Open-Minded Healing
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Open-Minded Healing
Dr. William Bruno - The Top Tests Your Doctor May Not Offer That Could Save Your Life, And Other Health Hacks For Longevity
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What if the secret to living longer isn't found in cutting-edge technology, but in the decisions you make every day? Dr. William Bruno's journey from conventional plastic surgeon to longevity advocate began with a shocking discovery: despite passing standard cardiac tests, he had established heart disease at age 49. This revelation transformed not just his personal health approach but his entire medical practice.
Dr. Bruno pulls back the curtain on the medical tests that could save your life—but that most doctors won't offer - along with other proactive measures that form his "longevity pyramid," a framework that prioritizes foundational habits over trendy interventions.
The conversation reveals three powerful longevity metrics that predict lifespan better than chronological age: Moving from poor to even average scores in these metrics can dramatically reduce mortality risk—by as much as 40-50% in some cases. Most importantly, these are factors we can improve at any age through consistent habits.
Beyond the science, Dr. Bruno offers immediately actionable advice. His message is ultimately empowering: approximately 80-90% of longevity factors are within our control. The path to a longer, healthier life isn't found in a pill or procedure—it's built through the small decisions we make every day.
You can find Dr. William Bruno at:
Wellness Program - https://www.williambrunomd.com/procedures/wellness-program/
Website -https://www.williambrunomd.com/
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Welcome back to Open-Minded Healing. My guest today, dr William Bruno, is a board-certified plastic surgeon based in Beverly Hills, california, where he has practiced aesthetic surgery since 2004 and performed over 6,000 procedures, specializing in breast and body contouring. But his own personal health crisis, which we're going to get into, has evolved his practice and his mission to now help people not only transform their outer physical appearance, but also prevent a health crisis and improve their longevity. Dr Bruno will be sharing the top tests your doctor might not offer that could actually save your life, and what three longevity metrics are better than your age, as well as how to outsmart the most preventable causes of death and many other cutting edge insights. Welcome, dr Bruno.
Dr. William Bruno:Thanks for having me, marla, I appreciate it.
Marla Miller:Well, there's a lot of I would call it exciting information. To get to that you have to share with people, because who doesn't want to not only live longer but live healthier? But before we dive into this wealth of knowledge you have to share and simple longevity hacks that you know, as well as other things we're going to discuss, can we first start with your own personal story? You started off you're a plastic surgeon. Your own personal story. You started off you're a plastic surgeon. When did something shift for you in how you viewed health and wellness, with your own personal crisis?
Dr. William Bruno:Yeah, it started for me about eight years ago.
Dr. William Bruno:On a sort of a routine blood test, I noticed I had relatively high cholesterol, LDL cholesterol in particular, which led me to a series of tests like an echo and a stress test, and then at that point the doctor felt I was okay and then I requested another test because I was aware of it.
Dr. William Bruno:It's called a coronary artery calcium scan, which is basically a CAT scan of your heart looking for calcifications, and that test is supposed to give a score of zero is normal, but my score was very high it was like over 400, indicating I had established heart disease, hard plaques in the heart, which led to another test called the CT angiogram, and that just led me down a pathway of changing my diet, changing lifestyle, and I more or less adopted a plant based diet I don't want to say strict vegan, but almost a vegan diet at that time and then just really dove into wellness, longevity and what I could do from a lifestyle standpoint to control that heart disease and stabilize it and hopefully prevent it from progressing, Because at the time I was 49 and I was worried, as a lot of people are, about what can I do to prevent a heart attack.
Dr. William Bruno:What can I do to prevent sudden death? So it just really led me into prevention, wellness and longevity Because up to that point I was on a typical standard American diet, eating processed foods, not really taking special interest in what I was eating. As a physician I grew up going to med school and residency eating hospital, cafeteria food vending machines.
Dr. William Bruno:It wasn't really a super healthy lifestyle up to that point. But I knew that there was opportunity to make changes and then I had that study done and then most recently had another year and a half and that it's stable. So I have to attribute the lifestyle to that. There's no worsening of the heart disease, but once you identify that you have, or you detect the disease or you're at risk for disease, it really motivates you and unfortunately, that's what it takes sometimes. So I wish we didn't have to be as motivated as that.
Dr. William Bruno:But that was my personal story. Then I started sharing a lot of these strategies and tips with my patients. I started posting more wellness content on my Instagram. I'm a plastic surgeon in my day-to-day life, but I still couldn't help but share this information with my patients about nutrition or exercise or sleep or supplements and things like that. But yeah, that's how I got to where I am now and it just led me down this pathway of really taking a deep dive in longevity, starting to go to conferences and starting to engage more in that world, which has nothing really to do with plastic surgery. But you know, it's one thing to look better, but I think also most people want to feel better and live longer too.
Marla Miller:Yeah, definitely work on the inner health and then top it off with a little touch up on the outside. Yeah, well, what other tests are valuable? The ones that doctors may not tell you about, that you think are valuable to people?
Dr. William Bruno:the ones that doctors may not tell you about that you think are valuable to people. Yeah, I think certainly. The coronary artery calcium scan also goes by the name of the calcium score, or CT scan of the heart looking for calcifications, and you know it's not covered by insurance but it's relatively inexpensive. It might be a $200 test and my cardiologist didn't even offer it to me. I had to ask for it, Knowing what I now know about that test. You know, it seems that most people over the age of 40, men and women, should have that as a baseline to see, because it doesn't tell you if you're at risk. It actually tells you if you have disease and if you have disease then you can act on that, whether that's lowering lipids, stopping smoking, lifestyle changes, so that's lowering lipid, stopping smoking, lifestyle changes. So that's one test I think most people over 40 should consider. And then the more advanced version of that that I got, it's called a ct angiogram, where they actually inject dye into you and then do the same cat scan and that looks into the blood vessels and it can actually tell you if you have soft plaques which are unstable plaques in, if you have soft plaques which are unstable plaques in addition to the hard plaques, which are the calcified, more stable plaques. And now they have a technology that uses AI. It's called a clearly scan, so it's a CT angiogram and then they superimpose AI over it and they can get a really accurate look inside the blood vessel walls to see how much disease you have, like what percent blockage you might have, you know, 20%, 50%, etc. And now that test is not covered by insurance and it's a bit more expensive, so it's maybe $1,500 or $2,000. But I think most people should start with a calcium score and then go from there based on their risk and based on lifestyle.
