Ten Percent Happier with Dan Harris - 609: Can You Really Live to 150 Years Old? | Dr. Mark Hyman
Episode Date: June 14, 2023Everyone from the Buddha to the Stoics have exhorted us to remember that we’re going to die. So what are we to make of Dr. Mark Hyman? He’s a physician and a student of Buddhism who is ju...st out with a new book, called, “Young Forever.” In it, he argues that your biological age can be reversed even as you grow chronologically older. So we decided to have him on, learn about his approach, and gently grill him on some of the things that made us most skeptical. This is the second part of our new six-part series, Get Fit Sanely series, where we are trying to help you to make sense of the noise around getting fit–and to do so without losing your mind.A little bit more about Dr. Hyman: He is a practicing family physician, the Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, and a fifteen-time New York Times best-selling author. He also has his own podcast, called The Doctor’s Farmacy.In this episode we talk about:Whether there’s a tension between Mark’s approach and BuddhismWhether it’s realistic for people alive today to think that we could make it to 150 or 200 years oldMark’s contention that he is in better shape at 63 than he was at 40His take on intuitive eatingHis top line recommendations on exerciseThe benefits of cuddlingHis response to critiques of functional medicineWhether his longevity routine is something regular people can doThe research on cold plunges and saunasHis advice on alcoholFull Shownotes: https://www.tenpercent.com/podcast-episode/dr-mark-hyman-609See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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This is the 10% happier podcast. I'm Dan Harris.
Hello, my fellow suffering beings. People have been promising eternal life for thousands of years. There's
a reason why the myth about the fountain of youth has had such staying power in so many
cultures and so many parts of the world for so long. We all know it's bullshit, but goddamn
it is compelling. Everybody from the Buddha to the Stoics have exhorted us to remember
though that we are going to die, that this whole being-alive business is super
short and quite fragile.
But we seem to be programmed for denial.
So then, what are we to make of Dr. Mark Hyman?
He's a physician and a student of Buddhism, who's just out with a new book called Young
Forever.
In it, he argues that your biological age can be reversed even as you grow chronologically
older.
He also lays out his extraordinary personal longevity regime, which includes check this
out.
Arobic exercise, strength training, hot yoga, mantra meditation, breathwork, sauna, cold
plunges, red light therapy supplements a specific diet.
He calls the pagan diet, timeed eating, using a low oxygen mask
while he's working at his desk, using blue blocker glasses
at night, getting massages, ozone therapy,
hyperbaric oxygen therapy, and by the way,
that's not even the whole list.
I should say on top of that, he also sometimes experiments
with things like peptide therapy, exosomes,
whatever those are, stem cells, natural killer cell infusions, and transfer plasma
exchange.
Okay, at this point, you may be thinking this sounds ridiculous, unrealistic, very expensive,
and supremely time consuming.
However, Wal-Mark is by his own admission, and you'll hear him cop to this in the course
of the interview, a bit controversial in some circles.
He is also a friend of mine who's been on the show before before and he's a very big deal in the health and wellness space. So we decided
to have him on and learn about his approach and gently, gingerly, and in a friendly manner,
grill him on some of the things that kind of made us my team and me just a little bit skeptical.
I should say, Dr. Mark Handle, this all very well. I should also say this is
the second part of our six part get fit safely series where we're actively trying to bring on a set
of diverse guests with in some cases contradictory viewpoints and then ask them tough questions and help
you make sense of all of the noise out there around getting fit and how to act on this advice without
losing your mind. A little bit more about Dr. Heimann before we dive in.
Here he's a practicing family physician, the founder and senior advisor for the Cleveland
Clinic Center for Functional Medicine and a 15-time New York Times best-selling author.
He also has his own podcast, which is called The Doctors Pharmacy, and I've been on there
a couple of times.
In this conversation, we talked about whether there's tension between Mark's approach and
Buddhism, whether it's realistic for people alive today to think that we could make it
to 150 or 200 years old, Mark's contention that he's in better shape at 63 than he was
at 40, his take on intuitive eating, his top line recommendations on exercise, the benefits of cuddling,
his response to critiques of functional medicine,
whether his longevity routine is something regular people
could do, the research on cold plunges and sonnas,
and his advice on alcohol.
Before we jump into today's show,
many of us wanna live healthier lives,
but keep bumping our heads up against the same obstacles over and over again. But what if there was a different way to relate
to this gap between what you want to do and what you actually do? What if you could find
intrinsic motivation for habit change that will make you happier instead of sending you
into a shame spiral? Learn how to form healthy habits without kicking your own ass unnecessarily
by taking our healthy habits course over on the 10% happier app. It's taught by the Stanford psychologist
Kelli McGonical and the great meditation teacher Alexis Santos to access the
course. Just download the 10% happier app wherever you get your apps or by
visiting 10% calm. All one word spelled out. Okay. On with the show.
Hey y'all, it's your girl K Kiki Palmer. I'm an actress, singer, and entrepreneur.
On my new podcast, Baby This is Kiki Palmer.
I'm asking friends, family, and experts
the questions that are in my head.
Like, it's only fans only bad.
Where did memes come from?
And where's Tom from MySpace?
Listen to Baby This is Kiki Palmer
on Amazon Music or wherever you get your podcast.
Dr. Mark Heimann and welcome to the show.
Thanks, Dan, for having me.
It's great to be back.
Yeah, I should have said welcome back to the show.
You and I were texting about this last night.
It's so interesting to me because you studied Buddhism in college.
You're quite familiar with Buddhism to this day.
And you know that in Buddhism, there's this huge emphasis on getting familiar with,
comfortable with, intimate with your mortality.
Then we are asked to remember that these bodies are of the nature to age and to die.
And yet you've just put out a book, congratulations on your new book, very successful book, and
the book is called Young Forever.
And so I'm wondering, is there any conflict there?
Not really. I mean, I think the Buddhists are very focused on this idea of impermanence,
right, that everything changes. And death is part of the impermanence. Things are born and they die.
So I think for me, the focus on longevity is really not about living longer per se. It's about
living better. It's about
increasing your health span, not your lifespan. And the lifespan extension is just a natural consequence
of dealing with increasing the quality of your health when you're alive. We also want to add more
life to your years, not just more years to your life. And so it's definitely not a conflict at all.
I don't really think that I want to live forever.
I think it's a bad idea. I'd love to be young as long as I'm alive. My joke is I basically would
like to die young as late as possible. So the title young forever is more of a poetic turn of phrase,
a switching of forever young as opposed to some sort of advertising promise.
Exactly, exactly.
Exactly.
There are longevity scientists that are talking about
longevity escape velocity, which is a concept I have trouble with,
even if we can scientifically achieve it,
which is essentially extending our life each year
more than the rate at which we're dying.
So if you can extend your life by year and a half
or ever you're alive, you perpetually never die.
I kind of don't like that idea,
but I think getting to 100 healthy years
is achievable for most of us, maybe even 120.
I think given what we know with longevity science now,
this might not be out of reach.
And the point is not just to live to be 120,
but to be able to do what you love to do. In fact, I just was with a friend in Turkey whose grandfather is over 100 years old,
just flew from Paris to Portugal to visit his grandkids,
hikes every day three kilometers. He was actually a survivor of Auschwitz,
which by the way is maybe part of the reason he has lived a long time, which is
starvation actually activates these ancient survival longevity pathways.
So I think if I can go visit my grandkids
and go for a hike with them,
at a hundred years old, I'm down.
But my kids are going at that rate.
It might not be till a hundred that I get grandkids.
So.
I have so many questions for you.
Okay.
So as I mentioned in Buddhism,
there are all these practices where you reflect on the
fact that the body, as I said before, is of the nature to age, to get sick, to die.
I think the Buddhist proposition is that it's worthwhile to get comfortable with your
mortality, with your finitude, because it makes the present moment more vibrant, gives your life a sense of
priority, and it aligns you with the non-negotiable truth.
Do you, given your emphasis on longevity, do you agree with the Buddhist approach in that
regard?
I mean, absolutely.
I mean, the whole point of life really is to show up, right?
It's to show up and be president president and fully experience what is right now.
And that's where joy comes from,
where happiness comes from, where love comes from,
when we're distracted and disconnected
and thinking about the future or the past,
we're not actually in a true moment of life,
we're in some abstraction.
And the purpose of Buddhism is to be fully present
and be fully aware and to be in this state of alertness to the moment.
