AGEIST
The AGEIST podcast is where we rewrite life after 50. Hosted by David Stewart, founder of AGEIST and Super Age, we talk with extraordinary people—scientists, creatives, and thinkers—about living vibrantly in your 50s, 60s, 70s and beyond. From longevity science to emotional well-being, fitness to purpose, we explore the tools and mindsets that help us stay curious, energized, and deeply engaged with life. This isn’t about aging gracefully—it’s about living boldly.
AGEIST
Dr. Michael Roizen: Can 90 Feel Like 40?
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Longer life is changing what people over 50 expect from medicine, themselves, and the decades ahead. In this encore episode, Dr. Michael Roizen argues that aging is increasingly shaped by informed choices, while the current culture surrounding longevity struggles to separate useful evidence from expensive fads.
Roizen examines the science behind epigenetic switches, protein cycling, metformin, stem cells, cardiovascular risk, and balance. The conversation offers a practical framework for evaluating new claims, protecting physical and cognitive function, and asking better questions before adopting a new treatment or supplement.
Join Us at the 2026 Super Age Games! Visit games.superage.com to learn more.
Special Thanks to Our Sponsors
True Nutrition: Stop settling for what’s on the shelf and build the protein blend that fits your lifestyle at truenutrition.com/AGEIST and use code AGEIST for 20% off your first custom blend.
LMNT Electrolytes: Try the all-new Lemonade Iced Tea! Our #1 electrolytes for optimal hydration. Get a free 8-count Sample Pack of LMNT’s most popular drink mix flavors with any purchase by using our link here. Find your favorite LMNT flavor, or share with a friend.
Timeline Nutrition: Our favorite supplement for cell support and mitochondrial function. Listeners can now get 20% off their first Timeline purchase by using the code “AGEIST” at checkout at TimelineNutrition.com/ageist.
Key Moments
“You’re a better genetic engineer for you than anyone else who went to Caltech or MIT.”
"Stressing the muscle not only repairs the muscle, but it turns on a gene that produces a small protein, which gets to the brain and makes the brain bigger. That’s why physical activity, we think, is so good for memory."
"Can we make a hundred year old person a 40 year old person? In other words, can we extend the period of life between when you’re most productive, your 40s to 60s, to being between 40 and 90? And that’s where a lot of the aging mechanism research is going."
Connect With Dr. Roizen
Connect with AGEIST
Click Here for the full interview transcript.
I'm David Stewart. Welcome to episode 295, the Ages Podcast. This week, one of our most information-packed conversations from a few years back, is with our friend, Dr. Mike Roisen. Mike was the first chief wellness officer at the Cleveland Clinic and the founding chair of its Wellness Institute. He's a board-certified physician in internal medicine and anesthesiology. He's a co-founder of RealAge. He's the author or co-author of several number one New York Times bestsellers, and someone who has spent decades translating complicated medical science into actionable information for the rest of us. He also happens to be a delightful human being and a world-class science nerd. I mean that it's the highest possible compliment. We love Mike. Mike reads medical research for fun. I mean, who does that? Mike does that. He's been known to read scientific papers during breaks at baseball games. More importantly, he has a rare ability to look at an exciting new treatment and ask the question, which we should all be asking, is this supported by good evidence? Is it? Or are we simply getting ahead of ourselves? In this conversation, we cover a tremendous amount of ground. We're going to talk about stem cells, metformin, aspirin, protein restriction, nitric oxide, cardiovascular risk, balance, brain health. Wow. We also talk about the possibility that medical science could eventually make a much older body function like a substantially younger one. Wow. I wonder if I could run again like I was 20. Wouldn't that be fun? That's a very big idea. But Mike's message is not that we should sit around waiting for a miracle. He is a staunch advocate for protecting our strength, mobility, metabolic health, and cognitive function now. So we are in a position to benefit from whatever medicine makes possible later on. We'll talk with Dr. Mike Roisen after a brief word from our sponsors. True Nutrition is protein powder you build yourself with the exact ingredients, flavor, and sweetener you want. I like that because believe it or not, I'm fairly particular about what I put in my body. With True Nutrition, I get to play chemist. On their website, I can choose the protein base, the flavor, how sweet I want it, and add things like collagen, fiber, probiotics, or aminos. It takes a few minutes and then your custom mix is saved for next time. The flavor and texture are excellent, with no chalky aftertaste. And I like that it can be sweetened with monk fruit too. Head to TrueNutrition.com slash agist and use code AGIST for 20% off your first custom protein blend. That's true nutrition.com slash agist code AGIST. Go build your own mix and take 20% off. Once you've had a protein you actually look forward to, you won't go back. Every movement we make starts with energy, and that energy starts inside our cells. As we age, our mitochondria, the little engines that power us, can become less efficient. That affects strength, recovery, resilience, all the things we actually care about. Timeline developed MitaPure with Urolithin A to support metophagy, the process that helps clear out damaged mitochondria so our cells can work better. I think of it as working closer to the source. Timeline's clinically proven formula is now available at a new, lower price. MidaPure now starts at $79 when you go to Timeline.com slash AGIST. That's Timeline.com slash AGIS. This season I've been paying more attention to the energy curve. Coffee can be useful, but too much of it, and I end up wired than flat. Alement Lemonade Iced Tea has been a better afternoon move. It uses full black tea extract with electrolytes, so the caffeine feels steadier and there's no sugar, artificial colors, or dodgy ingredients. Sharp and clear is the goal, especially when it's hot out and hydration matters. Get a free eight-count sample pack of Element's most popular drink mix flavors with any purchase at drinkelement.com slash agist. Find your favorite flavor or share with a friend. That's D-R-I-N-K-L-M-N-T.com slash agist. Before we begin, a quick note. Reviews really do help people find this show. So if this show has been useful to you, please take a moment to leave us a five-star review. We'll appreciate it more than you know. One of the central ideas of this conversation is that longevity is not simply about waiting for better medicine. It is about maintaining the capabilities that allow us to live well. And those are strength, balance, endurance, cognitive fitness, and resilience. These are also the core concepts behind the Super Age Games coming to New York City, November 7th, 2026. It is the first longevity fitness competition designed to measure and extend how long we will live well. This is not about pretending to be 25. I'm sorry, I'd like to be pretending like I'm a 25, but not gonna happen. It is about finding out where you are strong, where you have room to improve, and what is it worth training for. Essentially, how are you spending your time? You can learn more and secure your spot at games.superage.com. As always, this conversation is for general information and is not a substitute for medical advice from your own healthcare professional. So let's jump in with Dr. Mike Roisen right now. Mike, how are you doing today?
