Great Age Reboot: Cracking the Longevity Code with Dr. Michael Roizen, Health & Longevity Expert

We were thrilled to have Dr. Michael Roizen, one of the world's leading experts on aging and longevity, at our Summer 2023 Eye of the Executive In-Person Series in partnership with Cleveland Clinic Canada and Aird & Berlis LLP, on June 20, 2023. Dr. Roizen is the creator of the innovative RealAge concept, which motivates behavior change to promote wellness. He has authored over 190 peer-reviewed scientific publications, five New York Times #1 best sellers and ten overall bestsellers. His latest book, The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow, focuses on how to navigate upcoming changes, to make the best decisions for your brain, your body and your bank account. He helped start 13 companies and co-invented a drug approved by the FDA. He and Dr Oz coauthor a daily column syndicated to over 100 newspapers that translates current scientific reports into actionable steps for all audiences. In his keynote, he provided key insights on prevention, treatment, and technology that will reshape how we think about aging.

PEO Leadership provides its business community the ability to leverage its collective knowledge, experience and network; to challenge and be challenged in a high disclosure, objective and trusted environment through a combination of Peer Advisory Boards, One-on-One Coaching, and Thought Leadership Executive Networking Events - all for the purpose of enhancing the personal and professional lives of its members.

Transcript

Hi, I'm Leon Goren, president of PEO Leadership, a peer-to-peer leadership advisory firm. We're an amazing community of CEOs, presidents, and senior executives. Ask yourself, are you learning as fast as the world is changing? It's time for Ontario business leaders to band together for counsel and support. It's time for you to tap into the business wisdom of our peer groups and unlock new ways to grow. I want you to come out a better leader and your organization ready for what's next, take the first step at PEO-leadership.com. Special thanks to Cleveland Clinic for helping us bring you today's PEO Leadership's Way Forward podcast.

Welcome everyone. Welcome to our second Eye of the Executive. This is a very special one because we're getting someone who's returning to us probably after ten years, Michael Roizen spoke with us, I think it was at the Granite Club. The world has changed dramatically. So really looking forward to hearing you speak today. Now I'm not going to introduce Dr. Roizen and I'm going to introduce a good friend of mine who's going to make that introduction. And many of you know him. And that is Mr. Michael Kessel. Mike is the president and CEO of Cleveland Clinic. And he's been the CEO and president of Cleveland Clinic since 2009. Anyway, it's great to have Mike here.

Cleveland Clinic is a huge, obviously, educational partner of ours as well. And really has helped very much in sort of bringing Dr. Roizen here to us today. So Mike, the floor is yours. Thank you very much.

So the most important thing about Roizen, he's got a 177 page bio. So I'm not going to read it. I'll give you some of the highlights. I've known, he's been a good friend of mine for 20 years, where we actually had our business together with Northwestern Memorial Hospital. He's an anesthesiologist by trade and internal medicine physician.

He's had five New York Times best-selling books. I think they've sold over 30 million copies. He's also the co-founder of RealAge, which basically is everyone has a chronological age, but you also have a physiological age. We're a large, global teaching hospital. We now have close to 80, 000 people, but 6, 000 physicians.

When Obama came to the clinic, when he was in power, he wanted to meet with seven of our 6, 000 physicians. One of those physicians was Dr. Michael Roizen. So it speaks to kind of the type of person he is, intelligence, he's an incredible guy. So have fun with him, and with that, Dr. Michael Roizen. 

I don't know if the Obama thing is true. I did meet with him, but I, I don't, I have no idea. But the, uh, the thing that isn't true, Mike, is I've got ten New York Times bestsellers, but, but, but five number ones, including five in Canada. I was lucky enough to be on Canada AM a lot. So, let's start with the slides. This is a difficult, emotional talk, not for me, but for you.

Because it is telling you, and it is talking to you about the fact that your parents could get younger than you are. And you can get younger again. That is, what we've talked to up till now, That is 10 years ago, was we slowed the rate of aging so that you could really be, um, the equivalent of 60 when you were 80, or 60 was the new 40 if you will, and it was about a 20 year break.

This is talking about reversing aging. So the, the point is that this is talking about reversing aging. And it's really come about because of the Human Genome Project, and we'll get into that in a little bit. Okay, what am I doing wrong here? So the worst thing that'll come from this is you'll learn five keys to slow your rate of aging.

And we, we now think you can get about 30 years younger than your calendar age. without any big breakthrough. But there are 14 shots on goal that will go over and those 14 mean that it is very likely that one of those will break through and you'll be able to be if you're, when you're 90 to be 40 again.