And that's where life happens. That's the only place life happens. And so the practice of
Buddhism are all about that. And as long as we stay focused on that, then we actually have an
opportunity to fully live. And so the problem that I see so much now, Dan, is that most of us are not fully living
in its part because of our distracted life.
But it's also because we're sick.
You know, 93.2% of Americans are metabolically unhealthy, which means they have some form
of predivitis.
They have high blood sugar, high cholesterol, high blood pressure.
They've had a heart attack or stroke or overweight.
And so if you're walking around and you feel like crap,
it's hard to be present.
If you're tired, you're foggy,
or achy, you're dealing with medications and side effects
and just basically not in your full health,
it's really hard to be present and loving
and kind and compassionate.
There's a saying that a healthy man wants many things,
a sick man wants one thing.
So I think that's kind of the perspective I have.
So how do we say fully alive and present?
It's partly by taking care of our physical container.
You know, and I think this is not absent
in traditional Buddhist circles,
or Tibetan Buddhist doctors who are very much
about creating vitality.
There's long life ceremony.
So now they're using to actually help the dieloma,
to be 110 years old, but she promised. So it's not like they're opposed to living a long-life ceremony. So now they're using to actually help the dieloma to be 110 years old,
but you promise. So it's not like they're opposed to living a long-helfing life,
but whether you die at 70 or 100 or 110, you're still going to die. So you have to kind of face
mortality. So it's not mutually exclusive. Right. I would just say I was at a long-life ceremony
for his holiness a few months ago. And yes, he was right there. And he said to me, which he's,
I wasn't the first person to be said this to,
that he plans to live to 110.
So if I'm hearing you correctly
and I tend to agree with it,
there isn't a fundamental conflict
between the notion of getting comfortable
with your mortality and being as healthy as possible
while you are alive.
No, absolutely not.
It's not mutually exclusive.
In fact, the only way to actually,
I think live a fully robust, engaged life
where you're happy and joyful in yourself
and you're able to be in service and connected to others
is to feel good.
And so understanding the mechanism by which we get sick
and we become decrepit as we age is really important.
Because the Dalai Lama doesn't want to be 110 and not know his name
and not know where he is and not be able to teach. He wants to be able to be in service.
And so, in order to do that, you have to take care of the physical container you live in,
whether you like it or not.
I want to talk to you a lot about the how of that, but just staying on a high level for a second.
How far can we take this idea of longevity? Do you think it's realistic for people
alive today to think that we could make it to 150 or 200?
I think it's possible. I mean, the longest-lept human that's been well-documented was Madame
Clemah, who lived to be a hundred and twenty-two years old, while, by the way, smoking and drinking
wine and loving chocolate. I don't recommend her path, but it shows the potential limits.
Now, given what we know now about the science of epigenetic reprogramming, and I can explain
what that is, we now understand how to turn back our biological clocks.
And it's not through a lot of fancy expensive things, although there are things that are
fancy and expensive and are scientific advances that are coming down the pike, which are very exciting, which may allow us to accelerate
our epigenetic reprogramming to a younger you. I think most of us can reasonably expect
to be able to live 100 healthy years. I think most children today, if they avoid the ravages
of our modern society's food system and sedentary lifestyle and stresses and toxins, which by the way is
no easy task, that they actually could most of them reach a hundred years old. I think
getting 220 little harder, I think getting 150, 200 is definitely still in the realm of
sci-fi, but I think given what we are now understanding about the underlying mechanisms
of aging and the signs of longevity, I'm pretty hopeful that we're going to see
people living now who will be able to reach 120, 150. I'm hoping to get to 120, maybe 150. We'll
see how I'm doing, but I've not just go to Switzerland and call it a day.
Switzerland where you could like freeze your brain, you mean? No, no, I have legal euthanasia.
Oh, I see, got it. You can choose your day of exit. Got it.
Got it. Got it. Got it. Got it. That's a whole other conversation. Actually, we should have
at a time point, but because I'm interested in that. But just staying on task for a second,
or on topic for a second, hopefully more than a second, you're saying that somebody,
like you're your early 60s, I'm in my early 50s, if we live in a healthy way, which shouldn't require too many super expensive things, just
common sense things, hopefully, that we could reasonably expect to be healthy until 100.
Yeah, I think that's true.
I mean, I was in the Blue Zones, and it was amazing to see people whose environments
were naturally organized to activate their longevity pathways, right?
Their diet, their mandatory activity,
hurting sheep five miles a day at Rocky Terrain.
Their deep social networking connection,
their lack of exposure to toxins,
their lack of stress, chronic stress.
And they were people that were 100 years old,
95 years old, who were running up and down the mountain.
And I was like, holy cow, I can't keep up with this guy,
he's 95 years old.
And that's because he's been hurting his sheep of rocky slopes for 70 or more years.
Right.
Right.
Just for the uninitiated, we're doing a whole series on getting fit and staying healthy.
And the blue zones have come up a lot.
This concept was pioneered in large measure by a guy named Dan butiner who actually met
recently and may have him on the show at some point.
And Dan was working with National Geographic and traveling around the world as a kind of
professional adventurer and found these areas of the world where people are living longer
and they've come to be known as the blue zone and he's written books about what you can learn
from them and there's some overlap for sure in your work.
So you say you're healthier and better shape at 63
than you were at 40 and I'm curious,
is that really true?
And if so, how to do swing that?
Well, I actually think it's true
because not only do I look better,
but my biological age based on DNA methylation tests,
which we can talk about is 43, even though I'm 63.
And when I was younger, I followed the prevailing dietary recommendations,
which we see a lot of starch, right? Our dietary guidelines are food pyramid in 1992 said,
8, 6 to 11 servings of bread, rice, oil, and pasta every day, and fat sparingly. And now we know
that the biggest driver of aging is a high starch and sugar diet. And so that drives cancer, drives heart disease,
dementia, obviously diabetes, inflammation throughout the body.
And so I switched my diet to be quite different, to be much higher in good fats,
to be much higher in high quality protein, and higher in phytochemically-rich vegetables.
And that has changed my physiology, and I have greater muscle mass, I have greater strength.
I've also started resistance training,
which is the thing that's very important.
I was running and I was doing yoga, which I thought was enough,
but it really wasn't.
So I basically put together a strategy based
on the merging of science of longevity,
how to activate my body's own healing and repair mechanisms.
I've seen this over and over.
People basically can transform themselves at any age, whether you're 40, 50, 60, 70, 80, it's not too late to
start.
So if your diet's been off and you're 50, I'm asking for a friend clearly, you can still
turn things around. If you're 40, 30, 50, 60, get to 100 with a health span that is intact.
Absolutely.
I just had a quick story of a patient I had at Cleveland Clinic who was 66 years old.
Then for all intents and purposes, she was on her way to a heart and a kidney transplant.
She had heart failure.
She had detected diabetes on insulin for 10 years.
She had high blood pressure.
She had really poorly controlled diabetes.
Her A1C was 11, which is, you know, practically hospitalized levels. And she was on a pilot medication and mass
really overweight her body. Massendix was 43, normal is 25 over 30s OB.
So it's just huge. And within three days, she was off her insulin,
just using food as medicine. In three months, she was off all her
medications, or A1C went from 11 to 5 and a half, which is normal. Her heart
failure reversed, which you never see in medicine.
Her kidneys normalized, her liver normalized, she had fatty liver.
And she lost 116 pounds over the course of a year.
There is no drug on the planet that can do that.
No combination of drugs that can do that.
They can manage things better, but they can't actually reverse these conditions.
And that's the power of activating these ancient survival pathways that we have that are built in. You know, we have 3,000 genes out of our 20,000, which is a lot that are designed
to adapt to scarcity and starvation and survival, not to deal with the abundance of food and
sugar and calories we have today. So when we start to learn how to properly turn on what I call
the longevity switches, we can see radical
transformations in NEH. So let's talk about the how of this. In your book, you lay out at least
three big levers that we can pull, eating, exercise, and what you call lifestyle practices.
There's more, but those are the three biggies from what I can tell. Let's start with eating,
very basic level. What are your recommendations for those of us want to increase our health
span?
Well, I think the first thing is what not to eat, and then is what to eat, right? So what
not to eat is what we were told to eat for the last basically 50 years by our government,
which is a lot of starch, and often a lot of sugar also, which we're eating. They weren't
recommending that, but they're basically saying it's okay to have 10% of your calories
of sugar. It's really not.