Dr. William Bruno:As far as other blood tests, I think most people get just a simple cholesterol panel, like a lipid panel, but that doesn't really give you much information. It might tell you your total cholesterol and your LDL so-called bad cholesterol HDL so-called good cholesterol. But there are other panels that you could ask for that aren't that expensive. Or you could actually get the particle number, like what is the count of the LDL particles in your bloodstream and what are the size of those particles. That's more meaningful information. And again, most doctors, unless you're going to a cardiologist and you have a specific reason, they're not going to recommend those to you and I think those are highly valuable at really determining what level of risk you're at and then take the appropriate treatment, Because most cardiologists now at least, they will tell you if they find out you have high cholesterol, high LDL, to try to bring it down as low as you can. And if pharmaceuticals are needed, then so be it. But it really depends on finding out where your risk is at and I think the CAT scan of the heart, which is the calcium score, is the most important.
Dr. William Bruno:As far as other blood tests, I think a fasting insulin level is really important. I think most doctors don't order that. In a regular panel you might get, like your glucose, which is just your blood sugar, but fasting insulin tells you a lot more and it can detect if you have type 2 diabetes and insulin resistance, sometimes years, if not decades. Before presenting those are just a few that come to mind there. I mean there are a few others, but I would say most people suffer from, say, metabolic disease or cardiometabolic disease, when I'm sort of grouping together their heart disease and type two diabetes together, because those are some of the biggest diseases by number in this country and heart disease is the number one killer in this country, men and women, and in the world. So I think a lot of people need to focus on that, and I think the CAT scan on the heart calcium score is an easy screening tool. There's no dye you go in, it takes 10 minutes and then you'll know do you have disease or do you not have disease.
Marla Miller:That does sound like a very good place to start, especially, like you said, when this disease is so prevalent and really a killer. So this isn't something to be afraid of. It's giving you information that you can take action on and actually reverse things or prevent them from going further. Absolutely, yeah. And also you're saying they are a type of CAT scan. What do you say to people about the radiation, the?
Dr. William Bruno:exposure for the coronary calcium scan is quite low. For the CT angiogram where they inject the dye into you, it's a little bit longer study so there is a little bit more exposure but I think the risk-benefit is in favor of doing the study. If you think you're at higher risk or if you have a family history of heart disease, I think having a glimpse into the blood vessels and seeing that is probably worth that. Low radiation. Most people get exposed to radiation going on an airplane, for example, or going through a metal detector at the airport. I can't say where it compares, but it's relatively low and I think it's worth doing it at least once to have a baseline of where you're at. Then some people might repeat it, like in my case. I did both tests about seven years later just to track it and you could see are you slowing the progression and in some cases it can be regression if you have really great lifestyle and you're keeping your cholesterol levels very low.
Marla Miller:That is such powerful information to have. I'm already thinking of a bunch of people I know with those type of issues, and you also country where it's now affecting even children.
Dr. William Bruno:You know, childhood obesity at really high levels, along with adult obesity. A lot of it is contributed to type 2 diabetes, which is really a lifestyle disease. You know, in most cases from eating highly processed foods, highly processed carbohydrates in particular. And the drugs now that people are using, let's say, the Ozempics and the Lugovis and Munjaros, of course, were originally intended for type 2 diabetes. Now a lot of people use them, of course, for weight loss. But you can reverse type 2 diabetes in most cases with lifestyle changes and that's usually adopting a lower carbohydrate diet and eating more whole foods. It doesn't mean you have to become ketogenic, but you know, some people might go through a period where they're on a much lower carbohydrate diet than they're used to. Maybe they incorporate time-restricted eating, intermittent fasting, to really get their metabolism under control. Because most people I think the statistic is like 93% of Americans are metabolically unhealthy, which means they have high blood pressure, they have high blood sugar, they have high insulin, which most people don't test, but that's again, that's a blood test to look at. Or they have a high hemoglobin A1c, which is a sort of a three-month snapshot of where your blood sugar is at. And again, that's preventable.
Dr. William Bruno:Diabetes is probably fifth or sixth top killer in the United States. Heart disease is one cancer, two accidental injuries, then respiratory diseases. But diabetes is really important because that leads to dementia, which is maybe the sixth or seventh top cause of death. You know there's a lot of interrelation of all these diseases and if you can adopt a lifestyle that treats heart disease well, it's also going to help treat type 2 diabetes, it's also going to help reduce your risk of cancer and it's also going to help reduce your risk of dementia. So yeah, I mentioned diabetes, and I just because it's so common and it gets detected later in life. But it's preventable, and most heart disease is preventable too. I wish I could say the same for cancer. Some cancers are preventable. For example, smoking, alcohol and obesity probably contribute 80% to most cancers, but there is definitely still a genetic component to some cancer. I think that's the hardest one to prevent with lifestyle alone, but with early detection, even there there's lots of things that people can do to be a little more proactive.
Marla Miller:In order to help other people, educating them on longevity. You talk about the diet right, the health, and not eating the processed foods and things like that.
Dr. William Bruno:What do you tell them regarding exercise? Yeah, with regard to exercise, I think most people in this country they're either not doing it at all or they're not doing a sufficient amount. And I think, starting with the basics like walking, think of what's your step count or get a sense for that. You know most people have wearables or their iPhones that can track that. Most people are sedentary, which is defined by, let's say, a step count less than about four or 5,000 a day, and I think the optimal range at least the latest study came out it's about 7,000. If you can be 7,000 to 7,500 steps a day, that's something good to strive for.