Let me go and, and ask a question so I'm going to ask all of you. Do you worry more about brain function loss or Mobility loss? How many worry about brain function loss? And how many worry about mobility loss? Um, if you notice, it was the guys who put their hands up for mobility loss. Um, in Canada and the U.S. Women worry more about brain function loss on large surveys than men about mobility loss. And we're going to talk about both of those today. So, one, we'll talk about there are 38 things you can do to slow your rate of brain aging, and we'll talk about why that's important to do, even now, even if you're going to get a reversal.

And we're going to talk a little bit about how you can... keep your hips intact as well. But as I said, it all started with the Human Genome Project, and I always pick on one person, so I'm going to pick on you. Um, tell me what your name is. Dave. Dave, when the Human Genome Project started, how much did it cost to, uh, get one human genome?

To get one? Yeah, in other words, they did one human genome when the project started. It was done by Cooper at NIH and by Ventner and Private Industry and it cost them both the same amount of money. It was 2. 9 billion. Very good. 2. 9 billion. What does it cost? What did he say? Yeah, that was U. S. Um, what, you're in trouble.

What does it cost now if you want to get your genome done? It's 100 at Walmart, that's U. S. again, except when it's on sale, and it's on sale every Mother's Day and Father's Day. That's how fast the science has gone since the Human Genome Project has started. But the Human Genome Project's expected to find 300, 000 genes based on the amount of DNA in your nucleus.

But they found only 22, 500. What did they call the rest of the DNA? They called it initially junk DNA. Seven years later, it was found to be switches. Switches that control which of your genes are on or not. All genes do is make proteins or watch other genes, and you get to control your genes through those switches.

How much control do you have? At least 80%. of which genes are on or not. Let me repeat that. At least 80%, and in fact in the most recent twin studies, it's been 93 or 94%. What that means is you have enormous control over your life. Because everything in your body is controlled by the proteins you make. And you control at least 80 percent of which proteins you make or not.

This is one of those areas of the 14 areas of research into the mechanism of aging that has transformed, in this case, three animal species from the equivalent of 100 human years back to the equivalent of 40 human years. So this is switches reprogramming. So your genes don't get much damage as you go through life.

They're in the nucleus and protected largely. But your epigenes, the switches, are in the outer part of the cell as well as in the nucleus and they get a lot of damage, shown as those stars in the graph. And you'd say, can we fix those? And a guy named Yamanaka did 12 million experiments to find that if you turn on those four genes, OCK14, SOX2, KLF4, and CMYC, you reprogram your switches back to the way they were when you were born.

And if you do that, old mice become young again and live as if they were young again. to a normal lifespan, or they live 50 percent longer, when you do it at age 90, they reboot to 40 and live to 90 again. And, if you look at your organs, your pancreas, your muscles, your brain, every organ gets young again.

For the women, skin and hair get young, I often get asked that. Men get to reproduce again, women don't get the eggs again, but men do get, um,

Can you do it twice? We don't know, because it hasn't existed long enough. But a guy named Yamanaka did it. He got the Nobel Prize for it. What's wrong with this in turning it to humans? Well, it turns out that 20 percent of these mice develop a cancer. But now 6 labs have done it. if you will, turning, if you will, only three of these genes on, not turning C Myc on, and you don't develop cancer, and you reboot the animals.

Largest animal species is beagle dogs. It's been done in rats and mice as well. Google, moonshots on aging called Calico, published their success with it. if you will, about eight months ago. And this is now moving into human trials. Everything I'm talking about, these 14 moonshots on reversing aging, is now moving into human trials.

And with 14 shots on goal, it's likely you can get to be 40 again. With all the brain power of a 40 year old. So when they've done it in the male beagle dogs, The dogs act like young puppies, they look like young puppies, but they remember their master, they remember all the things they've learned along the way.

And that's what we think has the potential of happening in each of these 14 areas. What does that mean? Well, it's profound, right? Just think about real estate. You're not going to move out of your house if you're going to live to 120 and function as a 40 year old. You're not going to move out of your house into a retirement community when you're 60 or 65 because you're going to live 50 more years as a young person.

And it has every other profound implication, too. Now, let me go back and say where we are and how we got this way before we talk more about that and then what you can do to prepare for it. So, since 1890, we've extended life expectancy by we, I mean society. has extended life expectancy about two and a half years every decade.

And women are shown in blue here, men in green. Men live about two and a half years to three and a half years less than women at all ages. The initial increase was due to sanitation and then pediatric disease changes. More recently due to changing or improvements in managing the diseases of The elderly like high blood pressure, diabetes, valve disease, etc.

We think in the next decade that it is very likely we'll have an exponential increase of 30 years. And I really love doing that so I'm going to do it again. Um, meaning that's a huge jump that is likely. Now, Peter Diamandis defines exponential as you take 30 steps. and you're 30 yards or meters closer to your goal, you take 30 exponential steps, 1, 2, 4, 8, if you will, and you're 26 times around the Earth.