And that high amount is driving all the age-related diseases
and increasing mortality.
So if you look at the process that occurs
by it's called insulin resistance,
which is your body becomes resistant to the effects
of insulin, you make more and more insulin
to make your blood sugar normal,
and that insulin causes fat storage around your organs.
It causes inflammation.
It causes damage to your brain and dementia.
It increases cancer growth and risk.
So it's just, it accelerates every single pathway you do not want to accelerate if you want
to live a long time.
And so the first step is to cut down on the 152 pounds of sugar and 133 pounds of flour that the average American
is eating every year.
That's almost a pound a day per person per day.
That's just a pharmacologic dose of sugar and starch.
And that's driving so many problems that are related to aging and aging fast and all
the disease of aging.
So that's the first step.
And the second is just ultra-process food, which is 60% of our calories because they make
you eat more, they make you hungrier,
they're designed to be addictive,
and we just should not be eating those foods,
which are really not foods.
They're what I call food like substances.
And the 60% of our diet is 67% of kids diet.
And then the question is, what do you eat,
if you're not eating that, which is a majority of our diet,
what should you eat?
Well, your diet should include a lot of phytochemicals,
and those are plant
compounds that are found in fruits and vegetables that are highly bioactive and regulators of many
of the ancient survival pathways. So you might have heard about Corsetinal Lunggevity, which
reverses biological age or respiratory trauma, which you might have heard about from red wine,
although don't you drink red wine as a way to get it, but it has shown to extend life dramatically in animal models, with David Sinclair and Linnigority
from MIT.
There are other chemicals like green tea or pomegranate extracts or basic phytochemicals
from broccoli and a whole host of these compounds have been found to regulate these ancient longevity
switches.
Let's call them.
I'm happy to explain what those are if you want to get get into it. But basically, it turns on all the beneficial pathways
that reduce inflammation, that increase
your antioxidants, that help to increase your mitochondrial
function, mitochondria, the energy factories that
make energy from food and oxygen.
And that's critical to longevity and helps
your microbiome work better.
And every aspect of your health, these are critical.
So good quality fruits and vegetables.
The second is good fats.
Fats are really important for longevity,
especially omega-3 fats, olive oil,
avocados, nuts, seeds, just good fats.
And then lastly, protein.
And protein is the big kind of controversial question
in terms of health and longevity.
Because there's a camp that says,
we should all be vegan to live a long time.
And there's a camp that says, no, we need to eat more meat.
So who's right?
And I think when you look at the data,
it's quite interesting.
Muscle is the key to longevity.
If you want to stay functional,
if you want to be able to hike up that mountain,
you want to be able to get up off the floor,
if you fall down, you want to be able to tie your shoe
like this, you got to have muscle to do it.
And what happens to us as we age is the second law of thermodynamics, which
is entropy. We fall apart. Unless we have inputs that prevent us from falling apart. And
so we need to understand how do we design a way of living and eating that activates muscle
protein synthesis. In other words, how do we build muscle as we get older? And it turns out that
the best way to build muscle is to eat muscle, meaning animal protein, meat, fish, chicken, etc.
Now, if you eat a lot of meat all the time, that's not good either because there's an ancient
mechanism that's designed to build muscle called mTOR, but it also has to be turned off at important rates of time,
because if you don't give it a break, you're constantly building muscle, you can grow cancer
in many other things.
And when you inhibit mTOR by fasting, for example, like an overnight fast, which is usually
should be at least 12 hours, that's called breakfast, right, or 14 or 16 hours,
that inhibits this pathway called mTOR.
And when you inhibit this pathway,
it actually is the thing that extends life.
It's called autophagy or self-cleaning.
So at night, or when you fast,
you have this process of self-cleaning and self-repair
that basically activates everything you wanna activate
if you wanna live a long time.
It repairs your DNA.
It improves your mitochondrial function and energy production.
It reduces inflammation.
It leads to increasing antioxidant systems.
It helps to make you more insulin sensitive,
but does all the beneficial things you want
to actually live a long time?
And so you need to give yourself a break from eating,
but you also need to then,
when you do actually break the fast,
let's say after a 16 hour or 14 hour overnight fast, you need to refeed with the right substances and not what we eat
in America, which is sugar for breakfast.
We basically have dessert for breakfast in America, right?
We have cereal, we have pancakes, we have bagels, we have muffins, we have sweetened tea,
sweetened coffees, it's the worst.
So it turns out the science is very clear on this and this is from a large review of all the literature by the world's leading protein scientists called the Prodage study.
They found that as we get older we tend to get what we call anabolic resistance, meaning it's hard to build muscle.
And so we need more protein and we need more resistance exercise, otherwise known as string training.
So when you refeed you want to have about 30 or 40 grams of protein and you want to then do that within two hours
of exercising or weight training.
And depending on your size, and if you're five foot tall,
100 pound person, it's different than you
if you're a six foot six, 250 pound person,
you want to need a different amount of protein.
But you need more protein than we typically think.
And you need protein that has a very important amino acid
called loosing.
Loosing is basically the switch that turns on muscle protein synthesis.
If you have low loosing in your protein, which is basically most plant proteins,
you will not be able to turn on muscle synthesis.
And that's why weight protein or eating protein from a muscle like B for chicken or fish
actually is the best way to activate this.
So you have to actually increase your protein intake as you get older, but you also need
to have these breaks from eating, which are an overnight fast or longer fast, or take
a drug like Grappa Mison, that mimics calorie restriction to actually turn on this proper
cleanup system.
So you need both build up and making a muscle, but also clean up
repair and regeneration, which is basically what happens overnight. So it's a
little bit complicated, but the basic idea is we need more protein and we need
more animal protein as we get older. If you want to be a vegan, you can do it,
but you have to add amino acids and losing and other things to your diet
supplementally. You said a lot there. All of it. I did.
Yeah, very, very interesting.
No, that was not meant to be a criticism.
Let me see if I can state it to you in a super short form.
I think what you're saying is the traditional American diet
or the standard American diet, which is
acronymized at SAD, is something we should avoid.
And instead, we should be eating whole foods, vegetables,
and protein, animal protein has a lot
of benefits.
If you want to stay away from animal proteins, you need to supplement.
And we should be doing some daily fasting in the form of, you know, stopping eating at
a certain time and then eating breakfast 12 to 14 hours later.
Yeah, I mean, think about it.
If you eat dinner at six o'clock at night and you're finished, you can eat breakfast at six o'clock in the morning.
It's not a hardship.
You want to get a 14 hour fast, you can eat at eight in the morning.
If you want to do a 16 hour fast, that's 10 o'clock in the morning.
So most people can do that.
Unless you're really frailer fan or you have certain health conditions,
you may not want to do it.
But most people, particularly all the metabolic,
the unhealthy people actually should probably do that.
Coming up Mark talks about his take on intuitive eating, his top line recommendations on exercise,
his advice on lifestyle practices, the benefits of cuddling, and his take on supplements, which
is a big and crowded and unregulated market.
Let me just say a little bit about my own experience with this stuff. I will have, you know, for listeners of the show, you've heard me say some of this
and many of the episodes were running in the series, but I'm just going to say
because I want to get your response to it.
Personally, you know, at 51, I've gone through many food religions.
I am now a devout, non-combatant in the food and exercise and diet world.
You're practicing non-violence in terms of food?
Exactly. I am, perhaps embracing that in a big way. I don't want anybody to hate me
unnecessarily, because people get so worked up about this and I understand it.
That's true.
I'll just say what's happened with me, which is that I've gone through periods of time
where I was aggressively following some sort of diet.
You know, I was vegan for a long time.
I still am pretty light on animal protein.
And I've trapped my calories.
I've embraced all sorts of hardcore exercise regimes.
And then I found something that I'm sure you're familiar with, intuitive eating, which has its critics, but it's been very helpful to me personally. The basic idea is,
you know, rather than declaring certain foods off limits or sinful to eat what you want when you
want with the caveat, two caveats that are important at least one is you should be listening to your
body about when you're hungry, when you're full. And also, you should have a background of gentle nutrition and understanding of what the nutrition guidelines
are. And I've found that for me, this has turned the dial down in a very dramatic way on what is
sometimes called orthorexia, which is, you know, as you know, it's a, it's an unhealthy obsession
with eating or being healthy. And-
Yeah. Which sounds paradoxical, but it's true.