SPEAKER_00I'm doing great, Dave, and it's great to see you. Um I realize this is audio, but uh getting to see you is a is a thrill. Um, and you look uh healthy, happy, and uh young.
SPEAKER_02Thank you so much. It's great to have you on here. Um, as always, we always learn so much when you come on. Tell me a little bit about what you're up to with Longevity Playbook.
SPEAKER_00Well, the goal of this is to democratize, that is, to make available to everyone uh me. That is, the goal of Longevity Playbook is to have me in your pocket at all times so that all the knowledge that we talk about is ensconced there, if you will, so that people can do things in a systematic fashion to make their actual age younger. That is, we think that sometime in the next 10 years, there is likely to be, there are 14 shots on goal, um 14 different areas of aging mechanism research, and we think one of them is likely to break through and be able to turn the average 90-year-old into the average 40-year-old. To prepare for that, so you can be that functional 40-year-old, you want to stay as young as possible, have as many things healthy as possible, and that's what the longevity playbook curates the data so that you know what is science and what is BS. And only and don't waste time or money on things that aren't as healthy as uh some say they should be, or as healthful to you as some say they should be.
SPEAKER_01I'm a particularly fan of the library function.
SPEAKER_00Um the library goes through, it's got 180 things in it. They haven't all been released, but the scientific advisory board has looked at 180 different topics, everything from testosterone and hormone therapy and women and 51 different supplements. Should you take glutathione or catalase or metformin, and all the way back to blood pressure control and its importance or in what we think the uh optimal drugs might be in different races, genders, etc., what the scientific advisory board has not thought, but what the data are. So it's really to curate the data to make it available to each person as if I'm in your pocket.
SPEAKER_01Yeah, it's tremendous.
SPEAKER_02The way it opens up, there'll be a couple of paragraphs of the summation, then recommendations, and then the actual scientific abstracts, which I mean, for somebody like me, uh you you read scientific abstracts before you go to bed. You love them, but um for me, this is a good idea.
SPEAKER_00As you know, I have season tickets to uh the Browns, the Cavs, and uh 10 games to the Guardians or Indians. And uh during the timeouts, I read medicine, which is crazy, right? But um, but it that's my fun. Let's talk a little bit about your thoughts on aging.
SPEAKER_02And you know, we spoke a little bit about these genetic sort of control switches and the how these affect the proteins and the things that go wrong there.
SPEAKER_00Right. All genes are uh is protein factories, they manufacture a specific protein or set of proteins or parts of proteins. The things that control whether that gene is manufacturing or not are called epigenetic switches. And those switches you control. It turns out in the latest data, we we've generally accepted that by the age of 50 you control 70% of the switches. Well, the most recent data in twin studies at age 40, you control 93 to 94 percent in those two twin studies of those switches. So what proteins you make is largely up to you. Now, what we know is that when you get a misfolded protein, so proteins, if you will, they fold on each other in different ways. If you will, misfolded protein, um that um causes a different effect. It hits a receptor. So, for example, heart failure in 25 to 30 percent of people is caused by a misfolded amyloid protein, different amyloid than the brain. This one's made by the liver. And knocking that gene out with gene editing in 12 people in Australia literally cured heart failure. They went from an ejection fraction of under 12% and under six months to live. Ejection fraction is the percent of blood in your left heart in the ventricle that you eject into the systemic circulation into the rest of your body when you squeeze the heart, um, or pump, if you will, squeeze the muscle. Um, and they went from that under 12% to over 35% in seven of the 12 people who had heart failure. And instead of having a six-month life expectancy, those seven now have an 18-year life expectancy by knocking that abnormal protein manufacturing system out. Well, the interesting thing is you say, why didn't the other five get the result? Because they had so much structural change they couldn't recover their heart. So that's why the longevity playbook is important. It's to keep that structural change away. It also says that maybe we can control a lot of those switches to turn off or on those proteins, those gene manufacturing functions of the uh and the subsequent proteins and the subsequent response by our actions. Now, what we know that is so dramatic is that if you stress your bone, you jump up and down and cause a little injury to your bone, it turns on the bone repairing system. You turn on the osteoclasts that repair your bone. So you get stronger bone. Same thing when you do resistance exercise with your muscles. You create a little tear in the muscle, that turns on a muscle repairing system that makes the muscle stronger. Now we've just learned in the recent months, same thing with the brain. When you make the brain function quicker, like my having to answer questions from you and bring back um information, that makes that turns on a brain nerve repairing system called NPAS4. You don't have to know it, but it's a series of proteins that repair your brain. That's why speed, we think speed of processing games are one of the reasons they're so important. And the other, of course, the the other stressing the muscle has not only repairs the muscle, but it turns on a gene that produces a small protein called a risin, which gets to the brain and makes the brain bigger. That's why physical activity, we think, is so good for memory and for hippocampus. So you're you get to control by a lot of lifestyle choices how you function. And that's that that's really one of the keys. You're a better genetic engineer for you than anyone else who went to Caltech or M to MIT as an engineer for you. Do you want to, you you I think you mentioned 14 shots on goal. What are your top, say, four or five that you think? Well, well, one of them came out just yesterday reports. So I don't know if we're we've got a delay in this, but at least uh on the last day of July in uh 2023, a report came out from a small pharmaceutical company. Um I had no vested interest. I didn't do any of the research, etc. But it was on they had previously shown that giving a TNF alpha inhibitor a small molecule they made. By the way, TNF inhibitors are the largest selling drugs in the world. They're used for rheumatoid arthritis, et cetera, so and uh psoriasis, et cetera. Abby V, I think, sells $20 billion worth of uh humera or humera-like drugs. Well, they're $70,000 a year, and no one's looked at them for aging, if you will, in normal populations. But in mice, this company had looked at a TNF alpha inhibitor, and it literally takes mice that look that be are a hundred years old, hundred-week-old mice, the equivalent of a hundred-year-old human, and make them 40-week-old mice. Reverses the aging of their heart, of their muscles, of their brain, of their skin, their hair gets normal, their liver functions more normally, like a younger liver, like a younger brain, like a younger heart. Well, they now have started this in human studies, and they did a phase two study, which is a safety and efficacy on the biomarkers of aging and of muscle