut communicates to the brain, the brain communicates to the gut, that gut communicates to the microbiota. 3-way calling. Both going up and down the chain. 80 to 90% of the signals of the vagus nerve is afferent and 10 to 20% are efferent. So if you look at the anatomy, you see that the vagus nerve covers a litany of different organs. So vagus nerve afferent and nerve relay data from gut-to-brain axis, transmits information about pain, inflammation, satiety, motility. Presence of toxins and irritants, intestinal barrier issues, and the microbiome. Efferent going back down carries signals from the brain to the GI, modulating digestion, gut motility, hormone release, and neurotransmitters. Now, why did I put this in there? Well, both the afferent and the efferent pathways are both anti-inflammatory, but the vagus nerve, by stimulating it appropriately. Also has a 3rd anti-inflammatory pathway, and that's the vagal splenic nerve pathway. So the vagus nerve, or stimulating the vagus nerve, can dramatically reduce inflammation. Who better than manual therapists to decrease vagus nerve— excuse me, increase vagus nerve stimulation? Stimulating the vagus nerve increases acetylcholine. The positive to acetylcholine is it's the effect On the spleen, which is a respite for immune cells. These immune cells release macrophages. So the macrophages, when they're— when vagus nerve tone is down, also come and stimulate TNF-alpha. Acetylcholine, when vagus nerve is stimulated, blocks TNF-alpha. So the macrophages come out and do their work. And that's why vagus nerve is anti-inflammatory via the spleen. Stimulating the vagus nerve also reduces inflammation, improves outcomes in rheumatoid arthritis, inhibits cytokine production. So some hacks, lifestyle hacks for vagus nerve, physiological sigh, submerging the face in freezing water, cold plunge. The basic idea is sudden exposure to cold induces the activation of the parasympathetic nervous system. You could do a vagus nerve massage, stroking and twisting the trap muscles, gripping the trap in between that and the SCM, massage, anything. The key to vagus nerve stimulation or appropriate vagus nerve stimulation is increasing the heart rate variability. Sarcopenia. Everybody loses on average about 1 to 2% of their muscle each year after age 40. Some may lose up to 25% muscle mass by age 65. And I've also read up to 40% at age 70. Lean muscle, muscle mass is an effective endocrine organ because it enables you to efficiently dispose of glucose. It also has a very potent effect on microbiome modulation. So the pathogenesis of sarcopenia and cardiovascular disease. So sarcopenia, loss of muscle mass, you'll see both of them have commonalities in malnutrition, physical inactivity, Insulin resistance, inflammation, hormonal changes, autophagy, cell death, apoptosis, and oxidative stress. But each will lead to a different outcome: sarcopenia, falls and fractures, frailty, and cardiovascular disease, typically in many instances death. Muscle mass is your organ of longevity. We've heard that one before. And Peter Attia, who I quoted twice in this webinar, does a great job. I'm talking about his 4 pillars of fitness. Strength is the foundation of longevity. 50% of your workout is based on weight resistance. You should do practical, applicable movements like deadlifts, squats, shoulder presses, farmer's walks, pull-ups, push-ups, lunges. Stability should also be a component that you should partake in if you want to get that pillar of health. Plank, standing on one leg, goblet squats. Low-intense cardio for someone like me over 50, great choice because it promotes mitochondrial biogenesis. And intense exercise, rucking. Rucking is the exercise of 2024. It is wearing a weighted backpack. If anybody's interested in where to get the best rucking backpack, feel free to reach out to me. I'll share some contact information. Small doses when you're a little older. is better to and more effective to increase lifespan. So age-related causes of protein shortfall. Why are we having so much trouble? The memo is real simple. If you want longevity, you need to eat more protein as we age because muscle protein synthesis wants to slow down and digestion in the gut also has slowed down. So here are some reasons: inadequate intake of protein, reduced ability to use available protein, greater need for protein, All can lead to loss of functionality, i.e., muscle, bone, and immune systems. Sarcopenia: animal versus plant protein. I do not dislike plant protein. However, if you want to put muscle on and you have an option between the two, animal protein wins out, especially if it's grass-fed, grass-finished. It does so because the articles are robust. On its ability to put on muscle mass and increase muscle protein synthesis. Animal versus plant. So flicking the switches—that was one of the things that we talked about before. AMPK is activated protein kinase. It regulates the amount of energy. It's a nutrient and energy sensor. It maintains energy homeostasis. If you want to stimulate AMPK, alpha-pulk acid, berberine. Omega-3, resveratrol, intermittent fasting, high-intense exercise, and of course caffeine. You're gonna see some commonalities. So AMPK is good for fatty acid synthesis, mitochondrial biogenesis, protein synthesis, cytokine and eicosanoid synthesis, glucose uptake, blood flow, and activated B and T cells, i.e., your immune system. Sirtuins, they protect the cell from damage. They lead to repair. They reduce inflammation. They boost memory. They impair mitochondrial health. They repair mitochondrial health. They're stimulated by NMN. Wow. Which stimulates NAD+. NAD+ is without question a powerful nutrient that is under fire because they wanna make a prescription. EGCG, green tea, turmeric, resveratrol, quercetin, exercise, intermittent fasting, extra virgin olive oil, and coffee. Sirtuins activation increase brown fat activation, make you leaner, improve insulin sensitivity, improve exercise performance, improve NASH, optimize endothelial function, improve cardiac function, improve neurodegeneration, and optimize innate longevity pathways. So the one, the real