I know, but it's a big problem.
And so I guess what I'm wondering having said all of that is, A, what do you think of where
I've landed?
And B, do you worry at all about your recommendations based in science, though they may be team people
up for orthorexia?
Maybe.
I think people can become overly obsessed with anything.
I sort of wrote a book called The Pagan Diet, which was an attempt to you know point kind of a
comical finger at the incredible diet wars that are going on paleo vegan everything in between
and saying look guys it's not that hard we just need to eat real food not eat crap and you know
like we'll be okay and here's a general guideline.
You know, this is better for you than that.
And it's pretty simple.
So I agree with you.
People are overly obsessed and crazy about their food.
Part of the problem is,
in two to meetings, a great idea,
unless your biological hardware and software
are completely corrupted.
Now, I, for example, just got back from Turkey
and was very jet lag, and my
intuition was to eat a pint of chunky monkey ice cream because I was exhausted. And so,
you know, whether you're stressed or fatigued or asleep deprivation or whatever is driving
your desires, you have to be very aware of like what's truly self-regulation based on your
biological signals and what is disrupted
regulation.
And most people eating the typical American diet, ultra-processed diet, which is high
in starch and sugar, have dysregulated brain chemistry and hormones, which interrupts
their normal biological self-regulation signals.
So it's important to understand that you have to kind of reset to a healthy biochemistry
and metabolism in order to actually listen to your signals, because often the signals are
wrong, which is why people can go from like 150 pounds to 350 pounds, right?
It's because all their biology is out of whack, and it's not by accident, it's by design,
and Michael Moss has written a lot about this from the New York Times, Sugar Salt and
Fat, about the incredible
deliberate, and I would say in some ways, criminal application of science to creating highly addictive
foods that are driving our behavior.
That aside, yes, I agree, intuitive eating is great.
I think listening to your body is really important, but you have to actually get your body
straight in order to be able to listen to what it's saying.
Point taken.
And for me, just to say that intuitive eating has not been an overnight process, I still
am working on it.
It's been one of the most challenging things I've ever taken on because we get so much programming
from the culture either through messages or through the food we eat that it's just hard
to, hard to counter program against those.
But let me ask you, one of the things that I found liberating,
and maybe you disagree with this,
is that I don't need to get overly,
and if I could take my kid to the movies
and we wanna eat some starbursts, like I do it.
And if I'm at a restaurant
and there's beautiful, fresh-made sourdough, I eat it.
You know, this isn't every day,
but I'm not walking around uptight
in a way that takes me out of the moment in those moments.
Agreed. I mean, I agree. I would always say to people, is don't let your ideology trample over your biology.
People get so ideological about food. They don't actually listen to their body.
So they, I want to be a vegan, but all of a sudden they start feeling bad,
or their periods go away, or their muscle mass goes down, or they have this for that problem.
But I want to be vegan, you know, so like they don't actually listen to their body, but I do think it's okay to
go off the reservation.
I call it 9010.
You know, yeah, I was in Sardinia at one of the blue zones and it was its restaurant and
they made this incredible sourdough bread.
And of course, I had some, so I'm not going to eat that, but it's not something that I do
every day or it's a staple.
And it's really, you know, understanding also how do you create a finely tuned system so that you
are metabolically resilient.
And this is what people don't understand.
If you are metabolically resilient, you can handle a lot more stress.
For example, if you're tired and exhausted, even the littlest thing will be upsetting and
exhausting and tiring.
Like, I was so tired from jet, like I couldn't even answer one email, right?
I wake up in the morning and I can go through 100 emails, same person, but I was not resilient
in that moment.
And I think we forget to understand that metabolic resilience is something you're going to
achieve.
And that when you have metabolic resilience, you have more degrees of freedom.
So for example, if you're a type 2 diabetic, you probably can't eat ice cream.
For me, if I'm running five miles a day or biking 20 miles or 30 miles a day and I want to have some ice cream
I'll have some ice cream. I know I can handle it and my blood sugar doesn't go crazy and my insulin doesn't spike because even the same foods
Can create profoundly different responses depending on who's eating them, right?
If you're diabetic and you eat drink a coke one thing is gonna happen to your biology if you're not and you eat drink a Coke, one thing is going to happen here, biology. If you're not and you're a marathon runner,
it's probably not going to do anything serious.
And you probably want to do that over the long term,
but having a Coke here and there is not going to kill you.
So it's really about understanding
how to create metabolic resilience
and a more robust physiology.
Well, you brought up exercise there,
your references to running and biking.
So that's another big lever in your view when it comes to
increasing lifespan and health span. So what's your top line recommendation when it comes to exercise?
Well, it's really fascinating, Dan, when you look at the science of longevity and you look at the
mechanisms that exercise activates in your body, it's literally every single thing you'd want to do
to live a long time, right? It turns off inflammation.
It improves your mitochondrial function and number.
It improves your insulin sensitivity.
It helps repair your DNA.
It helps kill zombie cells.
I mean, every single thing you'd want to do, exercise is the magic pill.
So if there was like one thing that you would commit to for the rest of your life, it could
make a difference and actually mitigate a lot of other shitty stuff
you might do to yourself, it's exercise.
And there's really, I'd say three pillars of exercise.
One is cardio and conditioning.
So rear-arrowic fitness, two is your strength
and your muscle mass and three is your flexibility.
And you need to maintain all those as you can older.
And it's just a fact, but like if you're 25
and you used to running five miles a day,
and you take three months off,
you can probably run five miles
when you wanna get back to a three months later.
If you do that when you're 70, good luck.
Your body needs much more attention
to regular habits of activity as you get older,
because it's less driven by hormones,
like growth hormone and sex hormones that are driving health when you're younger, they decline as you get older because it's less driven by hormones, like growth hormone and sex hormones that
are driving health when you're younger, they decline as you get older. There's ways to boost them,
but you need to do more exercise as you get older, not less. And it's the key to longevity. So
cardio would be 30 minutes of some type of exercise that raises your heart rate. And ideally,
kinds of exercise that boosts your, we'll call VO2 max.
That's your metabolic efficiency.
So it's how much oxygen you can burn per minute,
which relates to how many calories can burn per minute,
how efficient and fast is your engine, right?
And if you do sprints or some type of variation of sprints,
we call interval training,
that actually will activate the pathways
that increase your VO2 max.
And that's correlated in a direct way with longevity.
The higher you veered to max, the longer you live.
And it doesn't take that much to do it.
30 minutes, three times a week of doing cycles
of like one minute sprinting, 33 minutes of walking,
that'll do it.
The second is string training.
And that's so important because, as I said,
the second law of thermodynamics, which is entropy,
will cause you to lose muscle if you do nothing.
So you can be the same weight as 65, that you work 25, and be twice as fat.
So you're not objectively overweight, but you're over fat and under lean.
This is what we call skinny fat.
That leads to all the same adverse metabolic consequences as being overweight overweight such as heart disease, cancer, dementia, diabetes. And the only way
to save that off is by a combination of string training, which could be resistance bands,
body weight, weights, different machines like tonal. I mean, there's a lot of mid-orange
theory across it. Where are we, where are you like? But you have to do that along with
the right amount of protein, which is the raw materials to build muscle.
So there's other tricks to it, like creatine
and some other things like uralythin A from pomegranate
that can help, but basically resistance exercise
combined with the right protein is key.
And lastly, it's flexibility.
You want to be able to tie your shoelaces, cut your toenails.
I mean, a lot of the reasons people end up
are nursing homes is because they can't tie their shoes
or cut their toenails anymore. And I'm not kidding.
It's his basic activities of daily living.
And Peter Tia talks about the sentinarian decathlon
and the sentinarian Olympics, you know?
What are the 10 things you need to be able to do
when you're 100 years old that you want to do?
Pick up your grandkids, get up off the floor,
tie your shoes, you know, basic stuff,
and you need to have a level of flexibility
as well as strength to do that.
So those are the real pillars of exercise. You know, basic stuff and you need to have a level of flexibility as well as strength to do that.
So those are the real pillars of exercise.
You mentioned Peter O'Toole.
We had him on recently as part of this series we're doing.
And one of the things that I talked about was, you know, how much time does it mean?
This is a guy and you may be in this camp, but he's exercising, I don't know, well over
10 hours a week, maybe 14 or 16 hours.