loss. So we lose muscle as we get older, at least due to some of it is due to inflammation. And what they showed is that all of the markers in this phase two study in humans could be reversed and made normal, and they reported no side effects. Now, this is an oral report, they haven't published the peer-reviewed paper yet or gone through FDA review. But if this holds, that's just one of the 14 areas, something that decreases inflammation or inflammaging. Um, and we know colducene and baby aspirin do it to a degree as well. Um, so that's one of those areas that looks at how do we stay both younger now? And is there going to be a big breakthrough where we take the 100-year-old person and make them physiologically a 40-year-old person? So some of the others, um, and you and I talked a little bit, senolytics, the harvesting of old cells that make their neighbors old, that's another one. Why is it that synolytics make their neighbors old? They release a protein. Again, here we're coming back to proteins that makes it. Another one is study of drugs that block aging phenomena. So, it's a $4 a month diuretic water pill. So it's used to get water out of the body. Usually it's a hypertensive or in heart failure, and it's largely been replaced by thurosamide or LASIKs and hydroclorthiazide. It was found is the Gladstone in San Francisco looked at all 1,363 drugs that had been approved by the FDA and become generic. And they looked at does one of these block the attachment of amyloid and tau in the brain to neurons, which is the start of or is associated with Alzheimer's disease and many other dementias, including Parkinson's and a different set of neurons. And what they found was fumetamide in animal models and a mouse model of Alzheimer's disease blocked it. Now, mice aren't men, as your friend quotes, so you have to do it in humans, and they looked at epidemiology of a 1.3 million person database and another 3.8 million person database, and they found that it blocked it in 70 and 70, that the people were taking this water pill compared to other water pills or compared to no water pill, had 70 and 72% less Alzheimer's disease and less dementia. So now they're doing human trials with that to say, can we, with this $4, literally $4 a month water pill, stop 70% of dementia? So again, it's working on a protein to block the actions of that protein, of that amyloid or tau in attaching. So there are 14 of these types of shots on goal. There's gene editing, there's uh stem cell research that is being done very well now in some areas. There is um, so there are there are literally 14 different shots on goal therapeutic plasma exchange, which is like synolytics, but a little different in that it gets rid of your old plasma proteins and forces you to make new proteins. Hyperbaric oxygen, which tricks the body into thinking it's in danger when it's done in a novel way. It's a hormetic hyperbaric, they probably should change the name because it isn't just hyperbaric oxygen. It's the tricking of the body to thinking you're at low oxygen when you're not that calls forth the repair mechanisms and generates more stem cells and more repair mechanisms. So there are a lot of approaches to saying, can we make a 100-year-old person a 40-year-old person? In other words, can we extend the period of life between that you're most productive, your 40s to 60s, to being between 40 and 90. Um, and that's where a lot of the the aging mechanism research is going. So um, and we think it is, uh, if you will, that the buildup of abnormal proteins causes us to age. And if we can get mechanisms that either inactivate, destroy, or prevent those abnormal proteins from being produced or being effective, or um even being around, um, that you can uh either stop or reverse aging.
SPEAKER_02Mike has given us quite a lot to think about already. One of the things I appreciate about him is that he can be excited about the future without confusing possibility with proof. And that distinction may save us a fair amount of money and possibly a few bad decisions. We're going to pause for brief words from our sponsors, and we'll be right back with Dr. Mike Roy. True Nutrition makes protein powder you actually customize with the exact nutrient ratios, ingredients, flavors, and sweetener you want. I've tried a lot of protein mixes over the years, and most of them are one size fits all. With True Nutrition, you build your formula around what works for you. Here's how simple it is. First, you pick your base. They have more than 20 protein options, including whey, plant-based, and dairy-free, all third-party tested and verified in-house. Then you choose your flavor and intensity. They have 28 flavors, and you can sweeten your blend with stevia or monk fruit. After that, add any boost you want, things like collagen, fiber, probiotics, aminos, colostrum, or lion's mane. Then choose how often you want it delivered and your formula is saved so you get the same mix every time. For me, quality matters. I want protein that supports muscle, recovery, and metabolic health without fillers, additives, gluten, or a bunch of strange ingredients I don't need. I also want something that tastes good enough to actually use consistently. True Nutrition checks all of those boxes and has become my go-to. It mixes well and it doesn't leave that chalky aftertaste. Head to TrueNutrition.com slash AGIST and use code AGIST for 20% off your first custom protein blend. That's true nutrition.com slash AGIST, code AGIST. Go build your own mix and take 20% off. Once you've had a protein you actually look forward to, you won't go back. Do its job. As we age, mitochondrial function naturally declines, and that can show up as lower energy, less strength, slower recovery, and a little less bounce back than we used to have. Timeline has spent more than 15 years researching mitochondrial health and developed mitopure, which contains urolithin A. Urolithin A supports metophagy, the body's process for clearing out damaged mitochondria and recycling cellular components. In one study, participants saw a 12% improvement in muscle strength in four months with no change in exercise. That gets my attention. For me, healthy aging means protecting capacity, the ability to move, train, recover, and keep showing up for the life I want. Supporting the cellular machinery underneath strength and energy feels like a very smart place to start. Timeline's clinically proven formula is now available at a new, lower price. Midopure now starts at $79 when you go to Timeline.com slash agist. Brilliant. And just sort of touch on them and see if there's anything new that we need to know about.
SPEAKER_00So that's why the longevity that's why we did the app and the website, and it's even on iPad as well as the website as well as an app, is because the science keeps changing and you want to update it. So I told you about stuff from yesterday on the TNF Alpha inhibitor. That's going to enter phase three studies pretty soon, I assume, from the company. And if it does, um, or if a bigger company buys that company out, we will keep track of it. There's also a CTEP inhibitor that produces more Apo E1 that blocks Alzheimer's disease in animals. That result we expect to see in September, October of this year. Um, so the another new drug by a different startup pharmaceutical company, but if this the CTAP cholesterol transferase esterase protein um ends up being beneficial, that's again, that's a huge moonshot to reversing. I mean, in other words, people care about bones and they care and mobility and they care about memory. And this one all, we've got a number of shots at memory as well as a number of shots at bone that are coming.
SPEAKER_02Amazing.