Dr. William Bruno:But beyond steps, I think probably one of the most important is resistance training, weight training of all ages men, women, young, old and it's never too late to start with weight training. I think some people think it's a young person's game, they think it's for bodybuilders, and so on. That's not true. I think everyone should be lifting weights at least twice a week. The more muscle you have on your body, the longer you will live. The more muscle you have on your body, the more your metabolism functions, better you can handle higher blood sugars and your insulin actually works better. You become more insulin sensitive, as they say.
Marla Miller:I agree, my mom's 91 and she's been going to the gym now for that resistance training, I think two or three times a week. So you're right, you can get out there at 91 and still do it.
Dr. William Bruno:Absolutely, because the more muscle you have on your body you try to ward off frailty. Because someone say in their 90s, should they fall, should they have a hip fracture for example, the likelihood of surviving it becomes very low at that age. But if you have more muscle mass on, you have more reserve and if you have more muscle mass you're stronger. You can maybe prevent that fall. You can grab on or hold on to something. It's never too late to start and they've done studies where they've started weight training patients in their 70s and 80s and they can gain meaningful amounts of muscle at that age. It's not just you have to do in your 20s or 30s, where you have high levels of circulating hormones. You can do it later in life and that's great to hear that your mom's actively doing that.
Marla Miller:Yeah, yeah, because she has heard that the resistance training it's good for the muscle building right and the brain and all kinds of things apparently.
Dr. William Bruno:Yeah, and along with the weight training, I would add definitely the cardio, and I talked about walking. A lot of people talk about zone two cardio, which is doing about 150 minutes a week of zone two is the kind of walking or treadmill where you're briskly walking, where it's hard to maintain a conversation. By definition, it should be about 60 to 70% of your maximal heart rate. So if you can do that 30 minutes a day, four or five days a week, that's a good base for your cardio. But don't neglect the strength training. I think the strength training I don't want to say one's more important than the other you should be doing everything and then maybe sprinkle in some high intensity training, maybe one day a week where you're doing like 30 seconds or a minute as fast as you can on a treadmill or a bike and then resting for a minute or two and then repeating that, let's say, five or six times.
Dr. William Bruno:But there's definitely needs to be a balance of cardio and weight training. And I would add if someone's interested in losing weight, don't rely on the cardio to lose weight. Rely on your diet to lose weight, to lose fat, and then do the resistance training and the cardio. For all these other benefits. The cardio benefits your brain, your heart, your lungs. But if you are interested in losing weight, I would actually focus more on weight training to lose fat and build muscle more than I would cardio. But you should do all you want to do some balance and flexibility in there too. But if I had to think of it in broad categories, I would think resistance training, cardio, and then two categories under cardio are sort of the steady state and then the high intensity. But focus on steady state there.
Marla Miller:It reminds me of when I was on crutches. I felt like that was a great routine because it took a lot of weight bearing to get around on crutches. I wasn't doing the typical gym exercise or cardio, it was more the strength and the diet. I had gone on a very strict diet so I was dropping weight, almost more so than I wanted at that time, but in building the muscle in my arms anyway, yeah, you probably built your upper body and, you know, maybe your lower body didn't do so well during that time period.
Dr. William Bruno:But, as you mentioned, the diet is everything. If you want to lose weight, you can do that with diet alone. You do not need cardio to lose fat. You can lift weights, eat an optimal amount of protein and you can improve your body composition. Cardio is good, though, because it's good for your brain, it's good for your mood, it's good for your lungs and just you know overall wellness, but if you're actually looking to change the composition of your body, that's where the weight training becomes really critical.
Marla Miller:Yeah. What are some simple longevity hacks people could do or incorporate as habits each day that aren't requiring hours of time or anything? What are some simple things With regard to exercise? Or no like longevity.
Dr. William Bruno:I created a course around this like a digital course, and I taught it through this framework of a longevity pyramid. So I can briefly get into that. Where you know, visualize a pyramid and at the base of it you have nutrition, exercise and sleep. That's the foundation and I think it's important to start there because most people they're not focusing on those or they're not doing it right or they're not, let's say, optimizing those areas. And I think a lot of people are jumping way up to things like I want to do red light therapy or a cold plunge or a hot sauna or a peptide or a stem cell treatment or NAD infusions, and there's value in those things. But if your foundation isn't optimized, you're not going to get much out of all those other interventions that I mentioned. So, when it comes to, let's say, the nutrition component, eat primarily whole foods, try to eat like single ingredient foods.
Dr. William Bruno:I don't want to say one diet over another. You know people get very passionate about that. I would just say sort of a Mediterranean style diet is probably the most accepted and one of the healthiest diets that's been studied in the world. And then think about how much fiber are you getting, because most people are really missing that. The requirements are about 25 grams for women and 35 for men per day and only about 2% of Americans are hitting that and that's the minimum for fiber. And I would also try to optimize protein.
Dr. William Bruno:Most people are under eating protein. You should shoot for maybe about a gram or just slightly less than a gram per pound of body weight. That's ideal body weight. So someone weighs 150 pounds but they want to be 130. They shoot 130 grams of protein per day. Eat minimally processed foods or whole foods and avoid the ultra processed foods Basically foods that come in a box or a package, that have a label and try to optimize fiber and protein and there's apps out there that you can use to track those and I think it's a good habit to get into once in a while to try to track things. Even if you do it for a week or two, it'll give you a sense for not just the calories you're eating, but specifically how much fiber, how much protein are you getting.
Marla Miller:I'm curious do you know of a couple names of some of the apps that do that?
Dr. William Bruno:Yeah, I would do MyFitnessPal. And then there's another one called Cronometer and they're free apps. I think with Cronometer they have an upgraded version that has more features to it, but it's free to start with and basically you can scan or type in the foods that you're eating and it'll give you all the nutritional information on it Fats, carbs, you know all the macronutrients, even micronutrients and fiber, so those are helpful to use until you get a sense. You can just look at a food and kind of estimate like, oh, chicken breast has 30 grams of protein. You can start to get a feel for that.