You talked about these three kinds of exercise, a cardiovascular or aerobic strength and flexibility.
How long should we be dedicating to this may long, should this mix?
Yeah, I mean, what's the minimal viable dose?
Yes, it's a class.
It's not as much you think.
You know, I would say 30 minutes of string training, three times a week.
I would say probably 30 minutes of cardio,
three to four times a week.
So you're up to three hours now a week.
And if you do 15 minutes of stretching,
three to four times a week, another hour.
So let's say four hours a week.
If you can't find four hours a week
to feel better, live longer, it's probably a good
aid-eating exam in your lifestyle. Yeah. And personally, I would love to do more. I like to go
for two-hour bike rides. I like to do yoga for an hour every day if I could. I do string training
four or five times a week. I often can't do that because I've got a lot going on, but I think the
minimal viable dose, though, is not as much as people think,
and it's something that's achieved by most people.
To relief.
I do wanna take a dive into your daily routine in a minute.
But let me just ask about lifestyle practices.
What do you mean by that?
What does that include?
It turns out that the mischievous ingredient
in longevity for most people is community.
Is there social network.
And I don't mean their Facebook followers
or Instagram followers, I mean their friends.
So many people in this country in particular
who can't pick up the phone to call one person
to confide in about something challenging their life.
Loneliness is an epidemic that is as dangerous
as smoking two packs of cigarettes a day.
It's worse than obesity for your health.
And in the blue zones, one of the defining features is this profound sense of community
and belonging, connection, meaning, and purpose.
You know, if you cured all cancer and heart disease from the face of the planet, you'd
extend life by seven years. If you have meaning and purpose in your life,
you extend your life by seven years.
If you're a tennis player, you extend your life by seven years.
So there's a lot to be said about this social connections
and fabric and community and belonging.
And I think it's really important to do that.
I actually was very sad.
I got an email from somebody who works for the Washington Post and said, I'm doing an article on loneliness and I realized that I'm seven years old and I don't
have a friend to call. And I felt really sad when I read that and he's writing an article about
the epidemic of loneliness in America. So I think that is such a huge factor when it comes to
longevity and health. I had a friend who said, oh my grandma, she was like, lived to be almost 100,
but she was really overweight, she had candy all day,
and she never exercised, but she had the most
incredible group of friends and community
and belonging that you could imagine it.
So I don't want to underestimate that.
Stress is another big one.
And I think community and friends
actually mitigate stress a lot.
But we all are subjected to huge amounts of
stressors, whether it's the stress of our food, which causes literally a
biological stress response. When you eat sugar, it causes cortisol to go up,
and adrenaline to go up, whether it's the stress of living in a world that we're
constantly being bombarded with bad news, and where there's a worn Ukraine and
climate change and a recession and crypto
collapse and I mean pretty much everything that you can make you depressed.
There's stresses of family and work and all the things we have to deal with and that's
why Dan would you do as so important as you teach people a tool, a meditation to help
mitigate that stress and there's a lot of other reasons to meditate but actually that's
a critical part of
staying healthy because stress in itself will cause so many harmful things in the body. And then sleep
is another one. Now, American sleep an hour or two less than they did a hundred years ago, and then
that is significant consequences because sleep is one of our bodies for pair, heal, renew, or brains clean up.
And it's a critical part of our life. And often we under sleep and we overeat and we under exercise and we over
stress. So getting those things under control makes a huge difference in your overall health.
Amen to all of those community meditation as a stress reducer and sleep. Let me go back to
the first in that list. I just so strongly agree in the often overlooked power of social connection.
So many of us optimize in many ways.
We optimize for sleep, we're meditating,
we're exercising, we're freaking out about our diet,
we are working on our Instagram feed,
we're working on our car, our interior design, our resume,
all of this shit, which is super important,
but the one lever that seems to be the most powerful
perhaps to pull in terms of health and happiness
is the quality of your relationships.
Absolutely.
It's crazy that we overlook this, I think, for somebody who has.
So, my question for you after that rant is, what are the practices?
What can we do to get better in this area?
Yeah, it's a great question.
And, you know, it really came home to me when I went to Haiti after the earthquake in 2010 and I met
Paul Farmer who essentially helped eradicate TBNades in the poorest country in the Western
hemisphere.
They had the worst conditions of TBNades that were given up on by the public health community.
And he did it not through better medication or surgery, but through the power we call
the company, and the company model was the French way they used for this.
And it was essentially community health workers, neighbors who helped their neighbors get
healthy and make sure they took their meds on time and so forth.
And it began to realize that, you know, the social threads that connect us are more important
than the genetic threads.
Our health is so much determined by our social network.
Christakis at Harvard has done a lot of work on this.
He wrote a book called Connected, essentially about the fact that if you're overweight, what's
the cause?
And he found that if your friends are overweight, you're 171% more likely to be overweight
than if a family member is overweight.
You're 40% more likely to be overweight.
So how did that work?
Well, it's because our social connections with Term terminal behavior, and out of that, I sort of came up with this concept of sociogenomics, which is this idea that our social connections
networks influence our gene expression.
And it turns out that that actually is a thing, and there's a whole field of sociogenomics.
So if you go on the PubMed and the National Library of Medicine, type it in, you'll see
this paper after paper, up how our genes are influenced by our social connections.
If you're in a conflictual relationship with someone, you're turning on inflammatory
genes.
If you're in a loving connected relationship, it's the opposite.
Even cuddling, for example, causes epigenetic reprogramming, which is amazing, and can
turn back to the biological clock.
So how do you do it?
Well, it depends what you're into, right?
So there's a lot of ways to get
connected socially. Maybe it's reaching out to old friends and starting a little Zoom group. Like I
did during COVID, I reached out to my six closest male friends from 40 plus years, and who's
each other once in a while. I said, why don't we meet every week on Zoom and let's have deep
conversations about where we're at with our lives. And we've been doing that for almost three years
now, and it's amazing. It can be joining a bowling group or a knitting circle
or becoming part of a yoga studio
or becoming part of a faith-based wellness program
or church.
There's a lot of ways to do it,
but it's about being intentional
about cultivating and developing deep social connections.
And it doesn't have to be that many.
Even having one or two close friends
can make a huge difference. This is something my wife and I talk about a lot. As you know,
and I think a lot of the listeners to the show know I retired from ABC News almost two years ago
and around that same time turned 50. And I recognize that as much as I loved ABC News, I loved being
a journalist, I loved being an anchor man. It came at a huge cost. I was working seven days a week,
early mornings on the weekends,
late nights during the week for nightline.
And one of the big costs was that I slash we were not
as connected to our friend group as we had historically been.
And so we really made this decision to start saying yes.
Not only to start saying yes to invitations,
but to even ridiculous invitations,
and I'll give you an example in a second,
but also to being more proactive in reaching out to people
and organizing events at our house.
And my day-to-day happiness is so much higher
as a consequence.
I'll just give you an example of yes.
I got a call recently from a friend of mine,
he said this hilarious thing.
He said, I have an offer for you that's both incredible and very rude.
It was incredible because he runs a company and they were doing a corporate boondoggle
at the Kentucky Derby and he said, you can come and we'll sit in the front row.
It was rude because the invitation was for literally the next day.
And somebody had dropped out of the group and he thought,
you got sloppy seconds.
Yes, exactly.
So I turned my wife, we were actually in LA
for something else.
And I said, do you want to do this?
And we were like, yes.
So we flew home, we grabbed our son,
we canceled all of our appointments,
and we went to the Kentucky Derby,
and we had this amazing time with our old friends
and met a bunch of new people.
And our son had a great time. And my friend shout the Kentucky Derby. We had this amazing time with our old friends and met a bunch of new people.
And our son had a great time.
And my friend, shout out to Tommy D,
he sent me a text afterwards.
And he, because we're old friends
and we don't see each other that often.
He said, we need to do this more often.
Let's play to the whistle.
Meaning, let's see each other until this game is over.
And I found that very moving.
And he had some suggestions to create structure
so that we continue to see each other.
All that comes to mind and out of my mouth
in listening to you that this is so important
and it is doable.
It doesn't have to be fancy at the Kentucky Derby
and just meeting your friend for a coffee.
It can. It can be really easy.
I'm a very close friend.