That's what exponential is. The other exponential is, if you look at the decline in price of defining your genome from 2. 9 billion to 100, That's exponential, how fast exponential science has been going. I look at it as how many new, how many scientific articles do I have to read? When I started in this field in 1979, it was about one every four months.

Now it is one every about twenty minutes. It's impossible to keep up, unless you have a team. So, we expect that this is likely to happen, and it's likely to happen if you make it ten years. And so the job, your job, if you will, is to preserve as much function as you can for the next ten years. I'll talk about the economics of this a little bit later if you want me to.

Um, but basically it means if you're going to live 40 years longer, you're going to work 20 years longer, which solves, and you're going to pay taxes and into retirement funds, etc. It actually, in the United States, when you calculate it out, it solves all of the budget deficit problem, it solves the trust fund problems for Social Security for our retirement funds, as well as our, our medical care funds.

That's the joy of, longevity. The negative is if we don't get it, we aren't producing enough kids to survive as societies anywhere close to where we are. So, I talked about the Human Genome Project. Let me show you this heat map. It's called a heat map because the genes that are on are red and the genes that are off are green.

This is 52 strips of genes. that are from men with prostate cancer. And you'll notice these genes on the left bottom. are on. What are these? These are the five RAS family of genes that promote the growth of breast, colon, and prostate cancer. Here are the same 52 men on, sorry, I'll do it here, sorry, the same 52 guys a year later, and you notice most of the red has turned green.

They turned off this family of genes that promotes the growth of breast, colon, and prostate cancer. Conversely, up here where they're green and turn red, these two promote, uh, or reproduce the GSTM1 proteins that cause prostate, breast, and colon cancer to commit suicide. What did they do to get this change?

Wasn't any medicine. The three guys who smoked quit smoking. They walked 10, 000 steps a day, they meditated 15 minutes morning and night, and they eliminated five foods. That's all they did. It's now 14 years later, and only one of the 52 has progressed beyond this treatment for their prostate cancer, as opposed to 32 in the control group that wasn't given any specific instruction.

You get to control even whether you have cancer. And whether you treat it. By turning on genes or off genes, you have that much control. This is what you're doing. You're changing which of your epigenes are on or not by your actions. And it's the same thing, only instead of us giving a drug which does that, you do it.

Now, in the meantime, what have we learned about preserving function? Well, we've learned that compounding matters. Every one of you knows about compounding savings. Well, compounding works for health as well. So, say you had a cholesterol of 140. If you lower it to 70 in the first 10 years, you have a 6 to 10 percent reduction in risk.

But by 30 to 40 years, you have a 30 to 60 percent reduction in risk. So there's a compounding of benefit. in health by getting normals early. The second thing is, there are what we call six really important normals. Normal blood pressure, normal LDL cholesterol, etc. I'll go into it in a second. And there is a multiplication of the benefit by getting all six of them normal.

Conversely, if you let any one of them be abnormal, you don't get the benefit of getting any place near as much benefit as you would. Thank you. If you got all six, if you only get five. Let me show you, so we did that at the Cleveland Clinic to see, could you do this for 101, 000 employees and dependents?

That is, can you do this on a large population basis, which is why I got to meet with Obama, because we were trying to get the US government to do this as well for all of us. And what we did was we had, when we initially started this in 2008, 6 percent of our employees had 6 plus 2 normals. And you say, why is medical care so expensive?

It's because, in fact, very few of us have. In this case, 6 percent at an average age of 47, exactly the US number in 2008, had 6 plus 2 normals. And we decided to pay employees. Our CEO said, let's pay employees to see if we can get them to change behavior. And now over 44 percent of our employees have 6 plus 2 normals.

Um, and in fact, this is the amount of money we save. It's over 190 million a year now, compared to our trend line, compared to our competitor, Mayo, and compared to our own, uh, national average of employee. So it is half of our operating margin. is in fact saving that. And for those of you who care about um, days away from work, it decreased our absentee days by 34%, which more than paid, and if all we counted was paying for our nurses, not administrators were useless and doctors were useless, if all we counted was the nurses and absenteeism, it more than paid for the entire program.

What are the 6 plus 2 normals? Blood pressure? Fasting, blood sugar, LDL or APOlipoprotein B, uh, waist less than half height or body mass index less than 27, no cotinine, tobacco in your urine, stress management program done and practiced, and the two are see a primary care practitioner at least once a year, and immunizations up to date.

There's no, none of that, and by the way, you really don't have to take pictures of this, you're welcome to. I'm not, there's no reason, uh, I'll send you all the slides, anyone who wants it through PEO if you want. And, uh, all the stuff is, most of the stuff in the first part at least is in the book. It decreased the rate of aging of our employees compared to the national averages, the, the employed, uh, knee hangs average in the United States by 15%.