Marla Miller:I have a question about the protein, because you know people get it from meat. It can be very filling like for them to get 130 grams or whatever it might be. People sometimes struggle with that. What are your top recommendations for getting a bunch of protein if people aren't doing meat or they don't want to eat that much? Do you have some other ideas for people? Yeah, when.
Dr. William Bruno:I was vegan, I think it's harder to get it. I mean, you can get it through, let's say, tempeh, tofu, beans, lentils very high sources of protein and fiber, by the way but along with that, you have to eat a lot more than like, say, eating a steak, so a lot more calories come with it. You might have to supplement with some plant-based protein powders or, if you're not vegan, you could use whey protein. I think that's a great way to get outside of eating, let's say, meat. If you are able to eat yogurt. I find Greek yogurt, cottage cheese these are great ways to get lots of protein. One serving of Greek yogurt, which is three quarters of a cup or a cup, it's almost 20 grams of protein. One serving of greek yogurt, which is three quarters of a cup or a cup, it's almost 20 grams of protein. So you could add protein powder to your greek yogurt and now you have about 40 grams.
Dr. William Bruno:And with regard to protein, it is important that first meal of the day, whether it's for you breakfast or for you lunch, whenever it is, it should have about 30 to 40 grams of protein in order to trigger muscle protein synthesis, because you know, overnight you're fasting, you're sleeping and then your body starts slowly breaking down muscle.
Dr. William Bruno:So it's important to get that dose of about 30 to 40 grams. So in the example of the 130 gram person or 130 pound person, if they get 30 or 40 at breakfast, maybe another 30 or 40 at lunch, and then let's say 40 or 50 at dinner, that's it, they've hit their goals in their three meals. You could throw in a snack here or there, you know, as needed. Maybe it's a protein bar, maybe it's a powder. I wouldn't rely so much on those, but they're good to fill in the gaps. You should try to get most of what you can from whole foods. But back to your question. Yeah, vegans, it's harder to do. They have to be more careful with it because the protein is more bioavailable when it comes from meat, fish, eggs than when it comes from plants.
Marla Miller:Okay, that's good to know. So back to that pyramid.
Dr. William Bruno:You're saying the foundation, so you talked about the nutrition total body chest, back, shoulders, arms, let's say on Monday, then you could repeat that on Thursday and then do some days of cardio in between, all along minding your step count, like in the background of your life. Your daily movement should be around 7,000, let's say ideally up to 8,000 steps a day. 10,000 isn't needed, 10,000 is great if you could get it, but that number is not necessarily what is required of people Moving along there. Sleep I haven't really mentioned that yet, but that's one of the foundational pillars, I think, of health, of longevity. It gets overlooked a lot, it doesn't quite get the attention that diet and exercise get, but I find it's probably equally as important, if not more important than those two, because and you probably know this if you have a bad night's sleep, it runs into the next day, it can ruin your next day, your thought, mentally, physically, inability to focus, and I find that sleep, because it gets neglected, most people don't try to work on it or work at it to improve it. And I think if you improve your sleep, then your workouts will be better and then you'll be metabolizing better all this healthy food that you're eating. But with regard to sleep, I would strive for about seven and a half to eight hours a night. I would strive for patients.
Dr. William Bruno:Going to bed at the same time and waking up at the same time each day, even on the weekends, is probably the most important habit you could adopt. And you know the basic things like sleeping in a cold, dark room, a quiet room. Some people use sleep masks as they need to, or earplugs, use blackout shades. Having the room at about 66 to 68 degrees is optimal for us to drift off to sleep. And it's really the habits too, around screens and phones and tvs. You know, avoiding a lot of that. I take at least an hour, ideally closer to two hours, before bedtime. If you must watch tv or use your screens, you can get blue blocker glasses which filter out a lot of the blue light. It's the blue light if you're like reading a book, let's say, on a tablet. That blue light is decreasing your melatonin secretion. It's really suppressing it, so it's going to make it much harder for you to fall asleep. So I think those kinds of habits which we call sleep hygiene, are really important for people to just use the bedroom for sleeping. You don't want to be eating in your bed. You don't want to sit in there and like watch TV all day in your bed. It should be attached to sleeping. It should be your sanctuary. You might want to put some plants in there which will take in some of the CO2 and create more oxygen in the environment. So, focusing on that.
Dr. William Bruno:And then I have a lot of my patients. I start them on an Oura Ring if they're involved in one of my coaching programs, or I'll send them an Oura Ring which is a sleep tracker. You could do a Fitbit or a Whoop Band there's different brands out there but an Oura Ring is a very accurate way to track your sleep in the night deep sleep, rem sleep. You know how many times did you wake up during the night? And it gives you a sleep score. So once you start tracking something like sleep, then you have a better sense of what you can do to improve it.
Dr. William Bruno:And that goes for the diet and exercise. By the way, again, I talked about the food trackers or tracking protein. Same with working out. Not only should you track steps, maybe you should start tracking your workouts how much weight did I lift this day, how many reps, how many sets and keep a log of that because you want to try to make progress. So, yeah, back to the pyramid. That's sort of the foundation, I think.
Dr. William Bruno:Spending time on nutrition and movement and sleep that's probably 80% of it, you know, before we sort of move up this pyramid, and I think that's where people they get that wrong and they don't focus on it or they don't emphasize it and they just want to do an injection or a pill or some sort of fancy gadget that they think is going to give them longevity, where longevity really is just your daily habits and the small little decisions you make each day. I think that is longevity. It's not technology, it's not IV infusions. I think it's these basic decisions you make. Like what am I going to eat today?
Dr. William Bruno:And I didn't mention this, I touched upon it the time-restricted eating, eating with your circadian rhythm. You want to try to eat most of your meals, let's say, between I don't know 8 and like 6 pm, between sunrise and sunset. That goes with all the hormones in your body. You know your biggest meal of the day should not be dinner. It should probably be earlier in the day, maybe around noon or 1 or 2, or you know the sun is out.