My best friend, when I was 18, and we've stayed really close throughout our lives. It can be really easy. You know, and I, I have a very close friend, my best friend from, you know, when I was 18 and we've said really close throughout our
lives, but he works really hard. My joke is, you know, when can Billy come out and play
again, you know, like my little friend Billy. And so I keep pressureing up. So like, you
know, we're intentional about it. We're, we try every year to take a trip for a week somewhere.
We're going to go biking and grease this summer. And you know, just, it's like, what do you have to do to maintain and develop and keep enriching these friendships
and relationships?
And maybe it's just like I said, having a regular weekly call with a friend or having a regular
weekly Zoom hang with a bunch of close friends.
It's quite amazing how powerful it is.
And it works not in an abstract way, but in a physiologic way to change your biology.
One of the key exciting things about our understanding of the longevity science is this idea of
epigenetics, which is not our genes, but the control mechanisms that determines which
genes are turned on or off and how these basic physiological processes get regulated in
their body.
What's exciting now is that we know
through all things we talked about, through food,
through exercise, through social connections,
through meditation, through sleep, through cuddling.
For example, we can reprogram our epigenome
to turn on health genes versus disease genes.
And that's really what's so exciting.
There's a lot of doorways into doing this,
but we have the ability to do this.
And a lot of it has to do with just simple practices
that don't cost a lot.
Yeah, my wife's gonna love hearing this
because she's been on me about cuddling for a while.
More cuddling.
I'm literally starting, literally last night
we had this conversation and I'm starting to crack.
I'm historically not the most affectionate.
Try it, you'll like it.
No, I do. Well, last night I started, I was like, I got into it.
And now I'm feeling even more enthusiastic after I've talked to you.
Now you can say it's just going to, I went into reprogrammed epigenome.
Can we get in bed for a minute?
Yeah, this is so much about my affection for you.
It's just about epigenetics, baby.
My doctor says I need to do this. My doctors as I need to do this.
All right. There are a couple more things that you talk about in your book that I want to
hit on. One is supplements. My hesitation about supplements is my understanding. It's a
pretty unregulated market. It's confusing to me at the very least. So how do we know what
to take and should we be doing this in conjunction with our doctor?
Yeah, great question.
So for as well, the whole industry is unregulated.
So you're kind of at the mercy of the manufacturer
about whether the product is properly made,
whether the dose that says on the labels,
actually the dose in the bottle,
whether it's got contaminants, whether it's bioavailable,
whether there's other additives that are problematic, like dyes and color, it's got contaminants, whether it's bioavailable, whether there's other additives that are problematic,
like dyes and colors, it's just a mess.
And then what actually works, what does it,
what is a science show, and then the research is very
confusing for people.
One day, fish shell is good, one day it's bad.
Everybody's kind of a little bit confused.
With that said, I've been practicing functional medicine
and doing diagnostic testing on nutritional
status on thousands and thousands of patients for almost three decades. And I can tell you, my
population is a select population of relatively health-conscious people. And I still find really
significant amounts of nutritional deficiencies. And these are across the board in our society.
Omega-3s, vitamin D, magnesium, zinc, some of the B vitamins like folate, iron.
These are really common nutritional deficiencies.
What nutrients do is they actually regulate your biochemistry.
Every chemical reaction that happens, and there's 37 billion, billion of these every
second in your body requires an enzyme, and every enzyme requires a helper, and those
helpers are vitamins and minerals. So you do need a basic multivitamin and a vitamin D and I would say a fish shell for most
people.
That's just kind of a basic maintenance and that can be really inexpensive, less than a
dollar a day.
And then the question is like, what is the other cool stuff that's coming out around longevity
and what am I taking and what's interesting?
And I think there's a whole host of compounds that are from plants that are hard to get,
but that show real promise for longevity, like Corsitan, which is from onions and apples
and things like that.
But that's shown to reverse biological age.
Also, pomegranate extracts, called uralythin A, which is actually, I'm called postbiotic,
that comes from your bacteria metabolizing something in pomegranate,
turning something good that you absorb and then improves your fitness and mitochondrial
function, or could be green tea in all its benefits or the broccoli extract.
So I take a combination of these phytochemicals because it's hard to be consistent every
day.
Then there's other compounds like NMN or NR or NAD, which are really showing some promise around longevity.
And I think are activating some of these longevity pathways.
So I think they're very exciting.
So I think there's a few things
that I think are worth looking at and trying
to have as basic foundational things.
And then for the longevity enthusiast,
there's a whole menu of things
that I talk about in the book that are worth exploring.
And it's always kind of like a cost-benefit analysis. What's the research, is your evidence for it, what's the cost,
are their side effects, is it safe, and I kind of go to that analysis. And taking vitamin D,
the downside is pretty much zero unless you're overdosing, and the upside is high. So it's really
looking at that calculus and figuring out what makes the most sense.
In the book, you talk about all of these sort of exotic, not only supplements, but other kinds of longevity treatments that you're exploring that don't necessarily have an evidence
base behind them. Yeah, a solid one.
Right. Or there's some, but not it's not as extensive of it would be like. Yeah.
Exactly. And some of these may be super expensive, but you're saying if you're in longevity nerd
and you've got the cash,
some of this stuff might be worth looking at.
Yeah, yeah.
I think there's a couple of things in that category.
One is hyperbaric oxygen,
which is a really hard thing to get,
because not a lot of chambers out there,
there's not a lot of chambers that do stuff that are off label.
Every hospital has a hyperbaric chamber
for wound healing and things, but you can't really go in and get it for longevity. But a large study out of Israel showed that they
actually were able to do a lot of things that promote longevity through about 60 sessions in a
hyperbaric oxygen chamber where they put you under two atmospheres of pressure at 100% oxygen for an
hour or so. And that kills zombie cells and makes you tell them you're longer and more than any other
treatment.
I think there's a lot of benefits to that.
I think also plasma pharesis is an interesting thing that I think we're going to see more
research on.
And you might have heard about Peter Teal and how he gets the blood of young people.
And you know, I got a, there was a whole episode I think God Silicon Valley about it called
Bloodboy.
And basically, the idea was that if you get the blood of young people, you can make yourself
younger. And now Chairman Mao did this. He got the blood of red army soldiers
back in the day. But it's kind of gruesome. So is there another way to achieve
this? Well, it turns out based on some animal studies, what they did was they
said to try to replicate these studies where they used to sew up an old mouse
and a young mouse together, their circulation and the old mouse become young.
And they're like, well, that's kind of cool.
Is it something magical in the young mouse that's causing the old mouse to get young or
is the young mouse filtering out the old mouse's blood somehow?
And so they did a study where they did a cleaning of the blood.
It's basically an oil change.
You basically take out your red cells and your white cells and your platelets
and you separate them from the plasma, which is a soup that your blood cells float around in.
And then you throw out the plasma, which is full of all kinds of stuff, from inflammatory
molecules, damaged proteins, zombie cells, all the kind of crap you want to not have.
You throw that out, and you either reconstitute with albumin, which is a protein of blood,
or just if you don't take out all the plasma, you just put in some saline.
And it turns out that it has a lot of longevity benefits.
So I think that's kind of an exciting thing.
And I personally, I found it great in all kinds of things
from people with long COVID to autoimmune diseases
and other problems.
So I think that's a promising thing.
Stem cells are another very promising area of research.
I think we're still at the infancy of that, but I think that's going to get more and
more popular and prevalent, and there's ways to do it that are not having to suck out
your own bone marrow or your fat cells, but that's expensive.
So there's kind of cool therapies out there that are, I think, are in the kind of leading
edge, maybe the leading edge, but I think for those people who want to try everything,
again, it's a cost-benefit risk-benefit
analysis.
PODM freezes is safe, hyperburet-merik option is safe for most people.
These are things that are maybe costly, but generally have evidence for them and are
very low inside effects.
Coming up, Mark talks about his response to the critiques of functional medicine, his
own longevity routine, and whether he thinks it's something the rest of us could actually do, the science on cold plunges and sonnas,
and his advice on alcohol.
You mentioned functional medicine.
I'm glad you brought this up, and I'm glad that we're talking today because out of a sheer
coincidence, I was actually asked recently to moderate a panel on functional medicine at a conference.
With Jeff Blan, I saw that.
Yes.
Dr. Jeffrey Blan, who's often referred to as the father of functional medicine.
And my wife, who's a physician, was with me.
And we walked away pretty skeptical.
Oh.
And in doing the research, I don't know how important a data point this is, but I was just
struck, the Wikipedia page for functional medicine refers to it as clackery, like in
the first sentence.