Meaning if you're going to live 80 years, the other group is going to live 12 extra years disability free. So it gives you much more human capital just doing that. And the third component is that people keep their organ functions normal. Remember I said our job for the next 10 years until the reboot comes in is to do that.

Why? Because, in fact, when you do that, you get to reverse it. Let me give you the example. So one of the examples is on heart failure. One of the causes of about 25 to 30 percent of heart failure is you produce an abnormal amyloid in your liver. Um, it's a different amyloid than is in the brain, but it's an amyloid that attaches to the brain and causes the heart to not squeeze blood out as well.

So you normally, per squeeze, will get out, um, someplace between 55 and 65 percent of the blood in your heart with each squeeze. These people had 12%. And so in Australia, they took 12 of these people. They were basically bedridden, or... at most chair, and they had a life expectancy of less than six months. And they knocked out the gene that produced that amyloid in the liver.

And what happened? Seven of them developed an ejection fraction greater than 35%, and instead of living... And expected life expectancy of under six months. They now had a life expectancy of 18 years. And they could play with their grandchildren, etc. They returned to normal function. What happened to the other five?

The other five had changes so significant that you couldn't reverse it. And so the point I'm making is you want to keep your function good enough so you will be able to reverse it when the reboot comes in. Now, I've talked a little bit about two things with changing the proteins you have. And we're going to go through more of that.

One is that epigenetic reprogramming, turning on different genes to make different proteins. And this one is knocking out through CasPER and CRISPR-Cas9, actually it's a modification of that, to knock out the production of an abnormal gene. But there are whole bunches of other things. So one of those is, why does your brain function improve when you exercise?

And the reason we always thought, that is until about four years ago, was that you were improving oxygenation and blood flow to the brain, and that would improve brain function. And it does. But the main reason is that when you stress a muscle, You turn on a gene in the muscle that makes a small protein called a RISN.

And a RISN goes across the blood brain barrier and turns on another gene that makes brain derived neurotrophic growth factor, which is like miracle growth for your brain. And you increase the only organ in the body where size matters, your hippocampus. Thank you for the few of you who laughed. Uh, uh, uh, uh.

The, the point is that, that, the, there is a benefit to size in one organ in your brain called the hippocampus. When it's big, your memories are retained and you function with normal cognitive function. Why does that work? It works because you've stressed your muscle to turn on a gene. . What that means is you are a genetic engineer for you.

In fact, as I said, you control at least 80%, maybe 93%. Now I disclose my conflicts of interest 'cause I'm an academic. I did write these books and I earned royalty on 'em. So I hope you buy them and thank you p e o for buying one of them. Um, but real age, the real claim to fame, real age when it came out, uh, displaced Harry Potter as number one on Amazon for seven days.

Um, when, uh, you, the owner's manual came out, it displaced Harry Potter for 35 days on Amazon. And the record is still held by this book, which is when we published that, it displaced Harry Potter for 177 days as number one on Amazon. He's not coming back, I hope. Not, I hope, from a standpoint, but I'd like to have the record.

Um, so this book actually, I think, is actually the most important one. So let me give you, so the first third of the book is on the 14 areas of change. The middle is on the economics and what it will mean to, what our best guess

is, on law. So if any of you are lawyers here, I'm sorry, I got, we have no idea on law. And the last third of the book is on those change, things you can do right now. Let me give you another example of these 14 areas. So one worries about how expensive they are. What does CRISPR-Cas9 cost to knock out that gene in that Australia study?

It's 5 of reagents. Now, when they, we've got, we know how to do this for sickle cell disease. What does the company that knows how to do it want to charge? 1. 2 million per treatment. But it's 5 worth of reagents, so eventually it will get much cheaper. One of the groups, the Gladstone Group in San Francisco, looked at all drugs that were already approved by our FDA and were generic.

So these are 4 a month drugs in the U. S. They looked at 1, 363 of them, and they used the IBM quantum computer to look at the fourth degree structure of the proteins that attach to brain neurons and are thought to cause Alzheimer's disease, amyloid and tau. And they looked at the structure of these drugs and say, do any of them block that attachment point?

And it turns out that a 4 a month Water pill, bumetanide, largely replaced by hydrochlorothiazide or furosemide lasix, but it's still available, 4 a month, knocked out, blocked the attachment of amyloid and tau to brain neurons. They then went to a mouse model of Alzheimer's, and it totally prevented Alzheimer's disease.

They then went to two large databases, a 1. 3 million one from the University of California, San Francisco, and a 3. 8 million one from the Cleveland Clinic, which is why I know about it. And they found that compared to other water pills, people who got this water pill, or compared to people who didn't get any diuretic, any water pill, it blocked the development of dementia, or it had a reduced rate of dementia, from, by 70 and 72 percent.

So it's now undergoing randomized controlled trials. The key point is that in each of these 14 areas, We are working, that is science is working, on changing the way you produce proteins, changing what proteins you produce, blocking the protein action, or knocking their function out, so that you have no proteins that cause you damage.