Dr. William Bruno:There's a lot of science to this. That's another thing. Most people eat a small breakfast or they skip breakfast. Small lunch, big dinner. Then they go to sleep right after their big dinner and that large amount of food disrupts their sleep. So, related to the sleep hygiene, I would try to put at least three hours between your dinner or your last meal of your day, and bedtime. The more time you can do, like maybe four or five hours, from dinner to bedtime, the better your deep sleep will be, because deep sleep really is where the body heals itself. Deep sleep is where fat burning happens. Deep sleep is where muscle building happens. You know, you look at all these high performing athletes, professional athletes. They really emphasize sleep because their performance depends on it. They'll sleep eight, nine hours and they won't let anything interfere with that.
Marla Miller:Yeah, I think the sleep is important. All those things that you said in the intermittent fasting I've done that and I find that really helpful. When I have eaten more at night, and especially if you watch TV or something at night, you get into this habit of eating. That's when I've had an issue both with the sleep but also with the digestion, where you just feel like you eat too much and you have indigestion. So the intermittent fasting has been really helpful.
Marla Miller:Your body's done all that digestive work before you go to bed and then you can just get into that deep sleep much more quickly and stay asleep much longer. And then in the morning you know when you do that sort of fasting you realize you don't really need that much food. Like the first day that you do it. I mean I feel like, oh my gosh, I'm so hungry and you realize how much of that is really more emotional or habitual to think you need to eat immediately upon waking. But once you like have, even if you have lemon water or just plain water and you get busy doing something else, you realize you didn't miss eating in that window where you typically eat. So everything you've said is awesome advice about the nutrition and the sleep and the exercise. So what is above those three things on your pyramid?
Dr. William Bruno:Yeah, I think you know.
Dr. William Bruno:The next thing is diagnostic testing as a category, which we touched upon, the two cardiac tests I mentioned before. I won't repeat those, but think about what diagnostic tests should you and and other inflammatory markers that your doctor can order for you, or considering the calcium scan or the CT angiogram, beyond ruling out heart disease and screening and testing for that. The number two killer is cancer. So think about especially someone over the age of 50, I would think about potentially a full-body MRI. There's a few services throughout the country. There's one, a company called Renuvo, which I have no affiliation with, but they'll do a full-body MRI and you can detect cancer at an early stage. They'll do full imaging of the brain, the torso extremities, looking for maybe an early tumor, maybe a cyst or aneurysm, or detecting a cancer in early stage and sort of along those same lines. There's a blood test that you could get. There's a company called Gallery and it's a blood test that looks for 50 types of cancer in one blood test, because we know 70% of the cancers that people get we're not screening for. In other words, get your colonoscopies, your mammograms, pap smears and everything, but that's only touching the surface. There are so many other organs and tissues that we cannot screen for. So now that again it's not covered by insurance. It might cost around $900 for that blood test, but I think someone over 50 should at least have a discussion with their physician about that. Does it make sense? Should we do that? And again, the full body MRI at this point the price is coming down but those could be up to $2,000 or $2,500. And again, this is screening because again, if cancer is the number two cause of death, let's think about that. Let's think about what could we do to maybe detect it in an early stage. And most cancers can be quite treatable at an early stage and a lot of them are untreatable at a late stage, for example, pancreas cancer, which presents very late and is very lethal.
Dr. William Bruno:Other testing you know I mentioned the fasting insulin before, if we're thinking about metabolic disease and diabetes, hemoglobin A1c I think most people are starting to get that now. I think it's included in a lot of regular panels, so that's good to see. But again, the fasting insulin will detect prediabetes or type 2 diabetes, sometimes a decade or so earlier than even a hemoglobin A1c or fasting blood sugar. And then there's genetic testing you could get. There's so many of these at-home testing kits that can determine if you're more predisposed to have a certain disease, and those are discussions to have with your doctor primary care doctor or maybe seek out a functional medicine doctor to see, based on your medical history and your age and your gender, what am I at higher risk for?
Dr. William Bruno:I think heart disease and cancer should be looked at most closely because they are by far the top causes of death in the world. So I have that, above that foundation of nutrition, exercise and sleep is just moving up this theoretical pyramid, and above that, the importance of social connections having a purpose and relieving stress in life. And above that, I had supplements. And then the category of hormesis, which is these stressors to our body like the hot sauna, fasting, cold plunge, things like that. And at the very top of the pyramid, prescription drugs, because there is a role for prescription drugs Peptides, which aren't necessarily prescription in all cases. I think there's a role there.
Dr. William Bruno:Visually, you need to have that foundation sort of set up before you want to jump to. You know these really more exotic, interesting things like glutathione injections or NAD, or you know all these other things that you hear about in social media you hear about on the internet, but most people are skipping the basics and I just want to remind people of that and try to shed more light on that that your lifestyle is more important than your genetics. A lot of people think, well, I'm just destined to get heart disease or cancer because my mother or father or grandparents had it. It's not true. You know, about 80 to 90 percent of your longevity is in your hands and you can control it through lifestyle changes.
Dr. William Bruno:It might be 10 or 20 percent genetics, but you have a lot of control. That's why I would encourage people to be proactive, take action and start to do some of these things.
Marla Miller:Well, I do want to touch upon the stress and the community, because I think those are really underplayed and stress can trigger autoimmune as well as do a lot of things to your body that aren't healthy. And that community that really, even when they do the what is it? The blue zones like community is a big part of that and why people live so long and healthy and happy there. So do you have any tips for alleviating stress or anything regarding the importance of community?