So and I didn't find many of the people on the panel as nice as I found them to be Dan
butner from Blue Zones was on the panel and I'm very interested in his work.
But some of the other folks, I was not convinced and neither was my wife. And so I'm just curious when people say this is
too far out there untested, unproven, how do you push back against that?
Well, I think that's a fair criticism. There has not been enough funding for the research
on functional medicine. Toby Cosgrove invited me, and by the way, I've been doing this for 30 years.
Toby Cosgrove was the former CEO of Cleveland Clinic
invited me almost 10 years ago to come to Cleveland Clinic
and start a center for functional medicine
as a way of addressing the burden of chronic disease
differently than we do now,
which is primarily through medications and surgery.
And it's using functional medicine,
it's using lifestyle and food as medicine primarily,
exercise, and it looks at root causes.
It's based on the paradigm shift that's happening in medicine called systems biology or systems
medicine.
This is not directly related to functional medicine.
It's happening in academic centers at Harvard.
There's a whole textbook called Network Medicine.
This is the future of how we're going to think about biology.
The way we think about diseases today
is going to be as we now think about bloodletting
or trefinition drilling holes in people's head
to get out evil humors.
I mean, I think the future of medicine
is understanding the body as a biological system,
as an ecosystem, as a network of networks.
And it's also going to be looking at one of the root causes
of all the chronic
diseases that we have.
So functional medicine is a clinical application of this thinking.
Now, is there data, is there not data?
Well, there's not enough, clearly.
And at Cleveland Clinic, we've raised about $20 million to research, but it's mostly from
philanthropists or people who've had positive experience with it and want to help and support
it.
And we've done a number of studies which show that compared to
Cleveland Clinic, Family Medicine Centers, and in terms of patient outcome data,
we do better in terms of autoimmune diseases. And this was data that was
done, was extracted from our clinic, and compared to the rheumatology clinic at Cleveland
Clinic, which is one of the best in the world, analyzed by the rheumatologist, not by us,
showed we did better across every metric
of pain, inflammation, and patient outcomes.
And there are many more other studies also that show this data.
Now do we need more absolutely?
But the fundamental idea that the body is an ecosystem, that we need to treat and optimize
our health through optimizing our biological networks, is really the future of healthcare.
And in fact, the longevity paradigm that is merging based on this idea of the hallmarks of aging
exactly mirrors functional medicine.
So what that framework says, basically, is that there's nine or ten or thirteen or constantly
parsing them differently, but there are these underlying things that tend to go wrong that
explain all disease.
So, science to say that if we address the hallmarks of aging, we wouldn't extend life by 5 to
7 years like we would by getting rid of cancer and heart disease, but maybe by 20 or 30 or
40 years.
Because we're dealing with the underlying causes of all disease.
Now what are those?
There's problems with regulating our nutritional pathways.
There's mitochondrial damage.
There's change under microbiome.
There's DNA jamage, epigenetic changes, inflammation, damaged proteins. These are all things that are mirrored in the framework
of functional medicine. So as a physician who's practiced and trained in conventional medicine,
who's been doing this for the last 30 years, I can tell you that this is something that's not a
fat, it's not kind of fringe, and the fact that there's a Wikipedia page doesn't
mean a lot. I mean, you're in the news. You know that a lot of the news is not really true.
If you Google me, you'll find them on Clack Watch. I'm all kinds of horrible articles written
about me on Science-based medicine. But you look at who's funding this stuff. There's all
sorts of money behind keeping the status quo.
So, I think we will get there, but it's one of those areas where when you actually look at
what's happening in the field and what people are doing and the results that they're getting by
applying this science, it's really profound whether it's people reversing autoimmune disease
or reversing diabetes. Like that first patient I told you about, you know, there's no medical treatment
that can reverse heart failure, diabetes,
or high blood pressure, or fatty liver,
or renal failure, and yet it all happened.
No, was this just a sort of a random spontaneous remission?
No, it was based on a scientific process
of actually applying food as medicine
and applying the science of functional medicine
to help people optimize their health.
So I get the criticism, but I'd love to hear your reason,
your skeptical.
I think that would be interesting to hear.
Well, first of all, I appreciate that answer.
Let me see if I can reflect it back to you just a little bit.
Functional medicine, which holds that we need to stop
looking at health as just disease treatment, but instead disease prevention.
That's one probably amateurish way to describe it.
Yeah, I would say it's actually the science of creating health as opposed to the science
of treating disease.
Now, we need both, but if we create health, often disease goes away as a side effect.
Right.
Okay.
Well, that sounds great.
The criticism is there's not enough evidence
and that proponents rely too much on anecdote
rather than large, well-vetted peer-reviewed science.
It sounds to me like you were saying,
yeah, we need more evidence,
but we are seeing really interesting results in our work
and both things can be true at the same time.
And that this trend toward looking at the body
holistically is happening in medicine writ large,
not just in functional medicine.
Yeah, absolutely.
It's absolutely true.
And I think the hallmarks of aging framework
is kind of fassing to me,
because it exactly mirrors functional medicine.
So whether you, people who are in that field know it or not,
they're talking about concepts that we've been talking about forever,
like insulin resistance, like mitochondrial dysfunction, like inflammation, like the microbiome,
these are all part of the hallmarks, right? When you call a functional medicine or just medicine,
it's where we're all going. Now, in terms of the evidence issue, I find that kind of funny because
multiple who say, well, where's the evidence,
it's just they haven't read the evidence,
or if they say there's no evidence,
they haven't looked at the evidence.
There's nine million research papers on PubMed,
have they read them all?
And when you look at the data on nutrition, on exercise,
on various interventions, for example,
with certain vitamins and nutritional supplements
for different conditions,
if you look at the research on the microbiome, on treating inflammation, on the role of mitochondrial
health and chronic disease, on the role of environmental toxins in our health, all the
data is there.
Now, are there large placebo controlled, randomized trials, doing multimodal interventions for chronic
disease using functional medicine at the scale we need?
No. And why is that?
It's because the entire research infrastructure is based on a pharmacological research model,
which is a single drug for a single pathway for a single disease.
That's what randomized trials are good at.
But the truth is they're not good at looking at what should we do as a whole?
Like if you want to grow a garden, you don't say, well, I'm just going to give my plant sunlight,
but no soil or water, or I'm just going to give my plant water, but no sunlight or soil.
I mean, it's absurd, right?
You know, well, we don't know it's going to work.
If you give people better exercise and better diet and stress reduction and social connections,
well, how do we know what works?
We have to study them all individually.
Well, no, you need all of those things to create a healthy human.
You know, it's just unfortunate.
We don't have a systems model for research
that's very effective right yet.
I don't want to spend too much time
litigating functional medicine
just to very quickly answer your question.
Why was I, my wife and I, why were we skeptical?
I think that really in my memory of how the panel went down, I can post a link to it in
the show notes.
I think there's a video of it.
I was supposed to be on that panel by the way, but I was in Europe.
Well, you know, it would have been helpful if you were because I didn't see you basically
were saying, yeah, here's where I think the deficiencies are.
We need more studies.
We don't have this evidence yet.
I didn't hear that kind of humility in the answers.
Maybe I missed something, so maybe I can go back and listen to it and hear something that
I missed in the real time.
But you were tackling my skeptical questions head on, and I felt like there was some
bobbin and weaving going on in the answer on the panel.
Anyway, I've got my eye in the clock here again.
There's a big area I want to hit before I let you go,
which is your routine because your routine is incredible.
And it really depends on the day.
Okay, well, at least it's described in the book.
It's a pretty incredible.
So I'd love to hear you just describe it in brief
and then I'll have some questions on the backside.
Well, I tried this morning and I got a 9.5 hours sleep.
I woke up and meditated for 20 minutes.
Then I had coffee, which I like to do.
And then I worked out.
I did a 30 minute rubber band like a resistance band
training program, which I love.
It's like Tom Brady's training program.
It's super easy to do.
And there's an app for it.
Really inexpensive. I try my everywhere then. I can do 30 minutes and I'm in and out. And then I had my healthy aging shake, which basically was consisting of
Regenomy's goat way, which is I use goat because it's less inflammatory than cow. It's Regenomy's raised.
And I put in creatine into that and I put in my dopure, which is basically this
pomegranate extract.
I put in some adeptogenic mushrooms that are good for general resilience and health.