And it's doable in 14 different ways. Let me give you another example. The CETP inhibitors. Anyone know about CETP inhibitors? There's no reason you would, except if you're in the financial industry, you might know that, that Pfizer wasted nine billion dollars in testing these. Why? Because the Pfizer drug raised blood pressure, and caused the side effect more severe than the benefit.

But what is the benefit of these? Well, it inhibits transfer of cholesterol from the healthy cholesterol. to the abnormal, or LDL cholesterol, which causes you plaque, or apolipoprotein B. So, if you inhibit this, you stop plaque development. And, as a side effect with these drugs, they increase the secretion, they turn on another gene that makes something that decreases dementia by 65%.

In addition, they decrease LDL and ApoB levels by more than 50 percent in people already taking the maximum dose of these. So if you lowered your LDL from, on a maximum dose of a statin or your Apolipoprotein B, from a hundred, from a hundred and sixty to a hundred. If you then gave this, it would lower it to fifty.

Why is that beneficial? Well, it decreases plaque in animal models. And as I said, the side effect in early studies was it increases blood pressure. The current one under testing in phase three decreases blood pressure. So what would it do if it proved beneficial? And we'll know in the first of those phase three studies.

Is due out in October, November this year, it would decrease dementia by 65% and it would knock out heart disease, stroke, and memory loss, other memory loss by about 65%. Imagine what that would do to your chances of living longer and living with less disability, and we think. That's going to be what we'll find out in October or November.

And how does it work? Again, it inhibits a protein, this one. Um, so there are, as I said, 14 approaches to changing which proteins you have that go all, go the full gamut of the way that are now being used to make you... younger, longer. Why is this also important? Because heart disease is predicted to increase just because of obesity by about double in the next 30 years.

So, let me go through some of the other 14 areas. Have any of you heard of the young blood hypothesis or of Silicon Valley? hiring young people to donate blood so they could get the young blood. Anybody heard of that? Bunch of you have. And you know why it stopped? It stopped because the FDA put a limit to it, not because the Silicon Valley successes weren't willing to pay the college students to donate blood, and not because the college students weren't willing to donate blood, and not because the company didn't want to do it.

It stopped because the FDA said you can't do this. But it was the wrong hypothesis. How did it start? It started with a study by the convoys. Um, in 1967 where they hooked up young rats and old rats and they did a cross circulation giving the old rats the young rat's blood. And what happened? The old rat became much younger.

The young rat became much older. And it was thought that there was something in the young rat's blood that did it. It turns out that's wrong. It was actually because of getting rid of Old cells. Dave, you're my victim.  What happens if you have a piece of rotten fruit to the rest of the fruit in the bowl?

It gives out gases that basically create the other fruit to go rotten. You're exactly right. So it, that's the first person that's ever answered that correctly. So it gives off gases. What are the gas? It's a protein that it. secretes the get that's volatile so it's a gas and it get attaches to the other fruit and it makes it rotten.

You have the same situation in your cell with old cells. Your old cells and old proteins make the neighboring cells old. So what was really working with the young blood old blood hypothesis was in fact That the old people were getting rid of their old protein. So when do you start, Dave, when do you start developing old cells?

The day you're born. Before that, in utero. But again, that's the best answer I've gotten. Laughter

I'm going to have to ask tougher questions. So, so in fact You start secreting them when you're in utero, but your immune system gets rid of them until you're about 30. At 30, you start accumulating them, and they make other cells old. In fact, most people believe that the largest cause of atrial fibrillation is those old cells making neighboring cells old and stopping the transmission impulses in the heart in the right way.

In any case, the point is... that if you look at this model, this lady is donating a unit of blood. But she gets her red cells washed back to her, and she dis her plasma, with its old proteins, gets thrown out. And instead she gets new proteins, albumin, or saline. And what happens, and these are called the AMBAR studies, so if you want to look it up on the web, you can, it reversed Alzheimer's disease.

So she donated, and she, in this randomized controlled trial of about 300 people, Donated 9 units of blood and the red is cognitive function getting better over 15 months. And in fact they've orally reported at 36 months it still gets better. As opposed to the control group, which donated blood and got their same blood back, did not have, keeps declining as Alzheimer's does.

It's the only thing we know that reverses Alzheimer's disease that's already existing. And you say, why don't we know more about it? Because the company that sponsored this, it was sponsored by a company, um, two centers in Spain, two in Chile, the University of Pittsburgh and Cleveland Clinic, why did it not get a follow up study, um, since this was out two years ago?

And it started. They started, the company started to enroll 3, 000 people at 100 centers in a phase 3B study. And it turns out that the saline group did as well as the albumin group. The company produces albumin. So they said it's not worth our doing this, obviously. And they stopped. So if anyone has a couple billion dollars, I think you can continue this study.