Dr. William Bruno:Yeah, you're right, the blue zones, the community is one of the foundational components of those areas where people live to be the longest. They have these tribes of people who they eat together, they'll celebrate together, they'll help each other out together. The closest one here to us, loma Linda, california, that's one of the blue zones, in particular because of its Seventh-day Adventist religion, which they don't eat a lot of meat, so it's a pretty healthy diet, but they're a tight-knit group. They do a lot of volunteering. They have in general a very positive attitude, which counts a lot, I guess, along with mindset you could sort of put into that category. Certainly matters. People who have stronger relationships not so many the number of friends, but the quality of each relationship tend to live longer. People who are socially isolated live shorter lives, and you're seeing this more especially with teens. They're isolated, they're on their computers and their tablets. They're not necessarily out engaging so much socially. They're on social media but not being social in real life.
Dr. William Bruno:And you see more, maybe teen suicide or just more illnesses related to social isolation. So the community is very important. I think it's not like a hard science per se, but I think it has a lot of value. And they say you're the average of the five people you spend the most time with, right. So I think trying to spend that time with people who may be like-minded or they want to be healthier, they want to be fit, they want to improve their lives, they want to be productive members of society. So I think, yes, that's very important.
Dr. William Bruno:People in the blue zones, they have a purpose in life, whether it's helping others, or usually they have a higher calling or they have a faith that they believe in. So all of those things matter. And you look at the five blue zones which, if your listeners don't know, they're like Sardinia, there's one in Ikaria, greece. If your listeners don't know, they're like Sardinia, there's one in Ikaria, greece. Loma Linda, california, costa Rica, nikoya and then Okinawa, japan. So these are places where people tend to live the longest. The centenarians are people that tend to live to be over 100.
Dr. William Bruno:Now, there might be some genetic component, because most of those places, with the exception of Loma Linda, are very secluded so there could be a genetic component there.
Dr. William Bruno:They have some favorable genetics living in those places. But generally, what they all have in common they have a sense of purpose, their faith-based sense of community. They tend to have natural movement, like they don't go to gyms there per se, but they walk around naturally, they're outside a lot, they get a lot of outdoor natural sunlight, they take afternoon naps or siestas and they eat mostly whole foods. They don't eat a lot of processed foods. So those are some of the common threads that you see in all the blue zones. So you know you could try to adopt some of those in your natural life and they've done that here. They've made blue zones throughout different parts of the United States with some high degree of success and I think even a sixth blue zone was Singapore, which is an island nation which they transformed from being an otherwise unhealthy nation in the 50s or 60s to being one of the top, you know, highest longevity countries in the world or highest life expectancy in the world.
Marla Miller:Yeah, definitely something to emulate to spread that around a little bit around the world, those kind of communities. So as far as stress goes. And then I want to get to the three longevity metrics. So as far as stress, do you have any personal hacks you use or tell your patients or clients?
Dr. William Bruno:The first thing that comes to mind I think it's the hardest one to do is meditation. I think that's a skill, an acquired skill. It's hard for me. There are apps out there like Calm and different ones for people to try, and there's some great tutorials on YouTube for that. I think it's something to look into. People who meditate tend to have longer telomeres, which you know genetically. They'll tend to have longer telomeres, which you know genetically. They'll tend to live longer and actually add years to your life.
Dr. William Bruno:I think having a hobby, having something for that like some people like running or swimming or cycling so the exercise part can de-stress a lot of people. I think being out in nature is very important. There's a lot of value in just going for a walk outside to de-stress. I think deep breathing, breathing techniques is another way to combat stress. But I think a lot of people have different forms of stress, whether it's work stress, physical stress from their environment or emotional stress. So that's a broad area and if someone does need counseling I would seek out professional help if they're overcoming trauma, past trauma, to uncover that. But those are just some thoughts that come to mind on the topic of stress.
Marla Miller:Yeah, and I was thinking, even if people can't exercise depending on their state of health or whatever, I thought of other things like doing puzzles, or someone might crochet or paint All those things can really help you dial in on the thing in front of you instead of all the stressors around you. So, yeah, I guess it's different for different people, like you said, different things that stress you out. Some people may have the exact same thing happen to them, but they react very differently. So, yeah, it's very individualized. But those are great suggestions that you gave and, yeah, there's a lot of environmental stress too.
Dr. William Bruno:I was just going to say like I don't want to go into toxins and everything, but what can you do in your own home to take away some of the toxic stress, let's say, from the cleaning products you use to the personal products you use your shampoo, your toothpaste, things like that, like what detergents are you using. You could take away some of that stress. Also, the stress from the radiation, the EMFs, right, electromagnetic radiation. There's different EMF blockers that you could get for the house. I have one on my phone, putting your phone on airplane mode, for example, when you're sleeping, or just keeping your phone out of the room, because that's another stress and it's an invisible one, so a lot of people don't even think about it.
Dr. William Bruno:But that's one other thing that just came to my mind is how to try to minimize the toxins in your home, and there's a good website. The Environmental Working Group has a great website, ewgorg. You can go there and get a list of which skincare products should I use, which cleaning products, which products for the bathroom and sunscreen and things like that, and they have approved products that have the least amount of toxins. So that's another thing to consider. I know it sometimes gets overlooked. But down to like what kind of sheets are on your bed? What kind of mattress do you have? Is your water filtered? Do you have an air filter in your home? Things like that which are easy to fix, but if you don't think about them, they just get overlooked.
Marla Miller:Yeah, I'm glad you brought that up. Those type of stressors add stress to your body as well as the emotional things or work related things. So what are the three longevity metrics that may surprise people that can really tell how long you may live?
Dr. William Bruno:The number one test and it's not a blood test but it's something that you could get done at a fitness center or gym. It's a test that's called VO2 max, which really represents how efficient is your body at using oxygen, like while you're exercising. So imagine you may have seen these tests done, where they'll put a mask over your face and they'll measure your oxygen consumption, your CO2 output. Usually it's done on a treadmill or a bicycle and it's measuring how well your cells, in particular your mitochondria in your cells, can use oxygen. So, for example, someone who's an Olympic cyclist has a really high score. These are some of the most physically fit endurance athletes in the world, so they'll have a really high VO2 max, which stands for volume of maximum oxygen used. And what's interesting about this is, as we get older, our VO2 max slowly declines.