I put in some probiotics from my gut, and a product I call gut food, which is like a
multivitamin for the gut.
And through some strawberries and some macadamia milk, unsweetened, and that was my breakfast
shake, and I took a handful of my supplements.
I took NMN, which I like.
I took something called Cynilotic Synergy, which essentially caught kill of things to
help zombie cells, like no extra action from strawberries and curcumin and green tea.
And I took a multibitamin, fish, all vitamin D, and a product that has quirked in it.
And a few other things that I kind of forget.
But basically, as's my morning supplements.
That was like 80% of my longevity routine right there.
And then this afternoon, after we get up this podcast,
I'm going to go for a bike ride
because it's a beautiful day and I have some time.
And then I'm gonna take a steam shower
and an ice plunge, I have a bathtub
and I just fill up with cold water.
And that's kind of my longevity routine.
It doesn't take that much time, an hour in the morning,
probably maybe a little more an hour.
And then I'm adding on an extra exercise thing in a sauna,
but it really doesn't have to be overwhelming.
And then I have a wonderful partner
with my fiance, Brianna, and we're gonna go biking
and spend some time together.
And tonight I actually have my men's group
with those guys who I've been friends with for 45 years.
So if we're about an hour and a half to our tonight,
we're gonna gather on Zoom and go deep together
and lash and cry and share stories.
And that's my day.
I'll buy a way, I did three podcasts
and a bunch of other stuff today too.
Exactly, that leaves that work.
Yes.
How confident are you that a person, I don't know how we define a regular or normal person, three podcasts and a bunch of other stuff today. Exactly. It leaves that work. Yes.
How confident are you that a person, I don't know how we define a regular or normal person,
but somebody that has a very demanding job, maybe two jobs, maybe kids, and doesn't have
a ton of money and maybe not be able to afford either the supplements or the ingredients
of the anti-aging smoothie that you make.
How confident are you that your routine is scalable to the regular person?
I mean, listen, food is food everybody has to eat. And honestly, if you look at the data on cost
of healthy food versus junk food, it's either the same or normally higher, like 50 cents more
a day. There's a great guide from the environmental working group on how to eat well for less,
called good food on a tight budget. I think there's a mythology around being hard and difficult to eat well.
It's just about education, knowledge,
and certain skills.
Second is exercise.
That's basically free.
You know, I mean, I exercise in my underwear
with a bunch of rubber bands.
So like it's pretty easy.
And then, you know, friends, they don't cost anything.
Yeah, most people have a shower.
They can take a cold shower the morning
as a way to increase what called Hermesus
to activate longevity pathways, take a hot bath.
You know, basic supplement regimen can be a dollar a day.
So you don't have to go on the crazy stuff.
And those basic things will get you 80 to 90% of the way there.
And for those extra longevity enthusiasts,
you don't wanna add these extra things, that's fine.
But I think the people in the blue zones
weren't taking a bunch of supplements.
They weren't going to the gym, they weren't doing a lot
of fancy stuff.
They were just living their life automatically
because the default conditions in their society
actually led them to do that.
We don't have those default conditions.
The other concept we didn't talk about is stress, a good stress, because it's hormesis, which is this idea
that it's stresses that don't kill you that make you stronger, and it's so key to longevity,
whether it's the overnight fast, whether it's exercise, which is a stress to your muscles
and your body, whether it's a cold plunge or a sauna, whether it's hyper-americ oxygen,
these are all stresses that actually activate
longevity pathways from your body.
So we can incorporate some of those pretty easily.
Cold plunge and heat like sonas or steam showers.
How solid are the data around those as interventions?
Well, I mean, there's a bunch of data on Finland
and these are observational data for sure.
They're not randomized controlled trials
because they're hard to do, right?
I mean, you can't take 10,000 people and randomized
half of them to Saunas for 20 years and half of them to not Saunas for 20 years and see
what happens. But in Finland, which, you know, basically the No Saunas in Finland for everybody
being a Saun at the same time, they showed that by the way, the control group had to be
person took one Saun a week because there wasn't a control group that didn't, but compared to the one sauna week,
the four sauna's a week were shown almost 47% reduction
in mortality, which is not insignificant.
There's a lot of reasons for that,
but it also increases cardiovascular fitness,
cardiovascular health, increases heat shock proteins,
the clean up old damage, proteins,
one of the homeworks of aging.
It actually increases your innate immune system
and immune function.
So there's a lot of benefits to that.
Cold therapy, again, there's a lot of research being done
and this I did a podcast with a woman PhDs scientists
in Denmark where she's written a lot about this
and actually showed that when you do a cold punch
for a minute or two, you activate brown fat,
which increases your mitochondrial function,
improves insulin sensitivity, increases
dopamine, and other things that help with happiness and alertness.
So there's plenty of evidence out there that these are effective therapies for activating
these pathways.
How often and for how long?
Well, they were 30 minutes in Asana four times a week, was the 47% reduction.
I think cold plunges, according to her, one minute can be enough. And I sometimes
say two or three minutes, I just turn on the cold water in my bathtub. Or you can start
with a cold shower. I mean, with a shower, you just take two minutes of cold shower. That's
great. You don't have to buy a fancy cold plunge. I friend of mine bought a trough, like a feeding
trough, like for cows and stores this stuff. It just throws a bunch of ice in there and some
water. So yeah, in my perfect world, I would have all of it.
And eventually when I move again to a new house, I'm going to have my sauna and my cold
flunge and all my stuff.
Last question, alcohol.
Unsafe at any dose or okay in moderation.
Tough question because a lot of people have heard over the years that red wine is associated
with longevity
and decreased diseases.
And I think the problem with these studies
is they're observational studies.
They don't actually prove cause and effect.
And so, you know, for example, you go to the blue zone,
you go, oh, these people are like drinking wine regularly
and they lived a be a long time.
Like maybe it's the wine or maybe it's all the other 40 things
they do to activate their longevity pathways.
It's not the one.
And I think when we look at cancer risk and brain health and many other things, I think
the data is increasingly showing that alcohol is really not safe in any dose.
Now, again, if you're a metabolically resilient healthy person, if you have a shot at tequila
or a drink once in a while or a bottle of wine with someone once in a while, no problem.
But if you're drinking two glasses a one a day, that's a disaster for your long-term health.
Anything I fail to ask that I should have asked?
I think we covered a lot.
I think we need to talk so much about the homeworks of aging, but it's a bit technical, but I
touched on them here and there.
But I think that's where the exciting research is really happening, right?
How do we activate these ancient systems to heal our bodies and and actually create the repair mechanisms. And I think the key message that I want
people to glee with is that we have within us on like Dorothy and in Ruby Red slippers the key
to our health. And we have these ancient mechanisms that are designed to repair renewal, regeneration,
to repair, renewal, regeneration, and optimization of our health. And what we do every day in most of our societies is to run
ramshot over those pathways and cause them to be dysfunctional.
And that we actually can learn how to activate these longevity pathways
through simple practices of diet, exercise, dress reduction, sleep,
a few little practice of hormesisis and maybe a few supplements.
And that can actually make a huge difference in increasing your health span and making it equal
your lifespan. In other words, die young as late as possible.
Before I let you go, can you please plug your new book and any of your older books that you
want people to know about your podcast, the Dr's pharmacy. Can you just give us the whole getting a little?
Sure.
Anybody wants to learn more about my work?
They can learn a lot about these concepts in my new book, Young Forever.
I have a podcast called The Doctors Pharmacy, which you've been on Dan.
And I have a website, drheiman.com and all my social media is just Dr. Mark Heimann.
And you have one of trouble finding me, I promise. If you're looking for the podcast,
it's Pharmacy Spell with an F.
F. Yeah, Dr. is Pharmacy with an F.
Mark, great to see you and talk to you as always.
Thank you so much for making time for this.
Thanks Dan, you're the best.
Right back at you.
Thanks again to Mark.
Thank you to you for listening.
And thanks, of course, to everybody who works so hard on this show.
10% Happier is produced by Gabrielle Zuckerman, Justin Davy, Lauren Smith, and Tara Anderson.
DJ Kashmir is our senior producer, Marissa Schneidermann is our senior editor, and Kimmy Regler
is our executive producer, scoring and mixing by Peter Bonaventure of Ultravalet Audio and
Nick Thorburn of one of my favorite Indy Rock bands, Islands,
Rotar Theme. We'll see you all on Friday for a bonus.
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