SPEAKER_00Let's talk about aspirin. So the data on aspirin are pretty clear. Um it decreases nine cancers between 20 and 40 percent, colorectal cancer, colon cancer, rectal cancer, esophageal cancer, breast cancer, etc. Um, nine cancers between 20 and 40 percent in epidemiology and in some randomized control trials. They obviously don't have enough randomized controlled trials for us to say definitively, or the the data would be clear that everyone should be taking uh a baby aspirin twice a day with uh half a glass of warm water before and after, and maybe bovine colostrum as well. I'll get to those things as well. Um, but it does increase bleeding, especially if you don't take it with a half a glass of warm water before and after or with bovine colostrum. Now, half a glass of warm water, 70% of the effects of aspirin are landing on the stomach lining and eroding it or the intestinal lining directly. If you take it with the water, it dissolves in the water and doesn't do that. That's why it's important to take half a glass of warm water. Warm just means it dissolves quicker. So I have a uh before I take my aspirin, I have at least half of a cup of coffee. I know we're doing this video, and I keep thinking I'm doing the the effects video, but it's not that too bad people aren't seeing the video. I just drank half a cup of coffee. Um, so coffee is fine for it to uh land in the coffee and dissolve in that. Um and then um bovine cholesterol in randomized controlled trials, um 2,000 milligrams, decreases by over 80% the shortening of the villi and what we call the the shortening, the the um bloating and the uh gastric um and intestinal uh leakage. Um that is the shortening of the villi mean the that you can break through and leak from uh inside inside the intestine to the rest of the body. Um and that uh process is totally aborted by bovine colostrum, which is the first, so that's why I take 2,000 milligrams of that and why I take my aspirin twice a day. Now, it will increase bleeding if you do extreme sports and get an accident. If you drive and get an accident and hit your head on something, um it will increase that. So there is risk, and that's why um finding something like a TNF-alpha inhibitor that is even more powerful at decreasing inflammation and doesn't have the risk may be wonderful. Um and we've now found recently the FDA approved colchicine, 500 milligrams. It's much cheaper if you get it as a 600 milligram pill, but 600 milligrams of colchicine or 500 milligrams of colchicine uh taken um daily um has been shown to decrease heart attacks and strokes, and presumably the uh dementia associated with that. So maybe when we get a study that compares colchicine, aspirin, and its side effects and benefits, we don't know if colchicine has um all the anti-cancer benefits that that uh aspirin has, whether it's a different effect of aspirin than its inflammatory effect. It looks, it correlates very well with its anti-inflammatory effect, but we don't know that. But colchicine seems to be more powerful, and the TNF alpha inhibitor may be even more powerful in this way. You know, these next 10 years will be amazing in the amount of data that comes out, and that's why we want to curate it, and that's why we did the longevityplaybook.com app and website and iPad version, so that people would know the latest data and what we think the scientific advisory board thinks um is the best for each individual personalized to them. So we'll have enough data from them and be able to personalize it to them, as you have seen on the longevity playbook app. But the key point is we're now in this rapid scientific period where we will learn a lot about how to keep younger longer, keep your functions longer, so that if we do get that what I call the great age reboot breakthrough, the breakthrough where you go from 90 back to 40 and stay in your 40s and 50s for 30 years instead of 10 years at a time, um, that if we do get that, you'll have all the functions intact. And if you don't, the worst side effect is you'll live with a lot less disability a lot longer.
SPEAKER_02I just I want to circle back to aspirin. And you mentioned bleeding events. So someone who's gonna have surgery, for instance, me, I'm having my knee cleaned out in three weeks. I currently take 81 milligrams in the morning in the evening, but we don't want to stop that hard, right? Because then we get a rebound effect. Is there a taper that you advise people to do on aspirin?
SPEAKER_00You you do get a rebound effect, but the data, and and as you know, I I ran um Cleveland Clinics Anesthesiology, uh, intensive care unit, and uh pain therapy, uh they were their institutes. They're so big. I mean, we we had 166 Rs, 184,000 operations when I last did that. But anyway, the uh 44,000 ICU days, 110,000 pain therapy patients. So those were big units. And what we rec what we data, aspirin stops the aggregation of platelets when the aspirin is present, it binds to the platelet that is created. You create new platelets every seven days. Every day you create one-seventh of your platelets. You need about one-seventh of your platelets to have normal clotting. For eye surgery, where it's very meticulous and you want absolute clotting, we say stop it for at least four days. For knee and plastic surgery, maybe four days as well. Um, but for knee surgery, you know, there's a lot of uh, you don't mind if there's a little extra blood around the knee. We have it stopped for three days, which means you get two days new of platelets. You want to be extra careful, you do it four days. You want to be really careful, you do it for seven days. But in any case, it's its anti-platelet effect that you're worried about. Um now, uh, what do we do? So we have not come to this decision yet, but my guess is that we would start coltrosine or something that has an anti-inflammatory effect maybe the day before you stop the aspirin. So um to get an ant to continue the anti-inflammatory effect. So the rebound is in the anti-inflammatory effect and the increased clotting. You don't see the increased clotting rebound if you stop it three days in advance, because four four days worth of your platelets are still inhibited and will be inhibited until those platelets die and get replaced by new platelets. So as long as you'll start it two days after surgery, you'll be fine. So stop three days before, start again two days after. To be extra careful, stop four days before, start two days after.
SPEAKER_01And are physicians prescribing cultrosine?
SPEAKER_00Um well I am. I've been doing this for about a month now since the data came out pretty clearly. Uh so at least uh yes, we are at the the clinic wellness group is, I don't, and our executive health group is, and I assume our uh cardiology group is. Um I haven't looked at the number of prescriptions, but uh my guess is uh it's gone up dramatically.
SPEAKER_02Um let's move on to something I find really puzzling, which is protein intake. And you know, you see all kinds of numbers out there, and sometimes it's um a gram of protein per ideal body weight. That is a that's a I mean, I've got 170 pounds, that's a lot of protein. Um is there data on this or are people just making this up?
SPEAKER_00Um there is epidemiologic data. There isn't good randomized controlled studies, and let me go through why I go off of protein for five days a month, low protein, and do a gram of protein per pound the rest of the time. And it's tough. So for example, I will have um if you will, and crazily, uh 10 egg white omelet, um, which gives you about um 65 grams of protein, um, if you will. But I'm still half, right? And then I'll have uh a couple uh salmon burgers on that day, which is uh uh 30 grams of protein, so I'll get there. Um uh but it is tough. But what protein does is it stimulates growth and repair. And one of the things that happens as we get older is we don't repair things as well and we don't regrow things. So you need that protein, and that's why when you're younger, um, you presumably don't need it. Now, what's the downside of that protein? Well, it stimulates cancer growth too, right? It's stimulating growth of everything. But five days a month, if you go off of it, this is Walter Longo's randomized control studies, going to low protein. I'm in my, let's see, Sunday, Monday, Tuesday. This is a Tuesday, so I'm in my third day of low protein uh this week. And I just five days a month, I circle the five days I'm home that I can do it. I'm not going out to dinner, I'm not going out to a ball game, I'm not doing anything where I'm going to be tempted to have more protein. But I'll have uh I'm gonna go over here and get it. I have a thermos, which if you look in the thermos, I'm gonna try and show you, Dave. I don't know if you can see it. This I can't turn it, but I don't know if you can. Can you I don't know if you now. What is that, Mike? What do you think? It's a tomato soup. Okay. So it's a very low protein. Uh-huh. It's tomatoes. Um, it's uh 36 ounces of diced tomatoes, 36 ounces of water, 12 ounces of uh corn niblets, 12 ounces of water, um, onions and spices to taste. Um and so, if you will, 48 ounces of water, 36 ounces of uh diced tomatoes, 12 ounces of corn nibblets. It's the original recipe, Volter Longo, um, at least in my understanding, used in the original studies. Uh, very inexpensive, tastes good, 17 portions a day, and you're 750 calories or less. So the data was 750 calories or less, low simple carbs, low um protein, obviously, virtually very little protein in that. And uh it turns off mTOR. It gets you to be in autophagy where you recycle your proteins. So hopefully you take all the bad proteins, all the cancer-forming cells that your immune system has been knocking out, get recycled rather than get to regrow um into normal cancer cells, if you will. And so that's the data that long go showed extended lifespan in mice without any real problem, meaning five days of this a month. Um, every month. I've been doing it for now six years, a little over six years since the data first came out in graduate students. Um, and it's been replicated now in 35 to 40 year olds, 40, uh 55 to 60 year olds, 65 to 70 year olds, and now uh 75 to 80 year olds, um, where it extends lifespan considerably.