Dr. William Bruno:But what you can do now, or at any age, is if you build up your base of cardio and that's low intensity cardio plus sprinkling in that high intensity cardio that I mentioned earlier, you can increase your VO2 max score. So let's say you took an age group like between 40 and 50. And if you're in the lowest quartile there, you're at higher risk of early death, and this is proven. This is across men, women, all different countries, and it stratifies you by your age. But you can get from that bottom quartile, let's say, to middle or average. You can improve your life expectancy and decrease the risk of death by like 40 or 50% and it doesn't take a lot to do that. And I'm not suggesting you need to become a professional cyclist or anything like that. But if people worked on their cardio and you kept yourself at least in the middle to upper quartile, you have this reserve Because as you get older let's say someone's in their 80s or 90s and their VO2 max is very low they can barely walk across the room.
Dr. William Bruno:We know that people that are in that bottom quartile or the bottom quintile, they will die earlier than people who have a high VO2 max. And again, there are different proxies for this. People can do an eight or 10 minute run as fast as you can do it, and then there's charts where you can sort of chart out roughly what your VO2 max is. But if you want to get it tested, I think they're about $200. Not that everyone needs to get it tested, but if you're curious or wondering where you're at, because this is something you can control. This has nothing to do with your genetics. You can improve your VO2 max so that as you get into your later years of life, you have this reserve.
Marla Miller:So that's one and that's Sorry so the VO2, you're saying you can improve it by doing the cardio, or is there any other way to improve it?
Dr. William Bruno:You can improve it by doing cardio, not necessarily through weight training. Weight training can help improve some of the mitochondria in your cells, but the cardio will help improve the number and the quality of those and the efficiency, let's say, of your mitochondria, which is of your cells. So, yes, it's basically a. A indicator of your cardiorespiratory fitness is the VO2 max, and I think most people would agree that is the gold standard of longevity in the world. Along those lines, I'd say number two on there would be grip strength. Now some people wonder well, why is grip strength so important? It kind of goes back to the muscle mass and strength that I may have mentioned earlier. The more muscle you have on your body and the more strength you have in particular, the less likely you are to have a fall later in life, the less frail you are. So, and I actually have one here, these are like a dynamometer. I don't know if you've ever seen these. You kinda squeeze them and again it will tell you, based on your gender and your age group, how strong your grip should be. And again, that's something you can improve. That grip strength is a proxy for your overall strength. I'm not suggesting just do exercise grip like that with a hand squeezer. But your grip strength is an overall indicator of your body's strength, not just your hand, and people can improve that with weight training. You can improve it by hanging on a pull-up bar, like just from a dead hang. People should be able to hang for at least 30 seconds up to a minute, sometimes even longer, depending on your age and, believe it or not, like it sounds simple. But grip strength is another good proxy for how long you'll live. So if someone's very weak or they're in that bottom quartile, they're more likely to, let's say, not survive a fall, because it's a sign that they probably don't have much muscle on their body.
Dr. William Bruno:I guess the third test I'd recommend would be a DEXA scan D-E-X-A and this is a scan that looks at your body. It's a great test. I think anyone should get it, regardless of their age. It's relatively inexpensive it's about $50 and you don't need a prescription. No radiation or minimal radiation I should say there's no IV and it will tell you your percent body fat, how much muscle you have, how much visceral fat you have, which is that deep internal fat. It'll tell your bone density as well, and this is really important to know, just especially if you're working out in training and you wanna know the things that you're doing in the gym and the diet you're on. Is it helping? Am I building muscle? Am I losing fat? And the DEXA scan is a really easy way to assess that.
Dr. William Bruno:Now there are these scales that you can get for home that give you a sense of the percent body fat. They're not very accurate. They're better for tracking trends. But a DEXA scan is something that anyone can get, anyone in your audience. If you just type in or Google dexascancom or dexascan near me, it'll tell you where they're usually done at like a wellness place or a gym or something and you go in, they scan you. It takes five minutes and then you get this readout and it gives you a picture, literally a picture of you, and then it gives you the numbers of what's going on. So those are three tests I would really look at. Your doctor isn't going to necessarily prescribe them to you, but again, try to be proactive and see, like where am I at? Is everything I'm doing in the gym working? Do I have a good VO2 max? Do I have a decent grip strength? Is my percent body fat in the right range, where it should be Not just for the aesthetics of having a low body fat, but just for your health really.
Marla Miller:Yeah, what great suggestions. So I'll have to get specific names from you of different tests and put them in the show notes. But yeah, those are so interesting about the grip strength too. So is there any last thing? Maybe we didn't cover that you wanted to be sure and let people know about, as far as longevity, their health.
Dr. William Bruno:You know, the one area I didn't touch on but it's really popular and people ask me all the time is supplements. People say what supplements should I take? Should I take this? And again in my hierarchy that's closer to the top of this pyramid, because not to say it's not important, but it's less important than exercise, sleep, nutrition. But I would say this if you're doing all the other things that we mentioned, if you have a good foundation, and you were to say what are some foundational supplements that almost everybody could benefit from for your audience, I would probably say a good quality omega-3 supplement. If you're not eating fish twice a week, I would absolutely invest in that, an omega-3 supplement from a reputable source. The one I use is called Nordic Naturals. I think it's a great company. I use a liquid form. They also have gel caps. Omega-3s are important for heart health, for brain health as well as for muscle health, and most people are deficient in that. So I'd say omega-3s, magnesium Most people are low in magnesium and, again, a simple blood test can tell you that.
Marla Miller:What form of magnesium, because there's so many different forms, right.
Dr. William Bruno:Yeah, there's so many different forms out there. I take one that has like seven different forms in it. It's by a company called BioOptimizers. Certain forms are better for certain things, like magnesium glycinate is helpful for sleep. There's magnesium citrate. Some are good for constipation and, again, I think, finding a good source of it because you know supplements aren't regulated of it because supplements aren't regulated. I guess I should start by saying that. So you want to find one that actually have the products in it that you're intending to take and don't have a lot of impurities in it. But that's one that I use, and most people are deficient in magnesium.