There are 14 areas that are shown here. My favorite from my co author's point of view, that is the favorite, was the elimination of obesity by turning white fat into brown fat. When you're born, you have brown fat. Dave, why do you have brown fat? To fuel growth. It's the energy that fuels your body. Um, no.

But you're very close. So you can call a friend, but I'm going to go ahead. Anyway, so brown fat warms you. So it does use energy. And it is to protect you when your mother can't swaddle you. So it keeps your organs warm. Once you're at six months, you stop producing brown fat, and the rest of the fat you produce from the same mother fat is white fat.

Well, imagine if you could take white fat, regress it to mother fat, and turn it into brown fat. And that's, again, been done in three different species, and now maybe a fourth, us. The largest non human species is sheep. Why did Clemson do it in sheep? Because sheep won't stop eating either. And they developed non alcoholic fatty liver disease, which means they stopped producing wool in an economic way.

So Clemson said, can we do this inexpensively? Because an inexpensive way to do it was published, and it works in sheep as well. What does that in humans? Well, you've all heard of the GLP 1s, we're GOVS. Semaglutide Ozempic, um, Monchardo. And that, those that decrease obesity, what do they do? They stop the stomach from emptying, they stop craving in the brain, but they also turn white fat into brown fat.

So they have a number of effects, and so that's a very expensive way of doing it now. Um, the inexpensive way is what, um, looks like it can do. And someone brought up this morning: Does cold doing it? Yes. 11 minutes at, if you're naked in water at 67 degrees for 11 minutes in a week, it will turn your white fat into brown fat.

Not many people do that routinely. Say it again? Not 11 minutes a day, 11 minutes a week. If you can hop in fast and hop out 2 minutes, um, every day of the week, you can do it. The, uh, and, and if you, you've all heard my favorite is the epigenetic reprogramming. Um, it's now moving into human trials in Italy with scientists from UCLA and from India involved in it as well.

So five tips that I want to leave you with as we start to change. One is change your attitude. You are a genetic engineer for you and what you do matters. The most important thing you can do is prevent stress. This is a brain neuron, and this is after one hour of stress. And what you'll notice is, in one hour of stress, this is a rat's neuron, you pruned the connections.

So this is the cell body, and these are called axons and dendrites, that's not important. What is important is you prune your memories. That's what happens with stress. And what is the greatest stress? It is actually caregiving. So this woman, and remember I told you your hippocampal neurons were the most important.

They're shown here in green, blue, and red. And this is this woman six months later. That's how fast you can lose your brain function. She was caring for her husband who had Alzheimer's disease, and her son died suddenly. So the point here is, caregiving, which all of us do in one way or another, at one time or another, is the most stressful thing you can do, so make sure if you're a caregiver, you do things for your health, and get help yourself, so that you're not the sole caregiver.

This is a heat map again. The genes are on, green the genes are off. This is a group of 25 nurses from the Cleveland Clinic who at N1 hadn't had stress management program. It's a 6 week program, N2 is 16 weeks later, and M is a year later. Stress management turned off largely these genes up here in the upper left.

and turned on these genes. What are the genes they turned off? Those produce inflammatory proteins. Just doing stress management changes over 250 genes from either on to off or off to on. And by the way, the ones they turned on basically decrease inflammation. You are an incredible genetic engineer for you and it's as simple as adopting any of the 12 stress management program processes that these, uh, people were exposed to.

So I've told you there are 38 choices that you can make to keep your brain young and one of them is getting your flu shot every year. So why? Well, this is a study where from age 59 to 65, these people got 0, 3, or 6 at their own choice. They were offered flu vaccinations. And the difference is a 40 percent reduction in dementia 15, 10 to 15 years later.

It's because the flu is a very inflammatory thing and causes brain inflammation, which is what kills our brains. And even if you don't prevent the flu with the flu shot, it decreases your inflammation. This has been repeated in British Columbia in another study, same study, 10 years, from 50 to 60.

Decreased it by about 50 percent after 10 years of flu shots. Kaiser did the same thing from 55 to 65. Again, the same result. So, it's consistent, and it's pretty easy. It's one two minute shot, if you will, once every, uh, year. Another one is the, the, and these are in order of importance. If you look at it, up at the top is a speed of processing game.

What is a speed of processing game? Well, this is called double decision. You hit the start button, and either the car or the truck appears to be where the start button was. In some place in the periphery, with distractors, a Route 66 sign appears. And you have to identify whether it was the car or the truck, and where the sign is.

If you get it right, the time goes down a little bit, so you get less time, and it trains your brain. If you get it wrong... You get, you have more time to do it. And so that is what we call double decision. Now doing that 2 hours a year for 10 years decreases dementia over the next 10 years by 48%. Randomized controlled trial been repeated 2 times now.