SPEAKER_01So But Mike, I want to circle back to this. Is the mechanism here the protein restriction or calorie restriction?
SPEAKER_00Protein we see it may be both. So we don't know the answer to that question. But obviously, if you're doing calorie restriction, you're doing protein restriction because most people won't in their calories just eat protein. Um but the goal is so what we know is that as you get older, you need more protein to repair and maintain muscle mass and other and and bone tissue, lean muscle mass and lean bone and bones. So that's why you do the increased protein after the age of 60 or so. What maybe 50 or so. We don't have good data on when to do it. Why you want to go without protein is to recycle damaged and old cells rather than let them propagate and cause problems. So that's why I think that the alternation, um, so I'm a big fan of Walter Longo's work. Of the longevity playbook, there are probably 180, I think, two choices you can make that are rational. Now, some of those choices, you know, avoiding catalyst, glutathione, and SOD as supplements, you know, I don't I count that as avoiding all the things that are bad for you. I count as as one's one choice. But in any case, there are 180 choices you can make, 182 choices you can make that keep you younger now. And I do almost all of them crazily, not because I'm obsessed by them, but because I've just built up those habits over the years. They I am obsessed by the five days a month because that does require you planning and sacrificing almost all the other things are pretty easy to do.
SPEAKER_02There is a practical theme running through this conversation. The future of medicine may be extraordinary, but the condition in which we arrive at that future still matters. Yep. We're talking a short break now, and then Mike and I will continue our conversation. I used to think the afternoon fade was a caffeine problem. Have another coffee, push through, keep going. But caffeine mostly mutes the signal that tells you you're tired. The fatigue is still there, building underneath, and when it wears off, you feel the drop. What I like about Element Lemonade Iced tea is that it takes a different approach. It uses full black tea extract. So the caffeine comes with L-theonine and polyphenols, the way it exists in the plant. Then it adds a meaningful dose of electrolytes, sodium, potassium, and magnesium, the same foundation as Elements Core Hydration Mix. For me, that makes sense in the summer. Heat, training, travel, long work days, all of that asks more from the system. I reach for lemonade iced tea when I want something that feels clean, steady, and actually refreshing, with no sugar, artificial colors, or strange ingredients. Get a free eight-count sample pack of Elements most popular drink mix flavors with any purchase at drinkelement.com slash aegist. Find your favorite flavor or share with a friend. Once again, that's D-R-I-N-K-L-M-N-T.com slash AGIS. You mentioned stem cells. And it's sort of a large topic. I know there are people, people I know who go to Mexico and get stem cell allegedly umbilical cord spin out the stem cells and they get these massive doses. There's also platelet-rich plasma, right? PRP, which is sort of similar to that. My understanding is the FDA in the US, there's a lot of restrictions on stem cell stuff.
SPEAKER_00Well, there's there are restrictions on it because it isn't proven. In most stem cells, you'll get 500 to 800 stem cells. That's useless. Except you get the exosomes, the factors with it that come with PRP that seem to be able to call forth your own stem cells to that area. So let me go through some of the process. Why do you get to a hospital fast after you've got a heart attack or stroke? One is to open up blood supply and that saves some cells around there. But it also lets the dying cells send out these messages. We call them exosomes. They're the inside the growth factors inside stem cells and inside other cells that call forth your own stem cells to repair this. How did we learn this? Well, this was actually in 2004, a male heart got put into a female person. That female then had a heart attack subsequent to that. When they after they opened up her blood vessels and restored it, she regrew and restored her heart function. When they looked at the cells that had done that, they were female stem cells. They were her own stem cells in that male heart. She was a female, and you can tell female versus male by looking at the chromosome and see XY, and uh she had she had the female markers, and that's what they were. So they call forth your own stem cells. That's what we think PRP platelet-rich plasma exosomes do. We're not sure of that at all. And the data are very the randomized control data show some people get benefit, most don't. There isn't a lot of difference between a saline injection and a PRP injection, except some people definitely get a benefit. It just isn't statistically a great enough number to make to make it statistically valid. Now, what about stem cells in Mexico? It's probably a fraud. What about stem cells in Panama? That's actually two places that are set up in Panama that are very legitimate. And in Japan, they're doing very legitimate studies. And Japan has interpreted the intention or the right to trade. Part of the international patent treaty differently than the U.S. has. In the U.S., if you find a treatment that works in one person and it's in a phase three study and you file a right to treat, you have to go through with each person the full process of getting that at the FDA, a long legal process. In Japan, once it's in phase three trial, and once one person has filed it, everyone gets the right to treat. So they have done a large stem cell. It takes four 30 to 50 million stem cells to repair something. So when you're doing a heart, when you're trying to repair the heart in someone who's got a heart attack, you've got to inject 30 to 50 million stem cells. No one in the U.S. does it. I don't think anyone in Mexico does it, to my knowledge. Um in Panama, they're doing it. In Japan, they're doing it. Um so you've got to grow them in culture, which means taking a biopsy from you and growing it in culture. Or, as they're doing in Japan, they knock out the immunogenicity, the HLA markers on a stem cell, and can mass produce trillions and trillions and then give them to everyone without getting fear of rejection. So stem cells in the U.S., well, maybe if given with exosomes, you're getting the benefit of the exosomes. PRP, maybe you're getting the benefit of the exosomes. We aren't sure yet. Um, the rest of the world, it's a wallet biopsy. If you got enough money, they're going to take it from you. Um, and uh in Panama and Japan, it seems to be in three or four specific places uh a legitimate attempt to get you those 20 to those 30 to 50 million stem cells done right.