Dr. William Bruno:I was also going to say vitamin D, specifically D3. Most people are deficient in that. A blood test can tell you, though. Don't just take vitamin D if your vitamin D levels are optimal, but you can get your blood checked, and again, there's a difference between normal and optimal. Vitamin D might have to be at least above 50 or 60 to be optimal. I would also add in there creatine. I think creatine is a supplement all people should be on, men and women, young and old, not just for bodybuilding, not just for building muscle, but a lot of cognitive benefits. Now at higher doses. Regular dose is five grams of creatine, but for the brain, some people are taking 10 grams. It's been studied for 50 or 60 years. It's one of the safest supplements that is out there. And then I would maybe finish my top five and say like a good multivitamin. Just to round things out, because most people are deficient in some trace element or zinc or selenium or something like that.
Marla Miller:Yeah, so the creatine. Do you have a particular kind of pure, clean product?
Dr. William Bruno:It's a creatine monohydrate is the form I think. The company I use is a company called Momentus. Again, I have no affiliation with them. I just based on my studies and learning. I found a few companies that I trust in these areas and that I personally use and we touched upon it before whey protein.
Dr. William Bruno:I guess that's a supplement too. I would say if you're having trouble hitting your target proteins, I would recommend a whey protein or, if you're vegan, a plant-based protein. And one thing I would add is they say the chocolate flavors have higher tendency to have heavy metal toxins in them, so you might want to opt for the unflavored or the vanilla, my chocolate. I think the cacao bean is more likely to have toxins in it, but I think that's another good supplement. I use supplements too because, yeah, it's hard to get 150 or whatever grams of protein that you need each day, but it's really important to ideally get it with food. But there is a role for supplements and I think some people get carried away and they're taking 20, 30, 40 supplements and then they realize, well, they're not sleeping or they're not exercising or they're eating highly processed foods. Then there's no point in taking all those supplements, you know.
Marla Miller:Yeah, very good point. Such great information. Hopefully people will have a pen and paper as they're listening and write down all these great ideas. You know the tests and information about the supplements and I would say, like you said, the supplements it's not regulated, so I would go direct to these companies that you know have pure products instead of jumping on something maybe like Amazon or you know, I wouldn't get my supplements from places like that.
Dr. William Bruno:Yeah, I would order them direct from the companies. So sometimes if you get direct from Amazon, you're not sure who the supplier is, so that, yes, that's a good point. I would go directly to, let's say, it's Nordic Naturals or Momentus or wherever, and get it from their website.
Marla Miller:Yeah, yeah. Well, where can people find you? I guess for both things. I mean, if they do want plastic surgery and they're looking for a surgeon, you can give them that information as well as the course you have. And why don't you explain a little?
Dr. William Bruno:bit to explain a little bit.
Dr. William Bruno:Yeah, my website where everything can be found. It's williambrunomdcom, which is my name, so that's my plastic surgery website. And within that, at the tab at the top, I have a wellness tab, which I have a few free eBooks that your audience might be interested in. One is on longevity. It's a short eBook, it's like 14 pages, but it's like my top 10 longevity tips. It's very actionable. And I also have an ebook on body recomposition building muscle, losing fat, losing weight.
Dr. William Bruno:And then I have a course. I created this digital course on wellness and longevity. It goes into a lot of the topics I discussed today in much more detail. I think it's about seven hours of content. It's video content of me talking about graphs and a lot of the topics I discussed today in much more detail. I think it's about seven hours of content. It's video content of me talking about graphs and a lot of visuals, along with PDFs and checklists, and then patients at the end can create their own longevity blueprint, you know, create, going up the pyramid, what things they should do, and that's sort of a do-it-yourself kind of program.
Dr. William Bruno:And then I have a newer program. It's sort of a coaching program on body recomposition, where I'll take patients in and we'll meet virtually twice a month. But at the beginning of the program we get comprehensive blood testing. I mail them an Oura ring and they get a DEXA scan and then we go over that and then six months later we repeat the scans and the lab work to see their improvement. And each month we're covering like a different topic, because they sort of coach them through and look at what they're eating, look at their food journals and their activity levels and their sleep and things like that. But yeah, all that can be found at my, at my website, under the wellness tab. All right, that's perfect. And I'm pretty active on Instagram. Yeah, my Instagram is at William Bruno MD. I have a lot of wellness tips, a lot of plastic surgery content too. I don't know if your audience is interested or not, but I have both on there.
Marla Miller:I'm sure. I'm sure people are interested in that as well. Yeah, so at William Bruno MD is the Instagram as well. Is that what you said? Okay, I'll put that in the show notes as well, and I appreciate this conversation so much. Like I said, so many people out there are looking for ways to enhance their health. I mean, we don't just want to live longer, we want our health to be good as well, not just our age. So thank you for all these really great tips Some of them I had not heard before and the tests that you mentioned. It's so good to know about those.
Dr. William Bruno:So people can no, thanks for having me and you know, yeah, I would just leave you and your audience. I would encourage people to take action. You know, a lot of times you listen to podcasts and you hear interesting things and you might not do anything. But even if it's as simple as tracking your steps or upping your protein or trying to improve your sleep, these are things you can do today for free. Most of them, for free, most of them and it can have a big impact. And I think, trying to be consistent with those and then you work them into your life and now you have a new habit and it's just automatic. So that's what I would just lead people with is take action on something like that yeah, and, like you said, pick one thing, don't get overwhelmed by everything shared.
Marla Miller:It's like you can pick one of those things track your sleep or track your steps or whatever and build momentum that way and then add another one eventually. Yeah, thank you so much for your time. I know you're right there in your scrubs, got ready to go, probably with another patient soon.
Dr. William Bruno:So thank you, thank you. Thank you, mala, for making the time. It's a pleasure to be on your show.