So pretty impressive, right? 48 percent reduction from age 73 to 83 in dementia by just doing speed of processing games. And why does it work? We know that now. So if you cause what we, we call a stressful change in any organ, you end up repairing that. So when you do weight lifting with your muscles, when you...

When you lift a weight, it causes a small injury in your muscle, and you activate the repair system in your muscle, so you build that muscle stronger. When you jump, you cause a little, if you will, tear in your hip bone, and your hip bone actually repairs itself by getting stronger. In the brain, when you're doing speed of processing games that challenge you, What we now know is you turn on a gene that makes the NPAS4 complex, no reason to know any of these names, but that repairs your brain.

And so what you're really doing in the same fashion when, now, do memory games work? Well, memory games improve your memory, but don't decrease dementia. How about, um, executive function games? They improve your executive function. but they don't decrease dementia. Only thing we know that decreases dementia is speed of processing gains and it's because you have to challenge your brain to turn on this repair system.

NPAS-4 repairs your brain and what that means, again, is you are a genetic engineer for you. The common theme for your organs is doing a, what we call a hormetic stress. That is, what we want you to do is a stress that turns on your repair system, but doesn't damage you. So if you look closely before, one of the 14 areas was hormetic hyperbaric oxygen therapy.

What is that? Well, the most serious stress to your body is a low oxygen level. When you get to a half atmosphere of oxygen, Which is around, I don't know, somebody who's a diver can probably tell, but it's probably around 22, 000 feet. You turn on all your repair systems, including you start making new stem cells.

Now, how do you get that body to do that without the damage that that would cause? Well, what they found is if you go to two atmospheres, And then down to one, you trick your body into a paradoxic response that gets your repair system to activate. And so, we're learning these tricks, um, if you will, that help us live younger, longer.

Where did 10, 000 steps a day come from? Dave? At least the original programming in the Fitbit, wasn't it? No, it came long before the Fitbit. It was actually a Japanese pedometer manufacturer who wanted to sell more pedometers. And it turned out he was right. Now, we don't know whether he had the data, but in fact, if you look here, this is all cause mortality.

10, 000 steps is the place where it's the lowest. Yeah, 4, 000 is greater than 2, and 6 reduces mortality compared to 4 and 8, but once you get past 10, you don't get any decrease in what we call disability free longevity. So that's the, the minimum you can do. Yeah. If you do more, you can lose calories. If you do more, you can get more fit, but you don't get more healthy longevity.

And it doesn't matter whether you're a man or a woman, doesn't matter your age, doesn't matter your ethnicity, it's 10, 000. It's the same 10, 000 if you're trying to prevent type 2 diabetes or reverse type 2 diabetes. It's the same 10, 000 for your brain. That's the area that is the best for, the minimum you can do for brain functioning.

So in fact, we've gone through it, it is basically you're turning on that arisen. How do you do that? So it's a hundred minutes a day of walking. Um, or it's any activity counts. So it's step by step equivalents per day. You heard Mike plays a mean game of ping pong. You get about a hundred and twenty three if you're an average ping pong player.

And don't have to chase the ball after Mike beats you with it. But in fact, you get 120 steps a minute. Gardening, 83 steps a minute. Playing with your grandkids depends on how vigorously you're playing. But you get step equivalents from everything you do. 30 minutes of Resistance X, by the way. Nothing I tell you today should you do without checking with your own practitioner.

Um, but 30 minutes of resistance, that's the legal disclaimer. 30 minutes a week of resistance activity, two 15 minute periods of core, um, is all you need to get the maximum benefit from minimum activity. Once you've done both of those for a couple months, then it is 21 minutes of cardio, three times a week.

at 80 percent of your maximum heart rate with, um, in two studies now, if you do high intensity interval training, you get a little extra benefit. What is your age adjusted maximum heart rate? It is 220 minus your age. For men, it's about that. For women, it's not exactly that. For women, but it's close enough.

220 minus your age, 80 percent of that. So, um, if you're 50, 220 minus 50 would be 170, take away 10 percent, 17, take away another 17, so it's, um, 34 minus 170, or you want to do 21 minutes at a heart rate of 136. And then the fourth is, uh, 40 jumps. On a hard surface, why? Because that's the only thing that builds hip bone strength.

So, some of you want to prevent disability. The leading cause, by the way, of death this last year in men in the United States over the age of 65 was a hip fracture. Um, that is if you, women get it more commonly, 40 percent of women get a hip fracture over the age of 65, 25 percent of them never recover from it.