SPEAKER_02Continuing in the realm of controversy, metformin.
SPEAKER_00So metformin has a number of benefits that were shown in one study. Let's go. What what metformin does is it lowers your blood glucose by facilitating the transfer of glucose, sugar, from your bloodstream into your cells. So sugar in your bloodstream gets on your proteins, causes them to malfunction. Again, the protein problem. Umoglobin A1C, which we measure in type 2 diabetes, and goes up from the normal 5.6% or less to 5% to maybe even 10 or 15%, 10%. Let's go. And what that does is it inhibits that hemoglobin from releasing oxygen normally. So you get ulcers, you get ischemic, you get lack of oxygen changes in your kidney, in your heart, in your brain. That's what type 2 diabetes is. And metformin facilitates getting the glucose out of the blood and into your cells. And in a large epidemiologic study, published, I think, 2013, they showed that people on metformin, diabetics on metformin, lived longer than diabetics on other type 2 diabetic drugs, and lived longer than non-diabetics. And that fit with some of our biases that sugar, that sugar in the bloodstream is bad. So people thought, and Nier Bezerral is one of the proponents of this, that maybe we should all be taking metformin, 500 milligrams in the morning, 1,000 in the evening. Um, it does have some stomach side effects, meaning you get some gastric upset, you can get constipation or diarrhea, you can get nausea with it. But assuming you don't get that and you're not on other things that lower your blood glucose, it won't lower your glucose so much as to cause low blood sugar in the vast majority of cases, and maybe has this longevity effect. Well, a repeat study in 2018 in the Netherlands, looking at the same type of data epidemiologically, found no benefit and no extension of lifespan from metformin compared to other anti-diabetics, and no benefit compared to people without diabetes who live longer than diabetics. So, one, there's some controversy there. The second thing is that metformin, the longer you give it, the less it helps in reversing type 2 diabetes. So if we're going to develop insulin resistance as we get older, which is what often happens, um, then you want metformin available. And if you've been using it for 20 years before that, it doesn't reverse it as well. And third is it seems to not have or to knock out the effect of exercise uh as a benefit for um decreasing your rate of aging, decreasing aging biomarkers, um, and increasing um a lot of other parameters, so and variables. So the point is we don't know if metformin has any benefit or in fact is harmful as you get older. Um and so I the Scientific Advisory Board of the Longevity Playbook says that if you're exercising, if you exercise with any regularity, probably not to take metformin. And if you don't have type 2 diabetes, but have it as a risk in your family, um, to not take it till you get prediabetes. And um, in general, it may not have a longevity benefit, but definitely if you exercise regularly or if you have a risk in your family, not to do it until it shows up in you. Okay. I'm giving you a lot of scientific nerdism, and I apologize.
SPEAKER_01Not at all. That's why we're here.
SPEAKER_02It I I'm just curious, you said if someone were to take metformin, it's 500 milligrams in the morning and a thousand in the evening. Why that and not a thousand in the morning and five hundred in the evening?
SPEAKER_00You know, I don't know the full data on that, but it probably relates to the nausea and the stomach effects, and that if you sleep, you don't have that effect with a thousand. So it does. So we normally start people with 500 for seven to thirty days, and then if they're fine, you go to a thousand, you go to a thousand, five hundred in the morning, five hundred in the evening. And if that's fine, then you go 500 in the morning, a thousand in the evening. So that's the normal way that most that that a lot of us started, for example, for PCOF or polycystic ovary syndrome or for type 2 diabetes.
SPEAKER_02Curcumin and the liver. So I know curcumin is when mixed with black pepper, seems to have a very positive effect.
SPEAKER_00But I so what you've mentioned is that black pepper is needed for the curcumin to be absorbed into the body. Um, so you've taken you said a very important thing very casually, Dave, and and a lot of the problem in the early studies on uh curcumin being a benefit or not, um, were that we never got absorption until people learned that you needed to put it with pipyrine.
SPEAKER_02And and are you seeing any negative effects on liver function from curcumin?
SPEAKER_00Yeah, you see, in in I believe, and I have no good data on this, but remember it's a supplement. And I believe that some of the adverse effects reported from it on the liver are due to contamination in the way it's prepared. Um we've used uh, you know, the the the data are best with a supplement that I have no stock in, no vested interest in. It's sold, I think at Walmart called Theracumin, was developed in Japan. It's a little more expensive, but it's much pure, and we don't see you you do see um some adverse effects, headaches, problems, sleeping in some people who take it. But usually uh we we haven't seen uh a significant increase in liver dysfunction with it. So it my own belief on uh curcumin is that it is the the contaminants with it, not the actual curcumin. Um now I tried to cook with it. I don't know if if you know um curcumin turns everything yellow. My wife hates that, by the way. And then it goes to brown, and it's a atrocious color brown. Um and so you gotta I so I was I tried to to get what is the right amount of curcumin I can put in. The reason being is curcumin um has a lot of epidemiologic evidence and some randomized animal data and a little human data, then it decreases risk of dementia. People who eat a lot of curcumin Indians have one-third the risk of dementia as the United States at the same every other phenom other characteristic. So um that was the start of this study on curcumin. And uh I so I tried this. It is it is very tough to get the right amount of curcumin to get the maximum the appropriate dose of curcumin by uh cooking with it in American foods.
SPEAKER_02Let's um something that's that's personally baffled me a little bit.
SPEAKER_00Basketing a whole bunch of controversial areas. That's why you're here, Mike, right?
SPEAKER_02The endothelial layer and nitric oxide and how this function seems to decrease with age. Sort of run us through what I'm talking about.