conversation, again, I was with a longevity expert today on my podcast that'll be coming out in a couple of weeks, Proven Health Alternatives. Interestingly enough, we talked about the mTOR pathway, and a lot of people like to upregulate it, other people like to downregulate it. I like to balance it because it's a central processing unit That makes all complex decisions related to cellular growth. It's a signal for growth rather than survival. So to balance or dim it a little, resveratrol, quercetin, zinc, melatonin, omega-3 fatty acids, curcumin, coffee, intermittent fasting, vitamin D, and the ketogenic diet. I use the term inhibit mTOR. How about dim it a little? If you can do that, And get it in the right spot. Remember, the body's all interconnected. The body, it's called homeostasis, it's balance. Switches on, switches off, switch in the middle. So this is a switch in the middle to a little bit off. If you do that with mTOR, you can induce autophagy, mitophagy, and mitochondrial biogenesis. You can preserve stem cell function, reduce inflammation, and regulate innate and adaptive immunity. Inhibit NF kappa B, so it can do a plethora of things when it's in the right space. So the switching of aging, real simple: you want to turn on sirtuins, you want to turn off AMPK, and modern America, you probably want to decrease or turn down mTOR. Fasting, I know it's it's I'm coming at you real rapid. Fasting, Paraclesus once said about intermittent fasting. Fasting is the greatest remedy. It is without question the physician within the patient. So mechanisms of intermittent fasting. Number 1, oxidative stress hypotheses. Number 2, circadian rhythm. And I think that may be the hidden gem. I think the idea of resetting yourself for circadian rhythm. 2 weeks ago, I had a specialist on and he specializes in circadian rhythm and figuring out your appropriate circadian rhythm and allowing you to exercise at that circadian rhythm. Circadian rhythm. I think that's a brilliant theme. Circadian rhythm, your sync with your environment, your time zone. So everybody knows I'm in New York. I travel all over the place nationally and internationally. So when I go nationally and I go to the Central Time Zone where Jessica is in Texas, it's 1 hour. I don't change my phone back. I live my life like I'm in the East Coast. I do the same when I'm in Mountain Time. I do struggle a little bit when I go to like the West Coast. The problems that I have are when I go to Hawaii and when I go to Europe. Now, when I go 5 hours ahead, going ahead in time is just horrific. Coming back in time is refreshing. So the sync of the circadian rhythm does enable you to optimize energy metabolism. And intermittent fasting will help you with ketosis. So some of the benefits of time-restrictive eating are inducing autophagy, improving the circadian rhythm, promoting longevity, improving cognition, increasing insulin sensitivity, promoting weight loss, and improving your gut health. Because I do believe the gut is the epicenter of your health. Some examples of intermittent fasting's effect on different organ systems— let's just go for it. Muscle, liver, bone, brain, gut, and fat, all having a positive outcome from intermittent fasting. Fasting actually reduces chronic inflammation but doesn't affect acute inflammation. And Mount Sinai did a study on that, and that's just fabulous. So it manages and modulates your inflammation. I am a big proponent of intermittent fasting. I like 14:10, a 14-hour fast, a 10-hour feeding time. So intermittent fasting, restricted hours of eating, 12 to 16 hours. Long fasts, which I do not like, 24 to 72 hours, nothing over 24. Fast-mimicking diets, data hasn't been proven on that. Ketogenic diets, proponent of a ketogenic diet, 70 to 75% fat, 20% protein, 5% carbohydrates in 5:2. I like the time-restricted eating the best. Anyway, the benefits of the time-restrictive eating are in to recap: inhibit mTOR, reduce insulin signaling, improves insulin sensitivity, activates AMPK, activates sirtuins, activates FOXO, activates autophagy and cell repair, and stem cell renewal. Senescent cells accumulate with normal aging and impede organ function. Create chronic inflammation, emit protein-destroying enzymes, shorten lifespan. Removing senescent cells usually confers with a healthy longevity, increased lifespan, increased healthspan, and of course, improved vitality. Which diet is the best? Well, any diet that isn't the standard American diet is gonna be more effective, 'cause the acronym for the standard American diet is SAD. Probably for successful aging, the Mediterranean diet has the most data. In this study, it showed an 11% decrease in cognitive impairment, a 51% increase in the quality of life, 10% higher odds of successful aging. All of these have beneficial health effects for mental and cognitive function.

That wraps up part 1 of our Look Back conversation with Dr. Robert Silverman. In this first half, we explored the difference between lifespan and healthspan, the role of immune resilience and inflammation in healthy aging, and why systems like the gut, mitochondria, vagus nerve, and muscle mass matter far more than most people realize. In part 2, we'll continue the conversation and go deeper into practical strategies and clinical applications for supporting long-term health and performance. Be sure to tune in for part 2. Episode 127 drops in 2 weeks. If today's episode sparked your interest in this topic, I encourage you to visit the link in our show notes for the Functional Nutrition Certification Program. This 50-hour program will teach you a holistic nutritional approach That looks at genetic, environmental, and lifestyle factors and provides a system-based framework for treating a variety of patient populations. Click the link in our show notes and use code PODCAST to take 10% off of registration. If you enjoyed today's episode, be sure to like, follow, and leave us a review on your favorite podcast player or on our website at factorpodcast.com. That's faktrpodcast.com. It helps more clinicians find the show, and every review is so important to us. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.