In men, it's 25 percent get a hip fracture, but 40 percent never recover from it. And so 65, 000 white guys in the United States over the age of 65 died of hip fracture this last year. It was actually the leading cause of death. How do you fight that? Well, jumping is the easiest way. And the second easiest way we'll get into in a few minutes, which is doing balance exercise.

and learn to follow classes. So we've gone over a number of things about proteins. One is the additions from stressing muscles or brain turn on your repair systems. The second is getting rid of old plasma and, uh, if you will, by plasma donation. A third is you block the attachment, that water pill, or you increase ApoE.

if you will, by the bumetamide, and those are all working on your proteins. So let's go and look at, um, Some other things. One is people always ask about supplements. So one of the supp there are 53 supplements that we've been asked to evaluate at the longevityplaybook.com scientific team. And 15 of them have enough benefit over risk that you should discuss with your practitioner if you're a guy over 40 or a woman over 45.

One of those simply is creatine. So creatine is used by muscle builders You know, guys between 15 and 30, to try and look like, um, Arnold. In the study, it was said, could we give this to old people and prevent muscle loss in those over the age of 50? And what happens is, the answer is yes. And in fact, women...

Going through menopause, one of the things you do is lose muscle at a faster rate in addition to other things. Increasing muscle strength is associated with less disability in the randomized controlled studies. It did that, and it was synergistic with resistance training. In addition, and by the way, how expensive is it?

It's, this bottle costs 36 for a four month supply on Amazon. And you take four grams of it a day. I put it in my coffee at 11. 30 in the morning, which is the first food I eat in a day. It's fine in coffee. It just isn't any big deal. More data are needed, but in fact, it improves short term working memory.

in the elderly who was given to improve muscle strength, and it did improve muscle strength as well. I'm not going to go through the rest of the supplements, but going to go through a bunch of other things. Extra virgin olive oil, coffee, smelling roses. Aromatherapy. So why we care, why we're so concerned in medicine about COVID is that in the Spanish flu of 1917 and 18, It went up the nose the same way COVID does, and affected our smell sense.

And, it went, those viral particles ended up in the basal ganglia, and almost all of the Parkinson's disease in the 1950s, 60s, and 70s was due to long Spanish flu. It turns out COVID does the same damn thing. It goes up the olfactory nerve, and when you do viral particle analysis, it's on that nerve and goes to your basal ganglia.

That's what causes Parkinson's disease. And guess how you can reverse it? In mouse models, the way you reverse it is by doing four intentional smells a day. That is, the plaque that builds up in a mouse model of COVID, along the olfactory nerve and into the basal ganglia, that plaque gets reversed by exposing the mice to four intentional smells a day.

And that's what actually happens with Alzheimer's patients. One of the first things you lose in Alzheimer's disease is your sense of smell. And by doing four smells a day in early trials, so there are only two trials of this, but in both of those trials, it slowed or reversed, um, in fact the development of Alzheimer's disease, cognitive dysfunction.

Decreased hearing is thought to account for 29 percent of dementia. That is, when people have decreased hearing, how many of you have a relative or friend who has problems hearing who won't wear hearing aids? Um, yeah, a whole bunch of us, right? And the problem is, those people become isolated. Um, because they can't hear.

And so when you looked at it in the Hopkins study, which was done, when people with a problem with hearing got hearing aids, they had no increased incidence of dementia, as opposed to if you had a, if you have a hearing problem and didn't have a hearing aid, you are much more likely to develop dementia.

So the point is, hearing aids have gotten a lot cheaper. What should they really get? Well, all it takes, you know, what does the Apple iPhone hearing devices cost? And it's controlled by your phone. That's essentially a hearing aid, and that's a very expensive form of a hearing aid. They charge much more for them in the States now, but they really will come down in price dramatically, we believe.

Black coffee. So you see me drinking coffee. If you're a fast metabolizer, And you tell that by a, you have an eight ounce cup of coffee in a one hour period, and you don't get a headache, gastric upset, anxiety, or abnormal heartbeats. You're one of the 80 to 85 percent of Americans and Canadians who are fast metabolizers.

If you're a fast metabolizer, the more coffee you have, the less... if you will, dementia you have. It decreases dementia in general, and Parkinson's disease more specifically, by 20 to 40%. If you have four cups a day, if you have eight cups a day, it decreases Parkinson's disease by about 60%. Um, green and black tea seem to do the same thing.

Decaf is about half as effective. The best thing for your liver and recovering is coffee. Again, decaf is half as effective. It decreases eight cancers, including breast cancer, by over 20%. What's found for breast cancer is usually found for prostate cancer, but we don't have the data on prostate cancer yet.

And you want it through a paper filter. The Keurigs are through a paper filter. Why through a paper filter? Because the roasting increases the production of something that increases your ApoB or LDL cholesterol levels. Uh, how about extra virgin olive oil? Well, a half or more tablespoon a day, whether drank directly, whether on bread, whether you use it to cook with, decreases dementia risk by 30 percent more, by 20 percent sorry, more is better.

It decreases cardiovascular disease in randomized controlled studies also by more than 20 percent and it decreases breast cancer as well.