SPEAKER_00Yeah, so you have a thin inner layer of cells lining your blood vessels called the endothelium. Endothelium, and then there's the muscular layer. There are three layers in most arteries and two layers in your arterioles, but there's the endothelium. And the endothelium secretes something called nitric oxide in two different fashions, and I'll come back to that in a second. And that dilates your arteries and allows increased blood flow. So, for example, when I squeeze my hand like this, my endothelium starts to release nitric oxide to the blood vessels that go to my hand, and that dilates and gives more oxygen to those muscles so they can keep contracting, as opposed to it doesn't get to my leg artery, so I don't dilate the blood vessels there because I'm not exercising my leg at the same time. You give it to the area you need it. Um we learned about this with uh, if you will, um the heart, and we gave nitroglycerin to dilate heart blood vessels when you were having a heart attack. That's one of the treatments to dilate the blood vessels of the heart. Um, but it dilates everything. So Viagra and Cialis, etc., uh Levitra, are maintain block the metabolism of nitric oxide so it stays in the circulation longer, so erections last longer. The blood flow into the penis lasts longer in those cases, or into the pulmonary circulation, or wherever it's being used for effectiveness. As we get older, we have two, I said, mech, two things. One is constituentive, and the other is inducible. So as we get older, we lose the constituent of the amount of nitric oxide that's always there. We still can induce nitric oxide. So foreplay for erections takes longer as you get older because you've lost your constituent of nitric oxide, and it you have to induce it, um, if you will. Uh, I don't know if that's an example I can use, but medicine's in no embarrassment zone. So um we lose that that constituent of somehow we don't cause um our bodies to use it. And so we lose that capability. So if you will, there's a there's, you know, if they use it or lose it, that's what happens. You lose the constituentiative if you're not dilating that blood vessel often enough. So the more times you have sex as a guy or woman and have an orgasm, the more you will have that constituent of as well as the inducible nitric oxide. Well, that goes for your muscles, your brain, your heart, the whole thing. Um, so we lose that over time. It's why warm-up takes longer in uh tennis players or or golfers or whatever, as they get older, because they have to get the inducible form up to normal speed before that muscle functions normally. So that's the thought on what's happening. And yes, uh leafy green vegetables are a great way of increasing that as long as you don't use alcohol mouthwash. So in do you eat the leafy green vegetables, you get the nitric oxide out, it circulates through your salivary gland, and you absorb it. It's also why you want to breathe through your nose. Because the nose has a lot of nitric oxide secreting cells in it, and breathing through your nose gets those to dilate the arteries in your lungs, and you oxygenate better.
SPEAKER_02Okay. Um is this also why as people get older their their hands get cold?
SPEAKER_00Um I don't know the uh reason for that. Um, you know, it may be a sympathetic, parasympathetic balance as we get older. I don't know the answer to that question. I'm sorry. Okay.
SPEAKER_02Um T M-A-O. Something whenever I talk to people about this, this is one of the most like divisive things.
SPEAKER_00Um shouldn't be divisive. It's pretty clear. Thirteen studies over um four continents that it's been studied in. It did start here at the Cleveland Clinic. Trimethylamine is an inflammatory molecule produced by um the certain of the bacteria inside you when you expose it to carnitine and um saturated fat at the same time. Carnitine pills don't do it, saturated fat alone doesn't do it, the two together do it. The bacteria, by the way, do it to old chicken, old meat, old uh fish. So the fish-like smell that is fishy is actually uh trimethylamine. Um so if you eat fish that isn't fresh frozen or that isn't fresh, you will have a TMAO level. Now, it isn't there's a bacteria producing it, they produced it in the fish by eating the fish. So you can't get a you can if you eat a level, um, if you eat old fish or you eat fish uh that that looks like it's fine but has been uh um gotten to by bacteria, you will have a you often will have a a TMAO level transiently elevated while you digest that. But it's not the same as your bacteria producing it. When you eat six ounces of red meat, um that carnitine chain and uh saturated fat for 80 some percent of us changes the bacteria to produce TMA for two weeks. You then convert that TMA to TMAO in your liver. Now, how do I know that smell? Because we tried, we gave a TMAO blocker that blocked the conversion of TMA to TMAO, thinking, well, you can block the oxidated form, which is the form that's inflammatory. TMAO isn't inflammatory, TMAO is. You block that in your human in humans by blocking their conversion. Well, those graduate students smelled like rotten fish for a week. Um, we hadn't counted on that. We stopped it after about uh, I think they stopped the study after about four students, uh, graduate students, because it's pretty no one would go around them. They literally smelled like rotten fish because they were meat eaters. Um that's who we did it in, obviously, uh try and block the conversion.
SPEAKER_01But Mike, is this um you said in 80% of the people, is this variable on our gut bacteria? Is that on our biome?
SPEAKER_00Yes. Okay. And we think, we think that's the cause. We and it's the you're literally when you eat, you turn on different genes in your bacteria, just like when you exercise, you turn on different genes in your muscles. So what you feed your gut bacteria is is then the gut produce the bacteria produce waste, and that's what you really absorb. Um, I hate to say it that way, but you're absorbing the gut bacteria's waste. In any case, um the point is that about 80% of 82%, or depends on um different studies, but it's over 80% of people will produce TMA when they get exposed to uh carnitine and saturated fat together. And that strongly correlates with inflammatory processes such as heart disease, stroke, memory loss, and even cancer. Um so strong very correlation and um in 13 different study centers, as it's been. It's not only Cleveland Clinic and at Cedars of Sinai, it's at three places in England, and a couple in uh the Netherlands, and one in um Israel, and another one in uh China, et cetera. So it's in Australia, et cetera. So it's been done on uh this is not unique to America or Americans. All right, we're in the bonus round here. So you you you measure TMAO after you haven't eaten fish for a day, uh-huh, and that's whether you're producing it. And if you want to challenge yourself, you have six ounces of steak two days beforehand and see if you're producing it. And if it's low, then then you're fine.
SPEAKER_02Then you don't have that bacteria and then you're fine.
unknownYeah.
SPEAKER_02Fascinating. Okay.
SPEAKER_00So then you can be a red meat eater without a problem.
SPEAKER_02I'm gonna touch on lipids, cardiovascular disease, number one cause of death worldwide, I believe.
SPEAKER_00What are your Yeah, by the way, in white men over 65, um, do you know what the cause of the leading cause of death last year was in the United States? COVID? Hip fracture. Oh, yeah. Oh, I tell people that and they think I'm crazy. Well, it wasn't hip fracture, it was falls, which included hip fracture and brain. Right. So you need to practice balance and take a learned-to-fall class. So I uh and you go in a, I don't know if you were a a uh truant in school, but I was, and uh, so I had to stand in the corner facing into the corner, face into the corner on one leg, and so you fall into the corner and practicing it. Don't do it on, don't do anything I say without checking with your physician first or practitioner first. Um, but that's how to practice balance and to improve your balance, just three weeks of that and remarkable improvement and take the learned default class. But cardiovascular disease, you correct worldwide in all genders and all ethnicities, et cetera. When you combine everyone, it's the leading cause of uh death. That's correct.
SPEAKER_02So what what are you looking at in terms of uh you know it used to be LDL, I think a lot of people now look at APO B. Maybe maybe you're looking at something else?
SPEAKER_00No, we look at um we look at both LDL and Apple B and hope that the Apple B is less than the LDL, which implies that the mole that the cholesterol is in big molecules and doesn't get into the wall easily. We shoot for levels under 70. It's hard to have a heart attack under over 70. If they've got an increased LPA, that's a lipoprotein A, both the genetic and the protein are both called the same thing. If they have an increased LPA, then we worry about valve disease. And we shoot for an uh LDL or Apple B under 40. And that's uh those are the basic mechanisms. We used to say 130 because that was pretty damn good. Um then we went to 100, and now we're under 70 for the general population and under 40 for those with increased LPA. We never used to worry about LPA. LPA increases, it puts the it somehow avidly gets the cholesterol to attach to the aortic valve and causes aortic valve disease as well as increased uh atherosclerosis, or disease of the blood vessels that is associated with plaque buildup. Um and so we measure LPA, you only have to measure it once in a lifetime. But there are three drugs in phase three trial that now will antagonize LPA, and so we may um shortly have uh a treatment for that specific to that, as well as uh lowering cholesterol. Um when do we start to measure it? If you've got an increased LPA, we will measure it in six-year-olds and see if the six-year-old, if the family member has it, and start treating them for that so they don't develop uh a valve disease. Um and so if you got teen if you've got an increased LPA, your teenagers should certainly have it if they haven't already been tested for it, and and start treating that early. Now, right now we have statins, but we're going to have um statins and we have bempadoic acid, and we have um other things and and uh Zetia and uh and and other things to treat it, and we're going to have um we think two more very good low-cost options um in addition to the the PCSK9 inhibitors are high priced now, um, very effective, but we will we think have um much less expensive versions of uh that that lower LDL and Apple B uh within the near future. I mentioned CTAP inhibitors, that's one of the the choices that we think is coming along.
SPEAKER_02Wonderful. I I just want to say the balance thing. So when we last met, you were you were talking to me about balanced stuff, and I can now brush my teeth single leg. I do everything I can on one leg. And I'm I'm up to now, I can do single leg eyes closed, which is really hard. I'm up to 20 seconds on that.
SPEAKER_00So that's the equivalent to your under 40 on your brain functioning. So somehow balance correlates with um brain functioning long term. It isn't 100%, it isn't a perfect correlation. But somehow balance takes into account it's it stresses your brain, which makes it repair its neurons. It may be that it increases the that you may turn on that repair gene NPAS4. Um, I don't know, the the genes that produce the NPAS4 uh proteins. I don't know what's going on, but um it does correlate with that.
SPEAKER_02Good to know. I have a healthier brain, I guess.
SPEAKER_00Yes, definitely. And so that's right. And I hope you've taken a learn to fall class. The key is um is practicing tucking your your head so whether you fall backwards, sideways, or frontwards, you don't have a head injury.
SPEAKER_02That's right. I I I studied judo for a while, and um which which is very good at that. You don't have to do it for life if you do it for six months or a year, and what they do is you have to stand there with your eyes closed, and then the sensei will push you, but you don't know where it's coming from. And then you have to you you either roll backwards, you roll forwards, even on your side, and you you just it just gets wired into your brain.
SPEAKER_00How to tuck and and and you do it practicing on mats. So yes, absolutely.
SPEAKER_02Yeah, yeah. Oh, it's very safe, and they start you kneeling and you sort of work up to that level. Yeah. Right. Mike, pleasure to have you on. Is there anything you want to lead people with today?
SPEAKER_00Um, well, you know, this is a uh self-serving statement, but uh the longevityplaybook.com app is like having me in your pocket, so it's having all the questions, and you can ask us questions. We answer questions with videos on the app uh every week, so you can ask us questions as well as uh um getting me and getting that advice just like we gave you now on all the subjects. Um, you know, you you you covered a bunch of controversial ones, which makes it fun, but it is on all the subjects. Uh, what what were the 16 supplements you should talk to your practitioner about and which ones don't bother with? Uh what what were the four exercises that you do for longevity and not? So everything's there at longevityplaybook.com. So that's the other thing. And uh of course, I think our book, um, The Great Age Reboot, um, which is really written in in lay language, so people have fun reading it, um, is uh is also uh available.
SPEAKER_02I I consult that book every week for something or other, Mike.
SPEAKER_00It's a it's a tremendous resource, yeah. Thanks. It does have good reference lists too, if for the scientific nerds, I'm sorry.
SPEAKER_02Between innings, reading scientific papers, you know.
SPEAKER_00Oh gosh. That that you know, actually one of the things was speeding up the pitching. I haven't I'm not able to read between pitches anymore. Used to be you could read between pitches. Now I'm getting a lot less reading done at the Guardian at the baseball games than I used to.
SPEAKER_01I'm sorry for you, Mike. That's too bad. Um, Mike, thank you so much. Always a pleasure, tremendous source of information.
SPEAKER_02Everybody, check out his app, Longevity Playbook. I have it on my phone. I think it's a tremendous resource. Thank you very much. Take care, Mike. That was Dr. Mike Roisen. Don't you love Mike? I really admire his appetite for science without loss of judgment. He's willing to consider these enormous possibilities, including the idea that aging may eventually become far more modifiable than it is today. But he's equally willing to say, yeah, you know, we don't know yet. Better to be cautious. That may be the most valuable phrase in longevity medicine. Now, a few things this chat reminded me of. First, I'm going to continue treating function as an asset. So that's strength, balance, cardiovascular fitness, mobility. These are not side projects. They determine what we were able to do, how independent we remain, and how much opportunity we have to participate in our own lives. Mike and I spoke about balance in particular. And I must say, I've got this habit of practicing balance while I brush my teeth. You know, why not? And you know, I've gotten a lot better on it over the years. But I think these small practices, they're very useful, providing they're done safely. You know, be sensible. Keep it simple, keep it measurable, keep it easy to repeat. If we take one thing from this call, let's remember before adding a new treatment or habit to our regime, we have to ask ourselves what is the evidence? What is the downside? What is appropriate for me? Could it interfere with something that is already working, including exercise? And have I discussed it with somebody qualified to understand my individual health? And that last sentence, I just want to, I'm gonna repeat this. There's a lot of stuff out there, the internet, social networks, all this sort of stuff. Please talk to a qualified professional before you start doing anything. So preparing for the future, this is an active process. We may see extraordinary medical advances, and I hope we do. I actually think we will. But waiting is really not a good longevity strategy. A much better plan is to arrive at that future with as much capability as possible. Keep that muscle, train your heart, protect your brain, practice balance, maintain the relationships that give us all this a reason to keep going, right? It's the people around us. That's it for this week. Stay strong, stay vibrant. We'll see you next time.